Sei Lee - Academia.edu (original) (raw)
Papers by Sei Lee
European Respiratory Journal, 2019
Gene-based diagnosis of tuberculosis with a new-generation pathogen enrichment technique To the E... more Gene-based diagnosis of tuberculosis with a new-generation pathogen enrichment technique To the Editors: While the Xpert MTB/RIF assay (Cepheid Sunnyvale, CA, USA) has greater than 95% sensitivity for identifying acid-fast bacilli (AFB) smear-positive tuberculosis (TB) cases, for smear-negative pulmonary tuberculosis (PTB) the sensitivity was as low as 60% [1, 2]. To address the low sensitivity of current TB diagnostics for AFB smear-negative cases, we developed a simple and label-free pathogen enrichment using homobifunctional imidoesters (HIs) using a microfluidic (SLIM) platform followed by conventional Mycobacterium tuberculosis PCR to extract low amounts of pathogens from clinical samples [3]. In this study, we compared the diagnostic performance of the SLIM assay with the Xpert MTB/RIF for PTB diagnosis in a country with an intermediate TB burden and a low human immunodeficiency virus burden. The SLIM assay was performed by using 1 mL and 2 mL aliquots of sputum, respectively. Adult patients for whom sputum TB test was indicated to confirm presumptive active TB were enrolled prospectively over 13 months at two tertiary referral hospitals. TB diagnosis was confirmed independently by three respiratory infection specialists experienced in TB diagnosis and treatment. The institutional review boards of two hospitals evaluated and approved the medical, scientific and ethical aspects of our study protocol (institutional review boards 2018-0020 and 4-2018-0029), and informed consent was obtained from all participants. Mycobacterial cultures were grown in liquid and solid culture media, and M. tuberculosis complex was identified with a duplex PCR using Advansure TB/NTM real-time PCR (LG Chemistry, Seoul, South Korea). Culture-positive TB cases were patients with at least one positive M. tuberculosis culture. Culture-positive patients were considered smear-positive with at least one positive smear (including faintly positive smears). Culture-negative TB cases were patients with a high probability of clinically active TB with negative mycobacterial culture findings after two or more sputum examinations, showing good clinical and radiographic responses to anti-TB treatment during follow-up. The specialists choosing TB treatment were blinded to SLIM assay results. SLIM assay principles and detailed methods have been described previously [3, 4]. Briefly, a mixture of sputum sample and liquefaction solution with HIs reagent were added to the SLIM system to enrich M. tuberculosis and DNA extracted without the need for detergents or bulky instruments.
Annals of the American Thoracic Society, Jan 26, 2015
Two adipokines, leptin and adiponectin regulate metabolic and inflammatory systems reciprocally. ... more Two adipokines, leptin and adiponectin regulate metabolic and inflammatory systems reciprocally. The role of adiponectin in chronic obstructive pulmonary disease (COPD) has been studied. However, there are few data evaluating the relationship of plasma leptin with COPD severity or progression. The objective of this study is to evaluate the relationship of leptin, adiponectin, and leptin/adiponectin ratio with the COPD severity and progression according to COPD phenotypes. Plasma leptin and adiponectin levels were measured in 196 COPD subjects selected from the Korean Obstructive Lung Disease cohort. Using a linear regression model and mixed linear regression, we determined the relationship of plasma leptin and adiponectin levels and leptin/adiponectin ratio with COPD severity and progression over 3 years. The concentration of adiponectin in plasma positively correlated with percent (%) emphysema on initial computed tomography (CT) (adjusted P = 0.022), while plasma leptin concentrat...
