1.A Retrospective Analysis of Bone Marrow Examination Results from a Single Center Institution: In What Situations Is Bone Marrow Examination Helpful?
Young-kyu LEE ; Min Jung KIM ; Min-Young LEE ; Kyoung Ha KIM ; Namsu LEE ; Jong-Ho WON ; Seug Yun YOON
Soonchunhyang Medical Science 2022;28(2):90-95
Objective:
Bone marrow (BM) examinations are performed to evaluate hematological abnormalities. Focusing on patients with cytopenia, we aimed to determine the circumstances under which a BM examination can assist in the diagnosis of hematologic diseases.
Methods:
The medical records of 738 patients who underwent BM examination from March 2011 to March 2019 at Soonchunhyang University Seoul Hospital were reviewed. In total, 234 patients underwent a BM examination to identify the cause of cytopenia. Excluded from the analysis were BM examinations performed to diagnose specific diseases and evaluate disease status.
Results:
Results suggesting suboptimal outcome (n=6) or BM invasion of solid tumors (n=13) were excluded. Immune thrombocytopenic purpura patients (n=52) with normal BM examination results were also excluded. One hundred sixty-three patients who underwent BM examination to determine the cause of cytopenia were included in the analysis. A comparison of non-specific results (n=56) to those pointing to an underlying hematologic disease (n=107) showed that patients with severe neutropenia or severe thrombocytopenia were more likely to be diagnosed with a hematologic disease. Specifically, as the number of severe cytopenias increased, the likelihood of a hematologic disease diagnosis was significantly augmented. Patients with end-stage renal disease, autoimmune disease, or liver cirrhosis were more likely to receive non-specific results.
Conclusion
In conclusion, seeking the underlying disease or drug should be a primary target for patients with cytopenia. In cases of severe cytopenia in more than one lineage, BM examination should be strongly considered to diagnose an underlying hematologic disease.
2.Human Herpesvirus-8 Positive Multicentric Castleman’s Disease with Complete Response after Rituximab Monotherapy: A Case Report
Jun Young KIM ; Seug Yun YOON ; Min-Young LEE ; Namsu LEE ; Jong-Ho WON ; In Ho CHOI ; Kyoung Min KIM ; Kyoung Ha KIM
Soonchunhyang Medical Science 2023;29(1):29-33
Castleman’s disease is a rare non-neoplastic lymphoproliferative disorder of unknown origin. It is classified into unicentric or multicentric based on its anatomical distribution. Multicentric Castleman’s disease can be subdivided according to the presence of human herpesvirus-8 (HHV-8) infection. Castleman’s disease has a rare incidence, and HHV-8-positive multicentric Castleman’s disease is even rarer. There are several types of natural course for this disease, and the rapidly progressing type can lead to death within a few weeks, emphasizing the need for prompt diagnosis and treatment. We report a recent case from Korea, presenting with multiple lymphadenopathies, confirmed as HHV-8-positive multicentric Castleman’s disease through biopsy, and achieving complete response with rituximab monotherapy.
3.Educational Outcomes and Perception Changes in Medical Students After Visiting a Blood Donation Center
Junseo LEE ; Seryeong KIM ; Sun Young JEONG ; Seug Yun YOON ; Namsu LEE ; Jong-Ho WON ; Jeong Won SHIN ; Soon Hyo KWON ; Min-Young LEE ; Kyoung Ha KIM
Annals of Laboratory Medicine 2024;44(5):455-458
Educating primary care physicians about blood donation and transfusion is critical. The Division of Hematology and Oncology at Soonchunhyang University Seoul Hospital in Korea introduced an on-site educational program termed the Blood Donation Center Visiting Program in the clerkship education for final-year medical students. We evaluated the educational outcomes and changes in perception among medical students after the Blood Donation Center Visiting Program based on a survey. The program was implemented from 2021 to 2023. As part of the program, students visited a blood donation center each week, one group at a time. They gained practical knowledge about the blood donation process, and some students actively participated in blood donation. After the program, 287 students were eligible for an online survey of the program, of whom 203 participated in the survey. Among the 203 students, 126 (62.1%) donated blood during their visit to the blood donation center as part of the program, and 88.7% of the students reported an increase (from 71.4% to 90.1%) in their knowledge and willingness to donate blood. The onsite educational Blood Donation Center Visiting Program appears to have generated positive changes in perceptions among students and enhanced their knowledge about blood donation.
