Biomedical subjects

Joungho Han

Publications and source records attributed to Joungho Han.

At least 19 recordsLinked to original sources

PubMed2006

Analyses on prognostic factors following tri-modality therapy for stage IIIa non-small cell lung cancer.

This study is to evaluate and report the prognostic factors of N2 positive stage IIIA non-small cell lung cancer (NSCLC) treated with concurrent radiochemotherapy (CRCT) and surgery. CRCT and surgery were planned in 66 patients with stage IIIA NSCLC, and 46 evaluable patients were analyzed. Thoracic radiation therapy (TRT) dose was 45 Gy over 5 weeks, chemotherapy consisted of two cycles of intravenous cisplatin (100mg/m(2), on days 1 and 29 of TRT) and oral etoposide (50mg/m(2)/day, on days 1-14 and 29-42 of TRT), and surgery was performed in 4 weeks following CRCT completion. With the median follow up duration of 23 (range 5-74) months, the overall survival, disease-free survival, and local control rates at 5 years in all patients were 27%, 24% and 90%, respectively. The overall survival and disease-free survival rates at 5 years in the patients who achieved ypN0 stage and ypN1/2 stages were 47% and 0% (p=0.008), and 42% and 7% (p=0.01), respectively. The corresponding figures in those with initial "bulky" N2 disease and "mediastinoscopic" N2 disease were 31% and 19% (p=0.98), and 23% and 26% (p=0.68), respectively. Following CRCT and surgery, achieving ypN0 stage turned out to be a significantly favorable indicator, while the initial mediastinal lymph node extent did not, with respect to overall survival and disease-free survival.

Adult↗

PubMed2006

Different susceptibility of increased DNMT1 expression by exposure to tobacco smoke according to histology in primary non-small cell lung cancer.

PURPOSE: DNA methyltransferase 1 (DNMT1) is known to play an important role in the development of cancers. However, the underlying mechanisms responsible for the altered expression of DNMT1 in non-small cell lung cancers (NSCLCs) remain to be elucidated. METHODS: We investigated the relationships of mRNA expression levels of DNMT1 to the altered expression of retinoblastoma (Rb) and p53 and to the clinicopathological variables in 153 NSCLCs. The expression of DNMT1 was determined by quantitative real-time PCR, and the altered expressions of p53 and Rb were assessed by immunohistochemistry. RESULTS: The increased expression of DNMT1 was found in 47 (31%) of 153 NSCLC patients examined. The prevalence of increased DNMT1 expression was significantly different between adenocarcinoma and squamous cell carcinoma (42% vs. 19%, respectively; P = 0.004). Patients who had smoked more than 65 packyears showed a 4.17 times [95% confidence interval (CI) = 1.17-69.49; P = 0.007] higher risk of increased DNMT1 expression compared to those who had smoked less than 45 packyears in adenocarcinoma. The expressions of Rb and p53 proteins were not associated with the increased expression of DNMT1 in 153 NSCLCs (P = 0.18 and 0.54, respectively). CONCLUSIONS: The present study suggests that the susceptibility of increased DNMT1 expression by exposure to tobacco smoke may be different according to histologic subtypes in NSCLC.

Adenocarcinoma↗

PubMed2006

Elevated mRNA levels of DNA methyltransferase-1 as an independent prognostic factor in primary nonsmall cell lung cancer.

