Real-World Outcomes of Amikacin Liposome Inhalation Suspension for Refractory Mycobacterium avium Complex Pulmonary Disease

Byung Woo Jhun,Bo-Guen Kim,Sae Rom Kim 대한결핵및호흡기학회 2024 Tuberculosis and Respiratory Diseases Vol.87 No.2

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The Clinical, Radiologic, and Bronchoscopic Findings in Benign Endobronchial Tumors

( Byung Woo Jhun ),( Kyeong Man Jeon ),( Won Jung Koh ),( Gee Young Suh ),( Man Pyo Chung ),( O Jung Kwon ),( Ho Joong Kim ) 대한결핵 및 호흡기학회 2012 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.114 No.-

Objectives: We evaluated the clinical, radiologic, and bronchoscopic findings in benign endobronchial tumors and treatment outcomes of bronchoscopic intervention. Methods: We retrospectively reviewed records of patients with benign endobronchial tumor who underwent rigid bronchoscopic intervention, and evaluated outcomes of 55 patients with hamartomas, leiomyoma, papilloma, carcinoid, and schwannoma, between April 1999 and July 2012. Results: The most common types of tumor was hamartomas (n=24) followed by leiomyoma (n=16), papilloma (n=7), carcinoid (n=5), and schwannoma (n=3). Clinically, 46 patients had respiratory symptoms. On chest CT, all patients showed mass or nodular lesions in tracheobronchial tree and were frequently accompanied by atelectasis (n=26) or obstructive pneumonia (n=17). At bronchoscopy, most tumors showed round shape, smooth surface, and pedunculated base. As a result, 49 of 55 patients had complete resection, and 1 patient with hamartoma had partial resection. However, 5 patients subsequently received surgery (2 carcinoids, 2 leiomyomas, and 1 hamartoma). Recurrences occurred in 4 papillomas and in 1 carcinoid, and 4 recurrent papillomas needed repeated bronchoscopic interventions and 1 recurrent carcinoid received surgery. The proportion of pedunculated base and no bleeding were high in successful removal group compared with unsuccessful removal group who had surgery, complications, or recurrence. Conclusions: We described characteristics of benign endobronchial tumors and provided the clinical data on the value of bronchoscopic intervention.

Vitamin D Status in South Korean Military Personnel with Acute Eosinophilic Pneumonia: A Pilot Study

Jhun, Byung Woo,Kim, Se Jin,Kim, Kang,Lee, Ji Eun,Hong, Duck Jin The Korean Academy of Tuberculosis and Respiratory 2015 Tuberculosis and Respiratory Diseases Vol.78 No.3

Background: A relationship between low vitamin D levels and the development or outcomes of respiratory diseases has been identified. However, there is no data on the vitamin D status in patients with acute eosinophilic pneumonia (AEP). We evaluated the vitamin D status in patients with AEP among South Korean military personnel. Methods: We prospectively compared the serum levels of total 25-hydroxyvitamin D [25(OH)D], 25(OH)D3, and 25(OH)D2 among patients with AEP, pulmonary tuberculosis (PTB), and community-acquired pneumonia (CAP). Results: In total, 65 patients with respiratory diseases, including AEP (n=24), PTB (n=19), and CAP (n=22), were identified. Of the 24 patients with AEP, 2 (8%) had deficient total 25(OH)D levels (<10 ng/mL), 17 (71%) had insufficient total 25(OH)D levels (${\geq}10$ to <30 ng/mL), and only 5 (21%) had sufficient total 25(OH)D levels (${\geq}30$ to <100 ng/mL). The difference in the total 25(OH)D levels among patients with AEP, PTB, and CAP was not statistically significant (p=0.230). The median levels of total 25(OH)D, 25(OH)D3, and 25(OH)D2 were 22.84, 22.84, and 0.00 ng/mL, respectively, and no differences in the 25(OH)D level were present among patients with AEP, PTB, and CAP with the exception of the total 25(OH)D level between patients with AEP and PTB (p=0.042). Conclusion: We have shown that low vitamin D levels are frequently found in patients with AEP and are comparable with those in patients with PTB and CAP.

