1.A Measles Outbreak in a Local Children’s Hospital in Korea, 2019
Hyejin SO ; Kyung Min KIM ; Eun Young BAE ; Eun Young CHO
Journal of Korean Medical Science 2023;38(3):e28-
A measles outbreak with 20 confirmed cases occurred at a local children’s hospital in Daejeon from March 28 to April 21, 2019. The index patient was a 7-month-old girl with a recent history of travel to Vietnam. Contact tracing, active surveillance, and post-exposure prophylaxis were conducted by health authorities. Among the 20 patients, 11 (55%) were infants (0–11 months of age), three (15%) were aged 1–3 years, one (5%) was aged 4 years, and five (25%) were adults. Fifteen (75%) patients did not have a history of measles vaccination, and five (25%) had received only one vaccine dose. This study described the importance of prompt application of infection control measures in susceptible environments, including hospitals. Age-appropriate vaccination and providing information on infectious diseases to international travelers and multicultural families in Korea is vital.
2.Retrospective Analysis of Clinical Patterns and Antibiotic Utilization in Pediatric Patients Hospitalized with Respiratory Syncytial Virus Pneumonia at a Recently Established General Hospital
Hyejin SO ; Kyung Min KIM ; Eun Young CHO
Pediatric Infection & Vaccine 2024;31(1):75-82
Purpose:
As the coronavirus disease 2019 (COVID-19) pandemic ended, the number of patients with respiratory syncytial virus (RSV) pneumonia increased during the spring/summer of 2022.This study aimed to analyze the clinical features and antibiotic usage of children hospitalized for RSV pneumonia in a recently established general hospital in Sejong city.
Methods:
In this retrospective review, we included inpatients of the Pediatric Department of Chungnam National University Sejong Hospital diagnosed with RSV pneumonia between March 2022 and April 2023. Patients were divided into 2 groups: with and without antibiotic treatment. Demographic data, initial presentations, and clinical courses were reviewed.
Results:
A total of 116 patients with RSV pneumonia were hospitalized during this period, of which 102 were analyzed, excluding 14 with underlying diseases or who did not fall within the definition of pneumonia. The median age was 17 months. Diagnoses of bacterial infections (acute otitis media and sinusitis) were documented in 9.8% of cases. Intravenous (IV) antibiotics were administered in 46% of cases. The group receiving IV antibiotics showed higher inflammatory levels (C-reactive protein; CRP), more infiltration on initial chest X-rays, and longer fever duration. There was no difference in the length of hospitalization between the groups with and without IV antibiotics.
Conclusions
This study showed a tendency for the attending physician to prescribe IV antibiotics to patients with longer fever duration, pulmonary infiltrations on the initial chest X-ray, and higher CRP levels. However, given the high rate of IV antibiotic usage compared to previous studies, care should be taken in antibiotic use.
3.Retrospective Analysis of Clinical Patterns and Antibiotic Utilization in Pediatric Patients Hospitalized with Respiratory Syncytial Virus Pneumonia at a Recently Established General Hospital
Hyejin SO ; Kyung Min KIM ; Eun Young CHO
Pediatric Infection & Vaccine 2024;31(1):75-82
Purpose:
As the coronavirus disease 2019 (COVID-19) pandemic ended, the number of patients with respiratory syncytial virus (RSV) pneumonia increased during the spring/summer of 2022.This study aimed to analyze the clinical features and antibiotic usage of children hospitalized for RSV pneumonia in a recently established general hospital in Sejong city.
Methods:
In this retrospective review, we included inpatients of the Pediatric Department of Chungnam National University Sejong Hospital diagnosed with RSV pneumonia between March 2022 and April 2023. Patients were divided into 2 groups: with and without antibiotic treatment. Demographic data, initial presentations, and clinical courses were reviewed.
Results:
A total of 116 patients with RSV pneumonia were hospitalized during this period, of which 102 were analyzed, excluding 14 with underlying diseases or who did not fall within the definition of pneumonia. The median age was 17 months. Diagnoses of bacterial infections (acute otitis media and sinusitis) were documented in 9.8% of cases. Intravenous (IV) antibiotics were administered in 46% of cases. The group receiving IV antibiotics showed higher inflammatory levels (C-reactive protein; CRP), more infiltration on initial chest X-rays, and longer fever duration. There was no difference in the length of hospitalization between the groups with and without IV antibiotics.