4.Educational Outcomes and Perception Changes in Medical Students After Visiting a Blood Donation Center
Junseo LEE ; Seryeong KIM ; Sun Young JEONG ; Seug Yun YOON ; Namsu LEE ; Jong-Ho WON ; Jeong Won SHIN ; Soon Hyo KWON ; Min-Young LEE ; Kyoung Ha KIM
Annals of Laboratory Medicine 2024;44(5):455-458
Educating primary care physicians about blood donation and transfusion is critical. The Division of Hematology and Oncology at Soonchunhyang University Seoul Hospital in Korea introduced an on-site educational program termed the Blood Donation Center Visiting Program in the clerkship education for final-year medical students. We evaluated the educational outcomes and changes in perception among medical students after the Blood Donation Center Visiting Program based on a survey. The program was implemented from 2021 to 2023. As part of the program, students visited a blood donation center each week, one group at a time. They gained practical knowledge about the blood donation process, and some students actively participated in blood donation. After the program, 287 students were eligible for an online survey of the program, of whom 203 participated in the survey. Among the 203 students, 126 (62.1%) donated blood during their visit to the blood donation center as part of the program, and 88.7% of the students reported an increase (from 71.4% to 90.1%) in their knowledge and willingness to donate blood. The onsite educational Blood Donation Center Visiting Program appears to have generated positive changes in perceptions among students and enhanced their knowledge about blood donation.
5.Educational Outcomes and Perception Changes in Medical Students After Visiting a Blood Donation Center
Junseo LEE ; Seryeong KIM ; Sun Young JEONG ; Seug Yun YOON ; Namsu LEE ; Jong-Ho WON ; Jeong Won SHIN ; Soon Hyo KWON ; Min-Young LEE ; Kyoung Ha KIM
Annals of Laboratory Medicine 2024;44(5):455-458
Educating primary care physicians about blood donation and transfusion is critical. The Division of Hematology and Oncology at Soonchunhyang University Seoul Hospital in Korea introduced an on-site educational program termed the Blood Donation Center Visiting Program in the clerkship education for final-year medical students. We evaluated the educational outcomes and changes in perception among medical students after the Blood Donation Center Visiting Program based on a survey. The program was implemented from 2021 to 2023. As part of the program, students visited a blood donation center each week, one group at a time. They gained practical knowledge about the blood donation process, and some students actively participated in blood donation. After the program, 287 students were eligible for an online survey of the program, of whom 203 participated in the survey. Among the 203 students, 126 (62.1%) donated blood during their visit to the blood donation center as part of the program, and 88.7% of the students reported an increase (from 71.4% to 90.1%) in their knowledge and willingness to donate blood. The onsite educational Blood Donation Center Visiting Program appears to have generated positive changes in perceptions among students and enhanced their knowledge about blood donation.
6.Educational Outcomes and Perception Changes in Medical Students After Visiting a Blood Donation Center
Junseo LEE ; Seryeong KIM ; Sun Young JEONG ; Seug Yun YOON ; Namsu LEE ; Jong-Ho WON ; Jeong Won SHIN ; Soon Hyo KWON ; Min-Young LEE ; Kyoung Ha KIM
Annals of Laboratory Medicine 2024;44(5):455-458
Educating primary care physicians about blood donation and transfusion is critical. The Division of Hematology and Oncology at Soonchunhyang University Seoul Hospital in Korea introduced an on-site educational program termed the Blood Donation Center Visiting Program in the clerkship education for final-year medical students. We evaluated the educational outcomes and changes in perception among medical students after the Blood Donation Center Visiting Program based on a survey. The program was implemented from 2021 to 2023. As part of the program, students visited a blood donation center each week, one group at a time. They gained practical knowledge about the blood donation process, and some students actively participated in blood donation. After the program, 287 students were eligible for an online survey of the program, of whom 203 participated in the survey. Among the 203 students, 126 (62.1%) donated blood during their visit to the blood donation center as part of the program, and 88.7% of the students reported an increase (from 71.4% to 90.1%) in their knowledge and willingness to donate blood. The onsite educational Blood Donation Center Visiting Program appears to have generated positive changes in perceptions among students and enhanced their knowledge about blood donation.
