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K O Park

Publications and source records attributed to K O Park.

17 recordsLinked to original sources

Dipyridamole modulated Tc-99m sestamibi lung SPECT in small cell lung cancer.

PURPOSE: In this study, the authors wanted to determine whether dipyridamole-modulated MIBI (dipyridamole-MIBI) could enhance the prediction of the response to chemotherapy in patients with small cell lung cancer. METHODS: Twenty-seven patients with biopsy-proved small cell lung cancer (25 men, 2 women; mean age, 61 +/- 7 years) underwent dipyridamole-MIBI SPECT 3 to 7 days before starting chemotherapy (80 mg/m2 etoposide and 80 mg/m2 cisplatin every 3 or 4 weeks for at least two cycles). Tomographic images before and after dipyridamole (0.84 mg/kg) were acquired 1 hour after injection of 370 (10 mCi) and 1,110 (30 mCi) MBq MIBI, respectively. The response to chemotherapy was grouped as specified as complete response (CR), partial (PR), no change (NC), or progressive disease (PD), according to the change in tumor size on chest roentgenography and CT. Patients showing CR and PR were classified as responders, and those who showed NC and PD were considered nonresponders. RESULTS: Among the 27 patients, 22 were responders (3 CR, 19 PR) and 5 were nonresponders (3 NC, 2 PD). The tumor-to-normal lung ratio (T:NL) of responders was significantly higher than that of nonresponders. The diagnostic accuracy of the T:NL ratio to differentiate responders and nonresponders was 33.3%, with a cutoff value of 2.5, which was significantly improved to 77.8% when an increased T:NL ratio after dipyridamole was assigned to a nonresponder. Furthermore, all patients with CR showed diminished T:NL ratios after dipyridamole, and all patients with NR showed an increased T:NL ratio after dipyridamole. CONCLUSION: Dipyridamole-MIBI SPECT could enhance the prediction of response to chemotherapy in patients with small cell lung cancer.

ATP Binding Cassette Transporter, Subfamily B, Mem

The interactive effect of Ras, HER2, P53 and Bcl-2 expression in predicting the survival of non-small cell lung cancer patients.

In patients with non-small cell lung cancer (NSCLC), tumor expression of P21-Ras, HER2, P53, and Bcl-2 has been reported as independent predictors of prognosis. However, the prognostic information carried by these proteins has usually been determined separately, and their potential interaction has not been taken into account. We conducted immunostaining for P21-Ras, HER2, P53 and Bcl-2 on 238 cases of NSCLC in a Korean population with 203 squamous cell carcinomas, and 35 adenocarcinomas. P21-Ras, HER2, P53 or Bcl-2 was expressed at high levels in 54.6, 42.0, 18.1 and 71.8% of the NSCLC studied, respectively. A total of 59 tumors (24.8%) expressed only one protein, while 70 (29.4%) expressed two, 59 (24.8) expressed three, and 17 tumors (7.1%) expressed all four proteins. Univariate analysis testing the association of marker expression with survival found Bcl-2 expression to be significantly associated with a poor prognosis, as well as the co-expression of Bcl-2 + HER2, Bcl-2 + HER2 + P53, and Bcl-2 + HER2 + P53 + P21-ras with an increasing hazard ratio. By multivariate analysis controlling for age, tumor stage and tumor type, only the combination of Bcl-2 + HER2 expression was an independent marker of poor prognosis (hazard ratio = 1.91, P = 0.003). Thus, a prospective analysis of the co-expression of Bcl-2 + HER2 in NSCLC patients may identify patients with a poor prognosis who may benefit from more aggressive therapy.

Adenocarcinoma

Technetium-99m-MIBI uptake in small cell lung cancer.

