1.Comparative Analysis of Clinical Outcomes Using Propensity Score Matching: Coronavirus Disease 2019vs. Seasonal Influenza in Korea
Jae Kyeom SIM ; Hye Sun LEE ; Juyeon YANG ; Jin GWACK ; Bryan Inho KIM ; Jeong-ok CHA ; Kyung Hoon MIN ; Young Seok LEE ; On behalf of the Severe Acute Respiratory Infection (SARI) Investigators
Journal of Korean Medical Science 2024;39(14):e128-
Background:
The advent of the omicron variant and the formulation of diverse therapeutic strategies marked a new epoch in the realm of coronavirus disease 2019 (COVID-19). Studies have compared the clinical outcomes between COVID-19 and seasonal influenza, but such studies were conducted during the early stages of the pandemic when effective treatment strategies had not yet been developed, which limits the generalizability of the findings.Therefore, an updated evaluation of the comparative analysis of clinical outcomes between COVID-19 and seasonal influenza is requisite.
Methods:
This study used data from the severe acute respiratory infection surveillance system of South Korea. We extracted data for influenza patients who were infected between 2018 and 2019 and COVID-19 patients who were infected in 2021 (pre-omicron period) and 2022 (omicron period). Comparisons of outcomes were conducted among the pre-omicron, omicron, and influenza cohorts utilizing propensity score matching. The adjusted covariates in the propensity score matching included age, sex, smoking, and comorbidities.
Results:
The study incorporated 1,227 patients in the pre-omicron cohort, 1,948 patients in the omicron cohort, and 920 patients in the influenza cohort. Following propensity score matching, 491 patients were included in each respective group. Clinical presentations exhibited similarities between the pre-omicron and omicron cohorts; however, COVID-19 patients demonstrated a higher prevalence of dyspnea and pulmonary infiltrates compared to their influenza counterparts. Both COVID-19 groups exhibited higher in-hospital mortality and longer hospital length of stay than the influenza group. The omicron group showed no significant improvement in clinical outcomes compared to the pre-omicron group.
Conclusion
The omicron group did not demonstrate better clinical outcomes than the pre-omicron group, and exhibited significant disease severity compared to the influenza group. Considering the likely persistence of COVID-19 infections, it is imperative to sustain comprehensive studies and ongoing policy support for the virus to enhance the prognosis for individuals affected by COVID-19.
2.The effect of interleukin-8 in the early stage after anterior cruciate ligament reconstruction with remnant preservation
Kyung-Ok KIM ; Jae Ang SIM ; Ji Uk CHOI ; Beom Koo LEE ; Hong Gi PARK
The Journal of Korean Knee Society 2020;32(1):e5-
Purpose:
We studied the effect of interleukin-8 (IL-8) as the factor for angiogenesis in the joint fluid of remnantpreserved anterior cruciate ligament reconstruction (RP-ACLR).
Materials and methods:
We measured 12 cytokines in joint fluid by multiplex assay and assessed the relationship between IL-8 and vascular endothelial growth factor (VEGF) concentrations. The signal intensity and mean sagittal diameter via postoperative magnetic resonance imaging (MRI) scans were evaluated and the stress X-ray image was analyzed at 3, 6, and 12 months after operation.
Results:
The IL-8 concentration was highest 3 months postoperatively in those patients who underwent RP-ACLR.Clinical data also showed that the signal intensity and stress radiography of the knee graft were significantly better at the early postoperative stage.Discussion: Our results show that IL-8 plays an important role in angiogenesis within 3 months after RP-ACLR. This effect yields better recovery after operation. RP-ACLR patients with high knee stability in clinical data were identical to those with high expression of IL-8 in experimental data. Therefore, IL-8 has been shown to help revascularization and ligamentization of the grafted tendon. These results indicate that IL-8 in RP-ACLR is an important factor for angiogenesis after operation. Unfortunately, the relationship of IL-8 and VEGF in vivo has not been studied.
Conclusion
Our results showed that the IL-8 concentration was very high within 3 months after RP-ACLR operation. The increase in concentration of IL-8 over time was consistent with the increase in VEGF concentration.In the IL-8 clinical setting, MRI analysis showed that ACL synovialization and tension were better in patients who underwent the remnant preservation method. In addition, it was shown that RP-ACLR may be advantageous for early anterior stability within 1 year post operation and beneficial for tendon graft in the early stage post operation.Taken together, our findings suggest that IL-8 may contribute to angiogenesis which is helpful for revascularization and ligamentization of the graft tendon in the early stages of RP-ACLR.
