Hye-Kyung Park

Pusan National University, Tsau-liang-hai, Busan, South Korea

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Publications (37)71.45 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: No attempt has yet been made to classify asthma phenotypes in the elderly population. It is essential to clearly identify clinical phenotypes to achieve optimal treatment of elderly patients with asthma. To classify elderly patients with asthma by cluster analysis and developed a way to use the resulting cluster in practice. We applied k-means cluster to 872 elderly patients with asthma (aged ≥65 years) in a prospective, observational, and multicentered cohort. Acute asthma exacerbation data collected during the prospective follow-up of 2 years was used to evaluate clinical trajectories of these clusters. Subsequently, a decision-tree algorithm was developed to facilitate implementation of these classifications. Four clusters of elderly patients with asthma were identified: (1) long symptom duration and marked airway obstruction, (2) female dominance and normal lung function, (3) smoking male dominance and reduced lung function, and (4) high body mass index and borderline lung function. Cluster grouping was strongly predictive of time to first acute asthma exacerbation (log-rank P = .01). The developed decision-tree algorithm included 2 variables (percentage of predicted forced expiratory volume in 1 second and smoking pack-years), and its efficiency in proper classification was confirmed in the secondary cohort of elderly patients with asthma. We defined 4 elderly asthma phenotypic clusters with distinct probabilities of future acute exacerbation of asthma. Our simplified decision-tree algorithm can be easily administered in practice to better understand elderly asthma and to identify an exacerbation-prone subgroup of elderly patients with asthma. Copyright © 2014 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
    Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology 10/2014; · 3.45 Impact Factor
  • Jeong Ha Mok, Ki Uk Kim, Hye-Kyung Park, Min Ki Lee
    Journal of the Formosan Medical Association. 10/2014; 113(10):764–765.
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    ABSTRACT: Evidence regarding the usefulness of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) in predicting the prognosis of non-small cell lung cancer is increasing. However, data on small cell lung cancer (SCLC) are scarce. The aim of this study was to evaluate the prognostic value of metabolic parameters measured using (18)F-FDG PET/CT in patients with SCLC.
    Cancer research and treatment : official journal of Korean Cancer Association. 04/2014; 46(2):165-71.
  • Kyung Hwa Shin, Ki Uk Kim, Geewon Lee, Hye-Kyung Park
    Journal of the Formosan Medical Association 02/2014; · 1.00 Impact Factor
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    ABSTRACT: Patients with chronic obstructive pulmonary disease (COPD), which is predicted to be the third most common cause of death worldwide by 2020, often suffer from depression, one of the most common and modifiable comorbidities of COPD. This study assessed the prevalence of depression in patients with COPD and the association of depression with disease severity. This was a multicenter, prospective cross-sectional study of 245 patients with stable COPD. Disease severity was assessed using two scales: the global initiative for chronic obstructive lung disease (GOLD) stage and BODE index. Depression was measured using the Centers for Epidemiologic Studies Depression (CES-D) scales. Data were analyzed using descriptive statistics, Spearman correlation, and multivariate logistic regression. Depression defined as a CES-D score of 24 and higher was observed in 17.6 % of patients with COPD. The prevalence of depression increased with disease severity based on the BODE quartile (r = 0.16; P = 0.014). By contrast, no difference was observed in the prevalence of depression among the severity groups using the GOLD staging system (r = - 0.01; P = 0.898). Elementary school graduates were more likely to experience depression than graduates of high school and above [odds ratio (OR) = 3.67; 95 % confidence interval (CI) 1.37-9.85] and patients in BODE quartile II were more likely to experience depression than those with BODE quartile I (OR = 2.5; 95 % CI 1.04-6.06). Depression was associated with disease severity according to the BODE quartile in patients with COPD. BODE quartile II was a significant predictor of depression. Screening patients with a high risk of depression and proactive intervention for those patients are needed.