BACKGROUND: Despite many reports about the involvement of DNA methyltransferases (DNMTs) in human cancers, including nonsmall cell lung cancer (NSCLC), the clinicopathologic significance of DNMTs in primary NSCLC remains to be elucidated. METHODS: The relation between the mRNA levels of DNMTs (1 and 3b) and the promoter methylation of the p16, RARbeta2, H-cadherin, GSTP1, RIZ, and FHIT genes and the clinicopathologic features in 102 fresh-frozen tissues and paraffin blocks were retrospectively studied. The mRNA levels of the DNMTs were assessed via semiquantitative reverse-transcription polymerase chain reaction (RT-PCR), and the methylation status of the CpG islands were determined by methylation-specific PCR. RESULTS: The mRNA levels of DNMT1 and DNMT3b were elevated in 53% and 58% of 102 NSCLCs, respectively. Hypermethylation of p16, RARbeta2, H-cadherin, GSTP1, RIZ, and FHIT occurred in 37%, 38%, 34%, 18%, 9%, and 31% of patients, respectively. Univariate analysis showed that elevated DNMT mRNA levels were not significantly associated with the hypermethylation of 6 genes. However, the elevated mRNA levels of DNMT1 were determined to be significantly associated with the hypermethylation of the p16 promoter (odds ratio [OR] = 2.70, 95% confidence interval [95% CI], 1.02-7.15; P = .02), after controlling for age, gender, pack-years smoked, histology, and pathologic stage. The hazard of failure in cases with elevated mRNA levels of DNMT1 was 3.51 (95% CI, 1.18-12.76; P = .02) times higher than that in those without. The elevated mRNA levels of DNMT3b were not ultimately associated with patient prognosis. CONCLUSIONS: Elevated mRNA expression of DNMT1 may be an independent prognostic factor in NSCLC and CpG island hypermethylation in NSCLC may be maintained by a complex interaction of several factors rather than by a simple transcriptional up-regulation of DNMT1.

Aged↗

PubMed2006

Lung metastasis from an immature teratoma of the nasal cavity masquerading as small cell carcinoma of the lung.

We report a case of small cell lung cancer that turned out to be a metastatic teratoma from the nasal cavity rather than a new primary cancer. A 54-year-old woman was diagnosed with an immature teratoma of the nasal cavity with a predominant neuroblastomatous component. Small cell lung cancer was detected by bronchoscopic biopsy 21 months later, and it was treated with concurrent radiochemotherapy as if it had been a new primary cancer. Since a recurrent tumor containing fat- like density grew slowly on the serial chest CT scans after achieving complete response, we reached the conclusion that the small undifferentiated cells could be metastatic neuroblastomatous components from the immature teratoma of the nasal cavity.

Biopsy↗

PubMed2006

Bronchoalveolar lavage in fibrotic idiopathic interstitial pneumonias.

The purpose of this study was to assess the role of bronchoalveolar lavage (BAL) in differentiating usual interstitial pneumonia (UIP) from non-specific interstitial pneumonia (NSIP) and in predicting the prognosis in fibrotic idiopathic interstitial pneumonia (IIP). A retrospective review of 122 patients (age 58+/-8 years, 70 male) with UIP (n=87) and NSIP (n=35) was carried out. Prior to surgical lung biopsy, all of them underwent BAL and high-resolution-computed tomography (HRCT) of the chest. Neutrophil count in BAL fluid was higher in UIP (7.0%) than NSIP (3.0%) (P=0.027). In contrast, BAL lymphocyte count was significantly higher in NSIP (29.0%) than UIP (5.5%) (P<0.0001). In 62 patients whose HRCT findings were atypical for UIP, BAL lymphocytosis was more frequently observed in NSIP (20/33) than UIP (4/29) (P<0.001) and the absence of BAL lymphocytosis suggested a diagnosis of UIP rather than NSIP (odds ratio 12.7, P<0.001). Pathologic diagnosis of NSIP was the only independent factor predicting a longer survival of our patients (median follow-up 21 months) (hazard ratio (HR) 0.035, P=0.005). When NSIP was not included in the survival analysis, higher BAL lymphocyte count was the only independent predictor of a longer survival (HR 0.909, P=0.029). BAL is an useful non-invasive tool in fibrotic IIP, not only for excluding a variety of specific non-IIP diseases but also for narrowing the differential diagnosis and predicting the prognosis in the absence of the histopathologic diagnosis.

Bronchoalveolar Lavage↗

PubMed2006

Pulmonary fungal infection: imaging findings in immunocompetent and immunocompromised patients.

Histoplasmosis is the most common endemic mycosis in North America, and is followed by coccidioidomycosis and blastomycosis. Although the majority of these infections in immunocompetent persons are self-limited, some patients can develop severe pneumonitis or various forms of chronic pulmonary infection. Cryptococcoci, Aspergillus, Candidas, and Mucorals are ubiquitous organisms, which may affect immunocompromised patients. Specific imaging findings can be expected, depending on the organisms involved, underlying patients' conditions (immune status), and specific situations after immune depleting procedures.

Humans↗

PubMed2006

Cohypermethylation of p16 and FHIT promoters as a prognostic factor of recurrence in surgically resected stage I non-small cell lung cancer.

