1.Cigarette smoking and acute eosinophilic pneumonia: insights from a case series of 17 patients
I Re HEO ; Tae Hoon KIM ; Kyung Nyeo JEON ; Ho Cheol KIM
Kosin Medical Journal 2025;40(1):41-48
Background:
Acute eosinophilic pneumonia (AEP) is a rare and severe lung condition characterized by a rapid accumulation of eosinophils in the alveoli, leading to respiratory distress. This study analyzed the clinical characteristics of affected patients, aiming to shed light on the relationship between cigarette smoking and AEP.
Methods:
This retrospective study analyzed 17 cases of AEP, focusing on patients' smoking habits, clinical symptoms, diagnostic findings, and treatment outcomes. Data were collected from medical records, imaging studies, and bronchoalveolar lavage (BAL) findings.
Results:
The study cohort consisted primarily of male military personnel (94.1%), with a mean age of 20.8 years. Symptoms generally appeared approximately 2.82 days prior to hospitalization, with a mean body temperature at admission of 37.6 °C. The mean initial peripheral blood white blood cell count was 15.3×103/μL, with eosinophil percentages starting at 0.2%, peaking at a mean of 16.1%, and reaching as high as 32.4%. BAL fluid analysis showed a mean eosinophil level of 46.6%±15.1% (range, 17%–67%). In most cases, radiological examinations revealed bilateral ground-glass opacities, interlobular septal thickening, various degrees of airspace consolidation, and bilateral pleural effusions. Steroid treatment was administered to 70.5% of patients, lasting a mean of 8.3 days and resulting in significant improvements.
Conclusions
These cases reinforce the strong link between cigarette smoking and AEP. Additionally, these cases demonstrate the importance of obtaining a detailed smoking history and thorough diagnostic assessments, including BAL, in order to facilitate a more rapid diagnosis and early initiation of corticosteroid treatment.
2.Association of Nutritional Intake with Physical Activity and Handgrip Strength in Individuals with Airflow Limitation
I Re HEO ; Tae Hoon KIM ; Jong Hwan JEONG ; Manbong HEO ; Sun Mi JU ; Jung-Wan YOO ; Seung Jun LEE ; Yu Ji CHO ; Yi Yeong JEONG ; Jong Deog LEE ; Ho Cheol KIM
Tuberculosis and Respiratory Diseases 2025;88(1):120-129
Background:
We investigated whether nutritional intake is associated with physical activity (PA) and handgrip strength (HGS) in individuals with airflow limitation.
Methods:
This study analyzed data from the 2014 and 2016 Korean National Health and Nutrition Examination Survey. We assessed total protein intake (g/day), caloric intake (kcal/day), and other nutritional intakes, using a 24-hour dietary recall questionnaire. HGS was measured three times for each hand using a digital grip strength dynamometer, and PA was assessed as health-enhancing PA. Airflow limitation was defined as a forced expiratory volume/forced vital capacity ratio of 0.7 in individuals over 40 years of age. Participants were categorized into groups based on their PA levels and HGS measurements: active aerobic PA vs. non-active aerobic PA, and normal HGS vs. low HGS.
Results:
Among the 622 individuals with airflow limitation, those involved in active aerobic PA and those with higher HGS had notably higher total food, calorie, water, protein, and lipid intake. The correlations between protein and caloric intake with HGS were strong (correlation coefficients=0.344 and 0.346, respectively). The forest plots show that higher intakes of food, water, calories, protein, and lipids are positively associated with active aerobic PA, while higher intakes of these nutrients are inversely associated with low HGS. However, in the multivariate logistic regression analysis, no significant associations were observed between nutritional intake and active aerobic PA or HGS.
Conclusion
Nutritional intake was found to not be an independent factor associated with PA and HGS. However, the observed correlations suggest potential indirect effects that warrant further investigation.
3.Risk Factors Associated with Middle Ear Barotrauma in Patients Undergoing Monoplace Hyperbaric Oxygen Therapy
Yoon Sung LEE ; Sang Won KO ; Hyoung Youn LEE ; Kyung Hoon SUN ; Tag HEO ; Sung Min LEE
Yonsei Medical Journal 2025;66(5):302-309
Purpose:
This study aimed to identify independent risk factors for middle ear barotrauma (MEB) symptoms in patients undergoing monoplace hyperbaric oxygen therapy (HBOT).
Materials and Methods:
We analyzed data from a single-center study involving 296 patients who received monoplace HBOT.Through multivariable logistic regression analysis, we examined the relationship between various factors and the occurrence of MEB to identify significant independent risk factors.
