Publications by authors named "Min Ki Lee"

119 Publications

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 Nov 19:1-7. Epub 2021 Nov 19.

Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.

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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http://dx.doi.org/10.1159/000520034DOI Listing
November 2021

Sequential afatinib and osimertinib in patients with EGFR mutation-positive NSCLC and acquired T790M: A global non-interventional study (UpSwinG).

Lung Cancer 2021 Sep 21;162:9-15. Epub 2021 Sep 21.

Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan. Electronic address:

Background: Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are standard of care for EGFR mutation-positive non-small cell lung cancer (NSCLC). However, optimal sequence of treatment has yet to be defined. Overall survival (OS) is influenced by the availability/use of subsequent therapy after first-line treatment. Emergence of T790M is the main mechanism of resistance to afatinib and second-line osimertinib could be a treatment option in this instance.

Methods: In this non-interventional, global study (NCT04179890), existing medical/electronic records were identified for consecutive EGFR TKI-naïve patients with EGFR mutation-positive NSCLC (Del19 or L858R) treated with first-line afatinib and second-line osimertinib in regular clinical practice (n = 191; all T790M-positive). The primary objective was time to treatment failure (TTF). Key secondary objectives were OS and objective response rate (ORR).

Results: At the start of afatinib treatment, median age (range) was 62 years (34-88). Fifty-five percent of patients were female and 67% were Asian. ECOG PS (0/1/≥2) was 31%/57%/12%. Fourteen percent of patients had brain metastases. At the start of osimertinib treatment, ECOG PS (0/1/≥2) was 25%/61%/14% and 14% had brain metastases (rising to 29% at the end of osimertinib treatment). The source of biopsy material (solid/liquid) was 86%/3% at the start of afatinib and 54%/33% at start of osimertinib. Mutations were mainly detected with PCR methods. Overall, median TTF was 27.7 months (95% CI: 24.0-30.2) and median OS was 36.5 months (95% CI: 32.9-41.8). ORR with afatinib and osimertinib was 74% and 45%. TTF, OS and ORR were generally consistent across subgroups.

Conclusion: Sequential afatinib and osimertinib demonstrated encouraging activity in patients with EGFR mutation-positive NSCLC and acquired T790M. Activity was observed across all subgroups, including patients with poor ECOG PS or brain metastases. ECOG PS and incidence of brain metastases remained stable prior to, and after, afatinib treatment.
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http://dx.doi.org/10.1016/j.lungcan.2021.09.009DOI Listing
September 2021

The Preventive Effect of the Phenotype of Tumour-Associated Macrophages, Regulated by CD39, on Colon Cancer in Mice.

Int J Mol Sci 2021 Jul 13;22(14). Epub 2021 Jul 13.

Department of Infection and Immunology, Konkuk University School of Medicine, Seoul 05029, Korea.

Background: This study was designed to investigate the effect of cluster differentiation (CD)39 and CD73 inhibitors on the expresion of tumour-associated macrophages (TAMs), M1- versus M2-tumour phenotypes in mice with colon cancer.

Methods: An in vivo study of co-culture with colon cancer cells and immune cells from the bone marrow (BM) of mice was performed. After the confirmation of the effect of polyoxotungstate (POM-1) as an inhibitor of CD39 on TAMs, the mice were randomly divided into a control group without POM-1 and a study group with POM-1, respectively, after subcutaneous injection of CT26 cells. On day 14 after the injection, the mice were sacrificed, and TAMs were evaluated using fluorescence-activated cell sorting.

Results: In the in vivo study, the co-culture with POM-1 significantly increased the apoptosis of CT26 cells. The cell population from the co-culture with POM-1 showed significant increases in the expression of CD11b for myeloid cells, lymphocyte antigen 6 complex, locus C (Ly6C) for monocytes, M1-tumour phenotypes from TAMs, and F4/80 for macrophages. In the in vivo study, tumour growth in the study group with POM-1 was significantly limited, compared with the control group without POM-1. The expressions of Ly6C and major histocompatibility complex class II for M1-tumour phenotypes from TAMs on F4/80 from the tumour tissue in the study group had significantly higher values compared with the control group.

Conclusion: The inhibition of CD39 with POM-1 prevented the growth of colon cancer in mice, and it was associated with the increased expression of M1-tumour phenotypes from TAMs in the cancer tissue.
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http://dx.doi.org/10.3390/ijms22147478DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8308112PMC
July 2021

Clinical course of asymptomatic malignant pleural effusion in non-small cell lung cancer patients: A multicenter retrospective study.

