1.A Case Of Sternocostoclavicular Hyperostosis: Differential Diagnosis of Sclerotic Metastasis.
Ju Young KIM ; Bin YOO ; Wan Sik EOM ; Kwang Su KIM ; Yuong Hyun NAM ; Hee Bom MOON
The Journal of the Korean Rheumatism Association 1994;1(2):251-255
Sternocostoclavicular hyperostosis is a chronic arthro-osteitis affecting mostly jux-tasternal structures. It is characterized clinically by painfull swelling of the upper anterior chest wall and occasionally is associated with pustulosis palmaris and plantaris. A 34-year-old female presented with upper anterior chest pain and low back pain. She was well until three months ago, then left shoulder pain and multiple pustule on both palms developed. She felt gradually exhausted in spite of symptomatic medication at drug store. Eight months before this admission she underwent an operation on the right sided breast due to a benign mass. On examination there was no evidence of conjunctivitis or aphthous oral ulcer, tenderness on left sternoclavicular joint was noted and flextion of the left hip joint was limited because of pain in the joint area. Multiple pustules were noted in the palms of both hands, but it wasn't associated with nail change. The mammographs was normal. Plain radiographs of the spine showed disc space narrowing of seventh thoracic spine and spondylolysis on fifth' lumbar vertebra. Radionuclide imaging with 99mTc-methylene diphosphonate of the bone showed multiple increased uptake on both sacroiliac joints, both first costochondra] joints, left sternoclavicular joint, and eighth thoracic vertebra. Magnetic Resonance Imaging reavealed low signal intensity in medial end of the left clavicle with joint effusion and Schmorl's node in seventh thoracic disc space. Laboratory tests were normal, except ESR 23mm/h. In this case we think that careful clinical differential diagnosis of sternocostoclavicular hyperostosis should include sclerotic metastasis.
Adult
;
Breast
;
Chest Pain
;
Clavicle
;
Conjunctivitis
;
Diagnosis, Differential*
;
Female
;
Hand
;
Hip Joint
;
Humans
;
Hyperostosis, Sternocostoclavicular*
;
Joints
;
Low Back Pain
;
Magnetic Resonance Imaging
;
Neoplasm Metastasis*
;
Oral Ulcer
;
Radionuclide Imaging
;
Sacroiliac Joint
;
Shoulder Pain
;
Spine
;
Spondylolysis
;
Sternoclavicular Joint
;
Technetium Tc 99m Medronate
;
Thoracic Wall
2.A Case of Primary Thyroid Lymphoma Involving Bone Marrow (Stage IVE) Assoeiated with Hashimoto's Thyroiditis
Young Kee SHONG ; Joong Yeol PARK ; Ghi Su KIM ; Jae Kun CHO ; Yun Ho CHU ; Wan Sik EOM ; Sang Hee KIM ; Hyun Sook CHI ; Gyung Yub GONG ; Ki Up LEE
Journal of Korean Society of Endocrinology 1994;9(4):390-394
Primary lymphoma of the thyroid is a relatively rare malignant tumor of the thyroid. It is known to be frequently associated with Hashimoto's thyroiditis. In Korea, a few cases of primary lymphoma of the thyroid have been reported and most of these cases were in the stage I E or II E. Recently, we experienced a case of the primary thyroid lymphoma, stage IV E associated with Hashimoto's thyroiditis in a 70-year-old woman who presented with dysphagia and dyspnea due to rapidly enlarging neck mass.She was treated with combination chemotherapy(cyclophosphamide, adriamycin, vincristine and methylprednisolone) and local radiotherapy and achieved partial response with resolution of dysphagia and dyspnea.
Aged
;
Bone Marrow
;
Deglutition Disorders
;
Doxorubicin
;
Dyspnea
;
Female
;
Humans
;
Korea
;
Lymphoma
;
Neck
;
Radiotherapy
;
Thyroid Gland
;
Thyroiditis
;
Vincristine
3.Korean Nosocomial Infections Surveillance System, Intensive Care Unit Module Report: Data Summary from July 2010 through June 2011.
