1.The Prevalence of Initial Drug Resistance among Pulmonary Tuberculosis Patients.
Jae Hwan KONG ; Sang Seok LEE ; Ha Yan KANG ; Jae Seuk PARK
Tuberculosis and Respiratory Diseases 2008;64(2):95-101
BACKGROUND: Drug resistant tuberculosis (TB) in patients who have not received previous TB treatment (initial drug resistance) is a serious problem for the control of TB. However, prevalence of initial drug resistance among pulmonary TB patients has not been well characterized in Korea, especially in the private sector. We assessed the prevalence of initial drug resistance and evaluated the risk factors for drug resistance in pulmonary TB patients, at a regional tertiary hospital in Cheonan. METHODS: We performed a drug susceptibility test for both first and second line anti-TB drugs in all culture-confirmed pulmonary TB patients who had not received a previous TB treatment at Dankook University Hospital from September 2005 to September 2007. In addition, we evaluated the initial drug resistance pattern and clinical characteristics of patients to evaluate the risk factors for initial drug resistance. We also assessed the influence of the drug susceptibility test results on the treatment regimen. RESULTS: Of the total 156 cases where the drug susceptibility test was performed, resistance to at least one anti-TB drug was found in 21 cases (15.6%) and multidrug resistance, where TB was resistant to at least isoniazid and rifampin, was found in one case (0.6%). Multivariate logistic regression showed no clinical characteristics were independently associated with initial drug resistance. Of the total 156 patients who underwent the drug susceptibility test, the treatment regimen was changed for 15 patients (9.6%) according to the results of the drug susceptibility test. CONCLUSION: Initial drug resistance is common and the drug susceptibility test is informative for pulmonary TB patients who have not received previous TB treatment.
Drug Resistance
;
Drug Resistance, Multiple
;
Humans
;
Isoniazid
;
Korea
;
Logistic Models
;
Prevalence
;
Private Sector
;
Rifampin
;
Risk Factors
;
Tertiary Care Centers
;
Tuberculosis
;
Tuberculosis, Pulmonary
2.The Performance of Serum Biomarkers for Predicting Fibrosis in Patients with Chronic Viral Hepatitis.
Chang Seok BANG ; Ha Yan KANG ; Gyu Ho CHOI ; Suk Bae KIM ; Wonae LEE ; Il Han SONG
The Korean Journal of Gastroenterology 2017;69(5):298-307
BACKGROUND/AIMS: The invasiveness of a liver biopsy and its inconsistent results have prompted efforts to develop noninvasive tools to evaluate the severity of chronic hepatitis. This study was intended to assess the performance of serum biomarkers for predicting liver fibrosis in patients with chronic viral hepatitis. METHODS: A total of 302 patients with chronic hepatitis B or C, who had undergone liver biopsy, were retrospectively enrolled. We investigated the diagnostic accuracy of several clinical factors for predicting advanced fibrosis (F≥3). RESULTS: The study population included 227 patients with chronic hepatitis B, 73 patients with chronic hepatitis C, and 2 patients with co-infection (hepatitis B and C). Histological cirrhosis was identified in 16.2% of the study population. The grade of porto-periportal activity was more correlated with the stage of chronic hepatitis compared with that of lobular activity (r=0.640 vs. r=0.171). Fibrosis stage was correlated with platelet count (r=-0.520), aspartate aminotransferase to platelet ratio index (APRI) (r=0.390), prothrombin time (r=0.376), and albumin (r=-0.357). For the diagnosis of advanced fibrosis, platelet count and APRI were the most predictive variables (AUROC=0.752, and 0.713, respectively). CONCLUSIONS: In a hepatitis B endemic region, platelet count and APRI could be considered as reliable non-invasive markers for predicting fibrosis of chronic viral hepatitis. However, it is necessary to validate the diagnostic accuracy of these markers in another population.
