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Biomedical subjects

K B Lee

Publications and source records attributed to K B Lee.

At least 19 recordsLinked to original sources

Preparation and activity measurement of electrodeposited alpha-emitting sources.

Alpha-emitting 238Pu and 241Am sources on stainless steel substrates have been prepared using a new electrodeposition method based on an ammonium oxalate-ammonium sulfate electrolyte containing diethyl triamino pentaacetic acid. The deposition yield is determined by measuring the activity of the sources using a high-efficiency 2pi alpha proportional counter and a backscattering chamber designed and fabricated for this purpose. Optimal electrodeposition parameters have been determined for 241Am, enabling manufacture of standard alpha-emitting sources with minimal radioactive waste.

Alpha Particles↗

Phase II study of capecitabine and irinotecan combination chemotherapy in patients with advanced gastric cancer.

The present study was conducted to evaluate the efficacy and safety of a combination regimen of capecitabine plus irinotecan in patients with advanced gastric cancer. Patients with previously untreated metastatic or recurrent, measurable gastric cancer received oral capecitabine 1000 mg m(-2) twice daily from day 1 to 14 and intravenous irinotecan 100 mg m(-2) on days 1 and 8, based on a 3-week cycle. Forty-one patients were enrolled in the current study, among whom 38 were assessable for efficacy and 40 assessable for toxicity. Three complete responses and 16 partial responses were confirmed, giving an overall response rate of 46.3%. At a median follow-up of 269 days, the median time to progression and overall survival were 5.1 and 8.6 months, respectively. Grade 3/4 neutropenia occurred in four patients and grade 3 febrile neutropenia was observed in two patients. Grade 3 diarrhoea and grade 2 hand-foot syndrome occurred in six patients and eight patients, respectively. The combination of capecitabine and irinotecan was found to be well tolerated and effective in patients with advanced gastric cancer. Accordingly, this regimen can be regarded as one of first-line treatment options for advanced gastric cancer.

Adenocarcinoma↗

Rapid helper T-cell recovery above 200 x 10 6/l at 3 months correlates to successful transplant outcomes after allogeneic stem cell transplantation.

The current study evaluates the role of quantitative measurement of peripheral lymphocyte subsets, especially CD4+ helper T-cell recovery, in predicting transplant outcomes including overall survival (OS) and non-relapse mortality (NRM) after allogeneic stem cell transplantation. A total of 69 allogeneic recipients were included with following diagnoses: acute myeloid leukemia 42, acute lymphoblastic leukemia 5, chronic myeloid leukemia 15, non-Hodgkin's lymphoma 5 and high-risk myelodysplastic syndrome 2. The peripheral lymphocyte subset counts (CD3+ T cells, CD3+4+ helper T cells, CD3+8+ cytotoxic T cells, CD19+ B cells, and CD56+ natural killer cells) were measured at 3, 6 and 12 months. The CD4+ helper T-cell reconstitution at 3 months was strongly correlated with OS (P<0.0001), NRM (P=0.0007), and opportunistic infections (P=0.0108) at the cutoff value of 200 x 10(6)/l CD4(+) helper T cells. Rapid CD4+ helper T-cell recovery was also associated with a higher CD4+ helper T-cell transplant dose (P=0.006) and donor type (P<0.001). An early CD4+ helper T-cell recovery at 3 months correlated with a subsequent faster helper T-cell recovery until 12 months, yet not with B-cell recovery. In a multivariate analysis, rapid recovery of CD4+ helper T cells at 3 months was a favorable prognostic factor together with higher CD34+ cell transplant dose in terms of OS (P=0.001) and NRM (P=0.005).

Adolescent↗

Comparison of calculated spectra for the interaction of photons in a liquid scintillator. Example of 54Mn 835 keV emission.

