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ABSTRACT: Asthma is a chronic airway disease characterized by reversible airflow limitation with airway wall thickening. Although some studies have reported changes in airway dimensions estimated on chest CT in patients with chronic asthma, little is known about dynamic changes in airway dimensions between acute exacerbations of asthma and recovery. Our case documents significant changes in the bronchial wall, as estimated on serial chest CT scans, over a short-term interval during an exacerbation of asthma.
Internal Medicine 01/2013; 52(6):679-83. · 0.94 Impact Factor
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ABSTRACT: To improve time and accuracy in differentiating diffuse interstitial lung disease for computer-aided quantification, we introduce a hierarchical support vector machine which selects a class by training a binary classifier at each node in a hierarchy, thus allowing each classifier to use a class-specific quasi-optimal feature set. In addition, the computational cost-sensitive group-feature selection criterion combined with the sequential forward selection is applied in order to obtain a useful and computationally inexpensive quasi-optimal feature set for the purpose of accelerating the classification time. The classification time was reduced by up to 57% and the overall accuracy was significantly improved in comparison with the one-against-all and one-against-one support vector machine methods with sequential forward selection (paired t-test, p<0.001). The reduction of classification time as well as the improvement of overall accuracy demonstrates promise for the proposed classification method to be adopted in various real-time and on-line image-based clinical applications.
Computers in biology and medicine 11/2012; · 1.27 Impact Factor
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ABSTRACT: OBJECTIVES: To evaluate the usefulness of a texture-based automated quantification system (AQS) for evaluating the extent and interval change of regional disease patterns on initial and follow-up high-resolution computed tomographies (HRCTs) of fibrotic interstitial pneumonia (FIP). METHODS: Eighty-nine patients with clinically and/or biopsy confirmed usual interstitial pneumonia (UIP) (n = 71) and non-specific interstitial pneumonia (NSIP) (n = 18) were included. An AQS to quantify five disease patterns (ground-glass opacity [GGO], reticular opacity [RO], honeycombing [HC], emphysema [EMPH], consolidation [CONS]) and normal lung was developed. The extent and interval changes of each disease pattern, FS (fibrosis score), TA (total abnormal lung fraction) of entire lung on initial and 1-year follow-up HRCTs were quantified. The agreement between the results of AQS and two readers was assessed. Results of AQS were correlated with forced vital capacity (FVC) and carbon monoxide diffusing capacity (DLco). RESULTS: The Intraclass correlation coefficient (ICC) study revealed acceptable agreement between visual assessment and AQS (r = 0.78, 0.66 for HC; 0.76, 0.61 for FS; 0.64, 0.68 for TA, initial and follow-up HRCTs, respectively). Linear regression analysis revealed the extent of HC, TA on initial CT, interval changes of FS contributed negatively to DLco, and interval changes of FS, TA contributed negatively to FVC. CONCLUSIONS: Our AQS is comparable with visual assessment for evaluating the disease extent and the interval changes of FIP on HRCT. KEY POINTS : • HRCT is widely used to assess fibrotic interstitial pneumonia • An automated quantification system matched well with visual assessment of HRCT • Abnormal lung fraction on HRCT correlated with the decrease in diffusion capacity • Automated quantification of HRCT images is useful in assessing fibrotic interstitial pneumonia.
