16 results on '"Sun-Mi Choi"'
Search Results
2. Response of the primary auditory and non-auditory cortices to acoustic stimulation: a manganese-enhanced MRI study.
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Hyungjun Kim, Junghun Cho, Young R Kim, Youngkyu Song, Song-I Chun, Ji-Yeon Suh, Jeong Kon Kim, Yeon-Hee Ryu, Sun-Mi Choi, Hyungjoon Cho, and Gyunggoo Cho
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Medicine ,Science - Abstract
Structural and functional features of various cerebral cortices have been extensively explored in neuroscience research. We used manganese-enhanced MRI, a non-invasive method for examining stimulus-dependent activity in the whole brain, to investigate the activity in the layers of primary cortices and sensory, such as auditory and olfactory, pathways under acoustic stimulation. Male Sprague-Dawley rats, either with or without exposure to auditory stimulation, were scanned before and 24-29 hour after systemic MnCl2 injection. Cortex linearization and layer-dependent signal extraction were subsequently performed for detecting layer-specific cortical activity. We found stimulus-dependent activity in the deep layers of the primary auditory cortex and the auditory pathways. The primary sensory and visual cortices also showed the enhanced activity, whereas the olfactory pathways did not. Further, we performed correlation analysis of the signal intensity ratios among different layers of each cortex, and compared the strength of correlations between with and without the auditory stimulation. In the primary auditory cortex, the correlation strength between left and right hemisphere showed a slight but not significant increase with the acoustic simulation, whereas, in the primary sensory and visual cortex, the correlation coefficients were significantly smaller. These results suggest the possibility that even though the primary auditory, sensory, and visual cortices showed enhanced activity to the auditory stimulation, these cortices had different associations for auditory processing in the brain network.
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- 2014
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3. Acupuncture for the treatment of dry eye: a multicenter randomised controlled trial with active comparison intervention (artificial teardrops).
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Tae-Hun Kim, Jung Won Kang, Kun Hyung Kim, Kyung-Won Kang, Mi-Suk Shin, So-Young Jung, Ae-Ran Kim, Hee-Jung Jung, Jin-Bong Choi, Kwon Eui Hong, Seung-Deok Lee, and Sun-Mi Choi
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Medicine ,Science - Abstract
To evaluate the effects of acupuncture compared to a control group using artificial tears.multicenter randomised controlled trial (three local research hospitals of South Korea).150 patients with moderate to severe dry eye.Participants were randomly allocated into four weeks of acupuncture treatment (bilateral BL2, GB14, TE 23, Ex1, ST1, GB20, LI4, LI11 and single GV23) or to the artificial tears group (sodium carboxymethylcellulose).The ocular surface disease index (OSDI), tear film break-up time (TFBUT), Schirmer Ι test, visual analogue scale (VAS) for self-assessment of ocular discomfort, general assessment (by both acupuncture practitioners and participants) and quality of life (QOL) through the Measure Yourself Medical Outcome Profile-2 (MYMOP-2).There was no statistically significant difference between two groups for the improvement of dry eye symptoms as measured by OSDI (MD -16.11, 95% CI [-20.91, -11.32] with acupuncture and -15.37, 95% CI [-19.57, -11.16] with artificial tears; P = 0.419), VAS (acupuncture: -23.84 [-29.59, -18.09]; artificial tears: -22.2 [-27.24, -17.16], P = 0.530) or quality of life (acupuncture: -1.32 [-1.65, -0.99]; artificial tears: -0.96 [-1.32, -0.6], P = 0.42) immediately after treatment. However, compared with artificial tears group, the OSDI (acupuncture: -16.15 [-21.38, -10.92]; artificial tears: -10.76 [-15.25, -6.27], P = 0.030) and VAS (acupuncture: -23.88 [-30.9, -16.86]; artificial tears: -14.71 [-20.86, -8.55], P = 0.018) were significantly improved in the acupuncture group at 8 weeks after the end of acupuncture treatment. TFBUT measurements increased significantly in the acupuncture group after treatment.Acupuncture may have benefits on the mid-term outcomes related to dry eye syndrome compared with artificial tears.ClinicalTrials.gov NCT01105221.