Respiratory care, 2014
The traditional oxygen delivery methods for oxygen therapy are continuous flow oxygen (CFO) and d... more The traditional oxygen delivery methods for oxygen therapy are continuous flow oxygen (CFO) and demand oxygen delivery (DOD); however, oxygen waste is considerable in CFO, while DOD is uncomfortable for patients. Synchronized DOD (SDOD), which was designed to overcome the drawbacks of both CFO and DOD, supplies oxygen according to the patient's breathing pattern and the desired oxygen saving. This study was conducted to examine the overall performance of SDOD in terms of oxygen saturation (SpO2 ), patients' comfort, and oxygen saving ratio (SR). Study subjects were patients who required oxygen for COPD or pneumonia. Patients received oxygen through nasal prongs by CFO and SDOD for 30 min each. SpO2 was measured every 10 min by pulse oximetry, and subjects recorded their level of comfort after 30 min. The flow of discharged oxygen was recorded to calculate SR. Ten subjects (median age, 68 y; range, 56-86 y) were enrolled. The SpO2 of patients during SDOD (97 ± 2%) was similar...
Respiratory Medicine, 2014
Background: Although the efficacy of inhaled long-acting bronchodilators has been well documented... more Background: Although the efficacy of inhaled long-acting bronchodilators has been well documented in randomised controlled studies, whether similar effects are obtained in real-life clinical practice is not clear. In this study, we analysed the effect of inhaled long-acting bronchodilators in newly-diagnosed COPD patients.
PLoS ONE, 2014
Background: Epidemiologic data regarding tuberculin skin test (TST) responses are an important ba... more Background: Epidemiologic data regarding tuberculin skin test (TST) responses are an important basis for TB control strategies. This study analyzed TST responses in Korea, which experienced a rapid change in BCG vaccination status. Methods: TST responses in young adults were examined over 5 years. Participants with active TB lesions were excluded. Results: A total of 5,552 participants were enrolled with median age of 21 years. When an induration diameter 10mmwasusedasthecriterionforapositivetest,TSTpositivityfell(from28.010 mm was used as the criterion for a positive test, TST positivity fell (from 28.0% in 2005 to 15.3% in 2009); however, they remained steady when the criterion was 10mmwasusedasthecriterionforapositivetest,TSTpositivityfell(from28.015-20 mm. A positive TST was associated with a personal or family of TB, the presence of a Bacille Calmette-Guérin (BCG) scar, and age (odds ratio [95% confidence interval] = 4.03 [2.61-6.22], 2.91 [1.80-4.71], 1.50 [1.31-1.72], and 1.15 [1.09-1.20], respectively). Among these factors, the decrease of participants with BCG scars was the most prominent change, which appeared to be associated with the change of TST positivity rate. Conclusion: Overall, the rate of TST positivity in Korea decreased. However, this trend seems associated with the change of BCG vaccination strategy rather than successful control of LTBI. This study showed that change in BCG vaccination strategy can have great impact on TB epidemiologic survey based on TST.
Journal of Korean Medical Science, 2015
Journal of thoracic disease, 2015
Prone positioning for acute respiratory distress syndrome (ARDS) has no impact on mortality despi... more Prone positioning for acute respiratory distress syndrome (ARDS) has no impact on mortality despite significant improvements in oxygenation. However, a recent trial demonstrated reduced mortality rates in the prone position for severe ARDS. We evaluated effects of prone position duration and protective lung strategies on mortality rates in ARDS. We extensively searched MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials to identify randomized controlled trials (RCTs) reporting on prone positioning during acute respiratory failure in adults for inclusion in our meta-analysis. Eight trials met our inclusion criteria, Totals of 1,099 and 1,042 patients were randomized to the prone and supine ventilation positions. The mortality rates associated with the prone and supine positions were 41% and 47% [risk ratio (RR), 0.90; 95% confidence interval (CI), 0.82-0.98, P=0.02], but the heterogeneity was moderate (P=0.01, I(2)=61%). In a subgroup analysis, the mortality rates...
PLoS ONE, 2014
Background: Epidemiologic data regarding tuberculin skin test (TST) responses are an important ba... more Background: Epidemiologic data regarding tuberculin skin test (TST) responses are an important basis for TB control strategies. This study analyzed TST responses in Korea, which experienced a rapid change in BCG vaccination status.
