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Kim SH, Hong CH, Shin MJ, Kim KU, Park TS, Park JY, Shin YB. Prevalence and clinical characteristics of Sarcopenia in older adult patients with stable chronic obstructive pulmonary disease: a cross-sectional and follow-up study. BMC Pulm Med 2024; 24:219. [PMID: 38698380 PMCID: PMC11067242 DOI: 10.1186/s12890-024-03034-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 04/23/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND The relationship between sarcopenia and chronic obstructive pulmonary disease (COPD) has been increasingly reported, and there is some overlap regarding their clinical features and pulmonary rehabilitation (PR) strategies. No Korean study has reported the actual prevalence of sarcopenia in patients with stable COPD who are recommended for pulmonary rehabilitation. This study evaluated the prevalence and clinical features of sarcopenia in older adult outpatients with stable COPD and the changes after 6 months. METHODS In this cross-sectional and 6-month follow-up study, we recruited 63 males aged ≥ 65 diagnosed with stable COPD. Sarcopenia was diagnosed using the AWGS 2019 criteria, which included hand grip strength testing, bioelectrical impedance analysis, Short Physical Performance Battery administration, and Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falling screening tool administration. A 6-minute walk test (6 MWT) was conducted, forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), maximal inspiratory and expiratory pressures (MIP and MEP, respectively) and peak expiratory flow (PEF) were assessed, and patient-reported questionnaires were administered. RESULTS At baseline, 14 (22%) patients were diagnosed with possible sarcopenia, and eight (12.6%) were diagnosed with sarcopenia. There were significant differences in the age; body mass index; Body mass index, airflow Obstruction, Dyspnea, and Exercise index; modified Medical Research Council dyspnea scores; and International Physical Activity Questionnaire scores between the normal and sarcopenia groups. Whole-body phase angle, MIP, MEP, PEF, and 6-minute walk distance (6 MWD) also showed significant differences. Over 6 months, the proportion of patients with a reduced FEV1 increased; however, the proportion of patients with sarcopenia did not increase. CONCLUSION A relatively low prevalence of sarcopenia was observed in older adult outpatients with stable COPD. No significant change in the prevalence of sarcopenia was found during the 6-month follow-up period. TRIAL REGISTRATION The study was registered with the Clinical Research Information Service (KCT0006720). Registration date: 30/07/2021.
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Affiliation(s)
- Sang Hun Kim
- Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital and Pusan National University School of Medicine, Busan, Republic of Korea
| | - Cho Hui Hong
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Physical Therapy, Graduate School, Kyungsung University, Busan, Republic of Korea
| | - Myung-Jun Shin
- Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital and Pusan National University School of Medicine, Busan, Republic of Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Tae Sung Park
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Jun Yong Park
- Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Yong Beom Shin
- Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital and Pusan National University School of Medicine, Busan, Republic of Korea.
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Choi JY, Kim KU, Kim DK, Kim YI, Kim TH, Lee WY, Park SJ, Park YB, Song JW, Shin KC, Um SJ, Yoo KH, Yoon HK, Lee CY, Lee HS, Leem AY, Choi WI, Lim SY, Rhee CK. Response. Chest 2024; 165:e126-e128. [PMID: 38599758 DOI: 10.1016/j.chest.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 11/01/2023] [Indexed: 04/12/2024] Open
Affiliation(s)
- Joon Young Choi
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ki Uk Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Seo-gu, Busan, Korea
| | - Deog Kyeom Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Yu-Il Kim
- Division of Pulmonary Medicine, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Tae-Hyung Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Won-Yeon Lee
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Yonsei University Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Seong Ju Park
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju, Korea
| | - Yong Bum Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Gangdong Sacred Heart Hospital, The Hallym University, Seoul, Korea
| | - Jin Woo Song
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyeong-Cheol Shin
- Division of Pulmonology and Allergy, Department of Internal Medicine, Regional Center for Respiratory Disease, College of Medicine, Yeungnam University, Daegu, Korea
| | - Soo-Jung Um
- Division of Respiratory Medicine, Department of Internal Medicine, Dong-A University Medical Center, Dong-A University College of Medicine, Busan, Korea
| | - Kwang Ha Yoo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Hyoung Kyu Yoon
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yeouido St. Mary`s Hospital, The Catholic University of Korea, Seoul, Korea
| | - Chang Youl Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Ho Sung Lee
- Division of Respiratory Medicine, Soonchunhyang University CheonAn Hospital, Cheonan, Chungcheongnam-do, Korea
| | - Ah Young Leem
- Division of Pulmonology, Department of Internal Medicine, Institute of Chest Disease, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Won-Il Choi
- Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Gyeongji-do, Korea
| | - Seong Yong Lim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chin Kook Rhee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Choi JY, Kim KU, Kim DK, Kim YI, Kim TH, Lee WY, Park SJ, Park YB, Song JW, Shin KC, Um SJ, Yoo KH, Yoon HK, Lee CY, Lee HS, Leem AY, Choi WI, Lim SY, Rhee CK. Pulmonary Rehabilitation Is Associated With Decreased Exacerbation and Mortality in Patients With COPD: A Nationwide Korean Study. Chest 2024; 165:313-322. [PMID: 37806492 DOI: 10.1016/j.chest.2023.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/12/2023] [Accepted: 09/20/2023] [Indexed: 10/10/2023] Open
Abstract
BACKGROUND Poor uptake to pulmonary rehabilitation (PR) is still challenging around the world. There have been few nationwide studies investigating whether PR impacts patient outcomes in COPD. We investigated the change of annual PR implementation rate, medical costs, and COPD outcomes including exacerbation rates and mortality between 2015 and 2019. RESEARCH QUESTION Does PR implementation improve outcomes in patients with COPD in terms of direct cost, exacerbation, and mortality? STUDY DESIGN AND METHODS Data of patients with COPD extracted from a large Korean Health Insurance Review and Assessment service database (2015-2019) were analyzed to determine the trends of annual PR implementation rate and direct medical costs of PR. Comparison of COPD exacerbation rates between pre-PR and post-PR, and the time to first exacerbation and mortality rate according to PR implementation, were also assessed. RESULTS Among all patients with COPD in South Korea, only 1.43% received PR. However, the annual PR implementation rate gradually increased from 0.03% to 1.4% during 4 years, especially after health insurance coverage commencement. The direct medical cost was significantly higher in the PR group than the non-PR group, but the costs in these groups showed decreasing and increasing trends, respectively. Both the incidence rate and frequency of moderate-to-severe and severe exacerbations were lower during the post-PR period compared with the pre-PR period. The time to the first moderate-to-severe and severe exacerbations was longer in the PR group than the non-PR group. Finally, PR implementation was associated with a significant decrease in mortality. INTERPRETATION We concluded that health insurance coverage increases PR implementation rates. Moreover, PR contributes toward improving outcomes including reducing exacerbation and mortality in patients with COPD. However, despite the well-established benefits of PR, its implementation rate remains suboptimal.
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Affiliation(s)
- Joon Young Choi
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Ki Uk Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Seo-gu, Busan, South Korea
| | - Deog Kyeom Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Yu-Il Kim
- Division of Pulmonary Medicine, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - Tae-Hyung Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, South Korea
| | - Won-Yeon Lee
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Yonsei University Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Seong Ju Park
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju, South Korea
| | - Yong Bum Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Gangdong Sacred Heart Hospital, The Hallym University, Seoul, South Korea
| | - Jin Woo Song
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Kyeong-Cheol Shin
- Division of Pulmonology and Allergy, Department of Internal Medicine, Regional Center for Respiratory Disease, College of Medicine, Yeungnam University, Daegu, South Korea
| | - Soo-Jung Um
- Division of Respiratory Medicine, Department of Internal Medicine, Dong-A University Medical Center, Dong-A University College of Medicine, Busan, South Korea
| | - Kwang Ha Yoo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea
| | - Hyoung Kyu Yoon
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Chang Youl Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, South Korea
| | - Ho Sung Lee
- Division of Respiratory Medicine, Soonchunhyang University CheonAn Hospital, Cheonan, Chungcheongnam-do, South Korea
| | - Ah Young Leem
- Division of Pulmonology, Department of Internal Medicine, Institute of Chest Disease, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Won-Il Choi
- Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Deogyang-gu, Goyang-si, Gyeongji-do, South Korea
| | - Seong Yong Lim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Chin Kook Rhee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
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Yoon EC, Koo SM, Park HY, Kim HC, Kim WJ, Kim KU, Jung KS, Yoo KH, Yoon HK, Yoon HY. Predictive Role of White Blood Cell Differential Count for the Development of Acute Exacerbation in Korean Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2024; 19:17-31. [PMID: 38192972 PMCID: PMC10773455 DOI: 10.2147/copd.s435921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 12/15/2023] [Indexed: 01/10/2024] Open
Abstract
Purpose Chronic obstructive pulmonary disease (COPD) is a respiratory disease characterized by chronic inflammation. Acute exacerbation of COPD (AECOPD) manifests as acute worsening of respiratory symptoms and is associated with high morbidity and mortality. The aim of the present study was to evaluate the predictive value of white blood count (WBC) and its derived inflammatory biomarkers for AECOPD. Methods From the Korean COPD Subgroup Study cohort, a prospective and multicenter observational study, 826 patients who had baseline complete blood count (CBC) and 3-year AECOPD data were included. Follow-up CBC data at 1 (n = 385), 2 (n = 294), and 3 (n = 231) years were collected for available patients. The primary outcome was the occurrence of AECOPD at 3 years. The risk of AECOPD was evaluated using a binary logistic analysis. Results The cumulative incidences of 12-, 24-, and 36-month AECOPD were 47.6%, 60.5%, and 67.6%, respectively. Patients with AECOPD at 3 years had higher baseline WBC counts, neutrophil counts, neutrophil/lymphocyte ratio (NLR), and neutrophil/monocyte ratio than those without AECOPD. Higher WBC count, neutrophil count, and NLR were associated with the 3-year occurrence of AECOPD in the univariate analysis, but only the higher neutrophil count was a significant risk factor (odds ratio [OR] = 1.468; 95% confidence interval [CI]: 1.024-2.104) in the covariates-adjusted analysis. In the analysis of changes in inflammatory parameters, a decrease in the platelet count (OR = 0.502; 95% CI: 0.280-0.902) and NLR (OR = 0.535; 95% CI: 0.294-0.974) at 2 years and an increase in the eosinophil count (OR = 2.130; 95% CI: 1.027-4.416) at 3 years were significantly associated with AECOPD in the adjusted analysis. Conclusion Our data suggest that a high baseline WBC count, particularly neutrophil count, was associated with a higher incidence of long-term AECOPD.
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Affiliation(s)
- Eun Chong Yoon
- Division of Allergy and Respiratory Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | - So-My Koo
- Division of Allergy and Respiratory Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | - Hye Yun Park
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ho Cheol Kim
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Republic of Korea
| | - Woo Jin Kim
- Department of Internal Medicine and Environmental Health Center, Kangwon National University, Chuncheon, Republic of Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Ki-Suck Jung
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Kwang Ha Yoo
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Hyoung Kyu Yoon
- Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hee-Young Yoon
- Division of Allergy and Respiratory Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
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Kim SH, Mok J, Kim S, Yoo WH, Jo EJ, Kim MH, Lee K, Kim KU, Park HK, Lee MK, Eom JS. Clinical outcomes of transbronchial cryobiopsy using a 1.1-mm diameter cryoprobe for peripheral lung lesions - A prospective pilot study. Respir Med 2023; 217:107338. [PMID: 37380091 DOI: 10.1016/j.rmed.2023.107338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/09/2023] [Accepted: 06/24/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVES Transbronchial cryobiopsy (TBCB) is a novel technique for the diagnosis of peripheral lung lesions (PLLs). We aim to evaluate the clinical outcomes of TBCB using a new 1.1-mm diameter cryoprobe for the diagnosis of PLLs. MATERIALS AND METHODS We performed a prospective observational pilot study on the diagnosis of PLLs (diameter ≤30 mm) by TBCB, using a 1.1-mm diameter cryoprobe with radial endobronchial ultrasound (RP-EBUS), virtual bronchoscopic navigation and fluoroscopy from December 2021 to July 2022. Primary outcome was the pathological diagnostic yield of TBCB, and secondary outcome was adverse event. RESULTS A total of 50 patients were enrolled (mean lesion size, 21 mm). TBCB was performed in 49 patients up to three times except for the one with "invisible" finding on RP-EBUS. The overall diagnostic yield of TBCB was 90% (45/50). There was no difference in the diagnostic yield between size (20 mm vs. 20-30 mm; 88% [22/25] vs. 92% [23/25]; P = 1.000), RP-EBUS findings (concentric vs. others; 97% [28/29] vs. 81% [17/21]; P = 0.148), and acute angle location (apical segment of both upper lobes vs. others; 92% [12/13] vs. 89% [33/37]; P = 1.000). The cumulative diagnostic yields of the first, second, and third TBCB were 82% (41/50), 88% (44/50), and 90% (45/50), respectively. Mild bleeding was developed in 56% (28/50), and moderate bleeding was found in 26% (13/50). CONCLUSION TBCB using a 1.1-mm diameter cryoprobe is an effective, reasonable method for the diagnosis of PLLs regardless of its size, RP-EBUS finding, and anatomical location without serious complication. TRIAL REGISTRATION Clinical Trials.Gov (NCT05046093).
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Affiliation(s)
- Soo Han Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea; Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Jeongha Mok
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea; Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Saerom Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea; Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Wan Ho Yoo
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea; Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Eun-Jung Jo
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea; Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Mi-Hyun Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea; Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Kwangha Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea; Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea; Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Hye-Kyung Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea; Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Min Ki Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea; Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Jung Seop Eom
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea; Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
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Kim SH, Mok J, Jo EJ, Kim MH, Lee K, Kim KU, Park HK, Lee MK, Eom JS. The Additive Impact of Transbronchial Cryobiopsy Using a 1.1-mm Diameter Cryoprobe on Conventional Biopsy for Peripheral Lung Nodules. Cancer Res Treat 2023; 55:506-512. [PMID: 36317360 PMCID: PMC10101800 DOI: 10.4143/crt.2022.1008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/31/2022] [Indexed: 04/14/2023] Open
Abstract
PURPOSE The diagnostic yield of transbronchial biopsy (TBB) using radial probe endobronchial ultrasound (RP-EBUS) is 71%, which is lower than that of transthoracic needle biopsy. We investigated the performance and safety of sequential transbronchial cryobiopsy (TBC) using a novel 1.1-mm diameter cryoprobe, after conventional TBB using RP-EBUS for the diagnosis of peripheral lung lesions (PLLs). Materials and Methods From April 2021 to November 2021, 110 patients who underwent bronchoscopy using RP-EBUS for the diagnosis of PLL ≤ 30 mm were retrospectively included in our study. All records were followed until June 2022. RESULTS The overall diagnostic yield of combined TBB and TBC was 79.1%, which was higher than 60.9% of TBB alone (p=0.005). The diagnostic yield of sequential TBC was 65.5%, which increased the overall diagnostic yield by 18.2%. The surface area of tissues by TBC (mean area, 18.5 mm2) was significantly larger than those of TBB by 1.5-mm forceps (3.4 mm2, p < 0.001) and 1.9-mm forceps (3.7 mm2, p=0.011). In the multivariate analysis, PLLs with the longest diameter of ≤ 22 mm were found to be related to additional diagnostic benefits from sequential TBC (odds ratio, 3.51; 95% confidence interval, 1.043 to 11.775; p=0.042). Complications were found in 10.5% of the patients: pneumothorax (1.0%), infection (1.0%), and significant bleeding (8.6%). None of the patients developed any life-threatening complications. CONCLUSION Sequential TBC with a 1.1-mm cryoprobe improved the performance of conventional TBB using RP-EBUS without serious complications.