Conclusions
This study showed a tendency for the attending physician to prescribe IV antibiotics to patients with longer fever duration, pulmonary infiltrations on the initial chest X-ray, and higher CRP levels. However, given the high rate of IV antibiotic usage compared to previous studies, care should be taken in antibiotic use.
4.Retrospective Analysis of Clinical Patterns and Antibiotic Utilization in Pediatric Patients Hospitalized with Respiratory Syncytial Virus Pneumonia at a Recently Established General Hospital
Hyejin SO ; Kyung Min KIM ; Eun Young CHO
Pediatric Infection & Vaccine 2024;31(1):75-82
Purpose:
As the coronavirus disease 2019 (COVID-19) pandemic ended, the number of patients with respiratory syncytial virus (RSV) pneumonia increased during the spring/summer of 2022.This study aimed to analyze the clinical features and antibiotic usage of children hospitalized for RSV pneumonia in a recently established general hospital in Sejong city.
Methods:
In this retrospective review, we included inpatients of the Pediatric Department of Chungnam National University Sejong Hospital diagnosed with RSV pneumonia between March 2022 and April 2023. Patients were divided into 2 groups: with and without antibiotic treatment. Demographic data, initial presentations, and clinical courses were reviewed.
Results:
A total of 116 patients with RSV pneumonia were hospitalized during this period, of which 102 were analyzed, excluding 14 with underlying diseases or who did not fall within the definition of pneumonia. The median age was 17 months. Diagnoses of bacterial infections (acute otitis media and sinusitis) were documented in 9.8% of cases. Intravenous (IV) antibiotics were administered in 46% of cases. The group receiving IV antibiotics showed higher inflammatory levels (C-reactive protein; CRP), more infiltration on initial chest X-rays, and longer fever duration. There was no difference in the length of hospitalization between the groups with and without IV antibiotics.
Conclusions
This study showed a tendency for the attending physician to prescribe IV antibiotics to patients with longer fever duration, pulmonary infiltrations on the initial chest X-ray, and higher CRP levels. However, given the high rate of IV antibiotic usage compared to previous studies, care should be taken in antibiotic use.
5.Late-onset non-thymomatous myasthenia gravis: Comparison with early-onset and very late-onset myasthenia gravis
Eun Bin Cho ; Ju-Hong Min ; Sujin Lee ; Cindy W Yoon ; Jin Myoung Seok ; HyeJin Cho ; Hye Lim Lee ; Byoung Joon Kim
Neurology Asia 2017;22(2):123-131
Objective: To identify the clinical characteristics of patients with myasthenia gravis (MG) according
to age at onset. Methods: We retrospectively recruited 227 non-thymomatous MG patients with adult
onset who had been followed up for more than one year. The patients were classified based on the
age of symptom onset as “early-onset MG” (EOMG,18–50 years; N=135), “late-onset MG” (LOMG,
50–64 years; N=53), and “very late-onset MG” (VLOMG, 65 years; N=39). Clinical features and
serological findings were compared between these groups. Results: LOMG patients showed more
frequent ocular MG (55%) and less frequent thymic hyperplasia (9%) compared to EOMG patients
(31% and 38%; p=0.006 and p<0.001, respectively), and no female preponderance compared to
VLOMG patients (female, 49% vs.77%; p=0.014). However, there were no significant differences
between VLOMG and EOMG patients, except for more frequent thymic hyperplasia (p<0.001) in
EOMG patients. When analyzing female patients only, less frequent secondary generalization (10%)
were additionally found in LOMG patients, compared to EOMG (47%, p= 0.008) and VLOMG (59%,
p=0.004) patients. Anti-acetylcholine receptor antibody (HR, 5.48; 95% CI, 1.73–17.37; p=0.004) was
independently associated with secondary generalization in female EOMG patients.
Conclusion: Our study suggests that LOMG patients, especially female, were characterized by frequent
ocular MG and less frequent secondary generalization, distinguished from EOMG and VLOMG
patients. Further large epidemiologic studies in Korea are needed to determine the characteristics of
MG patients according to the age at onset and gender.
