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Kim TH, Choi JH, Ahn MS, Lee HW, Kang SY, Choi YW, Koh YW, Sheen SS. Differential efficacy of tyrosine kinase inhibitors according to the types of EGFR mutations and agents in non-small cell lung cancer: a real-world study. BMC Cancer 2024; 24:70. [PMID: 38216948 PMCID: PMC10787420 DOI: 10.1186/s12885-023-11782-6] [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: 06/20/2023] [Accepted: 12/21/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Both first and second-generation EGFR-TKIs are recommended in advanced NSCLC with common EGFR mutations. However, there are few data on the difference in efficacy of EGFR-TKIs based on the type of EGFR mutation and agents. METHODS This retrospective real-world study evaluated the outcomes and clinicopathologic characteristics, including the type of EGFR mutations, of 237 advanced NSCLC patients treated with first- or second-generation (afatinib) EGFR-TKIs as first-line therapy. RESULTS The median progression-free survival (PFS) and overall survival (OS) of all patients were 11 months (M) and 25M, respectively. In the univariate analysis, patients with exon 19 deletion (del) (n=130) had significantly longer median OS compared to those with other mutations (L858R: 84, others: 23) (30 vs. 22 M, p=0.047), without a difference in PFS (p=0.138). Patients treated with afatinib (n=60) showed significantly longer median OS compared to those treated with first-generation TKIs (gefitinib: 159, erlotinib: 18) (30 vs. 23 M, p=0.037), without a difference in PFS (p=0.179). In patients with exon 19 del, there was no significant difference in median PFS (p=0.868) or OS (p=0.361) between patients treated with afatinib and those treated with first-generation TKIs, while significantly better PFS (p=0.042) and trend in OS (p=0.069) were observed in patients receiving afatinib in other mutations. Exon 19 del was independently associated with favorable OS (p=0.028), while age >70 years (p=0.017), ECOG performance status ≥2 (p=0.001), primary metastatic disease (p=0.007), and synchronous brain metastasis (p=0.026) were independent prognostic factors of poor OS. CONCLUSIONS The EGFR exon 19 del was associated with favorable OS in advanced NSCLC patients receiving first-line EGFR-TKIs. Moreover, in patients with exon 19 del, first-generation TKIs seem to be a reasonable treatment option if osimertinib is unavailable.
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Affiliation(s)
- Tae-Hwan Kim
- Departments of Hematology-Oncology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Gyeonggi-do, Korea
| | - Jin-Hyuk Choi
- Departments of Hematology-Oncology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Gyeonggi-do, Korea
| | - Mi Sun Ahn
- Departments of Hematology-Oncology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Gyeonggi-do, Korea
| | - Hyun Woo Lee
- Departments of Hematology-Oncology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Gyeonggi-do, Korea
| | - Seok Yun Kang
- Departments of Hematology-Oncology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Gyeonggi-do, Korea
| | - Yong Won Choi
- Departments of Hematology-Oncology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Gyeonggi-do, Korea.
| | - Young Wha Koh
- Departments of Pathology, Ajou University School of Medicine, 164 World cup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, Korea
| | - Seung-Soo Sheen
- Departments of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, 164 World cup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, Korea
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Kim TH, Choi JH, Jeon SM, Choi YW, Kwon M, Lee HW, Kang SY, Ahn MS, Son SY, Hur H, Han SU, Sheen SS. Thromboembolic events in patients who received adjuvant chemotherapy for gastric cancer: a single-center retrospective study. Gastric Cancer 2023; 26:1012-1019. [PMID: 37648892 DOI: 10.1007/s10120-023-01415-z] [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: 05/26/2023] [Accepted: 07/20/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Thromboembolic events (TEEs) are significant adverse events that can cause serious morbidities and mortality in cancer patients receiving chemotherapy. Patients with gastric cancer (GC) treated with palliative chemotherapy have been reported to experience a TEE incidence of 5-27%. However, very few reports have addressed TEEs in adjuvant chemotherapy (AC) for GC. METHODS This study retrospectively analyzed 611 GC patients (stage II: 309, III: 302) who started AC with capecitabine/oxaliplatin (167 patients) or S-1 (444 patients) after undergoing curative resection between January 2013 and June 2020 at a single center. The incidence of TEEs during AC or within 1 year after AC completion was investigated, while analyzing the factors that influenced the TEEs' occurrence. RESULTS TEEs were confirmed in 20 patients (3.3%), and TEEs occurred in almost all patients in the S-1 group (19 patients). The most common TEE types were cerebral infarction and pulmonary thromboembolism (five patients each). Although old age (≥ 70 years, p < 0.0001), S-1 treatment (p = 0.021), and hypertension (p = 0.017) were identified as significant risk factors for TEEs in univariate analysis, only old age showed a statistically significant correlation with TEEs' occurrence in multivariate analysis (odds ratio: 3.07; 95% confidence interval 1.11-8.48; p = 0.031). CONCLUSIONS TEEs occurred in fewer patients with GC who had been treated with AC than patients who had received palliative chemotherapy in previous reports. However, elderly GC patients who are undergoing AC require more careful surveillance for possible TEEs, considering relatively higher incidence of them.