European Radiology 08/2012; · 3.22 Impact Factor
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ABSTRACT: OBJECTIVES: To determine the improvement of emphysema quantification with density correction and to determine the optimal site to use for air density correction on volumetric computed tomography (CT). METHODS: Seventy-eight CT scans of COPD patients (GOLD II-IV, smoking history 39.2±25.3 pack-years) were obtained from several single-vendor 16-MDCT scanners. After density measurement of aorta, tracheal- and external air, volumetric CT density correction was conducted (two reference values: air, -1000HU/blood, +50HU). Using in-house software, emphysema index (EI) and mean lung density (MLD) were calculated. Differences in air densities, MLD and EI prior to and after density correction were evaluated (paired t-test). Correlation between those parameters and FEV(1) and FEV(1)/FVC were compared (age- and sex adjusted partial correlation analysis). RESULTS: Measured densities (HU) of tracheal- and external air differed significantly (-990±14, -1016±9, P<0.001). MLD and EI on original CT data, after density correction using tracheal- and external air also differed significantly (MLD: -874.9±27.6 vs. -882.3±24.9 vs. -860.5±26.6; EI: 16.8±13.4 vs. 21.1±14.5 vs. 9.7±10.5, respectively, P<0.001). The correlation coefficients between CT quantification indices and FEV(1), and FEV(1)/FVC increased after density correction. The tracheal air correction showed better results than the external air correction. CONCLUSION: Density correction of volumetric CT data can improve correlations of emphysema quantification and PFT.
European journal of radiology 05/2012; · 2.65 Impact Factor
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ABSTRACT: Intravascular thrombosis and systemic coagulation abnormalities are major hurdles to successful xenotransplantation and are signs of acute humoral rejection. Increased expression of tissue factor (TF) is associated with the development of microvascular thrombosis in xenografts. To develop an effective strategy to prevent accelerated coagulation in xenografts, we investigated the mechanism by which porcine endothelial cells (PECs) become procoagulant after contact with human blood.
The changes in TF mRNA levels and activity in PECs after incubation with 20% human serum or human bioactive molecules, including C5a, tumor necrosis factor-α (TNFα) and interleukin (IL)-1α, were evaluated using real-time PCR and the factor Xa chromogenic assay, respectively. The procoagulant changes in PECs by these agonists were evaluated by measuring the coagulation time of human citrated plasma suspended with PECs pretreated with each agonist. TF expression and coagulation times were also assessed in PECs transfected with short interfering RNA (siRNA) designed to knock down porcine TF. We also examined the production of proinflammatory cytokines in human whole-blood or plasma after contact with PECs, which were screened using the cytometric bead array system. TNFα levels were measured using ELISA in whole-blood after contact with PECs, with or without the addition of xenoreactive antibodies or C1 esterase inhibitor.
Porcine TF mRNA and activity in PECs were up-regulated in response to human TNFα and IL-1α but were not affected by C5a or 20% human serum. Up-regulation of TF expression by human TNFα or IL-1α shortened PEC-induced coagulation time, while siRNA-mediated knockdown of TF expression prolonged coagulation time. The incubation of PECs with human whole-blood led to a significant increase in human TNFα levels in the blood, which was promoted by the addition of xenoreactive antibodies and prevented by C1 esterase inhibitor.
Human TNFα level increases in human blood after contact with PECs, which is attributed to xenoreactive antibody binding and subsequent complement activation. Human TNFα induces procoagulant changes in PECs with increased TF expression. This study suggests that human TNFα may be one of the mediators linking complement activation with procoagulant changes in the xenoendothelium.
Xenotransplantation 05/2012; 19(3):186-95. · 2.33 Impact Factor
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Jae Seung Lee,
Jin Won Huh,
Eun Jin Chae,
Joon Beom Seo,
Seung Won Ra,
Ji-Hyun Lee,
Eun-Kyung Kim, Young Kyung Lee,
Tae-Hyung Kim,
Woo Jin Kim,
Jin Hwa Lee,
Sang-Min Lee,
Sangyeub Lee,
Seong Yong Lim,
Tae Rim Shin,
Ho Il Yoon,
Seung Soo Sheen,
Yeon-Mok Oh,
Sang-Do Lee
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ABSTRACT: Patients with chronic obstructive pulmonary disease (COPD) show different spirometric response patterns to bronchodilator, such that some patients show improvement principally in expiratory flow (forced expiratory volume in 1 s; FEV(1)), whereas others respond by improvement of lung volume (forced vital capacity; FVC). The mechanisms of these different response patterns to bronchodilator remain unclear. We investigated the associations between bronchodilator responsiveness and quantitative computed tomography (CT) indices in patients with COPD.