Aspartate Aminotransferases
;
Biomarkers*
;
Biopsy
;
Blood Platelets
;
Coinfection
;
Diagnosis
;
Fibrosis*
;
Hepatitis B
;
Hepatitis B, Chronic
;
Hepatitis C, Chronic
;
Hepatitis*
;
Hepatitis, Chronic
;
Humans
;
Liver
;
Liver Cirrhosis
;
Platelet Count
;
Prothrombin Time
;
Retrospective Studies
3.Protection of CSE/H2S system in hepatic ischemia reperfusion injury in rats.
Kai KANG ; Hong-chi JIANG ; Ming-yan ZHAO ; Xue-ying SUN ; Shang-ha PAN
Chinese Journal of Surgery 2010;48(12):924-928
OBJECTIVETo study the protective function and pathophysiology of cystathionine gamma-lyase (CSE)/hydrogen sulfide (H(2)S) system in hepatic ischemia-reperfusion injury (HIRI) in rats.
METHODSWistar rats were randomly distributed into sham group (n = 18), ischemia-reperfusion (IR) group (n = 18), IR + NaHS group (n = 18) and IR + DL-propargylglycine (PAG) group (n = 18). The hepatic IR model was established by Pringle's hepatic vascular occlusion. At each of the indicated time points (1, 3 and 6 hours after IR), the serum levels of H(2)S and the hepatic CSE activity were measured. The serum levels of inflammatory factors, including TNF-α, IL-10 were determined by ELISA methods. The expression of apoptotic protein, TNF-α, in liver tissue was tested by Western blot assay, cell apoptosis was examined by TUNEL and the histological changes were examined in each group.
RESULTSThe serum levels of H(2)S and CSE activity were significantly increased in group IR compared with group sham at all indicated time points (P < 0.05). The serum level of inflammatory factors (P < 0.01) and the hepatic expression of TNF-α protein (P < 0.05) were elevated obviously in group IR than that in group sham. Administration of NaHS could reduce the production of inflammatory factors in serum (P < 0.01), inhibit hepatic protein expression of TNF-α (P < 0.05) and attenuate the liver histological scores of IR injury (P < 0.05), whereas PAG aggravated them.
CONCLUSIONThe endogenous CSE/H(2)S system maybe involved in the pathogenesis of hepatic IR injury, which suggests that CSE/H(2)S system can protect liver from IR injury in rats by intervening in inflammatory reaction, attenuating the injury severity and inhibiting expression of apoptotic protein TNF-α.
Animals ; Apoptosis ; drug effects ; Cystathionine gamma-Lyase ; blood ; physiology ; Disease Models, Animal ; Hydrogen Sulfide ; blood ; Interleukin-10 ; blood ; Liver ; blood supply ; metabolism ; pathology ; Male ; Random Allocation ; Rats ; Rats, Wistar ; Reperfusion Injury ; metabolism ; pathology ; physiopathology ; prevention & control ; Sulfides ; pharmacology ; Tumor Necrosis Factor-alpha ; metabolism
4.Ruptured duodenal varices arising from the main portal vein successfully treated with endoscopic injection sclerotherapy: a case report.
Ha Yan KANG ; Won Kyung LEE ; Yong Hyun KIM ; Byung Woon KWON ; Myung Soo KANG ; Suk Bae KIM ; Il Han SONG
The Korean Journal of Hepatology 2011;17(2):152-156
Duodenal varices result from retroperitoneal portosystemic shunts that usually come from the pancreaticoduodenal vein and drain into the inferior vena cava. Because they are a rare but fatal cause of gastrointestinal bleeding, a prompt hemostatic intervention is mandatory. A 62-year-old man who had a history of excessive alcohol consumption presented with massive hematemesis and melena. Emergent endoscopy revealed ruptured varices with an adhering whitish fibrin clot on the postbulbar portion of the duodenum. Abdominal computed tomography demonstrated a cirrhotic liver with venous collaterals around the duodenum and extravasated contrast in the second and third portions. The collaterals originated from the main portal vein and drained via the right renal vein into the inferior vena cava. Endoscopic injection sclerotherapy with cyanoacrylate was successful in achieving hemostasis, and resulted in the near eradication of duodenal varices at a 6-month follow-up.
