1.Human Parechovirus: an Emerging Cause of Sepsis-Like Syndrome in Infants Aged under 3 Months
Da Eun ROH ; Jung Eun KWON ; Yeo Hyang KIM
Pediatric Infection & Vaccine 2020;27(2):102-110
Purpose:
This study aimed to investigate the clinical characteristics of human parechovirus (HPeV) infection in sepsis-like syndrome in infants aged under 3 months.
Methods:
Medical records of infants aged under 3 months with sepsis-like symptoms who were admitted between July 1, 2018 and August 31, 2018 were reviewed. A multiplex reverse transcription-polymerase chain reaction panel test was performed on the cerebrospinal fluid (CSF). Thirty-nine enrolled infants were categorized into three groups: 11 in group 1 (HPeV detected in the CSF), 13 in group 2 (enterovirus detected in the CSF), and 15 in group 3 (no virus detected in the CSF).
Results:
Compared with groups 2 and 3, a higher proportion of group 1 had tachycardia, tachypnea, apnea, and hypotension (P<0.05). A significantly lower white blood cell (WBC) count was noted in group 1 than in groups 2 and 3 (5,622±2,355/μL, 9,397±2,282/μL, and 12,312±7,452/μL, respectively; P=0.005). The CSF WBC count was lower in group 1 than in groups 2 and 3 (0.9±1.7/μL, 85.1±163.6/μL, and 3.7±6.9/μL, respectively; P=0.068). The proportion of patients requiring inotrope support (36.6% vs. 0% and 6.6%), mechanical ventilation (18.1% vs. 0% and 0%), and high flow nasal cannula (45.4% vs. 15.3% and 6.6%) was higher in group 1 than in groups 2 and 3. All patients recovered completely without complications.
Conclusions
HPeV infection shows a severe clinical course and can cause a severe sepsis-like syndrome in infants aged under 3 months. Early diagnosis and proper treatment of HPeV infection are required.
2.Diagnosis and management of Kawasaki disease
Da Eun ROH ; Jung Eun KWON ; Yeo Hyang KIM
Journal of the Korean Medical Association 2020;63(7):374-381
Kawasaki disease, also known as mucocutaneous lymph node syndrome, is a common form of vasculitis in childhood. Among the recent trends in Kawasaki disease, it is notable that the prevalence rate is increasing, and the proportion of “incomplete” Kawasaki disease is also increasing. A delayed diagnosis with prolonged fever can cause complications, such as coronary artery aneurysm and decreased myocardial contractility. These complications might lead to significant morbidity and mortality. Kawasaki disease is diagnosed when the patient meets the principal criteria for clinical symptoms. Following the diagnostic criteria can prevent overdiagnosis but lead to missing of the incomplete form of the disease. Therefore, it is important to accurately understand Kawasaki disease. As the coronavirus disease 2019 (COVID-19) pandemic continues, concerns about a novel severe Kawasaki-like disease in children related to COVID-19 emerges. Indeed, there have been several reports of Kawasaki-like disease related to COVID-19 in children. Kawasaki disease is no longer rare and is often encountered at hospitals. This paper will provide useful and accurate information on Kawasaki disease.
3.National Healthcare Service and Its Big Data Analytics.
Da Jeong NAM ; Hyuk Won KWON ; Haeyeon LEE ; Eun Kyung AHN
Healthcare Informatics Research 2018;24(3):247-249
No abstract available.
Delivery of Health Care*
4.Unusual Complication of Crohn's Disease: Portal Hypertension Related with Rapid Progression of Portal Vein and Superior Mesenteric Vein Thrombosis.
Da Yeon OH ; Hye Kyung JUNG ; Kyoung Joo KWON ; Jae In RYU ; Myung Eun SONG ; Kwon YOO ; Il Hwan MOON
Korean Journal of Medicine 2013;84(5):713-717
Thromboembolic events are rare among systemic complications of inflammatory bowel disease; however, they are a significant cause of mortality when they occur. Several reports have considered thromboembolic events in patients with ulcerative colitis presenting with venous or arterial thromboembolism, such as cerebral thrombosis, deep vein thrombosis, pulmonary thromboembolism, portal vein thrombosis, or mesenteric vein thrombosis. However, increased coagulability related to Crohn's disease is extremely rare compared with that of ulcerative colitis. We report a case of a 42-year-old man with complicated portal hypertension that occurred due to extensive portal vein and mesenteric vein thrombosis. He had a monozygotic twin brother who was also in remission with Crohn's disease. The patient showed protein C and protein S deficiencies; however, he recovered with early anticoagulation therapy.
