Min Ki Lee

Pusan National University, Busan, Busan, South Korea

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Publications (78)137.24 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of the study is to evaluate outcomes and objective parameters related to poor prognosis in patients who were defined as prolonged acute mechanical ventilation (PAMV; ventilator care ≥96 hours) in the medical intensive care unit of a university-affiliated tertiary care hospital in Korea. We analyzed retrospectively clinical data gathered from the medical records on day 4 of MV between 2008 and 2013. In total, 311 were categorized as PAMV. Their median age was 67 years (range, 18-93 years), and 71.7% were male. The 28-day mortality rate after intensive care unit admission was 34.7%. Four variables on day 4 of mechanical ventilation (need for neuromuscular blockers [hazard ratio {HR}, 2.432; 95% confidence interval, 1.337-4.422], need for vasopressors [HR, 2.312; 95% confidence interval, 1.258-4.248], need for hemodialyses [HR, 1.913; 95% confidence interval, 1.018-3.595], and body mass index ≤21 kg/m(2) [HR, 1.827; 95% confidence interval, 1.015-3.288]) were independent factors associated with mortality based on a Cox proportional hazards model. As the number of these prognostic factors increased, the survival rate decreased. Four clinical factors (body mass index ≤21, requirement for neuromuscular blockers, vasopressors, and hemodialysis) on day 4 of mechanical ventilation were associated with 28-day mortality in PAMV patients. Copyright © 2015. Published by Elsevier Inc.
    Journal of critical care 06/2015; DOI:10.1016/j.jcrc.2015.05.020 · 2.19 Impact Factor
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    ABSTRACT: To investigate the efficacy of systemic pulmonary rehabilitation (PR) after lung resection in patients with lung cancer. Forty-one patients undergoing lung resection were enrolled and classified into the experimental (n=31) and control groups (n=10). The experimental group underwent post-operative systemic PR which was conducted 30 min/day on every hospitalization day by an expert physical therapist. The control group received the same education about the PR exercises and were encouraged to self-exercise without supervision of the physical therapist. The PR group was taught a self-PR program and feedback was provided regularly until 6 months after surgery. We conducted pulmonary function testing (PFT) and used a visual analog scale (VAS) to evaluate pain, and the modified Borg Dyspnea Scale (mBS) to measure perceived respiratory exertion shortly before and 2 weeks, 1, 3, and 6 months after surgery. A significant improvement on the VAS was observed in patients who received systemic PR >3 months. Significant improvements in forced vital capacity (FVC) and mBS score were observed in patients who received systemic PR >6 months (p<0.05). Other PFT results were not different compared with those in the control group. Patients who received lung resection suffered a significant decline in functional reserve and increases in pain and subjective dyspnea deteriorating quality of life (QoL). Systemic PR supervised by a therapist helped improve reduced pulmonary FVC and QoL and minimized discomfort during the postoperative periods in patients who underwent lung resection.
    06/2015; 39(3):366-73. DOI:10.5535/arm.2015.39.3.366
  • Journal of the Formosan Medical Association 10/2014; 113(10):764–765. DOI:10.1016/j.jfma.2012.10.014 · 1.70 Impact Factor
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    ABSTRACT: Purpose Evidence regarding the usefulness of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-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 18F-FDG PET/CT in patients with SCLC. Materials and Methods We conducted a retrospective review of 114 patients with pathologically proven SCLC (26 cases of limited disease and 88 cases of extensive disease) who underwent pretreatment 18F-FDG PET/CT. The maximal SUV (SUVmax) was used quantitatively for determination of FDG PET activity. The SUVmax of the primary tumor (primary SUVmax), the sum of SUVmax values of malignant lesions (SUVsum), and the mean SUVmax of malignant lesions were calculated. Results The patient population was subdivided using a median SUVsum value of 24.6. High SUVsum showed a significant association with known factors for poor prognosis, including higher neuron-specific enolase (p=0.010), CYFRA 21-1 (p=0.014), and extensive disease status (p=0.007). Patients with high SUVsum had significantly shorter median overall survival (6.6 months vs. 13.0 months, p<0.001) and progression-free survival (5.2 months vs. 8.0 months, p<0.001) than patients with low SUVsum. Results of multivariate analysis showed that SUVsum, chemotherapy cycles, and the response to first-line treatment were significant prognostic factors of survival. In contrast, mean SUVmax and primary SUVmax were not significant predictors of survival. Conclusion In this study, metabolic burden represented by SUVsum from pretreatment 18F-FDG PET/CT was an independent prognostic factor in patients with SCLC.
    Cancer Research and Treatment 04/2014; 46(2):165-71. DOI:10.4143/crt.2014.46.2.165 · 2.98 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; 192(2). DOI:10.1007/s00408-013-9547-4 · 2.17 Impact Factor
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    ABSTRACT: The aim of this study is to describe the clinical course and outcome of patients who were diagnosed with acute respiratory distress syndrome (ARDS) caused by scrub typhus and who received ventilator care in the intensive care units (ICU) of two university hospitals.