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- 2012
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4. Respiratory virus of severe pneumonia in South Korea: Prevalence and clinical implications
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Sang Min Lee, S. K. Han, Sun Mi Choi, Jinwoo Lee, Youngwhan Kim, Chul Gyu Yoo, Hyung-Jun Kim, Jae-Joon Yim, Chang Hoon Lee, and Young Sik Park
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Male ,RNA viruses ,Viral Diseases ,Pulmonology ,Nosocomial Infections ,lcsh:Medicine ,Artificial Gene Amplification and Extension ,Pathology and Laboratory Medicine ,medicine.disease_cause ,Polymerase Chain Reaction ,law.invention ,0302 clinical medicine ,Risk Factors ,law ,Prevalence ,Medicine and Health Sciences ,Influenza A virus ,030212 general & internal medicine ,lcsh:Science ,Multidisciplinary ,Coinfection ,Reverse Transcriptase Polymerase Chain Reaction ,Viral Epidemiology ,Mortality rate ,General Medicine ,Middle Aged ,Intensive care unit ,Respiratory Syncytial Viruses ,Bacterial Pathogens ,Intensive Care Units ,Infectious Diseases ,Medical Microbiology ,Viral Pathogens ,Viral pneumonia ,Acute Disease ,Viruses ,Respiratory virus ,Female ,Seasons ,Pathogens ,General Agricultural and Biological Sciences ,Research Article ,medicine.medical_specialty ,Pneumonia, Viral ,Respiratory Syncytial Virus Infections ,Research and Analysis Methods ,Microbiology ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,Internal medicine ,Influenza, Human ,Republic of Korea ,Pneumonia, Bacterial ,medicine ,Humans ,Molecular Biology Techniques ,Microbial Pathogens ,Molecular Biology ,Aged ,business.industry ,lcsh:R ,Organisms ,Biology and Life Sciences ,Pneumonia ,Reverse Transcriptase-Polymerase Chain Reaction ,medicine.disease ,Influenza ,030228 respiratory system ,Co-Infections ,Paramyxoviruses ,lcsh:Q ,Respiratory Syncytial Virus ,business - Abstract
Background Severe viral pneumonia is associated with a high mortality rate. However, due to the vulnerability of critically ill patients, invasive diagnostic methods should be performed with caution in the intensive care unit (ICU). It would be helpful if the prevalence, risk factors, and clinical impact of virus detection are elucidated. Methods We evaluated patients with severe pneumonia between January 1st 2008 and December 31st 2015. Reverse transcription-polymerase chain reaction (RT-PCR) analysis was performed for 8 respiratory viruses when viral pathogen could not be excluded as the origin of severe pneumonia. The baseline characteristics, laboratory results, microbiological findings, and clinical outcomes of the patients were analyzed. Results Of the 2,347 patients admitted to the medical ICU, 515 underwent RT-PCR for respiratory viruses, 69 of whom had positive results. The detection rate was higher during the winter, with a community onset, in patients with history of recent chemotherapy, and low platelet count. Additional bronchoscopic sampling along with upper respiratory specimen increased the yield of viral detection. Respiratory syncytial virus was the most common pathogen detected, while influenza A was the most common virus with bacterial coinfection. Respiratory virus detection led to changes in clinical management in one-third of the patients. Conclusions The detection of viral pathogens in patients with severe pneumonia is not rare, and can be more common in certain group of patients. Invasive sampling for RT-PCR can be helpful, and such detection can lead to positive changes in clinical management.
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- 2018
- Full Text
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5. Clinical impact of depression and anxiety in patients with idiopathic pulmonary fibrosis
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Jongsun Park, Young Jae Cho, Jae Ho Lee, Yeon Joo Lee, Ye Jin Lee, Ho Il Yoon, Choon Taek Lee, and Sun Mi Choi
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Pulmonology ,Pulmonary Fibrosis ,Emotions ,lcsh:Medicine ,Social Sciences ,Comorbidity ,Anxiety ,Hospital Anxiety and Depression Scale ,Pulmonary function testing ,Idiopathic pulmonary fibrosis ,0302 clinical medicine ,Risk Factors ,Surveys and Questionnaires ,Prevalence ,Medicine and Health Sciences ,Psychology ,030212 general & internal medicine ,lcsh:Science ,Prospective cohort study ,Depression (differential diagnoses) ,Aged, 80 and over ,Multidisciplinary ,Depression ,Middle Aged ,respiratory system ,humanities ,Hospitals ,Respiratory Function Tests ,Hospitalization ,medicine.symptom ,Research Article ,medicine.medical_specialty ,Death Rates ,Chronic Obstructive Pulmonary Disease ,03 medical and health sciences ,Internal medicine ,Republic of Korea ,Mental Health and Psychiatry ,medicine ,Humans ,Mortality ,Survival rate ,Aged ,Proportional Hazards Models ,Demography ,Mood Disorders ,business.industry ,lcsh:R ,Biology and Life Sciences ,medicine.disease ,Fibrosis ,Idiopathic Pulmonary Fibrosis ,respiratory tract diseases ,Health Care ,Dyspnea ,030228 respiratory system ,Health Care Facilities ,People and Places ,Physical therapy ,lcsh:Q ,business ,Follow-Up Studies ,Developmental Biology - Abstract