    Beiträge zur Klinik der Tuberkulose 01/2014; · 2.06 Impact Factor
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    ABSTRACT: Acanthamoeba is a free-living amoeba commonly present in the environment and often found in human airway cavities. Acanthamoeba possesses strong proteases that can elicit allergic airway inflammation. To our knowledge, the aeroallergenicity of Acanthamoeba has not been reported. We repeatedly inoculated mice with Acanthamoeba trophozoites or excretory-secretory (ES) proteins intra-nasally and evaluated symptoms and airway immune responses. Acanthamoeba trophozoites or ES proteins elicited immune responses in mice that resembled allergic airway inflammation. ES proteins had strong protease activity and activated the expression of several chemokine genes (CCL11, CCL17, CCL22, TSLP, and IL-25) in mouse lung epithelial cells. The serine protease inhibitor phenyl-methane-sulfonyl fluoride (PMSF) inhibited ES protein activity. ES proteins also stimulated dendritic cells and enhanced the differentiation of naive T cells into IL-4-secreting T cells. After repeated inoculation of the protease-activated receptor 2 knockout mouse with ES proteins, airway inflammation and Th2 immune responses were markedly reduced, but not to basal levels. Furthermore, asthma patients had higher Acanthamoeba-specific IgE titers than healthy controls and we found Acanthamoeba specific antigen from house dust in typical living room. Our findings suggest that Acanthamoeba elicits allergic airway symptoms in mice via a protease allergen. In addition, it is possible that Acanthamoeba may be one of the triggers human airway allergic disease.
    PLoS ONE 01/2014; 9(3):e92726. · 3.53 Impact Factor
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    ABSTRACT: Although several studies have demonstrated that mesenchymal stem cells derived from adipose tissue (ASCs) can ameliorate allergic airway inflammation, the immunomodulatory mechanism of ASCs remains unclear. In this study, we investigated whether regulatory T cells (Tregs) induction is a potential mechanism in immunomodulatory effects of ASCs on allergic airway disease and how these induced Tregs orchestrate allergic inflammation. Intravenous administration of ASCs significantly reduced allergic symptoms and inhibited eosinophilic inflammation. Airway hyperresponsiveness, total immune cell and eosinophils in the bronchoalveolar lavage fluid, mucus production, and serum allergen-specific IgE and IgG1 were significantly reduced after ASCs administration. ASCs significantly inhibited Th2 cytokines (IL-4, IL-5, and IL-13) and enhanced Th1 cytokine (IFN-γ) and regulatory cytokines (IL-10 and TGF-β) in the bronchoalveolar lavage fluid and lung draining lymph nodes. Furthermore, levels of IDO, TGF-β, and PGE2 were significantly increased after ASCs administration. Interestingly, this upregulation was accompanied by increased Treg populations. In conclusion, ASCs ameliorated allergic airway inflammation and improved lung function through the induction of Treg expansion. The induction of Treg by ASCs involves the secretion of soluble factors such as IDO, TGF-β, and PGE2 and Treg might be involved in the downregulation of Th2 cytokines and upregulation of Th1 cytokines production.
    Mediators of Inflammation 01/2014; 2014:436476. · 3.88 Impact Factor
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    ABSTRACT: We report on a rare case of sarcoidosis that developed after chemotherapy for ovarian cancer, and mimicked a cancer metastasis. A 52-year-old female diagnosed with stage III ovarian cancer underwent curative surgery and postoperative chemotherapy. Four months later, her whole-body positron emission tomography and computed tomography (CT) scan showed high uptake in the mediastinal lymph nodes, and ovarian cancer recurrence was suspected. Biopsy of the mediastinal lymph nodes and subcutaneous nodules revealed noncaseating granulomas. These lesions resolved spontaneously without treatment; however, newly developed perilymphatic and centrilobular nodules were observed on follow-up chest CT. Surgical biopsy of these lesions also showed noncaseating granulomas. She was finally diagnosed with sarcoidosis.
    Cancer Research and Treatment 12/2013; 45(4):354-8. · 1.96 Impact Factor
  • Journal of the American Geriatrics Society 09/2013; 61(9):1631-2. · 4.22 Impact Factor
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    ABSTRACT: The aim of this study was to identify related factors of low levels of self-efficacy in patients with Chronic Obstructive Pulmonary Disease (COPD). A cross-sectional research design used descriptive statistics, χ(2) test, t-test, and binary logistic regression. Two hundred and forty-five patients with COPD were recruited from five hospitals in South Korea. The COPD Self-Efficacy Scale, the Bristol COPD Knowledge Questionnaire, Personal Resource Questionnaire 2000, BODE index, and the International Physical Activity Questionnaire short version were utilized to assess self-efficacy, disease-related knowledge, social support, disease severity, and physical activity, respectively. The BODE index, affect-oriented coping, and duration since diagnosis of COPD were included as significant predictors of self-efficacy. These findings suggest possible screening methods to identify patients with low levels of self-efficacy and future intervention targeting for these patients would strengthen the efficiency of an intervention.