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Affiliation(s)
- Tae-Hwan Kim
- Department of Hematology-Oncology, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Korea
| | - Jin-Hyuk Choi
- Department of Hematology-Oncology, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Korea
| | - Sang Min Jeon
- Department of Hematology-Oncology, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Korea
| | - Yong Won Choi
- Department of Hematology-Oncology, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Korea
| | - Minsuk Kwon
- Department of Hematology-Oncology, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Korea
| | - Hyun Woo Lee
- Department of Hematology-Oncology, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Korea
| | - Seok Yun Kang
- Department of Hematology-Oncology, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Korea
| | - Mi Sun Ahn
- Department of Hematology-Oncology, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Korea.
| | - Sang-Yong Son
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Hoon Hur
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Sang-Uk Han
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Seung-Soo Sheen
- Department of Pulmonology and Critical Care Medicine, Ajou University School of Medicine, Suwon, Korea
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Seo HJ, Kim SY, Park D, Sheen SS, Choi M, Jang BH, Lee SJ, Cha Y. Peer support for smoking cessation: a protocol of systematic review and meta-analysis. Syst Rev 2021; 10:296. [PMID: 34772455 PMCID: PMC8590240 DOI: 10.1186/s13643-021-01850-y] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 10/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Peer-support programs are a useful social support strategy for populations trying to quit smoking who are willing to maintain smoking abstinence. This study is a protocol for a systematic review and meta-analysis to assess the effectiveness of peer support for smoking cessation. METHODS This protocol will be conducted in accordance with the Cochrane Handbook of Systematic Reviews of Interventions 6.2. We will conduct a comprehensive search in the Cochrane Central Register of Controlled Trials, ovidEmbase, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, ovidMEDLINE, Google Scholar, and Open Grey, as well as the Trials Register of Promoting Health Interventions in EPPI-Centre, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform, and reference lists of included papers. The review will include randomized controlled trials of peer support interventions aimed to stop smoking in any population. Two reviewers will independently screen and select relevant studies. Version 2 of the Cochrane tool that assesses risk of bias in randomized trials will be used to assess the risk of bias in the included studies. The primary outcomes will be defined as the tobacco abstinence rate and adverse events. If a quantitative synthesis is not appropriate, a synthesis without meta-analysis will be undertaken. DISCUSSION This review will provide the best available evidence regarding the effects of peer support interventions to quit smoking. The results from this study will help to inform healthcare providers on the optimal peer support intervention modalities such as intensity, delivery methods, type of support provider, and duration of the intervention. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020196288.
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Affiliation(s)
- Hyun-Ju Seo
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea
| | - Soo Young Kim
- Department of Family Medicine, College of Medicine, Hallym University, Seoul, Republic of Korea. .,Kangdong Sacred Heart Hospital, 445 Gil-Dong, Gangdong-Gu, Seoul, 05354, Republic of Korea.
| | - Dongah Park
- National Evidence-based Healthcare Collaborating Agency, Seoul, Republic of Korea
| | - Seung-Soo Sheen
- Department of Pulmonology, Ajou University Hospital, Suwon, Republic of Korea
| | - Miyoung Choi
- National Evidence-based Healthcare Collaborating Agency, Seoul, Republic of Korea
| | - Bo-Hyoung Jang
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Su Jung Lee
- College of Nursing, Korea University, Seoul, Republic of Korea
| | - Youngju Cha
- Regulatory Site Service, Covance Korea, Seoul, Republic of Korea
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Lee KS, Chung WY, Park JE, Jung YJ, Park JH, Sheen SS, Park KJ. Interferon-γ-Inducible Chemokines as Prognostic Markers for Lung Cancer. Int J Environ Res Public Health 2021; 18:ijerph18179345. [PMID: 34501934 PMCID: PMC8431216 DOI: 10.3390/ijerph18179345] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 11/16/2022]
Abstract
Interferon (IFN)-γ-inducible chemokines in the CXCR3/ligand axis are involved in cell-mediated immunity and play a significant role in the progression of cancer. We enrolled patients with lung cancer (n = 144) and healthy volunteers as the controls (n = 140). Initial blood samples were collected and concentrations of IFN-γ and IFN-γ-inducible chemokines CXCL9, CXCL10, and CXCL11 were measured using enzyme-linked immunosorbent assay. Of patients with lung cancer, 125 had non-small cell lung cancer (NSCLC) and 19 had small cell lung cancer. The area under the curve (AUC) (95% CI) of CXCL9 was 0.83 (0.80-0.89) for differentiating lung cancer patients from controls. The levels of all the markers were significantly higher in NSCLC patients with stage IV than in those with stages I-III. A Kaplan-Meier survival analysis showed that NSCLC cancer patients with higher levels of all markers showed poorer survival than those with lower levels. In Cox multivariate analysis of patients with NSCLC, independent prognostic factors for overall survival were CXCL9 and CXCL11. CXCL9 was the only independent prognostic factor for cancer-specific survival. Serum IFN-γ-inducible chemokines may be useful as clinical markers of metastasis and prognosis in NSCLC, and CXCL9 levels showed the most significant results.
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Chung WY, Lee KS, Park JH, Jung YJ, Sheen SS, Park JE, Sun JS, Ko YH, Park KJ. TB Antigen-Stimulated CXCR3 Ligand Assay for Diagnosis of Tuberculous Lymphadenitis. Int J Environ Res Public Health 2021; 18:ijerph18158020. [PMID: 34360313 PMCID: PMC8345678 DOI: 10.3390/ijerph18158020] [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] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/23/2021] [Accepted: 07/25/2021] [Indexed: 12/21/2022]
Abstract
The diagnosis of tuberculous lymphadenitis (TB-LAP) is challenging. We evaluated the role of blood CXC chemokine receptor 3 (CXCR3) ligands in its diagnosis. A total of 65 lymphadenopathy patients were enrolled and lymph node sampling was performed. We also recruited 113 control subjects, consisting of 27 with positive results and 86 with negative results, in the interferon (IFN)-γ release assay (IGRA). In all study subjects, whole-blood samples were collected using the IGRA methodology. After incubation, plasma levels of IFN-γ and two CXCR3 ligands, IFN-inducible T-cell a chemoattractant (I-TAC) and monokine induced by IFN-γ (MIG), were measured using immunoassay. Fifty-three TB-LAP patients were enrolled. TB antigen-stimulated IFN-γ, I-TAC, and MIG levels were all significantly higher in the TB-LAP patients than in the controls and non-TB-LAP patients. The levels of I-TAC and MIG, but not IFN-γ, showed significant differences between the TB-LAP patients and IGRA-positive controls. Area under the receiver operating characteristic curves (AUROCs) of IFN-γ, I-TAC, and MIG were 0.955, 0.958, and 0.959, respectively, for differentiating TB-LAP from control group, and were 0.912, 0.956, and 0.936, respectively, for differentiating TB-LAP from non-TB-LAP. In conclusion, the TB antigen-stimulated MIG and I-TAC could be useful biomarkers in the diagnosis of TB-LAP.