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Affiliation(s)
- Soo Han Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jeongha Mok
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Eun-Jung Jo
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Mi-Hyun Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Kwangha Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Hye-Kyung Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Min Ki Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Jung Seop Eom
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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Kim SH, Jo EJ, Mok J, Lee K, Kim KU, Park HK, Lee MK, Eom JS, Kim MH. Real-world evaluation of atezolizumab and etoposide-carboplatin as a first-line treatment for extensive-stage small cell lung cancer. Korean J Intern Med 2023; 38:218-225. [PMID: 36800677 PMCID: PMC9993105 DOI: 10.3904/kjim.2022.361] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 12/21/2022] [Indexed: 02/21/2023] Open
Abstract
BACKGROUND/AIMS Despite the obvious benefits of adding immune checkpoint inhibitors to platinum-etoposide chemotherapy in patients with extensive-stage small-cell lung cancer (ES-SCLC), real-world data remain scarce. METHODS This retrospective study included 89 patients with ES-SCLC treated with platinum-etoposide chemotherapy alone (chemo-only group; n = 48) or in combination with atezolizumab (atezolizumab group; n = 41) and compared the survival outcomes between these two groups. RESULTS Overall survival (OS) was significantly longer in the atezolizumab group than in the chemo-only group (15.2 months vs. 8.5 months; p = 0.047), whereas the median progression-free survival was almost the same (5.1 months vs. 5.0 months) in both groups (p = 0.754). Subsequent multivariate analysis revealed that thoracic radiation (hazard ratio [HR], 0.223; 95% confidence interval [CI], 0.092-0.537; p = 0.001) and atezolizumab administration (HR, 0.350; 95% CI, 0.184-0.668; p = 0.001) were favorable prognostic factors for OS. In the thoracic radiation subgroup, patients who received atezolizumab demonstrated favorable survival outcomes and no grade 3-4 adverse events (AEs). CONCLUSION The addition of atezolizumab to platinum-etoposide resulted in favorable outcomes in this real-world study. Thoracic radiation was associated with improved OS and acceptable AE risk in combination with immunotherapy in patients with ES-SCLC.
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Affiliation(s)
- Soo Han Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan,
Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan,
Korea
| | - Eun Jung Jo
- Department of Internal Medicine, Pusan National University School of Medicine, Busan,
Korea
| | - Jeongha Mok
- Department of Internal Medicine, Pusan National University School of Medicine, Busan,
Korea
| | - Kwangha Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan,
Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan,
Korea
| | - Hye-Kyung Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan,
Korea
| | - Min Ki Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan,
Korea
| | - Jung Seop Eom
- Department of Internal Medicine, Pusan National University School of Medicine, Busan,
Korea
| | - Mi-Hyun Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan,
Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan,
Korea
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Lee SH, Kim KU. Risk Factors for Postoperative Pneumonia in the Elderly Following Hip Fracture Surgery: A Systematic Review and Meta-Analysis. Geriatr Orthop Surg Rehabil 2022; 13:21514593221083825. [PMID: 35634259 PMCID: PMC9133882 DOI: 10.1177/21514593221083825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/02/2022] [Accepted: 02/09/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction: Pneumonia is a serious complication following hip fracture surgery in older people. However, the prevalence and risk factors of postoperative pneumonia (POP) are not well-established. This study identified pre- and peri-operative factors associated with the development of POP following hip fracture surgery. Methods: We searched the Cochrane library, PubMed, and Embase databases for relevant articles published up to June 2021. Studies involving older patients who underwent hip fracture surgery were considered if they detailed the demographic or surgical characteristics of the participants. For all analyses, the pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. Results: A total of 24 studies (288819 participants) were included. The overall prevalence of POP following hip fracture surgery was 5.0%. There were 36 risk factors for POP, and the meta-analysis included the five most common: delayed surgery (OR: 1.84, 95% CI: 1.29-2.63), low serum albumin (OR: 2.34, 95% CI: .82-6.73), chronic respiratory diseases (OR: 2.42, 95% CI: 1.82-3.24), increased age (OR: 1.25, 95% CI:1.11-1.40), and male sex (OR: 2.22, 95% CI: 2.00-2.47). Conclusions: The prevalence of POP was 5.0% following hip fracture surgery in the elderly. Older age, male sex, chronic respiratory diseases, delayed surgery, and low serum albumin were significant risk factors. Clinicians treating hip fracture patients must remain be aware of these risk factors.
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Affiliation(s)
- Sang Hee Lee
- Department of Internal Medicine, Wonkwang University Sanbon Hospital, Gunpo-si, Republic of Korea.,Department of Internal Medicine, Wonkwang University College of Medicine, Iksan, Republic of Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
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9
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Kim SH, Park HE, Yoon JA, Shin YB, Shin M, Kong IJ, Kim KU. The Korean‐Lung Information Needs Questionnaire: Translation, validation and clinical implications in comprehensive pulmonary rehabilitation. Clinical Respiratory J 2022; 16:343-351. [PMID: 35472825 PMCID: PMC9366590 DOI: 10.1111/crj.13487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/07/2022] [Accepted: 03/16/2022] [Indexed: 01/17/2023]
Affiliation(s)
- Sang Hun Kim
- Department of Rehabilitation Medicine, Biomedical Research Institute Pusan National University Hospital Busan South Korea
| | - Ho Eun Park
- Department of Rehabilitation Medicine, Biomedical Research Institute Pusan National University Hospital Busan South Korea
| | - Jin A Yoon
- Department of Rehabilitation Medicine, Biomedical Research Institute Pusan National University Hospital and Pusan National University School of Medicine Busan South Korea
| | - Yong Beom Shin
- Department of Rehabilitation Medicine, Biomedical Research Institute Pusan National University Hospital and Pusan National University School of Medicine Busan South Korea
| | - Myung‐Jun Shin
- Department of Rehabilitation Medicine, Biomedical Research Institute Pusan National University Hospital and Pusan National University School of Medicine Busan South Korea
| | - In Joo Kong
- Department of Rehabilitation Medicine, Biomedical Research Institute Pusan National University Hospital Busan South Korea
| | - Ki Uk Kim
- Department of Internal Medicine Pusan National University School of Medicine Busan South Korea
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10
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Lee J, Kim C, Seol HY, Chung HS, Mok J, Lee G, Jo EJ, Kim MH, Lee K, Kim KU, Park HK, Lee MK, Eom JS. Safety and Diagnostic Yield of Radial Probe Endobronchial Ultrasound-Guided Biopsy for Peripheral Lung Lesions in Patients with Idiopathic Pulmonary Fibrosis: A Multicenter Cross-Sectional Study. Respiration 2021; 101:401-407. [PMID: 34802001 DOI: 10.1159/000520034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 09/29/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Radial probe endobronchial ultrasound-guided transbronchial lung biopsy (RP-EBUS-TBLB) is widely used for diagnosis of peripheral lung lesions (PLLs). To date, there have been no reports regarding the clinical outcomes of RP-EBUS-TBLB for PLLs in patients with idiopathic pulmonary fibrosis (IPF). OBJECTIVES This study was performed between October 2017 and December 2019 to identify the safety and diagnostic performance of RP-EBUS-TBLB in IPF patients. METHODS Patients were divided into the usual interstitial pneumonia (UIP) group (n = 39, 4%), the probable UIP group (n = 12, 1%), and the noninterstitial lung disease (non-ILD) group (n = 903, 95%). RESULTS The diagnostic yield was significantly lower in the UIP group than in the non-ILD group (62% vs. 76%; p = 0.042), but there were no significant differences between the UIP and probable UIP groups (62% vs. 83%; p = 0.293) or the probable UIP and non-ILD groups (83% vs. 76%; p = 0.741). Multivariate logistic analysis showed that the mean diameter of PLLs, positive bronchus sign on CT, and "within the lesion" status on EBUS were independently associated with success of the procedure. Especially, the presence of the UIP pattern on CT (OR, 0.385; 95% CI: 0.172-0.863; p = 0.020) was independently associated with failed diagnosis. Among patients with UIP, "within the lesion" status on EBUS (OR, 25.432; 95% CI: 2.321-278.666; p = 0.008) was shown to be a factor contributing to a successful diagnosis. Overall, there were no significant differences in complication rates among the 3 study groups. CONCLUSION RP-EBUS-TBLB can be performed safely with an acceptable diagnostic yield, even in patients with IPF.
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Affiliation(s)
- Jaemin Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Changhwan Kim
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Republic of Korea
| | - Hee Yun Seol
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Hyeon Sung Chung
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Jeongha Mok
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Geewon Lee
- Department of Radiology, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Eun Jong Jo
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Mi Hyun Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Kwangha Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Hye-Kyung Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Min Ki Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Jung Seop Eom
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
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11
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Kang Y, Jo EJ, Eom JS, Kim MH, Lee K, Kim KU, Park HK, Lee MK, Mok J. Treatment Outcomes of Patients with Multidrug-Resistant Tuberculosis: Comparison of Pre- and Post-Public-Private Mix Periods. Tuberc Respir Dis (Seoul) 2020; 84:74-83. [PMID: 33108860 PMCID: PMC7801811 DOI: 10.4046/trd.2020.0093] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 10/28/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND This study compared the treatment outcomes of patients with multidrug-resistant tuberculosis (MDR-TB) before and after the implementation of public-private mix (PPM). Factors affecting treatment success were also investigated. METHODS Data from culture-confirmed pulmonary MDR-TB patients who commenced MDR-TB treatment at Pusan National University Hospital between January 2003 and December 2017 were retrospectively reviewed. Patients were divided into two groups in terms of PPM status: pre-PPM period, patients who commenced MDR-TB treatment between 2003 and 2010; and post-PPM period, patients treated between 2011 and 2017. RESULTS A total of 176 patients were included (64 and 112 in the pre- and post-PPM periods, respectively). 36.9% of the patients were resistant to a fluoroquinolone or a second-line injectable drug, or both. The overall treatment success rate was 72.7%. The success rate of post-PPM patients was higher than that of pre-PPM patients (79.5% vs. 60.9%, p=0.008). Also, loss to follow-up was lower in the post-PPM period (5.4% vs. 15.6%, p=0.023). In multivariate regression analysis, age ≥65 years, body mass index ≤18.5 kg/m2, previous TB treatment, bilateral lung involvement, and extensively drug-resistant (XDR)- or pre-XDR-TB were associated with poorer treatment outcomes. However, the use of bedaquiline or delamanid for ≥1 month increased the treatment success. CONCLUSION The treatment success rate in MDR-TB patients was higher in the post-PPM period than in the pre-PPM period, particularly because of the low rate of loss to follow-up. To ensure comprehensive patient-centered PPM in South Korea, investment and other support must be adequate.
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Affiliation(s)
- Yewon Kang
- Department of Internal Medicine, VHS Medical Center, Busan, Republic of Korea
| | - Eun-Jung Jo
- Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Jung Seop Eom
- Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea.,Pusan National University School of Medicine, Busan, Republic of Korea
| | - Mi-Hyun Kim
- Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea.,Pusan National University School of Medicine, Busan, Republic of Korea
| | - Kwangha Lee
- Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea.,Pusan National University School of Medicine, Busan, Republic of Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea.,Pusan National University School of Medicine, Busan, Republic of Korea
| | - Hye-Kyung Park
- Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea.,Pusan National University School of Medicine, Busan, Republic of Korea
| | - Min Ki Lee
- Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea.,Pusan National University School of Medicine, Busan, Republic of Korea
| | - Jeongha Mok
- Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea.,Pusan National University School of Medicine, Busan, Republic of Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
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12
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Lee SH, Lee H, Kim YS, Kim KU, Park HK, Lee MK. Factors associated with sleep disturbance in patients with chronic obstructive pulmonary disease. Clin Respir J 2020; 14:1018-1024. [PMID: 32710487 DOI: 10.1111/crj.13235] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 06/30/2020] [Accepted: 07/17/2020] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Poor sleep quality in patients with chronic obstructive pulmonary disease (COPD) has been associated with poor health outcomes. However, there is a lack of research on factors associated with sleep disturbance in patients with COPD. OBJECTIVES We investigated patterns of sleep disturbance and factors associated with sleep impairment in patients with COPD. METHODS This was a prospective, multicenter cross-sectional study enrolling a sample of 245 COPD subjects. All patients completed the patient-reported measure, the COPD and Asthma Sleep Impact Scale (CASIS) to assess sleep impairment. The St. George's Respiratory Questionnaire (SGRQ), the 36-item Short-Form health survey (SF-36), Hospital Anxiety and Depression Scale (HADS), and the COPD Self-Efficacy Scale (CSES) were utilized to assess health-related quality of life (HRQL), anxiety/depression and self-efficacy, respectively. RESULTS About 35.1% of the patients reported that they had a bad night's sleep. Univariate analysis showed that the CASIS total score was significantly correlated with the modified Medical Research Council dyspnea scale, SGRQ total score, SF-36 PCS, SF-36 MCS, HADS-A, HADS-D and CSES (all P < 0.05). In a multivariate analysis, SGRQ total (r = 0.19, P = 0.006), SF-36 PCS (r = 0.14, P = 0.037), HADS-D (r = 0.24, P ≤ 0.001), and CSES(r = -0.12, P = 0.010) were independently associated with the CASIS score. CONCLUSIONS In this study, 35% of clinically stable patients with COPD reported poor sleep quality. Depression, poorer HRQL and self-efficacy were significantly associated with sleep disturbance in patients with COPD.