The CIEMAT/NIST and TDCR methods in liquid scintillation counting, initially developed for the activity standardization of pure-beta radionuclides, have been extended to the standardization of electron capture and beta-gamma radionuclides. Both methods require the calculation of the energy spectrum absorbed by the liquid scintillator. For radionuclides emitting X-rays or gamma-rays, when the energy is greater than a few tens of keV the Compton interaction is important and the absorption is not total. In this case, the spectrum absorbed by the scintillator must be calculated using analytical or stochastic models. An illustration of this problem is the standardization of 54Mn, which is a radionuclide decaying by electron capture. The gamma transition, very weakly converted, leads to the emission of an 835 keV photon. The calculation of the detection efficiency of this radionuclide requires the calculation of the energy spectrum transferred to the scintillator after the absorption of the gamma ray and the associated probability of absorption. The validity of the method is thus dependent on the correct calculation of the energy transferred to the scintillator. In order to compare the calculation results obtained using various calculation tools, and to provide the metrology community with some information on the choice of these tools, the LS working group of the ICRM organised a comparison of the calculated absorbed spectra for the 835 keV photon of 54Mn. The result is the spectrum of the energy absorbed by the scintillator per emission of an 835 keV gamma ray. This exercise was proposed for a standard 20 ml LS glass vial and for LS cocktail volumes of 10 and 15 ml. The calculation was done for two different cocktails: toluene and a widely used commercial cocktail, Ultima Gold. The paper describes the results obtained by nine participants using a total of 12 calculation codes.

Algorithms↗

Standardization of radionuclide by beta(LS)-gamma coincidence counting using the geometry-efficiency variation method.

A liquid scintillation counting method consisting of three photomultiplier tubes for beta counters and a NaI(Tl) gamma counter has been developed for the standardization of radionuclides with the beta-gamma coincidence technique. The beta detection efficiency functions are obtained by means of a geometry-variation method developed in the present work; an array of beta detectors is moved uniformly at the same time from a centrally located counting vial to 50 mm. The method has been applied in the standardization of 60Co and 134Cs. Unquenched liquid scintillation samples with nominal count rates from 1000 to 6000 s-1 were prepared. The observed beta detection efficiencies with this method are from 90 to 45% in the case of 60Co, and from 84 to 50% for 134Cs. The output of each beta channel is summed together and compared with gamma data by the coincidence analyzer. The dead time of each counting channel is adjusted to be 20 micros, sufficiently long to suppress the afterpulses in the beta counting channel. The activity of each sample is determined by using the Cox and Isham formula. The obtained results are in good agreement with KRISS certified values.

Beta Particles↗

Oncocytoma of the spinal cord causing paraplegia - a case report.

STUDY DESIGN: Case report. OBJECTIVES: To describe a rare case of oncocytoma arising from the spinal cord in a 40-year old woman. SETTING: Republic of Korea. METHODS: The patient's history, physical examination, radiological and pathological findings were reviewed. RESULTS: A 40-year-old woman presented with 3-month history of low back pain. Magnetic resonance imaging revealed an intradural extramedullary mass located between L1 and L4. She refused any surgical treatment and so was discharged. At 10 days after discharge, an emergency operation was performed because of sudden paralysis in both lower extremities. The confirmed diagnosis is oncocytoma. At 4 months after surgery, the patient failed to obtain neurological recovery from complete paraplegia. CONCLUSIONS: Since the progression of an intradural extramedullary mass that shows minor neurological symptoms can lead to complete paraplegia in a short time, close observation and early surgical decompression are necessary.

Adenoma, Oxyphilic↗

Prognostic significance of platelet recovery pattern after allogeneic HLA-identical sibling transplantation and its association with severe acute GVHD.

Thrombocytopenia (TP) is a frequent complication after allogeneic stem cell transplantation (SCT) and regarded as a poor prognostic factor when assessed beyond day 100. However, little is known about the clinical significance of the platelet recovery pattern before chronic graft-versus-host disease (GVHD) develops. Eighty-five patients undergoing HLA-identical sibling SCT were stratified according to their platelet recovery pattern between day +30 and +90 and the transplant outcomes analyzed, along with the association of each component of the acute GVHD grading system. Fifteen patients (18%) were classified with persistent TP, 33 patients (39%) with unstable TP, and 37 patients (43%) as non-TP. Persistent TP, which was strongly associated with severe acute GVHD (P<0.001), exhibited the worst 2-year OS (P<0.0001) and highest NRM (P<0.0001) and opportunistic infection rates (P<0.0001). In multivariate analyses, the platelet recovery pattern was identified as an independent prognostic factor (P=0.02) together with the disease risk (P=0.02) in terms of OS, and the only independent prognostic factor in terms of NRM (P=0.005) and the incidence of infectious events (P<0.001). Persistent TP was strongly associated with the development of extensive chronic GVHD (P=0.03). The platelet recovery pattern between day +30 and +90 can be used to predict the prognosis of SCT recipients.