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Affiliation(s)
- Wou-Young Chung
- Department of Pulmonology and Critical Care Medicine, Ajou University Hospital, Suwon 16499, Korea; (W.-Y.C.); (K.-S.L.); (J.-H.P.); (Y.-J.J.); (S.-S.S.); (J.-E.P.)
| | - Keu-Sung Lee
- Department of Pulmonology and Critical Care Medicine, Ajou University Hospital, Suwon 16499, Korea; (W.-Y.C.); (K.-S.L.); (J.-H.P.); (Y.-J.J.); (S.-S.S.); (J.-E.P.)
| | - Joo-Hun Park
- Department of Pulmonology and Critical Care Medicine, Ajou University Hospital, Suwon 16499, Korea; (W.-Y.C.); (K.-S.L.); (J.-H.P.); (Y.-J.J.); (S.-S.S.); (J.-E.P.)
| | - Yun-Jung Jung
- Department of Pulmonology and Critical Care Medicine, Ajou University Hospital, Suwon 16499, Korea; (W.-Y.C.); (K.-S.L.); (J.-H.P.); (Y.-J.J.); (S.-S.S.); (J.-E.P.)
| | - Seung-Soo Sheen
- Department of Pulmonology and Critical Care Medicine, Ajou University Hospital, Suwon 16499, Korea; (W.-Y.C.); (K.-S.L.); (J.-H.P.); (Y.-J.J.); (S.-S.S.); (J.-E.P.)
| | - Ji-Eun Park
- Department of Pulmonology and Critical Care Medicine, Ajou University Hospital, Suwon 16499, Korea; (W.-Y.C.); (K.-S.L.); (J.-H.P.); (Y.-J.J.); (S.-S.S.); (J.-E.P.)
| | - Joo-Sung Sun
- Department of Radiology, Ajou University Hospital, Suwon 16499, Korea;
| | - Young-Hwa Ko
- Department of Pathology, Ajou University Hospital, Suwon 16499, Korea;
| | - Kwang-Joo Park
- Department of Pulmonology and Critical Care Medicine, Ajou University Hospital, Suwon 16499, Korea; (W.-Y.C.); (K.-S.L.); (J.-H.P.); (Y.-J.J.); (S.-S.S.); (J.-E.P.)
- Correspondence: ; Tel.: +82-31-219-5120
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Sheen SS, Kim HJ, Singh D, Hwang SC, Park KJ, Ahn SV, Lee E, Park B, Jung JH, Park RW, Kim JH, Park HS, Park JH. Airflow limitation as a risk factor for vascular stiffness. Int J Tuberc Lung Dis 2021; 24:577-584. [PMID: 32552994 DOI: 10.5588/ijtld.19.0457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Cardiovascular disease is one of the main causes of mortality in patients with chronic obstructive pulmonary disease (COPD), and atherosclerosis is a cause of cardiac comorbidities in COPD. However, it is not clear whether airflow limitation is associated with atherosclerosis irrespective of smoking.OBJECTIVE: To investigate whether airflow limitation is independently associated with vascular stiffness.METHODS: We enrolled 18 893 participants (male 70.5%; mean age 47.5 ± 9.8 years; never smokers 44.2%) who underwent spirometry and brachial-ankle pulse wave velocity (baPWV) as part of a standard health examination at Ajou University Hospital, Suwon, South Korea, from January 2010 to December 2015.We defined vascular peripheral atherosclerosis as baPWV ≥ 1400 cm/s and airflow limitation as pre-bronchodilator ratio of forced expiratory volume in 1 sec (FEV1) to forced vital capacity (FVC) <70%.RESULTS: Mean baPWV was higher in subjects with airflow limitation (1477.6 ± 331.7 cm/sec, n = 638) than in those without airflow limitation (1344.1 ± 231.8 cm/sec, n = 18255, P < 0.001). In multivariate logistic regression analysis, the following were independent predictors associated with peripheral atherosclerosis (P < 0.05): age, male sex, fasting serum glucose, mean blood pressure, serum leukocyte count, serum low density lipoprotein level and FEV1.CONCLUSION: Airflow limitation was an independent predictor of vascular stiffness irrespective of smoking history, which suggests that airflow limitation is linked with atherosclerosis.
