Jung Hyun Chang

Ewha Womans University, Sŏul, Seoul, South Korea

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Publications (48)72.25 Total impact

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    ABSTRACT: Background The development of other primary cancers in patients with lung cancer is unfortunate and uncommon, although the frequency is increasing. The aim of this study was to determine the clinical features and prognosis in patients with multiple primary cancers (MPC) involving lung cancer.Methods After a retrospective review of 1644 patients who were newly diagnosed with primary lung cancer between 1998 and August 2012 at a tertiary hospital, 105 patients were included.ResultsThe median age at the time of lung cancer diagnosis was 67 years, and 68 patients were male. Synchronous primary cancers occurred in 47% of the study population (49/105). Among those with metachronous cancer (56/105), the median interval between the diagnosis of lung cancer and another malignancy was 47.1 months, and 21 patients were diagnosed with lung cancer as the first primary tumor. The most frequent type of other malignancy was urogenital (30%), followed by gastrointestinal (30%) and thyroid malignancies (16%). Advanced stage of lung cancer (hazard ratio (HR), 3.2; 95% confidence interval (CI), 1.8-5.7; P<0.001), supportive care only as treatment for lung cancer (HR, 2.8; 95% CI, 1.3-6.0; P=0.006), and head and neck cancer as another malignancy (HR, 3.9; 95% CI, 1.4-10.8; P=0.010) were independent predictors of shorter survival from the time of diagnosis of the second primary cancer.Conclusion Advanced lung cancer stage, symptomatic supportive care only without antitumor therapy for lung cancer, and head and neck cancer as another primary malignancy were poor prognostic factors in patients with MPC involving primary lung cancer.
    Thoracic Cancer. 07/2014;
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    ABSTRACT: This study analyzed the negative prognostic factors in patients who received second-line chemotherapy for advanced inoperable non-small cell lung cancer (NSCLC).
    Tuberculosis and Respiratory Diseases 07/2014; 77(1):13-7.
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    ABSTRACT: Gastroesophageal reflux disease is one of the most common causes of chronic cough and is a potential risk factor for the exacerbation of chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate the prevalence and risk factors for reflux esophagitis (RE) in COPD patients.
    The Korean Journal of Internal Medicine 07/2014; 29(4):466-73.
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    ABSTRACT: Acute eosinophilic pneumonia (AEP) is a disease characterized by an acute febrile onset, eosinophilia in bronchoalveolar lavage fluid, and a dramatic response to corticosteroids. Although many studies have reported a close relationship between direct cigarette smoking and AEP, few studies have identified an association between passive smoking and AEP. Here, we report a case of AEP in a 19-year-old female with cough, fever, and dyspnea after 4 weeks of intense exposure to secondhand smoke for 6 to 8 hours a day in an enclosed area.
    Tuberculosis and Respiratory Diseases 04/2014; 76(4):188-91.
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    ABSTRACT: Nontuberculous mycobacteria (NTM) are pathogens that cause chronic respiratory disease, even in immunocompetent patients. We hypothesized that low subcutaneous fat is a predisposing factor for NTM lung disease. Following a retrospective review of medical records from between 2005 and 2012, a total of 148 patients with NTM lung disease and 142 age- and sex-matched controls were enrolled. We evaluated subcutaneous fat using chest computed tomography (CT) scans at the midpole level of the left kidney. The median age of the patients was 62 years and 60.8 % were female. Approximately 71 % were classified into a nodular bronchiectatic group. The patient group had significantly less subcutaneous fat than the control group (39.3 vs. 53.0 cm(2), p = 0.001). Patients with both localized disease (43.5 vs. 53.0 cm(2), p = 0.042) and extensive disease (35.9 vs. 53.0 cm(2), p < 0.0001) had less subcutaneous fat compared with the control group. No difference in subcutaneous fat was observed with respect to the increasing bacterial load in sputum (p = 0.246). In 20 patients with prominent disease progression during the follow-up period, no significant difference was observed between subcutaneous fat at the initial diagnosis and that at the follow-up CT (36.2 vs. 42.0 cm(2), p = 0.47). Our results suggest that lower subcutaneous fat may contribute to host susceptibility to NTM lung disease.
