Background: Recent reports have suggested that pneumonitis is a rare complication following vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).However, its clinical features and outcomes are not well known. The aim of this study was to identify the clinical characteristics and outcomes of patients with vaccine-associated pneumonitis following vaccination against SARS-CoV-2. Methods: In this nationwide multicenter survey study, questionnaires were distributed to pulmonary physicians in referral hospitals. They were asked to report cases of development or exacerbation of interstitial lung disease (ILD) associated with the coronavirus disease 2019 vaccine. Vaccine-associated pneumonitis was defined as new pulmonary infiltrates documented on chest computed tomography within 4 weeks of vaccination and exclusion of other possible etiologies. Results: From the survey, 49 cases of vaccine-associated pneumonitis were identified between February 27 and October 30, 2021. After multidisciplinary discussion, 46 cases were analyzed. The median age was 66 years and 28 (61%) were male. The median interval between vaccination and respiratory symptoms was 5 days. There were 20 (43%), 17 (37%), and nine (19%) patients with newly identified pneumonitis, exacerbation of pre-diagnosed ILD, and undetermined pre-existing ILD, respectively. The administered vaccines were BNT162b2 and ChAdOx1 nCov-19/AZD1222 each in 21 patients followed by mRNA-1273 in three, and Ad26.COV2.S in one patient. Except for five patients with mild disease, 41 (89%) patients were treated with corticosteroid. Significant improvement was observed in 26 (57%) patients including four patients who did not receive treatment. However, ILD aggravated in 9 (20%) patients despite treatment. Mortality was observed in eight (17%) patients. Conclusion These results suggest pneumonitis as a potentially significant safety concern for vaccines against SARS-CoV-2. Clinical awareness and patient education are necessary for early recognition and prompt management. Additional research is warranted to identify the epidemiology and characterize the pathophysiology of vaccine-associated pneumonitis.

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrosing interstitial pneumonia, which presents with a progressive worsening dyspnea, and thus a poor outcome. The members of the Korean Academy of Tuberculosis and Respiratory Diseases as well as the participating members of the Korea Interstitial Lung Disease Study Group drafted this clinical practice guideline for IPF management. This guideline includes a wide range of topics, including the epidemiology, pathogenesis, risk factors, clinical features, diagnosis, treatment, prognosis, and acute exacerbation of IPF in Korea. Additionally, we suggested the PICO for the use of pirfenidone and nintendanib and for lung transplantation for the treatment of patients with IPF through a systemic literature review using experts' help in conducting a meta-analysis. We recommend this guideline to physicians, other health care professionals, and government personnel in Korea, to facilitate the treatment of patients with IPF.

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrosing interstitial pneumonia, which presents with a progressive worsening dyspnea, and thus a poor outcome. The members of the Korean Academy of Tuberculosis and Respiratory Diseases as well as the participating members of the Korea Interstitial Lung Disease Study Group drafted this clinical practice guideline for IPF management. This guideline includes a wide range of topics, including the epidemiology, pathogenesis, risk factors, clinical features, diagnosis, treatment, prognosis, and acute exacerbation of IPF in Korea. Additionally, we suggested the PICO for the use of pirfenidone and nintendanib and for lung transplantation for the treatment of patients with IPF through a systemic literature review using experts' help in conducting a meta-analysis. We recommend this guideline to physicians, other health care professionals, and government personnel in Korea, to facilitate the treatment of patients with IPF.
Delivery of Health Care ; Diagnosis ; Disease Management ; Dyspnea ; Epidemiology ; Humans ; Idiopathic Pulmonary Fibrosis ; Korea ; Lung Diseases, Interstitial ; Lung Transplantation ; Prognosis ; Risk Factors ; Tuberculosis

This study was conducted to compare the anesthetic effects of 2,2,2-tribromoethanol (TBE, Avertin®) in ICR mice obtained from three different sources. TBE (2.5%) was intraperitoneally injected at three doses: high-dose group (500 mg/kg), intermediate-dose group (250 mg/kg), and low-dose group (125 mg/kg). Anesthesia time, recovery time, end-tidal peak CO2 (ETCO₂), mean arterial blood pressure, heart rate, oxygen saturation (SpO₂), body temperature, pH, PCO₂, and PO₂ of the arterial blood were measured. Stable anesthesia was induced by all doses of TBE and the anesthesia time was maintained exhibited dose dependency. No significant differences in anesthetic duration were found among the three different strains. However, the anesthesia time was longer in female than in male mice, and the duration of anesthesia was significantly longer in female than in male mice in the high-dose group. The recovery time was significantly longer for female than male mice in the intermediate- and high-dose groups. In the ICR strains tested, there were no significant differences in the mean arterial blood pressure, SPO₂, arterial blood PCO₂, and PO₂, which decreased after TBE anesthesia, or in heart rate and ETCO₂, which increased after TBE anesthesia. In addition, body temperature, blood biochemical markers, and histopathological changes of the liver, kidney, and lung were not significantly changed by TBE anesthesia. These results suggested that ICR mice from different sources exhibited similar overall responses to a single exposure to TBE anesthesia. In conclusion, TBE is a useful drug that can induce similar anesthetic effects in three different strains of ICR mice.
Anesthesia ; Anesthetics* ; Animals ; Arterial Pressure ; Biomarkers ; Body Temperature ; Female ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Kidney ; Liver ; Lung ; Male ; Mice ; Mice, Inbred ICR* ; Oxygen ; Sex Characteristics

