Joo Hun Park

Ajou University, Sŏul, Seoul, South Korea

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Publications (20)46.12 Total impact

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    ABSTRACT: The ligands for CXC chemokine receptor 3 (CXCR3) recruit T helper type I cells, which play a major role in cell-mediated immunity in tuberculosis (TB). A total of 409 subjects were enrolled. The study population comprised 186 patients with active TB, 58 patients with non-TB pulmonary diseases, 50 controls with a positive interferon (IFN)-γ release assay (IGRA) result, and 115 controls with a negative IGRA result. Whole blood samples were collected using IGRA methodology. After incubation, plasma IFN-γ levels and two CXCR3 ligands, IFN-inducible T cell α chemoattractant (I-TAC, CXCL11) and monokine induced by IFN-γ (MIG, CXCL9) were measured by ELISA. Receiver operating characteristics (ROC) analysis was performed. The sensitivity and specificity values were based on cutoff points selected to maximize the Youden index. The TB-antigen-stimulated levels of IFN-γ, I-TAC, and MIG were significantly increased in active pulmonary TB compared with all other groups. From ROC analysis, for the diagnosis of active TB, I-TAC and MIG outperformed IFN-γ in all comparisons with IGRA-positive and -negative controls, and non-TB pulmonary diseases. The areas under the curve (95% CI) for differentiating active pulmonary TB from all other groups were 0.893 (0.864-0.924) for IFN-γ, 0.962 (0.946-0.978) for I-TAC, and 0.944 (0.922-0.965) for MIG. The sensitivity and specificity of I-TAC were 90.3% and 90.7%, respectively; those of MIG were 92.5% and 85.2%, respectively, and those of IFN-γ were 84.9% and 79.8%, respectively. TB antigen-stimulated assays of I-TAC and MIG may be useful surrogate markers for diagnosing active pulmonary TB.
    Chest 02/2014; · 7.13 Impact Factor
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    ABSTRACT: Apoptosis plays a role in the development of pleural effusion. Caspase-cleaved cytokeratin 18, a marker for epithelial cell apoptosis, was evaluated in pleural effusion. A total of 79 patients with pleural effusion were enrolled. The underlying causes were lung cancer (n=24), parapneumonic effusion (n=15), tuberculous effusion (n=28), and transudates (n=12). The levels of M30, an epitope of caspase-cleaved cytokeratin 18, were measured in blood and pleural fluids using enzyme-linked immunosorbent assay along with routine cellular and biochemical parameters. The expression of M30 was evaluated in the pleural tissues using immunohistochemistry for M30. The M30 levels in pleural fluid were significantly higher in patients with tuberculosis (2,632.1±1,467.3 U/mL) than in patients with lung cancer (956.5±618.5 U/mL), parapneumonic effusion (689.9±413.6 U/mL), and transudates (273.6±144.5 U/mL; all p<0.01). The serum levels were not significantly different among the disease groups. Based on receiver operating characteristics analysis, the area under the curve of M30 for differentiating tuberculous pleural effusion from all other effusions was 0.93. In the immunohistochemical analysis of M30, all pathologic types of cancer cells showed moderate to high expression, and the epithelioid cells in granulomas showed high expression in tuberculous pleural tissues. Caspase-cleaved cytokeratin 18 was most prominently observed in tuberculous pleural effusion and showed utility as a clinical marker. The main source of M30 was found to be the epithelioid cells of granulomas in tuberculous pleural tissues.
    Tuberculosis and Respiratory Diseases 01/2014; 76(1):15-22.