    Beiträge zur Klinik der Tuberkulose 02/2014; · 2.06 Impact Factor
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    ABSTRACT: To assess the image quality of ultra-low-dose computed tomography (ULDCT) using sinogram-affirmed iterative reconstruction (SAFIRE) compared to reduced dose CT (RDCT). Eighty-one consecutive patients underwent non-enhanced ULDCT using 80 kVp and 30 mAs and contrast-enhanced RDCT using automated tube potential selection and tube current modulation. CT images were reconstructed with SAFIRE. Image noise and subjective image quality of normal structures and various pulmonary lesions were assessed. The mean effective doses were 0.29 ± 0.03 and 2.88 ± 1.11 mSv for ULDCT and RDCT, respectively. ULDCT had significantly higher noise (p < 0.001). Image quality of five normal structures was diagnostic in 91.1 % of ULDCT and 100 % of RDCT. With ULDCT, the frequencies of non-diagnostic image quality were 2.0 (1/50), 4.6 (13/280), 25.5 (14/55), and 40.0 (8/20)% for BMIs of < 20, 20-25, 25-30, and >30. In the assessment of pulmonary lesions, non-diagnostic image quality was observed for 11.2 % of all lesions, 60.9 % of decreased attenuation (significantly more frequent for upper lung lesions), and 23.5 % of ground-glass nodules. ULDCT generates diagnostic images in patients with a BMI ≤25, but is of limited use for lesions with decreased attenuation, ground-glass nodules, or those located in the upper lobe. • Iterative reconstruction enables ultra-low-dose CT (ULDCT) with very low radiation doses. • Image quality of ULDCT depends on the patient body mass index (BMI). • Selection of kVp and mAs depends on both BMI and lesion type. • Diagnosis of pulmonary emphysema or ground-glass nodules requires higher radiation doses.
    European Radiology 01/2014; · 4.34 Impact Factor
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    ABSTRACT: Overlap syndrome shares features of both asthma and chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate characteristics of overlap syndrome and their effect on self-rated health (SRH).
    International journal of chronic obstructive pulmonary disease. 01/2014; 9:795-804.
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    ABSTRACT: The current study explored the relationship between lymphoid tissue inducer (LTi) cells and patients' clinical and immunological status. LTi cells are critical for lymphoid tissue development and maintenance of CD4 T cell-dependent immune responses. The percentage of CD117(+)CD3(-)CD56(-)CD127(+) RORγ(+) LTi cells isolated from human tonsils was determined and correlated with changes in other immune subsets and clinical factors. We found that the portion of LTi and CD4 T cells was significantly increased in chronic tonsillitis compared to non-inflamed tonsils. Additionally, the expression of OX40 by memory CD4 T cells and OX40 ligand (OX40L) and interleukin (IL)-22 by LTi cells was higher in chronically inflamed tonsils. The treatment for tonsillitis with ibuprofen did not alter LTi cell viability and the expression of OX40L and IL-22. These results demonstrate that during chronic inflammation, LTi cells are increased and express higher levels of OX40L and IL-22, and this is correlated with an increase in memory CD4 T cells.
