Roles of Inflammatory Biomarkers in Exhaled Breath Condensates in Respiratory Clinical Fields

Hye Jung Park, M.D., Ph.D.,Yong Jun Choi, M.D.,Min Jae Lee, M.D.,Min Kwang Byun, M.D., Ph.D.,Sangho Park, B.S.,Jimyung Park, M.D., Ph.D.,Dongil Park, M.D., Ph.D.,Sang-Hoon Kim, M.D., Ph.D.,Young Sam K 대한결핵및호흡기학회 2024 Tuberculosis and Respiratory Diseases Vol.87 No.1

Background: Exhaled condensates contain inflammatory biomarkers; however, theirroles in the clinical field have been under-investigated. Methods: We prospectively enrolled subjects admitted to pulmonology clinics. Wecollected exhaled breath condensates (EBC) and analysed the levels of six and 12biomarkers using conventional and multiplex enzyme-linked immunosorbent assay, respectively. Results: Among the 123 subjects, healthy controls constituted the largest group (81participants; 65.9%), followed by the preserved ratio impaired spirometry group (21patients; 17.1%) and the chronic obstructive pulmonary disease (COPD) group (21patients; 17.1%). In COPD patients, platelet derived growth factor-AA exhibited strongpositive correlations with COPD assessment test (ρ=0.5926, p=0.0423) and COPD-specificversion of St. George’s Respiratory Questionnaire (SGRQ-C) score (total, ρ=0.6725,p=0.0166; activity, ρ=0.7176, p=0.0086; and impacts, ρ=0.6151, p=0.0333). GranzymeB showed strong positive correlations with SGRQ-C score (symptoms, ρ=0.6078,p=0.0360; and impacts, ρ=0.6007, p=0.0389). Interleukin 6 exhibited a strong positivecorrelation with SGRQ-C score (activity, ρ=0.4671, p=0.0378). The absolute serum eosinophiland basophil counts showed positive correlations with pro-collagen I alpha 1(ρ=0.6735, p=0.0164 and ρ=0.6295, p=0.0283, respectively). In healthy subjects, forcedexpiratory volume in 1 second (FEV1)/forced vital capacity demonstrated significantcorrelation with CC chemokine ligand 3 (CCL3)/macrophage inflammatory protein 1alpha (ρ=0.3897 and p=0.0068). FEV1 exhibited significant correlation with CCL11/eotaxin(ρ=0.4445 and p=0.0017). Conclusion: Inflammatory biomarkers in EBC might be useful to predict quality of lifeconcerning respiratory symptoms and serologic markers. Further studies are needed.

The Association of Radiographic Severity and Treatment Outcome in Mycobacterium Abscessus Complex Pulmonary Disease

( Jimyung Park ),( Soon Ho Yoon ),( Nakwon Kwak ),( Jae-joon Yim ) 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.-

Background Treatment of Mycobacterium abscessus complex pulmonary disease (MABC-PD) is challenging. Furthermore, the lack of reliable predictors of treatment responses makes it difficult to decide whether to initiate treatment in patients with MABC-PD. The aim of this study was to investigate whether assessment of baseline radiographic disease severity could predict treatment outcomes in MABC-PD. Methods We retrospectively analyzed patients with MABC-PD in whom treatment was initiated in the Seoul National University Hospital between January 1, 2006 and December 31, 2019. Baseline radiographic disease severity was quantitatively scored with total score ranging from 0 to 30, based on chest computed tomography (CT) images at the initiation of treatment. Subsequent follow-up CT images acquired 2-8 weeks after treatment were evaluated for early radiographic responses. The association between these Results of radiographic assessment and treatment outcomes was analyzed. Treatment success was defined as sustained negative culture conversion. Results 49 patients with M. abscessus and 42 patients with M. massiliense were included for the analysis. The baseline radiographic severity was not different between the two groups (median score 14 points in M. abscessus and 15 points in M. massiliense). After antimicrobial therapy for median 79 weeks, the treatment success was achieved in 55.1% of M. abscessus patients and in 92.9% of M. massiliense patients. Adjusting for the infecting species between the two groups, higher baseline radiographic severity scores were significantly associated with treatment failure (adjusted odds ratio [aOR] 1.15, 95% CI 1.01-1.32, per 1 increase in score). This was particularly prominent in patients with radiographic severity score of ≥14 (aOR 3.50, 95% CI 1.12- 10.95). However, early radiographic improvement was not associated with long-term treatment success. Conclusions Given the association between baseline radiographic severity and treatment outcomes, initiation of treatment for MABC-PD should be considered actively before significant progression of radiographic lesions.

