Ki Hwan Jung

Korea University, Sŏul, Seoul, South Korea

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Publications (40)75.75 Total impact

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    ABSTRACT: Rationale Levofloxacin (LFX) and moxifloxacin (MXF) are the two most frequently recommended fluoroquinolones for treatment of patients with multidrug-resistant tuberculosis (MDR-TB). However, studies comparing the effectiveness of LFX and MXF among MDR-TB patients are lacking. Objectives To compare the effectiveness of LFX and MXF in terms of culture conversion after 3 months of treatment for MDR-TB Methods In this prospective multicenter randomized open label trial, we randomly assigned 182 patients with MDR-TB (sensitive to LFX and MXF) to receive either LFX (750 mg/day) (90 patients) or MXF (400 mg/day) (92 patients) with a background drug regimen. The primary outcome was the proportion of patients who achieved sputum culture conversion at 3 months of treatment. Secondary outcomes were time to culture conversion and time to smear conversion, with data censored at 3 months, and the proportions of adverse drug reactions. Measurements and Main Results At 3 months of treatment, 68 of the 77 patients (88.3%) in the LFX group and 67 of the 74 (90.5%) in the MXF group showed conversion to negative sputum cultures (odds ratio for LFX compared to MXF, 0.78; 95% confidence interval, 0.27-2.20). Adverse drug reactions were reported in six patients (7.7%) in the LFX group and four (5.2%) in the MXF group (P=0.75). Conclusions The choice of LFX or MXF for treatment of MDR-TB patients may not affect sputum culture conversion at 3 months of treatment.
    American Journal of Respiratory and Critical Care Medicine 08/2013; 188(7). DOI:10.1164/rccm.201303-0604OC · 11.99 Impact Factor
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    ABSTRACT: We report a very rare case of a bronchogenic cyst combined with nontuberculous mycobacterial pulmonary disease in an immunocompetent patient. A 21-year-old male was referred to our institution because of a cough, fever, and worsening of abnormalities on his chest radiograph, despite anti-tuberculosis treatment. Computed tomography of the chest showed a large multi-cystic mass over the right-upper lobe. Pathological examination of the excised lobe showed a bronchogenic cyst combined with a destructive cavitary lesion with granulomatous inflammation. Microbiological culture of sputum and lung tissue yielded Mycobacterium avium. The patient was administered anti-mycobacterial treatment that included clarithromycin.
    The Korean Journal of Internal Medicine 01/2013; 28(1):94-7. DOI:10.3904/kjim.2013.28.1.94
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    ABSTRACT: Hydatid disease is caused by the larval stage of taenia Echinococcus, which endemic in the Mediterranean region. Recently, the prevalence of the disease has increased worldwide due to an increase in the frequency of travel and immigration. As the infested larvae migrate through the bloodstream, the final destination is most commonly the liver or lungs; direct pleural invasion is very rare. A 50-year-old diabetic Korean man presented with an incidentally noted 2 cm right pleural nodule. On follow up imaging after three months, its size had increased. To confirm the diagnosis of the lesion, surgical excision was performed. Histopathological examination showed the diagnosis of a hydatid cyst. The patient had no history of overseas travel, but lives in an urban area where many foreign workers from endemic countries reside. This is the first reported case of primary pleural hydatid disease in a non-endemic country.
    Tuberculosis and Respiratory Diseases 01/2011; 70(4):338. DOI:10.4046/trd.2011.70.4.338
  • Ki Hwan Jung, Je Hyeong Kim
    American Thoracic Society 2010 International Conference, May 14-19, 2010 • New Orleans; 05/2010
  • American Thoracic Society 2010 International Conference, May 14-19, 2010 • New Orleans; 05/2010
  • American Thoracic Society 2010 International Conference, May 14-19, 2010 • New Orleans; 05/2010
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    ABSTRACT: The materials used for cosmetic procedures by physicians as well as illegally by non-medical personnel can cause non-thrombotic pulmonary embolism (NTPE). The case history is presented of a woman with acute respiratory failure after an illegal cosmetic vaginal procedure using hyaluronic acid (HA) dermal filler by an unlicensed medical practitioner on the day of symptom onset. Histopathological examination of a video-assisted thoracoscopic lung biopsy specimen showed a granulomatous foreign body reaction with multinucleated giant cells around amorphous basophilic materials in the pulmonary vessels and lung parenchyma, suggesting NTPE by HA. HA is approved for dermal implantation for the correction of facial wrinkles and folds. All other uses are considered off label. Although HA is supposedly devoid of immunological reactions, localised complications with granulomatous foreign body reactions by HA injection have been reported after cosmetic facial procedures. However, the case of a typical NTPE syndrome has not yet been reported. This is the first reported biopsy-proven case of a patient developing NTPE caused by HA.