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Affiliation(s)
- S S Sheen
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, South Korea
| | - H J Kim
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, South Korea
| | - D Singh
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester and University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
| | - S C Hwang
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, South Korea
| | - K J Park
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, South Korea
| | - S V Ahn
- Department of Health Convergence, Ewha Woman's University, Seoul
| | - E Lee
- Department of Biomedical Informatics
| | - B Park
- Department of Biomedical Informatics
| | - J H Jung
- Department of Biomedical Informatics
| | - R W Park
- Department of Biomedical Informatics
| | - J H Kim
- Department of Gastroenterology
| | - H-S Park
- Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea
| | - J H Park
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, South Korea
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Kim TH, Do Cho H, Choi YW, Lee HW, Kang SY, Jeong GS, Choi JH, Ahn MS, Sheen SS. Trastuzumab-based palliative chemotherapy for HER2-positive gastric cancer: a single-center real-world data. BMC Cancer 2021; 21:325. [PMID: 33771119 PMCID: PMC7995795 DOI: 10.1186/s12885-021-08058-2] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/15/2021] [Indexed: 12/12/2022] Open
Abstract
Background Since the results of the ToGA trial were published, trastuzumab-based chemotherapy has been used as the standard first-line treatment for HER2-positive recurrent or primary metastatic gastric cancer (RPMGC). However, the real-world data has been rarely reported. Therefore, we investigated the outcomes of trastuzumab-based chemotherapy in a single center. Methods This study analyzed the real-world data of 47 patients with HER2-positive RPMGC treated with trastuzumab-based chemotherapy in a single institution. Results With the median follow-up duration of 18.8 months in survivors, the median overall survival (OS) and progression-free survival were 12.8 and 6.9 months, respectively, and the overall response rate was 64%. Eastern Cooperative Oncology Group performance status 2 and massive amount of ascites were independent poor prognostic factors for OS, while surgical resection before or after chemotherapy was associated with favorable OS, in multivariate analysis. In addition, 5 patients who underwent conversion surgery after chemotherapy demonstrated an encouraging median OS of 30.8 months, all with R0 resection. Conclusions Trastuzumab-based chemotherapy in patients with HER2-positive RPMGC in the real world demonstrated outcomes almost comparable to those of the ToGA trial. Moreover, conversion surgery can be actively considered in fit patients with a favorable response after trastuzumab-based chemotherapy.
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Affiliation(s)
- Tae-Hwan Kim
- Department of Hematology-Oncology, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, 443-380, South Korea
| | - Hun Do Cho
- Department of Hematology-Oncology, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, 443-380, South Korea
| | - Yong Won Choi
- Department of Hematology-Oncology, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, 443-380, South Korea
| | - Hyun Woo Lee
- Department of Hematology-Oncology, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, 443-380, South Korea
| | - Seok Yun Kang
- Department of Hematology-Oncology, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, 443-380, South Korea
| | - Geum Sook Jeong
- Department of Hematology-Oncology, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, 443-380, South Korea
| | - Jin-Hyuk Choi
- Department of Hematology-Oncology, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, 443-380, South Korea.
| | - Mi Sun Ahn
- Department of Hematology-Oncology, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, 443-380, South Korea.
| | - Seung-Soo Sheen
- Department of Pulmonology and Critical Care Medicine, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, 443-380, South Korea
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Abstract
Background: Because type 2 diabetes mellitus is a critical health problem with increasing incidence, prevalence, and complications worldwide, e-health has been widely utilized for management in type 2 diabetes. Introduction: This scoping review of meta-analyses and systematic reviews on e-health interventions aimed to examine service platforms, program types, outcomes, current status of research activities, research gaps, and the effectiveness of type 2 diabetes self-care management among community-dwelling adults. Materials and Methods: Arksey and O'Malley's method was adopted for this review. The Ovid MEDLINE and Ovid EMBASE databases were searched from inception until April 2018. Two reviewers independently screened, selected, and charted studies using a piloted charting form. Discrepancies were resolved by consensus, and results were collated, summarized, and thematically analyzed. Results: The final studies (N = 81) related to e-health interventions included systematic reviews/meta-analyses on clinical effectiveness (n = 64), usability (n = 14), and behavioral outcomes (n = 47). The commonest e-health intervention subtypes for type 2 diabetes care were patient monitoring (53/163, 32.5%), treatment adherence (50/163, 30.7%), and diabetes-related advice/education (34/163, 20.9%). Mobile devices were most often used to provide e-health services (57/142, 40.1%), followed by the internet (41/142, 28.9%). The e-health strategy that was effective in controlling blood glucose in type 2 diabetes patients was a multimodal intervention comprising treatment advice or education, treatment adherence or reminder methods, and patient monitoring. Treatment adherence or reminder methods and/or patient monitoring showed behavioral effects, but the usability of e-health interventions was controversial. Conclusions: We suggest that e-health intervention should be complex intervention including treatment advice/education, patient monitoring, and treatment adherence or reminder methods.
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Affiliation(s)
- Hyun-Ju Seo
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea
| | - Soo Young Kim
- Department of Family Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Seung-Soo Sheen
- Department of Pulmonology, Ajou University Hospital, Suwon, Republic of Korea
| | - Youngju Cha
- Regulatory Site Service, Covance Korea, Seoul, Republic of Korea
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Park SJ, Lim HS, Sheen SS, Yang HM, Seo KW, Choi SY, Choi BJ, Yoon MH, Tahk SJ. Impact of body fat distribution on long-term clinical outcomes after drug-eluting stent implantation. PLoS One 2018; 13:e0197991. [PMID: 29799868 PMCID: PMC5969753 DOI: 10.1371/journal.pone.0197991] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 05/11/2018] [Indexed: 12/15/2022] Open
Abstract
Background and objective The distribution of body fat is closely related to cardiovascular disease and outcomes, although its impact on patient prognosis after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) has not been evaluated. We investigated the impact of truncal fat distribution on long-term clinical outcomes after DES treatment. Methods In 441 DES-treated patients, dual energy X-ray absorptiometry was performed to assess total and regional body fat distribution after index PCI. The ratio of truncal fat to total body fat mass (%FMtrunk/FMtotal) was calculated as a representative parameter for truncal fat distribution. The primary endpoint was major adverse cardiac events (MACE), a composite of ischemia-driven target vessel revascularization (TVR), non-procedural myocardial infarction, cardiac death at 5 years. Results During the median follow-up duration of 1780 days, MACE occurred in 22.0% of patients, with the highest-quartile group of %FMtrunk/FMtotal having a higher rate than the lowest quartile group (27.8% vs. 15.3%; log rank p = 0.026). The difference was driven by a higher rate of ischemia-driven TVR (25.9% vs. 9.9%; log rank p = 0.008). In multivariable Cox regression analyses, %FMtrunk/FMtotal was independently associated with MACE (hazard ratio: 1.075; 95% CI: 1.022–1.131; p = 0.005), but body mass index (BMI) was not. Conclusions In DES-treated patients, truncal fat distribution is associated with unfavorable clinical outcomes and is more clinically relevant than BMI.
