1.Antibiotic Prescription in Patients With Coronavirus Disease 2019:Analysis of National Health Insurance System Data in the Republic of Korea
Yunsang CHOI ; Minsun KANG ; Dong Hoon SHIN ; Jongtak JUNG ; Seong Jin CHOI ; Nak-Hyun KIM ; Song Mi MOON ; Kyoung-Ho SONG ; Eu Suk KIM ; Jaehun JUNG ; Hong Bin KIM
Journal of Korean Medical Science 2023;38(25):e189-
Background:
Although coronavirus disease 2019 (COVID-19) is a viral infection, antibiotics are often prescribed due to concerns about accompanying bacterial infection. Therefore, we aimed to analyze the number of patients with COVID-19 who received antibiotic prescriptions, as well as factors that influenced antibiotics prescription, using the National Health Insurance System database.
Methods:
We retrospectively reviewed claims data for adults aged ≥ 19 years hospitalized for COVID-19 from December 1, 2019 to December 31, 2020. According to the National Institutes of Health guidelines for severity classification, we calculated the proportion of patients who received antibiotics and the number of days of therapy per 1,000 patient-days. Factors contributing to antibiotic use were determined using linear regression analysis. In addition, antibiotic prescription data for patients with influenza hospitalized from 2018 to 2021 were compared with those for patients with COVID-19, using an integrated database from Korea Disease Control and Prevention Agency-COVID19-National Health Insurance Service cohort (K-COV-N cohort), which was partially adjusted and obtained from October 2020 to December 2021.
Results:
Of the 55,228 patients, 46.6% were males, 55.9% were aged ≥ 50 years, and most patients (88.7%) had no underlying diseases. The majority (84.3%; n = 46,576) were classified as having mild-to-moderate illness, with 11.2% (n = 6,168) and 4.5% (n = 2,484) having severe and critical illness, respectively. Antibiotics were prescribed to 27.3% (n = 15,081) of the total study population, and to 73.8%, 87.6%, and 17.9% of patients with severe, critical, and mild-to-moderate illness, respectively. Fluoroquinolones were the most commonly prescribed antibiotics (15.1%; n = 8,348), followed by third-generation cephalosporins (10.4%; n = 5,729) and beta-lactam/beta-lactamase inhibitors (6.9%; n = 3,822). Older age, COVID-19 severity, and underlying medical conditions contributed significantly to antibiotic prescription requirement. The antibiotic use rate was higher in the influenza group (57.1%) than in the total COVID-19 patient group (21.2%), and higher in severe-to-critical COVID-19 cases (66.6%) than in influenza cases.
Conclusion
Although most patients with COVID-19 had mild to moderate illness, more than a quarter were prescribed antibiotics. Judicious use of antibiotics is necessary for patients with COVID-19, considering the severity of disease and risk of bacterial co-infection.
2.Risk factors for type-specific persistence of high-risk human papillomavirus and residual/recurrent cervical intraepithelial neoplasia after surgical treatment
Yung-Taek OUH ; Hyun Woong CHO ; Seong Min KIM ; Kyung-Jin MIN ; Sang-Hoon LEE ; Jae-Yun SONG ; Jae-Kwan LEE ; Nak Woo LEE ; Jin Hwa HONG
Obstetrics & Gynecology Science 2020;63(5):631-642
Objective:
This study aimed to investigate the clinicopathologic risk factors for type-specific persistence of high-risk human papillomavirus (hrHPV) and residual/recurrent cervical intraepithelial neoplasia (CIN) after surgical treatment.
Methods:
Patients with CIN-2/3 who underwent conization or loop electrosurgical excision procedure (LEEP) at Korea University Hospital were enrolled. All patients underwent hrHPV testing and genotyping before conization or LEEP followed by both hrHPV genotyping and cytology. The significance of associations between patient characteristics and persistence of infection were assessed by multivariate logistic regression analyses.