Histopathologic heterogeneity of acute respiratory distress syndrome revealed by surgical lung biopsy and its clinical implications

( Jimyung Park ),( Yeon Joo Lee ),( Jinwoo Lee ),( Sung Soo Park ),( Young-jae Cho ),( Sang-min Lee ),( Young Whan Kim ),( Sung Koo Han ),( Chul-gyu Yoo ) 대한내과학회 2018 The Korean Journal of Internal Medicine Vol.33 No.3

Background/Aims: Diffuse alveolar damage (DAD) is the histopathologic hallmark of acute respiratory distress syndrome (ARDS). However, there are several non-DAD conditions mimicking ARDS. The purpose of this study was to investigate the histopathologic heterogeneity of ARDS revealed by surgical lung biopsy and its clinical relevance. Methods: We retrospectively analyzed 84 patients with ARDS who met the criteria of the Berlin definition and underwent surgical lung biopsy between January 2004 and December 2013 in three academic hospitals in Korea. We evaluated their histopathologic findings and compared the clinical outcomes. Additionally, the impact of surgical lung biopsy on therapeutic alterations was examined. Results: The histopathologic findings were highly heterogeneous. Of 84 patients undergoing surgical lung biopsy, DAD was observed in 31 patients (36.9%), while 53 patients (63.1%) did not have DAD. Among the non-DAD patients, diffuse interstitial lung diseases and infections were the most frequent histopathologic findings in 19 and 17 patients, respectively. Although the mortality rate was slightly higher in DAD (71.0%) than in non-DAD (62.3%), the difference was not significant. Overall, the biopsy results led to treatment alterations in 40 patients (47.6%). Patients with non-DAD were more likely to change the treatment than those with DAD (58.5% vs. 29.0%), but there were no significant improvements regarding the mortality rate. Conclusions: The histopathologic findings of ARDS were highly heterogeneous and classic DAD was observed in one third of the patients who underwent surgical lung biopsy. Although therapeutic alterations were more common in patients with non-DAD-ARDS, there were no significant improvements in the mortality rate.

Successful Treatment of a Large Pulmonary Arteriovenous Malformation by Repeated Coil Embolization

Park, Jimyung,Kim, Hyung-Jun,Kim, Jee min,Park, Young Sik The Korean Academy of Tuberculosis and Respiratory 2015 Tuberculosis and Respiratory Diseases Vol.78 No.4

Pulmonary arteriovenous malformations (AVMs) are caused by abnormal vascular communications between the pulmonary arteries and pulmonary veins, which lead to the blood bypassing the normal pulmonary capillary beds. Pulmonary AVMs result in right-to-left shunts, resulting in hypoxemia, cyanosis, and dyspnea. Clinical signs and symptoms vary depending on the size, number, and flow of the AVMs. Transcatheter embolization is the treatment of choice for pulmonary AVMs. However, this method can fail if the AVM is large or has multiple complex feeding arteries. Surgical resection is necessary in those kind of cases. Here, we report the case of a patient with a 6-cm pulmonary AVM with multiple feeding arteries that was successfully treated by repeated coil embolization without surgery.

