Hyun Kyung Kim

Seoul National University Hospital, Sŏul, Seoul, South Korea

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Publications (93)157.91 Total impact

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    ABSTRACT: Objectives: Use of a local calibrator has been recommended for standardization of the international normalized ratio (INR) and international sensitivity index (ISI). We investigated the performance of two commercial local calibrators for warfarin monitoring and determined the significance of liver-specific INR. Methods: ISI values were determined using the World Health Organization (WHO) method and two commercial local calibrators. Liver-specific ISI was determined using plasma samples from patients with liver cirrhosis and normal controls. Results: In warfarin monitoring, the two local ISIs determined by the two local calibrators showed better consistency than uncorrected ISI, although they were inferior to the ISIs calibrated using the WHO method. Alternative calibration using calibration plasma from patients with liver cirrhosis instead of warfarinized plasma reduced the INR variability. Conclusions: Local ISI determined by a commercial local calibrator improved INR standardization among thromboplastins. The alternative ISI calibration using liver-specific calibration plasma is expected to reduce INR variability for the evaluation of liver function.
    American Journal of Clinical Pathology 04/2014; 141(4):542-50. · 2.88 Impact Factor
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    ABSTRACT: Overall assessment of the hemostatic system including procoagulant and anticoagulant changes may help assess the clinical status and prognosis of disseminated intravascular coagulation (DIC). The thrombin generation assay provides useful information about the global hemostatic status. Therefore, we measured several parameters of global hemostatic potential by the thrombin generation assay in patients suspected of having DIC. A total of 114 patients with suspected DIC were included. The thrombin generation assay was performed on the calibrated automated thrombogram using tissue factor with or without the addition of thrombomodulin, showing three parameters: lag time, endogenous thrombin potential (ETP), and peak thrombin. Both 1 and 5 pmol/l tissue factor-stimulated ETP and peak thrombin were well correlated with DIC severity. Interestingly, antithrombin level greatly affected ETP, whereas protein C influenced lag time. Prognostic analysis revealed that the area under the curve of peak thrombin stimulated by 1 pmol/l tissue factor was superior to that of D-dimer. Moreover, multivariate Cox analysis showed that the lag time and time to peak with both 1 and 5 pmol/l tissue factor were independent prognostic markers. ETP and peak thrombin well reflect DIC severity. Hypocoagulability manifesting as prolonged lag time and time to peak is expected to be an independent prognostic marker in DIC.
    Blood coagulation & fibrinolysis: an international journal in haemostasis and thrombosis 04/2014; 25(3):241-7. · 1.25 Impact Factor
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    Annals of laboratory medicine. 03/2014; 34(2):159-62.
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    Qute Choi, Ki Ho Hong, Ji-Eun Kim, Hyun Kyung Kim
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    ABSTRACT: Dysfunctional natural anticoagulant systems enhance intravascular fibrin for mation in disseminated intravascular coagulation (DIC), and plasma levels of natural anti coagulants can be used in the diagnosis and prognosis of DIC. Herein, the diagnostic value of 4 natural anticoagulants was assessed, and the prognostic value of antithrombin and protein C were validated in a large population. Part 1 study included 126 patients with clinically suspected DIC and estimated plasma levels of 4 candidate anticoagulant proteins: antithrombin, protein C, protein S, and protein Z. Part 2 comprised 1,846 patients, in whom plasma antithrombin and protein C levels were compared with other well-known DIC markers according to the underlying dis eases. The 28-day mortality rate was used to assess prognostic outcome. Antithrombin and protein C showed higher areas under the ROC curve than pro tein S and protein Z. In part 2 of the study, antithrombin and protein C levels significantly correlated with DIC score, suggesting that these factors are good indicators of DIC severity. Antithrombin and protein C showed significant prognostic power in Kaplan-Meier analyses. In patients with sepsis/severe infection, antithrombin and protein C showed higher hazard ratios than D-dimer. Platelet count showed the highest hazard ratio in patients with hemato logic malignancy. In patients with liver disease, the hazard ratio for antithrombin levels was significantly high. Decreased plasma anticoagulant levels reflect florid consumption of the phys iologic defense system against DIC-induced hypercoagulation. Plasma antithrombin and protein C levels are powerful prognostic markers of DIC, especially in patients with sepsis/severe infection.