3.Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction Using an Outside-in Technique: Two- to Six-Year Clinical and Radiological Follow-up
Jae Ang SIM ; Yong Seuk LEE ; Kyung Ok KIM ; Jong Keun KIM ; Beom Koo LEE
The Journal of Korean Knee Society 2015;27(1):34-42
PURPOSE: We evaluated the clinical and radiological outcomes of double-bundle anterior cruciate ligament (ACL) reconstruction using an outside-in technique with a follow-up of two- to six-years, especially in terms of the sports activity level and radiological degeneration. MATERIALS AND METHODS: Sixty-seven patients who were available for a minimum two-year follow-up after double-bundle ACL reconstruction using an outside-in technique were retrospectively evaluated. The mean follow-up period was 43.7 months. The knee function and stability were evaluated before the operation, one year after the operation (short-term follow-up), and more than two years after the operation (last follow-up). RESULTS: Regarding the knee function, the Lysholm score, International Knee Documentation Committee (IKDC) evaluation, and hop test showed significant improvement. Regarding the stability, the Lachman test, pivot shift test, KT-2000 arthrometer data, and anterior drawer radiographs using Telos showed significant improvement. Regarding the sports activity level, the patients who returned to pre-injury level activity was 68.7% according to the Tegner activity score and 76.1% according to the Cincinnati sports activity scale score. The incidence of aggravated degeneration or development of greater than IKDC grade A degeneration after surgery was 10.4%. CONCLUSIONS: Double-bundle ACL reconstruction using an outside-in technique showed favorable clinical and radiological outcomes with respect to the knee function and stability, joint degeneraion, and, especially, return to pre-injury sports activity.
Anterior Cruciate Ligament
;
Anterior Cruciate Ligament Reconstruction
;
Follow-Up Studies
;
Humans
;
Humulus
;
Incidence
;
Joints
;
Knee
;
Retrospective Studies
;
Sports
4.Clinical Validity Comparison Study of Patients Severity Triage System in the Emergency Department: Modified Emergency Severity Index (mESI) and modified Canadian Triage Acuity System (mCTAS).
Jae Ran SIM ; Yeon Hee KIM ; Yeo Ok KIM ; Eun Hee CHO ; Jung Ran CHOI ; Yang Hee JUN ; Kyung Soo LIM
Journal of the Korean Society of Emergency Medicine 2012;23(6):776-783
PURPOSE: This study was conducted to identify better methods of determining the severity of triage by comparing triage results and clinical outcome of patients categorized by the modified Canadian Triage Acuity Scale (mCTAS) and modified Emergency Severity Index (mESI). METHODS: Subjects enrolled in this study consisted of 1,000 adult patients (age 16 years or older) who visited the emergency room of a university affiliated hospital between September 15, 2011 and September 30, 2011 and were categorized into five levels by mCTAS and mESI. RESULTS: 1) Good confidence was verified based on weighted kappa values of 0.70 between the physicians group and nurses group. 2) Upon evaluation of triage by mESI, the majority of patients were at level 3 among 5, followed by level 4, 2, 1 and 5 in order. The same level orders were shown upon evaluation of triage by mCTAS beside differences in patient numbers. 3) Comparing clinical outcome according to the mCTAS and the mESI revealed similar results in both triage tools, with a higher triage level being associated with a higher admission rate and lower triage level and the discharge rate became higher. CONCLUSION: Triage by mESI showed good agreement among asserters and high agreement between physicians and nurses. Clinical results based on mCTAS and mESI triage showed similar rates of admission to the ward or intensive care unit and rates of discharge. Although these two triage protocols are similar in many aspects, the use of mESI is perceived as a better because mCTAS requires knowledge of various diseases and mESI has a short training period.
Adult
;
Emergencies
;
Humans
;
Intensive Care Units
;
Triage
5.Psychosocial Adjustment of the Organ Transplantation Recipients in Korea.