UNLABELLED: Patients with small cell lung cancer (SCLC) often fail to respond to chemotherapy due to multidrug resistance (MDR). Technetium-99m-MIBI was reported to be a suitable transport substrate of P-glycoprotein, which is a cytoplasmic membrane protein encoded by the MDR gene. The purpose of this study was to evaluate whether or not the degree of MIBI uptake in SCLC or its retention on delayed imaging correlated with response to chemotherapy. METHODS: Twenty-five patients (19 men, 6 women; mean age 59 +/- 10 yr) with biopsy-proven SCLC had MIBI SPECT 3-7 days before starting chemotherapy. Imaging was acquired 1 and 4 hr after injection of 740 MBq MIBI using a single-head rotating gamma camera. Tumor-to-normal lung uptake ratio (T/NL) was measured. Percent retention (%R) was measured as: %R = 100 x (T/NL at 4 hr)/(T/NL at 1 hr). All patients received VAP chemotherapy (VP-16 100 mg/m2, adriamycin 40 mg/m2, cisplatin 25 mg/m2) every 4 wk for at least three times. Response to chemotherapy was grouped as complete remission, partial remission and no remission according to the change of tumor size on chest radiograph and CT images. Differences in T/NL and %R among the three groups were analyzed using ANOVA. RESULTS: T/NL of patients with complete remission (n = 7) and partial remission (n = 10) were significantly higher than that of no remission (n = 8) in 1 hr and 4 hr. T/NL at 1 hr in three groups were 2.75 +/- 0.78, 2.35 +/- 0.31 and 1.65 +/- 0.36, respectively. T/NL at 4 hr in three groups was 2.61 +/- 0.94, 2.48 +/- 0.50 and 1.66 +/- 0.42, respectively. However, %R was not different among three groups. Percent retention in three groups was 109.40 +/- 22.10, 96.71 +/- 14.25 and 103.59 +/- 28.43, respectively. CONCLUSION: SCLC with a higher MIBI uptake was more likely to respond to chemotherapy than that with a lower uptake. However, there was a considerable overlap of MIBI uptake among subjects. No significant correlation between the MIBI retention between 1 hr and 4 hr, and the response to chemotherapy was noted.

Antineoplastic Combined Chemotherapy Protocols

Combining ADA, protein and IFN-gamma best allows discrimination between tuberculous and malignant pleural effusion.

BACKGROUND: The purpose of this study is to assess the usefulness of various enzymes, cytokines and biochemical studies of pleural fluid for the differential diagnosis of tuberculosis from malignant pleural effusions, and to clarify the role of combining diagnostic tests. METHODS: The study group included 39 cases with tuberculous effusions and 31 cases with malignant effusions, whose diagnoses were confirmed by pleural biopsy, cytology or microbiological methods. We compared pleural fluid levels of ADA, TNF-alpha, IFN-gamma, IL-2, IL-6, IL-8, pH, protein, glucose, cholesterol, triglyceride, amylase and lactic dehydrogenase between tuberculous and malignant effusions. Using stepwise logistic regression analysis, we evaluated the benefit of combining various parameters. Receiver operating characteristic(ROC) curves of ADA, cytokines and equations generated from regression analyses were plotted and compared with the area under curve(AUC). Cut-off values showing the best diagnostic accuracy were selected and compared. RESULTS: Compared to malignant effusion, tuberculous effusion showed significantly higher levels of ADA, IFN-gamma, TNF-alpha and IL-2. There was a good correlation between IFN-gamma and TNF-alpha. By stepwise logistic regression analysis, IFN-gamma, protein and ADA were independent variables predicting tuberculous from malignant effusions. The diagnostic accuracy and AUC of regression equation was greater than any other single parameters. CONCLUSION: For the differential diagnosis of tuberculosis and malignant pleural effusions, combining ADA, protein and IFN-gamma best allows discrimination.

Adenosine Deaminase

A comparison of serum CYFRA 21-1 and SCC Ag in the diagnosis of squamous cell lung carcinoma.