Results:
Among 398 women with pathologically confirmed CIN-2/3, 154 (38.7%) patients showed hrHPV persistence after surgical treatment. In multivariate analysis, high preoperative hrHPV load (P<0.05; odds ratio [OR], 2.063), presence of CIN-2 at treatment (P<0.01; OR, 2.732), and multiple hrHPV infections (P<0.001; OR, 4.752) were associated with hrHPV persistence. HPV 53 was the most likely to persist after treatment (24/43, 55.8%). The risk of residual/recurrent CIN-2/3 was higher in persistent infection with HPV 16 than other types (P<0.05). Menopause (P<0.001; OR, 3.969), preoperative and postoperative hrHPV load (P<0.05; OR, 2.430; P<0.05; OR, 5.351), and infection with multiple hrHPV types (P<0.05; OR, 2.345) were significantly related to residual/recurrent CIN following surgical treatment.
Conclusion
HPV load before treatment and infection with multiple hrHPV types were predictors of postoperative hrHPV persistence. HPV 53 was the type most likely to persist, but HPV 16 was the type that was most closely associated with residual/recurrent CIN-2/3.
3.Risk factors for type-specific persistence of high-risk human papillomavirus and residual/recurrent cervical intraepithelial neoplasia after surgical treatment
Yung-Taek OUH ; Hyun Woong CHO ; Seong Min KIM ; Kyung-Jin MIN ; Sang-Hoon LEE ; Jae-Yun SONG ; Jae-Kwan LEE ; Nak Woo LEE ; Jin Hwa HONG
Obstetrics & Gynecology Science 2020;63(5):631-642
Objective:
This study aimed to investigate the clinicopathologic risk factors for type-specific persistence of high-risk human papillomavirus (hrHPV) and residual/recurrent cervical intraepithelial neoplasia (CIN) after surgical treatment.
Methods:
Patients with CIN-2/3 who underwent conization or loop electrosurgical excision procedure (LEEP) at Korea University Hospital were enrolled. All patients underwent hrHPV testing and genotyping before conization or LEEP followed by both hrHPV genotyping and cytology. The significance of associations between patient characteristics and persistence of infection were assessed by multivariate logistic regression analyses.
Results:
Among 398 women with pathologically confirmed CIN-2/3, 154 (38.7%) patients showed hrHPV persistence after surgical treatment. In multivariate analysis, high preoperative hrHPV load (P<0.05; odds ratio [OR], 2.063), presence of CIN-2 at treatment (P<0.01; OR, 2.732), and multiple hrHPV infections (P<0.001; OR, 4.752) were associated with hrHPV persistence. HPV 53 was the most likely to persist after treatment (24/43, 55.8%). The risk of residual/recurrent CIN-2/3 was higher in persistent infection with HPV 16 than other types (P<0.05). Menopause (P<0.001; OR, 3.969), preoperative and postoperative hrHPV load (P<0.05; OR, 2.430; P<0.05; OR, 5.351), and infection with multiple hrHPV types (P<0.05; OR, 2.345) were significantly related to residual/recurrent CIN following surgical treatment.
Conclusion
HPV load before treatment and infection with multiple hrHPV types were predictors of postoperative hrHPV persistence. HPV 53 was the type most likely to persist, but HPV 16 was the type that was most closely associated with residual/recurrent CIN-2/3.
4.Virus Isolation from the First Patient with SARS-CoV-2 in Korea
Wan Beom PARK ; Nak Jung KWON ; Su Jin CHOI ; Chang Kyung KANG ; Pyoeng Gyun CHOE ; Jin Yong KIM ; Jiyoung YUN ; Gir Won LEE ; Moon Woo SEONG ; Nam Joong KIM ; Jeong Sun SEO ; Myoung don OH
Journal of Korean Medical Science 2020;35(7):e84-
Novel coronavirus (SARS-CoV-2) is found to cause a large outbreak started from Wuhan since December 2019 in China and SARS-CoV-2 infections have been reported with epidemiological linkage to China in 25 countries until now. We isolated SARS-CoV-2 from the oropharyngeal sample obtained from the patient with the first laboratory-confirmed SARS-CoV-2 infection in Korea. Cytopathic effects of SARS-CoV-2 in the Vero cell cultures were confluent 3 days after the first blind passage of the sample. Coronavirus was confirmed with spherical particle having a fringe reminiscent of crown on transmission electron microscopy. Phylogenetic analyses of whole genome sequences showed that it clustered with other SARS-CoV-2 reported from Wuhan.
