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( Sunji Park ),( Jaehee Lee ),( Ji Eun Park ),( Sun Ha Choi ),( Hyewon Seo ),( Seung Soo Yoo ),( Shin Yup Lee ),( Yu Kyung Kim ),( Seung Ick Cha ),( Jae Yong Park ),( Tae In Park ),( Chang Ho Kim ) 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.-
Background The cause of epithelioid granulomatous inflammation varies widely depending on the affected organ, geographic region, and whether the granulomas morphologically contain necrosis. Compared with other organs, the etiological distribution and morphological patterns of pleural epithelioid granulomas have rarely been investigated. We evaluated the final etiologies and morphological patterns of pleural epithelioid granulomatous inflammation in a country with an intermediate tuberculosis (TB) prevalence. Methods The cases who had granulomatous pleural histology on pleural biopsy, retrospectively were reviewed and their final etiologies were identified. Patient with tuberculous pleurisy (TB-P) were classified into 2 groups according to the presence or absence of microbiological evidence: confirmed and probable TB-P. The clinical, blood, radiological, pleural fluid, and histological data were collected and compared between the confirmed and probable TB-P groups and between the confirmed TB-P and non- TB-P groups. Results Of 83 patients with pleural granulomas, 50 (60.2%) had confirmed TB-P and 29 (34.9%) had probable TB-P. Four patients (4.8%) with non-TB-P were diagnosed. With the exception of microbiological Results, there was no significant difference in patient characteristics and granuloma patterns between the confirmed TB-P and non-TB-P groups, or between patients with confirmed and probable TB-Ps. Additionally, anti-TB treatment outcomes were not significantly different between the confirmed and probable TB-P groups. Conclusions These findings suggest that most pleural granulomatous inflammation (95.2%) was attributable to TB-P in a TB-endemic area and that the granuloma patterns contributed little to the prediction of final diagnosis compared with other organs. However, the clinician should make active effort to find microbiological evidence for differentiation between TB-P and non-TB-P.
( Ji-eun Park ),( Sunji Park ),( Sun Ha Choi ),( Hyewon Seo ),( Yong-hoon Lee ),( Seung-soo Yoo ),( Shin-yup Lee ),( Jaehee Lee ),( Chang-ho Kim ),( Jae-yong Park ),( Seung-ick Cha ) 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.0
Background Data regarding predictors of the outcome for patients with community-acquired complicated parapneumonic effusion (CPPE) or empyema are insufficient. Method Patients with community-acquired pneumonia (CAP) were classified into CPPE or empyema and control groups based on pleural fluid analysis and microbiological data. The patients with CPPE or empyema were further divided into longer and shorter length of stay (LOS) groups, and clinical characteristics, pleural fluid data, and computed tomographic (CT) findings were compared between the two groups. Result Of outcome variables, LOS was significantly longer in CPPE or empyema group than in the control group (13 days [interquartile range, 10-17 days] versus 8 days [6-12 days], p < 0.001), whereas 30-day mortality and in-hospital mortality were not significantly different between the two groups. Patients with CPPE or empyema were divided into the shorter (≤ 13 days) and longer LOS (≥ 14 days) groups. Multivariate analysis demonstrated that pneumonia severity index (PSI) class IV-V (odds ratio [OR] 2.79, 95% CI 1.35-5.76, p=0.006), increased attenuation of extrapleural fat (OR 2.26, 95% CI 1.06-4.80, p=0.034), and air bubbles in pleural space (OR 3.93, 95% CI 1.03-14.98, p=0.045) were independent predictors of prolonged LOS in CAP patients with CPPE or empyema. Conclusion Increased attenuation of extrapleural fat and air bubbles in pleural space assessed with CT and PSI class IV-V independently predicted prolonged LOS in CAP patients with CPPE or empyema. These findings may be helpful to identify patients who need more intensive evaluation and intervention.