    Nursing and Health Sciences 05/2013; · 0.71 Impact Factor
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    ABSTRACT: Community-acquired pneumonia (CAP) is one of the leading causes of death among the elderly. Several studies have reported the clinical usefulness of serum procalcitonin, a biomarker of bacterial infection. However, the association between the levels of procalcitonin and the severity in the elderly with CAP has not yet been reported. The aim of this study was to evaluate usefulness of procalcitonin as a predictor of severity and mortality in the elderly with CAP. This study covers 155 CAP cases admitted to Pusan National University Hospital between January 2010 and December 2010. Patients were divided into two groups (≥65 years, n=99; <65 years, n=56) and were measured for procalcitonin, C-reactive protein (CRP), white blood cell, confusion, uremia, respiratory rate, blood pressure, 65 years or older (CURB-65) and pneumonia severity of index (PSI). The levels of procalcitonin were significantly correlated with the CURB-65, PSI in totals. Especially stronger correlation was observed between the levels of procalcitonin and CURB-65 in the elderly (procalcitonin and CURB-65, ρ=0.408 with p<0.001; procalcitonin and PSI, ρ=0.293 with p=0.003; procalcitonin and mortality, ρ=0.229 with p=0.023). The correlation between the levels of CRP or WBC and CAP severity was low. The existing cut-off value of procalcitonin was correlated with mortality rate, however, it was not correlated with mortality within the elderly. The levels of procalcitonin are more useful than the levels of CRP or WBC to predict the severity of CAP. However, there was no association between the levels of procalcitonin and mortality in the elderly.
    Tuberculosis and Respiratory Diseases 05/2013; 74(5):207-14.
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    ABSTRACT: The purpose of this study was to identify the relationship between nutritional status and the severity of the disease in patients with COPD in South Korea. This study used pretest data from a larger intervention study. Data were collected from March to October 2010, and 251 patients diagnosed with COPD from five hospitals in South Korea were included in the analysis. All participants were interviewed face-to-face. Actual dietary intake was measured by a 24-h dietary recall, and the body mass index (BMI), obstruction of the airway (FEV1% predicted), degree of dyspnea (modified Medical Research Council: MMRC), and exercise capacity (6min walking distance: 6MWD) (BODE) index was calculated to estimate the severity of the condition. Lower BODE index scores indicate lower risk of mortality. The data were analyzed by descriptive statistics, a χ(2) test, t-tests, analysis of variance (ANOVA), Pearson correlation, and hierarchical multiple regression using SPSS 18.0. The mean age of the participants was 66.83 years and 92.4% of the participants were men. The mean total energy intake was 1431.65kcal, and the mean BODE index score was 2.89. Total energy intake significantly explained additional variance in BODE, BMI, the severity of the perceived dyspnea, and the length of 6min walk after controlling for age, duration after diagnosed with COPD, and physical activities. The findings of this study emphasized the importance of calorie intake in the disease severity among COPD patients. Further research on the effects of nutritional intervention on the health outcomes of patients with COPD is warranted.
    Archives of gerontology and geriatrics 01/2013; · 1.36 Impact Factor
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    ABSTRACT: We report a rare case of multidrug-resistant pulmonary and testicular tuberculosis (TB) in a 25-year-old immunocompetent patient. The patient was suspected to have a testicular cancer. He underwent radical orchiectomy, and surgical pathology revealed a granuloma containing acid-fast bacilli in the testis. Bronchial washing fluid culture grew Mycobacterium tuberculosis resistant to isoniazid, rifampin, and ethambutol. To our knowledge, this patient represents the first case of testicular TB in multidrug-resistant pulmonary TB.