5.Virus Isolation from the First Patient with SARS-CoV-2 in Korea
Wan Beom PARK ; Nak Jung KWON ; Su Jin CHOI ; Chang Kyung KANG ; Pyoeng Gyun CHOE ; Jin Yong KIM ; Jiyoung YUN ; Gir Won LEE ; Moon Woo SEONG ; Nam Joong KIM ; Jeong Sun SEO ; Myoung don OH
Journal of Korean Medical Science 2020;35(7):84-
Novel coronavirus (SARS-CoV-2) is found to cause a large outbreak started from Wuhan since December 2019 in China and SARS-CoV-2 infections have been reported with epidemiological linkage to China in 25 countries until now. We isolated SARS-CoV-2 from the oropharyngeal sample obtained from the patient with the first laboratory-confirmed SARS-CoV-2 infection in Korea. Cytopathic effects of SARS-CoV-2 in the Vero cell cultures were confluent 3 days after the first blind passage of the sample. Coronavirus was confirmed with spherical particle having a fringe reminiscent of crown on transmission electron microscopy. Phylogenetic analyses of whole genome sequences showed that it clustered with other SARS-CoV-2 reported from Wuhan.
China
;
Coronavirus
;
Crowns
;
Genome
;
Humans
;
Korea
;
Microscopy, Electron
;
Microscopy, Electron, Transmission
;
Phylogeny
;
Vero Cells
6.Efficacy and local irritation evaluation of Eriobotrya japonica leaf ethanol extract
Nak Won SEONG ; Won Jun OH ; Il Soo KIM ; Su Jin KIM ; Ji Eun SEO ; Chang Eon PARK ; Da Young KIM ; Je Won KO ; Jong Choon KIM
Laboratory Animal Research 2019;35(1):13-22
BACKGROUND: Although Eriobotrya japonica leaves have been studied as a raw material for various cosmetic products, little is known about the anti-oxidant, anti-inflammatory, and anti-melanogenic activities of Eriobotrya japonica leaf ethanol extract (EJEE). METHODS: This study was conducted to evaluate the anti-oxidant, anti-inflammatory, and anti-melanogenic activities of EJEE using different in vitro models. In addition, we investigated the potential irritation of EJEE to skin and eye using animal alternative tests. RESULTS: The total content of polyphenols, one of the active constituents of EJEE, was analyzed by high-performance liquid chromatography and found to contain 88.68 mg tannic acid equivalent/g. EJEE showed a concentration-dependent 1,1-diphenyl-2-picrylhydrazyl radical scavenging activity, 2,2′-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid) radical scavenging activity, and a superoxide dismutase-like activity. The anti-inflammatory effect of 0.5% (w/v) EJEE was demonstrated by a reduction in lipopolysaccharide-induced nitric oxide and tumor necrosis factor-alpha levels in RAW 264.7 cells. EJEE also significantly inhibited melanogenesis in melanocyte stimulating hormone-induced B16F1 cells. EJEE did not show any irritation in skin and eye in animal alternative test. CONCLUSIONS: These results indicate that the EJEE possesses anti-oxidant, anti-inflammatory, and anti-melanogenic activities, while it did not induce toxicity or irritation in neither skin nor eye. Therefore, EJEE can be used as a cosmetic ingredient for skin improvement.
Animals
;
Chromatography, Liquid
;
Eriobotrya
;
Ethanol
;
In Vitro Techniques
;
Melanocytes
;
Nitric Oxide
;
Polyphenols
;
RAW 264.7 Cells
;
Skin
;
Superoxides
;
Tannins
;
Tumor Necrosis Factor-alpha
7.Comparison of Combined Therapy Using Conventional Chemoembolization and Radiofrequency Ablation Versus Conventional Chemoembolization for Ultrasound-Invisible Early-Stage Hepatocellular Carcinoma (Barcelona Clinic Liver Cancer Stage 0 or A).