Data on a total of 101 patients with stable COPD were retrospectively analysed. Volume and flow responses to bronchodilator were assessed by FVC and FEV(1) changes before and after inhalation of salbutamol (400 μg). Volumetric CT was performed to quantify emphysema, air trapping and large airway thickness. Emphysema was assessed by the volume fraction of the lung under -950 Hounsfield units (HU; V(950)) at full inspiration and air trapping by the ratio of mean lung density (MLD) at full expiration and inspiration. Airway wall thickness and wall area percentage (WA%; defined as wall area/[wall area + lumen area] × 100), were measured near the origin of right apical and left apico-posterior bronchus.
Among quantitative CT indices, the CT emphysema index (V(950 insp)) showed a significant negative correlation with postbronchodilator FEV(1) change (R = -0·213, P = 0·004), and the CT air-trapping index correlated positively with postbronchodilator FVC change(R = 0·286, P≤0·001). Multiple linear regression analysis showed that CT emphysema index had independent association with postbronchodilator FEV(1) change and CT air-trapping index with postbronchodilator FVC change.
The degrees of emphysema and air trapping may contribute to the different response patterns to bronchodilator in patients with COPD.
Clinical Physiology and Functional Imaging 01/2012; 32(1):12-8. · 1.33 Impact Factor
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Korean Circulation Journal 07/2011; 41(7):421.
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ABSTRACT: During warfarin treatment, determining the optimal dose and maintaining the target PT-INR are challenging. Increasing evidence supports the theory that genotypic polymorphisms influence an individual's warfarin dose requirement. In this study, we evaluated allele frequencies and effects of CYP2C9 and VKORC1 on warfarin response during initial anticoagulation therapy in Korean patients. We enrolled patients who had initiated warfarin therapy and undergone PT-INR testing at least three times within the first month of anticoagulation therapy. All the participating patients were tested for the detection of CYP2C9*3 (c.1075A>C) and VKORC1-1639G>A. A melting-curve analysis after real-time PCR was performed using CYP2C9*3 and VK1639 genotyping kits (Idaho Technology, US). A total of 37 patients were enrolled in this study. CYP2C9*1/*1 (87%) and VKORC1-1639AA genotypes (89%) were predominant in Korea. The CYP2C9*3 and VKORC1-1639G alleles were found in five (13%) and four patients (11%), respectively. Patients with the CYP2C9*3 allele received a lower warfarin dose (P = 0.018) and tended to show more rapid PT-INR increase than CYP2C9*1/*1 genotype. Patients with the VKORC1-1639G allele nonsignificantly received higher warfarin dose than those without. The CYP2C9*3 and VKORC1-1639G alleles influenced warfarin response during the first month of anticoagulation therapy. Considering these results, CYP2C9 and VKORC1 genotyping can be an useful tool to estimate initial warfarin dose and frequency of PT-INR monitoring during the first month of anticoagulation therapy.
Journal of Thrombosis and Thrombolysis 06/2011; 32(4):467-73. · 1.48 Impact Factor
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ABSTRACT: To evaluate the usefulness of an automated system for quantification and discrimination of usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP).
An automated system to quantify six regional high-resolution CT (HRCT) patterns: normal, NL; ground-glass opacity, GGO; reticular opacity, RO; honeycombing, HC; emphysema, EMPH; and consolidation, CONS, was developed using texture and shape features. Fifty-four patients with pathologically proven UIP (n = 26) and pathologically proven NSIP (n = 28) were included as part of this study. Inter-observer agreement in measuring the extent of each HRCT pattern between the system and two thoracic radiologists were assessed in 26 randomly selected subsets using an interclass correlation coefficient (ICC). A linear regression analysis was used to assess the contribution of each disease pattern to the pulmonary function test parameters. The discriminating capacity of the system between UIP and NSIP was evaluated using a binomial logistic regression.