Cyanoacrylates/therapeutic use
;
Duodenal Diseases/diagnosis/etiology/*therapy
;
Duodenum/*blood supply
;
Endoscopy, Gastrointestinal
;
Gastrointestinal Hemorrhage/etiology/*therapy
;
Humans
;
Male
;
Middle Aged
;
Portal Vein
;
Rupture
;
Sclerosing Solutions/therapeutic use
;
*Sclerotherapy
;
Tomography, X-Ray Computed
;
Varicose Veins/complications/*therapy
5.A case of superior mesenteric artery syndrome due to peritoneal seeding in a colon cancer patient.
Chang Seok BANG ; Soon Il LEE ; Geun Woo PARK ; Ha Yan KANG ; Sung Soo LA ; Jae Hwan KONG ; Jin Mo KANG
Korean Journal of Medicine 2009;76(3):380-384
Small bowel obstruction can develop from adhesions, hernias, and less frequently from tumors. Superior mesenteric artery (SMA) syndrome is an uncommon cause of small bowel obstruction. We experienced a case of SMA syndrome caused by peritoneal seeding from colon cancer. A 57-year-old woman presented with nausea, post-prandial vomiting, and weight loss. She had been receiving palliative chemotherapy for 12 months to treat colon cancer with peritoneal seeding. Abdominal computed tomography and a small bowel series revealed typical findings of SMA syndrome. As conservative treatment including nutritional support and positional change was ineffective, she was treated surgically. An adhesive mass compressing the SMA and duodenum was found at the third portion of the duodenum. The pathologic diagnosis was metastatic adenocarcinoma of colorectal origin. Adhesiolysis and duodenojejunostomy relieved her symptoms. This case shows that SMA syndrome can develop via peritoneal seeding in cancer patients.
Adenocarcinoma
;
Adhesives
;
Colon
;
Colonic Neoplasms
;
Duodenum
;
Female
;
Hernia
;
Humans
;
Intestinal Obstruction
;
Mesenteric Artery, Superior
;
Middle Aged
;
Nausea
;
Nutritional Support
;
Seeds
;
Superior Mesenteric Artery Syndrome
;
Vomiting
;
Weight Loss
6.A Study on Viral Hepatitis Markers and Abnormal Liver Function Test in Adults Living in Northwest Area of Chungnam.
Suk Bae KIM ; Won Kyung LEE ; Hoon CHOI ; So Mi KIM ; Rhan NOH ; Ha Yan KANG ; Sang Suk LEE ; Sung Soo RA ; Jae Hwan GONG ; Hyun Duk SHIN
The Korean Journal of Gastroenterology 2009;53(6):355-360
BACKGROUND/AIMS: We studied the prevalence of chronic hepatitis B, C and abnormality on liver function among the population in northwest area of Chungnam. METHODS: We have reviewed 40,112 adults who had received medical examination at health promotion center in Dankook university hospital. We studied them retrospectively about HBsAg, HBsAb, anti-HCV, and liver function test (LFT). RESULTS: Among the study subjects, 22,936 men and 17,176 women were involved. The overall seroprevalence of HBsAg was 4.2%. The prevalence in men (4.5%) was higher than that of women (3.7%) (p<0.001). The seroprevalence of HBsAg in their age was 5.1% in the 5th decade, 4.2% in the 2nd decade, 4.1% in the 4th decade, and 4.1% in the 6th decade. The overall seroprevalence of HBsAb was 65.1%. The overall seroprevalence of anti-HCV was 0.7%. After we reexamined them with HCV RNA or RIBA (Recombinant Immunoblot Assay), the prevalence of chronic hepatitis C was 0.09%. The LFT abnormality in total subjects was 11.4%. The LFT abnormality of chronic hepatitis B and C subjects was 21.72% and 63.2%. CONCLUSIONS: The prevalence of chronic hepatitis B and C was lower than that of previous studies. The prevalence of chronic hepatitis B in the 2nd decade was still high.