Adolescent↗

Risk-factor analysis for predicting progressive- or quiescent-type chronic graft-versus-host disease in a patient cohort with a history of acute graft-versus-host disease after allogeneic stem cell transplantation.

This study attempts to identify variables that can predict the development of progressive- or quiescent-type chronic GVHD (pq cGVHD) and transplant outcomes after the diagnosis of cGVHD in 99 patients who experienced acute GVHD (aGVHD) after allogeneic SCT. The prognostic significance of various clinical parameters at diagnosis of cGVHD was examined to determine the prognostic factors for GVHD-specific survival (GSS) in patients with pq cGVHD. Among 118 patients who experienced any degree of aGVHD, 99 were evaluated for cGVHD. The incidence of overall and extensive pq cGVHD at 2 years was estimated as 84.4 and 63.1%, respectively. A multivariate analysis showed that severe aGVHD (grade 3, 4) (P=0.022), primary treatment failure (P=0.009) and elevated alkaline phosphatase (P=0.001) were all significant independent factors predicting a higher overall incidence of pq cGVHD. The GSS and probability of systemic immunosuppressive treatment at 2 years after diagnosis of cGVHD were estimated as 55.9 and 51.9%. GVHD-specific survival was significantly associated with performance status (P=0.004) and lymphocytopenia (<or=1000/microl, P=0.022) at diagnosis of cGVHD by Cox's proportional hazard model. Severe aGVHD, primary treatment failure (PTF), lymphocytopenia and elevated alkaline phosphatase may be useful predictive factors for the development of pq cGVHD in patients who experience aGVHD after allogeneic SCT.

Acute Disease↗

PKD2 gene mutation analysis in Korean autosomal dominant polycystic kidney disease patients using two-dimensional gene scanning.

Autosomal dominant polycystic kidney disease (ADPKD) is genetically heterogeneous and is caused by mutations in the PKD1 or PKD2 genes. ADPKD caused by PKD2 mutations is characterized by a longer survival and a later onset of end-stage renal disease than ADPKD caused by PKD1 mutations. PKD2 encodes a 2.9-kb messenger RNA and is derived from 15 exons. Two-dimensional gene scanning (TDGS) is more efficient in detecting mutations in genes such as PKD2 because it can scan the whole coding regions simultaneously. In order to determine the prevalence of Korean PKD2 patients, all the coding sequences of PKD2 were screened using TDGS and direct sequencing in 46 randomly selected ADPKD patients (group 1). Another 45 ADPKD patients (group 2), who were presumed to be PKD2 patients, were screened in order to identify the type of mutation in the Korean PKD2 patients. Eight novel different mutations and three known mutations in the PKD2 gene were detected in 17 patients: 6 patients (13.0%) in group 1 and 11 patients (24.4%) in group 2. Considering the sensitivity of TDGS, the prevalence of PKD2 in Korean population might be greater than 18.6%. Both known and novel mutations were identified by TDGS in Korean PKD2 patients. Overall, these results showed that TDGS might be useful for diagnosing PKD2.

Chromosome Mapping↗

The prevalence and risk factors of microalbuminuria in normoglycemic, normotensive adults.

AIMS: Microalbuminuria is a risk factor for renal and cardiovascular disease. Recent studies have established this important relationship in patients with diabetes or hypertension, yet few studies have shown this relationship in healthy subjects. The purpose of this study is to examine the prevalence and the risk factors of microalbuminuria in normoglycemic, normotensive adults. SUBJECTS AND METHODS: We examined the prevalence of microalbuminuria in the adults who voluntarily took part in a health examination program. As a cross-sectional study, we examined the risk factors of microalbuminuria in 4883 normoglycemic, normotensive healthy adults. RESULTS: The prevalence of microalbuminuria was 2.8% in the normoglycemic, normotensive group (n=4883), 10.1% in the hypertensive group (n=1250), 16.0% in the diabetes group (n=455) and 5.4% in the total subjects (n=6588). The systolic blood pressure, high sensitive C-reactive protein (hsCRP) and insulin resistance were independently related with microalbuminuria on the logistic regression analysis. The odds ratio of microalbuminuria were 1.04 (1.02 - 1.05, 95% CI), 1.29 (1.10 - 1.51, 95% CI), and 1.83 (1.15 - 2.92, 95% CI), respectively. CONCLUSIONS: These finding suggest that the systolic blood pressure, hsCRP and insulin resistance are the independent risk factors for microalbuminuria in normoglycemic, normotensive adults.