European Respiratory Journal, 2019
Gene-based diagnosis of tuberculosis with a new-generation pathogen enrichment technique To the E... more Gene-based diagnosis of tuberculosis with a new-generation pathogen enrichment technique To the Editors: While the Xpert MTB/RIF assay (Cepheid Sunnyvale, CA, USA) has greater than 95% sensitivity for identifying acid-fast bacilli (AFB) smear-positive tuberculosis (TB) cases, for smear-negative pulmonary tuberculosis (PTB) the sensitivity was as low as 60% [1, 2]. To address the low sensitivity of current TB diagnostics for AFB smear-negative cases, we developed a simple and label-free pathogen enrichment using homobifunctional imidoesters (HIs) using a microfluidic (SLIM) platform followed by conventional Mycobacterium tuberculosis PCR to extract low amounts of pathogens from clinical samples [3]. In this study, we compared the diagnostic performance of the SLIM assay with the Xpert MTB/RIF for PTB diagnosis in a country with an intermediate TB burden and a low human immunodeficiency virus burden. The SLIM assay was performed by using 1 mL and 2 mL aliquots of sputum, respectively. Adult patients for whom sputum TB test was indicated to confirm presumptive active TB were enrolled prospectively over 13 months at two tertiary referral hospitals. TB diagnosis was confirmed independently by three respiratory infection specialists experienced in TB diagnosis and treatment. The institutional review boards of two hospitals evaluated and approved the medical, scientific and ethical aspects of our study protocol (institutional review boards 2018-0020 and 4-2018-0029), and informed consent was obtained from all participants. Mycobacterial cultures were grown in liquid and solid culture media, and M. tuberculosis complex was identified with a duplex PCR using Advansure TB/NTM real-time PCR (LG Chemistry, Seoul, South Korea). Culture-positive TB cases were patients with at least one positive M. tuberculosis culture. Culture-positive patients were considered smear-positive with at least one positive smear (including faintly positive smears). Culture-negative TB cases were patients with a high probability of clinically active TB with negative mycobacterial culture findings after two or more sputum examinations, showing good clinical and radiographic responses to anti-TB treatment during follow-up. The specialists choosing TB treatment were blinded to SLIM assay results. SLIM assay principles and detailed methods have been described previously [3, 4]. Briefly, a mixture of sputum sample and liquefaction solution with HIs reagent were added to the SLIM system to enrich M. tuberculosis and DNA extracted without the need for detergents or bulky instruments.
Annals of the American Thoracic Society, Jan 26, 2015
Two adipokines, leptin and adiponectin regulate metabolic and inflammatory systems reciprocally. ... more Two adipokines, leptin and adiponectin regulate metabolic and inflammatory systems reciprocally. The role of adiponectin in chronic obstructive pulmonary disease (COPD) has been studied. However, there are few data evaluating the relationship of plasma leptin with COPD severity or progression. The objective of this study is to evaluate the relationship of leptin, adiponectin, and leptin/adiponectin ratio with the COPD severity and progression according to COPD phenotypes. Plasma leptin and adiponectin levels were measured in 196 COPD subjects selected from the Korean Obstructive Lung Disease cohort. Using a linear regression model and mixed linear regression, we determined the relationship of plasma leptin and adiponectin levels and leptin/adiponectin ratio with COPD severity and progression over 3 years. The concentration of adiponectin in plasma positively correlated with percent (%) emphysema on initial computed tomography (CT) (adjusted P = 0.022), while plasma leptin concentrat...
