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Articles by D. H Lee
Total Records ( 7 ) for D. H Lee
  J. H Kim , J. H Shin , H. Y Song , J. Y Ohm , J. M Lee , D. H Lee and S. W. Kim
 

OBJECTIVE. The purpose of our study was to evaluate the clinical results of temporary stenting followed by radiation and/or chemotherapy in patients with inoperable malignant tracheobronchial strictures.

CONCLUSION. Temporary stenting combined with radiation therapy and/or chemotherapy may be clinically effective in the palliative treatment of patients with malignant tracheobronchial strictures. Stent placement may serve as an effective bridge to radiation and/or chemotherapy, allowing the latter to consolidate durable relief of obstructing symptoms by reducing tumor burden. Furthermore, our treatment strategy may increase patients' quality of life by reducing stent-related complications.

  S. C Park , D. H Lee , H. J Lee and C. Kee
 

Objective  To identify risk factors for normal-tension glaucoma among subgroups of patients.

Methods  In 93 patients with unilateral normal-tension glaucoma, intereye comparison of baseline spherical equivalent, central corneal thickness, untreated intraocular pressure, disc area, and zone β variables was performed among the following 4 subgroups classified according to age and visual field pattern standard deviation of the eye with glaucoma: subgroup 1 (age ≤50 years and visual field pattern standard deviation ≤8 dB), subgroup 2 (≤50 years and >8 dB), subgroup 3 (>50 years and ≤8 dB), and subgroup 4 (>50 years and >8 dB).

Results  Fourteen, 27, 30, and 22 patients were included in subgroups 1, 2, 3, and 4, respectively. The untreated intraocular pressure in subgroup 1 (P = .005), the zone β variables in subgroup 2 (P < .001), and both the untreated intraocular pressure (P = .010 and P = .034, respectively) and the zone β variables (P ≤ .008 and P ≤ .006, respectively) in subgroups 3 and 4 were significantly greater in the eyes with glaucoma than in the normal contralateral eyes (by paired t test or Wilcoxon signed rank test). The other variables showed no significant difference between the eyes in any subgroup.

Conclusion  The zone β variables (and not the untreated intraocular pressure) may represent significant risk factors in young patients having normal-tension glaucoma with moderate to severe visual field loss.

  D. H Lee and I. C. Kwon
  Background

The use of low concentrations of volatile anaesthetics with avoidance of opioids may induce intraoperative awareness and adverse haemodynamic responses during Caesarean section. Magnesium is well known to reduce anaesthetic requirements and to block noxious stimuli. We investigated whether i.v. magnesium sulphate modulates anaesthetic depth and analgesic efficacy during Caesarean section.

Methods

Seventy-two patients undergoing Caesarean section were randomly assigned to receive i.v. saline (control group) or magnesium sulphate 30 mg kg–1 bolus+10 mg kg–1 h–1 continuous infusion (Mg 30 group) or 45 mg kg–1 bolus+15 mg kg–1 h–1 continuous infusion (Mg 45 group) after induction. Bispectral index (BIS) value, mean arterial pressure (MAP), and midazolam, fentanyl, and atracurium consumptions were recorded.

Results

BIS values [mean (sd)] at 7.5 and 10 min after surgery and before delivery in the control [64 (9), 66 (8), 67 (8), P<0.001] and the Mg 30 groups [62 (8), P<0.01; 64 (7), 63 (9), P<0.001] were higher than in the Mg 45 group [56 (8), 55 (8), 55 (7)]. MAP was greater in the control group (P<0.05) than in the Mg 30 and Mg 45 groups during the pre-delivery period. The magnesium groups required less midazolam (P<0.05), fentanyl (Mg 30, P<0.05; Mg 45, P<0.01), and atracurium (P<0.001) vs the control group.

Conclusions

Preoperative i.v. magnesium sulphate attenuated BIS and arterial pressure increases during the pre-delivery period. Magnesium sulphate can be recommended as an adjuvant during general anaesthesia for Caesarean section to avoid perioperative awareness and pressor response resulting from inadequate anaesthesia, analgesia, or both.