PURPOSE: It has been studied prognostic factors about secondary displacement after conservative treatment of the distal radius fracture, but each study showed different results. Authors retrospectively evaluated factors known to be involved secondary displacement of the distal radius fracture to determine its significance. METHODS: One hundred eighteen cases of the radiographically unstable distal radius fractures that closed reduction was adequately performed were retrospectively studied and the radiographic images were taken at 1, 2, 3, 4, 6 weeks after closed reduction. During follow-up, dorsal tilt more than 15°, volar tilt more than 20°, ulnar positive variance more than 4 mm, radial length less than 6 mm, radial inclination less than 10° were thought of the loss of reduction. RESULTS: In 41 cases (34.7%), the loss of reduction occurred. Sex, intra-articular fracture, dorsal and volar comminution, concomitant ulnar fracture and involvement of the distal radio-ulnar joint were statistically not significant. Analysis results of the binomial logistic regression model were as follows: age (p=0.003), radial shortening (p=0.010) and ulnar positive variance (p=0.010) were statistically significant as the predictive prognostic factors. Analysis results of the multinomial logistic regression model showed age (p=0.006) as an only statistically significant factor. CONCLUSION: As the predictive prognostic factors for development of secondary displacement after conservative treatment of the unstable distal radius fracture, age was determined as most significant factor. Also radial shortening and ulnar positive variance were thought of the predictive factors for secondary displacement.
Colles' Fracture ; Follow-Up Studies ; Intra-Articular Fractures ; Joints ; Logistic Models ; Radius Fractures* ; Radius* ; Retrospective Studies

We present a case of Aspergillus septic hip arthritis in an immunocompetent patient with undiagnosed recurrent pulmonary aspergillosis who underwent arthroscopic surgery. Biopsy specimens of synovium revealed fungal hyphae, confirming Aspergillus infection. Aspergillus septic hip arthritis can occur in immunocompetent patients, and arthroscopy can be a noninvasive surgical option in these cases.
Arthritis ; Arthritis, Infectious* ; Arthroscopy ; Aspergillus* ; Biopsy ; Female* ; Hip* ; Humans ; Hyphae ; Pulmonary Aspergillosis* ; Synovial Membrane

The silkworm extract powder contain 1-deoxynojirimycin (DNJ), a potent alpha-glycosidase inhibitor, has therapeutic potency against diabetes mellitus. Therefore, natural products containing DNJ from mulberry leaves and silkworm are consumed as health functional food. The present study was performed to evaluate the safety of the silkworm extract powder, a health food which containing the DNJ. The repeated toxicity studies and gentic toxicity studies of the silkworm extract powder were performed to obtain the data for new functional food approval in MFDS. The safety was evaluated by a single-dose oral toxicity study and a 90 day repeated-dose oral toxicity study in Sprague-Dawley rats. The silkworm extract powder was also evaluated for its mutagenic potential in a battery of genetic toxicity test: in vitro bacterial reverse mutation assay, in vitro chromosomal aberration test, and in vivo mouse bone marrow micronucleus assay. The results of the genetic toxicology assays were negative in all of the assays. The approximate lethal dose in single oral dose toxicity study was considered to be higher than 5000 mg/kg in rats. In the 90 day study, the dose levels were wet at 0, 500, 1000, 2000 mg/kg/day, and 10 animals/sex/dose were treated with oral gavage. The parameters that were monitored were clinical signs, body weights, food and water consumptions, ophthalmic examination, urinalysis, hematology, serum biochemistry, necropsy findings, organ weights, and histopathological examination. No adverse effects were observed after the 90 day administration of the silkworm extract powder. The No-Observed-Adverse-Effect-Level (NOAEL) of silkworm extract powder in the 90 day study was 2000 mg/kg/day in both sexes, and no target organ was identified.
1-Deoxynojirimycin ; Animals ; Biochemistry ; Biological Agents ; Body Weight ; Bombyx* ; Bone Marrow ; Chromosome Aberrations ; Diabetes Mellitus ; Functional Food ; Food, Organic ; Hematology ; Mice ; Micronucleus Tests ; Morus ; Mutagenicity Tests ; Organ Size ; Rats ; Rats, Sprague-Dawley ; Toxicology ; Urinalysis ; Drinking