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Affiliation(s)
- Se-Jun Park
- Division of Cardiology, Cardiovascular Center, Chun-Cheon Sacred Heart Hospital, Hallym University College of Medicine, Chun-Cheon, Republic of Korea
| | - Hong-Seok Lim
- Department of Cardiology, Ajou University School of Medicine, Suwon, Republic of Korea
- * E-mail:
| | - Seung-Soo Sheen
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Hyoung-Mo Yang
- Department of Cardiology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Kyoung-Woo Seo
- Department of Cardiology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - So-Yeon Choi
- Department of Cardiology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Byoung-Joo Choi
- Department of Cardiology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Myeong-Ho Yoon
- Department of Cardiology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Seung-Jea Tahk
- Department of Cardiology, Ajou University School of Medicine, Suwon, Republic of Korea
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Park SJ, Yang HM, Seo KW, Choi SY, Choi BJ, Yoon MH, Hwang GS, Tahk SJ, Sheen SS, Choi BIW, Lim HS. The relationship between coronary atherosclerosis and body fat distribution measured using dual energy X-ray absorptiometry. Atherosclerosis 2016; 248:190-5. [PMID: 27018543 DOI: 10.1016/j.atherosclerosis.2016.03.014] [Citation(s) in RCA: 7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 02/24/2016] [Accepted: 03/10/2016] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Body fat distribution is closely related to cardiovascular diseases. We aimed to evaluate the relationship between truncal fat distribution and the extent of coronary atherosclerosis. METHODS Total body fat and regional body fat distributions were measured using dual-energy X-ray absorptiometry (DXA) in 746 Korean patients who underwent coronary angiography. The ratios of truncal fat mass to total body fat mass (FMtrunk/FMtotal), truncal fat mass to fat mass in both legs (FMtrunk/FMleg) and truncal fat mass to fat mass in both arms (FMtrunk/FMarm) were calculated as representative parameters for truncal fat accumulation. The extent of coronary atherosclerosis was assessed using the Gensini score. RESULTS The mean Gensini score of the patients was 21.3 ± 24.4. FMtrunk/FMtotal, FMtrunk/FMleg and FMtrunk/FMarm revealed positive correlations with the Gensini score (r = 0.242, p < 0.001; r = 0.219, p < 0.001; r = 0.133, p < 0.001, respectively). In contrast, body mass index (BMI) and total body fat mass did not correlate with the Gensini score. On multiple regression analysis, FMtrunk/FMtotal was associated with the Gensini score independently of age, gender, BMI and major risk factors of coronary heart disease (B = 0.039, p < 0.001). CONCLUSION Truncal fat distribution is associated with the extent of coronary atherosclerosis and more clinically relevant to that compared with total body fat or BMI in Korean patients.
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Affiliation(s)
- Se-Jun Park
- Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-Ro, Suwon 16499, Republic of Korea; Division of Cardiology, Cardiovascular Center, Chun-Cheon Sacred Heart Hospital, Hallym University College of Medicine, 77 Sakju-Ro, Chun-Cheon 24253, Republic of Korea
| | - Hyoung-Mo Yang
- Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-Ro, Suwon 16499, Republic of Korea
| | - Kyoung-Woo Seo
- Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-Ro, Suwon 16499, Republic of Korea
| | - So-Yeon Choi
- Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-Ro, Suwon 16499, Republic of Korea
| | - Byoung-Joo Choi
- Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-Ro, Suwon 16499, Republic of Korea
| | - Myeong-Ho Yoon
- Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-Ro, Suwon 16499, Republic of Korea
| | - Gyo-Seung Hwang
- Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-Ro, Suwon 16499, Republic of Korea
| | - Seung-Jea Tahk
- Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-Ro, Suwon 16499, Republic of Korea
| | - Seung-Soo Sheen
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, 164 Worldcup-Ro, Suwon 16499, Republic of Korea
| | - Byung-Il W Choi
- Department of Cardiology, Medical College of Wisconsin, Milwaukee, WI 53266, USA
| | - Hong-Seok Lim
- Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-Ro, Suwon 16499, Republic of Korea.