Medicine (Baltimore) 2021 May;100(19):e25748

Department of Internal Medicine.

Abstract: The British Thoracic Society guidelines recommend observation for patients with asymptomatic malignant pleural effusion (MPE). However, asymptomatic MPE can become symptomatic. This study examined the clinical course of asymptomatic MPE in patients with non-small cell lung cancer (NSCLC), including the incidence and timing of symptom development of asymptomatic MPE and the associated factors.Retrospective data of 4822 NSCLC patients between January 2012 and December 2017 were reviewed. Symptom development of asymptomatic MPE was defined as the development of symptoms requiring additional treatment, such as insertion of a chest tube, within 1 year in patients who lacked MPE symptoms at the time of diagnosis. Clinical information, pathological parameters, and radiological characteristics were reviewed. Patient data up to 1 year from the initial diagnosis were reviewed.Of 113 patients with asymptomatic MPE, 46 (41%) became symptomatic within 1 year despite appropriate anticancer treatment. The median time to symptom development was 4 months, and 38 patients (83%) developed symptoms within 6 months. Multivariate logistic regression showed that female sex (odds ratio [OR], 0.256; 95% confidence interval [CI], 0.101-0.649; P = .004) and the depth of pleural effusion on initial computed tomography (CT) (OR, 0.957; 95% CI, 0.932-0.982; P = .001) were independently associated with symptom development of asymptomatic MPE.A fraction of 41% of patients with asymptomatic MPE became symptomatic within 1 year. Female sex and larger MPE on initial CT were independently associated with symptom development of asymptomatic MPE.
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http://dx.doi.org/10.1097/MD.0000000000025748DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8133234PMC
May 2021

Cancer Testis Antigen, NOL4, Is an Immunogenic Antigen Specifically Expressed in Small-Cell Lung Cancer.

Curr Oncol 2021 05 20;28(3):1927-1937. Epub 2021 May 20.

Department of Biochemistry, School of Medicine, Pusan National University, Beomeo-ri, Mulgeum-eup, Yangsan 50612, Korea.

To identify cancer/testis (CT) antigens and immunogenic proteins, immunoscreening of testicular and small-cell lung cancer cell line NCI-H889 cDNA libraries was performed using serum obtained from a small-cell lung cancer (SCLC) patient. We obtained 113 positive cDNA clones comprised of 74 different genes, designated KP-SCLC-1 through KP-SCLC-74. Of these genes, 59 genes were found to be related to cancers by EMBASE analysis. Three of these antigens, including KP-SCLC-29 (NOL4), KP-SCLC-59 (CCDC83), and KP-SCLC-69 (KIF20B), were CT antigens. RT-PCR and western blot analysis showed that NOL4 was frequently present in small-cell lung cancer cell lines (8/9, 8/9). In addition, NOL4 mRNA was weakly, or at a low frequency, or not detected in various cancer cell lines. Our results reveal that NOL4 was expressed at protein levels in small-cell lung cancer tissues (10/10) but not detected in lung adenocarcinoma and squamous cell carcinoma by immunohistochemical analysis. Serological response to NOL4 was also evaluated by western blot assay using NOL4 recombinant protein. A humoral response against NOL4 proteins was detected in 75% (33/44) of small-cell lung cancer patients and in 65% (13/20) of healthy donors by a serological western blot assay. These data suggest that NOL4 is a specific target that may be useful for diagnosis and immunotherapy in SCLC.
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http://dx.doi.org/10.3390/curroncol28030179DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8161805PMC
May 2021

Prognostic Factors of Second-line Immune Checkpoint Inhibitors in Patients With Advanced-stage Non-Small Cell Lung Cancer: A Multicenter, Retrospective Study.

Am J Clin Oncol 2021 07;44(7):356-360

Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital.

Objectives: Immune checkpoint inhibitors (ICIs) targeting the programmed cell death receptor-1 and its ligand have achieved impressive success in treating patients with advanced-stage non-small cell lung cancer (NSCLC) after failed first-line cytotoxic chemotherapy. However, knowledge on clinical biomarkers that could help select patients who will respond well to second-line ICI therapy is limited.

Patients And Methods: Medical records of patients with NSCLC treated with first-line platinum-based chemotherapy and subsequent second-line ICI were collected from 6 medical centers between January 2018 and June 2020. Clinical information, pathologic variables, and radiologic findings of the data collected were reviewed. The patients were followed up until the date of the last visit, the death of any cause, or the end of data recording (December 31, 2020).