The overall ICC showed acceptable agreement among the system and the two radiologists (r = 0.895 for the abnormal lung volume fraction, 0.706 for the fibrosis fraction, 0.895 for NL, 0.625 for GGO, 0.626 for RO, 0.893 for HC, 0.800 for EMPH, and 0.430 for CONS). The volumes of NL, GGO, RO, and EMPH contribute to forced expiratory volume during one second (FEV₁) (r = 0.72, β values, 0.84, 0.34, 0.34 and 0.24, respectively) and forced vital capacity (FVC) (r = 0.76, β values, 0.82, 0.28, 0.21 and 0.34, respectively). For diffusing capacity (DL(co)), the volumes of NL and HC were independent contributors in opposite directions (r = 0.65, β values, 0.64, -0.21, respectively). The automated system can help discriminate between UIP and NSIP with an accuracy of 82%.
The automated quantification system of regional HRCT patterns can be useful in the assessment of disease severity and may provide reliable agreement with the radiologists' results. In addition, this system may be useful in differentiating between UIP and NSIP.
Korean journal of radiology: official journal of the Korean Radiological Society 05/2011; 12(3):297-307. · 1.32 Impact Factor
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Jae Seung Lee,
Jin Won Huh,
Eun Jin Chae,
Joon Beom Seo,
Seung Won Ra,
Ji-Hyun Lee,
Eun-Kyung Kim, Young Kyung Lee,
Tae-Hyung Kim,
Woo Jin Kim,
Jin Hwa Lee,
Sang-Min Lee,
Sangyeub Lee,
Seong Yong Lim,
Tae Rim Shin,
Ho Il Yoon,
Seung Soo Sheen,
Yeon-Mok Oh,
Sang-Do Lee
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ABSTRACT: Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease and responses to therapies are highly variable. The aim of this study was to identify the predictors of pulmonary function response to 3 months of treatment with salmeterol/fluticasone in patients with COPD. A total of 127 patients with stable COPD from the Korean Obstructive Lung Disease (KOLD) Cohort, which were prospectively recruited from June 2005 to September 2009, were analyzed retrospectively. The prediction models for the FEV(1), FVC and IC/TLC changes after 3 months of treatment with salmeterol/fluticasone were constructed by using multiple, stepwise, linear regression analysis. The prediction model for the FEV(1) change after 3 months of treatment included wheezing history, pre-bronchodilator FEV(1), post-bronchodilator FEV(1) change and emphysema extent on CT (R = 0.578). The prediction models for the FVC change after 3 months of treatment included pre-bronchodilator FVC, post-bronchodilator FVC change (R = 0.533), and those of IC/ TLC change after 3 months of treatment did pre-bronchodilator IC/TLC and post-bronchodilator FEV(1) change (R = 0.401). Wheezing history, pre-bronchodilator pulmonary function, bronchodilator responsiveness, and emphysema extent may be used for predicting the pulmonary function response to 3 months of treatment with salmeterol/fluticasone in patients with COPD.
Journal of Korean medical science 03/2011; 26(3):379-85. · 0.84 Impact Factor
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ABSTRACT: We propose the use of a context-sensitive support vector machine (csSVM) to enhance the performance of a conventional support vector machine (SVM) for identifying diffuse interstitial lung disease (DILD) in high-resolution computerized tomography (HRCT) images. Nine hundred rectangular regions of interest (ROIs), each 20 × 20 pixels in size and consisting of 150 ROIs representing six regional disease patterns (normal, ground-glass opacity, reticular opacity, honeycombing, emphysema, and consolidation), were marked by two experienced radiologists using consensus HRCT images of various DILD. Twenty-one textual and shape features were evaluated to characterize the ROIs. The csSVM classified an ROI by simultaneously using the decision value of each class and information from the neighboring ROIs, such as neighboring region feature distances and class differences. Sequential forward-selection was used to select the relevant features. To validate our results, we used 900 ROIs with fivefold cross-validation and 84 whole lung images categorized by a radiologist. The accuracy of the proposed method for ROI and whole lung classification (89.88 ± 0.02%, and 60.30 ± 13.95%, respectively) was significantly higher than that provided by the conventional SVM classifier (87.39 ± 0.02%, and 57.69 ± 13.31%, respectively; paired t test, p < 0.01, and p < 0.01, respectively). We conclude that our csSVM provides better overall quantification of DILD.