    01/2014; 29(3):189. DOI:10.4266/kjccm.2014.29.3.189
  • 01/2014; 29(4):348. DOI:10.4266/kjccm.2014.29.4.348
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    ABSTRACT: The prevalence of asthma among the elderly has increased in the aging society. However, limited studies have been conducted regarding the characteristics of elderly asthmatics. In this study, we aimed to evaluate control of asthma, comorbidities, depression and anxiety state, and quality of life in elderly asthmatics.
    01/2014; 2(3):194. DOI:10.4168/aard.2014.2.3.194
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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. DOI:10.4143/crt.2013.45.4.354 · 2.98 Impact Factor
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    ABSTRACT: The NSCLC patients who experienced good clinical responses to an EGFR-TKI will inevitably develop acquired resistance. A great deal of research is being carried out to discover the molecular mechanisms underlying this resistance. In comparison, few studies have been conducted to find out about the clinical characteristics of acquired resistance in the patients who had responded to an EGFR-TKI. Herein we investigated clinical characteristics of NSCLC patients who experienced acquired resistance during gefitinib therapy.
    Lung cancer (Amsterdam, Netherlands) 11/2013; 83(2). DOI:10.1016/j.lungcan.2013.11.008 · 3.74 Impact Factor
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    ABSTRACT: COPD Severity MetricsSESSION TYPE: Original Investigation SlidePRESENTED ON: Sunday, October 27, 2013 at 03:00 PM - 04:00 PMPURPOSE: Patients with chronic obstructive pulmonary disease (COPD), which is predicted to be the third most common cause of deaths worldwide by 2020, experience significant impairment in their quality of life (QOL). This study aimed to assess the association of health-related quality of life (HRQL) with disease severity according to the body mass index, degree of airflow obstruction, dyspnea, and exercise capacity (BODE) index in Korean patients with COPD.METHODS: This was a multicenter prospective cross-sectional study of 245 Korean patients with stable COPD. At enrollment, all patients completed the St George's Respiratory Questionnaire (SGRQ) and Medical outcomes short form-36 (SF-36). The Spearman correlation coefficient (r) was calculated to assess the association between health status scores and clinical or functional variables.RESULTS: Categorizing the BODE scores into four stages, we found that higher BODE stages were associated with higher (worse) SGRQ scores. The differences among the BODE stages in health status indexes were significant for total SGRQ as well as all three of the SGRQ subscales. In all sections of the SGRQ, scores were moderately to strongly associated with the BODE stages (r=0.25~0.65). The association between SF-36 and the BODE index was significant (p < 0.001).CONCLUSIONS: HRQOL was associated with disease severity according to the BODE stage in a large Korean population of COPD patients.CLINICAL IMPLICATIONS: BODE stage is useful for predicting the worsening of HRQL in COPD patients, which suggest action should be taken to support especially in advanced COPD patients.DISCLOSURE: The following authors have nothing to disclose: Kiuk Kim, Eun Jung Cho, Mi Hyun Kim, Woo Hyun Cho, Doo Soo Jeon, Yun Seong Kim, Min Ki LeeNo Product/Research Disclosure Information.
    Chest 10/2013; 144(4_MeetingAbstracts):720A. DOI:10.1378/chest.1691396 · 7.13 Impact Factor
  • Cancer Research 08/2013; 73(8 Supplement):4173-4173. DOI:10.1158/1538-7445.AM2013-4173 · 9.28 Impact Factor
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    ABSTRACT: Epidermal growth factor receptor (EGFR)-activating mutations are major determinants in predicting the tumor response to EGFR tyrosine kinase inhibitors in non-small cell lung cancer (NSCLC). Noninvasive test for the detection of EGFR mutations is required, especially in NSCLC patients from whom tissue is not available. In this study, we assessed the feasibility of detection of EGFR mutations in free DNA circulating in plasma. Plasma samples of 60 patients with partial response to gefitinib were analyzed to detect EGFR-activating mutations in exons 19 and 21. Forty (66.7%) of patients had tumor EGFR mutation results. EGFR mutations in plasma were detected using the peptide nucleic acid (PNA)-mediated polymerase chain reaction (PCR) clamping method. All clinical data and plasma samples were obtained from 11 centers of the Korean Molecular Lung Cancer Group (KMLCG). Of the 60 patients, 39 were female and the median age was 62.5 years. Forty-three patients never smoked, 53 had adenocarcinomas, and seven had other histologic types. EGFR-activating mutation was detected in plasma of 10 cases (exon 19 deletion in seven and exon 21 L858R point mutation in three). It could not be found in plasma after treatment for 2 months. When only patients with confirmed EGFR mutation in tumor were analyzed, 17% (6 of 35) of them showed positive plasma EGFR mutation and the mutation type was completely matched with that in tumor. There was no statistically significant difference in clinical parameters between patients with EGFR mutations in plasma and those without EGFR mutations. The detection rate of EGFR mutations from plasma was not so high despite highly sensitive EGFR mutation test suggesting that more advances in detection methods and further exploration of characteristics of circulating free DNA are required.