    Inflammation 09/2013; · 2.46 Impact Factor
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    ABSTRACT: More than half of cases for advanced non-small-cell lung cancer (NSCLC) occur in elderly patients with a median age at diagnosis of 70 years. The aim of our study was to examine the clinical features and prognostic factors contributing to mortality in elderly patients with advanced NSCLC. Following a retrospective review of clinical data, 122 patients aged 70 years and over with a histopathological diagnosis of locally advanced (stage IIIB, n=32) and metastatic (stage IV, n=90) NSCLC between 2005 and 2011 were enrolled. The median age was 76 years (interquartile range, [IQR], 72-80 years), and 85 (70%) patients were male. Fifty-seven (46%) patients had never smoked, and 17 (19%) were in a malnourished state with a body mass index (BMI) of <18.5 kg/m(2). The initial treatments included chemotherapy (40%) and radiotherapy (7%), but 57% of the patients received supportive care only. The 1-year survival rate was 32%, and the 3-year survival rate was 4%, with a median survival duration of 6.2 months (IQR, 2.5-15.3 months). Male gender (hazard ratio [HR], 2.2; 95% confidence interval [CI], 1.3-3.9; p=0.005), low BMI (HR, 2.3; 95% CI, 1.3-3.9; p=0.004), and supportive care only (HR, 1.9; 95% CI, 1.2-2.9; p=0.007) were independent predictors of shorter survival based on a Cox proportional hazards model. Elderly patients with advanced NSCLC had a poor prognosis, particularly male patients, those with a low BMI, and those who received supportive care only.
    Tuberculosis and Respiratory Diseases 08/2013; 75(2):52-8.
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    ABSTRACT: Background This study aimed to evaluate the characteristics of active anti-cancer treatment (AAT) compared with best supportive care (BSC) in elderly patients with advanced non-small cell lung cancer (NSCLC). Methods It was conducted as a retrospective analysis of 144 patients, aged 70 or older, with stage IIIb/IV NSCLC from 672 patients of confirmed lung cancer. ResultsMedian age at diagnosis was 77 years and median survival time was 5 months. On multivariate analysis, AAT independently contributed to decrease hazard ratio of death (P=0.04), whereas male gender (P=0.004), a body mass index less than 18.5 (P=0.004), and poor performance score was associated with increased risks of death (P < 0.001). The 52 subjects receiving AAT had longer survival than 92 subjects receiving BSC (median 7 months [AAT] vs. 3 months [BSC]; P < 0.001). When sub-classified into 5-year age intervals, AAT gave a significant advantage in overall survival (OS) only to patients aged 70–74, but not those ≥ 75 years old. ConclusionsAAT for patients ≥ 70 years old with advanced NSCLC extended OS. However, care should be taken in decisions on active anti-cancer treatments for patients over 75 years old. Prospective multicenter trial is required in near future.
    Thoracic Cancer. 07/2013;
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    ABSTRACT: OBJECTIVE: The objective was to present computed tomographic (CT) findings of generalized lymphangiomatosis in young adults that was at first misdiagnosed with malignancy. MATERIALS AND METHODS: We reviewed the clinical and radiological findings of three young adults who had histologically confirmed generalized lymphangiomatosis. RESULTS: Bony lesions were cystic forms and appeared as variably sized, well-circumscribed, irregular, microlobulated-contour, multiseptated masses. Lymphangiomas involving soft tissue were similar to bony lesions on CT. CONCLUSION: CT features of generalized lymphangiomatosis may be useful to prevent invasive procedures in young subjects. Generalized lymphangiomatosis involving bones in young adults shows less extensive and aggressive osteolytic pattern than known features in child.