Min Hyok JEON ; Wan Beom PARK ; Sung Ran KIM ; Hee Kyung CHUN ; Su Ha HAN ; Ji Hwan BANG ; Eun Suk PARK ; Sun Young JEONG ; Joong Sik EOM ; Young Keun KIM ; Hong Bin KIM ; Kil Yeon LEE ; Hee Jung CHOI ; Hyo Youl KIM ; Kyung Mi KIM ; Joo Hon SUNG ; Young UH ; Heoung Soo CHUNG ; Jun Wook KWON ; Jun Hee WOO
Korean Journal of Nosocomial Infection Control 2012;17(1):28-39
BACKGROUND: We present here the annual data of the intensive care unit (ICU) module of the Korean Nosocomial Infections Surveillance System (KONIS) from July 2010 through June 2011. METHODS: We performed a prospective surveillance of nosocomial urinary tract infections (UTI), bloodstream infections (BSI), and pneumonia (PNEU) at 130 ICUs in 72 hospitals using KONIS. Nosocomial infection (NI) rates were calculated as the number of infections per 1,000 patient-days or device-days. RESULTS: A total of 3,757 NIs were found: 1,978 UTIs (1,949 cases were urinary catheter-associated), 1,092 BSIs (with 932 being central line-associated), and 687 PNEUs (410 were ventilator-associated). The rate of urinary catheter-associated UTIs (CAUTIs) was 3.87 cases per 1,000 device-days (95% confidence interval, 3.70-4.05), and the urinary catheter utilization ratio was 0.86 (0.859-0.861). The rate of central line-associated BSIs was 3.01 per 1,000 device-days (2.82-3.21), and the utilization ratio was 0.53 (0.529-0.531). The rate of ventilator-associated PNEUs (VAPs) was 1.75 per 1,000 device-days (1.59-1.93), and the utilization ratio was 0.40 (0.399-0.401). Although both the ventilator utilization ratiosand the urinary catheter utilization ratios were lower in hospitals with 400-699 beds than thosein hospitals with 700-899 beds ormore than 900 beds, the rates of VAPsand CAUTIs were higher in hospitals with 400-699 beds than thosein hospitals with 700-899 beds or more than 900 beds. CONCLUSION: The risk of acquiring VAP and CAUTI is higher in the ICUs of 400-699 bed hospitals than in ICUs oflarger hospitals. Therefore, ongoing targeted surveillance and implementation of proven infection control strategies are needed especially for hospitals having fewer than 700 beds.
Benzamides
;
Cross Infection
;
Infection Control
;
Critical Care
;
Intensive Care Units
;
Pneumonia
;
Prospective Studies
;
Urinary Catheters
;
Urinary Tract Infections
;
Ventilators, Mechanical
4.Laparoscopy Assisted versus Open Distal Gastrectomy with D2 Lymph Node Dissection for Advanced Gastric Cancer: Design and Rationale of a Phase II Randomized Controlled Multicenter Trial (COACT 1001).
Byung Ho NAM ; Young Woo KIM ; Daniel REIM ; Bang Wool EOM ; Wan Sik YU ; Young Kyu PARK ; Keun Won RYU ; Young Joon LEE ; Hong Man YOON ; Jun Ho LEE ; Oh JEONG ; Sang Ho JEONG ; Sang Eok LEE ; Sang Ho LEE ; Ki Young YOON ; Kyung Won SEO ; Ho Young CHUNG ; Oh Kyoung KWON ; Tae Bong KIM ; Woon Ki LEE ; Seong Heum PARK ; Ji Young SUL ; Dae Hyun YANG ; Jong Seok LEE
Journal of Gastric Cancer 2013;13(3):164-171
PURPOSE: Laparoscopy-assisted distal gastrectomy for early gastric cancer has gained acceptance and popularity worldwide. However, laparoscopy-assisted distal gastrectomy for advanced gastric cancer is still controversial. Therefore, we propose this prospective randomized controlled multi-center trial in order to evaluate the safety and feasibility of laparoscopy assisted D2-gastrectomy for advanced stage gastric cancer. MATERIALS AND METHODS: Patients undergoing distal gastrectomy for advanced gastric cancer staged cT2/3/4 cN0/1/2/3a cM0 by endoscopy and computed tomography are eligible for enrollment after giving their informed consent. Patients will be randomized either to laparoscopy-assisted distal gastrectomy or open distal gastrectomy. Sample size calculation revealed that 102 patients are to be included per treatment arm. The primary endpoint is the non-compliance rate of D2 dissection; relevant secondary endpoints are three-year disease free survival, surgical and postoperative complications, hospital stay and unanimity rate of D2 dissection evaluated by reviewing the intraoperative video documentation. DISCUSSION: Oncologic safety is the major concern regarding laparoscopy-assisted distal gastrectomy for advanced gastric cancer. Therefore, the non-compliance rate of clearing the N2 area was chosen as the most important parameter for the technical feasibility of the laparoscopic procedure. Furthermore, surgical quality will be carefully reviewed, that is, three independent experts will review the video records and score with a check list. For a long-term result, disease free survival is considered a secondary endpoint for this trial. This study will offer promising evidence of the feasibility and safety of Laparoscopy-assisted distal gastrectomy for advanced gastric cancer.Trial Registration: NCT01088204 (international), NCCCTS-09-448 (Korea).