Background Although depression and anxiety represent significant yet treatable comorbidities in patients with idiopathic pulmonary fibrosis (IPF), their impact on the clinical course and prognosis of IPF remain unclear. Purpose We investigated the prevalence and clinical significance of depression and anxiety in patients with IPF. Methods The present study included a prospective cohort comprising 112 Korean patients with IPF who had completed the Hospital Anxiety and Depression Scale (HADS) questionnaire. Results Symptoms of depression and anxiety were present in 25.9% and 21.4% of patients with IPF, respectively (HADS scores ≥8). No significant differences in demographic data, age, sex, smoking status, Modified Medical Research Council Dyspnea Scale (MMRC) scores, pulmonary function tests, or Gender-Age-Physiology Index for IPF were observed between patients with depression or anxiety and those without. However, in patients with anxiety, St. George's Respiratory Questionnaire (SGRQ) scores were significantly higher than those of patients without anxiety (40.5 versus 23.5; p = 0.003). The survival rate and total number of hospital admissions did not significantly differ between patients with depression/anxiety and those without. Conclusions Our findings indicate that depression and anxiety are relatively common in patients with IPF. Although no significant differences were noted with regard to survival rate and hospitalization, the present study suggests that depression and anxiety significantly influence quality of life in patients with IPF.
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- 2017
6. Culture conversion rate at 2 months of treatment according to diagnostic methods among patients with culture-positive pulmonary tuberculosis
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Ha Youn Lee, Sun Mi Choi, Chang Hoon Lee, Sung Koo Han, Jinwoo Lee, Young Sik Park, Sang Min Lee, Chul-Gyu Yoo, Jae-Joon Yim, Kyoung Ok Chae, and Young Whan Kim
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Bacterial Diseases ,medicine.medical_specialty ,Time Factors ,Tuberculosis ,Antitubercular Agents ,Cell Culture Techniques ,lcsh:Medicine ,Cohort Studies ,Mycobacterium tuberculosis ,Bronchoscopy ,Recurrence ,Internal medicine ,Medicine and Health Sciences ,medicine ,Culture conversion ,Humans ,lcsh:Science ,Tuberculosis, Pulmonary ,Retrospective Studies ,Analysis of Variance ,Multidisciplinary ,medicine.diagnostic_test ,biology ,business.industry ,Surrogate endpoint ,lcsh:R ,Sputum ,Retrospective cohort study ,medicine.disease ,biology.organism_classification ,Surgery ,Infectious Diseases ,lcsh:Q ,medicine.symptom ,business ,Research Article ,Cohort study - Abstract
Introduction: The culture-negative conversion rate of sputum after 2 months of treatment in patients with pulmonary tuberculosis (TB) is used as a reliable surrogate marker for relapse after completion of treatment. We hypothesized that culture conversion of sputum at 2 months of anti-TB treatment and the time to culture conversion are different among pulmonary TB patients who are diagnosed using different methods. Methods: Culture-confirmed pulmonary TB patients who were diagnosed between 1 January, 2011 and 31 December, 2012 were classified into three groups based on the diagnostic method that prompted treatment initiation: positive acid-fast bacilli (AFB) staining of sputum (smear-positive group), negative AFB staining, but Mycobacterium tuberculosis was cultured from sputum (culture-positive group), and positive AFB staining, positive polymerase chain reaction (PCR) for M. tuberculosis, or culture of M. tuberculosis from a bronchoscopic specimen (bronchoscopy group). Rates of negative mycobacterial culture conversion at 2 months of anti-TB treatment and the time to negative culture conversion of sputum were compared among the three groups. Results: A total of 203 patients with culture-confirmed pulmonary TB were included in the final analysis. TB patients in the culture-positive group (94.1%) and the bronchoscopy group (97.6%) showed a higher culture conversion rate at 2 months of treatment than those in the smear-positive group (78.7%, P = 0.001). Additionally, the time to culture conversion was longer in the smear-positive group (median, 40 days) than in the culture-positive (median, 19 days; P = 0.009) and bronchoscopy groups (median, 29 days; P = 0.004). Conclusions: The higher culture conversion rate at 2 months and the shorter time to culture conversion among pulmonary TB patients with a negative AFB smear suggests the feasibility of shortening treatment duration and isolation in these patients.