CASE REPORT : Successful Treatment of a Large Pulmonary Arteriovenous Malformation by Repeated Coil Embolization

( Jimyung Park ),( Hyung Jun Kim ),( Jee Min Kim ),( Young Sik Park ) 대한결핵 및 호흡기학회 2015 Tuberculosis and Respiratory Diseases Vol.78 No.4

Pulmonary arteriovenous malformations (AVMs) are caused by abnormal vascular communications between the pulmonary arteries and pulmonary veins, which lead to the blood bypassing the normal pulmonary capillary beds. Pulmonary AVMs result in right-to-left shunts, resulting in hypoxemia, cyanosis, and dyspnea. Clinical signs and symptoms vary depending on the size, number, and flow of the AVMs. Transcatheter embolization is the treatment of choice for pulmonary AVMs. However, this method can fail if the AVM is large or has multiple complex feeding arteries. Surgical resection is necessary in those kind of cases. Here, we report the case of a patient with a 6-cm pulmonary AVM with multiple feeding arteries that was successfully treated by repeated coil embolization without surgery.

Longer Hospital Length of Stay after Admission Before Rapid Response System Activation is Associated with Worse Clinical Outcome: A Retrospective Multicenter Cohort Study

( Jimyung Park ),( Sang-min Lee ),( Yeon Joo Lee ),( Sang-bum Hong ),( Kyeongman Jeon ),( Jae Young Moon ),( Jung Soo Kim ),( Byung Ju Kang ),( Jong-joon Ahn ),( Dong-hyun Lee ),( Jisoo Park ),( Jae H 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.-

Background Rapid response system (RRS) has been increasingly adopted to improve patient safety in hospitals worldwide. However, predictors of survival outcome after RRS activation because of unexpected clinical deterioration are not well defined. We investigated whether hospital length of stay (LOS) before RRS activation can predict the clinical outcomes. Methods Using a nationwide multicenter RRS database, we identified patients for whom RRS was activated during hospitalization at 9 tertiary referral hospitals in South Korea between January 1, 2016, and December 31, 2017. All information on patient characteristics, RRS activation, and clinical outcomes were retrospectively collected by reviewing patient medical records at each center. Patients were categorized into two groups according to their hospital LOS before RRS activation: early deterioration (LOS <5 days) and late deterioration (LOS ≥5 days). The primary outcome was 28-day mortality and multivariable logistic regression was used to compare the two groups. In addition, propensity score-matched analysis was used to minimize the effects of confounding factors. Results Among 11,612 patients, 5,779 and 5,883 patients belonged to the early and late deterioration groups, respectively. Patients in the late deterioration group were more likely to have malignant disease and to be more severely ill at the time of RRS activation. After adjusting for confounding factors, the late deterioration group had higher 28-day mortality (aOR 1.60, 95% CI 1.44-1.77). Other clinical outcomes were worse in the late deterioration group as well, and similar Results were found in the propensity score-matched analysis (aOR for 28-day mortality 1.66, 95% CI 1.45-1.91). Patients who stayed longer in the hospital before RRS activation had worse clinical outcomes. When RRS team evaluates patients with sudden deterioration and considers the need for further intensive care, hospital LOS before RRS activation should be considered as a predictor of future outcome.

S-326 Comparison of Lung Disease Caused by Mycobacterium abscessus and Mycobacterium massiliense

( Jimyung Park ),( Chang-hoon Lee ),( Sung Koo Han ),( Jae-joon Yim ) 대한내과학회 2016 대한내과학회 추계학술발표논문집 Vol.2016 No.1