    Journal of Infection and Chemotherapy 10/2012; · 1.55 Impact Factor
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    ABSTRACT: We evaluated the clinical outcomes and prognostic factors of patients requiring prolonged mechanical ventilation (PMV), defined as ventilator care for ≥21 days, who were admitted to the medical intensive care unit (ICU) of a university hospital in Korea. During the study period, a total of 2,644 patients were admitted to the medical ICU, and 136 patients (5.1%) were enrolled between 2005 and 2010. The mean age of the patients was 61.3±14.5 years, and 94 (69.1%) were male. The ICU and six-month cumulative mortality rates were 45.6 and 58.8%, respectively. There were 96 patients with tracheostomy placement after admission and their mean period from admission to the day of tracheostomy was 21.3±8.4 days. Sixty-three patients (46.3%) were successfully weaned from ventilator care. Of the ICU survivors (n=74), 34 patients (45.9%) were transferred to other hospitals (not university hospitals). Two variables (thrombocytopenia [hazard ratio (HR), 1.964; 95% confidence interval (CI), 1.225~3.148; p=0.005] and the requirement for vasopressors [HR, 1.822; 95% CI, 1.111~2.986; p=0.017] on day 21) were found to be independent factors of survival on based on the Cox proportional hazard model. We found that patients requiring PMV had high six-month cumulative mortality rates, and that two clinical variables (measured on day 21), thrombocytopenia and requirement for vasopressors, may be associated with prognostic indicators.
    Tuberculosis and respiratory diseases. 10/2012; 73(4):224-30.
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    ABSTRACT: In a previous study, we demonstrated that the human macrophage migration inhibitory factor (MIF)-like protein (As-MIF) isolated from helminths could inhibit allergic airway inflammation via the recruitment of CD4(+)CD25(+)Foxp3(+) T cells. To evaluate the clinical importance of As-MIF as an antiasthma drug, we evaluated immune responses after recombinant As-MIF (rAs-MIF) treatment in peripheral blood mononuclear cell (PBMC) cultures. PBMC was isolated from 10 patients with atopic asthma, 8 patients with nonatopic asthma, and 12 nonatopic healthy subjects, and various concentrations of rAs-MIF were transferred into the PBMC culture medium. After 3 days, we measured the levels of T helper 2 and T helper 1 cytokines via ELISA. In atopic asthma, IL-4 and IL-5 production was significantly reduced in the PBMC cultures after rAs-MIF treatment. These inhibitory effects were not observed in the nonatopic asthma group. By way of contrast, IL-10 production in the PMBC cultures was significantly increased after rAs-MIF treatment in all experimental groups. The results of this study are similar to those previously reported in a mouse study, suggesting that As-MIF might be a candidate for the specific treatment of asthma.
    Journal of Asthma 12/2011; 49(1):10-5. · 1.85 Impact Factor
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    ABSTRACT: We have reported that a 24 kDa protein (22U homologous; As22U) of Anisakis simplex larvae could elicit several Th2-related chemokine gene expressions in the intestinal epithelial cell line which means that As22U may play a role as an allergen. In order to determine the contribution of As22U to allergic reactions, we treated mice with 6 times intra-nasal application of recombinant As22U (rAs22U). In the group challenged with rAs22U and ovalbumin (OVA), the number of eosinophils in the bronchial alveolar lavage fluid (BALF) was significantly increased, as compared to the group receiving only OVA. In addition, mice treated with rAs22U and OVA showed significantly increased airway hyperresponsiveness. Thus, severe inflammation around the airway and immune cell recruitment was observed in mice treated with rAs22U plus OVA. The levels of IL-4, IL-5, and IL-13 cytokines in the BALF increased significantly after treatment with rAs22U and OVA. Similarly, the levels of anti-OVA specific IgE and IgG1 increased in mice treated with rAs22U and OVA, compared to those treated only with OVA. The Gro-α (CXCL1) gene expression in mouse lung epithelial cells increased instantly after treatment with rAs22U, and allergy-specific chemokines eotaxin (CCL11) and thymus-and-activation-regulated-chemokine (CCL17) gene expressions significantly increased at 6 hr after treatment. In conclusion, rAs22U may induce airway allergic inflammation, as the result of enhanced Th2 and Th17 responses.