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    ABSTRACT: Objectives To investigate the prevalence of simple pulmonary eosinophilia (SPE) and validate CT findings of SPE found on follow-up CT of oncologic patients Methods We retrospectively reviewed 6977 cases of oncologic patients who underwent chest CT. A total of 66 individuals who met criteria for having SPE were identified. CT scans were fully re-assessed by consensus of 2 radiologists in terms of characteristics of pulmonary lesions. Results The prevalence of SPE was 0.95%. A total of 193 lesions were identified and most of the lesions showed part-solid pattern (69.9%), round to ovoid contour (46.1%), ill-defined margin (90.2%), or partial halo appearance (74.8%). In addition, almost half of the lesions showed the vascular contact (49%). SPE appeared as either solitary (42.4%) or multiple lesions (57.6%). The majority of lesions were located in the periphery (76.2%), and lower lung zonal (67.4%) predominance was found. Conclusions The frequency of SPE in oncologic patients with CT findings of GGO, part-solid lesion was high (17.5%). Therefore, when key features of CT findings suggesting SPE (part-solid nodule; ill-defined margin; peripheral distribution; and lower lung zone predominance) are newly discovered on follow-up chest CT in oncologic patients, it would be useful to correlate with blood test and do short-term follow-up in order to avoid unnecessary invasive procedure.
    European Journal of Radiology. 01/2014;
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    ABSTRACT: The Sequential Organ Failure Assessment (SOFA) score, originally developed to assess organ failure status, is widely used as a prognostic indicator in intensive care unit patients. Additional prognostic factors, such as age and comorbidities, may complement the predictive performance of the SOFA. In total, 1049 consecutive patients were enrolled prospectively. SOFA and other admission-based intensive care unit scores were recorded during the first 24 hours. A complemented SOFA (cSOFA) score model was constructed by adding age and comorbidity scores to the original SOFA score, based on logistic regression analysis. The predictive performance was evaluated with regard to hospital mortality by receiver operating characteristics analysis. The Hosmer-Lemeshow goodness-of-fit test was used to assess calibration of the model, and leave-one-out cross-validation was performed. The cSOFA score (maximum 30 points) was calculated as the SOFA score (24 points) + age score (2 points) + comorbidity score (4 points). The cSOFA score model showed satisfactory calibration and cross-validation performance. The AUC (95% CI) of the cSOFA score (0.812 [0.787-0.835]) was higher than the SOFA score (0.743 [0.715-0.769], P < .0001). The performance of the SOFA score to predict hospital mortality can be improved by considering age and comorbidity factors.
    Journal of critical care 10/2013; · 2.13 Impact Factor
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    ABSTRACT: Adequate assessment and control of sedation play crucial roles in the proper performance of mechanical ventilation. A total of 30 patients with various pulmonary diseases were prospectively enrolled. The study population was randomized into two groups. The sedation assessment group (SAG) received active protocol-based control of sedation, and in the empiric control group (ECG), the sedation levels were empirically adjusted. Subsequently, daily interruption of sedation (DIS) was conducted in the SAG. In the SAG, the dose of midazolam was significantly reduced by control of sedation (day 1, 1.3±0.5 µg/kg/min; day 2, 0.9±0.4 µg/kg/min; p<0.01), and was significantly lower than the ECG on day 2 (p<0.01). Likewise, on day 2, sedation levels were significantly lower in the SAG than in the ECG. Significant relationship was found between Ramsay sedation scale and Richmond agitation-sedation scale (RASS; r(s)=-0.57), Ramsay Sedation Scale and Bispectral Index (BIS; r(s)=0.77), and RASS and BIS (r(s)=-0.79). In 10 patients, who didn't require re-sedation after DIS, BIS showed the earliest and most significant changes among the sedation scales. Ventilatory parameters showed significant but less prominent changes, and hemodynamic parameters didn't show significant changes. No seriously adverse events ensued after the implementation of DIS. Active assessment and control of sedation significantly reduced the dosage of sedatives in patients receiving mechanical ventilation. DIS, conducted in limited cases, suggested its potential efficacy and tolerability.
    Tuberculosis and respiratory diseases. 09/2012; 73(3):151-61.