    Thorax 04/2010; 65(4):360-1. DOI:10.1136/thx.2009.128272 · 8.56 Impact Factor
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    ABSTRACT: Intralobar pulmonary sequestration is a rare congenital lung anomaly. It is defined as a portion of nonfunctioning lung parenchyma that receives its blood supply from an anomalous systemic artery. Patients often present with chronic or recurrent pneumonia. A chest radiograph may show a cystic lesion with air-fluid levels in the lung base. A high index of suspicion is needed for a diagnosis. Surgical removal of a symptomatic intralobar pulmonary sequestration is generally the treatment of choice. Identifying the aberrant artery is a difficult problem when resecting a pulmonary sequestration. The thoracic and abdominal aortas are the most common origins for the abnormal blood supply. However, arterial supply from the celiac artery is quite rare. We present a case of intralobar pulmonary sequestration with the blood supply originating from the celiac artery.
    Tuberculosis and Respiratory Diseases 01/2010; 68(6). DOI:10.4046/trd.2010.68.6.358
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    ABSTRACT: The increasing rate of drug-resistant tuberculosis (TB) is a threat to the public health and TB control. In Korea, about 75~80% of TB patients are treated in private hospitals and the rate has been continuously increasing since 2000.
    Tuberculosis and Respiratory Diseases 01/2010; 69(2):95. DOI:10.4046/trd.2010.69.2.95
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    ABSTRACT: Lymphomatoid granulomatosis (LYG) is a rare angiocentric and angiodestructive lymphoproliferative disease characterized by Epstein-Barr virus-positive B cells admixed with reactive T cells. LYG most commonly affects the lung but can also involve other extrapulmonary sites. Pulmonary LYG usually presents as multiple pulmonary nodules with rapid progression and excavation. It can mimic various infectious diseases, vasculitis or metastatic malignancy and is difficult to be diagnosed clinically. Standard treatment for LYG has not yet been established. Despite combination chemotherapy, the overall prognosis is poor. Recently, anti-CD20 monoclonal antibody, rituximab, has been used to treat LYG. We report the case of a 70-year-old male patient with pulmonary LYG, who showed rapid remission of the disease after combination chemotherapy with rituximab.
    Chemotherapy 09/2009; 55(5):386-90. DOI:10.1159/000237745 · 1.55 Impact Factor
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    ABSTRACT: The prevalence of obesity and asthma has been increasing during the last several decades. Obesity has been reported to be associated with asthma. Obesity, especially abdominal obesity, is the main component of the metabolic syndrome. We thus hypothesized that metabolic syndrome is an important contributing factor for the development of asthma-like symptoms. The Korean Health and Genome Study started in 2001 as an ongoing population-based study of Korean adults 40 to 69 years of age. The prevalence of asthma-like symptoms in the previous 12 months was obtained by a questionnaire, and spirometric testing was conducted. Among the 10,038 participants, the data from 9,942 individuals (4,716 men and 5,226 women) was available. Asthma-like symptoms (wheeze [p = 0.0006], resting dyspnea [p = 0.0062], and post-exercise dyspnea [p < 0.0001]) were increased in the subjects of the metabolic syndrome group. Subjects with asthma-like symptoms had a decreased lung function compared to subjects without asthma-like symptoms. Among the components of the metabolic syndrome, abdominal obesity and hypertension were the risk factors for asthma-like symptoms. Metabolic syndrome is associated with asthma-like symptoms. Among the components of metabolic syndrome, abdominal obesity and hypertension are the risk factors for asthma-like symptoms.