7.Pulmonary toxicities of molecular targeted antineoplastic agents: a single-center 10-year experience
Min-Young LEE ; Seug Yun YOON ; Kyoung Ha KIM ; Namsu LEE ; Ha Youn KIM ; Jung Hwa HWANG ; Jong-Ho WON
The Korean Journal of Internal Medicine 2021;36(3):689-698
Background/Aims:
A better understanding of cancer cell biology has led to the discovery and development of several new targeted agents for cancer. These drugs are widely used in cancer treatment and have good toxicity profiles. However, some patients are extremely sensitive to these drugs and can develop severe toxicities. Among the toxicities, pulmonary complications are infrequent with most targeted therapies. This study aimed to identify the radiologic pulmonary complications in various targeted therapies and to analyze the characteristics of patients with pulmonary toxicity.
Methods:
We retrospectively reviewed the medical records and chest image findings of 644 patients who were treated with targeted antineoplastic agents at Soonchunhyang University Hospital between May 2005 and September 2014.
Results:
Of these 644 patients, 90 (14.0%) developed pulmonary complications as noted on chest computed tomography. Among these patients, 15 (2.3%) developed drug-related pulmonary toxicities. Treatment with targeted agents was discontinued in all patients, while 11 patients were simultaneously treated with glucocorticoids. Three patients died of drug-related pulmonary toxicity.
Conclusions
During targeted therapy, clinicians should assess for pulmonary toxicities and symptoms that occur with dyspnea. If drug-induced pulmonary toxicities are suspected, imaging studies should be performed immediately, and the possibility of variable radiological patterns should be considered. Discontinuing the use of implicated causative agents and treatment with glucocorticoids resulted in an improvement in both symptoms and imaging findings, but some patients still experienced fatal pulmonary toxicities.
8.Pulmonary toxicities of molecular targeted antineoplastic agents: a single-center 10-year experience
Min-Young LEE ; Seug Yun YOON ; Kyoung Ha KIM ; Namsu LEE ; Ha Youn KIM ; Jung Hwa HWANG ; Jong-Ho WON
The Korean Journal of Internal Medicine 2021;36(3):689-698
Background/Aims:
A better understanding of cancer cell biology has led to the discovery and development of several new targeted agents for cancer. These drugs are widely used in cancer treatment and have good toxicity profiles. However, some patients are extremely sensitive to these drugs and can develop severe toxicities. Among the toxicities, pulmonary complications are infrequent with most targeted therapies. This study aimed to identify the radiologic pulmonary complications in various targeted therapies and to analyze the characteristics of patients with pulmonary toxicity.
Methods:
We retrospectively reviewed the medical records and chest image findings of 644 patients who were treated with targeted antineoplastic agents at Soonchunhyang University Hospital between May 2005 and September 2014.
Results:
Of these 644 patients, 90 (14.0%) developed pulmonary complications as noted on chest computed tomography. Among these patients, 15 (2.3%) developed drug-related pulmonary toxicities. Treatment with targeted agents was discontinued in all patients, while 11 patients were simultaneously treated with glucocorticoids. Three patients died of drug-related pulmonary toxicity.