Results: A total of 181 patients with NSCLC were treated with second-line ICI following first-line platinum-based doublet chemotherapy. The median progression-free survival was 2.0 months (interquartile range, 1.0 to 5.5 mo), and the median overall survival was 12.0 months (interquartile range, 6.0 to 20.0 mo). Low body mass index (BMI) was independently associated with progression-free survival (odds ratio [OR], 0.826; 95% confidence interval [CI], 0.723-0.945; P=0.005). Similarly, a low BMI (OR, 0.839; 95% CI, 0.740-0.952; P=0.005) and a high number of metastatic organs (OR, 1.682; 95% CI, 1.156-2.448; P=0.007) were independently associated with the overall survival after second-line ICI therapy.

Conclusion: BMI and the number of metastatic sites were significantly associated with second-line ICI therapy outcomes in patients with NSCLC receiving first-line platinum-based chemotherapy.
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http://dx.doi.org/10.1097/COC.0000000000000828DOI Listing
July 2021

An increasing trend of the number of meniscus allograft transplantation in Korea.

Knee Surg Sports Traumatol Arthrosc 2021 Dec 27;29(12):4131-4137. Epub 2021 Feb 27.

Department of Orthopaedic Surgery, Sports Medical Center and Sports Medical Research Institute, College of Medicine, Seoul Paik Hospital, Inje University, 9, Mareunnae-ro, Jung-gu, Seoul, Republic of Korea.

Purpose: Meniscus allograft transplantation (MAT) can be performed to treat symptomatic patients with meniscus-deficient knees. However, the current epidemiologic status of MAT is unknown in many countries, including Korea. This study aimed to investigate the national trends of MAT in Korea which covers MAT procedures by the Korean national health insurance system.

Methods: Information from the national database was acquired through the Korean Health Insurance Review and Assessment Service (HIRA) from 2010 to 2017. All patients encoded as MAT were included. The total number of MATs and their incidence per 100,000 persons were determined, and the results were stratified by age and sex.

Results: The total number of MATs and their incidence per 100,000 persons per year were 369 and 0.77, respectively, in 2010, which increased to 826 and 1.72, respectively, in 2017. The number of MATs increased by 124% over 8 years. The peaks for the total number of MATs and their incidence were seen in patients in their 20 s in 2010, but in 2017, the peaks were observed in patients who were in their 40 s. MAT was performed more frequently in males (61%) than in females (39%) over the study period.

Conclusion: The total number of MATs and their incidence had increased by 124% between 2010 and 2017. The peak treatment age range for MAT changed from 20 years of age in 2010 to 40 years of age in 2017, and MAT was performed more frequently in males than in females.

Level Of Evidence: IV.
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http://dx.doi.org/10.1007/s00167-021-06441-xDOI Listing
December 2021

Treatment Outcomes of Patients with Multidrug-Resistant Tuberculosis: Comparison of Pre- and Post-Public-Private Mix Periods.

Tuberc Respir Dis (Seoul) 2021 Jan 28;84(1):74-83. Epub 2020 Oct 28.

Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea.

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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http://dx.doi.org/10.4046/trd.2020.0093DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7801811PMC
January 2021

Antioxidant and Anti-Inflammatory Activities in Relation to the Flavonoids Composition of Pepper ( L.).

Antioxidants (Basel) 2020 Oct 13;9(10). Epub 2020 Oct 13.

Functional Food Division, National Institute of Agricultural Sciences, Rural Development Administration, Wanju 55365, Korea.

The chili pepper ( L.) is a food source that is rich in flavonoids such as luteolin and apigenin. Flavonoids are known to have anti-inflammatory and antioxidant activities; however, studies on the flavonoids composition identified and the anti-inflammatory and antioxidant effects in pepper leaves (PL) and fruits (PF) are insufficient. In the present study, we investigated the antioxidant and anti-inflammatory effects in vitro, and the flavonoids contents of the PL and PF. Pepper extracts showed radical scavenging activities and ameliorated the lipopolysaccharide (LPS)-stimulated inflammatory response by decreasing nitric oxide production and interluekin-6 and tumor necrosis factor alpha levels in RAW 264.7 cells, with more effective activities noted for PL than for PF. Furthermore, PL extracts markedly inhibited the LPS-induced production of reactive oxygen species accumulation. The flavonoid profile and content of pepper were dependent on the part, with PL showing higher total flavonoids than PF. In particular, the content of luteolin glycosides in PL was twice that in PF. Thus, PL may be useful to prevent oxidative stress and inflammation-related diseases.
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http://dx.doi.org/10.3390/antiox9100986DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7602036PMC
October 2020

Sequential Organ Failure Assessment score as a predictor of mortality in ventilated patients with multidrug-resistant bacteremia.