    Journal of Asthma 05/2009; 46(4):339-42. DOI:10.1080/02770900802660931 · 1.83 Impact Factor
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    ABSTRACT: A lateral position (LP) during sleep is effective in reducing sleep disorder symptoms in mild or moderate sleep apnea patients. However, the effect of head and shoulder posture in LP on reducing sleep disorders has not been reported. In this study, effective sleeping positions and a combination of sleep position determinants were evaluated with respect to their ability to reduce snoring and apnea. The positions evaluated included the following: cervical vertebrae support with head tilting (CVS-HT), scapula support (SS), and LP. A central composite design was applied for response surface analysis (RSA). Sixteen patients with mild or moderate positional sleep apnea and snoring who underwent polysomnography for two nights were evaluated. Based on an estimated RSA equation, LP (with a rotation of at least 30 degrees) had the most dominant effect [P = 0.0057 for snoring rate, P = 0.0319 for apnea-hypopnea index (AHI)]. In addition, the LP was found to interact with CVS-HT (P = 0.0423) for snoring rate and CVS-HT (P = 0.0310) and SS (P = 0.0265) for AHI. The optimal sleep position reduced mild snoring by more than 80% (i.e. snoring rate in the supine position was <20%) and the snoring rate was approximately zero with a 40 degrees rotation. To achieve at least 80% reduction of AHI, LP and SS should be >30 degrees and/or 20 mm respectively. To determine an effective sleep position, CVS-HT and SS, as well as the degree of the LP, should be concurrently considered in patients with positional sleep apnea or snoring.
    Journal of Sleep Research 03/2009; 18(1):26-35. DOI:10.1111/j.1365-2869.2008.00703.x · 2.95 Impact Factor
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    ABSTRACT: Prostaglandin (PGE2), synthesized by cyclooxygenase-2 (COX-2), is associated with cellular immune tolerance during the process of cancer development. Induction of tolerance requires a specific environment in which dendritic cells and regulatory T cells (Tregs) play an essential role. It was recently shown that maturation of dendritic cells in the presence of indoleamine 2, 3-dioxygenase (IDO) results in activation of Tregs, and inhibition of COX-2 activity regulated IDO expression within the tumor microenvironment. Thus, we hypothesized that the tumor immune tolerance would be inhibited by COX-2 inhibitor and this inhibition would be mediated by IDO-dependent Tregs inhibition. The PGE2 in Lewis lung cancer cells (3LL) and serum of mice were measured for the evaluation of COX-2 inhibitors' local and systemic effects. The production of PGE2 in 3LL cells and serum of 3LL tumor-bearing mice were decreased by COX-2 inhibition. However, there were no significant differences in serum PGE2 levels among normal control and celecoxib-treated nontumor-bearing mice. The accumulation of Tregs was reduced in the celecoxib-treated 3LL tumor-bearing mice. In addition, the expressions of COX-2, IDO, and Foxp3 were reduced in the mice treated with a COX-2 inhibitor, and this was found to correlate with a reduction in the size of tumor mass and metastasis. These results suggest that the antitumor effects of COX-2 inhibitors seemed to be correlated with the inhibition of IDO and Tregs. Therefore, COX-2 inhibitors might provide a therapeutic strategy for Tregs-induced tumor immune tolerance.
    Journal of immunotherapy (Hagerstown, Md.: 1997) 02/2009; 32(1):22-8. DOI:10.1097/CJI.0b013e31818ac2f7 · 3.35 Impact Factor
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    ABSTRACT: The smoking prevalence in asthma patients are similar to those in the general population. Asthma and active cigarette smoking can interact to create more severe symptoms, an accelerated decline in lung function and impaired therapeutic responses. Accordingly, asthmatics with a history of smoking were examined to define the clinical characteristics and lung function of smoking asthmatics.
    Tuberculosis and Respiratory Diseases 01/2009; 67(6). DOI:10.4046/trd.2009.67.6.506
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    ABSTRACT: The pathophysiologic mechanisms of early acute lung injury (ALI) differ according to the type of primary insult. It is important to differentiate between direct and indirect pathophysiologic pathways, and this may influence the approach to treatment strategies. NF-κB decoy oligodeoxynucleotide (ODN) is a useful tool for the blockade of the expression of NF-κB-dependent proinflammatory mediators and has been reported to be effective in indirect ALI. The purpose of this study was to investigate the effect of NF-κB decoy ODN in the lipopolysaccharide (LPS)-induced direct ALI model.
    Tuberculosis and Respiratory Diseases 01/2009; 67(2). DOI:10.4046/trd.2009.67.2.95
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    ABSTRACT: Despite the improvements in supportive care, early and late hematopoietic stem cell transplantation-related complications still remain a significant cause of morbidity and mortality. Pulmonary complications occur in 40~60% of patients who undergo allogeneic hematopoietic stem cell transplantation. Late-onset noninfectious pulmonary complications can occur months and even years after transplantation. Interstital lung disease has also been reported to be a late post-transplant complication. Exposure to cytotoxic drugs and/or irradiation has been implicated as a cause of pulmonary toxicity including pulmonary fibrosis. We report a case of an 18-year-old female with non-classifiable interstitial pneumonia that manifested eight and a half years after allogeneic hematopoietic stem cell transplantation. The condition worsened rapidly and the patient eventually died.