Despite advances in the detection and treatment of lung cancer, the prognosis for patients with lung cancer is poor, partly as a result of recurrences. We retrospectively analyzed the relationship between recurrence and survival in patients with non-small cell lung cancers (NSCLC), and the promoter methylation of p16, GSTP1, FHIT, H-cadherin, and RARbeta2 genes to identify a prognostic molecular marker associated with the recurrence of NSCLC. Methylation status from 335 paraffin blocks was determined by methylation-specific PCR. Of the 335 NSCLC samples, promoter methylation was detected in 35% for p16, 39% for RARbeta2, 42% for H-cadherin, 7% for GSTP1, and 21% for FHIT. Recurrence was observed in 39% (132 of 335) of the patients. Recurrence was significantly associated with histology (P = 0.001) and pathologic stage (P = 0.009). Hypermethylation of any single gene was not associated with recurrence in patients. However, cohypermethylation of p16 and FHIT genes in stage I NSCLCs was associated with an increased risk of recurrence [odds ratio, 6.43; 95% confidence interval (CI), 1.04-20.19; P = 0.02] and poor recurrence-free survival after surgery (hazard ratio, 2.03; 95% CI, 1.09-6.23; P = 0.02). In addition, their survival after recurrence was also 4.62 times poorer (95% CI, 1.27-16.48; P = 0.005) than for those without cohypermethylation of both genes. In conclusion, the present study suggests that cohypermethylation of p16 and FHIT genes in patients with stage I NSCLC may be a valuable biomarker for predicting the recurrence-associated prognosis of the disease.

Acid Anhydride Hydrolases↗

PubMed2006

Aberrant methylation of Fragile Histidine Triad gene is associated with poor prognosis in early stage esophageal squamous cell carcinoma.

The aim of this study was to understand the clinicopathological and prognostic significance of promoter methylation of Fragile Histidine Triad (FHIT) gene in esophageal cancer. FHIT methylation in 257 primary esophageal squamous cell carcinomas was retrospectively analyzed by methylation-specific polymerase chain reaction. Aberrant methylation of FHIT was found in 85 (33%) of 257 esophageal cancer patients. The FHIT methylation was found to be significantly associated with exposure to tobacco smoke (P = 0.007) and with a poor prognosis in cases of stage 1-2 cancer irrespective of recurrence. The hazard of failure after esophagectomy for stage 1-2 cancers with FHIT methylation was about 5.81 (95% CI = 1.15-14.07; P = 0.009) times higher than in those without. Recurrence occurred in 116 (45%) of the 257 patients studied. The survival after recurrence in stage 1-2 cancers was also poorer for patients with FHIT methylation than in those without (HR = 2.31; 95% CI = 1.18-7.92; P = 0.03). In conclusion, aberrant methylation of the FHIT promoter was found to be significantly associated with exposure to tobacco smoke and with a poor prognosis for stage 1-2 cases, but not with recurrence rate. Our study suggests that FHIT promoter methylation may be an independent prognostic biomarker in early stage esophageal squamous cell carcinoma.

Acid Anhydride Hydrolases↗

PubMed2006

Mycobacterium abscessus pulmonary infection presenting as a solitary pulmonary nodule.

Nontuberculous mycobacterial pulmonary infection is a rare cause of a solitary pulmonary nodule. All previously reported cases were caused by Mycobacterium avium complex, and a solitary pulmonary nodule caused by other NTM species has been very rarely reported. We describe the first case of Mycobacterium abscessus infection presenting as a solitary pulmonary nodule in a 51-year-old asymptomatic adult patient.

Female↗

PubMed2006

Spinal nerve sheath myxoma (neurothekeoma).

Nerve sheath myxoma (NSM) is a rare, benign tumor of predominantly cutaneous location. They usually arise from small cutaneous nerves in the head, neck, and extremities, but exceptionally they arise from spinal nerve roots. Only three cases of intraspinal NSM have been reported. Herein is describe two additional cases of spinal NSM. The patients were 64-year-old and 31-year-old men who presented with low back pain. Spine magnetic resonance imaging showed small intradural extramedullary masses at the L2-3 level. Both tumors had typical histological features of myxoid-type NSM. The tumors had a strong immunoreactivity for vimentin, S-100 protein, and neuron-specific enolase and focal expression of epithelial membrane antigen and phosphorylated neurofilament. Ultrastructural observation of tumor cells with perineurial, fibroblast-like, and Schwann-cell differentiation suggests an origin from nerve sheath precursor cells.