Background:?Mycobacterium abscessus?and?Mycobacterium massiliense?are grouped as theMycobacterium abscessus?complex. Although?M. massiliense?lung diseases are reported to have better treatment response, clinical comparisons between these two species remain limited. The aim of this study was to elucidate the differences between?M. abscessus?lung diseases and?M. massiliense?lung diseases in terms of progression rate, treatment outcome, and the predictors thereof.?Methods:?Between January 1, 2006 and June 30, 2015, 56 patients and 54 patients were diagnosed with?M. abscessus?and?M. massiliense?lung diseases, respectively. Time to progression requiring treatment and treatment outcomes were compared between the two groups. In addition, predictors of progression and sustained culture conversion with treatment were analyzed.?Results:?During follow-up, 21 of 56 (37.5%) patients with?M. abscessus?lung diseases and 21 of 54 (38.9%) patients with?M. massiliense?lung diseases progressed requiring treatment. There were no differences in progression rate (aOR 1.27; 95% CI 0.49-3.26) and time to progression between the two groups (P?= 0.941 by log-rank test). Younger age (<65 years; aOR 2.72; 95% CI 1.05-7.07), lower body mass index (<18.5 kg/m2; aOR 5.79; 95% CI 1.75-19.18), and the presence of cavities (aOR 4.38; 95% CI 1.62-11.85) were identified as predictors of disease progression. Among the patients who began treatment, infection with?M. massiliense?rather thanM. abscessus?(aOR 11.92; 95% CI 1.67-85.07) and the use of azithromycin rather than clarithromycin (aOR 10.42; 95% CI 1.34-80.76) were associated with sustained culture conversion. The difference in treatment outcomes between these two species was partly mediated by their difference in susceptibility to clarithromycin.?Conclusions:?Progression rates were similar but treatment outcomes differed significantly between patients with?M. abscessus?and?M. massiliense?lung diseases.

Impact of Preoperative Sarcopenia on Lung Transplantation Outcomes

( Hyunjun Park ),( Jimyung Park ),( Sun Mi Choi ),( Jong Hyuk Lee ),( Soon Ho Yun ),( Samina Park ),( Hyun Joo Lee ),( Young Tae Kim ) 대한결핵 및 호흡기학회 2023 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.136 No.0

풍동을 이용한 고속열차 머드플랩 형상변경에 따른 공력소음 특성 분석

류지명(Jimyung Ryu),박준홍(Junhong Park),박기형(Kihyoung Park),송시몬(Simon Song),최성훈(Sunghoon Choi) 한국소음진동공학회 2007 한국소음진동공학회 학술대회논문집 Vol.2007 No.3

Effect of Chlorhexidine Mouthrinse on Prevention of Microbial Contamination during EBUS-TBNA: A Randomized Controlled Trial

( Na Young Kim ),( Jae Hyeon Park ),( Jimyung Park ),( Nakwon Kwak ),( Sun Mi Choi ),( Young Sik Park ),( Chang-Hoon Lee ),( Jaeyoung Cho ) 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.-

Background Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a standard diagnostic method for mediastinal and hilar lymphadenopathy. Although rare, fatal infectious complications can occur following EBUS-TBNA. However, to date, there is a lack of effective preventive strategies to reduce these complications. We aim to investigate the effect of chlorhexidine mouthrinse on the prevention of microbial contamination during EBUSTBNA. Methods This was a single-center, parallel-group, assessor-blinded randomized controlled trial. We randomly assigned adult participants undergoing EBUS-TBNA using a convex probe to gargle for 1 minute with 100 mL of 0.12% chlorhexidine gluconate before EBUSTBNA or to receive usual care (no chlorhexidine mouthrinse) at a 1:1 ratio. Needle wash samples were collected immediately after completion of the procedure by instilling sterile saline into the used needle. The primary outcome was colony forming unit (CFU) counts in aerobic cultures of the needle wash samples. Secondary outcomes were CFU counts in anaerobic cultures, fever within 24 hours after EBUS-TBNA, and infectious complications within 4 weeks after EBUS-TBNA. Results From January 20, 2021 until June 11, 2021, a total of 112 participants underwent randomization and 106 (51 in the chlorhexidine mouthrinse group and 55 in the usual care group) were included in the analysis. The median CFU counts in aerobic cultures were not different in the two groups (10 CFU/ml vs 20 CFU/ml; p=0.70). There were also no significant differences between the groups in secondary outcomes, including median CFU counts in anaerobic cultures (p=0.41) and fever within 24 hours after EBUS-TBNA (11.8% and 5.6%, p=0.31). There were no infectious complications within 4 weeks after EBUS-TBNA in both groups. Conclusion Chlorhexidine mouthrinse before EBUS-TBNA did not result in a reduction in CFU counts of needle wash samples. (ClinicalTrials. gov number: NCT04718922)