1.Additional Drug Resistance Patterns among Multidrug-Resistant Tuberculosis Patients in Korea: Implications for Regimen Design.
Jeong Ha MOK ; Bo Hyoung KANG ; Taehoon LEE ; Hyun Kyung LEE ; Hang Jea JANG ; Yu Ji CHO ; Doosoo JEON
Journal of Korean Medical Science 2017;32(4):636-641
Detailed information on additional drug resistance patterns of multidrug-resistant tuberculosis (MDR-TB) is essential to build an effective treatment regimen; however, such data are scarce in Korea. We retrospectively analyzed the results of phenotypic drug susceptibility testing (DST) of culture confirmed-TB patients from January 2010 to December 2014 in 7 university hospitals in Korea. MDR-TB was identified among 6.8% (n = 378) of 5,599 isolates. A total of 57.1% (n = 216) of the MDR-TB patients had never been treated for TB. Strains from MDR-TB patients showed additional resistance to pyrazinamide (PZA) (35.7%), any second-line injectable drug (19.3%), and any fluoroquinolone (26.2%). Extensively drug resistant TB comprised 12.4% (n = 47) of the MDR-TB patients. Of 378 MDR-TB patients, 50.3% (n = 190) were eligible for the shorter MDR-TB regimen, and 50.0% (n = 189) were fully susceptible to the 5 drugs comprising the standard conventional regimen (PZA, kanamycin, ofloxoacin, prothionamide, and cycloserine). In conclusion, the proportion of new patients and the levels of additional drug resistance were high in MDR-TB patients. Considering the high levels of drug resistance, the shorter MDR-TB treatment regimen may not be feasible; instead, an individually tailored regimen based on the results of molecular and phenotypic DST may be more appropriate in MDR-TB patients in Korea.
2.Acute Severe Symptomatic Hyponatremia Following Coronary Angiography.
Eul Sik JUNG ; Woong Chol KANG ; Young Rock JANG ; Sejoong KIM ; Ji Won YANG ; Kyounghoon LEE ; Taehoon AHN
Korean Circulation Journal 2011;41(9):552-554
Hyponatremia is a relatively common electrolyte disorder. Although severe acute hyponatremia following coronary angiography is rare, potentially lethal neurologic manifestations may result. We describe a patient with severe, symptomatic hyponatremia, an unusual complication of coronary angiography. Lack of familiarity with contrast media-related hyponatremia caused a delay in diagnosis and therapy in our case. The diagnosis of acute hyponatremia should be considered in any patient who develops behavioral or neurologic manifestations following coronary angiography. Prompt diagnosis and treatment is essential to avoid permanent neurologic damage or death.
Coronary Angiography
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Humans
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Hyponatremia
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Neurologic Manifestations
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Recognition (Psychology)
3.Acute Myocardial Infarction due to Polyarteritis Nodosa in a Young Female Patient.
Jin WI ; Hyun Hee CHOI ; Chan Joo LEE ; Taehoon KIM ; Sanghoon SHIN ; Young Guk KO ; Yangsoo JANG ; Yong Bum PARK ; Young Joo KWON
Korean Circulation Journal 2010;40(4):197-200
Coronary artery aneurysms are uncommon, are usually associated with atherosclerosis, and rarely involve all three major coronary arteries. The present report describes a rare case of a young female patient presenting with acute myocardial infarction (AMI). Coronary angiography revealed multiple severe aneurysmal and stenotic changes. Based on clinical feature and angiographic findings, it was strongly suspected that the patient had polyarteritis nodosa (PAN) complicated by AMI. The patient was treated with standard cardiac medications and immunosuppressive agents and has remained stable without further complications during a follow-up period of 6 months.
Aneurysm
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Atherosclerosis
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Coronary Aneurysm
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Coronary Angiography
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Coronary Vessels
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Female
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Follow-Up Studies
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Humans
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Immunosuppressive Agents
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Myocardial Infarction
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Polyarteritis Nodosa
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Vasculitis
4.Comparisons of the Effects of Stent Eccentricity on the Neointimal Hyperplasia between Sirolimus-Eluting Stent versus Paclitaxel-Eluting Stent.
Byeong Keuk KIM ; Young Guk KO ; Seungjin OH ; Jung Sun KIM ; Woong Chol KANG ; Dong Woon JEON ; Joo Young YANG ; Donghoon CHOI ; Myeong Ki HONG ; Taehoon AHN ; Yangsoo JANG
Yonsei Medical Journal 2010;51(6):823-831
PURPOSE: Previous studies suggested that asymmetric stent expansion did not affect suppression of neointimal hyperplasia (NIH) after sirolimus-eluting stents (SES) implantation. The aim of this study was to evaluate the effects of stent eccentricity (SE) on NIH between SES versus paclitaxel-eluting stents (PES) using an intravascular ultrasound (IVUS) analysis from the randomized trial. MATERIALS AND METHODS: Serial IVUS data were obtained from Post-stent Optimal Expansion (POET) trial, allocated randomly to SES or PES. Three different SE (minimum stent diameter divided by maximum stent diameter) were evaluated; SE at the lesion site with maximal %NIH area (SE-NIH), SE at the minimal stent CSA [SE-minimal stent area (SE-MSA)], and averaged SE through the entire stent (SE-mean). We classified each drug-eluting stents (DES) into the concentric (> or = mean SE) and eccentric groups (< mean SE) based on the mean value of SE. RESULTS: Among 301 enrolled patients, 233 patients [SES (n = 108), PES (n = 125)] underwent a follow-up IVUS. There was no significant correlation between %NIH area and SE-NIH (r = - 0.083, p = 0.391) or SE-MSA (r = - 0.109, p = 0.259) of SES. However, SE-NIH of PES showed a weak but significant correlation with %NIH area (r = 0.269, p < 0.01). As to the associations between SE-mean and NIH volume index, SES revealed no significant correlation (r = - 0.001, p = 0.990), but PES showed a weak but significant correlation (r = 0.320, p < 0.01). However, there was no difference in the restenosis rate between the eccentric versus concentric groups of both DES. CONCLUSION: This study suggests that lower SE of both SES and PES, which means asymmetric stent expansion, may not be associated with increased NIH.
Aged
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Angiography/methods
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Coronary Restenosis/pathology/ultrasonography
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*Drug-Eluting Stents
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Female
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Humans
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Hyperplasia/*drug therapy/pathology
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Immunosuppressive Agents/administration & dosage
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Male
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Middle Aged
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Paclitaxel/*administration & dosage
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Sirolimus/*administration & dosage
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Tunica Intima
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Ultrasonography, Interventional/methods