Clinical Characteristics and Treatment Outcomes of Chronic Pulmonary Aspergillosis: a Retrospective Analysis of 70 Patients

( Byung Woo Jhun ),( Kyeong Man Jeon ),( Jung Seop Eom ),( Ji Hyun Lee,),( Gee Young Suh ),( Man Pyo Chung ),( O Jung Kwon ),( Won Jung Koh ) 대한결핵 및 호흡기학회 2012 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.114 No.-

Backgroud: Chronic pulmonary aspergillosis (CPA) is uncommon and there are few data on the clinical characteristics, optimal therapeutic strategies, and outcomes. Methods: We retrospectively reviewed the records of patients with newly diagnosed CPA and assessed the clinical, radiologic, and laboratory responses, and outcomes between January 2008 and January 2012. Results: A total of 70 CPA patients were included. Median age was 55 years and 51 patients (72.9% ) were men. Fifty-seven patients (81.4%) had a history of pulmonary tuberculosis and 32 patients (45.7%) had non-tuberculosis mycobacterium (NTM) lung disease, 17 of whom had a history of NTM treatment and 15 was under NTM treatment. Sixty-nine patients (98.6%) received oral itraconazole, except one with oral voriconazole for a median duration of 6.2 months. Symptomatic improvement occurred in 52 patients (74.3%), radiologic improvement occurred in 29 (41.4%), and laboratory tests improved more than 60% of all patients. Thirty-six patients (51.4%) achieved treatment success, defined as symptomatic improvement after at least 6 months of therapy regardless of radiological improvement, and 4 of whom needed retreatment after a median of 8.4 months. There was no difference in clinical characteristics and outcomes according to NTM status and 10 (14.3%) discontinued therapy due to adverse reactions. Death occurred in 10 (14.3%) and median follow-up duration was 11.2 months. Conclusion: Antifungal therapy for about 6 months and reassessment of disease might be feasible treatment strategy in managing patients with CPA.

Vitamin D Status in South Korean Military Personnel with Acute Eosinophilic Pneumonia: A Pilot Study

( Byung Woo Jhun ),( Se Jin Kim ),( Kang Kim ),( Ji Eun Lee ),( Duck Jin Hong ) 대한결핵 및 호흡기학회 2015 Tuberculosis and Respiratory Diseases Vol.78 No.3

Background: A relationship between low vitamin D levels and the development or outcomes of respiratory diseases has been identified. However, there is no data on the vitamin D status in patients with acute eosinophilic pneumonia (AEP). We evaluated the vitamin D status in patients with AEP among South Korean military personnel. Methods: We prospectively compared the serum levels of total 25-hydroxyvitamin D [25(OH)D], 25(OH)D3, and 25(OH)D2 among patients with AEP, pulmonary tuberculosis (PTB), and community-acquired pneumonia (CAP). Results: In total, 65 patients with respiratory diseases, including AEP (n=24), PTB (n=19), and CAP (n=22), were identified. Of the 24 patients with AEP, 2 (8%) had deficient total 25(OH)D levels (<10 ng/mL), 17 (71%) had insufficient total 25(OH)D levels (≥10 to <30 ng/mL), and only 5 (21%) had sufficient total 25(OH)D levels (≥30 to <100 ng/mL). The difference in the total 25(OH)D levels among patients with AEP, PTB, and CAP was not statistically significant (p=0.230). The median levels of total 25(OH)D, 25(OH)D3, and 25(OH)D2 were 22.84, 22.84, and 0.00 ng/mL, respectively, and no differences in the 25(OH)D level were present among patients with AEP, PTB, and CAP with the exception of the total 25(OH)D level between patients with AEP and PTB (p=0.042). Conclusion: We have shown that low vitamin D levels are frequently found in patients with AEP and are comparable with those in patients with PTB and CAP.