Adult↗

PubMed2006

Early intervention can improve clinical outcome of acute interstitial pneumonia.

STUDY OBJECTIVES: To report on our experience with acute interstitial pneumonia (AIP) in which patients underwent early diagnostic procedures and received mechanical ventilation with a "lung-protective" strategy and early institution of immunosuppressive therapy. DESIGN: A retrospective chart review. SETTING: A tertiary referral hospital. PARTICIPANTS: Ten patients with AIP who presented with idiopathic ARDS and showed diffuse alveolar damage on surgical lung biopsy specimens from July 1995 to March 2004. MEASUREMENTS AND RESULTS: The median age of patients was 65.5 years (age range, 38 to 73 years). Patients presented with a median duration of severe dyspnea of 9.5 days (range, 2 to 34 days) at the hospital visit. All patients required mechanical ventilation beginning at median time of hospital day 1 (range, hospital day 0 to 5), which continued for a median duration of 9.5 days (range, 4 to 98 days). Patients received ventilation in the pressure assist-control mode with a median tidal volume of 6.97 mL/kg (range, 6.05 to 8.86 mL/kg) and median positive end-expiratory pressure of 11 cm H(2)O (range, 8 to 16 cm H(2)O). An aggressive diagnostic workup for respiratory infection, including BAL at a median time of hospital day 2 (range, hospital day 1 to 5) was performed. High-dose steroid pulse therapy was initiated on median hospital day 3.5 (range, hospital day 1 to 8), while surgical lung biopsy was performed on median hospital day 4 (range, hospital day 2 to 7). Eight patients (80%) survived to hospital discharge. CONCLUSION: Earlier intervention, such as an aggressive diagnostic approach, mechanical ventilation with lung-protective strategy, and the early institution of immunosuppressive may improve clinical outcome in patients with AIP.

APACHE↗

PubMed2006

Tracheal metastasis of lung cancer: CT findings in six patients.

OBJECTIVE: Our objective was to assess CT findings of tracheal metastasis of lung cancer. CONCLUSION: Tracheal metastasis of primary non-small cell lung cancer manifested as an endotracheal nodule or eccentric wall thickening of the trachea, showing contrast enhancement with a predilection for the upper trachea on CT. During postoperative evaluation of patients with surgically resected lung cancer, the possibility of tracheal metastasis of lung cancer should be suggested when an endotracheal nodule or eccentric wall thickening is present on CT.

Aged↗

PubMed2006

Thoracic actinomycosis: CT features with histopathologic correlation.

OBJECTIVE: Thoracic actinomycosis is a chronic suppurative pulmonary or endobronchial infection caused by Actinomyces israelii, a gram-positive anaerobic organism. We present the CT features of thoracic actinomycosis with histopathologic correlation. CONCLUSION: The typical CT feature of parenchymal actinomycosis is a chronic segmental air-space consolidation containing necrotic low-attenuation areas with frequent cavity formation. A broncholith can be secondarily infected with Actinomyces organisms, resulting in endobronchial actinomycosis. It usually manifests as a proximal endobronchial calcification associated with distal obstructive pneumonia.

Actinomycosis↗

PubMed2006

Adenovirus pneumonia in adults: radiographic and high-resolution CT findings in five patients.

OBJECTIVE: The purpose of this study was to describe the radiographic and high-resolution CT (HRCT) findings of adenovirus pneumonia in five patients. CONCLUSION: Adenovirus pneumonia in adults appears as bilateral patchy parenchymal opacities on chest radiographs and as bilateral ground-glass opacities with a random distribution with or without consolidation on HRCT images. These findings, however, are not specific for adenovirus pneumonia.

Adenovirus Infections, Human↗

PubMed2006

Pulmonary sclerosing hemangioma presenting as solitary pulmonary nodule: dynamic CT findings and histopathologic comparisons.

OBJECTIVE: The purpose of this study was to describe the dynamic CT findings of pulmonary sclerosing hemangioma presenting as a solitary pulmonary nodule and to compare these findings with histopathologic findings. CONCLUSION: On dynamic CT, sclerosing hemangioma has strong and rapid enhancement attributed histopathologically to the presence of hemangiomatous or papillary components in the tumor.