    Annals of laboratory medicine. 03/2014; 34(2):85-91.
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    ABSTRACT: Neutrophil gelatinase-associated lipocalin (NGAL) exists as monomers, homodimers, and NGAL/matrix metalloproteinase-9 (MMP-9) complexes. Circulating neutrophils are activated in ongoing disseminated intravascular coagulation (DIC); therefore, plasma NGAL levels are likely to be increased in DIC. We investigated the diagnostic performance of plasma NGAL level in predicting acute kidney injury (AKI) in patients with DIC and determined the prognostic value of NGAL. A total of 126 patients with suspected DIC were enrolled. The plasma free NGAL was analyzed with a point-of-care immunoassay. Plasma total NGAL and NGAL/MMP-9 complex levels were measured using commercial kits. Median free and total NGAL levels were markedly higher in patients with AKI than those without AKI. However, no significant difference in NGAL/MMP-9 complex level was found between the groups. In patients without AKI, the plasma free and total NGAL levels were significantly higher in those with overt-DIC than in those without overt-DIC. Of note, free NGAL level showed a significant prognostic value in DIC. Plasma free and total NGAL proved to be powerful markers for AKI in DIC patients and plasma free NGAL also has prognostic relevance in DIC patients without AKI.
    Clinica chimica acta; international journal of clinical chemistry 02/2014; · 2.54 Impact Factor
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    ABSTRACT: Aims A prothrombotic state characterized by activation of the coagulation system has been implicated in the pathogenesis of vascular complications in diabetes mellitus. Recently, a thrombin generation assay was introduced as a laboratory assessment of global hemostatic potential. We used this thrombin generation assay to investigate global hemostatic potential in patients with diabetes who did not have macrovascular complications. Methods This study was a prospective case–control study comparing 89 patients with diabetes with 49 healthy controls. The thrombin generation assay was conducted with the calibrated automated thrombogram using tissue factor with or without the addition of thrombomodulin, giving values for lag time, endogenous thrombin potential, and peak thrombin. Results Patients with diabetes showed hypercoagulability, as detected by the thrombin generation assay, compared with healthy controls. Correspondingly, high levels of coagulation factors (II, V, VII, VIII, and X) and low levels of anticoagulant (protein C) were major contributing factors in this hypercoagulability. Interestingly, a high blood glucose level was correlated with shortened clotting time, reflecting the association between hyperglycemia and hypercoagulability. Patients who were taking statins or angiotensin receptor blockers showed decreased endogenous thrombin potential ratio and increased protein C levels, suggesting relative hypocoagulability. Conclusions Patients with diabetes showed hypercoagulability, high levels of coagulation factors, and low levels of protein C. Further study is required to investigate how this hemostatic potential may be used to guide physicians toward more effective management of hemostatic complications.
    Journal of diabetes and its complications 01/2014; · 2.11 Impact Factor
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    ABSTRACT: Patients with end-stage renal disease (ESRD) on maintenance haemodialysis are predisposed to bleeding and thrombotic events. Recently thrombin generation assay (TGA) has been introduced as a laboratory assessment of global haemostatic potential. We investigated the global haemostatic potential assessed by TGA in ESRD patients on haemodialysis and patients who developed vascular access thrombosis. A total of 69 ESRD patients who underwent haemodialysis (58 stable patients and 11 vascular access thrombosis patients) were included and 33 healthy controls were included. TGA was performed on the calibrated automated thrombogram using tissue factor with/without addition of thrombomodulin or activated protein C, producing three parameters including lag time, endogenous thrombin potential (ETP) and peak thrombin. Haemodialysis patients showed low ETP values measured by thrombin generation assay compared with the healthy controls. Interestingly, patients with vascular access thrombosis exhibited short PT and aPTT and increased resistance of coagulation inhibition to APC anticoagulant protein, reflecting hyper-coagulability. Haemodialysis patients who are taking anti-platelet agents showed decreased thrombin inhibition rate, representing antithrombotic effect of anti-platelet agents. Whereas the haemodialysis patients showed hypo-coagulability, the patients with vascular access thrombosis exhibited hyper-coagulability. Further study is required to investigate how this haemostatic potential may be utilized to guide the physician to more effective management of haemostatic complication.