Colitis, Ulcerative
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Crohn Disease
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Humans
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Hypertension, Portal
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Intracranial Thrombosis
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Mesenteric Veins
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Portal Vein
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Protein C
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Protein S
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Pulmonary Embolism
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Siblings
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Thromboembolism
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Thrombosis
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Twins, Monozygotic
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Venous Thromboembolism
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Venous Thrombosis
5.Baseline Serum Interleukin-6 Levels Predict the Response of Patients with Advanced Non-small Cell Lung Cancer to PD-1/PD-L1 Inhibitors
Da Hyun KANG ; Cheol-Kyu PARK ; Chaeuk CHUNG ; In-Jae OH ; Young-Chul KIM ; Dongil PARK ; Jinhyun KIM ; Gye Cheol KWON ; Insun KWON ; Pureum SUN ; Eui-Cheol SHIN ; Jeong Eun LEE
Immune Network 2020;20(3):e27-
Although various studies on predictive markers in the use of PD-1/PD-L1 inhibitors are in progress, only PD-L1 expression levels in tumor tissues are currently used. In the present study, we investigated whether baseline serum levels of IL-6 can predict the treatment response of patients with advanced non-small cell lung cancer (NSCLC) treated with PD-1/PD-L1 inhibitors. In our cohort of 125 NSCLC patients, the objective response rate (ORR) and disease control rate (DCR) were significantly higher in those with low IL-6 (<13.1 pg/ml) than those with high IL-6 (ORR 33.9% vs. 11.1%, p=0.003; DCR 80.6% vs. 34.9%, p<0.001). The median progression-free survival was 6.3 months (95% confidence interval [CI], 3.9–8.7) in the low IL-6 group, significantly longer than in the high IL-6 group (1.9 months, 95% CI, 1.6–2.2, p<0.001). The median overall survival in the low IL-6 group was significantly longer than in the high IL-6 group (not reached vs. 7.4 months, 95% CI, 4.8–10.0). Thus, baseline serum IL-6 levels could be a potential biomarker for predicting the efficacy and survival benefit of PD-1/PD-L1 inhibitors in NSCLC.
6.Agrifood consumer competency index and food consumption behaviors based on the 2019 Consumption Behaviors Survey for Food
Eun-kyung KIM ; Yong-seok KWON ; Da Eun LEE ; Hee Jin JANG ; Young Hee PARK
Journal of Nutrition and Health 2021;54(2):199-210
Purpose:
This study investigated the food consumption behaviors in Korean adults, according to the agrifood consumer competency index (ACCI).
Methods:
Data obtained from the 2019 Consumption Behaviors Survey for Food were analyzed. A total of 6,176 adults (2,783 males, 3,393 females) aged ≥ 19 years, were included in the study. Based on the score of agrifood consumer competency index, the subjects were classified into three groups. The dietary habits, eating-out and food-delivery/take-out behaviors, opinion of food labeling, and concerns for domestic products were compared among the 3 groups.
Results:
The ACCI scores of the male and female subjects were 63.6 and 64.8, respectively. Subjects of both genders in the highest tertile of the ACCI were more likely to have a higher education level and higher health concerns, as compared to subjects in the lowest tertile (p < 0.05). Male subjects having highest tertile of the ACCI reported significantly more exercise and alcohol consumption, as compared to subjects in the lowest tertile (p < 0.05). A higher score of the ACCI also portrayed a higher satisfaction in own diet and greater checking of the food label. Moreover, subjects with a higher score of the ACCI showed greater satisfaction and reliability in the food label, as well as increased concerns for domestic agrifoods, local foods, and eco-friendly foods. Subjects in the lowest tertile of the ACCI acquired their dietary information from acquaintances, whereas subjects in the highest tertile of the ACCI learnt the information from food labels themselves.
Conclusion
These results are indicative of the food consumption and behaviors of Koreanadults according to their ACCI scores, and provide basic data that will be useful for implementing an effective food policy.
7.Microneedles: quick and easy delivery methods of vaccines.
Ki Mun KWON ; Su Min LIM ; Seulgi CHOI ; Da Hee KIM ; Hee Eun JIN ; Grace JEE ; Kee Jong HONG ; Joo Young KIM
Clinical and Experimental Vaccine Research 2017;6(2):156-159
Vaccination is the most efficient method for infectious disease prevention. Parenteral injections such as intramuscular, intradermal, and subcutaneous injections have several advantages in vaccine delivery, but there are many drawbacks. Thus, the development of a new vaccine delivery system has long been required. Recently, microneedles have been attracting attention as new vaccination tools. Microneedle is a highly effective transdermal vaccine delivery method due to its mechanism of action, painlessness, and ease of use. Here, we summarized the characteristics of microneedles and the possibilities as a new vaccine delivery route.
Communicable Diseases
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Injections, Subcutaneous
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Methods*
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Vaccination
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Vaccines*
8.Recurred Cryptogenic Liver Abscess Secondary to Colon Cancer in a Non-diabetic Man.