Adult↗

Phase II study of concurrent chemoradiotherapy with capecitabine and cisplatin in patients with locally advanced squamous cell carcinoma of the head and neck.

We aimed to evaluate the efficacy and safety of concurrent chemoradiotherapy with capecitabine and cisplatin in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN). In total, 37 patients with stage III or IV SCCHN were enrolled on the study. The chemotherapy consisted of two cycles of intravenous cisplatin of 80 mg m(-2) on day 1 and oral capecitabine 825 mg m(-2) twice daily from day 1 to day 14 at 3-week intervals. The radiotherapy (1.8-2.0 Gy 1 fraction day(-1) to a total dose of 70-70.2 Gy) was delivered to the primary tumour site and neck. The primary tumour sites were as follows: oral cavity (n=6), oropharynx (n=11), hypopharynx (n=8), larynx (n=3), nasopharynx (n=6), and paranasal sinus (n=3). After the chemoradiotherapy, 29 complete responses (78.4%) and 6 partial responses (16.2%) were confirmed. Grade 3 or 4 neutropenia occurred only in two patients, plus grade 3 febrile neutropenia was observed only in one patient. At a median follow-up duration of 19.8 months, the estimated overall survival and progression-free survival rate at 2-year was 76.8 and 57.9%, respectively. Concurrent chemoradiotherapy with capecitabine and cisplatin was found to be well tolerated and effective in patients with locally advanced SCCHN.

Adult↗

Measurement of the D(s)+ lifetime.

A high statistics measurement of the D(s)+ lifetime from the Fermilab fixed-target FOCUS photoproduction experiment is presented. We describe the analysis of the two decay modes, D(s)+ --> phi(1020)pi+ and D(s)+ -->K*(892)0K+, used for the measurement. The measured lifetime is 507.4 +/- 5.5(stat) +/- 5.1(syst) fs using 8961 +/- 105 D(s)+ --> phi(1020)pi+ and 4680 +/- 90 D(s)+ --> K*(892)0K+ decays. This is a significant improvement over the present world average.

Journal Article↗

Measurement of beta surface emission rate from an extended area 36Cl source using a multiwire proportional counter.

We have developed, as a national standard, a windowless multiwire proportional counting (MWPC) system for gross measurements of alpha- and beta-emitting radionuclides at an uncertainty level below 1%. Various detector characteristics have been studied and several working parameters of the system have been determined in order to achieve an optimized detection capability. The detector is commissioned through an international comparison of the beta emission rate from an extended area (36)Cl source. Correction for the dead time loss is made by the non-extendable dead time method. A linear extrapolation of pulse height spectrum is employed to correct for the loss in the detection efficiency due to discriminating against the events formed from a small number of original ion pairs. The surface emission rate was measured to be 1.84 x 10(3) counts/s with the relative combined standard uncertainty of 0.46%. The measured uncertainty indicates that the constructed MWPC is capable of serving as a national standard.

Journal Article↗

Effectiveness of transdermal fentanyl patch for treatment of acute pain due to oral mucositis in patients receiving stem cell transplantation.

The current study was performed to evaluate the effectiveness and safety of transdermal therapeutic system (TTS) fentanyl in the management of acute pain due to oral mucositis in patients receiving stem cell transplantation. A cohort of consecutive patients with painful oral mucositis were enrolled. Initially, 25 microg/h of TTS fentanyl was administered for the treatment of oral mucositis pain. The pain score, based on a visual analogue scale, and mood and quality of sleep as determined by EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire, Cancer 30), were all recorded before the treatment, then 2, 6, and 10 days later. Twenty-two patients with hematologic malignancies were enrolled. Three patients were excluded from the response assessment, as their TTS fentanyl treatment was stopped owing to related complaints, including severe dizziness, severe vomiting, and an extensive body rash. The total duration of the treatment was 8 days (range, 6-15 days) and the total amount of TTS fentanyl administered per patient was 2.21 at 25 microg/h and 0.63 at 50 microg/h. Six (31.6%) of the remaining 19 patients required an escalated dose of TTS fentanyl at 50 mug/h. The mean pain scores before treatment and 2, 6, and 10 days later were 6.68, 5.17, 3.42, and 2.13, respectively (P < .001). Eight (42.1%) and seven (36.8%) patients experienced improved sleep and mood after treatment, respectively. The TTS fentanyl was effective in both relieving oral mucositis pain with an excellent tolerability and improving the quality of life for hematological patients receiving high-dose chemotherapy with stem cell transplantation.