Journal of Digital Imaging 02/2011; 24(6):1133-40. · 1.25 Impact Factor
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ABSTRACT: A 69-year-old woman with relapsed primary central nervous system (CNS) lymphoma was treated with intrathecal rituximab without a concomitant systemic steroid or other chemotherapeutic drugs. Her initial viral status was HBs Ag negative and anti-HBs Ab positive. After 12 weeks of the last intrathecal rituximab application, the levels of AST and ALT were 1,005 and 1,134 IU/l, respectively. The viral status was changed as follows: HBs Ag positive, anti-HBs Ab negative, anti-HBe Ag positive, and anti-HBe Ab negative. The titer of hepatitis B virus (HBV) DNA was 106,000 IU/ml. She was diagnosed with acute hepatitis due to HBV reactivation. To our knowledge, this is the first reported case of HBV reactivation occurring after intrathecal rituximab monotherapy, suggesting that monitoring of HBV markers should be considered during intrathecal rituximab treatment in primary CNS lymphoma patients who are HBs Ag positive or anti-HBs Ab positive.
Acta Haematologica 12/2010; 125(3):121-4. · 1.35 Impact Factor
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Hee-Yeon Woo,
Sang-Yong Shin,
Hyosoon Park,
Young Jae Kim,
Hee-Jin Kim, Young Kyung Lee,
Seok-Lae Chae,
Yoon Hwan Chang,
Jong Rak Choi,
Kyungja Han,
Sung Ran Cho,
Kye Chul Kwon
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ABSTRACT: Manual slide review (MSR) is usually triggered by the results of automated hematology analyzers, but each laboratory has different criteria for MSR. This study was carried out to investigate the current status of MSR criteria of automated complete blood cell count (CBC) and white blood cell (WBC) differential results and to propose a basic guideline for MSR.
Total 111 laboratories were surveyed regarding MSR using questionnaires. The questionnaire asked: kinds of automated hematology analyzers used and the presence of criteria triggering MSR in seven categories: 1) CBC results, 2) 5 differential WBC counts, 3) 3 differential WBC counts, 4) automated reticulocyte counts, 5) delta check, 6) instrument flags (or messages), 7) clinical information (wards or diseases). Based on the survey results, we determined basic and extended criteria for MSR. With these criteria, we consulted nine hematology experts to get a consensus.
All 111 laboratories had their own MSR criteria. Among 111 laboratories, 98 (88.3%) used more than three criteria for MSR including CBC results and 5-part WBC differential count results and 95 (85.6%) had criteria of flags triggering MSR. For MSR criteria with numeric values, the 10th, 50th, and 90th percentiles of upper and lower threshold values were obtained. The basic guideline for MSR was made.
We proposed a basic guideline for MSR. This guideline would be helpful to hematology laboratories for their daily operation and providing more rapid and accurate CBC and WBC differential results.
The Korean Journal of Laboratory Medicine 12/2010; 30(6):559-66. · 0.63 Impact Factor
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ABSTRACT: The purpose of this study was to compare quantitative and visual assessments of regional heterogeneity of emphysema and to investigate the influence of regional heterogeneity on pulmonary function in smoking-related emphysema.
We developed an automatic computerized algorithm to quantitatively assess heterogeneity in the upper-lower, anterior-posterior, and central-peripheral directions. The emphysema index was plotted with a linear function (emphysema index slopes: slope of emphysema index in upper-lower direction, slope of emphysema index in anterior-posterior direction, and slope of emphysema index in central-peripheral direction) for consecutive 1-pixel-thick slices using volumetric CT data of 59 patients (58 men and one woman; mean age, 65.7 years). Emphysema index was defined as the percentage area of lung with attenuation values below -950 HU. Visual assessment was performed using a 5-point scoring system. Quantitative and visual assessments were compared. Multiple linear regression was performed to evaluate the influence of emphysema index and emphysema index slopes on the pulmonary function test.