6.Structure Determination of Heishuixiecaoline A from Valeriana fauriei and Its Content from Different Cultivated Regions by HPLC/PDA Analysis
Hyejin CHO ; Ki Hyun KIM ; Sin Hee HAN ; Hak-Jae KIM ; Ik-Hyun CHO ; Sanghyun LEE
Natural Product Sciences 2022;28(4):181-186
A germacrane-type sesquiterpenoid was isolated and purified from a methanol extract of the roots of Valeriana fauriei (RVF) through open column chromatography using silica gel. This compound was verified to be heishuixiecaoline A by spectroscopic analysis. This compound was isolated for the first time from RVF.Quantitative analysis of heishuixiecaoline A from RVF cultivated from three different regions (Eumseong, Jinbu, and Jinan regions) was performed by combining high-performance liquid chromatography with a photodiode array detector. The extract of RVF cultivated in the Jinbu region showed the highest content (9.23 mg/g). In addition, a significant amount of the compound was detected in all RVF samples, which could be expected since it is a characteristic compound of RVF. The sesquiterpenoid group heishuixiecaoline A was isolated from RVF, a resource for various pharmacological substances, and quantitative analysis of RVF cultivated from three different regions was performed. As a result of these experiments, basic data on RVF that can be used in the development and application of pharmaceuticals and health functional foods in the future were obtained.
7.Health Inequities in Cancer Incidence According to Economic Status and Regions Are Still Existed Even under Universal Health Coverage System in Korea: A Nationwide Population Based Study Using the National Health Insurance Database
Youngs CHANG ; Soo-Hee HWANG ; Sang-A CHO ; Hyejin LEE ; Eunbyul CHO ; Jin Yong LEE
Cancer Research and Treatment 2024;56(2):380-403
Purpose:
The purpose of this study is to determine the level of health equity in relation to cancer incidence.
Materials and Methods:
We used the National Health Insurance claims data of the National Health Insurance Service between 2005 and 2022 and annual health insurance and medical aid beneficiaries between 2011 and 2021 to investigate the disparities of cancer incidence. We calculated age-sex standardized cancer incidence rates by cancer and year according to the type of insurance and the trend over time using the annual percentage change. We also compared the hospital type of the first diagnosis by cancer type and year and cancer incidence rates by cancer type and region in 2021 according to the type of insurance.
Results:
The total cancer incidence increased from 255,971 in 2011 to 325,772 cases in 2021. The absolute difference of total cancer incidence rate between the NHI beneficiaries and the medical aid (MA) recipients increased from 510.1 cases per 100,000 population to 536.9 cases per 100,000 population. The odds ratio of total cancer incidence for the MA recipients increased from 1.79 (95% confidence interval [CI], 1.77 to 1.82) to 1.90 (95% CI, 1.88 to 1.93). Disparities in access to hospitals and regional cancer incidence were profound.
Conclusion
This study examined health inequities in relation to cancer incidence over the last decade. Cancer incidence was higher in the MA recipients, and the gap was widening. We also found that regional differences in cancer incidence still exist and are getting worse. Investigating these disparities between the NHI beneficiaries and the MA recipients is crucial for implementing of public health policies to reduce health inequities.
8.A Case of Emphysematous Pyelonephritis Associated with Emphysematous Ureteritis and Cystitis.
Inchul CHOI ; Taekyung KANG ; Hyejin KIM ; Sungchan OH ; Sukjin CHO ; Sanglae LEE ; Seokyong RYU
Journal of the Korean Society of Emergency Medicine 2011;22(5):584-587
Emphysematous pyelonephritis (EPN) is a necrotizing infection of the renal parenchyma and its surrounding tissues that results in the accumulation of gas in the renal parenchyma, collecting system or perinephric tissue. EPN is a potentially life-threatening condition, which is most commonly associated with poorly controlled diabetes. We describe a case of emphysematous pyelonephritis associated with emphysematous ureteritis and cystitis in a 68-year-old diabetic woman, who was cured with medical treatment and surgical intervention.