( Ji Eun Park ),( Jang Hyuck Lee ),( Shin Yup Lee ),( Hee Won Kwon ),( Yong Seon Yun ),( Sunji Park ),( Ji Yun Jeong ),( Eung Bae Lee ),( Sun Ha Choi ),( Yong Hoon Lee ),( Hye Won Seo ),( Seung Soo Yo 대한결핵 및 호흡기학회 2019 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.127 No.-
Background: Accumulating evidence suggests that necroptosis, or programmed necrotic cell death, may play a significant role in cancer. We evaluated the expression of key molecules in necroptosis and their association with the prognosis in NSCLC. Methods: A total of 258 NSCLC patients (96 squamous cell carcinoma [SCC] cases and 157 adenocarcinoma [AC] cases) who underwent curative resection were included. Tumor tissues and corresponding normal tissues were investigated for relative mRNA expression levels of RIPK1, RIPK3, and MLKL. Difference in disease free survival (DFS) was analyzed according to the expression levels of these molecules in tumor tissues. Results: NSCLC tissues had significantly lower expression of RIPK1, RIPK3, and MLKL compared to normal tissues (P = 8 x 10-5, P = 5 x 10-6, and P = 6 x 10-7, respectively). Low expression of RIPK1, RIPK3, and MLKL was associated with a worse DFS (HR = 1.55, P = 0.03; HR = 1.55, P = 0.03; and HR = 1.47, P = 0.05, respectively) in multivariate analysis. In subgroup analysis, SCCs had significantly lower RIPK1, RIPK3, and MLKL expression (P = 5 x 10-4, P = 3 x 10-15, and P = 1 x 10-5, respectively), and ACs had significantly lower RIPK1 and MLKL expression (P = 0.01 and P = 5 x 10-4, respectively) compared to normal tissues. In SCC, none of the RIPK1, RIPK3, and MLKL expression was significantly associated with DFS. However, in AC, low expression of RIPK1, RIPK3, and MLKL was associated with worse DFS (HR = 1.53, P = 0.08; HR = 1.76, P = 0.02; and HR = 1.61, P = 0.05, respectively). Conclusions: Key regulatory molecules in necroptosis, RIPK1, RIPK3, and MLKL, were downregulated in NSCLC, and their low expression may be used to predict early recurrence after curative resection, especially in AC.
( Ji Eun Park ),( Sunji Park ),( Sun Ha Choi ),( Yong Hoon Lee ),( Hye Won Seo ),( Seung Soo Yoo ),( Shin Yup Lee ),( Seung Ick Cha ),( Jae Yong Park ),( Chang Ho Kim ),( Jaehee Lee ) 대한결핵 및 호흡기학회 2019 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.127 No.-
Background: Undiagnosed pleural effusion (UPE) even after video-assisted thoracoscopic surgery (VATS) pleural biopsy is challenging because there is concern about missing malignant pleural effusion (MPE) with inconclusive cytology results. Better understanding of clinical characteristics of patients with UPE and cytology-negative MPE may improve differential diagnosis. However, little is known about the clinical factors that can help distinguish patients with UPE from those with cytology-negative MPE. Methods: Patients who were diagnosed with UPE and MPE, respectively, between January 2010 and December 2017, were enrolled in this retrospective study. Clinical, laboratory, and radiologic characteristics were compared between patients with UPE and cytology-negative MPE. Diagnostic performances of predictors for UPE were assessed using receiver-operating characteristic curves. Results: During the study period, 223 patients with confirmed MPE (pleural fluid cytology-positive [n=169] and -negative [n=54]) were enrolled. During the same study period, 22 patients with UPE were identified. Multivariate analysis demonstrated that minimal amount of pleural effusion (odds ratio [OR] = 12.41, p=0.039), presence of pleural nodularity (OR = 0.01, p < 0.001), and pleural fluid carcinoembryonic antigen (CEA) levels less than 14 ng/mL (OR = 87.59, p=0.002) were independent factors for identifying UPE among cytology-negative cases. Combination of absence of pleural nodularity and pleural fluid CEA levels less than 14 ng/mL yielded the area under the curve of 0.94 and had a sensitivity of 91% and a specificity of 96%. Conclusions: A significant portion of patients undergoing VATS pleural biopsy fail to get a definite diagnosis. Amount of pleural effusion, pleural nodularity, and pleural fluid CEA levels may help guide differentiation of UPE from cytology-negative MPE.
