Cardiovascular and Cerebrovascular Mortality in Asthma Patients with Preceding Exacerbation

( Soojoung Yu ),( Ji Ye Jung ),( Sang Chul Lee ),( Jung Hwa Hong ),( Chang Hoon Han ),( Seon Cheol Park ) 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.-

Purpose Asthma is associated with increased cardiovascular and cerebrovascular disease (CCD) incidence. We aimed to examine the effect of preceding acute asthma exacerbation (AAE) on CCD mortality. Method Using a nationwide population-based database of National Health Insurance Service-National Sample Cohort in the Republic of Korea from 2002 to 2018, we performed a retrospective cohort study on asthma patients who experienced first-time CCDs. Three different cohorts were defined: asthma-acute myocardial infarction (AMI) cohort (n=1,900), asthma-ischemic stroke cohort (n=3,864), and asthma-heart failure cohort (n=2,529). Each cohort was classified according to the severity and frequency of AAE that took place within one year before the CCD event, and the effect of AAE on 90-day, 1-year, and overall mortalities were evaluated. Results The proportions of patients that experienced AAE within a one-year period from AMI, ischemic stroke, and heart failure were 15.05%, 11.6%, and 17.6%, respectively. In all three cohorts, moderate to severe exacerbation that required emergency room visit or hospitalization was independently associated with 90-day, 1-year, and overall mortality after AMI (90-day HR 3.12, 95% CI 1.92-5.09; 1-year HR 2.85, 95% CI 1.88-4.33; overall HR 2.21, 95% CI 1.59-3.06), after ischemic stroke (90-day HR 2.54, 95% CI 1.63-3.96; 1-year HR 2.00, 95% CI 1.39-2.88; overall HR 1.65, 95% CI 1.26-2.18), and after heart failure (90-day HR 1.90 95% CI 1.33- 2.73; 1-year HR 1.98, 95% CI 1.49-2.64; overall HR 1.99, 95% CI 1.60-2.47). However, mild exacerbation treated on an outpatient basis showed lack of association with mortality. Frequency of preceding non-hospitalized exacerbation was not related with mortality after CCD events. Conclusion Preceding moderate to severe asthma exacerbation within one year from a CCD event increased cardiovascular and cerebrovascular mortality.

Changes in Panel-Reactive Antibodies and Lung Transplant Outcome

( Soojoung Yu ),( A La Woo ),( Moo Suk Park ),( Song Yee Kim ) 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.-

Background Pre-transplant humoral sensitization is associated with higher rate of allograft rejection and poor outcome in solid organ transplant recipients. However, recipient’s sensitization status often differs post-transplant, and it is yet unknown how this alteration associates with outcomes after lung transplantation (LTx). Method A retrospective evaluation of 298 LTx recipients at a single center from January 2012 to April 2020 was performed. Patients were divided into four groups based on sensitization status before and after transplant with PRA level 50% used as benchmark. Chronic lung allograft dysfunction (CLAD) development and survival in association to changes in PRA were analyzed. Results There were 162 (81%) patients who were not sensitized prior to LTx, and 130 (65%) patients continued to be non-sensitized, while 32 (16%) patients became newly sensitized after LTx. Of the 38 (19%) patients who were sensitized before LTx, 20 (10%) patients continued to be sensitized, while 18 (9%) patients became non-sensitized following LTx. Patients who initially were not sensitized but measured PRA greater than 50% after transplant were associated with CLAD occurrence with p-value of 0.021. However, patients who had high PRA levels prior to transplant, and either continued to be sensitized after transplant or experienced decrease in PRA levels below 50%, did not show association with CLAD. Patients with persistent PRA levels under 50% before and after transplant also did not show association with CLAD. In the survival analysis, there was no association between PRA changes and survival. Conclusion Increase of anti-HLA antibodies after LTx are associated with CLAD development, highlighting the importance of regular screening of PRA levels, not only in sensitized patients, but in non-sensitized patients as well.

Performance evaluation of Barozen Lipid Plus for point-of-care testing of lipid profiles: a method comparison study

Soojoung Yu,선화연,Byungwook Yoo 영남대학교 의과대학 2023 Yeungnam University Journal of Medicine Vol.40 No.-

Background: The quick and easy nature of point-of-care (POC) testing devices allows regular monitoring of serum lipid levels to increase efficiency. The purpose of this study was to assess a POC lipid analyzer, Barozen Lipid Plus (MICO Biomed Co., Ltd.), which uses capillary blood to measure total cholesterol (TC), triglycerides (TGs), and high-density lipoprotein cholesterol (HDL-C). Methods: Capillary and venous blood samples were collected from 110 participants at a single center in Korea between June 10 and June 26, 2021. TC, TG, and HDL-C measurements using Barozen Lipid Plus were compared with measurements using our reference device, the Roche-Hitachi Cobas 8000 c702 (Hitachi High-Technologies Corporation). This study followed the guidelines of the Clinical and Laboratory Standards Institute and the Clinical Laboratory Improvement Amendments. We surveyed participants regarding the convenience of the POC device using a questionnaire following the completion of blood collection. Results: When compared to the reference equipment, the measurements obtained using Barozen Lipid Plus were more than 95% satisfactory within TC±10%, TG±25%, and HDL-C±30%. The coefficient of variation in the repeatability testing was within 5% for TC, 5% for TGs, and 7% for HDL-C. The survey results indicated high levels of satisfaction. No adverse events were reported. Conclusion: These findings suggest that Barozen Lipid Plus is reliable for measuring lipid profiles and can therefore be used to monitor lipid levels at the time and place of patient care.