Acute Crit Care 2020 Aug 31;35(3):169-178. Epub 2020 Aug 31.

Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.

Background: The occurrence of multidrug-resistant (MDR) bacteremia in ventilated patients may be associated with a high mortality rate. We evaluated whether Sequential Organ Failure Assessment (SOFA) score on the day of bacteremia could predict 90-day mortality in these patients.

Methods: Data were obtained retrospectively from 202 patients (male, 60.4%; median age, 64 years) hospitalized at a single university-affiliated tertiary care hospital. All adult patients who had were ventilated and had one of the following six MDR bacteremias between March 2011 and February 2018 were enrolled: methicillin-resistant Staphylococcus aureus, extended-spectrum β-lactamase-producing Gram-negative bacteria (Escherichia coli and Klebsiella pneumonia), carbapenem-resistant Gram-negative rods (Acinetobacter baumannii and Pseudomonas aeruginosa), or vancomycin-resistant Enterococcus faecium.

Results: The overall 90-day mortality rate after the day of bacteremia was 59.9%. The areas under the receiver operating characteristic curves for the SOFA and Acute Physiology and Chronic Health Evaluation (APACHE) II scores were 0.732 (95% confidence interval [CI], 0.666 to 0.792; P<0.001) and 0.662 (95% CI, 0.593 to 0.727; P<0.001), respectively, with no difference between the two (P=0.059). Also, the cutoff value of the SOFA score was 9 (based on Youden's index). Multivariate Cox regression analysis showed that this cut-off value was significantly associated with higher mortality rate (hazard ratio, 2.886; 95% CI, 1.946 to 4.221; P<0.001).

Conclusions: SOFA score measured on the day of bacteremia may be a useful prognostic indicator of 90-day mortality in ventilated patients with MDR bacteremia.
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http://dx.doi.org/10.4266/acc.2020.00143DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7483015PMC
August 2020

Factors associated with sleep disturbance in patients with chronic obstructive pulmonary disease.

Clin Respir J 2020 Nov 13;14(11):1018-1024. Epub 2020 Aug 13.

Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea.

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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http://dx.doi.org/10.1111/crj.13235DOI Listing
November 2020

Predictors of Low-Level Disease-Specific Knowledge in Patients with Chronic Obstructive Pulmonary Disease.

Int J Chron Obstruct Pulmon Dis 2020 19;15:1103-1110. Epub 2020 May 19.

Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea.

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 FEV % predicted (r = -0.24), the post-bronchodilator FEV/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 < 0.05). FEV (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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http://dx.doi.org/10.2147/COPD.S244925DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7245443PMC
June 2021

Atypical musculoskeletal manifestations on flexor hallucis longus tendon of gout causing tarsal tunnel syndrome in diabetic patients: A case report.

Medicine (Baltimore) 2019 Dec;98(51):e18374

Department of Orthopedic Surgery, Seoul Paik Hospital, Inje University, Seoul, Republic of Korea.

Rationale: Deposition of tophus is a common feature in chronic gout; however, signs and symptoms are not always well-pronounced in cases of uncommon sites. We report a rare case with a tophaceous tendonitis on the flexor hallucis longus (FHL) tendon with tarsal tunnel syndrome (TTS). This is the first surgical case of TTS by gouty tophi in FHL.

Patient Concerns: A 55-year-old woman presented with a 6-month history of mild discomfort at the right foot, which gradually worsened in the past 3 weeks. The patient visited our outpatient clinic due to persistent and aggravating foot pain and swelling around the tarsal tunnel.

Diagnosis: The patient was diagnosed with hyperuricemia and diabetes mellitus with chronic kidney disease, and did not receive regular antigout treatments. Paresthesia was found along the distribution of medial and plantar nerve and tinel test was positive on tarsal tunnel. Biochemical examination showed she had raised serum uric acid (10.6 mg/dL) and decreased estimated glomerular filtration rate (69 mL/min/1.73 m). Conventional radiography examination showed negative pathology except soft tissue swelling. Magnetic resonance imaging revealed a fusiform mass within the FHL tendon and fluid collection around tarsal tunnel.

Interventions: Surgical exploration was performed to remove the mass. Inflammation fluid exploded out from FHL tendon sheath, which was later proven to have infiltration of monosodium urate crystal. Superficial dissection revealed a white chalky mass and posterior tibial nerve was significantly compressed by the tophus mass.

Outcomes: The mass was removed and the symptoms were relieved at immediate postoperative period.