Respiratory care, 2014
The traditional oxygen delivery methods for oxygen therapy are continuous flow oxygen (CFO) and d... more The traditional oxygen delivery methods for oxygen therapy are continuous flow oxygen (CFO) and demand oxygen delivery (DOD); however, oxygen waste is considerable in CFO, while DOD is uncomfortable for patients. Synchronized DOD (SDOD), which was designed to overcome the drawbacks of both CFO and DOD, supplies oxygen according to the patient's breathing pattern and the desired oxygen saving. This study was conducted to examine the overall performance of SDOD in terms of oxygen saturation (SpO2 ), patients' comfort, and oxygen saving ratio (SR). Study subjects were patients who required oxygen for COPD or pneumonia. Patients received oxygen through nasal prongs by CFO and SDOD for 30 min each. SpO2 was measured every 10 min by pulse oximetry, and subjects recorded their level of comfort after 30 min. The flow of discharged oxygen was recorded to calculate SR. Ten subjects (median age, 68 y; range, 56-86 y) were enrolled. The SpO2 of patients during SDOD (97 ± 2%) was similar...
Respiratory Medicine, 2014
Background: Although the efficacy of inhaled long-acting bronchodilators has been well documented... more Background: Although the efficacy of inhaled long-acting bronchodilators has been well documented in randomised controlled studies, whether similar effects are obtained in real-life clinical practice is not clear. In this study, we analysed the effect of inhaled long-acting bronchodilators in newly-diagnosed COPD patients.
PLoS ONE, 2014
Background: Epidemiologic data regarding tuberculin skin test (TST) responses are an important ba... more Background: Epidemiologic data regarding tuberculin skin test (TST) responses are an important basis for TB control strategies. This study analyzed TST responses in Korea, which experienced a rapid change in BCG vaccination status. Methods: TST responses in young adults were examined over 5 years. Participants with active TB lesions were excluded. Results: A total of 5,552 participants were enrolled with median age of 21 years. When an induration diameter 10mmwasusedasthecriterionforapositivetest,TSTpositivityfell(from28.010 mm was used as the criterion for a positive test, TST positivity fell (from 28.0% in 2005 to 15.3% in 2009); however, they remained steady when the criterion was 10mmwasusedasthecriterionforapositivetest,TSTpositivityfell(from28.015-20 mm. A positive TST was associated with a personal or family of TB, the presence of a Bacille Calmette-Guérin (BCG) scar, and age (odds ratio [95% confidence interval] = 4.03 [2.61-6.22], 2.91 [1.80-4.71], 1.50 [1.31-1.72], and 1.15 [1.09-1.20], respectively). Among these factors, the decrease of participants with BCG scars was the most prominent change, which appeared to be associated with the change of TST positivity rate. Conclusion: Overall, the rate of TST positivity in Korea decreased. However, this trend seems associated with the change of BCG vaccination strategy rather than successful control of LTBI. This study showed that change in BCG vaccination strategy can have great impact on TB epidemiologic survey based on TST.
Journal of Korean Medical Science, 2015
Journal of thoracic disease, 2015
Prone positioning for acute respiratory distress syndrome (ARDS) has no impact on mortality despi... more Prone positioning for acute respiratory distress syndrome (ARDS) has no impact on mortality despite significant improvements in oxygenation. However, a recent trial demonstrated reduced mortality rates in the prone position for severe ARDS. We evaluated effects of prone position duration and protective lung strategies on mortality rates in ARDS. We extensively searched MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials to identify randomized controlled trials (RCTs) reporting on prone positioning during acute respiratory failure in adults for inclusion in our meta-analysis. Eight trials met our inclusion criteria, Totals of 1,099 and 1,042 patients were randomized to the prone and supine ventilation positions. The mortality rates associated with the prone and supine positions were 41% and 47% [risk ratio (RR), 0.90; 95% confidence interval (CI), 0.82-0.98, P=0.02], but the heterogeneity was moderate (P=0.01, I(2)=61%). In a subgroup analysis, the mortality rates...
PLoS ONE, 2014
Background: Epidemiologic data regarding tuberculin skin test (TST) responses are an important ba... more Background: Epidemiologic data regarding tuberculin skin test (TST) responses are an important basis for TB control strategies. This study analyzed TST responses in Korea, which experienced a rapid change in BCG vaccination status.