Aged
;
Cystitis
;
Female
;
Humans
;
Pyelonephritis
;
Ureter
9.A Case of Concomitant Inv(3)(q21q26) and Cryptic BCR/ABL1 Rearrangement in the Blast Crisis of Chronic Myeloid Leukemia.
Hyejin LEE ; Chihyun CHO ; Min Jung KWON ; Myung Hyun NAM ; Chang Kyu LEE ; Young Kee KIM
Laboratory Medicine Online 2011;1(3):163-167
Structural abnormalities of the long arm of chromosome 3 (3q) have been associated with elevated platelet count and hyperplasia of megakaryocytes with dysplasia in various hematological malignancies. Some cases of chronic myeloid leukemia (CML) may acquire inv(3) (q21q26) or t(3;3)(q21;q26), and such a finding usually indicates accelerated or blast phase of their disease. We report a case of concomitant inv(3) (q21q26) and cryptic BCR/ABL1 rearrangement in the blast crisis of CML. The patient was 17-year-old male and showed marked leukocytosis and thrombocytosis at admission. Leukocyte differentials showed eosinophilia, basophilia and increased blasts. The bone marrow was hypercellular with granulocytic hyperplasia, and dysmorphic megakaryocytes were frequently observed. Conventional cytogenetic analysis revealed only an inv(3)(q21q26) and no Philadelphia chromosome was observed. FISH and RT-PCR analyses confirmed cryptic BCR/ABL1 rearrangement. The patient responded poorly with imatinib and induction chemotherapy, and expired during the course of 2nd chemotherapy with increased dose of imatinib.
Adolescent
;
Arm
;
Benzamides
;
Blast Crisis
;
Bone Marrow
;
Chromosomes, Human, Pair 3
;
Cytogenetic Analysis
;
Eosinophilia
;
Hematologic Neoplasms
;
Humans
;
Hyperplasia
;
Induction Chemotherapy
;
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
;
Leukocytes
;
Leukocytosis
;
Male
;
Megakaryocytes
;
Philadelphia Chromosome
;
Piperazines
;
Platelet Count
;
Pyrimidines
;
Thrombocytosis
;
Imatinib Mesylate
10.Generation and characterization of integration-free induced pluripotent stem cells from patients with autoimmune disease.
Mi Young SON ; Mi Ok LEE ; Hyejin JEON ; Binna SEOL ; Jung Hwa KIM ; Jae Suk CHANG ; Yee Sook CHO
Experimental & Molecular Medicine 2016;48(5):e232-
Autoimmune diseases (AIDs), a heterogeneous group of immune-mediated disorders, are a major and growing health problem. Although AIDs are currently treated primarily with anti-inflammatory and immunosuppressive drugs, the use of stem cell transplantation in patients with AIDs is becoming increasingly common. However, stem cell transplantation therapy has limitations, including a shortage of available stem cells and immune rejection of cells from nonautologous sources. Induced pluripotent stem cell (iPSC) technology, which allows the generation of patient-specific pluripotent stem cells, could offer an alternative source for clinical applications of stem cell therapies in AID patients. We used nonintegrating oriP/EBNA-1-based episomal vectors to reprogram dermal fibroblasts from patients with AIDs such as ankylosing spondylitis (AS), Sjögren's syndrome (SS) and systemic lupus erythematosus (SLE). The pluripotency and multilineage differentiation capacity of each patient-specific iPSC line was validated. The safety of these iPSCs for use in stem cell transplantation is indicated by the fact that all AID-specific iPSCs are integrated transgene free. Finally, all AID-specific iPSCs derived in this study could be differentiated into cells of hematopoietic and mesenchymal lineages in vitro as shown by flow cytometric analysis and induction of terminal differentiation potential. Our results demonstrate the successful generation of integration-free iPSCs from patients with AS, SS and SLE. These findings support the possibility of using iPSC technology in autologous and allogeneic cell replacement therapy for various AIDs, including AS, SS and SLE.
Autoimmune Diseases*
;
Fibroblasts
;
Humans
;
In Vitro Techniques
;
Induced Pluripotent Stem Cells*
;
Lupus Erythematosus, Systemic
;
Pluripotent Stem Cells
;
Spondylitis, Ankylosing
;
Stem Cell Transplantation
;
Stem Cells
;
Transgenes