Yi Hyeong Lee

Vascular endothelial growth factor in the serum of patients with non-small cell lung cancer: correlation with platelet and leukocyte counts.

BACKGROUND Vascular endothelial growth factor (VEGF) is a potent angiogenic peptide expressed in a wide variety of tumors, and it stimulates angiogenesis and increases vascular permeability. Increased expression of VEGF may be associated with advanced stage and poor prognosis in patients with non-small cell lung cancer (NSCLC). METHODS Using enzyme-linked immunosorbent assay, the levels of VEGF were determined in serum from 41 patients with untreated NSCLC (Stage: IIB, 3; IIIA, 6; IIIB, 17; IV, 15; HISTOLOGY squamous cell carcinoma, 18; adenocarcinoma. 14; undetermined, 9). RESULTS The median VEGF level was 312 pg/ml, ranging from 70 to 1440 pg/ml. Patients were divided into high VEGF (>312 pg/ml) and low VEGF (< or =312 pg/ml) groups using the median value as a cut-off. There were no significant associations between the serum VEGF levels and various clinicopathologic characteristics including age, gender, histologic type, stage and treatment. A significant positive correlation was found between serum VEGF levels and platelet counts (r=0.495; P=0.001). In addition, serum VEGF levels also correlated with leukocyte counts (r=0.478; P=0.002). In seven patients with measurement of follow-up serum VEGF levels at the end of treatment (chemotherapy and/or radiotherapy), the median serum VEGF level significantly decreased after the treatment (416 pg/ml; range, 96-812 pg/ml vs. 185 pg/ml; range, 49-487 pg/ml; P=0.028). However, the median platelet count (317,000/microl; range, 190,000-395,000/microl vs. 246,000/microl; range, 72,000-271,000/microl; P=0.028) and leukocyte count (10,000/microl; range, 8700-17,200/microl vs. 5100/microl; range, 3900-9500/microl; P=0.018) also decreased after the treatment. There was no statistically significant difference in the median survival of the patients between high VEGF group and low VEGF group (8 months vs. 9 months, P=0.647). CONCLUSIONS Although serum VEGF level was significantly associated with platelet and leukocyte counts in NSCLC patients, it did not correlate with tumor burden and prognosis of the patients.

The Imbalance between Coagulation and Fibrinolysis is Related to the Severity of the Illness and the Prognosis in Sepsis

Objectives The coagulation and fibrinolytic system appears to be activated by the septic process independently, leading to the syndrome of disseminated intravascular coagulation(DIC). In this study, we investigated the changes within the hemostatic system related to the severity of the illness and the prognosis in patients with sepsis. Methods Plasma thrombin-antithrombin III (TAT) and plasmin-α2-antiplasmin (PAP) complexes were measured using ELISA methods in 32 patients with sepsis and 20 controls and were analyzed according to the APACHE III scores and survival of the patients. Results Plasma TAT and PAP in patients with sepsis were significantly higher than controls. Nonsurvivors showed greater levels of TAT(21.7±22.3ng/mL) and lower levels of PAP(628.4±378.1ng/mL) than survivors (TAT: 11.1±11.2ng/mL; PAP: 857.1±364.1ng/mL). The imbalance between coagulation and fibrinolysis described as TAT/PAP ratio was closely related with APACHE III scores in patients with sepsis(r=0.47) and the TAT/PAP ratio in nonsurvivors was significantly higher compared with survivors(34.4±21.4 vs. 14.4±13.8). Conclusion In sepsis, both coagulation and the fibrinolysis system are activated and the imbalance between coagulation and fibrinolysis predisposes to the hypercoagulation state and is closely related to the severity of the disease and the prognosis.

Assessment of Right Ventricular Function in Patients with Chronic Obstructive Pulmonary Disease Using Echocardiographic Tei Index

Background : Advanced chronic obstructive pulmonary disease is characterized by progressive pulmonary hypertension leading to right heart dysfunction, which plays a Important role in clinical evaluation but remains difficult and challenging to quantify. The noninvasive doppler echocardiographic value referred to as the Tei index has been suggested as a simple, reproducible and reliable parameter of the right ventricular function. The purpose of this was to assess the right ventricular function in patients with chronic obstructive pulmonary disease using the Tei index and to evaluate its relationship with the pulmonary functional status. Methods : The study population comprised of 26 patients with chronic obstructive pulmonary disease and 10 normal control subjects. The Tei index was obtained by dividing the sum of the isovolumetric contraction and the relaxation times by the ejection time using a pulsed-wave doppler. It was compared with the other available Doppler echocardiographic parameters of systolic or diastolic function and with the pulmonary function of the patients. Results : The Tei indices of the patients with COPD were significantly higher than those of normal subjects( vs. , p vs. , p vs. , p vs. , p vs. msec, p (r=-0.46, p) compared to those with a mild and moderate ventilatory dysfunction. The tei indices showed an inverse correlation to with the ejection time (r=-0.469), the isovolumetric contraction time/ejection time(r=0.453), the isovolumetric relaxation time/ejection time(r=0.896) and the preejection period/ejection time(r=0.480). Conclusion : The tei index appeared to be a useful noninvasive means of evaluating the right ventricular function. It revealed a significant correlation with the pulmonary function in patients with COPD.