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    ABSTRACT: Oxidative stress results in protein oxidation and is implicated in carcinogenesis. Sulfiredoxin (Srx) is responsible for the enzymatic reversal of inactivated peroxiredoxin (Prx). Nuclear factor E2-related factor 2 (Nrf2) binds to antioxidant responsive elements and upregulates the expression of Srx and Prx during oxidative stress. We aimed to elucidate the biological functions and potential roles of Srx in lung cancer. To study the roles of Srx and Prx III in lung cancer, we compared the protein levels of Nrf2, Prxs, thioredoxin, and Srx in 40 surgically resected human lung cancer tissues using immunoblot and immunohistochemical analyses. Transforming growth factor-β(1), tumor necrosis factor-α, and camptothecin treatment were used to examine Prx III inactivation in Mv1Lu mink lung epithelial cells and A549 lung cancer cells. Prx I and Prx III proteins were markedly overexpressed in lung cancer tissues. A significant increase in the oxidized form of a cysteine sulfhydryl at the catalytic site of Prxs was found in carcinogenic lung tissue compared to normal lung tissue. Densitometric analyses of immunoblot data revealed significant Srx expression, which was higher in squamous cell carcinoma tissue (60%, 12/20) than in adenocarcinoma (20%, 4/20). Also, Nrf2 was present in the nuclear compartment of cancer cells. Srx and Prx III proteins were markedly overexpressed in human squamous cell carcinoma, suggesting that these proteins may play a protective role against oxidative injury and compensate for the high rate of mitochondrial metabolism in lung cancer.
    The Korean Journal of Internal Medicine 09/2011; 26(3):304-13.
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    ABSTRACT: Epithelial cell apoptosis plays an important role in the pathogenesis of idiopathic interstitial pneumonia (IIP). Serum levels of caspase-cleaved cytokeratin-18 (M30) were measured in 55 patients with IIP and 34 healthy controls using enzyme-linked immunosorbent assays. The IIP cases included usual interstitial pneumonia (UIP; n = 30), nonspecific interstitial pneumonia (NSIP; n = 15), and cryptogenic organizing pneumonia (COP; n = 10). The radiological scoring was performed based on high-resolution computed tomography (HRCT) findings. Patients with IIP had higher serum M30 levels than did the control group (178.6 ± 91.5 vs. 113.7 ± 46.8 U/L, p < 0.05). Among IIP patients, COP patients had higher serum M30 levels than did UIP or NSIP patients (264.9 ± 132.7, 139.2 ± 49.7, and 201.2 ± 81.1 U/L, respectively; COP vs. UIP, p < 0.01). Serum M30 levels were negatively correlated with forced vital capacity (FVC; r(s) = -0.31), percent-predicted FVC (FVC%; r(s) = -0.38), and percent-predicted forced expiratory volume in 1 s (FEV(1)%; r(s) = -0.36). Serum M30 levels were correlated with radiological ground-glass opacity scores (r(s) = 0.61). The epithelial apoptosis marker serum level was correlated with IIP clinical status and is a potential marker to assess IIP.
    Respiratory medicine 11/2010; 104(11):1722-8. · 2.33 Impact Factor
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    ABSTRACT: It is unclear whether emphysema, regardless of airflow limitation, is a predictive factor associated with survival after lung cancer resection. Therefore, we investigated whether emphysema was a risk factor associated with the outcome after resection for lung cancer. This study enrolled 237 patients with non small cell lung cancer with stage I or II who had surgical removal. Patient outcome was analyzed based on emphysema. Emphysema was found in 43.4% of all patients. Patients with emphysema were predominantly men and smokers, and had a lower body mass index than the patients without emphysema. The patients without emphysema (n=133) survived longer (mean 51.2+/-3.0 vs. 40.6+/-3.1 months, P=0.042) than those with emphysema (n=104). The univariate analysis showed a younger age, higher FEV(1)/FVC, higher body mass index, cancer stage I, and a lower emphysema score were significant predictors of better survival. The multivariate analysis revealed a younger age, higher body mass index, and cancer stage I were independent parameters associated with better survival, however, emphysema was not. This study suggests that unfavorable outcomes after surgical resection of lung cancer should not be attributed to emphysema itself.