Quantitative and visual assessments were significantly correlated in both upper-lower (r(2) = 0.40 and r(2) = 0.67 for observers 1 and 2, respectively) and central-peripheral (r(2) = 0.51 and r(2) = 0.47, respectively) directions. Multiple linear regression revealed that emphysema index, slope of emphysema index in upper-lower direction, and slope of emphysema index in anterior-posterior direction were independent determinants of forced expiratory volume in 1 second (FEV(1)) (r(2) = 0.30; p < 0.001). Emphysema index and slope of emphysema index in upper-lower direction were independent determinants of the ratio of FEV(1) to forced vital capacity (FEV(1)/FVC) (r(2) = 0.32; p < 0.001). In addition to higher emphysema index, lower and posterior lung dominance was associated with a decrease in FEV(1) and FEV(1)/FVC.
Computerized, quantitative assessment using the emphysema index slope is comparable to visual assessment in the evaluation of regional heterogeneity of emphysema. In addition to the emphysema index, regional heterogeneity of smoking-related emphysema contributes to impairment of pulmonary function.
American Journal of Roentgenology 03/2010; 194(3):W248-55. · 2.78 Impact Factor
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Jae Jin Lee,
Chi Hoon Maeng,
Seon Kyung Baek,
Gou Young Kim,
Jee-Hong Yoo,
Cheon Woong Choi,
Yee Hyung Kim,
Young-Tae Kwak,
Dae-Hyun Kim, Young Kyung Lee,
Jung Bo Kim,
Si-Young Kim
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ABSTRACT: We evaluated whether ribonucleotide reductase regulatory subunit M1 (RRM1) protein expression by immunohistochemistry (IHC) is a predictor of survival and response in gemcitabine-treated, advanced non-small cell lung cancer (NSCLC). We retrospectively collected 40 formalin-fixed, paraffin-embedded NSCLC tissues to investigate the protein expression of RRM1 by IHC with a purified rabbit anti-human RRM1 polyclonal antibody (ProteinTech Group, Chicago, IL, USA). RRM1 expression was positive in 14 (35%) and negative in 26 (65%) cases. Ten (25%) patients were treated as first-line and 30 (75%) patients as second-line. The median age was 61 years and M/F was 31/9. Stage IIIB/IV was 7/33 and adenocarcinoma/squamous cell carcinoma/other cell type was 20/16/4. Other characteristics, including age, gender, stage, cell type and first/second-line were not statistically different in the RRM-positive and RRM-negative groups. The overall survival of RRM1-positive groups was significantly shorter than RRM-negative groups (5.1 months vs. 12.9 months, p = 0.022). The response rates of 38 out of 40 patients were assessable. Disease control rate (PR+SD) of the RRM1-positive groups was significantly lower than that of RRM1-negative groups (23% vs. 56%, p = 0.053). In patients with gemcitabine-treated advanced NSCLC, patients with RRM1-positive tumors had worse overall survival and disease control than patients with RRM1-negative tumors.
Lung cancer (Amsterdam, Netherlands) 03/2010; 70(2):205-10. · 3.14 Impact Factor
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Ji-Hyun Lee, Young Kyung Lee,
Eun-Kyung Kim,
Tae-Hyung Kim,
Jin Won Huh,
Woo Jin Kim,
Jin Hwa Lee,
Sang-Min Lee,
Sangyeub Lee,
Seong Yong Lim,
Tae Rim Shin,
Ho Il Yoon,
Seung Soo Sheen,
Namkug Kim,
Joon Beom Seo,
Yeon-Mok Oh,
Sang Do Lee
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ABSTRACT: Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous disorder in which a number of different pathological processes lead to recognition of patient subgroups that may have individual characteristics and distinct responses to treatment.