    Journal of Experimental & Clinical Cancer Research 08/2013; 32(1):50. DOI:10.1186/1756-9966-32-50 · 3.27 Impact Factor
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    ABSTRACT: Background Pulmonary actinomycosis is a chronic pulmonary infection caused by Actinomyces. Both improving oral hygiene and early application of antibiotics to the case of suspicious pulmonary infections result in changes in incidences and presentations of pulmonary actinomycosis. However, there are little reports dealt with the recent clinical characteristics of pulmonary actinomycosis. This study aimed to review the characteristics of pulmonary actinomycosis occurred during the first decade of 21st century. Methods This retrospective study was performed on 94 subjects with pulmonary actinomycosis diagnosed pathologically from January 2000 to December 2010 in 13 hospitals in Korea. Results The data of the study showed that pulmonary actinomycosis occurs frequently in middle to old-aged males (mean age; 57.7 years old) and that the most common symptoms are cough, hemoptysis, and sputum production. Various radiologic features such as the consolidation with central low attenuation (74.5%) and no regional predominance were also observed. Most of patients recovered completely with medical and/or surgical treatment, reaching approximately 98% cure rate. Conclusions The results demonstrate that pulmonary actinomycosis is one of the cautious pulmonary diseases. More importantly, in cases of persistent hemoptysis or for differential diagnosis from lung malignancy, our data have revealed that surgical resection appears to be a useful intervention and that radiologic diagnosis may not provide decisive information. These findings indicate that it is important for the clinicians to include pulmonary actinomycosis as one of differential diagnoses for refractory pulmonary abnormal lesions to the current usual management.
    BMC Infectious Diseases 05/2013; 13(1):216. DOI:10.1186/1471-2334-13-216 · 2.61 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. DOI:10.4046/trd.2013.74.5.207
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    ABSTRACT: Pulmonary extrauterine epithelioid trophoblastic tumors (ETTs) are extremely rare. A 26-year-old nonsmoking woman with a history of a suspected subclinical miscarriage presented with a large mass in the right lower lobe that was confirmed to be a pulmonary extrauterine ETT using immunohistochemical stains. When a nonsmoking fertile woman presents with a pulmonary mass and an elevated serum β-human chorionic gonadotrophin in the absence of gynecologic disease, pulmonary extrauterine ETT should be considered.
    The Thoracic and Cardiovascular Surgeon 01/2013; 61(1). DOI:10.1055/s-0032-1331264 · 1.08 Impact Factor
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    ABSTRACT: This study was conducted to evaluate the clinical characteristics and outcomes of mechanically ventilated patients with carbapenem-resistant Acinetobacter baumannii (CRAB) isolates from tracheal secretions in a medical intensive care unit (ICU) of a university hospital.
    01/2013; 28(3):173. DOI:10.4266/kjccm.2013.28.3.173
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    ABSTRACT: Vancomycin frequently induces hypersensitivity reactions including red man syndrome (RMS) and anaphylaxis. Lowering infusion rate with antihistamine premedication is usually effective to reduce RMS, however, desensitization should be considered for severe reactions not responding to usual measures. Here, we report a case of a patient with pyogenic spondylitis who had developed hypersensitivity reaction to vancomycin, got a full recovery with vancomycin desensitization. A 63-year-old man was transferred to our hospital for back pain, proved to pyogenic spondylitis. As methicillin-resistant Staphylococci aureus infection was suspected, vancomycin was administrated. But, he showed hypersensitivity reactions such as hypotension, dyspnea and severe flushing after vancomycin administration at previous hospital. Readministration of vancomycin at a lower infusion rate with premedication was tried. Three hours after vancomycin infusion, he developed fever, chills, rash and hypotension. Thrombocytopenia was occurred after administration of other antibiotics including cefazolin and teicoplanin. Vancomycin administration was attempted according to a rapid desensitization protocol. The infusion rate of vancomycin was increased to the standard rate. After the desensitization, he successfully completed the full course of treatment with vancomycin. Vancomycin desensitization could be the option for the vancomycin hypersensitivity when other antibiotics are not feasible.
    01/2013; 1(2):168. DOI:10.4168/aard.2013.1.2.168
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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; 19(4). DOI:10.1007/s10156-012-0508-2 · 1.38 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.
    10/2012; 73(4):224-30. DOI:10.4046/trd.2012.73.4.224

Publication Stats

270 Citations
137.24 Total Impact Points

Institutions

  • 2006–2015
    • Pusan National University
      • • Department of Internal Medicine
      • • Department of Diagnostic Radiology
      Busan, Busan, South Korea
  • 2011
    • Chungbuk National University
      • School of Mechanical Engineering
      Chinsen, North Chungcheong, South Korea