Factors Related to Diagnostic Yield of Lung Biopsy Using both Radial EBUS and Fluoroscopy

( Seung Hyun Yong ),( Soojoung Yu ),( Young Mok Park ),( A La Woo ),( Ah Young Leem ),( Su Hwan Lee ),( Sang Hoon Lee ),( Kyung Soo Chung ),( Song Yee Kim ),( Eun Young Kim ),( Ji Ye Jung ),( Young Ae 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.-

Background Transbronchial lung biopsy (TBLB) is a key modality in the diagnosis of peripheral lung lesions. Radial EBUS is new diagnostic technology which can apply to enhance the accuracy of peripheral lung biopsy during bronchoscopy. The purpose of this study was to investigate factors related to diagnostic yield of TBLB with radial EBUS Method A retrospective analysis on the diagnostic yield of TBLB under fluoroscopy consist with radial EBUS, with or without guide sheath (GS) was conducted. Data included TBB that was performed from 2020 to 2021 at a single center by a single operator Results 294 patients with confirmed final diagnoses were included in this study. Definitive diagnosis was established by TBLB in 117/155 (75.48%) patients using radial EBUS without GS, 55/69 (79.71%) patients using EBUS with GS, and 54/70 (77.14%) patients whose tissues were obtained partly without GS and partly with GS. We compared diagnostic yield by type pulmonary lesion which was inconsistent between the diagnostic modalities, but overall, solid lesions had highest diagnostic yield (77.05%) compared to pure ground glass opacities (75%) and part-solid lesions (76.09%). Lung cancer patients that underwent rebiopsy were analyzed in this study which showed diagnostic yield of 68.29%. Diagnostic yield showed improvement over time in radial EBUS assisted TBLB cases that did not use GS with yield of 59.62% in 2020 and 83.5% in 2021. Conclusion For many decades there has not been another diagnostic method to enhance the TBLB in diagnosis of peripheral pulmonary lesions until radial EBUS is introduced. This investigation reviewed current diagnostic usage of TBLB accompanied by radial EBUS and compared diagnostic yields not only by size and targeting, but solid components and exam period as well. Further studies on re-biopsy by TBLB will be needed to learn more about its significance in clinical application.

Clinical Significance of Various Pathogens in Acute Exacerbations of COPD: Multi-center Study in Korea

( Hyun Woo Ji ),( Ji Ye Jung ),( Soojoung Yu ),( Hyun Woo Lee ),( Yun Su Sim ),( Hyewon Seo ),( Jeong-Woong Park ),( Kyung Hoon Min ),( Jae Ha Lee ),( Byung-Keun Kim ),( Myung Goo Lee ),( Yeon Mok Oh 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.0

Background One of the major causes of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is respiratory infection. In this study, we investigated types of bacteria and virus identified in AECOPD patients in Korea, and compared clinical difference according to different types of pathogen Methods We reviewed 1186 cases of AECOPD patients recruited at 28 hospitals in Korea from January 2015 to December 2019. Pathogen was identified by microbiological tests. We analyzed bacterial and viral identification rate, along with basic characteristics and clinical presentation of patients associated with the different types of pathogens, and risk factors for potentially drug-resistant (PDR) pathogen. Results The number of patients infected with bacteria, virus, and both bacteria and virus were 262 (22.1%), 265 (22.5%), and 129 (10.9%), respectively. The most common bacteria identified were Pseudomonas aeruginosa (9.8%), Mycoplasma pneumoniae (6.2%), and Streptococcus pneumoniae (5.0%). The most common virus identified Influenza A (10.4%), Rhinovirus (8.7%), and RSV (3.5%) Compared to patients without identified pathogens, patient with identified pathogens had a higher rate of systemic steroid use within six months (22.7% vs 16.9%; P=0.015), presented more cough and sputum (76.4% vs 68.9%; P=0.004, 78.9% vs 68.7%; P=0.015), and required longer period of systemic steroid during AECOPD (11.2days vs 4.4days; P=0.012). Past history of pulmonary tuberculosis (OR 1.66; P=0.046) and bronchiectasis (OR 1.99; P=0.032), and the history of triple inhaler use within six months (OR 2.04; P=0.005) have been confirmed as risk factors for the identification of PDR pathogen. In addition, hospital stay was longer (15.9days vs 12.4days; P=0.018) and ICU admission rate was high (15.9% vs 9.5%; P=0.030) when PDR pathogen was identified Conclusions The various types of pathogens caused AECOPD. In addition, risk factors for the identification of PDR pathogen were past history of pulmonary tuberculosis and bronchiectasis, and history of triple inhaler use.