    Thrombosis Research 09/2013; · 3.13 Impact Factor
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    ABSTRACT: To examine the effects of presurgical corticosteroid treatment for normal-risk penetrating keratoplasty (NRPK), high-risk penetrating keratoplasty (HRPK), and high-risk penetrating keratoplasty plus lensectomy. We used 3 corneal transplantation models (NRPK, HRPK, and high-risk penetrating keratoplasty plus lensectomy). For each model, we tried to compare the effect of corticosteroid treatment according to different timetables as follows: The first trial began with a corticosteroid injection given 2 weeks before the PK and continued until 4 weeks after the PK (group 1). The second trial started with a corticosteroid injection given on the day of the PK and continued for 4 weeks after the PK (group 2). The third trial started with a corticosteroid injection administered on the day of the PK and continued for 8 weeks after the PK (group 3). After harvesting and immunostaining of corneas, graft survival, neovascularization (NV), and lymphangiogenesis (LY) were compared among the groups. A P value <0.05 was considered as being statistically significant. With respect to graft survival, group 1 had improved graft survival compared with that of group 3 in the HRPK model (P = 0.025). In all the 3 PK models, groups 2 and 3 demonstrated a similar graft survival (P > 0.05). With respect to NV and LY, in NRPK, group 1 showed less NV than did group 2 (P < 0.001) and group 3 (P = 0.016). In HRPK, group 1 also demonstrated less NV and LY than did group 3 (P = 0.045 and 0.044, respectively). The initiation time point of the corticosteroid treatment is important for graft survival. Corticosteroid pretreatment is an effective means to increase graft survival for HRPK and to decrease NV and LY for both NRPK and HRPK.
    Cornea 09/2013; · 1.75 Impact Factor
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    ABSTRACT: Bloodstream infection (BSI) is a significant cause of morbidity and mortality in liver transplant (LT) recipients. This study aimed to investigate the epidemiology and clinical features of post-transplant BSI in LT recipients. The microbiology, frequency, and outcome of post-transplant BSI in the first year after LT were retrospectively analyzed in 222 consecutive patients who had received liver transplants at a single center between 2005 and 2011. The risk factors for post-transplant BSI and death were evaluated. During a 1-year period after LT, 112 episodes of BSI occurred in 64 of the 222 patients (28.8%). A total of 135 microorganisms were isolated from 112 BSI episodes including 18 polymicrobial episodes. The median time to BSI onset ranged from 8 days for Klebsiella pneumoniae to 101 days for enterococci, and the overall median for all microorganisms was 28 days. The most frequent pathogens were Enterobacteriaceae members (32.5%), enterococci (17.8%), yeasts (14.0%), Staphylococcus aureus (10.3%), and Acinetobacter baumannii (10.3%); most of them showed resistance to major antibiotics. The major sources of BSI were biliary tract (36.2%), abdominal and/or wound (28.1%), and intravascular catheter (18.5%) infections. The independent risk factors for post-transplant BSI were biliary complications (odds ratio [OR]: 2.91, 95% confidence interval [CI]: 1.29 to 6.59, P = 0.010) and longer hospitalization in the intensive care unit (OR: 1.04, 95% CI: 1.00 to 1.08, P < 0.001) after LT. BSI was an independent risk factor for death (hazard ratio [HR]: 3.92, 95% CI: 2.22 to 6.91, P < 0.001), with a poorer survival rate observed in patients with BSI than in those without BSI (1-year survival rate: 60.0% versus 89.5%, respectively, P < 0.001) after LT. The strongest predictors for death in patients with BSI were hepatocellular carcinoma (HR: 3.82, 95% CI: 1.57 to 9.32, P = 0.003), candidemia (HR: 3.71, 95% CI: 1.58 to 8.71, P = 0.003), polymicrobial bacteremia (HR: 3.18, 95% CI: 1.39 to 7.28, P = 0.006), and post-transplant hemodialysis (HR: 2.44, 95% CI: 1.02 to 5.84, P = 0.044). BSI was a frequent post-transplant complication, and most of the causative pathogens were multi-drug resistant. Biliary complications and BSIs resulting from biliary infection are major problems for LT recipients. The prevention of BSI and biliary complications is critical in improving prognosis in liver transplant recipients.