Lessons: A tophaceous tendonitis on FHL tendon can cause TTS and surgical decompression of the gout lesion can reduce the symptoms.
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http://dx.doi.org/10.1097/MD.0000000000018374DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6940121PMC
December 2019

Social support is a strong determinant of life satisfaction among older adults with chronic obstructive pulmonary disease.

Clin Respir J 2020 Feb 28;14(2):85-91. Epub 2019 Nov 28.

Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea.

Introduction: Older adults with chronic obstructive pulmonary disease (COPD) are frequently compromised in terms of social life and functional capacity, triggering reduced in life satisfaction (LS). We investigated the level of LS among elderly patients with COPD and factors associated with LS.

Materials And Methods: This was a prospective cross-sectional survey enroling a sample of 160 COPD subjects aged 65 y or older. At enrolment, all patients completed measures of LS (the Satisfaction with Life Scale; SWLS) and social support (Personal Resource Questionnaire; PRQ). The health-related quality of life (HRQL) was measured using St. George's Respiratory Questionnaire (SGRQ) and 36-item Short-Form Health Survey (SF-36). Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS).

Results: About 30.6% of the patients reported that they were satisfied or highly satisfied with their lives. In univariate analysis, post-bronchodilator FEV percentage predicted was significantly associated with SWLS score (r = 0.205, P = .009). Age (r = 0.207), diabetes (r = 0.209), osteoporosis (r = -0.190), PRQ (r = 0.388), SGRQ total (r = -0.291), SF-36 PCS (r = 0.233), SF-36 MCS (r = 0.274), HADS-A (r = -0.291) and HADS-D (r = -0.352) were also associated with SWLS score (all P < .05). Multivariate analysis revealed that FEV (r = 0.223, P = .04) and PRQ (r = .244, P = .002) were independently associated with SWLS score.

Conclusions: Less than one-third of older adults with COPD reported that they were satisfied with their lives. Better lung function and greater social support were independently associated with high LS.
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http://dx.doi.org/10.1111/crj.13104DOI Listing
February 2020

Bronchoscopic management of solitary bronchial myelolipoma: a case report.

BMC Pulm Med 2019 Sep 2;19(1):151. Epub 2019 Sep 2.

Department of Intermal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, South Korea.

Background: Myelolipoma is a rare benign tumor composed of mature adipose and hematopoietic tissues. Most myelolipomas are found in the adrenal glands, whereas intrathoracic myelolipoma is extremely rare. In particular, bronchial myelolipoma without the involvement of lung parenchyma has never been reported.

Case Presentation: A previously healthy 38-year-old male developed dyspnea and a productive cough. Computed tomography revealed an endobronchial mass at the right bronchus intermedius and subsequent atelectasis of the right middle and lower lobes. Flexible bronchoscopy found a total obstruction of the right bronchus intermedius due to an endobronchial tumor. Using a rigid bronchoscope, the endobronchial tumor was resected and the base of the tumor was additionally ablated with a diode laser to prevent recurrence. The removed endobronchial tumor was a 13 mm × 20 mm-sized oval-shaped mass and was pathologically diagnosed as bronchial myelolipoma. Chest radiographs, obtained on the day following the procedure, showed an improvement of atelectasis, and accompanying symptoms were immediately improved. Follow-up bronchoscopy performed after 12 months evidenced no recurrence of the bronchial myelolipoma.

Conclusions: We used bronchoscopic intervention in patients with solitary bronchial myelolipoma and there was no evidence of recurrence.
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http://dx.doi.org/10.1186/s12890-019-0910-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6717974PMC
September 2019

Sleep disturbance in patients with mild-moderate chronic obstructive pulmonary disease.

Clin Respir J 2019 Dec 30;13(12):751-757. Epub 2019 Aug 30.

Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.

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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http://dx.doi.org/10.1111/crj.13085DOI Listing
December 2019

Comprehensive characterization of hydroxycinnamoyl derivatives in green and roasted coffee beans: A new group of methyl hydroxycinnamoyl quinate.

Food Chem X 2019 Jun 23;2:100033. Epub 2019 May 23.

National Institute of Agricultural Science, Rural Development Administration, 166, Nongsaengmyeong-ro, Iseo-myeon, Wanju-gun, Jeollabuk-do, Republic of Korea.