    Journal of Korean medical science 08/2010; 25(8):1146-51. · 0.84 Impact Factor
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    ABSTRACT: Peroxiredoxin (Prx) belongs to a ubiquitous family of antioxidant enzymes that regulates many cellular processes through intracellular oxidative signal transduction pathways. Silica-induced lung damage involves reactive oxygen species (ROS) that trigger subsequent toxic effects and inflammatory responses in alveolar epithelial cells resulting in fibrosis. Therefore, we investigated the role of Prx in the development of lung oxidant injury caused by silicosis, and determined the implication of ROS in that process. Lung epithelial cell lines A549 and WI26 were treated with 1% silica for 0, 24, or 48 hours, following pretreatment of the A549 cells with N-acetyl-L-cysteine and diphenylene iodonium and no pretreatment of the WI26 cells. We transfected an HA-ubiquitin construct into the A549 cell line and then analyzed the cells via Western blotting and co-immunoprecipitation. Silica treatment induced cell death in the A549 lung epithelial cell line and selectively degraded Prx I without impairing protein synthesis in the A549 cells, even when the ROS effect was blocked chemically by N-acetyl-L-cysteine. A co-immunoprecipitation study revealed that Prx I did not undergo ubiquitination. Silica treatment induces a decrease of Prx I expression in lung epithelial cell lines regardless of the presence of ROS. The silica-induced degradation of Prx does not involve the ubiquitin-proteasomal pathway.
    The Korean Journal of Internal Medicine 10/2009; 24(3):220-6.
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    ABSTRACT: The recruitment maneuver (RM) in acute respiratory distress syndrome (ARDS) can cause hemodynamic derangement. We evaluated circulatory and cardiac changes during RMs. We performed sustained inflation (SI) with a pressure of 40 cm H(2)O for 30 seconds as an RM on 22 patients with ARDS. Blood pressure (BP) and heart rate were recorded immediately before, every 10 seconds during, and 30 seconds after the RM. Ventricular dimensions were obtained simultaneously using M-mode echocardiography, and tissue Doppler imaging was performed on the left ventricular wall. Mean, systolic, and diastolic BP decreased at 20 and 30 seconds during 30-second RMs (mean BP: 92 +/- 12 at baseline to 83 +/- 18 mm Hg at the end of the RM, P < .05) and subsequently recovered. Heart rate decreased at 10 and 20 seconds during the RM, and tended to increase afterward. Both ventricular dimensions decreased significantly during the RM. The left ventricular ejection fraction and peak velocity of the left ventricle during systole remained stable. The fractional changes in mean BP and left ventricular end-diastolic dimension during the RMs were correlated significantly with each other (r(s) = 0.59). Static compliance of the respiratory system (Crs) was lower in patients with mean BP change > or =15% than in patients in whom the change was <15% (P < .05). A transient decrease in mean BP was observed during the RM, and its degree was correlated with the preload decrease, while cardiac contractility was maintained.
    Journal of Intensive Care Medicine 10/2009; 24(6):376-82.
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    ABSTRACT: We evaluated the clinical significance of angiopoietins and vascular endothelial growth factor (VEGF) in patients with resected early stage lung cancer. The study enrolled 101 patients with completely resected non-small cell lung cancer (NSCLC) of stage I or II, along with 70 healthy volunteers. Serum concentrations of angiopoietin-1, angiopoietin-2, and VEGF were measured with an ELISA. Immunohistochemical expression of angiopoietin-1 was compared with the microvessel density on the lung cancer tissues. The patients had lower serum angiopoietin-1 (32.1+/-9.9 ng/mL vs. 39.0+/-10.8 ng/mL, p<0.001), higher angiopoietin-2 (1949.2+/-1099.4 pg/mL vs. 1498.6+/-650.0 pg/mL, p<0.01), and higher VEGF (565.1+/-406.3 pg/mL vs. 404.6+/-254.8 pg/mL, p<0.01) levels than the controls. The angiopoietin-2 level was higher in stage II than in stage I patients (p<0.05). The levels of angiopoietin-1 (r=0.28) and angiopoietin-2 (r=0.36) each correlated with the VEGF level. Patients with a higher level of angiopoietin-1 (> or =31.2 ng/mL) had better disease-specific and relapse-free survival than those with a lower angiopoietin-1 level (<31.2 ng/mL). Angiopoietin-1 expression negatively correlated with the microvessel density. Serum angiopoietin-1 is a potential marker for predicting postoperative survival and recurrence in patients with early stage NSCLC.