Adult↗

PubMed2006

Delayed bronchostenosis after blunt chest trauma in children: CT and pathologic findings.

Tracheobronchial disruption is an uncommon injury associated with blunt chest trauma. We report CT features and pathologic findings of two pediatric cases in which a bronchial injury was unnoticed initially but was diagnosed later by appearance of delayed bronchostenosis with distal atelectasis after blunt chest trauma in recent motor vehicle accidents. Pathologically, obliteration of the bronchial lumen was caused by dense fibrous overgrowth and granulation tissue.

Accidents, Traffic↗

PubMed2005

Aberrant methylation of H-cadherin (CDH13) promoter is associated with tumor progression in primary nonsmall cell lung carcinoma.

BACKGROUND: Abnormalities in the H-cadherin gene have been reported in several human malignancies, including nonsmall cell lung carcinoma (NSCLC). Aberrant methylation of the H-cadherin promoter also has been reported in NSCLC, but its clinical significance remains to be elucidated. METHODS: The authors studied H-cadherin methylation in 305 patients with NSCLC to gain a further understanding of the clinicopathologic and prognostic significance of H-cadherin methylation in patients with NSCLC. The methylation status of the H-cadherin gene was investigated by using methylation-specific polymerase chain reaction analysis in paraffin blocks from 305 patients with NSCLC. Ki-67 expression was assessed by immunohistochemical staining. All statistical analyses were 2-sided with a 5% Type I error rate. RESULTS: H-cadherin methylation was observed in 130 of 305 tumor samples (43%). The prevalence of H-cadherin methylation was associated significantly with pathologic stage and was observed in 44% of patients with Stage I disease, in 23% of patients with Stage II disease, in 59% of patients with Stage III, and in 88% of patients with Stage IV disease (P = 0.001). H-cadherin methylation occurred with a 2.71 times greater prevalence (95% confidence interval [95% CI], 1.21-6.09; P = 0.01) T2 tumors than in T1 tumors and with a 3.78-fold greater prevalence (95% CI, 1.05-13.59; P = 0.04) in T3 tumors than in T1 tumors. However, lymph node metastasis was related inversely with H-cadherin methylation (odds ratio = 0.51; 95% CI, 0.28-0.95; P = 0.03), and H-cadherin methylation was not associated with the Ki-67 labeling index (P = 0.53) or with tumor size (P = 0.89). No relation was found between H-cadherin methylation and survival in patients with Stage I NSCLC (P = 0.51) or in patients with Stage II NSCLC (P = 0.46). CONCLUSIONS: The current findings suggested an association between H-cadherin methylation and tumor progression in NSCLC but had no prognostic significance in patients with early-stage NSCLC. In addition, H-cadherin methylation may be a valuable candidate molecular marker for the early detection of NSCLC.

Adenoma↗

PubMed2005

Prognostic factors and causes of death in Korean patients with idiopathic pulmonary fibrosis.

The purpose of this study was to investigate the prognostic factors at initial presentation and the causes of death in Korean patients with idiopathic pulmonary fibrosis (IPF), which might be different report wise, in comparison to the western countries. A retrospective review of 88 patients (mean 60.3 years, 69 male) was carried out and they were diagnosed as IPF positive. After diagnosis, the survival rate was 57% and 41% for third and fifth year, respectively (mean follow-up 39.1 months). Mortality was closely correlated with severe dyspnea at presentation (Hazard Ratio [HR], 2.6 per grade; p=0.015), lower initial forced vital capacity (HR, 1.7 per 10% predicted; p=0.004) and lower initial diffusing capacity of the lung (HR, 1.5 per 10% predicted; p=0.033). Treatment with specific drugs was ineffective against the survival when compared with symptomatic supportive care. Thirty-four patients (68%) died of worsened respiratory failure, seven (14%) died of infection and only one patient showed cardiovascular death. In conclusion, our study suggests that the severity of dyspnea and lung function tests at the time of diagnosis are the predictive factors for the survival of patients with IPF. In comparison to the reports from western countries, we observed that respiratory failure and pulmonary infection were more frequent causes of death, while cardiovascular death was rare in Korean patients with IPF.

Aged↗