    Infection & chemotherapy. 09/2013; 45(3):315-24.
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    ABSTRACT: In the conversion of lignocellulose into high-value products, including fuels and chemicals, the production of cellulase and the enzymatic hydrolysis for producing fermentable sugar are the largest contributors to the cost of production of the final products. The marine bacterium Saccharophagus degradans 2-40(T) can degrade more than ten different complex polysaccharides found in the ocean, including cellulose and xylan. Accordingly, S. degradans has been actively considered as a practical source of crude enzymes needed for the saccharification of lignocellulose to produce ethanol by others including a leading commercial company. However, the overall enzyme system of S. degradans for hydrolyzing cellulose and hemicellulose has not been quantitatively evaluated yet in comparison with commercial enzymes. In this study, the inductions and activities of cellulase and xylanase of cell-free lysate of S. degradans were investigated. The growth of S. degradans cells and the activities of cellulase and xylanase were promoted by adding 2 % of cellulose and xylan mixture (cellulose:xylan = 4:3 in mass ratio) to the aquarium salt medium supplemented with 0.2 % glucose. The specific cellulase activity of the cell-free lysate of S. degradans, as determined by the filter paper activity assay, was approximately 70 times lower than those of commercial cellulases, including Celluclast 1.5 L and Accellerase 1000. These results imply that significant improvement in the cellulase activity of S. degradans is needed for the industrial uses of S. degradans as the enzyme source.
    Bioprocess and Biosystems Engineering 08/2013; · 1.87 Impact Factor
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    ABSTRACT: The yield of ethanol from oil palm empty fruit bunches (EFB) was increased on exploiting maleic acid pretreatment combined with fermentation of the pretreated whole slurry. The optimized conditions for pretreatment were to expose EFB to a high temperature (190 °C) with 1 % (w/v) maleic acid for a short time duration (3 min ramping to the set temperature with no holding) in a microwave digester. An enzymatic digestibility of 60.9 % (based on theoretical glucose yield) was exhibited using pretreated and washed EFB after 48 h of hydrolysis. Simultaneous saccharification and fermentation (SSF) of the whole slurry of pretreated EFB for 48 h resulted in 61.3 % theoretical yield of ethanol based on the initial amount of glucan in untreated EFB. These results indicate that maleic acid is a suitable catalyst not requiring detoxification steps for whole slurry fermentation of EFB for ethanol production, thus improving the process economics. Also, the whole slurry fermentation can significantly increase the biomass utilization by converting sugar from both solid and liquid phases of the pretreated slurry.
    Bioprocess and Biosystems Engineering 08/2013; · 1.87 Impact Factor
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    ABSTRACT: Monocytes express substantial amounts of thrombomodulin, which is consumed throughout ongoing thrombin generation. The modulation of thrombomodulin may aggravate intravascular fibrin deposition and the clinical course of disseminated intravascular coagulation (DIC). Although thrombomodulin restoration has received considerable attention, no reports have been published on the in vivo expression status of thrombomodulin. CD14 expression on monocytes is important for regulation of the inflammatory response. We used an ex vivo stimulation study to evaluate the association of the levels of monocyte-expressed thrombomodulin and CD14 messenger RNA (mRNA) with the severity and prognosis of disseminated intravascular coagulation. A total of 78 patients with suspected DIC were enrolled. Thrombomodulin and CD14 mRNA levels were measured in peripheral blood by real-time quantitative reverse-transcription polymerase chain reaction. Thrombomodulin and CD14 mRNA were also assessed in ex vivo cultures of peripheral whole blood that were stimulated by lipopolysaccharide or thrombin. The levels of monocyte-expressed thrombomodulin mRNA were significantly lower in the non-survivors than in the survivors. A low level of monocyte-expressed thrombomodulin mRNA was a significant prognostic marker, but CD14 did not possess prognostic power. Monocyte-expressed CD14 mRNA correlated significantly with the severity of DIC in survivors. In addition, stimulation of ex vivo cultures of whole blood demonstrated that thrombin upregulates both thrombomodulin and CD14 mRNA, and lipopolysaccharide downregulates thrombomodulin mRNA. The downregulation of thrombomodulin on monocytes reflects the decompensated status of physiological defenses against hypercoagulopathy and represents the poor prognosis in DIC. The expression levels of thrombomodulin on monocytes may be a useful marker to screen for candidates eligible for recombinant thrombomodulin therapy in future.