Hea Seon HA ; Jae Sim JEONG ; Young Ran CHAE ; Jung Ja HONG ; In Ok KIM ; Myungsun YI ; Deok Bog MOON ; Sung Gyu LEE
The Journal of the Korean Society for Transplantation 2007;21(2):269-281
PURPOSE: This study was aimed to understand the experience and adjustment process of organ transplantation recipients in Korea, using grounded theory method. METHODS: Eight patients after liver transplantation and two patients after heart transplantation were selected for this study, for whom minimum follow-up duration was at least 6 months after transplantation. Data was collected from July to November 2005 through in-depth individual interviews either at home or hospital. The data were analyzed using a constant comparative method in which new data was continuously coded into categories and properties. RESULTS: Data analysis revealed that "safekeeping the graft" was the core category in experience of organ transplantation recipients. In order to safekeep transplanted organ, recipients used seven different strategies to deal with various problems and conflicts which occurred during the recovery process: 1) altering the role function of family, 2) complying the treatment regimen, 3) developing the know-how for self-care, 4) returning to the normal life, 5) keeping the positive thinking, 6) concerning for the donor, and 7) improving the self-fulfillment. CONCLUSION: The results of this study provided deep understanding on the recovery process after organ transplantation and these would help establishing more appropriate intervention to improve quality of life for organ transplantation recipients.
Adaptation, Psychological
;
Follow-Up Studies
;
Heart Transplantation
;
Humans
;
Korea*
;
Liver Transplantation
;
Organ Transplantation*
;
Qualitative Research
;
Quality of Life
;
Self Care
;
Social Adjustment
;
Statistics as Topic
;
Thinking
;
Tissue Donors
;
Transplants*
6.Changes in Refraction following Pediatric Cataract Surgery.
Jae Ok SIM ; Mi Ra PARK ; Soo Chul PARK
Journal of the Korean Ophthalmological Society 2005;46(5):768-774
PURPOSE: To evaluate the factors influencing the refractive changes and to predict the ideal intraocular lens powers in children who had undergone cataract surgery. METHODS: The medical records of the pediatric patients with aphakia or pseudophakia who were followed for more than 5 years postoperatively were reviewed retrospectively. They were grouped according to the age at surgery and were followed-up every six months postoperatively. The myopic changes and the factors associated with these changes among the groups were evaluated and compared. RESULTS: The follow-up time was 5 years. In the age-matched subset of patients, no statistically significant difference in the refractive change were found between the aphakic and pseudophakic eyes as well as between the unilateral and bilateral cataracts. Children operated on at 1 month to 1 year of age had a mean myopic shift of -5.58D (range -1.88 to -12.85) and children operated on at 1 to 3 years of age had a shift of -4.25D (range -1.78 to -8.71). The mean myopic shift decreased as the age at operation increased. Children operated on at 10 to 15 years of age had a shift of -1.46D (range 0 to -5.28). CONCLUSIONS: During the first 5 years after surgery, no statistically significant difference in refractive change was observed between the aphakic eyes and pseudophakic eyes as well as between the unilateral and bilateral cataracts. The increasing difficulty in deciding the ideal IOL-power is expected in young children as the refractive change becomes more unpredictable when surgery is performed on younger patients.
Aphakia
;
Cataract*
;
Child
;
Follow-Up Studies
;
Humans
;
Lenses, Intraocular
;
Medical Records
;
Pseudophakia
;
Retrospective Studies
7.A Case of Rifampicin Induced Pseudomembranous Colitis in Elderly Patient.
Jong Dae BONG ; Gyi Beom BOO ; Doo Sun SIM ; Hyun Ok PARK ; Tae Woong LEE ; Kang Soek KOH ; Jong Jae CHUNG
Journal of the Korean Geriatrics Society 2005;9(3):239-242
Nowadays, the increasing use of antibiotics induces many complications including pseudomembranous colitis. Isolates of toxigenic Clostridium difficile, the most frequent cause of antibiotic-associated pseudomembranous colitis, are almost always highly susceptible to rifampicin. However, resistant isolates exist and have been associated with colitis in humans. We report a case of pseudomem- branous colitis associated with rifampicin administration.
Aged*
;
Anti-Bacterial Agents
;
Clostridium difficile
;
Colitis
;
Enterocolitis, Pseudomembranous*
;
Humans
;
Rifampin*
8.A Case of Hypersensitivity Pneumonitis Caused by Penicillium species in a Home Environment.
Young Mok LEE ; Yang Ki KIM ; Shin Ok KIM ; Sang Jae KIM ; Hae Sim PARK
Journal of Korean Medical Science 2005;20(6):1073-1075
We report a case of hypersensitivity pneumonitis in a 30-yr-old female housewife caused by Penicillium species found in her home environment. The patient was diagnosed according to history, chest radiograph, spirometry, high-resolution chest CT, and transbronchial lung biopsy. To identify the causative agent, cultured aeromolds were collected by the open-plate method. From the main fungi cultured, fungal antigens were prepared, and immunoblot analysis with the patient's serum and each fungal antigen was performed. A fungal colonies were isolated from the patient's home. Immunoblotting analysis with the patient's sera demonstrated a IgG-binding fractions to Penicillium species extract, while binding was not noted with control subject. This study indicates that the patient had hypersensitivity pneumonitis on exposure to Penicillium species in her home environment.