Arm
;
Disease-Free Survival
;
Endoscopy
;
Gastrectomy
;
Humans
;
Informed Consent
;
Laparoscopy
;
Length of Stay
;
Lymph Node Excision
;
Lymph Nodes
;
Postoperative Complications
;
Prospective Studies
;
Sample Size
;
Stomach Neoplasms
5.Clinical and Virologic Effectiveness of Remdesivir Treatment for Severe Coronavirus Disease 2019 (COVID-19) in Korea: a Nationwide Multicenter Retrospective Cohort Study
Eun-Jeong JOO ; Jae-Hoon KO ; Seong Eun KIM ; Seung-Ji KANG ; Ji Hyeon BAEK ; Eun Young HEO ; Hye Jin SHI ; Joong Sik EOM ; Pyoeng Gyun CHOE ; Seongman BAE ; Sang Hyun RA ; Da Young KIM ; Baek-Nam KIM ; Yu Min KANG ; Ji Yeon KIM ; Jin-Won CHUNG ; Hyun-Ha CHANG ; Sohyun BAE ; Shinhyea CHEON ; Yoonseon PARK ; Heun CHOI ; Eunjung LEE ; Bo young LEE ; Jung Wan PARK ; Yujin SOHN ; Jung Yeon HEO ; Sung-Han KIM ; Kyong Ran PECK
Journal of Korean Medical Science 2021;36(11):e83-
Background:
Remdesivir is widely used for the treatment of coronavirus disease 2019 (COVID-19), but controversies regarding its efficacy still remain.
Methods:
A retrospective cohort study was conducted to evaluate the effect of remdesivir on clinical and virologic outcomes of severe COVID-19 patients from June to July 2020. Primary clinical endpoints included clinical recovery, additional mechanical ventilator (MV) support, and duration of oxygen or MV support. Viral load reduction by hospital day (HD) 15 was evaluated by calculating changes in cycle threshold (Ct) values.
Results:
A total of 86 severe COVID-19 patients were evaluated including 48 remdesivirtreated patients. Baseline characteristics were not significantly different between the two groups. Remdesivir was administered an average of 7.42 days from symptom onset. The proportions of clinical recovery of the remdesivir and supportive care group at HD 14 (56.3% and 39.5%) and HD 28 (87.5% and 78.9%) were not statistically different. The proportion of patients requiring MV support by HD 28 was significantly lower in the remdesivir group than in the supportive care group (22.9% vs. 44.7%, P = 0.032), and MV duration was significantly shorter in the remdesivir group (average, 1.97 vs. 5.37 days; P = 0.017). Analysis of upper respiratory tract specimens demonstrated that increases of Ct value from HD 1–5 to 11–15 were significantly greater in the remdesivir group than the supportive care group (average, 10.19 vs. 5.36; P = 0.007), and the slope of the Ct value increase was also significantly steeper in the remdesivir group (average, 5.10 vs. 2.68; P = 0.007).
Conclusion
The remdesivir group showed clinical and virologic benefit in terms of MV requirement and viral load reduction, supporting remdesivir treatment for severe COVID-19.
6.Clinical and Virologic Effectiveness of Remdesivir Treatment for Severe Coronavirus Disease 2019 (COVID-19) in Korea: a Nationwide Multicenter Retrospective Cohort Study
Eun-Jeong JOO ; Jae-Hoon KO ; Seong Eun KIM ; Seung-Ji KANG ; Ji Hyeon BAEK ; Eun Young HEO ; Hye Jin SHI ; Joong Sik EOM ; Pyoeng Gyun CHOE ; Seongman BAE ; Sang Hyun RA ; Da Young KIM ; Baek-Nam KIM ; Yu Min KANG ; Ji Yeon KIM ; Jin-Won CHUNG ; Hyun-Ha CHANG ; Sohyun BAE ; Shinhyea CHEON ; Yoonseon PARK ; Heun CHOI ; Eunjung LEE ; Bo young LEE ; Jung Wan PARK ; Yujin SOHN ; Jung Yeon HEO ; Sung-Han KIM ; Kyong Ran PECK
Journal of Korean Medical Science 2021;36(11):e83-
Background:
Remdesivir is widely used for the treatment of coronavirus disease 2019 (COVID-19), but controversies regarding its efficacy still remain.
Methods:
A retrospective cohort study was conducted to evaluate the effect of remdesivir on clinical and virologic outcomes of severe COVID-19 patients from June to July 2020. Primary clinical endpoints included clinical recovery, additional mechanical ventilator (MV) support, and duration of oxygen or MV support. Viral load reduction by hospital day (HD) 15 was evaluated by calculating changes in cycle threshold (Ct) values.
Results:
A total of 86 severe COVID-19 patients were evaluated including 48 remdesivirtreated patients. Baseline characteristics were not significantly different between the two groups. Remdesivir was administered an average of 7.42 days from symptom onset. The proportions of clinical recovery of the remdesivir and supportive care group at HD 14 (56.3% and 39.5%) and HD 28 (87.5% and 78.9%) were not statistically different. The proportion of patients requiring MV support by HD 28 was significantly lower in the remdesivir group than in the supportive care group (22.9% vs. 44.7%, P = 0.032), and MV duration was significantly shorter in the remdesivir group (average, 1.97 vs. 5.37 days; P = 0.017). Analysis of upper respiratory tract specimens demonstrated that increases of Ct value from HD 1–5 to 11–15 were significantly greater in the remdesivir group than the supportive care group (average, 10.19 vs. 5.36; P = 0.007), and the slope of the Ct value increase was also significantly steeper in the remdesivir group (average, 5.10 vs. 2.68; P = 0.007).
Conclusion
The remdesivir group showed clinical and virologic benefit in terms of MV requirement and viral load reduction, supporting remdesivir treatment for severe COVID-19.