Results:
The multivariable logistic regression analysis indicated that an altered mental state was associated with increased odds of MEB occurrence [odds ratio (OR) 2.50; 95% confidence interval (CI): 1.13–5.51]. Furthermore, patients in the emergency treatment group for HBOT, as defined by the national health insurance in Korea, were found to be 6.75 times more likely to experience MEB (95% CI: 1.33–34.20).
Conclusion
This study identified altered mental status and classification in the emergency treatment group for monoplace HBOT as independent risk factors for MEB. These findings can aid in developing safer protocols for monoplace HBOT chamber operations.
4.Association between Tumor Size at the Time of Disease Progression and Survival Outcomes
Chi Hoon MAENG ; Bum Jun KIM ; Myung-Ju AHN ; In Sil CHOI ; Dae Young ZANG ; Bo-Hyung KIM ; Minji KWON ; Dae Seog HEO ; Bhumsuk KEAM
Cancer Research and Treatment 2025;57(2):362-368
Purpose:
This study evaluates the prognostic significance of tumor size at disease progression (PD) and depth of response (DOR) in cancer patients.
Materials and Methods:
We performed post hoc analysis using data from six prospective clinical trials conducted by the Korean Cancer Study Group. Patients with tumor size at PD was categorized into ‘Mild PD’ and ‘Significant PD’ based on the cutoff values of relative change from baseline using maximally selected rank statistics. The overall survival (OS) and progression-free survival (PFS) were compared between PD and DOR categories.
Results:
Among the 194 evaluable patients, 130 experienced PD. A 35.48% decrease from baseline in tumor size at PD was chosen for the cutoff between mild and significant PD for OS (mild PD: tumor size from the baseline ≤ −35.48%; significant PD > −35.48%). The mild PD had superior OS compared to the significant PD (25.8 vs. 12.8 months; Hazard ratio [HR] 0.47, 95% CI 0.266-0.843, p=0.009). When using an exploratory cutoff based on whether the tumor size was below vs. exceeded from the baseline (mild PD: tumor size from the baseline ≤ 0%; significant PD > 0%), OS remained significantly longer in the mild PD (17.1 vs. 11.8 months; HR 0.60, 95% CI 0.392-0.932, p=0.021). The greatest DOR was associated with the longest OS and PFS (p<0.001 for both).
Conclusion
Tumor size at PD and DOR were significant prognostic factors for progressive disease. Maintaining a sufficiently reduced tumor size even during PD was associated with better survival outcomes.
5.The Survival and Financial Benefit of Investigator-Initiated Trials Conducted by Korean Cancer Study Group
Bum Jun KIM ; Chi Hoon MAENG ; Bhumsuk KEAM ; Young-Hyuck IM ; Jungsil RO ; Kyung Hae JUNG ; Seock-Ah IM ; Tae Won KIM ; Jae Lyun LEE ; Dae Seog HEO ; Sang-We KIM ; Keunchil PARK ; Myung-Ju AHN ; Byoung Chul CHO ; Hoon-Kyo KIM ; Yoon-Koo KANG ; Jae Yong CHO ; Hwan Jung YUN ; Byung-Ho NAM ; Dae Young ZANG
Cancer Research and Treatment 2025;57(1):39-46
Purpose:
The Korean Cancer Study Group (KCSG) is a nationwide cancer clinical trial group dedicated to advancing investigator-initiated trials (IITs) by conducting and supporting clinical trials. This study aims to review IITs conducted by KCSG and quantitatively evaluate the survival and financial benefits of IITs for patients.
Materials and Methods:
We reviewed IITs conducted by KCSG from 1998 to 2023, analyzing progression-free survival (PFS) and overall survival (OS) gains for participants. PFS and OS benefits were calculated as the difference in median survival times between the intervention and control groups, multiplied by the number of patients in the intervention group. Financial benefits were assessed based on the cost of investigational products provided.
Results:
From 1998 to 2023, KCSG conducted 310 IITs, with 133 completed and published. Of these, 21 were included in the survival analysis. The analysis revealed that 1,951 patients in the intervention groups gained a total of 2,558.4 months (213.2 years) of PFS and 2,501.6 months (208.5 years) of OS, with median gains of 1.31 months in PFS and 1.58 months in OS per patient. When analyzing only statistically significant results, PFS and OS gain per patients was 1.69 months and 3.02 months, respectively. Investigational drug cost analysis from six available IITs indicated that investigational products provided to 252 patients were valued at 10,400,077,294 won (approximately 8,046,481 US dollars), averaging about 41,270,148 won (approximately 31,930 US dollars) per patient.