Adolescent↗

Impact of ABO incompatibility on outcome after allogeneic peripheral blood stem cell transplantation.

Few studies have addressed the incidence of graft-versus-host disease (GVHD) or survival after ABO-incompatible allogeneic peripheral blood stem cell transplantation (PBSCT). We analyzed the clinical outcome of ABO incompatibility after allogeneic PBSCT. A total of 89 consecutive adult patients with hematological diseases including 49 ABO-identical, 20 major, 15 minor, and five bidirectional ABO-incompatible transplants were enrolled from four medical centers in Korea. No significant difference in engraftment times, graft failure, or transfusion requirements between groups was noted. A clinical diagnosis of severe immune hemolysis or pure red cell aplasia was not made for any patient after transplantation. The incidence of acute or chronic GVHD did not statistically differ between groups. With a median follow-up duration of 13 months (range, 0.5-61 months), the 3-year overall survival estimates for the ABO-identical, major/bidirectional, and minor group were 44.6.0+/-9.0, 43.1+/-11.6, and 43.8+/-13.5%, respectively (P=0.8652), while the 3-year disease-free survival estimates were 33.8+/-7.6, 39.9+/-11.4, and 45.7+/-13.1%, respectively (P=0.8546). We observed that time to neutrophil, platelet, and red blood cell engraftment, transfusion requirements, incidence of acute or chronic GVHD, relapse, and survival were not influenced by ABO incompatibility after allogeneic PBSCT from HLA-matched sibling donors.

ABO Blood-Group System↗

Protective role of interleukin-10 promoter gene polymorphism in the pathogenesis of invasive pulmonary aspergillosis after allogeneic stem cell transplantation.

The current study attempted to evaluate the association between the IL-10 promoter gene single nucleotide polymorphism (SNP) and invasive pulmonary aspergillosis (IPA) after allogeneic stem cell transplantation (SCT) in 105 patients. Three single-nucleotide polymorphisms were investigated in the proximal region of the IL-10 promoter gene (-1082/-819/-592). Two haplotypes (1082*A/819*T/592*A [ATA] and 1082*A/819*C/592*C [ACC]) were found in the current study. The overall incidence of IPA was estimated as 14.1+/-4.5% with a median onset at 186 days post-transplant (62 approximately 405 days). An increased occurrence of IPA was noted dependent on the IL-10 haplotype (0% vs 11.5+/-6.4% vs 19.7+/-7.7% for ACC/ACC vs ATA/ACC vs ATA/ATA haplotype, P=0.0307 when comparing ACC with non-ACC haplotype). In a multivariate survival analysis using Cox's proportional hazard model, the IL-10 promoter gene SNPs were identified as an independent predictive factor for the development of IPA (P=0.012, hazard ratio (HR) 9.3), along with an histocompatibility leukocyte antigen (HLA)-identical donor (P=0.005, HR 16.3), the CD34+ cell dose transplanted (P=0.004, HR 26.5), and time-dependent chronic graft-versus-host disease (GVHD; P=0.049, HR 16.0). The IL-10 ACC haplotype was found to have an apparent protective role in the development of IPA after allogeneic transplantation, regardless of HLA-disparity or chronic GVHD.

Adolescent↗

Implementation of CIEMAT/NIST LSC efficiency tracing method in KRISS: (204)T1 standardization.

The CIEMAT/NIST efficiency tracing method has been widely used for radionuclide standardization. The method consists of the theoretical calculations of counting efficiencies and the experimental data obtained from a commercially available double photomultiplier detector. We have recently implemented the technique using (3)H as a tracer. Our implementation of the method was validated by participating into an international comparison of activity measurements of a solution of (204)T1. We report in this paper the procedure employed to implement the technique and compare our measurement result of (204)T1 activity with that of the international comparison.

Journal Article↗