Butyrate-treated M2 Macrophage Polarization is CECR1-dependent
( Ji Eun Park ),( Ha Jeong Kim ),( Sunji Park ),( Sun Ha Choi ),( Yong Hoon Lee ),( Hye Won Seo ),( Seung Soo Yoo ),( Shin Yup Lee ),( Jaehee Lee ),( Seung Ick Cha ),( Jae Yong Park ),( Chang Ho Kim ) 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.-
Background The Cat Eye Syndrome Critical Region, Candidate 1 (CECR1) gene and its product adenosine deaminase 2 (ADA2) are highly expressed by macrophages. Patients with tuberculous pleural effusion (TPE) usually have elevated ADA2 levels in pleural fluid. In terms of immunomodulatory functions of intestinal metabolite butyrate, it may affect CECR1 expression in patients with TPE. We examined the effect of butyrate on CECR1 expression of macrophages and the role of CECR1 on butyrate-related immune response. Additionally, relationship between ADA2 and macrophage phenotype in pleural fluid of patients with TPE was investigated. Methods Expression of CECR1 was evaluated in LPS-stimulated and/or butyrate treated THP-1 cells. The role of CECR1 on butyrate-induced immune response was evaluated using siRNA transfected THP-1 cells. Correlation between the levels of chemokines associated with M1/M2 macrophage phenotype and ADA2 in pleural fluid of patients with TPE were analyzed. Results Butyrate promoted the expression of CECR1 and M2-macrophage marker in THP-1 cells. In LPS-stimulated THP-1 cells, butyrate facilitated M2-macrophage marker/anti-inflammatory cytokine expression and inhibited M1-macrophage marker/pro-inflammatory cytokine expression in a CECR1-dependent manner. Among M1 chemokines measured, there was a significant negative correlation between pleural fluid CCL21 and ADA2 levels and between CCL25 and ADA2 levels in patients with TPE (CCL21; Spearman r = -0.478, p = 0.050: CCL25; Spearman r = -0.808, p<0.001). Among M2 chemokines measured, there was a significant positive correlation between TGF-β and ADA2 levels and between IL-22 and ADA2 levels in pleural fluid of patients with TPE (TGF-β; Spearman r = 0.603, p<0.001: IL-22; Spearman r = 0.470, p = 0.050). Conclusions Butyrate enhanced M2-macrophage marker/anti-inflammatory cytokine expression of LPS-stimulated THP-1 cells in a CECR1- dependent manner. ADA2 may exert anti-inflammatory effect during the process of pleural inflammation in patients with TPE.
Lee Jaehee,Park Sunji,Park Ji Eun,Choi Sun Ha,Seo Hyewon,Yoo Seung Soo,Lee Shin Yup,Kim Yu Kyung,Cha Seung-Ick,Park Jae Yong,Park Tae In,Kim Chang Ho 대한의학회 2021 Journal of Korean medical science Vol.36 No.1
The cause of epithelioid granulomatous inflammation varies widely depending on the affected organ, geographic region, and whether the granulomas morphologically contain necrosis. Compared with other organs, the etiological distribution and morphological patterns of pleural epithelioid granulomas have rarely been investigated. We evaluated the final etiologies and morphological patterns of pleural epithelioid granulomatous inflammation in a tuberculosis (TB)-prevalent country. Of 83 patients with pleural granulomas, 50 (60.2%) had confirmed TB pleurisy (TB-P) and 29 (34.9%) had probable TB- P. Four patients (4.8%) with non-TB-P were diagnosed. With the exception of microbiological results, there was no significant difference in clinical characteristics and granuloma patterns between the confirmed TB-P and non-TB-P groups, or between patients with confirmed and probable TB-Ps. These findings suggest that most pleural granulomatous inflammation (95.2%) was attributable to TB-P in TB-endemic areas and that the granuloma patterns contributed little to the prediction of final diagnosis compared with other organs.