Adolescent
;
Adult
;
Aged
;
Aged, 80 and over
;
Child
;
Female
;
Hepatitis B Antibodies/blood
;
Hepatitis B Surface Antigens/blood
;
Hepatitis B, Chronic/*epidemiology/immunology/physiopathology
;
Hepatitis C Antibodies/blood
;
Hepatitis C, Chronic/*epidemiology/immunology/physiopathology
;
Humans
;
Korea
;
Liver Function Tests
;
Male
;
Middle Aged
;
Prevalence
;
RNA, Viral/blood
;
Retrospective Studies
7.Phlebosclerotic Colitis in a Cirrhotic Patient with Portal Hypertension: The First Case in Korea.
Ha Yan KANG ; Ran NOH ; So Mi KIM ; Hyun Deok SHIN ; Se Young YUN ; Il Han SONG
Journal of Korean Medical Science 2009;24(6):1195-1199
Phlebosclerotic colitis is a rare form of ischemic colitis characterized by the thickening of the wall of the affected colon due to fibrous degeneration of submucosal layer of colon and fibrotic obstruction of the colono-mesenteric vein, resulting in the disturbance of venous return from the colon. The pathogenic mechanism of this entity remains unknown but chronic liver disease with portal hypertension is maybe thought to be one of the speculated mechanisms. Here we first report the case of surgically confirmed phlebosclerotic colitis, that was in the early stage but showed the aggressive nature, in a 61-yr-old cirrhotic patients with portal hypertension in Korea.
Colitis/pathology
;
Colon/blood supply/*pathology
;
Colonoscopy
;
Humans
;
Hypertension, Portal/*pathology
;
Korea
;
Liver Cirrhosis/pathology
;
Male
;
Middle Aged
;
Tomography, X-Ray Computed
8.Cerebral salt wasting following pituitary surgery for macroadenoma.
Tak Ho SONG ; Sung Soo LA ; Chang Seok BANG ; Sang Seok LEE ; Ha Yan KANG ; Hee Jin KIM ; Sang Koo LEE
Korean Journal of Medicine 2007;73(4):432-437
The central nervous system (CNS) has important roles in the regulation of sodium and water homeostasis, so the risk of hyponatremia is increased for patients with neurological disorders. Cerebral salt wasting (CSW) is a syndrome that is characterized by hyponatremia and extracellular volume contraction, and these problems are caused by natriuresis and the concomitant polyuria in patient with intracranial disease. It is critical to differentiate CSW from syndrome of inappropriate secretion of antidiuretic hormone (SIADH) for patients with hyponatremia and after they experience cerebral insults. This is because fluid restriction is the treatment of choice for SIADH and administration of isotonic or hypertonic saline is important for treating CSW. We report here on a case of CSW following trassphenoidal surgery for pituitary tumor in a 67-year-old man with nonfunctioning pituitary macroadenoma. Hyposmotic hyponatremia, increased urine output and signs of dehydration developed postoperatively, and the patient was managed by water and salt supplementation.
Aged
;
Central Nervous System
;
Dehydration
;
Homeostasis
;
Humans
;
Hyponatremia
;
Inappropriate ADH Syndrome
;
Natriuresis
;
Nervous System Diseases
;
Pituitary Neoplasms
;
Polyuria
;
Sodium
9.Respiratory Syncytial Virus Outbreak Without Influenza in the Second Year of the Coronavirus Disease 2019 Pandemic: A National Sentinel Surveillance in Korea, 2021–2022 Season
Jong-Hun KIM ; Ha Yan KIM ; Myeongjee LEE ; Jong Gyun AHN ; Jee Yeon BAEK ; Min Young KIM ; Kyungmin HUH ; Jaehun JUNG ; Ji-Man KANG
Journal of Korean Medical Science 2022;37(34):e258-
Background:
This study aimed to investigate whether respiratory syncytial virus (RSV) and influenza virus (IFV) infections would occur in 2021–2022 as domestic nonpharmaceutical interventions (NPIs) are easing.