Conclusions
During targeted therapy, clinicians should assess for pulmonary toxicities and symptoms that occur with dyspnea. If drug-induced pulmonary toxicities are suspected, imaging studies should be performed immediately, and the possibility of variable radiological patterns should be considered. Discontinuing the use of implicated causative agents and treatment with glucocorticoids resulted in an improvement in both symptoms and imaging findings, but some patients still experienced fatal pulmonary toxicities.
9.Posaconazole versus Itraconazole as Prophylactic Antifungal Agents during Induction Chemotherapy for Acute Myeloid Leukemia: A Real-World Single Center Comparison
Changgon KIM ; Seug Yun YOON ; Min Young LEE ; Kyoung Ha KIM ; Namsu LEE ; Jong Ho WON
Soonchunhyang Medical Science 2019;25(2):91-96
OBJECTIVE:
To prevent invasive fungal disease (IFD) in acute myeloid leukemia (AML) patients, the use of posaconazole as a prophylactic antifungal agent has become standard in patients undergoing induction chemotherapy. However, there are few data comparing itraconazole and posaconazole as prophylactic antifungal agents in the real world.
METHODS:
Patients at the Soonchunhyang University Seoul Hospital, who were treated with itraconazole or posaconazole for preventing IFD during induction chemotherapy for AML from January 2009 to April 2018, were included in the study. The collected clinical data were reviewed, and IFD was diagnosed using the revised definition of IFD from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group.
RESULTS:
A total of 53 patients were recruited to receive either posaconazole (n=29) or itraconazole (n=24). IFD occurred in seven patients (29.1%) who used posaconazole and in six patients (20.6%) who used itraconazole for antifungal prophylaxis (P=0.475). The 100-day mortality rate was 4 (13.8%) in the posaconazole group and 2 (8.3%) in the itraconazole group (P=0.535).
CONCLUSION
There was no significant difference in the incidence of IFD and 100-day mortality between the patients with induction chemotherapy for newly diagnosed AML who received posaconazole and itraconazole as prophylactic antifungal agents. These results suggest that it would be worthwhile to ascertain whether posaconazole is widely known as a better approach than itraconazole as prophylactic antifungal agents in the real-world.
10.Eosinophilia in Patients with End Stage Renal Disease Undergoing Hemodialysis
Kyoung Ha KIM ; Tae Ik CHANG ; Seug Yun YOON ; Min-Young LEE ; Namsu LEE ; Jong-Ho WON ; Myung Hee CHANG
Soonchunhyang Medical Science 2021;27(2):67-70
Objective:
Eosinophilia in patients on hemodialysis has already been reported. It has been associated with allergy to dialyzers and exaggerated activation of complement during hemodialysis. Its etiology, however, remains unknown. In addition, there are not enough studies on eosinophilia in patients on hemodialysis in Korea. Therefore, we performed this retrospective study to find out the prevalence and possible etiologic factors of blood eosinophilia in patients undergoing hemodialysis.
Methods:
Between January 2013 to December 2015, the patients hospitalized for hemodialysis at Soonchunhyang University Hospital and National Health Insurance Service Medical Center (Ilsan Hospital) were included in this study. Eosinophilia was defined when absolute eosinophil count was greater than 500/μL, respectively. We retrospectively reviewed the medical records of patients about parasite infection, other malignancies, and history of kidney transplantation.
Results:
Of the 2,155 patients hospitalized for hemodialysis at two centers, 1,057 patients (49%) were found to have eosinophilia. We investigated 1,199 patients’ information (Soonchunhyang University Hospital) by the medical records. Two hundred two patients (16.8%) had no identifiable and/or possible causes. Only two patients complained of symptoms such as itching. Steroids were administered to control symptoms, and both patients had normal eosinophil levels, and steroids were discontinued. Other patients did not complain of specific symptoms associated with eosinophilia and did not take medication such as steroids. Eosinophilia was improved in 49% of patients without special treatments.
Conclusion
We found that the eosinophil counts in patients with end stage renal disease on hemodialysis were frequently elevated. However, in most cases, eosinophilia was not clinically relevant.