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- 2014
7. The Association of EGFR Mutations with Stage at Diagnosis in Lung Adenocarcinomas
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Jae-Joon Yim, Sung Koo Han, Chang Hoon Lee, Jinwoo Lee, Sang Min Lee, Sun Mi Choi, Jaeyoung Cho, Chul Gyu Yoo, Doo Hyun Chung, Young Whan Kim, and Young Sik Park
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Male ,0301 basic medicine ,Oncology ,Lung Neoplasms ,Biopsy ,Mutagenesis and Gene Deletion Techniques ,DNA Mutational Analysis ,Gene Identification and Analysis ,lcsh:Medicine ,Lung and Intrathoracic Tumors ,0302 clinical medicine ,Mutation Rate ,Positron Emission Tomography Computed Tomography ,Adenocarcinomas ,Odds Ratio ,Medicine and Health Sciences ,Epidermal growth factor receptor ,Stage (cooking) ,lcsh:Science ,Multidisciplinary ,Adenocarcinoma of the Lung ,biology ,Middle Aged ,ErbB Receptors ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Female ,Stage at diagnosis ,Research Article ,medicine.medical_specialty ,Adenocarcinoma of Lung ,Adenocarcinoma ,Research and Analysis Methods ,Carcinomas ,03 medical and health sciences ,Diagnostic Medicine ,Internal medicine ,Genetics ,Cancer Detection and Diagnosis ,medicine ,Adenocarcinoma of the lung ,Humans ,Point Mutation ,Molecular Biology Techniques ,Molecular Biology ,Mutation Detection ,Aged ,Neoplasm Staging ,Retrospective Studies ,Lung ,business.industry ,Point mutation ,lcsh:R ,Cancers and Neoplasms ,Biology and Life Sciences ,Odds ratio ,medicine.disease ,Confidence interval ,Non-Small Cell Lung Cancer ,Mutational Analysis ,030104 developmental biology ,Mutation ,biology.protein ,lcsh:Q ,business - Abstract
Background The prognostic role of epidermal growth factor receptor (EGFR) mutations in patients with lung adenocarcinomas remains controversial and the association between EGFR mutations and stage at the time of the initial diagnosis is debatable. In this study, we evaluated the association of EGFR mutations with stage at diagnosis in lung adenocarcinomas. Materials and Methods We retrospectively analyzed 1004 consecutive patients who were diagnosed with lung adenocarcinomas and tested for EGFR mutations between June 2011 and December 2014. Results EGFR mutations were detected in 49.2% of 1004 patients with lung adenocarcinomas. In multivariable analysis, EGFR mutations were significantly associated with early stage disease (stage I to II) at diagnosis (odds ratio [OR], 0.65; 95% confidence interval [CI], 0.49–0.87; P = 0.003). When adjusted for age, sex, smoking status, and screening, the adjusted proportion of EGFR mutations significantly decreased according to stage. The adjusted proportions of EGFR mutations were 57.6% (95% CI, 51.7%–63.3%) for stage I, 47.9% (95% CI, 36.9%–59.0%) for stage II, 47.5% (95% CI, 39.6%–55.5%) for stage III, and 43.4% (95% CI, 38.3%–48.6%) for stage IV (P = 0.0082). Conclusions The presence of EGFR mutations is significantly associated with early stage disease at initial diagnosis in lung adenocarcinomas after adjusting for age, sex, smoking status, and screening. This finding implies that EGFR mutations may play a role as a positive prognostic marker.