Hyukjoon LEE ; Chang Jin YOON ; Nak Jong SEONG ; Sook Hyang JEONG ; Jin Wook KIM
Korean Journal of Radiology 2018;19(6):1130-1139
OBJECTIVE: To compare the therapeutic efficacy between conventional transarterial chemoembolization (cTACE) and combined therapy using cTACE and radiofrequency ablation (RFA) in ultrasound (US)-invisible early stage hepatocellular carcinoma (HCC). MATERIALS AND METHODS: From January 2008 to June 2016, 167 patients with US-invisible early stage HCCs were treated with cTACE alone (cTACE group; n = 85) or cTACE followed by immediate fluoroscopy-guided RFA targeting intratumoral iodized oil retention (combined group; n = 82). Procedure-related complications, local tumor progression (LTP), time to progression (TTP), and overall survival (OS) were compared between the two groups. Multivariate analyses were performed to identify prognostic factors. RESULTS: There was no major complication in either group. The cTACE group showed higher 1-, 3-, and 5-year LTP rates than the combined group; i.e., 12.5%, 31.7%, and 37.0%, respectively, in the cTACE group; compared to 7.3%, 16.5%, and 16.5%, respectively, in the combined group; p = 0.013. The median TTP was 18 months in the cTACE group and 24 months in the combined group (p = 0.037). Cumulative 1-, 3-, and 5-year OS rates were 100%, 93.2%, and 87.7%, respectively, in the cTACE group and 100%, 96.6%, and 87.4%, respectively, in the combined group (p = 0.686). Tumor diameter > 20 mm and cTACE monotherapy were independent risk factors for LTP and TTP. CONCLUSION: Combined therapy using cTACE followed by fluoroscopy-guided RFA is a safe and effective treatment in US-invisible early stage HCCs. It provides less LTP and longer TTP than cTACE alone.
Carcinoma, Hepatocellular*
;
Catheter Ablation*
;
Humans
;
Iodized Oil
;
Liver Neoplasms*
;
Liver*
;
Multivariate Analysis
;
Risk Factors
;
Ultrasonography
8.Post-Operative Hemorrhage after Myomectomy: Safety and Efficacy of Transcatheter Uterine Artery Embolization.
Alvin Yu Hon WAN ; Ji Hoon SHIN ; Hyun Ki YOON ; Gi Young KO ; Sangik PARK ; Nak Jong SEONG ; Chang Jin YOON
Korean Journal of Radiology 2014;15(3):356-363
OBJECTIVE: To evaluate the safety and clinical efficacy of transcatheter uterine artery embolization (UAE) for post-myomectomy hemorrhage. MATERIALS AND METHODS: We identified eight female patients (age ranged from 29 to 51 years and with a median age of 37) in two regional hospitals who suffered from post-myomectomy hemorrhage requiring UAE during the time period from 2004 to 2012. A retrospective review of the patients' clinical data, uterine artery angiographic findings, embolization details, and clinical outcomes was conducted. RESULTS: The pelvic angiography findings were as follows: hypervascular staining without bleeding focus (n = 5); active contrast extravasation from the uterine artery (n = 2); and pseudoaneurysm in the uterus (n = 1). Gelatin sponge particle was used in bilateral uterine arteries of all eight patients, acting as an empirical or therapeutic embolization agent for the various angiographic findings. N-butyl-2-cyanoacrylate was administered to the target bleeding uterine arteries in the two patients with active contrast extravasation. Technical and clinical success were achieved in all patients (100%) with bleeding cessation and no further related surgical intervention or embolization procedure was required for hemorrhage control. Uterine artery dissection occurred in one patient as a minor complication. Normal menstrual cycles were restored in all patients. CONCLUSION: Uterine artery embolization is a safe, minimally invasive, and effective management option for controlling post-myomectomy hemorrhage without the need for hysterectomy.
Adult
;
Female
;
Humans
;
Hysterectomy
;
Leiomyoma/blood supply/*surgery
;
Middle Aged
;
Postoperative Hemorrhage/*therapy
;
Retrospective Studies
;
Treatment Outcome
;
Uterine Artery Embolization/adverse effects/*methods
;
Uterine Neoplasms/blood supply/*surgery
;
Uterus/blood supply/surgery
9.A Case of Systemic Lupus Erythematosus Occurring after H1N1 Influenza Vaccination.