To evaluate the usefulness of CYFRA 21-1 and SCC Ag in the diagnosis of squamous cell carcinoma (SQC) of the lung, we tested sera from 124 patients with lung cancers (squamous cell ca 72, adenoca 22, large cell ca 4, small cell ca 18 and undetermined 8) and 78 patients with inflammatory lung diseases (bronchitis 24, bronchiectasis 29, tuberculosis 19 and others 6) using immunoradiometric assay kit for cytokeratin fragment 19 (CYFRA 21-1) and radioimmunoassay kit for SCC Ag. The serum CYFRA 21-1 and SCC Ag were significantly higher in lung cancer patients compared with control subjects. However, the significant difference was restricted only to SQC. In patients with SQC, CYFRA 21-1 and SCC Ag showed significantly higher levels according to the advanced anatomic stages (stage I-IIIa vs. stage IIIb, IV, p < 0.05). There was a good correlation between CYFRA 21-1 and SCC Ag (r = 0.41, p < 0.001). Receiver operating characteristic (ROC) curves were generated from results of both tumor markers and areas under the curves (AUC) were calculated. AUC of CYFRA 21-1 (0.93) were significantly larger than that of SCC Ag (0.77) for the diagnosis of SQC (p < 0.05). Therefore, we conclude that CYFRA 21-1 is superior to SCC Ag in the diagnosis of squamous cell carcinoma of the lung.

Aged

Acute lung injury after phosgene inhalation.

Phosgene (COCl2) is a colorless oxidant gas which is heavier than air and the lethal exposure dose (LC50) in humans is 500 ppm/min. This gas was originally manufactured as an agent for chemical warfare during World War I and there had been a great deal of studies on phosgene poisoning during the early years of industrial use. It is still widely used in the synthesis of chemicals and plastics. In the modern era, however, phosgene poisoning is relatively uncommon except in accidental exposures. In Korea, there has been no report about lung injury from phosgene inhalation. We present a clinical experience with six patients accidentally exposed to phosgene.

Accidents, Occupational

DNA ploidy and proliferative activity in bcl-2 expressed non-small cell lung cancer.

OBJECTIVES: The expressions of bcl-2 have been reported recently in non-small cell lung carcinoma (NSCLC*). As oncogensis is believed to involve a number of genetic alterations, there can be differences in DNA ploidy or proliferative activity even in bcl-2 positive cases according to the superimposed genetic events. SUBJECTS AND METHODS: On the assumption that we might further discern the biologic behavior of bcl-2 positive NSCLC according to the status of DNA ploidy and proliferative activity, we conducted a study for bcl-2 expression with immunohistochemical staining and DNA analysis on 52 surgical specimens of NSCLC. RESULTS: The bcl-2 was positive in 52% (27/52) of specimens, According to the status of bcl-2 expression, there were no significant differences in tumor stages, performance status score and survival time. Among bcl-2 positive NSCLC, aneuploidy and high proliferative activity were noted in 40% and 44%, respectively. In cases with squamous cell carcinoma (SQC**), the proportion of aneuploidy was significantly higher in bcl-2 positive group compared to bcl-2 negative group (p < 0.01), which could not be explained with the sole effect of bcl-2. In bcl-2 positive NSCLC, there was no significant survival difference by the status of DNA analysis results. With a Coxproportional hazard model, only T stage was an independent prognostic factor. CONCLUSION: In bcl-2 expressed NSCLC, proliferative activity and DNA ploidy were not homogeneous, suggesting other genetic alterations. This may explain our results which showed no differences in survival according to the status of the bcl-2 expression.

Adult

Tc-99m MIBI uptake in simultaneous thyroid and lung cancers.