Evidence for the Ras-Independent Signaling Pathway Regulating Insulin-Induced DNA Synthesis

Jhun, Byung H . 생화학분자생물학회 2000 BMB Reports Vol.32 No.2

The existence of the Ras-independent signal transduction pathway of insulin leading to DNA synthesis was investigated in Rat-1 fibroblasts overexpressing human insulin receptor (HIRc-B) using the single-cell microinjection technique. Microinjection of a dominant-negative mutant Ras^(N17) protein into quiescent HIRc-B cells inhibited the DNA synthesis stimulated by insulin. Microinjection of oncogenic HRas^(V12) protein (H-Ras^(V12)) (0.1 ㎎/㎖) induced DNA synthesis by 35%, whereas that of control-injected IgG was induced by 20%. When the marginal amount of oncogenic H-Ras^(V12) protein was coinjected with a dominant-negative mutant of the H-Ras^(V12) protein (H-Ras^(N17)), DNA synthesis was 35% and 74% in the absence and presence of insulin, respectively. This full recovery of DNA synthesis by insulin suggests the existence of the Ras-independent pathway. The same recovery was observed in the cells coinjected with either H-Ras^(V12) plus H-Ras^(V12) plus SH2 domain of the p85 subunit of PI3-kinase (p85^(SH2-N)) or H-Ras^(V12) plus H-Ras^(N17) plus interfering anti-Shc antibody. When coinjected with a dominant-negative Rac1^(N17), the DNA synthesis induced by the Ras-independent pathway was blocked. These results indicate that the Rasindependent pathway of insulin leading to DNA synthesis exists, bypassing the p85 of PI3-kinase and Shc protein, and requires Rac1 protein.

Free Paper Presentation : OS-59 ; Value of Flexible Bronchoscopy in Patients with Persistent Ground Glass Opacity Nodules

( Byung Woo Jhun ),( Kyung Jong Lee ),( Gee Young Suh ),( Man Pyo Chung ),( Hojoong Kim ),( O Jung Kwon ),( Kyung Soo Lee ),( Joung Ho Han ),( Sang Won Um ) 대한결핵 및 호흡기학회 2014 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.118 No.-

Background: There are no accurate data on the diagnostic value of preoperative flexible bronchoscopy (FB) for persistent ground glass opacity (GGO) nodules. Methods: We retrospectively searched a database for subjects who had ‘GGO,’ ‘non-solid nodule,’ ‘part-solid nodule,’ or ‘sub-solid nodule’ in radiological reports of chest computed tomography between February 2004 and March 2012. Patients who had infiltrative GGO, focal GGO larger than 3 cm, or were lost to follow-up were excluded. We assessed the diagnostic value of preoperative FB in patients with persistent GGO nodules who underwent planned surgical resection. Results: In total, 296 GGO nodules were evaluated by FB in 264 patients with persistent GGO nodules who underwent preoperative FB and planned surgical resection. The median size of the GGO nodules was 18 mm, and 135 (46%) were pure GGO and 161 (54%) were mixed GGO. No visible tumor or unsuspected endobronchial metastasis was identified by preoperative FB. Only 3 (1%, 3/208) GGO nodules were identified preoperatively as malignant by bronchial washing cytology, which were all mixed GGO; no other accompanying etiology was identified by FB. Of all GGO nodules, 271 (91%) were subsequently confirmed as malignant and 25 (9%) were confirmed as benign by surgical resection. Consequently, the overall diagnostic sensitivity and negative predictive value of preoperative FB on a per-nodule basis were 1% (3/271) and 8% (25/293), respectively. The preoperative FB did not change the planned surgical strategy. Conclusions: Preoperative FB should not be routinely recommended in surgical candidates with persistent GGO nodules, especially pure GGO nodules.