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Affiliation(s)
- Sang Hee Lee
- Department of Internal Medicine, Wonkwang University Sanbon Hospital, Gunpo-si, Republic of Korea.,Department of Internal Medicine, Wonkwang University College of Medicine, Iksan, Republic of Korea
| | - Haejung Lee
- Department of Nursing, Pusan National University College of Nursing, Yangsan-si, Republic of Korea
| | - Yun Seong Kim
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan-si, Republic of Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea.,Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Hye-Kyung Park
- Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea.,Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Min Ki Lee
- Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea.,Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
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13
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Lee SH, Lee H, Kim YS, Park HK, Lee MK, Kim KU. Predictors of Low-Level Disease-Specific Knowledge in Patients with Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2020; 15:1103-1110. [PMID: 32546998 PMCID: PMC7245443 DOI: 10.2147/copd.s244925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 05/03/2020] [Indexed: 01/07/2023] Open
Abstract
Background Disease-specific knowledge is associated with outcomes of patients, but the knowledge level of chronic obstructive pulmonary disease (COPD) patients is known to be low. Objective We measured the level of disease-specific knowledge and defined factors associated with poor disease knowledge in COPD patients. Materials and Methods A cross-sectional survey was performed in five hospitals in South Korea. At enrolment, all patients completed the Bristol COPD Knowledge Questionnaire (BCKQ), Satisfaction with Life Scale (SWLS), Personal Resource Questionnaire (PRQ), St. George’s Respiratory Questionnaire (SGRQ), 36-item Short-Form Health Survey (SF-36), and the Hospital Anxiety and Depression Scale (HADS). The data were analyzed via linear regression to identify factors associated with low-level knowledge of COPD. Results A total of 245 COPD patients were enrolled in this study. The mean total BCKQ score was 28.1 (SD, 7.4). The lowest scores were seen for items exploring knowledge of “Oral steroids” and “Inhaled steroids”. In univariate analysis, higher level of education (r = 0.17), low income (r = 0.13), the post-bronchodilator FEV1, % predicted (r = −0.24), the post-bronchodilator FEV1/FVC ratio (r = −0.13), SWLS (r = 0.15), PRQ (r = 0.16), SF-36 MCS (r = 0.13), HADS-A (r = −0.17), and HADS-D (r = −0.28) scores correlated with the BCKQ score (all p < 0.05). FEV1 (r = −0.25, p < 0.001) and HADS-D score (r = −0.29, p < 0.001) were significantly associated with the total BCKQ score in multivariate analysis. Conclusion Our Korean patients with COPD lacked knowledge on oral and inhaled steroid treatments. In particular, patients with higher-level lung function and/or depressive symptoms exhibited poorer disease-specific knowledge; such patients may require additional education.
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Affiliation(s)
- Sang Hee Lee
- Department of Internal Medicine, Wonkwang University Sanbon Hospital, Gunpo-si, Republic of Korea.,Department of Internal Medicine, Wonkwang University College of Medicine, Iksan, Republic of Korea
| | - Haejung Lee
- Department of Nursing, Pusan National University College of Nursing, Yangsan-si, Republic of Korea
| | - Yun Seong Kim
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan-si, Republic of Korea
| | - Hye-Kyung Park
- Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea.,Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Min Ki Lee
- Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea.,Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea.,Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
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14
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Choi HS, Park YB, Yoon HK, Lim SY, Kim TH, Park JH, Lee WY, Park SJ, Lee SW, Kim WJ, Kim KU, Shin KC, Kim DJ, Kim TE, Yoo KH, Shim JJ, Hwang YI. Validation of Previous Spirometric Reference Equations and New Equations. J Korean Med Sci 2019; 34:e304. [PMID: 31808325 PMCID: PMC6900406 DOI: 10.3346/jkms.2019.34.e304] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 10/07/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Pulmonary functions are interpreted using predicted values from reference equations that vary with ethnicity, gender, age, height, and weight. The universally used Choi's reference equations are not validated for Korean populations, and the purpose of this study was to validate them and develop new reference equations. METHODS Subjects with normal spirometry and chest radiographs, no co-morbidities, and non-smokers, from the Korean National Health and National Examination Survey (KNHANES)-VI were enrolled (n = 117). Intraclass correlation coefficient (ICC) was assessed for reliability of reference equations. New reference equations were developed using linear regression analysis. Differences between observed and predicted values were assessed to compare the reference equations from Choi's, Global Lung Function Initiative 2012, KNHANES-IV, and newly developed equations. RESULTS The ICC of Choi's reference equations was 0.854 (P < 0.001). The new reference equations for men were: forced vital capacity (FVC) (L) = - 4.38775 - 0.01184 × age + 0.05547 × height, forced expiratory volume - 1 second (FEV₁) (L) = - 2.40147 - 0.02134 × age + 0.04103 × height; and for women: FVC (L) = - 3.09063 + 0.003904 × age + 0.038694 × height; FEV₁ (L) = - 1.32933 - 0.00872 × age + 0.02762 × height. The differences between the predicted and observed means were largest in Choi's equations, but lowest in the new equations with highest goodness of fit. CONCLUSION Because Choi's reference equations presented larger differences from the observed values, despite reliability, and the new reference equations showed better goodness of fit, we suggest the latter for Korean populations.
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Affiliation(s)
- Hye Sook Choi
- Department of Internal Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Yong Bum Park
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
- Lung Research Institute, Hallym University College of Medicine, Chuncheon, Korea
| | - Hyoung Kyu Yoon
- Division of Pulmonology, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seong Yong Lim
- Division of Pulmonary and Critical Care Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Hyung Kim
- Division of Pulmonology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Joo Hun Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Won Yeon Lee
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Seoung Ju Park
- Division of Pulmonary, Allergy and Critical Care Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea
| | - Sei Won Lee
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Jin Kim
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Korea
| | - Kyeong Cheol Shin
- Regional Center for Respiratory Disease, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
| | - Do Jin Kim
- Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Tae Eun Kim
- Department of Clinical Pharmacology, Konkuk University School of Medicine, Seoul, Korea
| | - Kwang Ha Yoo
- Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea
| | - Jae Jeong Shim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Yong Il Hwang
- Lung Research Institute, Hallym University College of Medicine, Chuncheon, Korea
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
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15
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Lee SH, Lee H, Kim YS, Park H, Lee MK, Kim KU. Social support is a strong determinant of life satisfaction among older adults with chronic obstructive pulmonary disease. Clin Respir J 2019; 14:85-91. [DOI: 10.1111/crj.13104] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 08/25/2019] [Accepted: 11/07/2019] [Indexed: 01/07/2023]
Affiliation(s)
- Sang Hee Lee
- Department of Internal Medicine Wonkwang University Sanbon Hospital Gunpo‐si Republic of Korea
- Department of Internal Medicine Wonkwang University College of Medicine Iksan Republic of Korea
| | - Haejung Lee
- Department of Nursing Pusan National University College of Nursing Yangsan‐si Republic of Korea
| | - Yun Seong Kim
- Department of Internal Medicine Pusan National University Yangsan Hospital Yangsan‐si Republic of Korea
| | - Hye‐Kyung Park
- Department of Internal Medicine Pusan National University Hospital Busan Republic of Korea
- Medical Research Institute Pusan National University Hospital Busan Republic of Korea
| | - Min Ki Lee
- Department of Internal Medicine Pusan National University Hospital Busan Republic of Korea
- Medical Research Institute Pusan National University Hospital Busan Republic of Korea
| | - Ki Uk Kim
- Department of Internal Medicine Pusan National University Hospital Busan Republic of Korea
- Medical Research Institute Pusan National University Hospital Busan Republic of Korea
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16
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Kim J, Lee CH, Hwang SS, Kim DK, Yoon HI, Lee SH, Kim KU, Kim EK, Kim TH, Lee JH, Oh YM, Lee SD. The Ability of Different Scoring Systems to Predict Mortality in Chronic Obstructive Pulmonary Disease Patients: A Prospective Cohort Study. Respiration 2019; 98:495-502. [PMID: 31665736 DOI: 10.1159/000502826] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 08/20/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality, therefore the prediction of mortality in COPD patients is crucial. In the current study, the abilities of different categorization systems to predict mortality in stable COPD patients from a prospective cohort were compared. METHODS The ability to predict mortality was compared in terms of discrimination by Harrell's C (HC) index and calibration using graphical comparison among the GOLD (Global Initiative for Chronic Obstructive Lung Disease) 2011, GOLD 2017, GOLD grade, BODE (BMI, Airflow Obstruction, Dyspnea, Exercise), updated BODE, BODEx (BMI, Airflow Obstruction, Dyspnea, Exacerbation), e-BODE (Exacerbation and BODE), ADO (Age, Dyspnea, Airflow Obstruction), COPD prognostic index (CPI), and simplified/optimized B-AE-D (BMI, Acute Exacerbation, Dyspnea) indexes. RESULTS The study included 520 patients, of whom 63 died during a median 40-month follow-up period. Combined prediction systems exhibited higher discrimination properties than single predictors. The CPI exhibited the highest with a HC of 0.768, followed by the simplified B-AE-D (HC 0.761), ADO (HC 0.760), and optimized B-AE-D (HC 0.756). The BODE and its variants other than the ADO exhibited relatively lower HCs (0.656-0.705), and GOLD exhibited the lowest discrimination ability among the combined indices (HCs 0.628-0.637). Subjective symptom questionnaires such as the modified Medical Research Council (mMRC) scale (HC 0.693) and SGRQ (HC 0.679) exhibited the highest ability to predict mortality among the single indices. CONCLUSION The ADO, simplified B-AE-D, optimized B-AE-D, and GOLD 2017 exhibited good calibration properties, but the CPI did not. The simplified and optimized B-AE-Ds and the ADO index had good discrimination and calibration properties for the prediction of mortality in stable COPD patients.
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Affiliation(s)
- Joohae Kim
- Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea
| | - Chang-Hoon Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea,
| | - Seung-Sik Hwang
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Deog-Kyeom Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Ho Il Yoon
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-Si, Republic of Korea
| | - Sang Haak Lee
- Pulmonary Division, Department of Internal Medicine, Critical Care and Sleep Medicine, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Eun Kyung Kim
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Tae-Hyung Kim
- Division of Pulmonology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea
| | - Ji-Hyun Lee
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Yeon-Mok Oh
- Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang-Do Lee
- Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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17
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Mok J, Jo EJ, Eom JS, Kim MH, Kim KU, Park HK, Lee MK, Lee K. Clinical efficacy of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry in patients with multidrug-resistant bacteremia: a single-center study in Korea. Korean J Intern Med 2019; 34:1058-1067. [PMID: 31072077 PMCID: PMC6718763 DOI: 10.3904/kjim.2018.169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 08/02/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND/AIMS Matrix-assisted laser desorption/ionization time-of-f light mass spectrometry (MALDI-TOF MS) is a new diagnostic tool for microorganism identification. The clinical usefulness of this approach has not been widely examined in Korea. This retrospective pre-post-intervention quasi-experimental study examined the effect of MALDI-TOF MS on patients with multidrug-resistant (MDR) bacteremia in the intensive care unit (ICU). METHODS All consecutive patients with MDR bacteremia in the ICU of a tertiary care hospital between March 2011 and February 2013 and between March 2014 and February 2016 were enrolled. MALDI-TOF MS was introduced between these periods. In the pre-intervention and intervention groups, microorganisms were identified by conventional means and by MALDI-TOF MS, respectively. The groups were compared in terms of time from venipuncture to microorganism identification and antimicrobial susceptibility test results. RESULTS In total, 187 patients (mean age, 61.0 years; 56.7% male) were enrolled. Of these, 97 and 90 were in the pre-intervention and intervention groups, respectively. The intervention group had a significantly shorter time from venipuncture to microorganism identification and antimicrobial susceptibility test results (82.5 ± 21.6 hours vs. 92.3 ± 40.4 hours, p = 0.038). The antibiotics were adjusted in 52 patients (26 each in the pre-intervention and intervention groups) based on these results. These groups did not differ in terms of time from venipuncture to antibiotic adjustment, and multivariate regression analysis showed that MALDI-TOF MS-based microorganism identification was not associated with 28-day mortality. CONCLUSION Our study showed that MALDI-TOF MS accelerated microorganism identification in patients with MDR bacteremia, but did not inf luence 28-day mortality.
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Affiliation(s)
- Jeongha Mok
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Eun-Jung Jo
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Jung Seop Eom
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Mi-Hyun Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Ki Uk Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Hye-Kyung Park
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Min Ki Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Kwangha Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
- Correspondence to Kwangha Lee, M.D. Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seogu, Busan 49241, Korea Tel: +82-51-240-7743 Fax: +82-51-254-3127 E-mail:
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18
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Lee SH, Kim KU, Lee H, Park HK, Kim YS, Lee MK. Sleep disturbance in patients with mild-moderate chronic obstructive pulmonary disease. Clin Respir J 2019; 13:751-757. [PMID: 31449723 DOI: 10.1111/crj.13085] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 08/12/2019] [Accepted: 08/16/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Although sleep problems have an important impact on daily life and health outcome measures in patients with chronic obstructive pulmonary disease (COPD), patterns of sleep disturbance in patients with mild-moderate COPD remain unknown. OBJECTIVE The aim of this study was to investigate patterns of sleep disturbance and factors associated with sleep impairment in patients with mild-moderate COPD. METHODS This prospective cross-sectional study enrolled 148 male patients with COPD. At enrolment, all patients completed a disease-specific sleep measure, the COPD and Asthma Sleep Impact Scale (CASIS) to assess sleep impairment. Health-related quality of life (HRQL) was measured using the St. George's Respiratory Questionnaire (SGRQ) and the 36-item Short-Form health survey (SF-36). Anxiety and depression status were assessed using the Hospital Anxiety and Depression Scale (HADS). Self-efficacy was measured by the COPD Self-Efficacy Scale (CSES). RESULTS The mean age of the subjects was 67 years [standard deviation (SD) = 8.11]. The proportion of patients who indicated that they had a bad night's sleep was 33.1%. Univariated analysis showed that CASIS score was significantly correlated with the modified Medical Research Council (mMRC) dyspnea scale, SGRQ, SF-36 Physical Component Summary, SF-36 Mental Component Summary, HADS-anxiety, HADS-depression and CSES scores (all P < 0.05). In a multivariate analysis, SGRQ and CSES were independently associated with CASIS score. CONCLUSION Poorer HRQL and lower self-efficacy are significantly associated with sleep disturbance and perhaps may be improved by better sleep quality. Future research is required to enhance sleep quality in patients with mild-moderate COPD.