    Lung cancer (Amsterdam, Netherlands) 03/2009; 66(3):359-64. · 3.14 Impact Factor
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    ABSTRACT: Primary pulmonary malignant fibrous histiocytoma (MFH) is very rare, so only a few imaging features have been reported. We report one case of rapidly growing primary pulmonary MFH mimicking a partially thrombosed pulmonary artery aneurysm and its radiologic findings, including multidetector row computed tomography (MDCT), conventional angiography, and fluorodeoxyglucose-positron emission tomography CT ([18F] FDG-PET/CT). On multi-phasic MDCT, this mass mimicked a pulmonary artery aneurysm with partial thrombosis. However, pulmonary artery aneurysm was excluded and suggested as a hypervascular parenchymal mass by subsequent conventional angiography. On [18F] FDG-PET/CT, it was a highly metabolic mass, showing a maximal standard uptake value (SUV) 12.1. Although primary pulmonary MFH is very rare and has no specific imaging findings, our experience might be helpful to differentiate a hypervascular pulmonary mass.
    European Radiology 09/2008; 18(8):1653-7. · 4.34 Impact Factor
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    ABSTRACT: Apoptosis is thought to play an important role in the development of acute respiratory distress syndrome (ARDS). We evaluated the bronchoalveolar lavage (BAL) fluid from ARDS patients focusing on apoptosis. The study enrolled 31 ARDS patients and 20 healthy controls. BAL fluid levels of caspase-cleaved cytokeratin-18 (CK-18) and soluble mediators such as interleukin-8 (IL-8), soluble Fas (sFas), soluble Fas ligand (sFasL), growth-related oncogene-alpha (GRO-alpha), granulocyte colony-stimulating factor (G-CSF), and tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) were measured using enzyme-linked immunosorbent assay (ELISA). The BAL fluid caspase-cleaved CK-18 levels in ARDS patients were higher than those in controls, reflecting increased epithelial apoptosis, and were correlated with lung injury scores (rs=0.49). The BAL fluid levels of all mediators were significantly higher in ARDS patients than in controls. In ARDS patients, the BAL fluid IL-8 level was positively correlated with the levels of sFas (rs=0.57), GRO-alpha (rs=0.47), and TRAIL (rs=0.45). The BAL fluid IL-8 (rs=0.61), sFas (rs=0.57), G-CSF (rs=0.44), and TRAIL (rs=0.33) levels were correlated with the BAL fluid neutrophil count. The G-CSF levels were significantly higher in non-surviving than in surviving ARDS patients [median 183.4 pg/mL (interquartile range 76.7-315.9) vs. 63.8 pg/mL (36.2-137.2); p<0.05]. The sFas levels were positively correlated with the PaO2/FiO2 ratio (rs=0.40), and the TRAIL levels were negatively correlated with the multiple organ dysfunction scores (rs=-0.37). Among the mediators in BAL fluid from ARDS patients, G-CSF had the most significant prognostic implications, and the sFas and TRAIL levels were correlated with clinical severity.
    Respiratory Medicine 03/2008; 102(3):464-9. · 2.59 Impact Factor
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    ABSTRACT: The overall safety of surgical lung biopsy in patients with idiopathic interstitial pneumonia (IIP) remains controversial. This study was performed to investigate the mortality and complication rate and identify the risk factors for surgical lung biopsy in patients with IIP. A total of 200 patients with IIP who underwent surgical lung biopsy at the Asan Medical Center, Korea, from April 1990 to August 2003, were enrolled. Complications and mortality were analyzed retrospectively. (1) The mortality rate 30 days after the surgical lung biopsy was 4.3%, which was significantly higher than the control group. Biopsy performed at the time of acute exacerbation (AE) resulted in higher 30-day mortality (28.6%) compared to non-AE (3.0%; p<0.05). AE was followed by biopsy itself in three cases. (2) Univariate analysis indicated that lower FVC, lower DL(CO), and presence of AE were significant risk factors for 30-day mortality (p<0.05). However, multivariate analysis revealed that only AE (OR: 11.334, 95% CI: 1.727-74.365, p=0.011) was an independent risk factor. (3) The patients with low DL(CO) (<50% predicted) had higher mortality and complication rate than high DL(CO) group. Our data suggested that the presence of acute exacerbation at the time of biopsy and lower DL(CO) were predictors of higher mortality after the surgical lung biopsy.