Ethanol Impairs Insulin's Actions Through Phosphatidylinositol 3-Kinase

Byung H. Jhun,이선주 한국식품영양과학회 2004 Journal of medicinal food Vol.7 No.1

Insulin plays an important role in cell metabolism and proliferation. In the present study, we examined the effect of ethanol on insulin actions such as glucose uptake, DNA synthesis, and c-Jun gene expression. Acute treatment of ethanol (200 mM) for 60 min inhibited insulin-stimulated 2-deoxy-glucose uptake by 50% in 3T3-L1 adipocytes. Insulin-induced DNA synthesis and c-Jun protein expression were also reduced by ethanol treatment in Rat-1 fibroblasts overexpressing normal human insulin receptor (HIRc). Ethanol has no effect on tyrosine phosphorylation of insulin receptor and IRS-1. However, association of the insulin receptor and IRS-1 with SH2 domain of the p85 subunit of phosphatidylinositol (PI) 3-kinase was reduced by ethanol. Pretreatment with the antidiabetic drug troglitazone, an insulin-sensitizer, reversed ethanols inhibition. These results suggest that ethanol specifically inhibits the association of the insulin receptor and IRS-1 with the p85 subunit of PI3-kinase, which is required for increased glucose uptake, DNA synthesis, and c-Jun expression by insulin.

Evidence for the Ras-Independent Signaling Pathway Regulating Insulin-Induced DNA Synthesis

Jhun, Byung-H. Korean Society for Biochemistry and Molecular Biol 1999 Journal of biochemistry and molecular biology Vol.32 No.2

The existence of the Ras-independent signal transduction pathway of insulin leading to DNA synthesis was investigated in Rat-1 fibroblasts overexpressing human insulin receptor (HIRc-B) using the single-cell microinjection technique. Microinjection of a dominant-negative mutant $Ras^{N17}$ protein into quiescent HIRc-B cells inhibited the DNA synthesis stimulated by insulin. Microinjection of oncogenic H-$Ras^{V12}$ protein ($H-Ras^{V12}$) (0.1 mg/ml) induced DNA synthesis by 35%, whereas that of control-injected IgG was induced by 20%. When the marginal amount of oncogenic H-$Ras^{V12}$ protein was coinjected with a dominant-negative mutant of the H-Ras protein ($Ras^{N17}$), DNA synthesis was 35% and 74% in the absence and presence of insulin, respectively. This full recovery of DNA synthesis by insulin suggests the existence of the Ras-independent pathway. The same recovery was observed in the cells coinjected with either H-$Ras^{V12}$ plus H-$Ras^{N17}$ plus SH2 domain of the p85 subunit of PI3-kinase ($p85^{SH2-N}$) or H-$Ras^{V12}$ plus H-$Ras^{N17}$ plus interfering anti-Shc antibody. When co-injected with a dominant-negative H-$Ras^{N17}$, the DNA synthesis induced by the Ras-independent pathway was blocked. These results indicate that the Ras-independent pathway of insulin leading to DNA synthesis exists, bypassing the p85 of PI3-kinase and Shc protein, and requires Rac1 protein.

Treatment of Isoniazid-Resistant Pulmonary Tuberculosis

( Byung Woo Jhun ),( Won-jung Koh ) 대한결핵 및 호흡기학회 2020 Tuberculosis and Respiratory Diseases Vol.83 No.1

Tuberculosis (TB) remains a threat to public health and is the leading cause of death globally. Isoniazid (INH) is an important first-line agent for the treatment of TB considering its early bactericidal activity. Resistance to INH is now the most common type of resistance. Resistance to INH reduces the probability of treatment success and increases the risk of acquiring resistance to other first-line drugs such as rifampicin (RIF), thereby increasing the risk of multidrug-resistant-TB. Studies in the 1970s and 1980s showed high success rates for INH-resistant TB cases receiving regimens comprised of first-line drugs. However, recent data have indicated that INH-resistant TB patients treated with only first-line drugs have poor outcomes. Fortunately, based on recent systematic meta-analyses, the World Health Organization published consolidated guidelines on drug-resistant TB in 2019. Their key recommendations are treatment with RIF-ethambutol (EMB)-pyrazinamide (PZA)-levofloxacin (LFX) for 6 months and no addition of injectable agents to the treatment regimen. The guidelines also emphasize the importance of excluding resistance to RIF before starting RIF-EMB-PZA-LFX regimen. Additionally, when the diagnosis of INH-resistant TB is confirmed long after starting the first-line TB treatment, the clinician must decide whether to start a 6-month course of RIF-EMB-PZA-LFX based on the patient’s condition. However, these recommendations are based on observational studies, not randomized controlled trials, and are thus conditional and based on low certainty of the effect estimates. Therefore, further work is needed to optimize the treatment of INH-resistant TB.