We tested the hypothesis that responses of lung function to 3 months of combined inhalation of long-acting beta-agonist and corticosteroid might differ among patients with various COPD subtypes.
We classified 165 COPD patients into four subtypes according to the severity of emphysema and airflow obstruction: emphysema-dominant, obstruction-dominant, mild-mixed, and severe-mixed. The emphysema-dominant subtype was defined by an emphysema index on computed tomography of more than 20% and FEV(1) more than 45% of the predicted value. The obstruction-dominant subtype had an emphysema index < or = 20% and FEV(1) < or = 45%, the mild-mixed subtype had an emphysema index < or = 20% and FEV(1) > 45%, and the severe-mixed subtype had an emphysema index > 20% and FEV(1) < or = 45%. Patients were recruited prospectively and treated with 3 months of combined inhalation of long-acting beta-agonist and corticosteroid.
After 3 months of combined inhalation of long-acting beta-agonist and corticosteroid, obstruction-dominant subtype patients showed a greater FEV(1) increase and more marked dyspnea improvement than did the emphysema-dominant subgroup. The mixed-subtype patients (both subgroups) also showed significant improvement in FEV(1) compared with the emphysema-dominant subgroup. Emphysema-dominant subtype patients showed no improvement in FEV(1) or dyspnea after the 3-month treatment period.
The responses to 3 months of combined inhalation of long-acting beta-agonist and corticosteroid differed according to COPD subtype.
Respiratory medicine 11/2009; 104(4):542-9. · 2.33 Impact Factor
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ABSTRACT: Transcobalamin-bound vitamin B(12), or holotranscobalamin (HoloTC), a biologically active form, is believed to be a sensitive marker of vitamin B(12) deficiency. We investigated the prevalence of vitamin B(12) deficiency in gastrectomized patients using HoloTC and total vitamin B(12) to determine the diagnostic utility of HoloTC. We enrolled 128 gastrectomized patients and measured serum HoloTC, total vitamin B(12), homocysteine (Hcy), and complete blood count (CBC). HoloTC values were also obtained from 100 healthy controls. The precision of HoloTC measurement was good and the normal range of HoloTC was set at >or=42.48 pmol/L. Among the 128 gastrectomized subjects, HoloTC was low (<42.48 pmol/L) in 32 patients (25.0%) and total vitamin B(12) was low (<189 pg/ml) in 10 patients (7.8%). Among the patients who had total vitamin B(12) concentrations in the borderline range (189 approximately 400 pg/ml), 44% had low HoloTC concentrations. Clinical findings as well as Hcy concentrations suggested vitamin B(12) deficiency in this subset of patients. The patients with both low total vitamin B(12) and low HoloTC had significantly higher Hcy concentrations than those with either normal total vitamin B(12) or normal HoloTC. Although a quarter of gastrectomized patients had low HoloTC, some of these had normal total vitamin B(12) concentrations. Our study suggests that serum HoloTC is a more sensitive marker than total vitamin B(12) in diagnosing vitamin B(12) deficiency.
Annals of clinical and laboratory science 01/2009; 39(4):361-6. · 0.96 Impact Factor
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ABSTRACT: Multiple myeloma (MM) is a malignant neoplasm of plasma cell origin. Pleural effusion may develop in the setting of MM due to various reasons, but myelomatous pleural effusion (MPE) is rare. We report a case of MPE in a patient with advanced MM. A 76-year-old woman with MM was admitted to hospital because of dyspnea. Chest X-ray showed right-sided pleural effusion. Protein electrophoresis of the pleural fluid showed monoclonal protein, and cytology demonstrated monoclonal plasma cells. Hospice care was implemented, and the patient died one month later. We present an analysis of the clinical characteristics of 57 MPE cases reported in the English literature. Our review revealed that MPE patients had poor overall survival irrespective of whether MPE develops in the course of their disease or presents as the initial manifestation of MM. Based on this analysis, MPE is a poor prognostic factor, and aggressive treatment should be considered, especially for patients with early-onset MPE.