Methods:
Data were collected from the Korean Influenza and Respiratory Virus Monitoring System database. The weekly positivity rates of respiratory viruses and number of hospitalizations for acute respiratory infections were evaluated (January 2016–2022).The period from February 2020 to January 2022 was considered the NPI period. The autoregressive integrated moving average model and Poisson analysis were used for data analysis. Data from 14 countries/regions that reported positivity rates of RSV and IFV were also investigated.
Results:
Compared with the pre-NPI period, the positivity and hospitalization rates for IFV infection during 2021–2022 significantly decreased to 0.0% and 1.0%, respectively, at 0.0% and 1.2% of the predicted values, respectively. The RSV infection positivity rate in 2021–2022 was 1.8-fold higher than that in the pre-NPI period at 1.5-fold the predicted value. The hospitalization rate for RSV was 20.0% of that in the pre-NPI period at 17.6% of the predicted value. The re-emergence of RSV and IFV infections during 2020–2021 was observed in 13 and 4 countries, respectively.
Conclusion
During 2021–2022, endemic transmission of the RSV, but not IFV, was observed in Korea.
10.Significance of Serum Antibody Test for Toxocariasis in Healthy Healthcare Examinees with Eosinophilia in Seoul and Gyeongsangnam-do, Korea.
Hong Seok KIM ; Yan JIN ; Min Ho CHOI ; Jae Hwan KIM ; Young Ha LEE ; Cheong Ha YOON ; Eui Hyuk HWANG ; Hun KANG ; Sang Yong AHN ; Gi Jin KIM ; Sung Tae HONG
Journal of Korean Medical Science 2014;29(12):1618-1625
There have been numerous reports on the relationship between eosinophilia and toxocariasis. The present study investigated seropositive rates of toxocariasis among healthy people with or without eosinophilia in urban and rural areas, and assessed risk factors for positive antibody test. A total of 610 healthy people, who visited health check-up (Medicheck(R), Korea Association of Health Promotion), 310 from Seoul and 300 from Gyeongsangnam-do, were subjected for this study. Their serum samples were tested by ELISA with the crude antigen of Toxocara canis larvae. Cross-reactions with other tissue invading helminth antigens were also investigated. Total antibody positive rate of toxocariasis was 8.7% of the 610 subjects. When the subjects were grouped into 3 by their eosinophil counts, the antibody positive rates significantly differed by the groups; 5.9% (18/306) in the group<350/microL, 10.0% (11/110) in the group 350-500/microL, and 12.4% (24/194) in the group>500/microL (P=0.028). A total of 22 serum samples cross-reacted with other tissue-invading helminth antigens. A questionnaire analysis recognized drinking alcohol and smoking as significant risk factors of toxocariasis. In conclusion, toxocariasis antibody positive rate is correlated with eosinophil counts. It is recommended that healthy subjects with eosinophilia by routine health examination and risk factors undergo Toxocara serology by multiantigen ELISA to investigate etiology.
Age Distribution
;
Comorbidity
;
Eosinophilia/*diagnosis/*epidemiology
;
Female
;
Humans
;
Incidence
;
Male
;
Middle Aged
;
Reference Values
;
Republic of Korea/epidemiology
;
Risk Factors
;
Rural Population/*statistics & numerical data
;
Serologic Tests/statistics & numerical data
;
Sex Distribution
;
Toxocariasis/*diagnosis/*epidemiology
;
Urban Population/*statistics & numerical data