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Affiliation(s)
- Sang Hee Lee
- Department of Internal Medicine, Wonkwang University Sanbon Hospital, Gunpo, Republic of Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.,Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Haejung Lee
- College of Nursing, Pusan National University, Yangsan, Republic of Korea
| | - Hye-Kyung Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.,Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Yun Seong Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Min Ki Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.,Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
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19
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Lee KM, Lee G, Kim A, Mok J, Lee JW, Jeong YJ, Jo EJ, Kim MH, Lee K, Kim KU, Park HK, Lee MK, Eom JS. Clinical outcomes of radial probe endobronchial ultrasound using a guide sheath for diagnosis of peripheral lung lesions in patients with pulmonary emphysema. Respir Res 2019; 20:177. [PMID: 31387600 PMCID: PMC6683511 DOI: 10.1186/s12931-019-1149-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 07/31/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Generally, structural destruction of lung parenchyma, such as pulmonary emphysema, is considered to be related to the low diagnostic yields and high complication rates of lung biopsies of peripheral lung lesions. Currently, little is known about the clinical outcomes of using endobronchial ultrasound with a guide sheath (EBUS-GS) to diagnose peripheral lesions in patients with emphysema. METHODS This retrospective study was performed to identify the clinical outcomes of EBUS-GS in patients with pulmonary emphysema. This study included 393 consecutive patients who received EBUS-GS between February 2017 and April 2018. The patients were classified according to the severity of their emphysema, and factors possibly contributing to a successful EBUS-GS procedure were evaluated. RESULTS The overall diagnostic yield of EBUS-GS in patients with no or mild emphysema was significantly higher than in those with moderate or severe pulmonary emphysema (78% vs. 61%, P = 0.007). There were no procedure-related complications. The presence of a bronchus sign on CT (P < 0.001) and a "within the lesion" status on EBUS (P = 0.009) were independently associated with a successful EBUS-GS procedure. Although the diagnostic yield of EBUS-GS in patients with moderate-to-severe emphysema was relatively low, a bronchus sign and "within the lesion" status on EBUS were contributing factors for a successful EBUS-GS. CONCLUSIONS EBUS-GS is a safe procedure with an acceptable diagnostic yield, even when performed in patients with pulmonary emphysema. The presence of a bronchus sign and "within the lesion" status on EBUS were predictors of a successful procedure.
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Affiliation(s)
- Kyu Min Lee
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea
| | - Geewon Lee
- Department of Radiology, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Ahreum Kim
- Biostatistics Team of Regional Center for Respiratory Diseases, Pusan National University Hospital, Busan, Republic of Korea
| | - Jeongha Mok
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea
| | - Ji Won Lee
- Department of Radiology, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Yeon Joo Jeong
- Department of Radiology, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Eun-Jung Jo
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea
| | - Mi Hyun Kim
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea
| | - Kwangha Lee
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea
| | - Hye-Kyung Park
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea
| | - Min Ki Lee
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea
| | - Jung Seop Eom
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea. .,Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
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20
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Roh J, Jo EJ, Eom JS, Mok J, Kim MH, Kim KU, Park HK, Lee MK, Yeom S, Lee K. Factors predicting long-term survival of patients with sepsis on arrival at the emergency department: A single-center, observational study. Medicine (Baltimore) 2019; 98:e16871. [PMID: 31415425 PMCID: PMC6831115 DOI: 10.1097/md.0000000000016871] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Predicting long-term outcomes after sepsis is important when caring for patients with this condition. The purpose of the present study was to develop models predicting long-term mortality of patients with sepsis, including septic shock.Retrospective data from 446 patients with sepsis (60.8% men; median age, 71 years) treated at a single university-affiliated tertiary care hospital over 3 years were reviewed. Binary logistic regression was used to identify factors predicting mortality at 180 and 365 days after arrival at the emergency department. Long-term prognosis scores for the 180- and 365-day models were calculated by assigning points to variables according to their β coefficients.The 180- and 365-day mortality rates were 40.6% and 47.8%, respectively. Multivariate analysis identified the following factors for inclusion in the 180- and 365-day models: age ≥65 years, body mass index ≤18.5 kg/m, hemato-oncologic diseases as comorbidities, and ventilator care. Patients with scores of 0 to ≥3 had 180-day survival rates of 83.8%, 70.8%, 42.3%, and 25.0%, respectively, and 365-day survival rates of 72.1%, 64.6%, 36.2%, and 15.9%, respectively (all differences P < .001; log-rank test). The areas under the receiver operating characteristic curves of the 180- and 365-day models were 0.713 (95% confidence interval [CI] 0.668-0.756, P < .001) and 0.697 (95% CI 0.650-0.740, P < .001), respectively.These long-term prognosis models based on baseline patient characteristics and treatments are useful for predicting the 6- and 12-month mortality rates of patients with sepsis.
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Affiliation(s)
- Jiyeon Roh
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine
| | - Eun-Jung Jo
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine
| | - Jung Seop Eom
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine
| | - Jeongha Mok
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine
| | - Mi Hyun Kim
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine
| | - Ki Uk Kim
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine
| | - Hye-Kyung Park
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine
| | - Min Ki Lee
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine
| | - Seokran Yeom
- Department of Emergency Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Kwangha Lee
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine
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21
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Jo EJ, Eom JS, Mok J, Kim MH, Lee K, Kim KU, Lee MK, Park HK. Patterns of sensitization to aeroallergens and their effect on airway hyper-responsiveness in Busan, Korea. Asian Pac J Allergy Immunol 2019; 39:182-189. [PMID: 31310146 DOI: 10.12932/ap-261118-0447] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Allergen sensitization and its influence on allergic disease can vary depending on ethnicity and geography. OBJECTIVE To investigate aeroallergen sensitization patterns and their effect on airway hyper-responsiveness (AHR) in Busan, Korea. METHODS We reviewed data for subjects who attended for evaluation of respiratory symptoms between 2011 and 2016. The skin test results of 16 allergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae, cat, dog, Alternaria, Aspergillus fumigatus, early blossoming tree pollen mix, late blossoming tree pollen mix, alder, birch, oak, grass mix, mugwort, ragweed, and Japanese hop) were analyzed. Age was categorized as group I (15 to < 65 years) or group II (≥ 65 years). RESULTS A total of 2,791 subjects were analyzed (mean age: 50.9 years, female 61.3%). AHR was demonstrated in 15.8%; sputum eosinophilia in 12.1%; and atopy in 31.2%. The most commonly sensitizing allergen was house dust mite (17.4% to D. pteronyssinus and 17.9% to D. farinae), followed by late blossoming tree pollen mix (8.8%) and early blossoming tree pollen mix (8.6%). AHR was associated with sensitization to D. pteronyssinus, D. farina, Alternaria, dog, cat, alder, birch, oak, and mugwort. However, group II did not show any associations between AHR and any of the aeroallergens except D. farina. Multiple logistic regression analyses showed that the independent factors for AHR were ever-smoker status, D. farina, and oak sensitization. CONCLUSIONS Sensitization to house dust mites and tree pollen was found to be common in Busan. These aeroallergens significantly affected AHR, particularly in the younger group.
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Affiliation(s)
- Eun-Jung Jo
- Department of Internal Medicine, Pusan National University School of Medicine, Busan.,Department of Internal Medicine, Pusan National University Hospital, Busan.,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Jung Seop Eom
- Department of Internal Medicine, Pusan National University School of Medicine, Busan.,Department of Internal Medicine, Pusan National University Hospital, Busan.,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Jeongha Mok
- Department of Internal Medicine, Pusan National University School of Medicine, Busan.,Department of Internal Medicine, Pusan National University Hospital, Busan.,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Mi-Hyun Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan.,Department of Internal Medicine, Pusan National University Hospital, Busan.,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Kwangha Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan.,Department of Internal Medicine, Pusan National University Hospital, Busan.,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan.,Department of Internal Medicine, Pusan National University Hospital, Busan.,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Min Ki Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan.,Department of Internal Medicine, Pusan National University Hospital, Busan.,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Hye-Kyung Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan.,Department of Internal Medicine, Pusan National University Hospital, Busan.,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
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22
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Kim I, Eom JS, Jo EJ, Mok Ki Uk J, Lee K, Uk Kim K, Park HK, Lee MK, Kim MH. Prognostic value of quantitative measurement of EGFR mutation using peptide nucleic acid clamping in advanced EGFR mutant non-small cell lung cancer patients. Thorac Cancer 2019; 10:1561-1566. [PMID: 31148357 PMCID: PMC6610248 DOI: 10.1111/1759-7714.13101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/08/2019] [Accepted: 05/09/2019] [Indexed: 11/28/2022] Open
Abstract
Background The presence of EGFR mutation in patients with advanced non‐small cell lung cancer (NSCLC) plays an important role in determining the appropriate treatment, response, and survival. Therefore, this study attempted to predict the prognosis of NSCLC patients using data from quantitative mutation measurements. Methods The data of patients with advanced NSCLC who underwent EGFR mutation testing using the peptide nucleic acid (PNA) mediated clamping method at the Pusan National University Hospital from October 2015 to December 2017 were retrospectively analyzed. The efficiency of PNA clamping was determined by measuring the threshold cycle (Ct) value. The ΔCt−1 value (standard Ct value minus sample Ct value) was calculated to quantify EGFR mutation. Results During the study period, 71 patients were treated with EGFR‐tyrosine kinase inhibitors. The cutoff point for the ΔCt−1 value derived from the receiver operating characteristic curve was 5.32. A survival benefit was observed in the group with an ΔCt−1 value > 5.32 or with a common EGFR mutation type compared to the group with an ΔCt−1 value < 5.32. Conclusion EGFR mutation testing using PNA clamping may predict patient survival, especially in patients with common EGFR mutations, such as exon 19 deletion or L858R. A higher ΔCt−1 value correlates with better survival.
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Affiliation(s)
- Insu Kim
- Department of Internal Medicine, School of Medicine, Pusan National University, Busan, South Korea
| | - Jung Seop Eom
- Department of Internal Medicine, School of Medicine, Pusan National University, Busan, South Korea
| | - Eun Jung Jo
- Department of Internal Medicine, School of Medicine, Pusan National University, Busan, South Korea
| | - Jeongha Mok Ki Uk
- Department of Internal Medicine, School of Medicine, Pusan National University, Busan, South Korea
| | - Kwangha Lee
- Department of Internal Medicine, School of Medicine, Pusan National University, Busan, South Korea
| | - Ki Uk Kim
- Department of Internal Medicine, School of Medicine, Pusan National University, Busan, South Korea
| | - Hye-Kyung Park
- Department of Internal Medicine, School of Medicine, Pusan National University, Busan, South Korea
| | - Min Ki Lee
- Department of Internal Medicine, School of Medicine, Pusan National University, Busan, South Korea
| | - Mi-Hyun Kim
- Department of Internal Medicine, School of Medicine, Pusan National University, Busan, South Korea.,Medical Research Institute, Pusan National University Hospital, Busan, South Korea
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Abstract
Sarcopenia is frequently associated with chronic diseases such as chronic obstructive pulmonary disease (COPD) and cancer. COPD, which is characterized by an irreversible airflow limitation, exacerbates respiratory distress as the disease progresses. The prevalence of sarcopenia in stable COPD was reported to be 15% to 25% in previous foreign studies and 25% in a Korean study. As the amount of activity decreases, muscle mass decreases and eventually oxygen cannot be used effectively, resulting in a vicious cycle of deterioration of exercise capacity. Deconditioning due to decreased activity is a major cause of limb muscle dysfunction in patients with COPD. In these patients, the factors that decrease muscle strength and endurance include chronic inflammation, oxidative stress, inactivity, hypoxemia, hormone abnormality, deficits of nutrients such as protein and vitamin D, and the use of systemic corticosteroid. Therefore, treatment and management should either inhibit this process or should be directed toward supplementing the deficiency, such as with exercise, nutritional support, and medications and supplements. The relationship between sarcopenia and COPD is increasingly being reported, with some overlap in clinical features and treatments. We are fascinated to be able to diagnose 2 diseases through similar physical performance tests and to improve both diseases using the same treatment such as exercise. Therefore, this review summarizes the clinical relevance and integrative management of the 2 diseases.
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Affiliation(s)
- Sang Hun Kim
- Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Myung Jun Shin
- Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Yong Beom Shin
- Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
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24
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Kim I, Kim A, Lee CH, Lee G, Kim A, Jo EJ, Kim MH, Mok J, Lee K, Kim KU, Park HK, Lee MK, Eom JS. Reliability of PD-L1 assays using small tissue samples compared with surgical specimens. Medicine (Baltimore) 2019; 98:e14972. [PMID: 30946323 PMCID: PMC6455756 DOI: 10.1097/md.0000000000014972] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Programmed death ligand 1 (PD-L1) immunohistochemistry (IHC) assays are widely used for complementary or companion diagnostic purposes during treatment with immune checkpoint inhibitors. However, limited information is available on the clinical reliability of the PD-L1 IHC assay using small biopsy samples.Participants included 46 patients with nonsmall cell lung cancer who underwent PD-L1 testing using 3 PD-L1 IHC assays (22C3, SP142, and SP263) for both small biopsy samples and surgical specimens from November 2017 to June 2018. The PD-L1 IHC assay results were analyzed with cut-off values of 1%, 5%, 10%, and 50%. The PD-L1 IHC results obtained from the surgical specimens were regarded as the reference values.The 22C3, SP142, and SP263 PD-L1 IHC assays were performed in 26 (57%), 20 (43%), and 46 (100%) patients, respectively. Biopsy methods included radial probe endobronchial ultrasound using a guide sheath, endobronchial ultrasound-guided transbronchial needle aspiration, bronchoscopic biopsy, and percutaneous needle aspiration in 26 (57%), 4 (9%), 12 (25%), and 4 (9%) patients, respectively. The 22C3, SP142, and SP263 PD-L1 assays had concordance rates of 73-96, 65-80, and 72%-91%, respectively, compared with the reference values.PD-L1 testing with 3 commercial PD-L1 IHC assays using small biopsy samples is reliable in patients with nonsmall cell lung cancer.