Adult
;
Alveolitis, Extrinsic Allergic/*etiology/immunology/*microbiology
;
Antibodies, Fungal/blood
;
Antigens, Fungal
;
Environmental Microbiology
;
Female
;
Housing
;
Humans
;
Immunoglobulin G/blood
;
Korea
;
Penicillium/*immunology/isolation and purification/*pathogenicity
9.Optic Nerve Head Analysis Obtained by Optical Coherence Tomography for the Diagnosis of Glaucoma in Koreans.
Journal of the Korean Ophthalmological Society 2004;45(11):1885-1892
PURPOSE: To find the optimal parameter of the optic nerve head (ONH) analysis using Optical Coherence Tomography (OCT) and to form a diagnostic classification for the detection of glaucoma in Koreans. METHODS: The subjects of this study were 799 eyes of 400 patients at Kangnam St. Mary's Hospital from June 2003 to March 2004. Complete ophthalmic examinations containing the visual field test and OCT ONH analysis (StratusOCT, software ver. 3.0, Carl Zeiss Meditec, Inc, Dublin, CA, USA) were performed and the results were analyzed in the normal, glaucoma suspect and glaucoma groups. RESULTS: In the 799 eyes, there were 378 glaucomatous eyes. There was a statistically significant difference between glaucoma and non-glaucoma patients in all parameters of OCT ONH analysis except for the disc area. The horizontal integrated rim area (HIRA) was most significantly correlated with the visual field indices (MD and CPSD) and was the most useful parameter in glaucoma detection. Based on age and HIRA, the new discriminant formula = -1.858 - 0.028 x Age + 2.518 x HIRA was obtained and its accuracy, sensitivity and specificity were 72.8%, 71.5% and 73.8% respectively. CONCLUSIONS: HIRA was the most useful parameter in the detection of glaucoma. The new discriminant formula from OCT ONH analysis is expected to be useful in the diagnosis and follow-up of glaucoma in Koreans.
Classification
;
Diagnosis*
;
Follow-Up Studies
;
Glaucoma*
;
Humans
;
Optic Disk*
;
Optic Nerve*
;
Sensitivity and Specificity
;
Tomography, Optical Coherence*
;
Visual Field Tests
;
Visual Fields
10.Clinical Ability of High Frequency Pattern VEP and Flicker ERG Examination to Detect Glaucomatous Visual Field Change.
Jae Ok SIM ; Chan Kee PARK ; Jung Il MOON
Journal of the Korean Ophthalmological Society 2004;45(8):1315-1321
PURPOSE: We investigated whether pattern visual evoked potential (VEP) and flicker electroretinogram (ERG) are helpful in detecting the progression of glaucomatous field defect on standard automated perimetry. METHODS: We investigated 50 eyes with primary open-angle glaucoma (POAG) (n=18), glaucoma suspect (n=21), and control (n=11) tested with high frequency pattern VEP and flicker ERG at first visit in our hospital from 1998 to 2002. The results were applied as a prospective study. RESULTS: Thirteen eyes (study group) showed progressive defects, whereas 37 eyes (control group) showed no progression. The hit ratio, sensitivity and specificity were 78.0%, 84.6% and 75.7%, respectively, according to retino-cortical time (RCT) of 88 msec using the receiver operating characteristic curves. The mean survival time for the group with RCT less than 88.0 msec (41.95 months) was longer than that for the group with RCT more than 88.0 msec (31.0 months). The group which had more than 88.0 msec in RCT showed a hazard ratio of glaucomatous field defect progression of 7.855 compared to the other group (RCT: difference between P100 latency in VEP and a wave implicit time in ERG). CONCLUSIONS: Our study showed that high frequency pattern VEP and flicker ERG were significant in the progression of glaucomatous field defect.
Evoked Potentials, Visual
;
Glaucoma
;
Glaucoma, Open-Angle
;
Prospective Studies
;
ROC Curve
;
Sensitivity and Specificity
;
Survival Rate
;
Visual Field Tests
;
Visual Fields*

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