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- 2016
8. Diagnostic accuracy and turnaround time of the Xpert MTB/RIF assay in routine clinical practice
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Young Whan Kim, Sung Koo Han, Chul-Gyu Yoo, Nakwon Kwak, Jinwoo Lee, Chang Hoon Lee, Young Sik Park, Sun Mi Choi, Jae-Joon Yim, and Sang Min Lee
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Male ,medicine.medical_specialty ,Tuberculosis ,Time Factors ,Antitubercular Agents ,lcsh:Medicine ,Diagnostic accuracy ,Sensitivity and Specificity ,Mycobacterium tuberculosis ,Pulmonary tuberculosis ,Internal medicine ,Republic of Korea ,Tuberculosis, Multidrug-Resistant ,medicine ,polycyclic compounds ,Humans ,In patient ,Routine clinical practice ,lcsh:Science ,Tuberculosis, Pulmonary ,Aged ,Multidisciplinary ,biology ,business.industry ,Multi-drug-resistant tuberculosis ,lcsh:R ,Sputum ,Reproducibility of Results ,Middle Aged ,biochemical phenomena, metabolism, and nutrition ,medicine.disease ,biology.organism_classification ,bacterial infections and mycoses ,Virology ,Biological Assay ,Female ,lcsh:Q ,Reagent Kits, Diagnostic ,medicine.symptom ,Rifampin ,business ,Research Article - Abstract
The Xpert MTB/RIF assay was introduced for timely and accurate detection of tuberculosis (TB). The aim of this study was to determine the diagnostic accuracy and turnaround time (TAT) of Xpert MTB/RIF assay in clinical practice in South Korea. We retrospectively reviewed the medical records of patients in whom Xpert MTB/RIF assay using sputum were requested. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the diagnosis of pulmonary tuberculosis (PTB) and detection of rifampicin resistance were calculated. In addition, TAT of Xpert MTB/RIF assay was compared with those of other tests. Total 681 patients in whom Xpert MTB/RIF assay was requested were included in the analysis. The sensitivity, specificity, PPV and NPV of Xpert MTB/RIF assay for diagnosis of PTB were 79.5% (124/156), 100.0% (505/505), 100.0% (124/124) and 94.0% (505/537), respectively. Those for the detection of rifampicin resistance were 57.1% (8/14), 100.0% (113/113), 100.0% (8/8) and 94.9% (113/119), respectively. The median TAT of Xpert MTB/RIF assay to the report of results and results confirmed by physicians in outpatient settings were 0 (0–1) and 6 (3–7) days, respectively. Median time to treatment after initial evaluation was 7 (4–9) days in patients with Xpert MTB/RIF assay, but was 21 (7–33.5) days in patients without Xpert MTB/RIF assay. Xpert MTB/RIF assay showed acceptable sensitivity and excellent specificity for the diagnosis of PTB and detection of rifampicin resistance in areas with intermediate TB burden. Additionally, the assay decreased time to the initiation of anti-TB drugs through shorter TAT.
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- 2013
9. Acupuncture for the treatment of dry eye: a multicenter randomised controlled trial with active comparison intervention (artificial teardrops)
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Kwon Eui Hong, So-Young Jung, Mi-Suk Shin, Tae-Hun Kim, Ae-Ran Kim, Sun-Mi Choi, Kyung-Won Kang, Jung Won Kang, Hee-Jung Jung, Seung-Deok Lee, Kun Hyung Kim, and Jin-Bong Choi
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medicine.medical_specialty ,Visual analogue scale ,Clinical Research Design ,medicine.medical_treatment ,Dry Eye Syndromes ,lcsh:Medicine ,law.invention ,Randomized controlled trial ,Quality of life ,Complementary and Alternative Medicine ,law ,Outcome Assessment, Health Care ,Acupuncture ,medicine ,Humans ,Ocular Surface Disease Index ,Clinical Trials ,Adverse effect ,lcsh:Science ,Multidisciplinary ,business.industry ,lcsh:R ,eye diseases ,Artificial tears ,Ophthalmology ,Physical therapy ,Corneal Disorders ,Medicine ,lcsh:Q ,Ophthalmic Solutions ,business ,Research Article - Abstract
Purpose To evaluate the effects of acupuncture compared to a control group using artificial tears. Methods Setting & design: multicenter randomised controlled trial (three local research hospitals of South Korea). Study Population: 150 patients with moderate to severe dry eye. Intervention: Participants were randomly allocated into four weeks of acupuncture treatment (bilateral BL2, GB14, TE 23, Ex1, ST1, GB20, LI4, LI11 and single GV23) or to the artificial tears group (sodium carboxymethylcellulose). Main Outcome Measure(s): The ocular surface disease index (OSDI), tear film break-up time (TFBUT), Schirmer Ι test, visual analogue scale (VAS) for self-assessment of ocular discomfort, general assessment (by both acupuncture practitioners and participants) and quality of life (QOL) through the Measure Yourself Medical Outcome Profile-2 (MYMOP-2). Results There was no statistically significant difference between two groups for the improvement of dry eye symptoms as measured by OSDI (MD −16.11, 95% CI [−20.91, −11.32] with acupuncture and −15.37, 95% CI [−19.57, −11.16] with artificial tears; P = 0.419), VAS (acupuncture: −23.84 [−29.59, −18.09]; artificial tears: −22.2 [−27.24, −17.16], P = 0.530) or quality of life (acupuncture: −1.32 [−1.65, −0.99]; artificial tears: −0.96 [−1.32, −0.6], P = 0.42) immediately after treatment. However, compared with artificial tears group, the OSDI (acupuncture: −16.15 [−21.38, −10.92]; artificial tears: −10.76 [−15.25, −6.27], P = 0.030) and VAS (acupuncture: −23.88 [−30.9, −16.86]; artificial tears: −14.71 [−20.86, −8.55], P = 0.018) were significantly improved in the acupuncture group at 8 weeks after the end of acupuncture treatment. TFBUT measurements increased significantly in the acupuncture group after treatment. Conclusions Acupuncture may have benefits on the mid-term outcomes related to dry eye syndrome compared with artificial tears. Trial registration ClinicalTrials.gov NCT01105221.