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Affiliation(s)
| | | | | | - Geewon Lee
- Department of Radiology, Pusan National University School of Medicine
| | - Ahreum Kim
- Biostatistics Team of Regional Center for Respiratory Diseases
| | | | | | | | | | | | | | | | - Jung Seop Eom
- Department of Internal Medicine
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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25
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Cho J, Lee CH, Hwang SS, Kim KU, Lee SH, Park HY, Park SJ, Min KH, Oh YM, Yoo KH, Jung KS. Risk of acute exacerbations in chronic obstructive pulmonary disease associated with biomass smoke compared with tobacco smoke. BMC Pulm Med 2019; 19:68. [PMID: 30902075 PMCID: PMC6429752 DOI: 10.1186/s12890-019-0833-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 03/13/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Risk of exacerbations in chronic obstructive pulmonary disease (COPD) associated with biomass smoke has not been well addressed, although biomass smoke is similar in composition to tobacco smoke. METHODS To investigate whether the risk of exacerbations in COPD associated with biomass smoke differs from that in COPD associated with tobacco smoke, we recruited patients with COPD from two Korean multicenter prospective cohorts. In a multiple linear regression model, the standardized regression coefficient (β) of biomass smoke exposure ≥25 years was most similar to that (β') of tobacco smoke exposure ≥10 pack-years (β = - 0.13 and β' = - 0.14). We grouped patients with COPD into four categories based on the above cut-offs: Less Tobacco-Less Biomass, Less Tobacco-More Biomass, More Tobacco-Less Biomass, and More Tobacco-More Biomass. The main outcome was the incidence of moderate or severe exacerbations. RESULTS Among 1033 patients with COPD, 107 were included in Less Tobacco-Less Biomass (mean age: 67 years, men: 67%), 40 in Less Tobacco-More Biomass (mean age: 70 years, men: 35%), 631 in More Tobacco-Less Biomass (mean age: 68 years, men: 98%), and 255 in More Tobacco-More Biomass (mean age: 69 years, men: 97%). The incidence rates of exacerbations were not significantly different between Less Tobacco-More Biomass and More Tobacco-Less Biomass (adjusted incidence rate ratio, 1.03; 95% confidence interval, 0.56-1.89; P = 0.921). No interaction between sex and tobacco and biomass smoke was observed. When propensity score matching with available covariates including age and sex was applied, a similar result was observed. CONCLUSIONS Patients with COPD associated with biomass smoke and those with COPD associated with tobacco smoke had a similar risk of exacerbations. This suggests that patients with COPD associated with biomass smoke should be treated actively.
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Affiliation(s)
- Jaeyoung Cho
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Chang-Hoon Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Seung-Sik Hwang
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Sang Haak Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hye Yun Park
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seoung Ju Park
- Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Republic of Korea
| | - Kyung Hoon Min
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yeon-Mok Oh
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kwang Ha Yoo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Ki-Suck Jung
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
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Kim I, Eom JS, Kim AR, Lee CH, Lee G, Jo EJ, Kim MH, Mok JH, Lee K, Kim KU, Park HK, Lee MK. Molecular analysis of small tissue samples obtained via transbronchial lung biopsy using radial probe endobronchial ultrasound. PLoS One 2019; 14:e0212672. [PMID: 30807604 PMCID: PMC6391011 DOI: 10.1371/journal.pone.0212672] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 02/07/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Radial probe endobronchial ultrasound using a guide sheath (EBUS-GS) is used to diagnose peripheral lung cancer. The aim was to identify the accuracy of molecular analysis that were performed with EBUS-GS specimens in patients with non-small cell lung cancer (NSCLC). METHOD From December 2015 to September 2017, we retrospectively studied 91 patients with peripheral NSCLC who underwent surgery after EBUS-GS. Epidermal growth factor receptor (EGFR) mutational and anaplastic lymphoma kinase (ALK) translocation status obtained from surgical specimens served as the references. RESULTS Compared to the reference data, EGFR mutational testing of EBUS-GS specimens was in 97% agreement, and the κ coefficient was 0.931 (P< 0.001). In addition, on ALK translocation testing, the results of all 91 patients were in agreement with the reference data (concordance rate of 100%, κ coefficient 1.000; P< 0.001). CONCLUSION We found that EBUS-GS could be used for molecular diagnosis, such as EGFR mutational and ALK translocation status, in patients with peripheral NSCLC.
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Affiliation(s)
- Insu Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Jung Seop Eom
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Ah Rong Kim
- Department of Pathology, Pusan National University School of Medicine, Busan, Korea
| | - Chang Hun Lee
- Department of Pathology, Pusan National University School of Medicine, Busan, Korea
| | - Geewon Lee
- Department of Radiology, Pusan National University School of Medicine, Busan, Korea
| | - Eun Jung Jo
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Mi-Hyun Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Jeong Ha Mok
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Kwangha Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Hye-Kyung Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Min Ki Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
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27
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Eom JS, Mok JH, Kim I, Lee MK, Lee G, Park H, Lee JW, Jeong YJ, Kim WY, Jo EJ, Kim MH, Lee K, Kim KU, Park HK. Radial probe endobronchial ultrasound using a guide sheath for peripheral lung lesions in beginners. BMC Pulm Med 2018; 18:137. [PMID: 30103727 PMCID: PMC6090614 DOI: 10.1186/s12890-018-0704-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 08/01/2018] [Indexed: 12/26/2022] Open
Abstract
Background The diagnostic yields and safety profiles of transbronchial lung biopsy have not been evaluated in inexperienced physicians using the combined modality of radial probe endobronchial ultrasound and a guide sheath (EBUS-GS). This study assessed the utility and safety of EBUS-GS during the learning phase by referring to a database of performed EBUS-GS procedures. Methods From December 2015 to January 2017, all of the consecutive patients who underwent EBUS-GS were registered. During the study period, two physicians with no previous experience performed the procedure. To assess the diagnostic yields, learning curve, and safety profile of EBUS-GS performed by these inexperienced physicians, the first 100 consecutive EBUS-GS procedures were included in the evaluation. Results The overall diagnostic yield of EBUS-GS performed by two physicans in 200 patients with a peripheral lung lesion was 73.0%. Learning curve analyses showed that the diagnostic yields were stable, even when the procedure was performed by beginners. Complications related to EBUS-GS occurred in three patients (1.5%): pneumothorax developed in two patients (1%) and resolved spontaneously without chest tube drainage; another patient (0.5%) developed a pulmonary infection after EBUS-GS. There were no cases of pneumothorax requiring chest tube drainage, severe hemorrhage, respiratory failure, premature termination of the procedure, or procedure-related mortality. Conclusions EBUS-GS is a safe and stable procedure with an acceptable diagnostic yield, even when performed by physicians with no previous experience. Electronic supplementary material The online version of this article (10.1186/s12890-018-0704-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jung Seop Eom
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, South Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Jeong Ha Mok
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, South Korea
| | - Insu Kim
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, South Korea
| | - Min Ki Lee
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, South Korea.
| | - Geewon Lee
- Department of Radiology, Pusan National University School of Medicine, Busan, South Korea
| | - Hyemi Park
- Biostatistics Team of Regional Center for Respiratory Diseases, Pusan National University School of Medicine, Busan, South Korea
| | - Ji Won Lee
- Department of Radiology, Pusan National University School of Medicine, Busan, South Korea
| | - Yeon Joo Jeong
- Department of Radiology, Pusan National University School of Medicine, Busan, South Korea
| | - Won-Young Kim
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, South Korea
| | - Eun Jung Jo
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, South Korea
| | - Mi Hyun Kim
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, South Korea
| | - Kwangha Lee
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, South Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, South Korea
| | - Hye-Kyung Park
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, South Korea
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28
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Kim WY, Jo EJ, Eom JS, Mok J, Kim MH, Kim KU, Park HK, Lee MK, Lee K. Combined vitamin C, hydrocortisone, and thiamine therapy for patients with severe pneumonia who were admitted to the intensive care unit: Propensity score-based analysis of a before-after cohort study. J Crit Care 2018; 47:211-218. [PMID: 30029205 DOI: 10.1016/j.jcrc.2018.07.004] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 06/28/2018] [Accepted: 07/03/2018] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate the efficacy of combined vitamin C, hydrocortisone, and thiamine in patients with severe pneumonia. MATERIALS AND METHODS All consecutive patients with severe pneumonia who were treated with the vitamin C protocol (6 g of vitamin C per day) in June 2017-January 2018 (n = 53) were compared to all consecutive patients with severe pneumonia who were treated in June 2016-January 2017 (n = 46). Propensity score analysis was used to adjust for potential baseline differences between the groups. RESULTS In the propensity-matched cohort (n = 36/group), the treated patients had significantly less hospital mortality than the control group (17% vs. 39%; P = 0.04). The vitamin C protocol associated independently with decreased mortality in propensity score-adjusted analysis (adjusted odds ratio = 0.15, 95% confidence interval = 0.04-0.56, P = 0.005). Relative to the control group, the treatment group had a significantly higher median improvement in the radiologic score at day 7 compared with baseline (4 vs. 2; P = 0.045). The vitamin C protocol did not increase the rates of acute kidney injury or superinfection. CONCLUSIONS Combined vitamin C, hydrocortisone, and thiamine therapy may benefit patients with severe pneumonia.
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Affiliation(s)
- Won-Young Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan 49241, Republic of Korea; Biomedical Research Institute, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan 49241, Republic of Korea.
| | - Eun-Jung Jo
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan 49241, Republic of Korea.
| | - Jung Seop Eom
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan 49241, Republic of Korea.
| | - Jeongha Mok
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan 49241, Republic of Korea.
| | - Mi-Hyun Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan 49241, Republic of Korea.
| | - Ki Uk Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan 49241, Republic of Korea.
| | - Hye-Kyung Park
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan 49241, Republic of Korea.
| | - Min Ki Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan 49241, Republic of Korea.
| | - Kwangha Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan 49241, Republic of Korea; Biomedical Research Institute, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan 49241, Republic of Korea.
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29
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Kim WY, Kim MH, Jo EJ, Eom JS, Mok J, Kim KU, Park HK, Lee MK, Lee K. Predicting Mortality in Patients with Tuberculous Destroyed Lung Receiving Mechanical Ventilation. Tuberc Respir Dis (Seoul) 2018; 81:247-255. [PMID: 29926549 PMCID: PMC6030661 DOI: 10.4046/trd.2017.0126] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 02/11/2018] [Accepted: 03/12/2018] [Indexed: 01/09/2023] Open
Abstract
Background Patients with acute respiratory failure secondary to tuberculous destroyed lung (TDL) have a poor prognosis. The aim of the present retrospective study was to develop a mortality prediction model for TDL patients who require mechanical ventilation. Methods Data from consecutive TDL patients who had received mechanical ventilation at a single university-affiliated tertiary care hospital in Korea were reviewed. Binary logistic regression was used to identify factors predicting intensive care unit (ICU) mortality. A TDL on mechanical Ventilation (TDL-Vent) score was calculated by assigning points to variables according to β coefficient values. Results Data from 125 patients were reviewed. A total of 36 patients (29%) died during ICU admission. On the basis of multivariate analysis, the following factors were included in the TDL-Vent score: age ≥65 years, vasopressor use, and arterial partial pressure of oxygen/fraction of inspired oxygen ratio <180. In a second regression model, a modified score was then calculated by adding brain natriuretic peptide. For TDL-Vent scores 0 to 3, the 60-day mortality rates were 11%, 27%, 30%, and 77%, respectively (p<0.001). For modified TDL-Vent scores 0 to ≥3, the 60-day mortality rates were 0%, 21%, 33%, and 57%, respectively (p=0.001). For both the TDL-Vent score and the modified TDL-Vent score, the areas under the receiver operating characteristic curve were larger than that of other illness severity scores. Conclusion The TDL-Vent model identifies TDL patients on mechanical ventilation with a high risk of mortality. Prospective validation studies in larger cohorts are now warranted.
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Affiliation(s)
- Won Young Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Mi Hyun Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Eun Jung Jo
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Jung Seop Eom
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Jeongha Mok
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Ki Uk Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Hye Kyung Park
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Min Ki Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Kwangha Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
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30
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Kim JE, Eom JS, Kim WY, Jo EJ, Mok J, Lee K, Kim KU, Park HK, Lee MK, Kim MH. Diagnostic value of microRNAs derived from exosomes in bronchoalveolar lavage fluid of early-stage lung adenocarcinoma: A pilot study. Thorac Cancer 2018; 9:911-915. [PMID: 29806739 PMCID: PMC6068458 DOI: 10.1111/1759-7714.12756] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/09/2018] [Accepted: 04/09/2018] [Indexed: 11/29/2022] Open
Abstract
Background Low‐dose computed tomography can identify smaller nodules more often than chest radiography in lung screening. However, complications from invasive diagnostic procedures performed to detect nodules are common. Exosomes contain a diverse array of biomolecules that reflect the biological state of the cell from which they are released. The aim of this study was to investigate the diagnostic value of bronchoalveolar lavage (BAL) fluid exosomal microRNAs (miRNAs) for early‐stage lung adenocarcinoma. Methods We evaluated miRNAs (miR‐7, miR‐21, miR‐126, Let‐7a, miR‐17, and miR‐19) known to have diagnostic value for lung adenocarcinoma. Exosomes were isolated from the BAL fluid of control subjects (n = 15) and patients with lung adenocarcinoma (n = 13). Exosomal miRNA was analyzed using a commercial kit containing probes targeting six selected miRNAs. Results were validated via quantitative PCR. Results The presence of miRNAs was confirmed in exosomes from BAL fluid of both lung adenocarcinoma patients and control subjects. miR‐126 (P < 0.001) and Let‐7a (P = 0.015) levels were significantly higher in the BAL fluid of lung adenocarcinoma patients than in control subjects. The BAL fluid miRNA signature was confirmed using an independent set of paired adenocarcinoma and normal tissue samples (n = 4). Lung adenocarcinoma tissues showed increased expression of miR‐126 (P = 0.039) compared to normal tissue samples. Conclusion We identified a close correlation between BAL fluid exosomal miRNAs and tumor miRNAs. BAL fluid exosomal miRNAs obtained through noninvasive methods could serve as diagnostic biomarkers in early‐stage lung adenocarcinoma.