    Clinical imaging 02/2013; · 0.73 Impact Factor
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    ABSTRACT: SESSION TYPE: Lung Cancer Posters IIPRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PMPURPOSE: Lung cancer has highest mortality among cancer in Korea. In advanced nonsmall cell lung cancer (NSCLC), major therapeutic modality is chemotherapy. With the progression of lung cancer, second line chemotherapy is demanded. However, there is a controversy about 2nd-line chemotherapy in terms of selection of chemotherapeutics, number of cycles, and response rates. Even numbers of clinical trials has been done for the effect of 1st-line chemotherapy, the study of 2nd-line chemotherapy is limited. The objective of this study is the analysis of determinants on the success of 2nd-line chemotherapy in advanced non-operable NSCLC.METHODS: The patients' records were reviewed retrospectively from 2005 to 2011 in Ewha Medical Center, Seoul, Korea. Included 87 patients were non-operable cases of stage III-IV NSCLC, received 2nd-line chemotherapy. The patients were divided into two groups: 47 subjects of successful chemotherapy, defined as more than 3 cycles (success group) and 40 subjects of unfavorable chemotherapy, defined as below 3 cycles (failure group).RESULTS: Success in 2nd-line chemotherapy was not affected from baseline BMI, gender, smoking, albumin level, lung function, platinum based chemotherapy in 1st-line, duration of 1st-line, use of newer chemotherapeutics in 1st-line, T stage, M stage, histology of adenocarcinoma, and previous radiotherapy to lung. Only, Age and N stage were different significantly between 2 groups. Success group showed better survival (21±12mo) than failure group (13±10mo).CONCLUSIONS: Relatively younger age and less N stage regardless of previous therapeutic condition are most important determinants on the success of 2nd-line chemotherapy, which affects to survival directly in advanced non-operable NSCLC.CLINICAL IMPLICATIONS: Successful 2nd-line chemotherapy is very difficult in advanced lung cancer. It guides an implication of effectiveness and prognosis prior to 2nd-line chemotherapy with the consideration of age and N stage.DISCLOSURE: The following authors have nothing to disclose: Seok Jeong Lee, Hyun Ju Kang, Yon Ju Ryu, Jin Hwa Lee, Jung Hyun ChangNo Product/Research Disclosure InformationMokdong Hospital Ewha Womans University, Seoul, Republic of Korea.
    Chest 10/2012; 142(4_MeetingAbstracts):641A. · 5.85 Impact Factor
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    ABSTRACT: SESSION TYPE: Respiratory Infections Posters IPRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PMPURPOSE: The incidence of tuberculosis in Korea is still high among OECD nations as 74.3/100,000 in 2010, although it has a declining tendency. AFB smear test has low sensitivity in the diagnosis of tuberculosis and AFB culture has a disadvantage of taking time. Real time PCR has been introduced for rapid diagnosis and differential diagnosis with nontuberculous mycobacterium. This study was designed to evaluate the clinical accuracy of real time PCR in the specimen of sputum and/or bronchoscopic aspirates.METHODS: The 3525 patients who took sputum PCR and/or bronchoscopic PCR were reviewed retrospectively from Mar, 2006 to Sept, 2011 in Ewha Medical Center, Seoul, Korea. In all cases, AFB smear and culture were examined together in all cases. The diagnosis of tuberculosis was defined positive for tuberculosis microbiologically, pathologic finding of tuberculosis in lung and pleura, or clinical decision of active tuberculosis following anti-tuberculous medication more than 6 months. Finally 3501 subjects were included excluding 24 subjects due to insufficient observational period.RESULTS: In sputum PCR, sensitivity was 45% (272 among 607 cases of tuberculosis diagnosis); specificity 99.6% (1936/1944); accuracy 87% (272+1936)/2551. In bronchoscopic PCR, sensitivity was 64% (319 among 496 cases of tuberculosis diagnosis); specificity 98% (1143/1171); accuracy 88% (319+1143)/1667. In total cases of sputum and/or bronchoscopic samples, sensitivity was 59% (498/838), specificity was 99% (2629/2663), and finally accuracy was increased to 89% (498+2629)/3501.CONCLUSIONS: The positivity of PCR in sputum or bronchoscopic specimen suggests high probability of tuberculosis in clinically suspected cases.CLINICAL IMPLICATIONS: In case of positivity in real time PCR, the patient should be evaluated further for active tuberculosis and considered to start anti-tuberculous medication.DISCLOSURE: The following authors have nothing to disclose: Jung Hyun Chang, Seo Woo Kim, Seok Jeong Lee, Jin Hwa Lee, Yon Ju RyuNo Product/Research Disclosure InformationEwha Womans University, Seoul, Republic of Korea.