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Seo HJ, Kim SY, Lee YJ, Jang BH, Park JE, Sheen SS, Hahn SK. A newly developed tool for classifying study designs in systematic reviews of interventions and exposures showed substantial reliability and validity. J Clin Epidemiol 2016; 70:200-5. [DOI: 10.1016/j.jclinepi.2015.09.013] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 09/09/2015] [Accepted: 09/16/2015] [Indexed: 11/26/2022]
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12
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Sheen SS, Park RW, Yoon D, Shin GT, Kim H, Park IW. The Model for End-stage Liver Disease score is potentially a useful predictor of hyperkalemia occurrence among hospitalized angiotensin receptor blocker users. J Clin Pharm Ther 2014; 40:48-54. [PMID: 25328056 DOI: 10.1111/jcpt.12224] [Citation(s) in RCA: 3] [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: 11/28/2013] [Accepted: 09/17/2014] [Indexed: 12/28/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Angiotensin receptor blockers (ARBs) are medications commonly used for treating conditions such as hypertension. However, ARBs are frequently associated with hyperkalemia, a potentially critical adverse event, in high-risk patients. Although both the liver and the kidney are major elimination routes of ARBs, the relationship between hepatorenal function and ARB-related hyperkalemia has not yet been investigated. The purpose of this study was to evaluate the risk of hyperkalemia, in terms of various hepatorenal functions, for hospitalized patients newly initiated on ARB treatment. METHODS We evaluated ARB-related hyperkalemia in a cohort of 5530 hospitalized patients, who had not previously used ARBs, between 12 April 2004 and 31 May 2012. Hepatorenal function was assessed by the Model for End-stage Liver Disease (MELD) score. Hyperkalemia risk was assessed by hepatorenal function, risks were categorized into the four MELD scoring groups, and the groups were compared with one another. RESULTS AND DISCUSSION The MELD score was significantly different between the hyperkalemic and non-hyperkalemic groups (independent t-test, P < 0.001). The MELD score 10-14, 15-19 and ≥ 20 groups showed higher risks of hyperkalemia than the lowest MELD score group {log-rank test, P < 0.001; multiple Cox proportional hazard model, hazard ratios 1.478 (P = 0.003), 2.285 (P < 0.001) and 3.024 (P < 0.001), respectively}. WHAT IS NEW AND CONCLUSION The MELD score showed a stronger predictive performance for hyperkalemia than either serum creatinine or estimated glomerular filtration rate alone. Furthermore, the MELD score showed good predictive performance for ARB-related hyperkalemia among hospitalized patients. The clinical implications and reasons for these findings merit future investigation.
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Affiliation(s)
- S S Sheen
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Korea
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Park IW, Sheen SS, Yoon D, Lee SH, Shin GT, Kim H, Park RW. Onset time of hyperkalaemia after angiotensin receptor blocker initiation: when should we start serum potassium monitoring? J Clin Pharm Ther 2013; 39:61-8. [PMID: 24262001 DOI: 10.1111/jcpt.12109] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [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: 10/11/2013] [Accepted: 10/14/2013] [Indexed: 12/19/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Angiotensin receptor blockers (ARBs) frequently induce hyperkalaemia in high-risk patients. Early detection of hyperkalaemia can reduce the subsequent harmful effects. This study was performed to examine the onset time of hyperkalaemia after ARB therapy. METHODS We carried out a retrospective analysis to determine the onset time of hyperkalaemia (serum potassium >5·5 mm) among hospitalized patients newly starting ARB therapy between 2004 and 2012, in a tertiary teaching hospital. Predefined possible risk factors and concomitant medications were evaluated. RESULTS AND DISCUSSION During the 97-month study period, a total of 4267 hospitalized patients started ARBs as new drugs and 225 patients showed hyperkalaemia. A significantly increased risk of hyperkalaemia was detected among patients with a high baseline potassium [odds ratio (OR) 6·0] and those who took non-potassium-sparing diuretics (OR 2·2) or potassium supplements (OR 1·6). A high glomerular filtration rate (GFR) was associated with a lower risk of hyperkalaemia (OR 0·992). Fifty-two percentage of hyperkalaemic events occurred within the first week after initiation of ARB therapy. The highest frequency of hyperkalaemia occurred on the first day after initiation of ARBs. Hyperkalaemia occurred earlier in patients with a high baseline serum potassium level, reduced GFR, diabetes and in those without heart failure. WHAT IS NEW AND CONCLUSION Hyperkalaemia occurs most frequently at the beginning of ARB therapy in hospitalized patients. Monitoring of serum potassium and estimated GFR after initiation of ARBs should be started within a few days or not later than 1 week, especially in patients with risk factors.
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Affiliation(s)
- I-W Park
- Department of Nephrology, Ajou University School of Medicine, Suwon, Korea
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Lee JH, Oh YM, Seo JB, Lee YK, Kim WJ, Sheen SS, Kim TH, Lee JH, Kim EK, Lee JS, Huh JW, Lim SY, Yoon HI, Shin TR, Lee SM, Lee SY, Lee SD. Pulmonary artery pressure in chronic obstructive pulmonary disease without resting hypoxaemia. Int J Tuberc Lung Dis 2012; 15:830-7. [PMID: 21575307 DOI: 10.5588/ijtld.10.0598] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) can lead to pulmonary hypertension and cor pulmonale, which are predictors of mortality. OBJECTIVE To identify predictors of increased pulmonary artery pressure (PAP) in COPD patients without resting hypoxaemia, and to characterise COPD patients with increased PAP. DESIGN A study of 117 COPD patients from the Korean Obstructive Lung Disease (KOLD) cohort who had measurable tricuspid regurgitant flow under transthoracic Doppler echocardiography and no resting hypoxaemia. RESULTS The mean patient age was 67 years. Mean forced expiratory volume in 1 second (FEV(1)) was 47% predicted, mean haemoglobin (Hb) concentration was 145 g/l and mean systolic PAP (sPAP) was 33 mmHg. Multiple linear regression analysis showed that Hb was the only factor independently associated with sPAP (beta = -1.752, P = 0.005). Cluster analysis using FEV(1)% predicted, sPAP and Hb concentration as variables indicated three patient clusters: Cluster 1 (n = 36; mean FEV(1) 44% predicted, mean sPAP 39 mmHg, mean Hb 132 g/l), Cluster 2 (n = 45; FEV(1) 35% predicted, sPAP 31 mmHg, Hb 154 g/l), and Cluster 3 (n = 36; FEV(1) 65% predicted, sPAP 29 mmHg, Hb 148 g/l). CONCLUSION Elevated PAP was linked to low haemoglobin levels in COPD without resting hypoxaemia.