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Affiliation(s)
- Ji Eun Kim
- Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea
| | - Jung Seop Eom
- Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea
| | - Won-Young Kim
- Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea
| | - Eun Jung Jo
- Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea
| | - Jeongha Mok
- Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea
| | - Kwangha Lee
- Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea
| | - Ki Uk Kim
- Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea
| | - Hye-Kyung Park
- Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea
| | - Min Ki Lee
- Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea.,Medical Research Institute, Pusan National University, Busan, Republic of Korea
| | - Mi-Hyun Kim
- Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea.,Medical Research Institute, Pusan National University, Busan, Republic of Korea
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31
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Jang SM, Kim KU, Na HJ, Song SE, Lee SH, Lee H, Kim YS, Lee MK, Park HK. Depression is a major determinant of both disease-specific and generic health-related quality of life in people with severe COPD. Chron Respir Dis 2018; 16:1479972318775422. [PMID: 29742914 PMCID: PMC6302962 DOI: 10.1177/1479972318775422] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The quality of life of patients with chronic obstructive pulmonary disease (COPD)
decreases significantly as the disease progresses; those with severe COPD are
affected most. This article investigates predictors of the disease-specific and
generic health-related quality of life (HRQL) in patients with severe COPD. This
multicentre prospective cross-sectional study enrolled 80 patients with severe
COPD. At enrolment, all patients completed a disease-specific instrument, the St
George’s Respiratory Questionnaire (SGRQ), and a generic instrument, the Short
Form 36 Health Survey Questionnaire (SF-36). The data were analyzed by Pearson’s
correlation and multiple linear regression. The mean age of the patients was 66
± 8 years; 93% were males. The SGRQ and SF-36 scores were not influenced by age
or sex. Depression, dyspnea, the number of exacerbations, and exercise capacity
significantly predicted the total SGRQ score (p < 0.05).
Depression was the strongest determinant of the total SGRQ score. The SF-36
physical component summary scores were related to depression, dyspnea, and the
number of exacerbations (p < 0.05). In comparison, the SF-36
mental component summary scores were related to depression and anxiety
(p < 0.05). Depression is a significant determinant of
both the disease-specific and generic HRQL in patients with severe COPD.
Screening and early intervention for depression in patients with severe COPD
could improve the HRQL.
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Affiliation(s)
- Sun Mi Jang
- 1 Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea.,2 Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Ki Uk Kim
- 1 Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea.,2 Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Hae Jung Na
- 1 Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea.,2 Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Seung Eun Song
- 1 Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea.,2 Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Sang Hee Lee
- 3 Department of Internal Medicine, Sanbon Hospital, Wonkwang University, Gunpo, Republic of Korea
| | - Haejung Lee
- 4 Department of Nursing, College of Nursing, Pusan National University, Yangsan, Republic of Korea
| | - Yun Seong Kim
- 1 Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea
| | - Min Ki Lee
- 1 Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea.,2 Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Hye-Kyung Park
- 1 Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea.,2 Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
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Lee SH, Kim KU, Lee H, Kim YS, Lee MK, Park HK. Factors associated with low-level physical activity in elderly patients with chronic obstructive pulmonary disease. Korean J Intern Med 2018; 33:130-137. [PMID: 28602061 PMCID: PMC5768538 DOI: 10.3904/kjim.2016.090] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 07/26/2016] [Accepted: 10/26/2016] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS In patients with chronic obstructive pulmonary disease (COPD), the extent of physical activity (PA) is correlated with disease severity and prognosis. However, factors associated with low-level PA in elderly COPD patients are not known. We assessed the levels of PA and clinical factors associated with low-level of PA in elderly COPD patients. METHODS This was a secondary analysis of a multicenter, prospective study of 245 patients with COPD. Among them, 160 patients with 65 years or more were included. Three PA groups were defined with respect to daily activity time (low, moderate, and high). Health related quality of life (HRQL) was measured using St. George's respiratory questionnaire (SGRQ) and 36-item short-form health survey. Anxiety and depression status were assessed employing the hospital anxiety and depression scale (HADS). Multivariate logistic regression was performed to identify independent predictors of low-level PA in elderly COPD patients. RESULTS Of all the 160 patients, 103 (64.4%) engaged in low-level PA. Upon univariate analysis, a decreased exercise capacity (6-minute walk test < 250 m), an increased dyspnea (the modified medical research council [MMRC] dyspnea scale ≥ 2), a decreased HRQL (total SGRQ score), and a presence of depression (HADS-D ≥ 8) were significantly associated with low-level PA. Upon multivariate analysis, an MMRC grade ≥ 2 (hazard ratio [HR], 2.550; p = 0.034), and HADS-D ≥ 8 (HR, 2.076; p = 0.045) were independently associated with low-level PA in elderly COPD patients. CONCLUSIONS Two-thirds of elderly patients with COPD reported low-level of PA. More severe dyspnea and a presence of depression were independently associated with low-level PA in elderly COPD patients.
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Affiliation(s)
- Sang Hee Lee
- Department of Internal Medicine, Wonkwang University Sanbon Hospital, Gunpo, Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Haejung Lee
- Department of Nursing, Pusan National University College of Nursing, Yangsan, Korea
| | - Yun Seong Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Min Ki Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Hye-Kyung Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
- Correspondence to Hye-Kyung Park, M.D. Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeokro, Seo-gu, Busan 49241, Korea Tel: +82-51-240-7802 Fax: +82-51-254-3127 E-mail:
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Hwang YI, Park YB, Yoon HK, Lim SY, Kim TH, Park JH, Lee WY, Park SJ, Lee SW, Kim WJ, Kim KU, Shin KC, Kim DJ, Kim HJ, Kim TE, Yoo KH, Shim JJ. Development of Prediction Equation of Diffusing Capacity of Lung for Koreans. Tuberc Respir Dis (Seoul) 2018; 81:42-48. [PMID: 29332323 PMCID: PMC5771745 DOI: 10.4046/trd.2017.0118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 12/06/2017] [Accepted: 12/07/2017] [Indexed: 11/24/2022] Open
Abstract
Background The diffusing capacity of the lung is influenced by multiple factors such as age, sex, height, weight, ethnicity and smoking status. Although a prediction equation for the diffusing capacity of Korea was proposed in the mid-1980s, this equation is not used currently. The aim of this study was to develop a new prediction equation for the diffusing capacity for Koreans. Methods Using the data of the Korean National Health and Nutrition Examination Survey, a total of 140 nonsmokers with normal chest X-rays were enrolled in this study. Results Using linear regression analysis, a new predicting equation for diffusing capacity was developed. For men, the following new equations were developed: carbon monoxide diffusing capacity (DLco)=−10.4433−0.1434×age (year)+0.2482×heights (cm); DLco/alveolar volume (VA)=6.01507−0.02374×age (year)−0.00233×heights (cm). For women the prediction equations were described as followed: DLco=−12.8895−0.0532×age (year)+0.2145×heights (cm) and DLco/VA=7.69516−0.02219×age (year)−0.01377×heights (cm). All equations were internally validated by k-fold cross validation method. Conclusion In this study, we developed new prediction equations for the diffusing capacity of the lungs of Koreans. A further study is needed to validate the new predicting equation for diffusing capacity.
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Affiliation(s)
- Yong Il Hwang
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.,Lung Research Institute of Hallym University College of Medicine, Chuncheon, Korea
| | - Yong Bum Park
- Lung Research Institute of Hallym University College of Medicine, Chuncheon, Korea.,Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Hyoung Kyu Yoon
- Division of Pulmonology, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seong Yong Lim
- Division of Pulmonary and Critical Care Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Hyung Kim
- Division of Pulmonology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Joo Hun Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Won Yeon Lee
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Seong Ju Park
- Division of Pulmonary, Allergy and Critical Care Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea
| | - Sei Won Lee
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Jin Kim
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Korea
| | - Kyeong Cheol Shin
- Regional Center for Respiratory Disease, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
| | - Do Jin Kim
- Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Hui Jung Kim
- Division of Pulmonary and Critical Care Medicine, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea
| | - Tae Eun Kim
- Department of Clinical Pharmacology, Konkuk University School of Medicine, Seoul, Korea
| | - Kwang Ha Yoo
- Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea.
| | - Jae Jeong Shim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea.
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Eom JS, Kim I, Kim WY, Jo EJ, Mok J, Kim MH, Lee K, Kim KU, Park HK, Lee MK. Household tuberculosis contact investigation in a tuberculosis-prevalent country: Are the tuberculin skin test and interferon-gamma release assay enough in elderly contacts? Medicine (Baltimore) 2018; 97:e9681. [PMID: 29505017 PMCID: PMC5779786 DOI: 10.1097/md.0000000000009681] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 11/06/2017] [Accepted: 12/28/2017] [Indexed: 11/26/2022] Open
Abstract
The high background rates of positive results on the tuberculin skin test (TST) and interferon-gamma release assay (IGRA) sometimes confuse the investigation of tuberculosis (TB) contact in TB-prevalent countries, particularly in elderly contacts. The aim was to investigate the predictive value of TST and IGRA for diagnosing latent TB infection (LTBI) in elderly household contacts in South Korea.In this retrospective study, TST and IGRA results of household contacts of suspected pulmonary TB patients were reviewed according to the index patient's final diagnosis (TB group: culture-confirmed pulmonary TB, non-TB group: pulmonary disease other than TB).A total of 249 contacts were included in the analysis (188 in the TB group and 61 in the non-TB group). In the TB group, TST and IGRA were positive in 42.6% and 45.7% of contacts, respectively. In the non-TB group, TST and IGRA were positive in 32.8% and 23.0% of contacts, respectively. TST did not show any differences between the TB and non-TB groups for any age group, whereas IGRA showed differences between the 2 groups for those ages 18 to 39 and 40 to 59 years. However, there were no significant differences between the groups for the ≥60 years old group.In elderly contacts, neither TST nor IGRA showed clear discrimination of positivity between the groups. Further studies are needed to predict which elderly contacts are at risk for progression to active TB as well as to accurately detect recent Mycobacterium tuberculosis infection in this vulnerable population.
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Affiliation(s)
- Jung Seop Eom
- Department of Internal Medicine, Pusan National University School of Medicine
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Insu Kim
- Department of Internal Medicine, Pusan National University School of Medicine
| | - Won-Young Kim
- Department of Internal Medicine, Pusan National University School of Medicine
| | - Eun-Jung Jo
- Department of Internal Medicine, Pusan National University School of Medicine
| | - Jeongha Mok
- Department of Internal Medicine, Pusan National University School of Medicine
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Mi-Hyun Kim
- Department of Internal Medicine, Pusan National University School of Medicine
| | - Kwangha Lee
- Department of Internal Medicine, Pusan National University School of Medicine
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine
| | - Hye-Kyung Park
- Department of Internal Medicine, Pusan National University School of Medicine
| | - Min Ki Lee
- Department of Internal Medicine, Pusan National University School of Medicine
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Kim WY, Jo EJ, Eom JS, Mok J, Kim MH, Kim KU, Park HK, Lee MK, Lee K. Validation of the Prognosis for Prolonged Ventilation (ProVent) score in patients receiving 14days of mechanical ventilation. J Crit Care 2017; 44:249-254. [PMID: 29202432 DOI: 10.1016/j.jcrc.2017.11.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 11/19/2017] [Accepted: 11/21/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate the performance of the Prognosis for Prolonged Ventilation (ProVent) 14 score in patients requiring prolonged mechanical ventilation (PMV). MATERIALS AND METHODS Data were obtained from 366 patients receiving at least 14days of MV between January 2011 and December 2015 at a university-affiliated tertiary care hospital in Korea. ProVent 14 scores were assessed using the six standard variables. Model discrimination was assessed with the area under the receiver operating characteristic curve. Kaplan-Meier estimates were stratified according to the ProVent 14 score to predict 1-year survival. RESULTS The median age of the study group was 62years (range, 50-72years); 65% were male, and medical patients comprised 66% of the group. Overall mortality at 1year was 43%. For ProVent 14 scores ranging from 0 to ≥4, 1-year mortality rates were 7%, 22%, 41%, 52%, and 75%, respectively (log-rank test, P<0.001). The area under the receiver operating characteristic curve of the ProVent 14 score predicting 1-year mortality was 0.74 (95% confidence interval, 0.69-0.78). CONCLUSIONS The ProVent 14 score accurately identified patients receiving PMV with a high 1-year mortality risk. Further validation in a larger sample is required.
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Affiliation(s)
- Won-Young Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan 49241, Republic of Korea.
| | - Eun-Jung Jo
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan 49241, Republic of Korea.
| | - Jung Seop Eom
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan 49241, Republic of Korea.
| | - Jeongha Mok
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan 49241, Republic of Korea.
| | - Mi-Hyun Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan 49241, Republic of Korea.
| | - Ki Uk Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan 49241, Republic of Korea.
| | - Hye-Kyung Park
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan 49241, Republic of Korea.
| | - Min Ki Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan 49241, Republic of Korea.
| | - Kwangha Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan 49241, Republic of Korea.
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Eom JS, Ahn HY, Mok JH, Lee G, Jo EJ, Kim MH, Lee K, Kim KU, Park HK, Lee MK. Pleurodesis Using Mistletoe Extract Delivered via a Spray Catheter during Semirigid Pleuroscopy for Managing Symptomatic Malignant Pleural Effusion. Respiration 2017; 95:177-181. [PMID: 29131094 DOI: 10.1159/000481869] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 09/29/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Talc poudrage during thoracoscopy is considered the standard procedure for patients with symptomatic malignant pleural effusion (MPE). Until now, no alternative technique other than talc poudrage for pleurodesis during medical thoracoscopy has been proposed. Liquid sclerosants, such as mistletoe extract, have been sprayed evenly into the pleural cavity during semirigid pleuroscopy for chemical pleurodesis. OBJECTIVE We conducted a retrospective study using the database of semirigid pleuroscopy to identify the usefulness of pleurodesis using a mistletoe extract delivered via a spray catheter during semirigid pleuroscopy for symptomatic MPE. METHODS All consecutive patients with symptomatic MPE who underwent semirigid pleuroscopy from October 2015 to September 2016 were registered. The responses were evaluated using chest X- ray or computed tomography 4 weeks after pleurodesis. RESULTS The study included 43 patients who underwent pleurodesis with mistletoe extract via a spray catheter during semirigid pleuroscopy. Complete and partial responses were seen in 21 (49%) and 19 (44%) patients, respectively. The median duration of chest tube placement after pleurod-esis was 7 days (range 6-8 days) in the 40 patients with complete or partial responses. No cases of severe hemorrhage, empyema formation, respiratory failure, or procedure-related mortality were observed in the subjects at 4 weeks after semirigid pleuroscopy. CONCLUSION Pleurodesis with mistletoe extract delivered via a spray catheter during semirigid pleuroscopy is a safe and effective procedure for managing symptomatic MPE.