  R. A Linker , D. H Lee , S Demir , S Wiese , N Kruse , I Siglienti , E Gerhardt , H Neumann , M Sendtner , F Luhder and R. Gold
 

Brain-derived neurotrophic factor plays a key role in neuronal and axonal survival. Brain-derived neurotrophic factor is expressed in the immune cells in lesions of experimental autoimmune encephalomyelitis and multiple sclerosis, thus potentially mediating neuroprotective effects. We investigated the functional role of brain-derived neurotrophic factor in myelin oligodendrocyte glycoprotein-induced experimental autoimmune encephalomyelitis, an animal model of multiple sclerosis. Mice deficient for brain-derived neurotrophic factor in immune cells displayed an attenuated immune response in the acute phase of experimental autoimmune encephalomyelitis, but progressive disability with enhanced axonal loss in the chronic phase of the disease. In mice deficient for central nervous system-derived brain-derived neurotrophic factor via glial fibrillary acidic protein-crescentin-mediated deletion, a more severe course of experimental autoimmune encephalomyelitis and an overall increased axonal loss was observed. In a lentiviral approach, injection of brain-derived neurotrophic factor-overexpressing T cells led to a less severe course of experimental autoimmune encephalomyelitis and direct axonal protection. Our data imply a functional role of brain-derived neurotrophic factor in autoimmune demyelination by mediating axon protection.

  H Wang , A Zhao , L Chen , X Zhong , J Liao , M Gao , M Cai , D. H Lee , J Li , D Chowdhury , Y. g Yang , G. P Pfeifer , Y Yen and X. Xu
 

Human Rap1-interacting protein 1 (RIF1) contributes to the ataxia telangiectasia, mutated-mediated DNA damage response against the dexterous effect of DNA lesions and plays a critical role in the S-phase checkpoint. However, the molecular mechanisms by which human RIF1 conquers DNA aberrations remain largely unknown. We here showed that inhibition of RIF1 expression by small interfering RNA led to defective homologous recombination-mediated DNA double-strand break repair and sensitized cancer cells to camptothecin or staurosporine treatment. RIF1 underwent caspase-dependent cleavage upon apoptosis. We further found that RIF1 was highly expressed in human breast tumors, and its expression status was positively correlated with differentiation degrees of invasive ductal carcinoma of the breast. Our results suggest that RIF1 encodes an anti-apoptotic factor required for DNA repair and is a potential target for cancer treatment.

  D. H Lee , K. J Buth , B. J Martin , A. M Yip and G. M. Hirsch
 

Background— Frailty is an emerging concept in medicine yet to be explored as a risk factor in cardiac surgery. Where elderly patients are increasingly referred for cardiac surgery, the prevalence of a frail group among these is also on the rise. We assessed frailty as a risk factor for adverse outcomes after cardiac surgery.

Methods and Results— Functional measures of frailty and clinical data were collected prospectively for all cardiac surgery patients at a single center. Frailty was defined as any impairment in activities of daily living (Katz index), ambulation, or a documented history of dementia. Of 3826 patients, 157 (4.1%) were frail. Frail patients were older, were more likely to be female, and had risk factors for adverse surgical outcomes. By logistic regression, frailty was an independent predictor of in-hospital mortality (odds ratio 1.8, 95% CI 1.1 to 3.0), as well as institutional discharge (odds ratio 6.3, 95% CI 4.2 to 9.4). Frailty was an independent predictor of reduced midterm survival (hazard ratio 1.5, 95% CI 1.1 to 2.2).

Conclusions— Frailty is a risk for postoperative complications and an independent predictor of in-hospital mortality, institutional discharge, and reduced midterm survival. Frailty screening improves risk assessment in cardiac surgery patients and may identify a subgroup of patients who may benefit from innovative processes of care.

  C Yoo , J. E Kim , J. L Lee , J. H Ahn , D. H Lee , J. S Lee , S Na , C. S Kim , J. H Hong , B Hong , C Song and H. Ahn
  Objective

The effects of sunitinib in a broad patient population, especially those of Asian ethnicity, have been rarely investigated. Here, we assessed the efficacy and safety of sunitinib in Korean patients with advanced renal cell carcinoma.

Methods

Between April 2006 and August 2008, 77 Korean patients with advanced renal cell carcinoma were treated with sunitinib. We performed retrospective analysis for efficacy in terms of survival outcomes and response rate. Toxicity profiles were also assessed.

Results

A total of 65 patients, including 39 (60%) patients without previous cytotoxic or immunotherapy, were eligible for the analysis. In 53 patients with measurable lesions, the objective response rate was 43% and disease control was achieved in 46 (86%) patients. The median time to treatment failure, time to progression and overall survival were 7.0, 11.8 and 22.8 months, respectively, with a median follow-up of 26.8 months in surviving patients. The most common treatment-related adverse events were fatigue (81%) and stomatitis (60%). The most common Grade 3 or 4 adverse events were hand–foot syndrome (16%), thrombocytopenia (16%) and stomatitis (10%). Dose reduction was required in 46% of patients.

Conclusions

The efficacy was similar to a previous Phase III trial and a safety profile of sunitinib was manageable in Korean patients with advanced renal cell carcinoma, although the incidence of dose reduction and Grade 3 or 4 adverse events were higher than those of western reports. Future studies should investigate the ethnic differences in toxicity profiles of sunitinib.

 
 
 
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