    Chest 10/2012; 142(4_MeetingAbstracts):203A. · 5.85 Impact Factor
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    Ji Hye Kim, Jin Hwa Lee, Yon Ju Ryu, Jung Hyun Chang
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    ABSTRACT: Idiopathic pulmonary fibrosis (IPF) is a progressive disease. Effective treatment is not currently available and the prognosis is poor. The aim of our study was to identify clinical predictors of survival in patients with IPF. By using medical record database of a university hospital, we reviewed the records of patients who had been diagnosed as having IPF from January 1996 through December 2007. Among 89 patients considered as having interstitial lung disease (ILD) on computed tomography (CT) of the chest, 22 were excluded because of the diagnosis of other ILDs or connective tissue disease, and finally, 67 met the criteria of IPF. The mean age at the diagnosis of IPF was 70 years (range, 41~87 years) and 43 (64%) were male. The mean survival time following the diagnosis of IPF was 40 months (range, 0~179 months). Among them, 28 cases were diagnosed as the progressive state of IPF on the follow-up CT examination, and the mean duration between diagnosis of IPF and progression was 31 months. Multivariate analysis using Cox regression model revealed that body mass index (BMI) less than 18.5 kg/m(2) (p=0.030; hazard ratio [HR], 12.085; 95% confidence interval [CI], 1.277~114.331) and CT progression before 36 months from the diagnosis of IPF (p=0.042; HR, 13.564; 95% CI, 1.101~167.166) were independently associated with mortality. Since low BMI at the diagnosis of IPF and progression on follow-up CT were associated with poor prognosis, IPF patients with low BMI and/or progression before 36 months following the diagnosis should be closely monitored.
    Tuberculosis and respiratory diseases. 09/2012; 73(3):162-8.
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    ABSTRACT: The conventional treatment for community-acquired pneumonia (CAP) involves combination therapy consisting of a β-lactam penicillin or a cephalosporin with a macrolide. Alternatively, high-dose levofloxacin treatment has been used as single-agent therapy for treating CAP, covering atypical pathogens. This study compared the clinical efficacy and safety of high-dose levofloxacin with combined ceftriaxone and azithromycin for the treatment of CAP. This phase IV, prospective, randomized, open-label trial enrolled patients admitted to a tertiary referral hospital for CAP treatment from 2010 to 2011. Hospital admission was decided based on clinical judgement and the pneumonia severity index. Forty subjects were enrolled and assigned to two treatment arms using a random numbers table. The 20 subjects in the experimental group were given levofloxacin 750 mg intravenously once daily, followed by the same dose of oral levofloxacin at discharge when clinically improved and the 20 subjects in the control group were given ceftriaxone 2.0 g intravenously once daily plus oral azithromycin 500 mg for 3 consecutive days, followed by oral cefpodoxime 200 mg per day at discharge after clinical improvement. The primary outcome was the clinical success rate. Secondary outcomes were the microbiological success rate and adverse events during the study. Of the 40 subjects enrolled, 36 completed the study: 17 in the experimental group and 19 in the control group. The groups did not differ in terms of demographic factors or clinical findings at baseline. The clinical success rate (cured + improved) was 94% in the experimental (levofloxacin) group and 84% in the control group (p > 0.05). The microbiological success rate and overall adverse events were also similar in both groups. Single-agent, high-dose levofloxacin treatment exhibited excellent clinical and microbiological efficacy with a safety profile comparable to that of ceftriaxone plus azithromycin therapy. Large-scale clinical trials are required to verify these results. WHO International Clinical Trials Registry: KCT0000374; Daiichi-Sankyo Korea study code: T11-13-V1.