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Affiliation(s)
- Jung Seop Eom
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Hyo Yeong Ahn
- Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Jeong Ha Mok
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Geewon Lee
- Department of Radiology, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Eun-Jung Jo
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Mi-Hyun Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Kwangha Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Hye-Kyung Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Min Ki Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
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Sim YS, Lee JH, Kim KU, Ra SW, Park HY, Lee CH, Kim DK, Shin KC, Lee SH, Hwang HG, Ahn JH, Park YB, Kim YI, Yoo KH, Jeong I, Oh YM, Lee SD. Determinants of Nicotine Dependence in Chronic Obstructive Pulmonary Disease. Tuberc Respir Dis (Seoul) 2017; 80:277-283. [PMID: 28747961 PMCID: PMC5526955 DOI: 10.4046/trd.2017.80.3.277] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 01/31/2017] [Accepted: 03/10/2017] [Indexed: 01/06/2023] Open
Abstract
Background Smoking cessation is the most powerful intervention to modify progress of chronic obstructive pulmonary disease (COPD), and nicotine dependence is one of the most important determinants of success or failure in smoking cessation. We evaluated nicotine dependence status and investigated factors associated with moderate to high nicotine dependence in patients with COPD. Methods We included 53 current smokers with COPD in the Korean Obstructive Lung Disease II cohort enrolled between January 2014 and March 2016. Nicotine dependence was measured by using Fagerstrom test for nicotine dependence (FTND). Cognitive function was assessed by Korean version of Montreal Cognitive Assessment. Results The median FTND score was 3, and 32 patients (60%) had moderate to high nicotine dependence. The median smoking amount was 44 pack-years, which was not related to nicotine dependence. Multiple logistic regression analysis revealed that high education status (odds ratio, 1.286; 95% confidence interval, 1.036–1.596; p=0.023), age <70 (odds ratio, 6.407; 95% confidence interval, 1.376–29.830; p=0.018), and mild to moderate airflow obstruction (odds ratio, 6.969; 95% confidence interval, 1.388–34.998; p=0.018) were related to moderate to high nicotine dependence. Conclusion Nicotine dependence does not correlate with smoking amount, but with education level, age, and severity of airflow obstruction. Physicians should provide different strategies of smoking cessation intervention for current smokers with COPD according to their education levels, age, and severity of airflow obstruction.
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Affiliation(s)
- Yun Su Sim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Jin Hwa Lee
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Seung Won Ra
- Division of Pulmonary Medicine, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Hye Yun Park
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chang-Hoon Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Deog Kyeom Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Kyeong-Cheol Shin
- Regional Center for Respiratory Disease, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
| | - Sang Haak Lee
- Department of Internal Medicine, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hun Gyu Hwang
- Respiratory Division, Department of Internal Medicine, Soonchunhyang University Gumi Hospital, Soonchunhyang University College of Medicine, Gumi, Korea
| | - Joong Hyun Ahn
- Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Yong Bum Park
- Department of Pulmonary and Critical Care Medicine, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Yu-Il Kim
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Kwang Ha Yoo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Ina Jeong
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - Yeon-Mok Oh
- Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang-Do Lee
- Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Lee G, Kim KU, Lee JW, Suh YJ, Jeong YJ. Serial changes and prognostic implications of CT findings in combined pulmonary fibrosis and emphysema: comparison with fibrotic idiopathic interstitial pneumonias alone. Acta Radiol 2017; 58:550-557. [PMID: 27565631 DOI: 10.1177/0284185116664227] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Background Although fibrotic idiopathic interstitial pneumonias (IIPs) alone and those combined with pulmonary emphysema are naturally progressive diseases, the process of deterioration and outcomes are variable. Purpose To evaluate and compare serial changes of computed tomography (CT) abnormalities and prognostic predictive factors in fibrotic IIPs alone and those combined with pulmonary emphysema. Material and Methods A total of 148 patients with fibrotic IIPs alone (82 patients) and those combined with pulmonary emphysema (66 patients) were enrolled. Semi-quantitative CT analysis was used to assess the extents of CT characteristics which were evaluated on initial and follow-up CT images. Univariate and multivariate analyses were performed to assess the effects of clinical and CT variables on survival. Results Significant differences were noted between fibrotic scores, as determined using initial CT scans, in the fibrotic IIPs alone (21.22 ± 9.83) and those combined with pulmonary emphysema groups (14.70 ± 7.28) ( P < 0.001). At follow-up CT scans, changes in the extent of ground glass opacities (GGO) were greater ( P = 0.031) and lung cancer was more prevalent ( P = 0.001) in the fibrotic IIPs combined with pulmonary emphysema group. Multivariate Cox proportional hazards analysis showed changes in the extent of GGO (hazard ratio, 1.056) and the presence of lung cancer (hazard ratio, 4.631) were predictive factors of poor survivals. Conclusion Although patients with fibrotic IIPs alone and those combined with pulmonary emphysema have similar mortalities, lung cancer was more prevalent in patients with fibrotic IIPs combined with pulmonary emphysema. Furthermore, changes in the extent of GGO and the presence of lung cancer were independent prognostic factors of poor survivals.
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Affiliation(s)
- Geewon Lee
- Department of Radiology, Pusan National University Hospital, Busan, Republic of Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Ki Uk Kim
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Ji Won Lee
- Department of Radiology, Pusan National University Hospital, Busan, Republic of Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Young Ju Suh
- Department of Biomedical Sciences, School of Medicine, Inha University, Incheon, Republic of Korea
| | - Yeon Joo Jeong
- Department of Radiology, Pusan National University Hospital, Busan, Republic of Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
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Kim YH, Yoo KH, Yoo JH, Kim TE, Kim DK, Park YB, Rhee CK, Kim TH, Kim YS, Yoon HK, Um SJ, Park IN, Ryu YJ, Jung JW, Hwang YI, Lee HB, Lim SC, Jung SS, Kim EK, Kim WJ, Lee SS, Lee J, Kim KU, Kim HK, Kim SH, Park JH, Shin KC, Choe KH, Yum HK. The Need for a Well-Organized, Video-Assisted Asthma Education Program at Korean Primary Care Clinics. Tuberc Respir Dis (Seoul) 2017; 80:169-178. [PMID: 28416957 PMCID: PMC5392488 DOI: 10.4046/trd.2017.80.2.169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Revised: 01/13/2017] [Accepted: 02/13/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The purpose of this study was to assess the effect of our new video-assisted asthma education program on patients' knowledge regarding asthma and asthma control. METHODS Adult asthmatics who were diagnosed by primary care physicians and followed for at least 1 year were educated via smart devices and pamphlets. The education sessions were carried out three times at 2-week intervals. Each education period lasted at most 5 minutes. The effectiveness was then evaluated using questionnaires and an asthma control test (ACT). RESULTS The study enrolled 144 patients (mean age, 56.7±16.7 years). Half of the patients had not been taught how to use their inhalers. After participating in the education program, the participants' understanding of asthma improved significantly across all six items of a questionnaire assessing their general knowledge of asthma. The proportion of patients who made errors while manipulating their inhalers was reduced to less than 10%. The ACT score increased from 16.6±4.6 to 20.0±3.9 (p<0.001). The number of asthmatics whose ACT score was at least 20 increased from 45 (33.3%) to 93 (65.3%) (p<0.001). The magnitude of improvement in the ACT score did not differ between patients who received an education session at least three times within 1 year and those who had not. The majority of patients agreed to the need for an education program (95.8%) and showed a willingness to pay an additional cost for the education (81.9%). CONCLUSION This study indicated that our newly developed education program would become an effective component of asthma management in primary care clinics.
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Affiliation(s)
- Yee Hyung Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea
| | - Kwang Ha Yoo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea
| | - Jee-Hong Yoo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea
| | - Tae-Eun Kim
- Department of Clinical Pharmacology, Konkuk University Medical Center, Seoul, Korea
| | - Deog Kyeom Kim
- Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Yong Bum Park
- Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Korea
| | - Chin Kook Rhee
- Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Tae-Hyung Kim
- Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea
| | - Young Sam Kim
- Division of Pulmonology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyoung Kyu Yoon
- Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Soo-Jung Um
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - I-Nae Park
- Department of Internal Medicine, Inje University Seoul Paik Hospital, Seoul, Korea
| | - Yon Ju Ryu
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Jae-Woo Jung
- Division of Pulmonary Medicine, Department of Internal Medicine, Chung-Ang University School of Medicine, Seoul, Korea
| | - Yong Il Hwang
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Heung Bum Lee
- Department of Internal Medicine, Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonju, Korea
| | - Sung-Chul Lim
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Sung Soo Jung
- Division of Pulmonology, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Eun-Kyung Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Woo Jin Kim
- Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, Chuncheon, Korea
| | - Sung-Soon Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Jaechun Lee
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Hyun Kuk Kim
- Division of Pulmonology, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Sang Ha Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Joo Hun Park
- Department of Internal Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Kyeong Cheol Shin
- Regional Center for Respiratory Disease, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
| | - Kang Hyeon Choe
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Ho-Kee Yum
- Department of Internal Medicine, Inje University Seoul Paik Hospital, Seoul, Korea
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Kim SW, Rhee CK, Kim KU, Lee SH, Hwang HG, Kim YI, Kim DK, Lee SD, Oh YM, Yoon HK. Factors associated with plasma IL-33 levels in patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2017; 12:395-402. [PMID: 28176939 PMCID: PMC5268328 DOI: 10.2147/copd.s120445] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Interleukin (IL)-33 promotes T helper (Th)2 immunity and systemic inflammation. The role of IL-33 in asthma has been widely investigated. IL-33 has also been suggested to play an important role in the pathogenesis of chronic obstructive pulmonary disease (COPD). This study investigated the clinical significance and usefulness of plasma IL-33 level in patients with COPD. METHODS A total of 307 patients with stable COPD from 15 centers, who were in the Korean Obstructive Lung Disease cohort, were enrolled in this study. Plasma IL-33 levels were measured by enzyme-linked immunosorbent assay. We analyzed the association between IL-33 level and other clinical characteristics related to COPD. We also examined the features of patients with COPD who exhibited high IL-33 levels. RESULTS IL-33 levels varied, but were very low in most patients. Eosinophil count was significantly correlated with a plasma IL-33 level. In addition, old age and current smoking were related to a low IL-33 level. Significantly more patients with a higher IL-33 level had chronic bronchitis compared with those with a low IL-33 level. CONCLUSION Plasma IL-33 level in patients with stable COPD was related to eosinophil count and chronic bronchitis phenotype. Further studies are needed to identify the precise mechanisms of IL-33/ST2 pathway in patients with COPD.
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Affiliation(s)
- Sei Won Kim
- Division of Pulmonary, Department of Internal Medicine, Yeouido St Mary's Hospital
| | - Chin Kook Rhee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University, School of Medicine, Busan
| | - Sang Haak Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, St Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul
| | - Hun Gyu Hwang
- Department of Internal Medicine, Soonchunhyang University Gumi Hospital, Gumi
| | - Yu Il Kim
- Division of Pulmonology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju
| | - Deog Kyeom Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine
| | - Sang Do Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yeon-Mok Oh
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyoung Kyu Yoon
- Division of Pulmonary, Department of Internal Medicine, Yeouido St Mary's Hospital
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Song SE, Lee SH, Jo EJ, Eom JS, Mok JH, Kim MH, Kim KU, Lee MK, Lee K. The Prognostic Value of the Charlson's Comorbidity Index in Patients with Prolonged Acute Mechanical Ventilation: A Single Center Experience. Tuberc Respir Dis (Seoul) 2016; 79:289-294. [PMID: 27790281 PMCID: PMC5077733 DOI: 10.4046/trd.2016.79.4.289] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 02/04/2016] [Accepted: 08/10/2016] [Indexed: 11/24/2022] Open
Abstract
Background The aim of our study was to evaluate the prognostic value of Charlson's weighted index of comorbidities (WIC) in patients with prolonged acute mechanical ventilation (PAMV, ventilator care ≥96 hours). Methods We retrospectively enrolled 299 Korean PAMV patients who were admitted in a medical intensive care unit (ICU) of a university-affiliated tertiary care hospital between 2008 and 2013. Survivors were defined as patients who survived for 60 days after ICU admission. Results The patients' mean age was 65.1±14.1 years and 70.6% were male. The mean ICU and hospital length of stay was 21.9±19.7 and 39.4±39.1 days, respectively. In addition, the 60-day mortality rate after ICU admission was 35.5%. The mean WIC was 2.3±1.8, with significant differences between nonsurvivors and survivors (2.7±2.1 vs. 2.1±1.7, p<0.05). The area under the curve of receiver-operating-characteristics curve for WIC was 0.593 (95% confidence interval [CI], 0.523–0.661; p<0.05). Based on Kaplan-Meier curves of 60-day survival, WIC ≥5 had statistically lower survival than WIC <5 (log-rank test, p<0.05). In a multivariate Cox proportional hazard model, WIC ≥5 was associated with poor prognosis (hazard ratio, 1.901; 95% CI, 1.140–3.171; p<0.05). The mortality rate of patients with WIC ≥5 was 54.2%. Conclusion Our study showed a WIC score ≥5 might be helpful in predicting 60-day mortality in PAMV patients.
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Affiliation(s)
- Seung Eon Song
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Sang Hee Lee
- Division of Pulmonology, Department of Internal Medicine, Wonkwang University Sanbon Hospital, Gunpo, Korea
| | - Eun-Jung Jo
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Jung Seop Eom
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Jeong Ha Mok
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Mi-Hyun Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Ki Uk Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Min Ki Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Kwangha Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
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Kim MH, Jo EJ, Eom JS, Mok JH, Lee K, Kim KU, Park HK, Lee MK. Diagnostic Value of Micrornas Derived Exosomes From Bronchoalveolar Lavage Fluid in Early Stage Lung Adenocarcinoma. Chest 2016. [DOI: 10.1016/j.chest.2016.08.798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Jeong KH, Song YJ, Han JY, Kim KU. Relationship Between Cytogenetic Complexity and Peritumoral Edema in High-Grade Astrocytoma. Ann Lab Med 2016; 36:583-9. [PMID: 27578512 PMCID: PMC5011112 DOI: 10.3343/alm.2016.36.6.583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 06/09/2016] [Accepted: 07/27/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The purpose of the study is to reveal the association of cytogenetic compltyexi and peritumoral edema volume (PTEV) and its prognostic significance in high-grade astrocytoma patients by culturing patient tumor cells. METHODS Twenty-seven high-grade astrocytoma patients were divided into three groups according to karyotype complexity: normal, non-complex karyotype (NCK), and complex karyotype (CK). Endothelial growth factor receptor (EGFR) amplification was detected by FISH, and its association with chromosome 7 abnormalities was analyzed. Mean PTEV of each group was compared by ANOVA to evaluate the relationship between PTEV and cytogenetic complexity. RESULTS The PTEV of patients in normal (n=6), NCK (n=8), and CK (n=13) groups were 24.52±17.73, 34.26±35.04, and 86.31±48.7 cm³, respectively (P=0.005). Ten out of 11 patients with EGFR amplification showed abnormalities in chromosome 7. The mean PTEV of EGFR-amplified and non-amplified groups were 80.4±53.7 and 41.3±37.9 cm³, respectively (P=0.035). The average survival of patients with PTEV less than 90 cm³ was 30.52±26.11 months, while in patients with PTEVs over or equal to 90 cm³, it was 10.83±5.53 months (P=0.007). CONCLUSIONS The results show an association of complex karyotype with the PTEV of high-grade astrocytoma. EGFR amplification plays a significant role in the formation of peritumoral edema, causing PTEV to increase, which is related with survival. This implies that cytogenetic karyotype can be applied as a prognostic factor.