    European Journal of Cardio-Thoracic Surgery 07/2007; 31(6):1115-9. · 2.67 Impact Factor
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    ABSTRACT: Angiopoietins play a critical role in the angiogenesis related to tumor growth in concert with vascular endothelial growth factor (VEGF), and enhanced expression of angiopoietin-2 has been reported in lung cancer tissue. Patients with lung cancer (n = 136) and healthy volunteers (n = 40) were enrolled. Serum angiopoietin-2 and VEGF concentrations were measured using enzyme-linked immunosorbent assay. Patients with lung cancer had higher serum angiopoietin-2 (2,046.3 +/- 1,171.3 pg/mL vs 1,269.8 +/- 494.1 pg/mL, p < 0.001) and VEGF (542.9 +/- 445.8 pg/mL vs 364.7 +/- 185.9 pg/mL, p < 0.05) [mean +/- SD] levels than the control group. Serum angiopoietin-2 and VEGF levels correlated with each other in patients with lung cancer (Spearman r = 0.30, p < 0.001), specifically in non-small cell lung cancer (NSCLC) [n = 110; r = 0.34; p < 0.001] but not in small cell lung cancer (n = 26). With stage progression in NSCLC, serum angiopoietin-2 levels increased, and patients with distant metastasis had higher levels than those without metastasis (p < 0.005). By contrast, serum VEGF level did not increase with stage progression, and only had a trend toward elevation in distant metastasis (p = 0.05). In NSCLC, the low angiopoietin-2 group (< 1,605.5 pg/mL) had a better overall survival compared to the high angiopoietin-2 group (> or = 1,605.5 pg/mL; p < 0.05), although this survival benefit was not maintained after controlling for stage in a multivariate analysis. The angiopoietin-2 levels were higher in NSCLC patients with postoperative recurrence than in those without. Our study suggests that serum angiopoietin-2 is a useful clinical marker for detecting NSCLC with distant metastasis and is of potential prognostic value.
    Chest 07/2007; 132(1):200-6. · 7.13 Impact Factor
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    ABSTRACT: To investigate whether the better prognosis of interstitial pneumonias associated with collagen vascular disease (CVD) compared with idiopathic interstitial pneumonia (IIP) is due to higher frequency of the nonspecific interstitial pneumonia (NSIP) pattern in CVD, we compared the outcomes of patients from these two groups with the same histopathologic pattern. The clinical features and survival of 362 patients (269 with IIP and 93 with CVD) diagnosed using surgical lung biopsy were analyzed. The mean survival of the CVD group (131.0 mo) was longer than that of the IIP group (80.5 mo) (p<0.0001). The patients with usual interstitial pneumonia pattern among the CVD group (n=36) was younger, female, and predominantly nonsmoking compared with the IIP group (n=203). Although baseline lung functions were not significantly different, the CVD group survived longer (mean, 177.0 mo) than the IIP group (mean, 66.9 +/- 6.5 mo; p=0.001). By multivariate analysis, younger age, better pulmonary function, and the presence of a CVD were independent prognostic factors. In NSIP pattern, no significant differences in survival, clinical features, or lung function were found between the two groups. Our data suggest that the better prognosis of patients in the CVD group is not solely due to the predominance of the NSIP pattern. The prognosis of patients with the usual interstitial pneumonia pattern in CVD is better than in those with idiopathic pulmonary fibrosis, despite the same pathologic pattern. In contrast, in those with an NSIP pattern, the prognosis is similar in both groups.