( Ji Eun Park ),( Shin Yup Lee ),( Hyo Gyoung Kang ),( Jin Eun Choi ),( Sun Ha Choi ),( Sunji Park ),( Yong Hoon Lee ),( Hye Won Seo ),( Seung Soo Yoo ),( Jaehee Lee ),( Seung Ick Cha ),( Chang Ho Kim 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.-
Background Transcription factor ATF3 plays a significant role in cancer development and progression. We investigated the association between the SNPs in eQTLs within ATF3 binding regions and the prognosis of NSCLC after surgery. Methods 89 SNPs were selected using publicly available web server (http://galaxyproject.org). Results Among those SNPs, HAX1 rs11265425T>G was associated with significantly worse DFS (aHR = 1.30, 95% CI = 1.00-1.69, P = 0.05), and the ME3 rs10400291C>A was associated with significantly better DFS (aHR = 0.66, 95% CI = 0.46-0.95, P = 0.03). According to tumor histology, the HAX1 rs11265425T>G was associated with significantly worse DFS (aHR = 1.45, 95% CI = 1.02-2.05, P = 0.04) only in adenocarcinoma (AC), and the ME3 rs10400291C>A was associated with significantly better DFS (aHR = 0.46, 95% CI = 0.25-0.86, P = 0.01) only in squamous cell carcinoma (SCC). ChIP-qPCR assays showed that rs11265425T>G and rs10400291C>A reside in active enhancers where H3K27Ac and ATF3 binding occurs. HAX1 RNA expression was significantly higher in tumor compared to non-malignant lung, and higher in rs11265425TG or GG genotypes than in rs11265425TT genotype. Conversely, ME3 expression was significantly lower in tumor than normal lung, and higher in rs10400291AA genotype than in rs10400291CC or CA genotypes. Conclusion n Conclusion, this study shows that the functional polymorphisms in ATF3 binding sites, HAX1 rs11265425T>G and ME3 rs10400291C>A are associated with the clinical outcomes of patients in surgically resected NSCLC. The analysis of those genetic variants may be useful for predicting patients’ prognosis after surgery, thereby helping to refine therapeutic decisions for better clinical outcomes in NSCLC.
( Hyewon Seo ),( Seung-ick Cha ),( Ji-eun Park ),( Sunji Park ),( Sun Ha Choi ),( Yong-hoon Lee ),( Seung-soo Yoo ),( Shin-yup Lee ),( Jaehee Lee ),( Chang-ho Kim ),( Jae-yong Park ) 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.0
Introduction Few studies have investigated the influence of emphysema on clinical features of patients presenting with community-acquired pneumonia (CAP). Objectives: The aim of this study was to examine the clinical and microbiological features of patients with both CAP and emphysema. Methods This retrospective study included patients with CAP who underwent computed tomography (CT) scan at the time of presentation. Patients were allocated into emphysema and control groups, and clinical variables were compared between the 2 groups. The emphysema group was further divided into 3 subgroups (mild, moderate, and severe) according to the extent of emphysema on CT scan. The clinical variables of each subgroup were compared with the control group. Results Of 1676 patients, 431 patients (25.7%) were classified into the emphysema group. CAP patients with emphysema were more likely to have a high CURB-65 score and pneumonia severity index and a lower incidence of complicated parapneumonic effusion or empyema. The emphysema group exhibited longer hospital stay. In addition, 30-day mortality in the severe emphysema group was significantly higher compared with the control group. As etiological agents, Streptococcus pneumoniae, Pseudomonas aeruginosa, Enterobacteriaceae, and multi-drug resistant pathogens were significantly more common in the emphysema group compared with the control group. Conclusion The presence of emphysema in CAP patients was associated with a more severe form of CAP, a longer hospital stay, and a lower incidence of complicated parapneumonic effusion or empyema. Moreover, CAP patients with severe emphysema exhibited higher 30-day mortality than those without emphysema.