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- 2012
10. Prevalence and Global Initiative for Chronic Obstructive Lung Disease Group Distribution of Chronic Obstructive Pulmonary Disease Detected by Preoperative Pulmonary Function Test
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Sang Min Lee, Chang Hoon Lee, Sun Mi Choi, Jae-Joon Yim, Sung Koo Han, Chul-Gyu Yoo, Young Whan Kim, Jinwoo Lee, and Young Sik Park
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Adult ,Male ,Spirometry ,Vital capacity ,Chronic bronchitis ,medicine.medical_specialty ,Exacerbation ,lcsh:Medicine ,Pulmonary function testing ,Pulmonary Disease, Chronic Obstructive ,Internal medicine ,Preoperative Care ,Prevalence ,medicine ,Humans ,lcsh:Science ,Aged ,Asthma ,Aged, 80 and over ,COPD ,Multidisciplinary ,medicine.diagnostic_test ,business.industry ,lcsh:R ,Middle Aged ,medicine.disease ,Obstructive lung disease ,respiratory tract diseases ,Physical therapy ,lcsh:Q ,Female ,business ,Research Article - Abstract
Background Despite being a major public health problem, chronic obstructive pulmonary disease (COPD) remains underdiagnosed, and only 2.4% COPD patients are aware of their disease in Korea. The objective of this study was to estimate the prevalence of COPD detected by spirometry performed as a preoperative screening test and to determine the Global Initiative for Chronic Obstructive Lung Disease (GOLD) group distribution and self-awareness of COPD. Methods We reviewed the medical records of adults (age, ≥40 years) who had undergone spirometry during preoperative screening between April and August 2013 at a tertiary hospital in Korea. COPD was defined as a postbronchodilator forced expiratory volume in 1 s/forced vital capacity ratio of 40 years who had undergone spirometry as a preoperative screening test, 474 (15.6%; 404 men; median age, 70 years; range, 44–93 years) were diagnosed with COPD. Only 26 (5.5%) patients reported previous diagnosis of COPD (2.1%), emphysema (0.8%), or chronic bronchitis (2.5%). The GOLD group distribution was as follows: 63.3% in group A, 31.2% in group B, 1.7% in group C, and 3.8% in group D. Conclusions The prevalence of COPD diagnosed by preoperative spirometry was 15.6%, and only 5.5% patients were aware of their disease. Approximately one-third of the COPD patients belonged to GOLD groups B, C, and D, which require regular treatment.
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- 2015
11. Impact of staffing model conversion from a mandatory critical care consultation model to a closed unit model in the medical intensive care unit
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Sung Jun Ko, Jaeyoung Cho, Sun Mi Choi, Young Sik Park, Chang-Hoon Lee, Chul-Gyu Yoo, Jinwoo Lee, and Sang-Min Lee
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Medicine ,Science - Abstract
Background The intensive care unit (ICU) staffing model affects clinical outcomes of critically ill patients. However, the benefits of a closed unit model have not been extensively compared to those of a mandatory critical care consultation model. Methods This retrospective before-after study included patients admitted to the medical ICU. Anthropometric data, admission reason, Acute Physiology and Chronic Health Evaluation II score, Eastern Cooperative Oncology Group grade, survival status, length of stay (LOS) in the ICU, duration of mechanical ventilator care, and occurrence of ventilator-associated pneumonia (VAP) were recorded. The staffing model of the medical ICU was changed from a mandatory critical care consultation model to a closed unit model in September 2017, and indices before and after the conversion were compared. Results A total of 1,526 patients were included in the analysis. The mean age was 64.5 years, and 954 (62.5%) patients were men. The mean LOS in the ICU among survivors was shorter in the closed unit model than in the mandatory critical care consultation model by multiple regression analysis (5.5 vs. 6.7 days; p = 0.005). Central venous catheter insertion (38.5% vs. 51.9%; p < 0.001) and VAP (3.5% vs. 8.6%; p < 0.001) were less frequent in the closed unit model group than in the mandatory critical care consultation model group. After adjusting for confounders, the closed unit model group had decreased ICU mortality (adjusted odds ratio 0.65; p < 0.001) and shortened LOS in the ICU compared to the mandatory critical care consultation model group. Conclusion The closed unit model was superior to the mandatory critical care consultation model in terms of ICU mortality and LOS among ICU survivors.