    The Korean Journal of Parasitology 12/2011; 49(4):373-80. · 0.88 Impact Factor
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    ABSTRACT: The goal of this study was to examine the unique contributions of sleep disturbance to depression in patients with chronic obstructive pulmonary disease (COPD) after controlling for other contributing variables, including patient characteristics, self-efficacy, and physical activity. One hundred thirty-one outpatients diagnosed with COPD from 3 hospitals in South Korea participated in the study. Data were collected from March to June 2010 and analyzed with descriptive statistics, Pearson correlation, and hierarchical multiple regression using the SPSS WIN program. The level of depression reported in this study was 13.84. Sleep disturbance, not living with a spouse, and self-efficacy were all predictors of depression and accounted for 45% of the variance. These findings show the need to screen routinely for sleep disturbance in patients with COPD and support potential benefits of interventions to enhance self-efficacy and quality of sleep in reducing depression in COPD patients.
    Geriatric nursing (New York, N.Y.) 11/2011; 32(6):408-17. · 0.79 Impact Factor
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    ABSTRACT: Interferon-γ release assays (IGRAs) have been incorporated into several national guidelines for latent TB infection (LTBI) diagnosis. However, their optimal application is still controversial and evolving. The aim of this study is to evaluate the performance of confirmatory IGRAs in addition to tuberculin skin tests (TSTs) in high school students with TST-positive (TST+) results who have had contact with another student who had TB (referred to in this article as "contacts") in TB outbreaks in a high BCG-vaccinated population. We conducted a retrospective observational study of contacts in five school TB outbreaks in South Korea. The progression rates of TB within 2 years were compared among the groups based on the results of TSTs and QuantiFERON-TB gold assays (QFT-Gs). Among 1,826 contacts, 21 (1.2%) developed active TB. Of the untreated groups, the rate of progression to TB was higher in the group with TST-positive (TST+) results (6.1%, six of 99) than in that with TST-negative (TST-) results (0.6%, 10 of 1,556; P < .001). Among TST+ contacts, the rate of progression to TB was higher in the group with QFT-G-positive (QFT-G+) results (18.75%, six of 32) than that with QFT-G-negative (QFT-G(-)) results (0%, 0 of 67; P = .001). None of the 67 contacts with TST+/QFT-G(-) results progressed to active TB. The addition of a confirmatory IGRA for TST+ contacts could effectively focus the targeting of LTBI treatment to fewer contacts in an intermediate-incidence setting in a high BCG-vaccinated population.
    Chest 10/2011; 141(4):983-8. · 7.13 Impact Factor
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    ABSTRACT: In order to get a better understanding of the role of protease-activated receptor 2 (PAR2) in type 2 helper T (Th2) cell responses against Trichinella spiralis infection, we analyzed Th2 responses in T. spiralis-infected PAR2 knockout (KO) mice. The levels of the Th2 cell-secreted cytokines, IL-4, IL-5, and IL-13 were markedly reduced in the PAR2 KO mice as compared to the wild type mice following infection with T. spiralis. The serum levels of parasite-specific IgE increased significantly in the wild type mice as the result of T. spiralis infection, but this level was not significantly increased in PAR2 KO mice. The expression level of thymic stromal lymphopoietin, IL-25, and eotaxin gene (the genes were recently known as Th2 response initiators) of mouse intestinal epithelial cells were increased as the result of treatment with T. spiralis excretory-secretory proteins. However, the expression of these chemokine genes was inhibited by protease inhibitor treatments. In conclusion, PAR2 might involve in Th2 responses against T. spiralis infection.
    The Korean Journal of Parasitology 09/2011; 49(3):235-43. · 0.88 Impact Factor
  • American Thoracic Society 2011 International Conference, May 13-18, 2011 • Denver Colorado; 05/2011

Publication Stats

192 Citations
71.45 Total Impact Points

Institutions

  • 2008–2014
    • Pusan National University
      • • Department of Internal Medicine
      • • College of Nursing
      • • School of Medicine
      Tsau-liang-hai, Busan, South Korea
  • 2007
    • Seoul National University Hospital
      • Department of Internal Medicine
      Sŏul, Seoul, South Korea