    Clinical Drug Investigation 07/2012; 32(9):569-76. · 1.70 Impact Factor
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    Yun Su Sim, Jin Hwa Lee, Yookyung Kim, Jung Hyun Chang
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    ABSTRACT: Airway obstruction and the extent of emphysema are reported to be responsible for reduced bone mineral density (BMD). Corresponding to different phenotypes of a pulmonary disease, different severity in extra pulmonary features may exist. We compared BMDs of subjects with or without airway obstruction and/or emphysema and investigated the relationships among BMD, the severity of airway obstruction, and the extent of emphysema. Using a university hospital database, we reviewed patients over 40 years old who performed spirometry, computed tomography of chest, and measurement of BMD of the lumbar (L) spine. According to the presence or absence of airway obstruction and/or emphysema, four groups were classified. Among a total of 59 subjects, 33 (56%) had osteoporosis. The prevalence of osteoporosis in subjects with no airway obstruction and no emphysema, those with only emphysema, those with only airway obstruction, and those with both airway obstruction and emphysema were 42%, 57%, 64%, and 73%, respectively (p=0.047 by linear-by-linear association). The mean T-scores of BMD of L1 (p=0.032) and L1-4 spines were different among the four groups (p=0.034). Although the T-score of L1 BMD negatively correlated with the extent of emphysema (r=-0.275, p=0.035) and positively with each of body mass index (BMI) (r=0.520, p<0.001), forced expiratory volume in one second (FEV(1)) (r=0.330, p=0.011), FEV(1)/forced vital capacity (r=0.409, p=0.001), and forced expiratory flow at 25~75% of FVC (FEF(25-75%)) (r=0.438, p=0.0001), respectively, multiple linear regression analysis indicated that BMI (p<0.001) and FEF(25-75%) were predictive of BMD (p=0.012). Low BMI and airway obstruction were strongly associated with reduced bone density rather than the extent of emphysema.
    Tuberculosis and Respiratory Diseases 03/2012; 72(3):310-7.
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    ABSTRACT: To evaluate the accuracy of depth measurements on supine chest computed tomography (CT) for transthoracic needle biopsy (TNB). We measured skin-lesion depths from the skin surface to nodules on both prebiopsy supine CT scans and CT scans obtained during cone beam CT-guided TNB in the supine (n=29) or prone (n=40) position in 69 patients, and analyzed the differences between the two measurements, based on patient position for the biopsy and lesion location. Skin-lesion depths measured on prebiopsy supine CT scans were significantly larger than those measured on CT scans obtained during TNB in the prone position (p<0.001; mean difference±standard deviation (SD), 6.2 ± 5.7 mm; range, 0-18 mm), but the differences showed marginal significance in the supine position (p=0.051; 3.5 ± 3.9 mm; 0-13 mm). Additionally, the differences were significantly larger for the upper (mean±SD, 7.8 ± 5.7 mm) and middle (10.1 ± 6.5mm) lung zones than for the lower lung zones (3.1 ± 3.3mm) in the prone position (p=0.011), and were larger for the upper lung zone (4.6 ± 5.0mm) than for the middle (2.4 ± 2.0mm) and lower (2.3 ± 2.3mm) lung zones in the supine position (p=0.004). Skin-lesion depths measured on prebiopsy supine chest CT scans were inaccurate for TNB in the prone position, particularly for nodules in the upper and middle lung zones.
    European journal of radiology 02/2011; 81(5):1045-9. · 2.65 Impact Factor
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    ABSTRACT: Reduced lung function is an important risk factor for lung cancer and increases surgical risk in patients with operable stages of lung cancer. Nevertheless, there have been few studies to reveal association of lung function with mortality in patients with advanced lung cancer. The aim of this study was to investigate whether low forced expiratory volume in 1 second (FEV1) is an independent predictor of mortality in patients with advanced lung cancer. Data were retrospectively collected from patients with non-small cell lung cancer of stage IIIB or IV and available spirometry at diagnosis of lung cancer. They had the last follow-up consecutively between April 2003 and July 2009 in a tertiary referral hospital. Among a total of 156 patients, 118 died as of July 2009. Their mean age was 65 years; 115 (74%) were men. Mean FEV1 was 1.91 liters (79% of predicted). Seventy-one patients (46%) had adenocarcinoma, and 48 (31%) had squamous cell carcinoma. In a multivariate analysis using Cox regression model, independent prognostic factors were FEV1 less than 50% of predicted (hazard ratio [HR] = 2.704, 95% confidence interval [CI]: 1.516-4.823, p = 0.001), chemotherapy (HR = 0.311, 95% CI: 0.192-0.503, p < 0.001), adenocarcinoma (HR = 0.459, 95% CI: 0.300-0.701, p < 0.001), body mass index (HR = 0.921, 95% CI: 0.870-0.975, p = 0.005), and the presence of malignant pleural effusion (HR = 1.673, 95% CI: 1.102-2.540, p = 0.016). Reduced FEV1 is strongly associated with mortality in advanced non-small cell lung cancer.
    Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer 02/2011; 6(2):305-9. · 4.55 Impact Factor
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    ABSTRACT: Several dietary factors, such as antioxidant vitamins, have potential roles in the development of obstructive lung diseases. However, the results of studies on the relationships between dietary factors and obstructive lung diseases are inconsistent. The aim of this study was to determine which nutrients are related to airway obstruction (AO) in the Korean population. We used data obtained as part of the Korean National Health and Nutrition Examination Survey (NHANES II) in 2001. Analysis was restricted to 1,005 adults who were 18 years of age and older, who had two or more acceptable spirometry curves, and who had participated in the nutrition examination survey. AO was defined as the ratio of forced expiratory volume in one second (FEV1) to forced vital capacity (FVC) of less than 0.7. Of the 1,005 study subjects, 78 (7.8%) had AO. Statistically significant factors associated with AO were 55 years of age or older (p = 0.032), central obesity (p = 0.047), hypertension (p < 0.001), smoking of 20 pack-years or more (p < 0.001), low income (p < 0.001), and low dietary protein intake expressed as a ratio of protein to recommended dietary allowance for Koreans (p = 0.037). Multiple logistic regression analyses revealed four factors that were independently associated with AO: smoking of 20 pack-years or more (odds ratio [OR], 5.801; p < 0.001), hypertension (OR, 3.905; p < 0.001), low protein intake (OR, 0.992; p = 0.004), and low income (OR, 1.962; p = 0.018). In the Korean NHANES, smoking, hypertension, and low income were related to AO. Among dietary factors, only low protein intake was associated with AO.
    The Korean Journal of Internal Medicine 06/2010; 25(2):132-9.
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    ABSTRACT: Obesity is a worldwide concern, but its influence on critical care outcomes is not well understood. We tested the hypothesis that abnormal body mass index (BMI) would be an independent predictor of higher mortality rates in intensive care unit (ICU). We retrospectively reviewed patients who had admitted to the ICU from January 2007 to December 2007. Admission BMI was analyzed as both a three categorical (underweight, < 18.5 kg/m(2); normal weight, 18.5 to 24.9 kg/m(2); overweight and obese, > or = 25 kg/m(2)) and continuous variables among all patients with an ICU length of stay > or = 4 days. The primary outcome was ICU mortality. The multivariate analysis on ICU mortality selected Mortality Prediction Model-Admission (MPM at time zero) (hazard ratio [HR], 1.024; p = 0.001; 95% confidence interval [CI], 1.010 to 1.037), failed extubation (HR, 5.092; p = 0.0001; 95% CI, 2.742 to 9.456) as significant risk factors. When controlling these variables, none of the BMI group and BMI as a continuous variable had an independent association with ICU mortality. BMI did not have a significant influence on ICU mortality. The ICU mortality was influenced more strongly by severity of illness and failed extubation rather than BMI.
    The Korean Journal of Internal Medicine 06/2010; 25(2):162-7.

Publication Stats

248 Citations
72.25 Total Impact Points

Institutions

  • 2003–2014
    • Ewha Womans University
      • • Department of Internal Medicine
      • • Medical Research Institute
      Sŏul, Seoul, South Korea
  • 2010–2013
    • National Health Insurance Corporation Ilsan Hospital
      Sŏul, Seoul, South Korea
  • 2006
    • Sungkyunkwan University
      • School of Medicine
      Seoul, Seoul, South Korea
    • Yonsei University Hospital
      • Department of Internal Medicine
      Sŏul, Seoul, South Korea