    Thrombosis Research 08/2013; · 3.13 Impact Factor
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    ABSTRACT: Background: Coagulation and anticoagulation systems are good targets of antiphospholipid antibodies. We assessed the contribution of the antiphospholipid antibodies to the thrombotic risk. Methods: Enzyme-linked immunosorbent assays on antibodies against phosphatidylserine and prothrombin (PS/PT), protein C, protein S, protein Z, and thrombomodulin were performed in 164 patients who showed positive results for lupus anticoagulant or anticardiolipin antibody. Results: Anti-β-2-glycoprotein I (β2GPI) and anti-PS/PT were significant risk factors for thrombotic events (P < .001, P = .049). However, there was no association between antiprotein C, antiprotein S, antiprotein Z, or antithrombomodulin and thrombosis. Coexistence of anti-β2GPI and anti-PS/PT antibodies was significantly associated with thrombotic events (P = .001). Interestingly, the absence of both anti-β2GPI and anti-PS/PT antibodies was a significant preventive factor for thrombosis (P = .003). Conclusion: Our data show a lack of association of antiprotein C, antiprotein S, antiprotein Z, and antithrombomodulin antibodies with thrombosis. However, the combination of conventional anti-β2GPI with anti-PS/PT antibody is expected to enhance the predicting power of thrombotic risk.
    Clinical and Applied Thrombosis/Hemostasis 07/2013; · 1.02 Impact Factor
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    ABSTRACT: BACKGROUND: The effects of warfarin are measured with the international normalized ratio (INR). However, the thrombin generation assay (TGA) may offer more information about global coagulation. We analyzed the monitoring performance of the TGA and INR and investigated the impact of procoagulants (fibrinogen, factor (F)II, FVII, FIX, and FX) and anticoagulants (proteins C, S, and Z) on them. METHODS: The TGA was performed on a calibrated automated thrombogram, producing lag time, endogenous thrombin potential (ETP), and peak thrombin in 239 patients treated with warfarin. Pro- and anticoagulant levels were also measured. RESULTS: The INR was significantly and inversely correlated with ETP. The therapeutic range of ETP comparable to an INR range of 2.0-3.0 was 290.1-494.6. ETP showed comparable performance to the INR as a warfarin-monitoring parameter with respect to clinical complication rate. The median levels of FII, FVII, FIX, and FX and proteins C and Z tended to decrease gradually with increasing anticoagulation intensity according to the INR or ETP. Of note, protein Z levels decreased dramatically with increasing anticoagulation status. INRs were significantly determined by FII, FVII, and protein Z. ETP was significantly dependent on FVII, and proteins C and Z concentration. Protein Z significantly reduced the total amount of thrombin generation and prolonged PT value in vitro. CONCLUSIONS: The INR and ETP exhibit similar efficacy for warfarin monitoring according to the clinical complication rate. Protein Z is considered to be a significant determinant of INR and ETP in patients on warfarin therapy.
    Thrombosis Research 06/2013; · 3.13 Impact Factor
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    Blood research. 06/2013; 48(2):160-3.