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- 2021
12. Respiratory virus of severe pneumonia in South Korea: Prevalence and clinical implications.
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Hyung-Jun Kim, Sun Mi Choi, Jinwoo Lee, Young Sik Park, Chang-Hoon Lee, Jae-Joon Yim, Chul-Gyu Yoo, Young Whan Kim, Sung Koo Han, and Sang-Min Lee
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Medicine ,Science - Abstract
BACKGROUND:Severe viral pneumonia is associated with a high mortality rate. However, due to the vulnerability of critically ill patients, invasive diagnostic methods should be performed with caution in the intensive care unit (ICU). It would be helpful if the prevalence, risk factors, and clinical impact of virus detection are elucidated. METHODS:We evaluated patients with severe pneumonia between January 1st 2008 and December 31st 2015. Reverse transcription-polymerase chain reaction (RT-PCR) analysis was performed for 8 respiratory viruses when viral pathogen could not be excluded as the origin of severe pneumonia. The baseline characteristics, laboratory results, microbiological findings, and clinical outcomes of the patients were analyzed. RESULTS:Of the 2,347 patients admitted to the medical ICU, 515 underwent RT-PCR for respiratory viruses, 69 of whom had positive results. The detection rate was higher during the winter, with a community onset, in patients with history of recent chemotherapy, and low platelet count. Additional bronchoscopic sampling along with upper respiratory specimen increased the yield of viral detection. Respiratory syncytial virus was the most common pathogen detected, while influenza A was the most common virus with bacterial coinfection. Respiratory virus detection led to changes in clinical management in one-third of the patients. CONCLUSIONS:The detection of viral pathogens in patients with severe pneumonia is not rare, and can be more common in certain group of patients. Invasive sampling for RT-PCR can be helpful, and such detection can lead to positive changes in clinical management.
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- 2018
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13. Clinical impact of depression and anxiety in patients with idiopathic pulmonary fibrosis.
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Ye Jin Lee, Sun Mi Choi, Yeon Joo Lee, Young-Jae Cho, Ho Il Yoon, Jae-Ho Lee, Choon-Taek Lee, and Jong Sun Park
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Medicine ,Science - Abstract
Although depression and anxiety represent significant yet treatable comorbidities in patients with idiopathic pulmonary fibrosis (IPF), their impact on the clinical course and prognosis of IPF remain unclear.We investigated the prevalence and clinical significance of depression and anxiety in patients with IPF.The present study included a prospective cohort comprising 112 Korean patients with IPF who had completed the Hospital Anxiety and Depression Scale (HADS) questionnaire.Symptoms of depression and anxiety were present in 25.9% and 21.4% of patients with IPF, respectively (HADS scores ≥8). No significant differences in demographic data, age, sex, smoking status, Modified Medical Research Council Dyspnea Scale (MMRC) scores, pulmonary function tests, or Gender-Age-Physiology Index for IPF were observed between patients with depression or anxiety and those without. However, in patients with anxiety, St. George's Respiratory Questionnaire (SGRQ) scores were significantly higher than those of patients without anxiety (40.5 versus 23.5; p = 0.003). The survival rate and total number of hospital admissions did not significantly differ between patients with depression/anxiety and those without.Our findings indicate that depression and anxiety are relatively common in patients with IPF. Although no significant differences were noted with regard to survival rate and hospitalization, the present study suggests that depression and anxiety significantly influence quality of life in patients with IPF.
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- 2017
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14. The Association of EGFR Mutations with Stage at Diagnosis in Lung Adenocarcinomas.
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Jaeyoung Cho, Sun Mi Choi, Jinwoo Lee, Chang-Hoon Lee, Sang-Min Lee, Jae-Joon Yim, Doo Hyun Chung, Chul-Gyu Yoo, Young Whan Kim, Sung Koo Han, and Young Sik Park
- Subjects
Medicine ,Science - Abstract
BACKGROUND:The prognostic role of epidermal growth factor receptor (EGFR) mutations in patients with lung adenocarcinomas remains controversial and the association between EGFR mutations and stage at the time of the initial diagnosis is debatable. In this study, we evaluated the association of EGFR mutations with stage at diagnosis in lung adenocarcinomas. MATERIALS AND METHODS:We retrospectively analyzed 1004 consecutive patients who were diagnosed with lung adenocarcinomas and tested for EGFR mutations between June 2011 and December 2014. RESULTS:EGFR mutations were detected in 49.2% of 1004 patients with lung adenocarcinomas. In multivariable analysis, EGFR mutations were significantly associated with early stage disease (stage I to II) at diagnosis (odds ratio [OR], 0.65; 95% confidence interval [CI], 0.49-0.87; P = 0.003). When adjusted for age, sex, smoking status, and screening, the adjusted proportion of EGFR mutations significantly decreased according to stage. The adjusted proportions of EGFR mutations were 57.6% (95% CI, 51.7%-63.3%) for stage I, 47.9% (95% CI, 36.9%-59.0%) for stage II, 47.5% (95% CI, 39.6%-55.5%) for stage III, and 43.4% (95% CI, 38.3%-48.6%) for stage IV (P = 0.0082). CONCLUSIONS:The presence of EGFR mutations is significantly associated with early stage disease at initial diagnosis in lung adenocarcinomas after adjusting for age, sex, smoking status, and screening. This finding implies that EGFR mutations may play a role as a positive prognostic marker.