    Tuberculosis and Respiratory Diseases 01/2009; 66(2). DOI:10.4046/trd.2009.66.2.122
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    ABSTRACT: Pulmonary arteriovenous malformation (PAVM) is a rare pulmonary vascular anomaly due to an abnormal communication between the pulmonary artery and vein. The most common presenting symptom is a dyspnea on exertion related to this right-to-left shunt. If left untreated, PAVM has been known to result in serious complications. Incomplete pulmonary capillary network can be the cause of cerebral abscesses and other non-infectious neurological complications, such as stroke and transient ischemic attacks due to paradoxic embolism Transcatheter embolotherapy, using coils or balloons, has replaced surgical resection as the treatment of choice for PAVM. However, the risk of device embolization has limited the use of coil embolotherapy, while the size of PAVM is huge. Recently, Amplatzer® Vascular Plug has been proposed as an alternative endovascular occlusion device for arteriovenous malformation. We report a case of 81-year-old male patient with a giant PAVM, which was successfully treated by transcatheter embolotherapy using the Amplatzer® Vascular Plug.
    Tuberculosis and Respiratory Diseases 01/2009; 67(1). DOI:10.4046/trd.2009.67.1.52
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    ABSTRACT: Poly (ADP-ribose) polymerase (PARP) participates in inflammation by cellular necrosis and the nuclear factor-kappa-B (NF-kappaB)-dependent transcription. The purpose of this study was to examine the roles of PARP in ventilator-induced lung injury (VILI) in normal mice lung. Male C57BL/6 mice were divided into four groups: sham tracheostomized (sham), lung-protective ventilation (LPV), VILI, and VILI with PARP inhibitor PJ34 pretreatment (PJ34+VILI) groups. Mechanical ventilation (MV) settings were peak inspiratory pressure (PIP) 15 cm H2O + positive end-expiratory pressure (PEEP) 3 cm H2O + 90 breaths per minute for the LPV group and PIP 40 cm H2O + PEEP 0 cm H2O + 90 breaths per minute for the VILI and PJ34+VILI groups. After 2 hours of MV, acute lung injury (ALI) score, wet-to-dry (W/D) weight ratio, PARP activity, and dynamic compliance (CD) were recorded. Tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), myeloperoxidase (MPO) activity, and nitrite/nitrate (NOX) in the bronchoalveolar lavage fluid and NF-kappaB DNA-binding activity in tissue homogenates were measured. The VILI group showed higher ALI score, W/D weight ratio, MPO activity, NOX, and concentrations of TNF-alpha and IL-6 along with lower CD than the sham and LPV groups (P < 0.05). In the PJ34+VILI group, PJ34 pretreatment improved all histopathologic ALI, inflammatory profiles, and pulmonary dynamics (P < 0.05). NF-kappaB activity was increased in the VILI group as compared with the sham and LPV groups (P < 0.05) and was decreased in the PJ34+VILI group as compared with the VILI group (P = 0.009). Changes in all parameters were closely correlated with the PARP activity (P < 0.05). Overactivation of PARP plays an important role in the inflammatory and transcriptional pathogenesis of VILI, and PARP inhibition has potentially beneficial effects on the prevention and treatment of VILI.
    Critical care (London, England) 09/2008; 12(4):R108. DOI:10.1186/cc6995
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    American Journal of Respiratory and Critical Care Medicine 09/2008; 178(4):431; author reply 432-3. DOI:10.1164/ajrccm.178.4.431 · 11.99 Impact Factor
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    ABSTRACT: We report the patient presented with a left-sided pleural effusion. Pleural fluid analysis revealed lymphocyte-dominant exudates with lower level of adenosine deaminase and negative cytologic malignancy. Thoracoscopic examination and histologic examination revealed metastatic nodules on pleurae, proven to be from the papillary thyroid cancer. There were no other sites of distant metastases. Though papillary thyroid cancer is characterized with slow progression and relatively good prognosis, metastatic pleural effusion as an initial manifestation of undiagnosed papillary thyroid cancer can be considered.
    Tuberculosis and Respiratory Diseases 01/2008; 64(4). DOI:10.4046/trd.2008.64.4.314