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    ABSTRACT: The underlying inflammatory or infectious condition in disseminated intravascular coagulation (DIC) may stimulate the formation of antiheparin/platelet factor 4 (PF4) antibody, and the resulting antibody may affect the clinical course of DIC. We investigated the prognosis of antiheparin/PF4 antibodies in patients with suspected DIC. We measured heparin/PF4 immunoglobulin G (IgG) and total antibody levels using an automated chemiluminescence system in 118 patients with DIC. Of the 118 patients, 13 (11.0%) patients were positive for total antiheparin/PF4, and 6 (5.1%) patients were positive for antiheparin/PF4 IgG. These 13 patients were negative for platelet-activating antibody and had low-heparin-induced thrombocytopenia probability scores. Patients with antiheparin/PF4 IgG were older and had lower antithrombin levels than patients without antiheparin/PF4 IgG. Patients with antiheparin/PF4 IgG had a higher risk of mortality than those without antiheparin/PF4 IgG. The presence of antiheparin/PF4 IgG in old age or low antithrombin level patients with DIC with old age or low antithrombin level suggests a poor prognosis.
    Clinical and Applied Thrombosis/Hemostasis 05/2013; · 1.02 Impact Factor
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    ABSTRACT: INTRODUCTION: Disseminated intravascular coagulation (DIC) is diagnosed based on the combination of predisposing underlying conditions and laboratory tests for plasma coagulation markers. Because the collection of blood plasma samples is a fastidious procedure, the serum sample method may be preferred for measurement of coagulation markers when feasible. MATERIALS AND METHODS: The novel serum marker des-R prothrombin activation peptide fragment 2 (des-R F2) was measured using a sandwich enzyme-linked immunosorbent assay in 181 patients suspected of having DIC. Thrombin generation potential was estimated with a calibrated automated thrombogram. RESULTS: Serum des-R F2 was generated with an in vitro clotting process within a serum separation tube after blood collection. Carboxypeptidase inhibitor inhibited the formation of des-R F2 during in vitro clotting. Low levels of prothrombin and thrombin generation potential resulted in low serum des-R F2 levels. Serum des-R F2 was significantly decreased in overt DIC. Levels of des-R F2 correlated with DIC severity and other coagulation markers. Of note, the decrease in serum des-R F2 levels was a significant marker for predicting mortality. CONCLUSIONS: The serum marker, des-R F2, can be used for the investigation of DIC severity and prognosis. It should be considered a useful marker, especially when only serum samples are available.
    Thrombosis Research 05/2013; · 3.13 Impact Factor
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    ABSTRACT: Background/Aims: Transcriptional repression of tumor suppressor genes is determined by the quantity of promoter hypermethylation. We analyzed the methylation quantity of CDKN2B in pediatric myelodysplastic syndromes (MDS). Methods: Quantitative measurement of CDKN2B methylation was performed in 25 pediatric MDS patients and 12 controls using pyrosequencing, and the result was compared with those from 74 adult MDS cases and 31 adult controls. The association between CDKN2B methylation quantity and factors related to prognosis including bone marrow blast percentage and karyotype was analyzed. Results: Pediatric MDS patients showed a higher methylation level (MtL) of CDKN2B than pediatric controls (2.94 vs. 1.62; p = 0.031) but a lower level than adult MDS patients (8.76; p < 0.001). MtL was higher in pediatric MDS cases with >5% blasts than in pediatric controls (3.78 vs. 1.62; p = 0.052). Pediatric MDS cases with abnormal karyotype showed a higher MtL than pediatric controls (5.95 vs. 1.62; p = 0.045). Conclusions: We confirmed that methylation of CDKN2B is associated with the pathogenesis and prognosis in pediatric MDS. The difference in MtLs between pediatric and adult MDS might be related to the physiological hypermethylation of tumor suppressor genes in aging.