BACKGROUND AND OBJECTIVES: Transcatheter aortic valve implantation (TAVI) was recently introduced in Korea. The present report describes the experience of early TAVI cases. SUBJECTS AND METHODS: Between March, 2010 and October, 2011, 48 patients with severe symptomatic aortic stenosis (AS) were screened at the Asan Medical Center to determine their suitability for surgical intervention. Of these, 23 were considered unsuitable and underwent TAVI. Procedural success rates, procedure-related complications, and clinical outcomes were evaluated in the TAVI patients. RESULTS: Transfemoral (n=20) or transapical (n=3) TAVI was performed. The mean age of patients was 75.9+/-5.4 years and 57% were females. The mean logistic European System for Cardiac Operative Risk Evaluation was 25.6+/-5.1%. Implantation was successful in 22 patients (19 transfemoral, three transapical). After successful implantation, the mean aortic valve area increased from 0.68+/-0.14 cm2 to 1.45+/-0.33 cm2. There were no procedure-related complications or mortality. The patients showed no paravalvular aortic regurgitation with > or = moderate degree and remained stable without progression during follow-up. During follow-up (interquartile range, 1.1-12.9), all patients were alive without any occurrence of valve failure. CONCLUSION: TAVI procedure is feasible in patients with inoperative symptomatic AS leading to hemodynamic and clinical improvement. With accumulation of experience, proper patient selection and development of device technologies, TAVI should decrease adverse events and expand the indications in the near future.
Aortic Valve ; Aortic Valve Insufficiency ; Aortic Valve Stenosis ; Female ; Follow-Up Studies ; Hemodynamics ; Humans ; Korea ; Patient Selection

BACKGROUND: Varenicline is recently known as smoking cessation medicine has no results of researches conducted in the actual practice settings except for incipient clinical trials. This research attempted to analyze the factors for smoking cessation by using Varenicline prescribed in the family clinic, and the efficacy of Varenicline. METHODS: Brief smoking cessation education was conducted on 140 people who visited the Department of Family Medicine at Dankook University and Varenicline was prescribed for them. This research checked whether smoking was stopped or not after six months and analyzed the factors for succeeding in smoking cessation. RESULTS: Varenicline was prescribed for the 140 people. After six months, 46 smokers were successful in smoking cessation, representing the rate of success of 35.4%, and after 12 months, 31 people of 83 people were successful in smoking cessation, representing the rate of success of 37.3%. The group less smoke than 24.3 cigarettes/day (the average daily smoking amount) has higher quit rate than the group more smoke than 24.3 by 4.9 times. The group takes Varenicline longer than 26.7 days (the average Varenicline dosage period) has higher quit rate than the group takes Varenicline shorter than 26.7 by 4 times. Smoking-cessation rate was 4.5 times when trying to stop smoking by the doctor's recommendation. It was higher than when trying to stop smoking by self-determination. In the multivariate analysis, there were significant relationships in daily smoking amount, dosage and period of Varenicline, and motivation of visits. CONCLUSION: Varenicline is one of the useful medication for quitting smoking in family practice setting. Better compliance of medicine shows better quitting rate.
Benzazepines ; Compliance ; Family Practice ; Humans ; Motivation ; Multivariate Analysis ; Quinoxalines ; Smoke ; Smoking ; Smoking Cessation ; Varenicline

In 2007, the Korean Interstitial Lung Disease Society had collected clinical data of patients who have diagnosed as Lymphangioleiomyomatosis (LAM) since 1990 through nationwide survey, which showed that LAM patients had increased sharply after 2004. The present study was performed to show the clinical features of Korean patients with LAM, and to establish the reason for the recent increase in the diagnosis. All 63 patients were women and the mean age at diagnosis was 36 yr. The most common presenting symptom was dyspnea and 8 patients had tuberous sclerosis complex. The survival rate at 5 yr after diagnosis was 84%. Compared with patients diagnosed after 2004 (n=34), the patients diagnosed before 2004 (n=29) complained with dyspnea more (P=0.016) and had lower FEV1% predicted (P=0.003), and DLco% predicted (P=0.042). The higher proportion of patients diagnosed after 2004 showed the normal chest radiography, and they were detected by routine chest CT screening (P=0.016). This study showed that clinical features of Korean patients with LAM were not different from those reported elsewhere. It is concluded that the reason for the increase of newly diagnosed patients is the result of increase in detection of the early stage LAM by the widespread use of chest CT screening.
Adult ; Aged ; Early Diagnosis ; Female ; Humans ; Lung Neoplasms/*diagnosis/mortality/radiography ; Lymphangioleiomyomatosis/*diagnosis/mortality/radiography ; Middle Aged ; Republic of Korea ; Respiratory Function Tests ; Survival Rate ; Tomography, X-Ray Computed