Seong Min JO ; Jong Ho SHIN ; Ki Tae BANG ; Jin Uk JEONG ; Nak Min KIM ; Ji Wook CHOI ; Ju Hun KIM
Korean Journal of Medicine 2013;84(2):295-298
The recent worldwide outbreak of H1N1 has led to the universal administration of H1N1 influenza vaccination, including in South Korea. Several complications have been reported with use of H1N1 influenza vaccine, but systemic lupus erythematosus (SLE) has not been reported as a complication until now. Here, we report a case of SLE occurrence after H1N1 influenza vaccination. A 17-year-old girl who had not been diagnosed with SLE was hospitalized with fever, myalgia, and arthralgia after H1N1 influenza vaccination. Laboratory tests revealed increased levels of antinuclear antibody and anti-ds-DNA antibody, and decreased levels of C3 and C4 as well as proteinuria. The pathological findings confirmed a diagnosis of lupus nephritis. The patient was treated with high-dose corticosteroid and hydroxychloroquine. This is the first report of SLE following H1N1 influenza vaccination in South Korea.
Antibodies, Antinuclear
;
Arthralgia
;
Collodion
;
Fever
;
Humans
;
Hydroxychloroquine
;
Influenza A Virus, H1N1 Subtype
;
Influenza Vaccines
;
Influenza, Human
;
Lupus Erythematosus, Systemic
;
Lupus Nephritis
;
Proteinuria
;
Republic of Korea
;
Vaccination
10.Application of 3D Surface Scanners in Forensic Science and Medicine ( I ): Digital Storage of Human Skeletons and Development of Appraisal Methods for Incident Scenes.
Nak Eun CHUNG ; Hyung Nam KOO ; Hyun Moo KANG ; Sang Seob LEE ; Hye Jin PARK ; Hyung Joong KIM ; Kyung Rak LEE ; Ik Jo CHUNG ; Dae Yeol KIM ; Dal Won KIM ; Sang Beom LIM ; Saebomi LEE ; Han Soo HAN ; Jung LEE ; Jun Suk KIM ; Ki Woong MOON ; Byong Hyun KIM ; Kyun Woo CHO ; Jin Pyeo KIM ; Yeo Soo KIM ; Sung Ho KIM ; In Soo SEO ; Dae Kyun PARK ; Jae Kwang CHUNG ; Yi Suk KIM ; Seong Kyu CHOI ; U Young LEE ; Hoon LEE ; Chae Keun KIM ; In Soo LEE ; Hoon KANG ; Won Seob KIM ; Dong Kyu KIM ; Dong Soo KIM ; Hyeong Jin CHOI ; Dong Il PARK ; Hong Soon CHOI ; Si Ro KIM ; Yong Seok HEO
Korean Journal of Legal Medicine 2012;36(1):85-96
The aim of this project was to use 3D scanning data collected at incident scenes and various evidence to 1) develop surveying methods based on 3D data consisting of overall and detailed scene evidence, captured by long-range and micros-canner, which can be shared by personnel working in different fields such as forensic medicine, video analysis, physical analysis, traffic engineering, and fire investigation; 2) create digital storage for human skeletons and set the foundation for virtual anthropology; and 3) improve the credibility of 3D evidence by virtual remodeling and simulation of incident scenes and evidence to provide a basis for advanced and high-tech scientific investigation. Two complete skeletons of male and female were scanned using 3D micro-scanner. Each bone was successfully reproduced and assembled in virtual space. In addition, recreating evidence scheduled for invasive examination by creating RP (rapid prototype) was possible. These outcomes could play an important role in setting up the new field of virtual anthropology. Case-specific surveying methods were developed through analysis of 3D scanning data collected by long-range surface scanners at the scenes of vehicular accidents, falls, shootings, and violent crimes. A technique and recording method was also developed for detecting forged seals by micro-scanning the pressure exerted on the seal. Appraisal methods developed in this project could be utilized to secure 3D data of human skeletal remains and incident scenes, create a standard for application, and increase objectivity, reproducibility, and accuracy of scanning methods. We plan to develop case-specific 3D data analysis techniques to improve the credibility of analysis at the NFS and to establish a 3D data collection and analysis team.
Crime
;
Data Collection
;
Female
;
Fires
;
Forensic Medicine
;
Forensic Sciences
;
Humans
;
Male
;
Skeleton
;
Statistics as Topic

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