    American Journal of Respiratory and Critical Care Medicine 04/2007; 175(7):705-11. · 11.04 Impact Factor
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    Tuberculosis and Respiratory Diseases 01/2007; 62(4).
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    ABSTRACT: Peroxiredoxins (Prxs) have been implicated in regulating many cellular processes including cell proliferation, differentiation and apoptosis. However, the pathophysiological significance of Prx proteins, especially in lung disease, has not been defined. Therefore, the authors investigated the distribution and expression of various Prx isoforms in lung cancer and compared this with normal lung from human and mouse. Patients diagnosed with lung cancer who underwent surgery at Ajou Medical Center were enrolled. Expression of Prxs, thioredoxin and thioredoxin reductase was analysed by proteomic techniques. Immunohistochemistry was performed to localize Prx proteins. Immunohistochemical staining showed that the isoforms of Prx I, II, III and V were predominantly expressed in bronchial and alveolar epithelium as well as in alveolar macrophages of the normal mouse lung. The isoforms I, III and thioredoxin were overexpressed in lung cancer tissues compared with normal lungs. There was also an increased amount of oxidized form of Prx I and a putative truncated form of Prx III in lung cancer samples when analysed on two-dimensional electrophoresis. In addition, a 40-kDa intermediate MW protein band and high MW bands of over 20 kDa, recognized by anti-Prx (a-Prx) I antibody, were present in tissue extracts of lung cancer patients on one-dimensional electrophoresis. The upregulation of Prx I, Prx III and thioredoxin in lung cancer tissue may represent an attempt by tumour cells to adjust to the microenvironment in a manner that is advantageous to survival and proliferation.
    Respirology 06/2006; 11(3):269-75. · 2.78 Impact Factor
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    ABSTRACT: There are contradictory reports concerning hypercapnia as a predictor of a better outcome in COPD. This study examined the clinical implications of hypercapnea in COPD patients (M:F = 59:19) who required mechanical ventilation. The clinical parameters at the time of MICU admission, the total ventilation time, the APACHE II score and the pulmonary function testing were retrospectively analyzed between the survivors and nonsurvivors. Univariate analysis showed that compared with the nonsurvivors, the survivors had lower AaDO2 values (59.8 +/- 53.5 vs. 105.0 +/- 73.3 mmHg, p=0.000), higher PaCO2 values (64.9 +/- 16.0 vs. 48.9 +/- 17.8 mmHg, p=0.000), lower APACHE II scores (19.0 +/- 3.8 vs. 24.1 +/- 5.1, p=0.002), the more frequent application of initial noninvasive positive pressure ventilation (44.0 vs. 14.3%, p=0.008), and a lower combined rate of septic shock (4.0 vs. 39.3%, p=0.000). Multivariate analysis revealed that a lower PaCO2 (OR: 0.94, p=0.008), the presence of septic shock (OR: 10.16, p=0.011), a higher APACHE II score (OR: 1.22, p=0.040) and a longer ventilation time (OR: 1.002, p=0.041) were the risk factors for mortality. A lower PaCO2 was also verified as the predictor. for mortality by multivariate analysis when excluding septic shock. Hypercapnia at admission is thought to be an independent predictor of better survival for the COPD patients who require mechanical ventilation.
    The Korean Journal of Internal Medicine 04/2006; 21(1):1-9.
  • Tuberculosis and Respiratory Diseases 01/2006; 61(4).

Publication Stats

285 Citations
46.12 Total Impact Points

Institutions

  • 2006–2014
    • Ajou University
      • Department of Pulmonary and Critical Care Medicine
      Sŏul, Seoul, South Korea
  • 2010
    • Seoul National University Hospital
      • Department of Internal Medicine
      Seoul, Seoul, South Korea
  • 2007
    • University of Ulsan
      • Department of Medicine
      Ulsan, Ulsan, South Korea
    • Asan Medical Center
      • Department of Pulmonary and Critical Care Medicine
      Seoul, Seoul, South Korea