The authors present a patient with simultaneous follicular thyroid and small-cell lung cancers, both of which showed Tc-99m MIBI uptake. CT scans showed two masses: one involving the right lower neck including the right supraclavicular area and the right superior mediastinum, and the other involving the peripheral portion of the right upper lobe of the lung. I-131 imaging showed increased uptake in the right neck mass only. Tc-99m MIBI imaging, which was performed for evaluation of chest pain, showed intense uptake in the neck mass (tumor to heart ratios in planar and tomographic images were 0.92 and 0.96, respectively), and less uptake in the lung mass (tumor to heart ratios in planar and tomographic images were 0.53 and 0.40, respectively). Biopsy of the right supraclavicular mass revealed a follicular carcinoma, and a bronchoscopic biopsy of the right upper lobe mass revealed a small cell carcinoma.

Adenocarcinoma, Follicular

[A study on factors related to daily activities of post myocardial infarction patients].

The purpose of this study was to identify factors related to daily activities of post myocardial infarction patients. Data were collected from Aug. 1 to Aug. 31, 1988 through an interview schedule lasting for about 30-60 minutes by the investigators. Tools for this study were a daily activities scale and a subjective physical symptom scale developed by the researchers, and Zung's self rating depression scale. The subjects were 45 men 18 women post myocardial infarction patients who were receiving follow up care at SNU Hospital. The data were analyzed by percentage, mean, t-test, ANOVA, the Pearson moment Correlation Coefficient test, and Cronbach's a reliability test. The results were as follows. 1. Reliability of the daily activities scale was 0.91 by Cronbach's a. In the daily activities scale, items about transfer, exercise, and job related activities were most highly rated as meaningful to the post myocardial infarction patients. 2. The average daily activities score of these patients was 3.30 (maximum point:4) all scores were high except for exercise and job related activities. 3. There was a significant difference in daily activities according to sex; men had a higher daily activities score than women (T=2.32, P less than 0.05). 4. There was a significant difference in daily activities according to job status. Subjects having a job had a higher daily activities score. 5. The lower the depression score, the higher the daily activities score (gamma=-0.5748, P less than 0.05). 6. The lower the subjective physical symptoms score, the higher the daily activities score (gamma=-0.6015, P less than 0.05).

Activities of Daily Living

[Experimental study on bond strength of gold plated etched-metal surfaces of resin bonded restorations].

The purpose of this study was to compare the tensile bond strength of the resin-metal interface between etched only and etched & goldplated metal specimens. Etched only and etched & goldplated metal specimens were treated or were not treated with bonding agent and bonded to metal specimens with Comspan and MBAS. Also, electrochemically only etched metal surface and etched & goldplated metal surface was observed by SEM. The following results were obtained: 1. The tensile bond strength of the electrochemically etched only and gold-plated specimens were not significantly different in Comspan group, but the gold-plated specimens in MBAS group demonstrated slightly lower values than the etched only specimens. 2. The tensile bond strengths were not significantly different between the treated group with bonding agent and not-treated group with bonding agent. 3. The tensile bond strengths were not significantly different between the Comspan and MBAS groups. 4. The basic microretentive structures, maintained obviously in the etched and goldplated metal surfaces by SEM.

Acid Etching, Dental

[Development or the nursing productivity conceptual framework].

This study was performed to develop the conceptual framework of the nursing productivity. The study efforts were made: (1) to define the concept the nursing productivity, (2) to identify the elements of the productivity, and (3) to determine the relationship among the elements. With the aim, the study employed a descriptive analysis by way of reviewing various references related to the subject. The nursing productivity consists of such elements as the nursing efficiency and the nursing effectiveness which are complementary to each other. The nursing efficiency is the quantitative input/output ratio, while the nursing effectiveness represents the integrated outcome of such sub-elements as the degree of accomplishing nursing goals, the quality of nursing service, consumer's satisfaction, and the degree of improvement of nurse's attitude toward the quality care. The nursing productivity can be estimated by summing up the nursing efficiency and the effectiveness. By employing the system theory model, the elements of the nursing productivity consist of three elements; the input, the process, and the output. By the process elements, the system inputs are transformed to the system outputs nursing efficiency and nursing effectiveness which are input to the system, in turn, through feedback mechanism (Figure 4).

Efficiency