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- 2016
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15. Prevalence and global initiative for chronic obstructive lung disease group distribution of chronic obstructive pulmonary disease detected by preoperative pulmonary function test.
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Sun Mi Choi, Jinwoo Lee, Young Sik Park, Chang-Hoon Lee, Sang-Min Lee, Jae-Joon Yim, Young Whan Kim, Sung Koo Han, and Chul-Gyu Yoo
- Subjects
Medicine ,Science - Abstract
Despite being a major public health problem, chronic obstructive pulmonary disease (COPD) remains underdiagnosed, and only 2.4% COPD patients are aware of their disease in Korea. The objective of this study was to estimate the prevalence of COPD detected by spirometry performed as a preoperative screening test and to determine the Global Initiative for Chronic Obstructive Lung Disease (GOLD) group distribution and self-awareness of COPD.We reviewed the medical records of adults (age, ≥ 40 years) who had undergone spirometry during preoperative screening between April and August 2013 at a tertiary hospital in Korea. COPD was defined as a postbronchodilator forced expiratory volume in 1 s/forced vital capacity ratio of 40 years who had undergone spirometry as a preoperative screening test, 474 (15.6%; 404 men; median age, 70 years; range, 44-93 years) were diagnosed with COPD. Only 26 (5.5%) patients reported previous diagnosis of COPD (2.1%), emphysema (0.8%), or chronic bronchitis (2.5%). The GOLD group distribution was as follows: 63.3% in group A, 31.2% in group B, 1.7% in group C, and 3.8% in group D.The prevalence of COPD diagnosed by preoperative spirometry was 15.6%, and only 5.5% patients were aware of their disease. Approximately one-third of the COPD patients belonged to GOLD groups B, C, and D, which require regular treatment.
- Published
- 2015
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16. Diagnostic accuracy and turnaround time of the Xpert MTB/RIF assay in routine clinical practice.
- Author
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Nakwon Kwak, Sun Mi Choi, Jinwoo Lee, Young Sik Park, Chang-Hoon Lee, Sang-Min Lee, Chul-Gyu Yoo, Young Whan Kim, Sung Koo Han, and Jae-Joon Yim
- Subjects
Medicine ,Science - Abstract
The Xpert MTB/RIF assay was introduced for timely and accurate detection of tuberculosis (TB). The aim of this study was to determine the diagnostic accuracy and turnaround time (TAT) of Xpert MTB/RIF assay in clinical practice in South Korea. We retrospectively reviewed the medical records of patients in whom Xpert MTB/RIF assay using sputum were requested. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the diagnosis of pulmonary tuberculosis (PTB) and detection of rifampicin resistance were calculated. In addition, TAT of Xpert MTB/RIF assay was compared with those of other tests. Total 681 patients in whom Xpert MTB/RIF assay was requested were included in the analysis. The sensitivity, specificity, PPV and NPV of Xpert MTB/RIF assay for diagnosis of PTB were 79.5% (124/156), 100.0% (505/505), 100.0% (124/124) and 94.0% (505/537), respectively. Those for the detection of rifampicin resistance were 57.1% (8/14), 100.0% (113/113), 100.0% (8/8) and 94.9% (113/119), respectively. The median TAT of Xpert MTB/RIF assay to the report of results and results confirmed by physicians in outpatient settings were 0 (0-1) and 6 (3-7) days, respectively. Median time to treatment after initial evaluation was 7 (4-9) days in patients with Xpert MTB/RIF assay, but was 21 (7-33.5) days in patients without Xpert MTB/RIF assay. Xpert MTB/RIF assay showed acceptable sensitivity and excellent specificity for the diagnosis of PTB and detection of rifampicin resistance in areas with intermediate TB burden. Additionally, the assay decreased time to the initiation of anti-TB drugs through shorter TAT.
- Published
- 2013
- Full Text
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