Conclusion
Our findings, based on analysis of published research, suggest that IITs conducted by KCSG led to survival benefits for participants and, in some studies, may have provided financial benefits by providing investment drugs.
6.Cigarette smoking and acute eosinophilic pneumonia: insights from a case series of 17 patients
I Re HEO ; Tae Hoon KIM ; Kyung Nyeo JEON ; Ho Cheol KIM
Kosin Medical Journal 2025;40(1):41-48
Background:
Acute eosinophilic pneumonia (AEP) is a rare and severe lung condition characterized by a rapid accumulation of eosinophils in the alveoli, leading to respiratory distress. This study analyzed the clinical characteristics of affected patients, aiming to shed light on the relationship between cigarette smoking and AEP.
Methods:
This retrospective study analyzed 17 cases of AEP, focusing on patients' smoking habits, clinical symptoms, diagnostic findings, and treatment outcomes. Data were collected from medical records, imaging studies, and bronchoalveolar lavage (BAL) findings.
Results:
The study cohort consisted primarily of male military personnel (94.1%), with a mean age of 20.8 years. Symptoms generally appeared approximately 2.82 days prior to hospitalization, with a mean body temperature at admission of 37.6 °C. The mean initial peripheral blood white blood cell count was 15.3×103/μL, with eosinophil percentages starting at 0.2%, peaking at a mean of 16.1%, and reaching as high as 32.4%. BAL fluid analysis showed a mean eosinophil level of 46.6%±15.1% (range, 17%–67%). In most cases, radiological examinations revealed bilateral ground-glass opacities, interlobular septal thickening, various degrees of airspace consolidation, and bilateral pleural effusions. Steroid treatment was administered to 70.5% of patients, lasting a mean of 8.3 days and resulting in significant improvements.
Conclusions
These cases reinforce the strong link between cigarette smoking and AEP. Additionally, these cases demonstrate the importance of obtaining a detailed smoking history and thorough diagnostic assessments, including BAL, in order to facilitate a more rapid diagnosis and early initiation of corticosteroid treatment.
7.Association of Nutritional Intake with Physical Activity and Handgrip Strength in Individuals with Airflow Limitation
I Re HEO ; Tae Hoon KIM ; Jong Hwan JEONG ; Manbong HEO ; Sun Mi JU ; Jung-Wan YOO ; Seung Jun LEE ; Yu Ji CHO ; Yi Yeong JEONG ; Jong Deog LEE ; Ho Cheol KIM
Tuberculosis and Respiratory Diseases 2025;88(1):120-129
Background:
We investigated whether nutritional intake is associated with physical activity (PA) and handgrip strength (HGS) in individuals with airflow limitation.
Methods:
This study analyzed data from the 2014 and 2016 Korean National Health and Nutrition Examination Survey. We assessed total protein intake (g/day), caloric intake (kcal/day), and other nutritional intakes, using a 24-hour dietary recall questionnaire. HGS was measured three times for each hand using a digital grip strength dynamometer, and PA was assessed as health-enhancing PA. Airflow limitation was defined as a forced expiratory volume/forced vital capacity ratio of 0.7 in individuals over 40 years of age. Participants were categorized into groups based on their PA levels and HGS measurements: active aerobic PA vs. non-active aerobic PA, and normal HGS vs. low HGS.
Results:
Among the 622 individuals with airflow limitation, those involved in active aerobic PA and those with higher HGS had notably higher total food, calorie, water, protein, and lipid intake. The correlations between protein and caloric intake with HGS were strong (correlation coefficients=0.344 and 0.346, respectively). The forest plots show that higher intakes of food, water, calories, protein, and lipids are positively associated with active aerobic PA, while higher intakes of these nutrients are inversely associated with low HGS. However, in the multivariate logistic regression analysis, no significant associations were observed between nutritional intake and active aerobic PA or HGS.
Conclusion
Nutritional intake was found to not be an independent factor associated with PA and HGS. However, the observed correlations suggest potential indirect effects that warrant further investigation.
8.Risk Factors Associated with Middle Ear Barotrauma in Patients Undergoing Monoplace Hyperbaric Oxygen Therapy
Yoon Sung LEE ; Sang Won KO ; Hyoung Youn LEE ; Kyung Hoon SUN ; Tag HEO ; Sung Min LEE
Yonsei Medical Journal 2025;66(5):302-309
Purpose:
This study aimed to identify independent risk factors for middle ear barotrauma (MEB) symptoms in patients undergoing monoplace hyperbaric oxygen therapy (HBOT).