The aim of this study was to quantitatively characterize 19 green and roasted coffee beans by ultra-performance liquid chromatography coupled with diode array detector and quadrupole time-of-flight mass spectrometry. A total of 57 phenolic acids including nine methyl ester of mono-, di-caffeoylquinic acid, and feruloylquinic acid were identified. The methyl hydroxycinnamoyl quinates are reported for the first time from and The total phenolic content ranged from 5628 ± 227 to 8581 ± 109 mg/100 g dry weight (DW) in green, and from 791 ± 63 to 1891 ± 37 mg/100 g DW roasted beans. The methyl caffeoylquinates accounted for 2.1% of the total phenolic acids. The result suggested that the phenolic composition was affected by the type of species, cultivars, and roasting process. Hence, to retain the balance between health beneficial phenolics and sensory attributes, optimization of roasting condition specific to the cultivar type substantially required.
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http://dx.doi.org/10.1016/j.fochx.2019.100033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6694859PMC
June 2019

Factors predicting long-term survival of patients with sepsis on arrival at the emergency department: A single-center, observational study.

Medicine (Baltimore) 2019 Aug;98(33):e16871

Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine.

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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http://dx.doi.org/10.1097/MD.0000000000016871DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6831115PMC
August 2019

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 Aug 6;20(1):177. Epub 2019 Aug 6.

Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea.

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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http://dx.doi.org/10.1186/s12931-019-1149-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683511PMC
August 2019

Genetic Variant of Notch Regulator DTX1 Predicts Survival After Lung Cancer Surgery.

Ann Surg Oncol 2019 Oct 16;26(11):3756-3764. Epub 2019 Jul 16.

Department of Biochemistry and Cell Biology, School of Medicine, Kyungpook National University, Daegu, Korea.

Background: We evaluated the association between genetic variants in the Notch pathway and survival outcomes of patients with surgically resected NSCLC.

Methods: Sixty-four single nucleotide polymorphisms (SNPs) in the Notch pathway genes were evaluated in the discovery study (n = 354) and two sequential validation studies (n = 772 and n = 746, respectively). The association of genotype with overall survival (OS) and disease-free survival (DFS) was evaluated.

Results: Of the 64 SNPs analyzed in the discovery study, 9 were significantly associated with OS or DFS. Among them, the association remained significant only for Deltex-1 (DTX1) rs1732786A>G in the first validation study. The second validation study confirmed again the association between DTX1 rs1732786A>G and survival outcomes. In the combined analysis, rs1732786A>G was significantly associated with better OS and DFS (adjusted HR ·aHR· for OS, 0.75; 95% CI 0.64-0.87; P = 0.0002; aHR for DFS, 0.79; 95% CI 0.71-0.89; P = 0.0001). In vitro luciferase assay showed that the rs1732786G allele was associated with higher promoter activity compared to rs1732786A allele. Consistently, relative mRNA expression level of DTX1 showed significant positive correlation with rs1732786 A-to-G change (P = 0.02) in tumor tissues.

Conclusions: These results suggest that DTX1 rs1732786 is a potential prognostic factor that may have clinical utility in the management of early stage NSCLC.
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http://dx.doi.org/10.1245/s10434-019-07614-2DOI Listing
October 2019

Patterns of sensitization to aeroallergens and their effect on airway hyper-responsiveness in Busan, Korea.

Asian Pac J Allergy Immunol 2021 Sep;39(3):182-189

Department of Internal Medicine, Pusan National University School of Medicine, Busan.

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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http://dx.doi.org/10.12932/AP-261118-0447DOI Listing
September 2021

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 07 30;10(7):1561-1566. Epub 2019 May 30.

Department of Internal Medicine, School of Medicine, Pusan National University, Busan, South Korea.

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 (C ) value. The ΔC -1 value (standard C value minus sample C 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 ΔC -1 value derived from the receiver operating characteristic curve was 5.32. A survival benefit was observed in the group with an ΔC -1 value > 5.32 or with a common EGFR mutation type compared to the group with an ΔC -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 ΔC -1 value correlates with better survival.
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http://dx.doi.org/10.1111/1759-7714.13101DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6610248PMC
July 2019

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 Sep 13;34(5):1058-1067. Epub 2019 May 13.

Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.

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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http://dx.doi.org/10.3904/kjim.2018.169DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6718763PMC
September 2019

Time to appropriate treatment in patients with multidrug-resistant tuberculosis in South Korea: Are we still in 2010?

PLoS One 2019 25;14(4):e0216084. Epub 2019 Apr 25.

Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.

Background: This study investigated the time to appropriate treatment and factors affecting late treatment initiation in patients with multidrug-resistant tuberculosis (MDR-TB) in South Korea.