Seung Jung JUN ; Tae Hun KIM ; Min Sun RYU ; Da Yeon OH ; Myung Eun SONG ; Shina LEE ; Jae In RYU ; Hye In KIM ; Il Hwan MOON ; Kwon YOO
The Ewha Medical Journal 2011;34(2):60-63
The causes of pyogenic liver abscess has been known as biliary tract disease or intrabadominal infection but the large proportions of the patients has no apparent underlying disorders. Recently colonic mucosal lesions were reported in patients with cryptogenic liver abscess and it has been suggested that colonic mucosal break may play a role in developing liver abscess in otherwise healthy patients. We experienced a patient of severe recurrent liver abscess complicated with endophthalmitis only 3 months after successful treatment of initial cryptogenic liver abscess and a polypoid colon cancer was discovered by chance. It seems prudent to proceed colonoscopic examination in patients with cryptogenic liver abscess especially when it is recurrent.
Biliary Tract Diseases
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Colon
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Colonic Neoplasms
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Endophthalmitis
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Humans
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Klebsiella pneumoniae
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Liver
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Liver Abscess
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Liver Abscess, Pyogenic
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Recurrence
9.Pericoronary fat attenuation index in computed tomography angiography is associated with mortality in end-stage renal disease
Nam-Jun CHO ; Bo Da NAM ; Samel PARK ; Hyoungnae KIM ; Hyunjin NOH ; Jin Seok JEON ; Dong Cheol HAN ; Eun Young LEE ; Hyo-Wook GIL ; Soon Hyo KWON
Kidney Research and Clinical Practice 2022;41(1):66-76
An increased pericoronary fat attenuation index (FAI) on computed tomography angiography (CTA) is associated with increased all-cause and cardiac mortality in the general population. However, the ability of pericoronary FAI to predict long-term outcomes in chronic kidney disease (CKD) patients is unknown. Methods: In this single-center retrospective longitudinal cohort study, we assessed the utility of CTA-based pericoronary FAI measurement to predict mortality of CKD patients, including those with end-stage renal disease (ESRD). Mapping and analysis of pericoronary FAI involved three major proximal coronary arteries. The prognostic value of pericoronary FAI for long-term mortality was assessed with multivariable Cox regression models. Results: Among 268 CKD participants who underwent coronary CTA, 209 participants with left anterior descending artery (LAD) FAI measurements were included. The pericoronary FAI measured at the LAD was not significantly associated with adjusted risk of allcause mortality (hazard ratio [HR], 2.08; 95% confidence interval [CI], 0.94–3.51) in any CKD group. However, ESRD patients with elevated pericoronary FAI values had a greater adjusted risk of all-cause mortality compared with the low-FAI group (HR, 2.26; 95% CI, 1.11–4.61). Conclusion: The pericoronary FAI measured at the LAD predicted long-term mortality in patients with ESRD, which could provide an opportunity for early primary intervention in ESRD patients.
10.Impact of Cytomegalovirus Disease on New-Onset Type 2 Diabetes Mellitus: Population-Based Matched Case-Control Cohort Study
Seul Gi YOO ; Kyung Do HAN ; Kyoung Hwa LEE ; Yeonju LA ; Da Eun KWON ; Sang Hoon HAN
Diabetes & Metabolism Journal 2019;43(6):815-829
BACKGROUND: A latent cytomegalovirus (CMV) cause chronic inflammation through undesirable inflation of cell-mediated immune response. CMV immunoglobulin G has been associated with cardiovascular disease and type 1 diabetes mellitus. We evaluated impact of CMV diseases on new-onset type 2 diabetes mellitus (T2DM).METHODS: From the Korean Health Insurance Review and Assessment Service claim database of entire population with 50 million, we retrieved 576 adult case group with CMV diseases diagnosed with International Statistical Classification of Diseases and Related-Health Problems 10th Revision (ICD-10) B25 code between 2010 and 2014 after exclusion of patients with T2DM to 2006. The 2,880 control patients without T2DM from 2006 to cohort entry point were selected between 2010 and 2014 by age, sex matching with case group. The subjects without new-onset T2DM were followed until 2015. T2DM, hypertension (HTN), dyslipidemia (DYS), and end-stage renal disease (ESRD) were coded as ICD-10.RESULTS: The frequency of new-onset T2DM in case group was significantly higher than that in control (5.6% vs. 2.2%, P<0.001). The group with T2DM (n=95) had higher incidence of CMV diseases than the group without T2DM (n=3,361) (33.7% vs. 16.2%, P<0.001). In multivariate regression model adjusted by age, sex, lower income, HTN, and DYS, the incidence rate (IR) of T2DM in case group was significantly higher than that in the control group (IR per 1,000, 19.0 vs. 7.3; odds ratio, 2.1; 95% confidence interval, 1.3 to 3.2). The co-existence of HTN, DYS, and ESRD with CMV diseases did not influence the IR of T2DM.CONCLUSION: CMV diseases increase the patients' risk of developing T2DM.
Adult
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Cardiovascular Diseases
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Case-Control Studies
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Classification
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Cohort Studies
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Cytomegalovirus
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Diabetes Mellitus, Type 1
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Diabetes Mellitus, Type 2
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Dyslipidemias
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Humans
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Hypertension
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Immunoglobulin G
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Incidence
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Inflammation
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Inflation, Economic
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Insurance, Health
;
International Classification of Diseases
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Kidney Failure, Chronic
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Odds Ratio