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Affiliation(s)
- J H Lee
- Department of Internal Medicine, Ewha Womans University School of Medicine, Ewha Medical Research Institute, Seoul, Republic of Korea
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Lee JS, Huh JW, Chae EJ, Seo JB, Ra SW, Lee JH, Kim EK, Lee YK, Kim TH, Kim WJ, Lee JH, Lee SM, Lee S, Lim SY, Shin TR, Yoon HI, Sheen SS, Oh YM, Lee SD. Different therapeutic responses in chronic obstructive pulmonary disease subgroups. Int J Tuberc Lung Dis 2011; 15:1104-10. [PMID: 21740676 DOI: 10.5588/ijtld.10.0553] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Eleven referring hospitals in South Korea. OBJECTIVE To compare therapeutic responses in chronic obstructive pulmonary disease (COPD) subgroups, classified by diffusing capacity of the lung for carbon monoxide (DL(CO)) and lung volume. DESIGN A total of 130 stable male COPD patients were classified into four subgroups according to baseline DL(CO) and residual volume/total lung capacity (RV/TLC) ratio. We compared therapeutic responses to short acting β(2)-agonist (SABA) and 3-month combined inhalation of long-acting β(2)-agonist (LABA) and corticosteroid among patients with these subgroups. RESULTS Among the 130 COPD patients, 41 (31.5%) had normal DL(CO) and RV/TLC, 28 (21.5%) low DL(CO) and normal RV/TLC, 31 (23.8%) normal DL(CO) and high RV/TLC, and 30 (23.1%) low DL(CO) and high RV/TLC. The normal DL(CO)/high RV/TLC subgroup showed a significantly larger flow response (changes in forced expiratory volume in 1 s) to salbutamol than the normal DL(CO)/RV/TLC subgroups, and a larger volume response (changes in forced vital capacity) than the two normal RV/TLC subgroups. The normal DL(CO)/high RV/TLC subgroup also showed significantly larger flow and volume response to 3-month combined inhalation of LABA and corticosteroid than the two normal RV/TLC subgroups. CONCLUSION COPD subgroups classified by DL(CO) and RV/TLC may have different pulmonary function responses to pharmacological treatment.
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Affiliation(s)
- J S Lee
- Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Seoul, South Korea
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Jo KW, Ra SW, Chae EJ, Seo JB, Kim NK, Lee JH, Kim EK, Lee YK, Kim TH, Huh JW, Kim WJ, Lee JH, Lee SM, Lim SY, Shin TR, Yoon HI, Sheen SS, Lee JS, Lee SD, Oh YM. Three phenotypes of obstructive lung disease in the elderly. Int J Tuberc Lung Dis 2010; 14:1481-1488. [PMID: 20937191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
SETTING Eleven referring hospitals in South Korea. OBJECTIVE To classify the phenotypes in elderly subjects with obstructive lung disease (OLD). METHODS We analysed 191 subjects aged ≥ 60 years with chronic respiratory symptoms and either obstructive spirometry or bronchial hyperresponsiveness. Factor analysis was performed using commonly measured variables and revealed four significant variables: 1) the ratio of inspiratory capacity to total lung capacity, 2) the total score on the St George's Respiratory Questionnaire, 3) the volume fraction of the lung less than 950 Hounsfield Unit at full inspiration on volumetric computed tomography and 4) post-bronchodilator forced expiratory volume in 1 second (FEV(1)) changes. We performed a cluster analysis on these four variables. RESULTS The mean age was 68.5 (± 5.2 SD) years and the mean post-bronchodilator FEV(1) was 52.4% (± 16.5) predicted. Three clusters with the following phenotypes were identified: Cluster 1 included subjects with moderate to severe airflow obstruction and bronchodilator reversibility; Cluster 2 subjects had moderate airflow obstruction without bronchodilator reversibility, and Cluster 3 subjects had severe airflow obstruction without bronchodilator reversibility. CONCLUSIONS We identified three phenotypes in elderly subjects with OLD. Follow-up studies are needed to explore the clinical significance of each phenotype.
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Affiliation(s)
- K-W Jo
- Department of Pulmonary and Critical Care Medicine & 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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Ji SM, Kim SY, Sheen SS, Heo DS, Kim NS. Consensus on definition and quality standard of clinical practice guideline using RAND method. Korean Journal of Health Policy and Administration 2010. [DOI: 10.4332/kjhpa.2010.20.2.001] [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: 10/19/2022] Open
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Hur GY, Choi GS, Sheen SS, Lee HY, Park HJ, Choi SJ, Ye YM, Park HS. Serum ferritin and transferrin levels as serologic markers of methylene diphenyl diisocyanate-induced occupational asthma. J Allergy Clin Immunol 2008; 122:774-780. [PMID: 19014769 DOI: 10.1016/j.jaci.2008.07.034] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2008] [Revised: 07/28/2008] [Accepted: 07/29/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND Although methylene diphenyl diisocyanate (MDI) may induce occupational asthma in the workplace, the pathogenic mechanisms are unclear. OBJECTIVES By using bronchoalveolar lavage fluid, we sought to identify proteins that were differentially expressed between subjects with MDI-induced occupational asthma (MDI-OA) and asymptomatic exposed controls (AECs). METHODS To find proteins that were differentially expressed between the MDI-OA and AEC groups, 2-dimensional electrophoresis was performed by using bronchoalveolar lavage fluid obtained from subjects after MDI-specific inhalation challenge. The selected protein spots were then identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The clinical relevance of the differentially expressed spots was compared by ELISA using sera from the MDI-OA/eosinophilic bronchitis, AEC, and unexposed healthy control groups. Receiver operating characteristic curves were then plotted, and the sensitivity and specificity were determined. RESULTS Twenty-three protein spots were identified that distinguished the subjects with MDI-OA from those in the AEC group. Among them, ferritin expression was downregulated whereas transferrin expression was upregulated in subjects with MDI-OA compared with AEC; these results were validated by ELISA using sera from the MDI-OA/EB and AEC groups. To identify subjects with MDI-OA, the optimal serum cutoff levels were 69.84 ng/mL for ferritin and 2.48 microg/mL for transferrin. When these 2 parameters were combined, the sensitivity was 71.43% and the specificity was 85.71%. CONCLUSION Serum ferritin and transferrin levels are associated with the phenotype of MDI-OA.