Methods: Data from patients with culture-confirmed pulmonary MDR-TB who received treatment at Pusan National University Hospital (PNUH) between January 2010 and July 2018 were reviewed retrospectively. Patients were divided into two groups according to the first institution they visited [patients who were transferred to PNUH after diagnosis of MDR-TB (Group A) and patients who were initially diagnosed with TB at PNUH (Group B)].

Results: A total of 100 patients were included (53 in Group A and 47 in Group B). The percentage of patients in whom line probe assays (LPAs) for isoniazid and rifampin or Xpert MTB/RIF assays were performed was higher in Group B than in Group A [20.8 vs. 57.4% (P < 0.001) and 17.0 vs. 46.8% (P = 0.001), respectively]. The median time from the first visit to appropriate treatment initiation was longer in Group A (102.0 vs. 77.0 days, P = 0.002). However, a subgroup analysis of patients with pre-extensively or extensively drug-resistant TB (pre-XDR- or XDR-TB) revealed that the time to appropriate treatment did not differ between Groups A and B. Although the time to appropriate treatment decreased during the study period in both Groups A and B, this trend was not evident in patients with pre-XDR- or XDR-TB in Group B. Based on multivariate analyses, performance of LPAs for isoniazid and rifampin, performance of Xpert MTB/RIF assays, and the presence of uncomplicated MDR-TB were protective against delays in appropriate treatment initiation.

Conclusions: The time to appropriate treatment in patients with MDR-TB in South Korea was not acceptable, particularly for patients diagnosed outside of PNUH and for patients with pre-XDR- or XDR-TB. The use of rapid molecular drug susceptibility tests in various healthcare settings and introduction of second-line LPAs are required.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0216084PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483266PMC
January 2020

Reliability of PD-L1 assays using small tissue samples compared with surgical specimens.

Medicine (Baltimore) 2019 Apr;98(14):e14972

Department of Internal Medicine.

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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http://dx.doi.org/10.1097/MD.0000000000014972DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6455756PMC
April 2019

Molecular analysis of small tissue samples obtained via transbronchial lung biopsy using radial probe endobronchial ultrasound.

PLoS One 2019 26;14(2):e0212672. Epub 2019 Feb 26.

Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.

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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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0212672PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6391011PMC
November 2019

Development of Protocol for Korean Lung Cancer Screening Project (K-LUCAS) to Evaluate Effectiveness and Feasibility to Implement National Cancer Screening Program.

Cancer Res Treat 2019 Oct 19;51(4):1285-1294. Epub 2019 Feb 19.

National Cancer Control Institute, National Cancer Center, Goyang, Korea.

Purpose: To reduce lung cancer mortality, lung cancer screening was recommended using low-dose computed tomography (LDCT) to high-risk population. A protocol for multicenter lung cancer screening pilot project was developed to evaluate the effectiveness and feasibility of lung cancer screening to implement National Cancer Screening Program in Korea.

Materials And Methods: Multidisciplinary expert committee was comprised to develop a standardized protocol for Korean Lung Cancer Screening Project (K-LUCAS). K-LUCAS is a population-based single arm trial that targets high-risk population aged 55-74 years with at least 30 pack-year smoking history. LDCT results are reported by Lung-RADS suggested by American Radiology Society. Network-based system using computer-aided detection program is prepared to assist reducing diagnostic errors. Smoking cessation counselling is provided to all currently smoking participants. A small pilot test was conducted to check the feasibility and compliance of the protocols for K-LUCAS.

Results: In pilot test, 256 were participated. The average age of participants was 63.2 years and only three participants (1.2%) were female. The participants had a smoking history of 40.5 pack-year on average and 53.9% were current smokers. Among them, 86.3% had willing to participate in lung cancer screening again. The average willingness to quit smoking among current smokers was 12.7% higher than before screening. In Lung-RADS reports, 10 (3.9%) were grade 3 and nine (3.5%) were grade 4. One participant was diagnosed as lung cancer.

Conclusion: The protocol developed by this study is assessed to be feasible to perform K-LUCAS in multicenter nationwide scale.
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http://dx.doi.org/10.4143/crt.2018.464DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6790831PMC
October 2019

Hepatoprotective effects of blue honeysuckle on CCl-induced acute liver damaged mice.

Food Sci Nutr 2019 Jan 27;7(1):322-338. Epub 2018 Nov 27.

Department of Food and Nutrition College of BioNano Technology Gachon University Seongnam-si Gyeonggi-do Korea.