Acta Haematologica 11/2008; 120(2):108-11. · 1.35 Impact Factor
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Woo Jin Kim,
Yeon-Mok Oh,
Joohon Sung, Young Kyung Lee,
Joon Beom Seo,
NamKug Kim,
Tae-Hyung Kim,
Jin Won Huh,
Ji-Hyun Lee,
Eun-Kyung Kim,
Jin Hwa Lee,
Sang-Min Lee,
Sangyeub Lee,
Seong Yong Lim,
Tae Rim Shin,
Ho Il Yoon,
Sung-Youn Kwon,
Sang Do Lee
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ABSTRACT: Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease that is characterized by varying degrees of involvement of airway and lung parenchyma. Although cigarette smoke is the major risk factor for COPD, the principal determining factors of involvement of the airway or lung parenchyma have not been clearly defined. Genetic variability in COPD patients might influence the varying degrees of involvement of airway and parenchyma. We therefore studied whether airway and parenchyma involvement might be associated with the ADRB2 genotype, which has been reported to be associated with COPD susceptibility and the bronchodilator response.
One hundred and eleven COPD subjects, whose post-bronchodilator FEV(1)/FVC values were less than 0.7, and who had histories of smoking exceeding 10 pack-years, were prospectively recruited from pulmonology clinics of 11 hospitals in Seoul, Korea. The degrees of involvement of airway and parenchyma were evaluated by volumetric computed tomography (CT) scans. In-house software automatically calculated luminal areas, airway wall areas, percentages of wall areas in segmental bronchi, emphysema indices, and mean lung densities in the whole lung parenchyma. The ADRB2 genotypes at codon 16 were determined for all patients.
Gly16 was associated with lumen diameter, luminal area, and percentage of wall area in patients with COPD (p=0.02), whereas neither wall area nor wall thickness differed with ADRB2 genotype. Neither emphysema index nor mean lung density was associated with ADRB2 genotype.
Gly16 variant in ADRB2 gene was associated with airway wall phenotypes measured using CT scanning in COPD patients.
Respiratory medicine 10/2008; 103(1):98-103. · 2.33 Impact Factor
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ABSTRACT: Aspirin is the most common drug used for the prevention of arterial thrombosis. However, platelet responsiveness to aspirin is variable among individuals and it is important to detect aspirin resistance to improve clinical outcome. We analyzed the changes of platelet reactivity before and after aspirin treatment. We also investigated the incidence and influencing factors of aspirin resistance in Korean.
We tested platelet function in 198 patients who had been treated with aspirin in a Korean university hospital, and 59 of these patients were tested for platelet function before and after aspirin treatment. We also analyzed platelet reactivity in 136 patients who had not been treated with aspirin. Platelet function was tested using the VerifyNow Aspirin Assay (Accumetrics, USA). Platelet reactivity was expressed as aspirin reaction unit (ARU) and > or =550 ARU was defined as aspirin resistance.
Platelet reactivity of 136 patients who had not been treated with aspirin was 632.2plusmn;46.3 ARU (meanplusmn;SD) (range, 462-675). Platelet reactivity of 198 patients who had been treated with aspirin was 472.5plusmn;60.0 (338-666) ARU, and 10.1% of patients were aspirin-resistant. The difference of platelet reactivity before and after aspirin treatment was 128.3plusmn;68.7 (-40-248) ARU. Hb level was lower and platelet count was higher in aspirin-resistant group than in aspirin-sensitive group (P<0.05).
We demonstrated the distribution of platelet reactivity before and after aspirin treatment using the VerifyNow Aspirin Assay. The incidence of aspirin resistance was 10.1%, and low Hb level and high platelet count were related with aspirin resistance.
The Korean Journal of Laboratory Medicine 08/2008; 28(4):251-7. · 0.63 Impact Factor