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Affiliation(s)
- Gyu-Young Hur
- Department of Allergy and Rheumatology, Ajou University School of Medicine, Suwon, South Korea
| | - Gil-Soon Choi
- Department of Allergy and Rheumatology, Ajou University School of Medicine, Suwon, South Korea
| | - Seung-Soo Sheen
- Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, South Korea
| | - Hyun-Young Lee
- Department of Allergy and Rheumatology, Ajou University School of Medicine, Suwon, South Korea
| | - Han-Jung Park
- Department of Allergy and Rheumatology, Ajou University School of Medicine, Suwon, South Korea
| | - Sung-Jin Choi
- Department of Allergy and Rheumatology, Ajou University School of Medicine, Suwon, South Korea
| | - Young-Min Ye
- Department of Allergy and Rheumatology, Ajou University School of Medicine, Suwon, South Korea
| | - Hae-Sim Park
- Department of Allergy and Rheumatology, Ajou University School of Medicine, Suwon, South Korea.
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Hur GY, Sheen SS, Kang YM, Koh DH, Park HJ, Ye YM, Yim HE, Kim KS, Park HS. Histamine release and inflammatory cell infiltration in airway Mucosa in methylene diphenyl diisocyanate (MDI)-induced occupational asthma. J Clin Immunol 2008; 28:571-80. [PMID: 18484168 DOI: 10.1007/s10875-008-9199-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2008] [Accepted: 03/13/2008] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Although methylene diphenyl diisocyanate (MDI) is widely used in industries, there have been few studies of the pathogenic mechanisms of MDI-induced occupational asthma (MDI-OA). METHODS We performed immunohistochemical analyses, measured inflammatory mediators and cytokines, and quantified histamine release (HR) from peripheral basophils in MDI-OA patients. Thirteen MDI-exposed workers (five MDI-OA, two MDI-induced esoinophilic bronchitis, and six asymptomatic exposed controls, AEC) were enrolled. RESULTS AND DISCUSSION Immunochemical analyses indicated significantly increased anti-eosinophilic cationic protein-stained cells in MDI-OA patients as compared with controls (P < 0.05). Sputum eosinophil cationic protein levels were increased after MDI-specific inhalation challenge test in MDI-OA/EB patients (P < 0.02). Sputum eosinophil counts were highly correlated with IL-8 and MMP-9 levels (P < 0.05 and P < 0.01, respectively). Basophil HR was significantly increased in MDI-OA patients after stimulations with anti-IgG4 and MDI-human serum albumin conjugates (both P < 0.05). Eosinophil activation is a major feature of airway inflammation in MDI-OA patients. Increased HR by MDI may contribute to the pathogenic mechanisms of MDI-OA.
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Affiliation(s)
- Gyu-Young Hur
- Department of Allergy and Rheumatology, Ajou University School of Medicine, San-5, Wonchun-dong, Youngtong-gu, Suwon 443-721, Korea
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Lee HW, Choi JH, Lim HY, Park JS, Kim HC, Kang S, Oh YT, Chun M, Sheen SS, Oh YJ, Park KJ, Hwang SC. The addition of induction chemotherapy with etoposide, ifosfamide, and cisplatin failed to improve therapeutic outcome of concurrent chemoradiotherapy in patients with locally advanced non-small cell lung cancer -- single institution retrospective analysis. Neoplasma 2006; 53:30-6. [PMID: 16416010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Although chemoradiotherapy (CRT) is a standard treatment for unresectable locally advanced non-small cell lung cancer (NSCLC), the optimal sequencing remains to be determined. We retrospectively compared the treatment results of induction chemotherapy followed by concurrent CRT (induction group, 32 patients) with those of concurrent CRT alone (concurrent group, 41 patients) in unresectable stage IIIA/IIIB NSCLC patients. In induction group, 2 cycles of induction chemotherapy (etoposide/ifosfamide/cisplatin: 24 patients, others: 8 patients) were followed by concurrent CRT (60 Gy/30 fractions, 6 mg/m2 of cisplatin daily), while the same concurrent CRT was administered in concurrent group. Clinicopathologic characteristics including age, weight loss, histologic types, and clinical stage did not show significant differences between two groups except for a higher proportion of patients with ECOG performance status 2 in concurrent group (3% vs. 27%, p=0.015). Overall toxicity was generally acceptable with 1 treatment-related death from tracheoesophageal fistula in induction group. The response rates after concurrent CRT were 41% for induction group and 54% for concurrent group, which showed no significant difference (p=0.560). With median follow-up of 13 (1-92) months, there was a trend toward an advantage for concurrent group in median progression-free survival (6 months vs 8.3 months, p=0.067) and overall survival (12 months vs. 14.5 months, p=0.059). In multivariate analysis, only more than 10% weight loss within 6 months was significantly associated with poor survival (p=0.001). In conclusion, the addition of induction chemotherapy to concurrent CRT did not show any advantage over concurrent CRT alone in locally advanced NSCLC.
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Affiliation(s)
- H-W Lee
- Department of Hematology-Oncology, Ajou University School of Medicine, Suwon 443-721, Korea (Rep.)
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Park JS, Kim SH, Sheen SS, Jeong SM, Lee YJ. Effectiveness of the PRISM III score for predicting mortality in pediatric intensive care neurologic patients. Crit Care 1998. [PMCID: PMC3301402 DOI: 10.1186/cc290] [Citation(s) in RCA: 2] [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: 11/26/2022] Open
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