The objective of this study was to evaluate the hepatoprotective effects of blue honeysuckle (BH) on carbon tetrachloride (CCl)-induced acute hepatic damage in mice. The experiment used a total of 60 ICR mice, which were divided into six groups. Except for the intact control groups, all groups received a single intraperitoneal injection of CCl after a 7 day pre-treatment period with distilled water, BH extracts, or silymarin. Twenty-four hours after the CCl injection, the following observations, representative of classical oxidative stress-mediated centrolobular necrotic acute liver injuries, were observed: decreased body weight; small nodule formation and enlargement on the gross inspections with related liver weight increase; elevation of serum AST and ALT, increases in hepatic lipid peroxidation and related depletion of endogenous antioxidants and antioxidative enzymes; centrolobular necrosis; increases in apoptotic markers, lipid peroxidation markers, and oxidative stress markers. However, liver damage was significantly inhibited by the pre-treatment with BH extracts. The present study demonstrated that oral administration of BH extracts prior to exposure to CCl conferred favorable hepatoprotective effects. These results demonstrated that BHe possessed suitable properties for use as a potent hepatoprotective medicinal food.
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http://dx.doi.org/10.1002/fsn3.893DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6341158PMC
January 2019

Impact of afatinib dose modification on safety and effectiveness in patients with EGFR mutation-positive advanced NSCLC: Results from a global real-world study (RealGiDo).

Lung Cancer 2019 01 2;127:103-111. Epub 2018 Nov 2.

Department of Medical Oncology, Catalan Institute of Oncology Badalona, Hospital Germans Trias i Pujol, Badalona, Spain. Electronic address:

Objectives: In the LUX-Lung clinical trials of afatinib in EGFR mutation-positive NSCLC, tolerability-guided dose adjustment reduced the incidence and severity of adverse events while maintaining efficacy. The RealGiDo study evaluated the impact of afatinib dose adjustment in a real-world setting.

Materials And Methods: This non-interventional, observational study used medical records of EGFR mutation-positive NSCLC patients treated with first-line afatinib. Primary outcomes were adverse drug reaction (ADR) incidence and severity, time to treatment failure (TTF), and time to progression (TTP), relative to LUX-Lung 3 (LL3).

Results: 228 patients were enrolled from 13 countries. Baseline characteristics were in line with LL3 but with more Del19 patients (78.1% vs. 49.0%) and fewer Asian patients (43.9% vs. 72.2%); 11.8% had ECOG performance status 2-3. A total of 71 (31.1%) received a modified starting dose of ≤30 mg. Of patients who started with 40 mg, 67.1% underwent dose reductions, 86.5% of which were in the first 6 months. Dose reductions were mainly due to ADRs and were more common in female, East Asian, and low body-weight patients. There were no new safety signals and fewer ≥grade 3 ADRs (28.4% vs. 48.9%) and serious adverse events (5.2% vs. 14.0%) than in LL3. Median TTF and TTP were 18.7 and 20.8 months, respectively, and were not impacted by reduced starting dose or dose modification.

Conclusion: Real-world data show that afatinib dose adjustments reduced the frequency and intensity of ADRs without compromising effectiveness, highlighting the benefit of tailoring afatinib dose to optimise treatment outcomes and supporting clinical decision-making. The study is registered at clinicaltrials.gov (NCT02751879).
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http://dx.doi.org/10.1016/j.lungcan.2018.10.028DOI Listing
January 2019

Characterization and quantification of flavonoid glycosides in the genus by UPLC-DAD-QTOF/MS.

Saudi J Biol Sci 2018 Dec 16;25(8):1622-1631. Epub 2016 Aug 16.

Department of Agro-Food Resources, National Academy of Agricultural Science, Rural Development Administration, Republic of Korea.

Widely distributed in plants, flavonoids reduce the incidence of cancer and cardiovascular disease. In this study, flavonoid content and composition in members of the genus were evaluated using liquid chromatography with diode array and electrospray ionization mass spectrometric detection (UPLC-DAD-ESI/QTOF-MS). Flavonoids in plants of the genus include the basic structures of kaempferol, quercetin, and catechin, and exist as mono-, di-, or tri-glycoside compounds mono-acylated with acetic acid. A total of 23 individual flavonoids were isolated and confirmed, three of which appear to be newly identified compounds: quercetin 3--(2″--acetyl)neohesperidoside, quercetin 3--(4″--acetyl)rutinoside, and kaempferol 3--(4″--acetyl)rutinoside. Japanese apricot and Chinese plum contained the highest amounts of flavonoids in the genus. During the ripening stage of Japanese apricot, the total flavonol content was reduced, while the catechin content was increased.
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http://dx.doi.org/10.1016/j.sjbs.2016.08.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6303141PMC
December 2018
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