Materials and Methods:
We analyzed data from a single-center study involving 296 patients who received monoplace HBOT.Through multivariable logistic regression analysis, we examined the relationship between various factors and the occurrence of MEB to identify significant independent risk factors.
Results:
The multivariable logistic regression analysis indicated that an altered mental state was associated with increased odds of MEB occurrence [odds ratio (OR) 2.50; 95% confidence interval (CI): 1.13–5.51]. Furthermore, patients in the emergency treatment group for HBOT, as defined by the national health insurance in Korea, were found to be 6.75 times more likely to experience MEB (95% CI: 1.33–34.20).
Conclusion
This study identified altered mental status and classification in the emergency treatment group for monoplace HBOT as independent risk factors for MEB. These findings can aid in developing safer protocols for monoplace HBOT chamber operations.
9.Cigarette smoking and acute eosinophilic pneumonia: insights from a case series of 17 patients
I Re HEO ; Tae Hoon KIM ; Kyung Nyeo JEON ; Ho Cheol KIM
Kosin Medical Journal 2025;40(1):41-48
Background:
Acute eosinophilic pneumonia (AEP) is a rare and severe lung condition characterized by a rapid accumulation of eosinophils in the alveoli, leading to respiratory distress. This study analyzed the clinical characteristics of affected patients, aiming to shed light on the relationship between cigarette smoking and AEP.
Methods:
This retrospective study analyzed 17 cases of AEP, focusing on patients' smoking habits, clinical symptoms, diagnostic findings, and treatment outcomes. Data were collected from medical records, imaging studies, and bronchoalveolar lavage (BAL) findings.
Results:
The study cohort consisted primarily of male military personnel (94.1%), with a mean age of 20.8 years. Symptoms generally appeared approximately 2.82 days prior to hospitalization, with a mean body temperature at admission of 37.6 °C. The mean initial peripheral blood white blood cell count was 15.3×103/μL, with eosinophil percentages starting at 0.2%, peaking at a mean of 16.1%, and reaching as high as 32.4%. BAL fluid analysis showed a mean eosinophil level of 46.6%±15.1% (range, 17%–67%). In most cases, radiological examinations revealed bilateral ground-glass opacities, interlobular septal thickening, various degrees of airspace consolidation, and bilateral pleural effusions. Steroid treatment was administered to 70.5% of patients, lasting a mean of 8.3 days and resulting in significant improvements.
Conclusions
These cases reinforce the strong link between cigarette smoking and AEP. Additionally, these cases demonstrate the importance of obtaining a detailed smoking history and thorough diagnostic assessments, including BAL, in order to facilitate a more rapid diagnosis and early initiation of corticosteroid treatment.
10.Association of Nutritional Intake with Physical Activity and Handgrip Strength in Individuals with Airflow Limitation
I Re HEO ; Tae Hoon KIM ; Jong Hwan JEONG ; Manbong HEO ; Sun Mi JU ; Jung-Wan YOO ; Seung Jun LEE ; Yu Ji CHO ; Yi Yeong JEONG ; Jong Deog LEE ; Ho Cheol KIM
Tuberculosis and Respiratory Diseases 2025;88(1):120-129
Background:
We investigated whether nutritional intake is associated with physical activity (PA) and handgrip strength (HGS) in individuals with airflow limitation.
Methods:
This study analyzed data from the 2014 and 2016 Korean National Health and Nutrition Examination Survey. We assessed total protein intake (g/day), caloric intake (kcal/day), and other nutritional intakes, using a 24-hour dietary recall questionnaire. HGS was measured three times for each hand using a digital grip strength dynamometer, and PA was assessed as health-enhancing PA. Airflow limitation was defined as a forced expiratory volume/forced vital capacity ratio of 0.7 in individuals over 40 years of age. Participants were categorized into groups based on their PA levels and HGS measurements: active aerobic PA vs. non-active aerobic PA, and normal HGS vs. low HGS.
Results:
Among the 622 individuals with airflow limitation, those involved in active aerobic PA and those with higher HGS had notably higher total food, calorie, water, protein, and lipid intake. The correlations between protein and caloric intake with HGS were strong (correlation coefficients=0.344 and 0.346, respectively). The forest plots show that higher intakes of food, water, calories, protein, and lipids are positively associated with active aerobic PA, while higher intakes of these nutrients are inversely associated with low HGS. However, in the multivariate logistic regression analysis, no significant associations were observed between nutritional intake and active aerobic PA or HGS.
Conclusion
Nutritional intake was found to not be an independent factor associated with PA and HGS. However, the observed correlations suggest potential indirect effects that warrant further investigation.

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