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Affiliation(s)
- Kyung Ho Jeong
- Department of Neurosurgery, Medical Science Research Center, College of Medicine, Dong-A University, Busan, Korea
| | - Young Jin Song
- Department of Neurosurgery, Medical Science Research Center, College of Medicine, Dong-A University, Busan, Korea.,Brain Tumor Institute, Medical Science Research Center, College of Medicine, Dong-A University, Busan, Korea
| | - Jin Yeong Han
- Department of Laboratory Medicine, College of Medicine, Dong-A University, Busan, Korea
| | - Ki Uk Kim
- Department of Neurosurgery, Medical Science Research Center, College of Medicine, Dong-A University, Busan, Korea.,Brain Tumor Institute, Medical Science Research Center, College of Medicine, Dong-A University, Busan, Korea.
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Mok JH, Kim YH, Jeong ES, Eom JS, Kim MH, Kim KU, Lee MK, Lee K. Clinical application of the ProVent score in Korean patients requiring prolonged mechanical ventilation: A 10-year experience in a university-affiliated tertiary hospital. J Crit Care 2016; 33:158-62. [PMID: 26994779 DOI: 10.1016/j.jcrc.2016.02.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 01/26/2016] [Accepted: 02/22/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE We evaluated the clinical usefulness of a prognostic scoring system ("the ProVent score") in Korean patients requiring prolonged mechanical ventilation. MATERIAL AND METHODS We retrospectively analyzed the data of 184 patients in a medical intensive care unit of a tertiary care hospital between January 2004 and December 2013. RESULTS The patients' median age was 65 years, and 66.8% were male. One-year mortality was 67.4%. On day 21 of mechanical ventilation, the ProVent score was 0 in 13 patients (7.1%), 1 in 39 patients (21.2%), 2 in 73 patients (39.7%), 3 in 42 patients (22.8%), and greater than or equal to 4 in 17 patients (9.2%). For patients with a ProVent score ranging from 0 to greater than or equal to 4, 1-year mortality was 46.2%, 53.8%, 68.5%, 76.2%, and 88.2%, respectively. The Kaplan-Meier curves of 1-year survival for each ProVent score showed statistically significant differences (log-rank test: P = .001). Logistic regression analysis showed that only thrombocytopenia was independently associated with 1-year mortality in our cohort (odds ratio = 4.786, P < .001). CONCLUSIONS In our study, the ProVent score could be applied to predict 1-year mortality for patients requiring prolonged mechanical ventilation in Korea. Among variables contributing to this score, only thrombocytopenia was an independent prognostic factor for 1-year mortality.
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Affiliation(s)
- Jeong Ha Mok
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 49241, Korea
| | - Yang Hee Kim
- Department of Respiratory Prevention and Management, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan, 49241, Korea
| | - Eun Suk Jeong
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 49241, Korea
| | - Jung Seop Eom
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 49241, Korea
| | - Mi Hyun Kim
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 49241, Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 49241, Korea
| | - Min Ki Lee
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 49241, Korea
| | - Kwangha Lee
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 49241, Korea.
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Park HK, Park MK, Kim KU, Kang SA, Park SK, Ahn SC, Kim DH, Yu HS. Evaluation of allergic sensitivity to Acanthamoeba allergen in patients with chronic cough. Allergy Asthma Proc 2016; 37:141-7. [PMID: 26932171 DOI: 10.2500/aap.2016.37.3922] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Acanthamoeba and their proteins can elicit severe allergic airway inflammation in experimental mice. OBJECTIVE Although Acanthamoeba can induce severe allergic airway inflammation in mice, there is no allergenicity data for humans. METHODS We performed a skin-prick test on 65 patients with chronic cough by using 54 previously known allergens and Acanthamoeba excretory-secretory proteins and enzyme-linked immunosorbent assay on 34 patients to evaluate Acanthamoeba-specific serum immunoglobulin (Ig) levels. To detect a novel Acanthamoeba allergen, Western blot analysis was performed on serum from patients who reacted positively to Acanthamoeba or some pollen allergens. RESULTS After skin-prick testing, 29 patients (44.6%) showed positive reactions to one or more common aeroallergens. Acanthamoeba allergenicity was evaluated in 4 of 65 subjects (6.1%). An Acanthamoeba-positive reaction was closely related to several pollen allergens, especially willow tree, poplar, elm, oak, velvet grass, and cockroach. Average levels of Acanthamoeba-specific IgG subtypes in patient serum did not differ compared with healthy subjects; however, Acanthamoeba-specific IgE titers of patients were significantly higher than in healthy subjects. IgE antibodies of patients who tested positive in the skin-prick test reacted strongly to the 15 kDa excretory-secretory protein. Moreover, these antigens also reacted with those who tested positive in the skin-prick test to pollens. CONCLUSION Taken together, our results indicated that some patients with allergy showed a positive response to the skin-prick test and that they also have high IgE serum levels. However, further experimental investigation is warranted because our preliminary findings indicated that Acanthamoeba might be a new allergen in humans.
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Affiliation(s)
- Hye-Kyung Park
- Department of Internal Medicine, Pusan National University College of Medicine, South Korea
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Kim DC, Kim KU, Kim YZ. Prognostic Role of Methylation Status of the MGMT Promoter Determined Quantitatively by Pyrosequencing in Glioblastoma Patients. J Korean Neurosurg Soc 2016; 59:26-36. [PMID: 26885283 PMCID: PMC4754584 DOI: 10.3340/jkns.2016.59.1.26] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Revised: 09/21/2015] [Accepted: 10/28/2015] [Indexed: 11/27/2022] Open
Abstract
Objective This study investigated whether pyrosequencing can be used to determine the methylation status of the MGMT promoter as a clinical biomarker using relatively old archival tissue samples of glioblastoma. We also examined other prognostic factors for survival of glioblastoma patients. Methods The available study set included formalin-fixed paraffin-embedded (FFPE) tissue from 104 patients at two institutes from 1997 to 2012, all of which were diagnosed histopathologically as glioblastoma. Clinicopathologic data were collected by review of medical records. For pyrosequencing analysis, the PyroMark Q96 CpG MGMT kit (Qiagen, Hilden, Germany) was used to detect the level of methylation at exon 1 positions 17–39 of the MGMT gene, which contains 5 CpGs. Results Methylation of the MGMT promoter was detected in 43 (41.3%) of 104 samples. The average percentage methylation was 14.0±16.8% overall and 39.0±14.7% for methylated cases. There was no significant pattern of linear increase or decrease according to the age of the FFPE block (p=0.687). In multivariate analysis, age, performance status, extent of surgery, method of adjuvant therapy, and methylation status estimated by pyrosequencing were independently associated with overall survival. Additionally, patients with a high level of methylation survived longer than those with low methylation (p=0.016). Conclusion In this study, the status and extent of methylation of the MGMT promoter analyzed by pyrosequencing were associated with overall survival in glioblastoma patients. Pyrosequencing is a quantitative method that overcomes the problems of MSP and a simple technique for accurate analysis of DNA sequences.
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Affiliation(s)
- Dae Cheol Kim
- Department of Pathology, Dong-A University College of Medicine, Busan, Korea
| | - Ki Uk Kim
- Department of Neurosurgery, Dong-A University College of Medicine, Busan, Korea
| | - Young Zoon Kim
- Division of Neurooncology, Department of Neurosurgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
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Eom JS, Mok JH, Lee MK, Lee K, Kim MJ, Jang SM, Na HJ, Song SE, Lee G, Jo EJ, Kim MH, Kim KU, Park HK. Efficacy of TB-PCR using EBUS-TBNA samples in patients with intrathoracic granulomatous lymphadenopathy. BMC Pulm Med 2015; 15:166. [PMID: 26710846 PMCID: PMC4693414 DOI: 10.1186/s12890-015-0162-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 12/15/2015] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is widely used to perform mediastinal lymph node sampling. However, little information is available on polymerase chain reaction for Mycobacterium tuberculosis (TB-PCR) using EBUS-TBNA samples in patients with intrathoracic granulomatous lymphadenopathy (IGL). METHODS A retrospective study using a prospectively collected database was performed from January 2010 to December 2014 to evaluate the efficacy of the TB-PCR test using EBUS-TBNA samples in patients with IGL. During the study period, 87 consecutive patients with isolated intrathoracic lymphadenopathy who received EBUS-TBNA were registered and 46 patients with IGL were included. RESULTS Of the 46 patients with IGL, tuberculous lymphadenitis and sarcoidosis were diagnosed in 16 and 30 patients, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of TB-PCR for tuberculous lymphadenitis were 56, 100, 100, and 81%, respectively. The overall diagnostic accuracy of TB-PCR for tuberculous lymphadenitis was 85%. In addition, seven (17%) patients had non-diagnostic results from a histological examination and all of them had non-diagnostic microbiological results of an acid-fast bacilli smear and culture. Four (57%) of the seven patients with non-diagnostic results had positive TB-PCR results, and anti-tuberculosis treatment led to clinical and radiological improvement in all of the patients. CONCLUSIONS TB-PCR using EBUS-TBNA samples is a useful laboratory test for diagnosing IGL. Moreover, this technique can prevent further invasive evaluation in patients whose histological and microbiological tests are non-diagnostic.
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Affiliation(s)
- Jung Seop Eom
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea. .,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
| | - Jeong Ha Mok
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea. .,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
| | - Min Ki Lee
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea. .,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
| | - Kwangha Lee
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea.
| | - Min Ji Kim
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea.
| | - Sun Mi Jang
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea.
| | - Hae Jung Na
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea.
| | - Seung Eon Song
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea.
| | - Geewon Lee
- Department of Radiology, Pusan National University School of Medicine, Busan, Korea.
| | - Eun-Jung Jo
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea.
| | - Mi-Hyun Kim
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea.
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea.
| | - Hye-Kyung Park
- Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea.
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Mok JH, Eom JS, Jo EJ, Kim MH, Lee K, Kim KU, Park HK, Yi J, Lee MK. Clinical utility of rapid pathogen identification using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry in ventilated patients with pneumonia: A pilot study. Respirology 2015; 21:321-8. [PMID: 26545565 DOI: 10.1111/resp.12677] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Revised: 07/20/2015] [Accepted: 08/23/2015] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND OBJECTIVE We evaluated the clinical utility of rapid identification of microorganisms in bronchoalveolar lavage (BAL) fluid using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) in terms of the clinical outcomes of ventilated patients with pneumonia. METHODS Patients for whom microorganisms were identified via MALDI-TOF MS (from March 2013 to February 2014; post-intervention group) were compared with patients for whom microorganisms were identified using conventional methods (from March 2012 to February 2013; pre-intervention group). All pneumonia types (community-acquired, hospital-acquired, healthcare-associated and ventilator-associated pneumonia) were included in the analysis. RESULTS In total, 77 patients (50 men, mean age 67.2 ± 12.5 years) were included (40 patients in the pre-intervention group and 37 in the post-intervention group). The time from BAL fluid collection to microorganism identification and the availability of antimicrobial susceptibility results was shorter in the post- compared with the pre-intervention group (51.9 ± 11.3 vs 67.3 ± 17.4 h, P < 0.001). Also, the time from BAL fluid collection to adjustment of antibiotic therapy was shorter in the post-intervention group (56.5 ± 10.9 vs 73.2 ± 18.5 h, P < 0.001). Microorganism identification via MALDI-TOF MS was independently associated with a shorter intensive care unit (ICU) stay after BAL fluid was drawn (hazard ratio = 2.324, P = 0.007). CONCLUSION Rapid identification of microorganisms in BAL fluid via MALDI-TOF MS was associated with adjustment of antibiotic therapy and a shorter ICU stay after BAL fluid was collected from ventilated patients with pneumonia.
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Affiliation(s)
- Jeong Ha Mok
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jung Seop Eom
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Eun Jung Jo
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Mi Hyun Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Kwangha Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Hye-Kyung Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Jongyoun Yi
- Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Min Ki Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
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Kim DC, Song YJ, Lee EH, Kim KU, Kim YZ. MPTH-14PROGNOSTIC ROLE OF METHYLATION STATUS OF MGMT PROMOTER ON GLIOBLASTOMA PATIENTS ESTIMATED QUANTITATIVELY BY PYROSEQUENCING. Neuro Oncol 2015. [DOI: 10.1093/neuonc/nov222.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lee KM, Jang SM, Oh SY, Kim DY, Lee G, Kim A, Kim MJ, Kim TH, Park JW, Lee K, Kim KU, Lee MK, Eom JS. The Natural Course of Endobronchial Inflammatory Polyps as a Complication after Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration. Tuberc Respir Dis (Seoul) 2015; 78:419-22. [PMID: 26508937 PMCID: PMC4620343 DOI: 10.4046/trd.2015.78.4.419] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Revised: 06/11/2015] [Accepted: 06/29/2015] [Indexed: 02/01/2023] Open
Abstract
We presented a case of unusual endobronchial inflammatory polyps as a complication following endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in a patient with tuberculous lymphadenitis. EBUS-TBNA of the right hilar lymph node was performed in a 29-year-old, previously healthy man. The patient was confirmed with tuberculous lymphadenitis and received antituberculosis medication over the course of 6 months. Chest computed tomography, after 6 months of antituberculosis therapy following the EBUS-TBNA showed nodular bronchial wall thickening of the right main bronchus. Histological and microbiological examinations revealed inflammatory polyps. After 7 months, the inflammatory polyps regressed almost completely without need for removal.
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Affiliation(s)
- Kyu Min Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Sun Mi Jang
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Seo Young Oh
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Do Young Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Geewon Lee
- Department of Radiology, Pusan National University School of Medicine, Busan, Korea
| | - Ahrong Kim
- Department of Pathology, Pusan National University School of Medicine, Busan, Korea
| | - Min Ji Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Tae Hwa Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Joon Woo Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Kwangha Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Min Ki Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Jung Seop Eom
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
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