    Acta Haematologica 04/2013; 130(2):115-121. · 0.89 Impact Factor
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    ABSTRACT: It remains unclear how coagulation and anticoagulant factors influence global coagulation assays such as prothrombin time (PT), activated partial thromboplastin time (aPTT), and thrombin generation assay (TGA). We measured PT, aPTT, coagulation factor and protein levels, and TGA parameters (lag time, endogenous thrombin potential [ETP], and peak thrombin) in 252 apparently healthy adults. Vitamin K-dependent coagulation and anticoagulant factors were significantly correlated with blood lipids. PT was determined by factor (F) V and FVII; aPTT was dependent on antithrombin, protein C, FVIII, and FXII. Lag time was mainly determined by FVII, FXII, and protein S and peak thrombin by FVIII and FIX. Antithrombin (for ETP and lag time) and protein S (for lag time) contributed significantly to TGA inhibition. This knowledge about determinants of global coagulation assays may help interpret the results of coagulation assays and contribute to the future development of diagnostic tools. The synchronized plasma levels of vitamin K-dependent proteins with opposite functionalities may compensate a propensity to hyper- or hypocoagulability in a normal population.
    American Journal of Clinical Pathology 03/2013; 139(3):370-9. · 2.88 Impact Factor
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    ABSTRACT: Fibrin-related markers may help differentiate disseminated intravascular coagulation (DIC) from liver cirrhosis-associated dysfunctional coagulation. We investigated the significance of three fibrin-related markers [D-dimer, fibrin degradation product (FDP), and soluble fibrin complexes (sFC)] for the assessment of DIC status and prognosis. We classified 235 patients with suspected DIC into two groups according to their condition: the liver cirrhosis group (n = 47) and the no liver cirrhosis group (n = 188). Prothrombin time (PT), and fibrinogen, sFC, D-dimer, antithrombin, and protein C concentrations were measured and DIC scores were calculated using four parameters: platelet count, D-dimer, fibrinogen, and PT. In the liver cirrhosis group, the sFC concentration increased significantly in accordance with DIC score compared with the no liver cirrhosis group, and this increase was more prominent than D-dimer and FDP concentration increases. For the diagnosis of overt DIC in patients with liver cirrhosis, the area under the concentration curve (AUC) was larger for sFC (0.746) than for D-dimer (0.733) and FDP (0.687). Cox analysis also indicated that an elevated sFC concentration is a more significant prognostic factor of DIC than D-dimer or FDP (hazard ratio: 10.78; P = 0.036) in liver cirrhosis group; however, it was not a prognostic factor in the no liver cirrhosis group. sFC is a powerful diagnostic and prognostic marker of DIC in patient with liver cirrhosis. The use of sFC is expected to enhance the diagnosis and prognosis of DIC, particularly in patients with liver cirrhosis.
    Blood coagulation & fibrinolysis: an international journal in haemostasis and thrombosis 01/2013; · 1.25 Impact Factor

Publication Stats

256 Citations
157.91 Total Impact Points

Institutions

  • 2007–2014
    • Seoul National University Hospital
      • • Department of Internal Medicine
      • • Department of Laboratory Medicine
      Sŏul, Seoul, South Korea
    • Korea Institute of Science and Technology
      Sŏul, Seoul, South Korea
  • 2013
    • Korea University
      Sŏul, Seoul, South Korea
    • Hallym University Medical Center
      • Department of Laboratory Medicine
      Seoul, Seoul, South Korea
  • 2012–2013
    • Catholic University of Korea
      • College of Medicine
      Sŏul, Seoul, South Korea
  • 2010–2013
    • Chonbuk National University
      • College of Nursing
      Tsiuentcheou, North Jeolla, South Korea
    • Soonchunhyang University
      Onyang, South Chungcheong, South Korea
    • Asan Medical Center
      • Department of Laboratory Medicine
      Seoul, Seoul, South Korea
    • Yonsei University Hospital
      • Department of Internal Medicine
      Seoul, Seoul, South Korea
  • 2008–2011
    • Seoul National University
      • Department of Laboratory Medicine
      Sŏul, Seoul, South Korea
    • Ewha Womans University
      Sŏul, Seoul, South Korea
  • 2009
    • Gangneung Asan Hospital
      Sŏul, Seoul, South Korea
    • University of Illinois at Chicago
      • College of Nursing
      Chicago, IL, United States
  • 2006–2008
    • Korea Advanced Institute of Science and Technology
      • Graduate School of Management
      Sŏul, Seoul, South Korea
    • National Institutes of Health
      • Basic Research Laboratory
      Bethesda, MD, United States