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( Dongsub Jeon ),( Minkook Son ),( Jonggi Choi ) 대한내과학회 2021 The Korean Journal of Internal Medicine Vol.36 No.5
Background/Aims: The impact of liver cirrhosis (LC) on the clinical outcomes of patients with coronavirus disease 2019 (COVID-19) remains elusive. This study evaluated the association between LC and the development of severe complications from COVID-19. Methods: We used the National Health Insurance claims data of Korea. We included 234,427 patients older than 19 years who tested for severe acute respiratory syndrome coronavirus 2. Patients with LC who were infected with COVID-19 (n = 67, LC+ COVID+) were matched with those with cirrhosis only (n = 332, LC+ COVID-) and those with COVID-19 only (n = 333, LC- COVID+) using a propensity score in a 1:5 ratio. The primary outcome was the development of severe complications. Results: Of the matched patients, the mean age was 60 years and 59.7% were male. Severe complications occurred in 18, 54, and 60 patients in the LC+ COVID+, LC+ COVID-, and LC- COVID+ groups, respectively. After adjusting for comorbidities, there was no significant difference in the risk of developing severe complications from COVID-19 between the LC+ COVID+ and LC- COVID+ groups but significant difference exists between the LC+ COVID+ and LC+ COVID-. Older age, hypertension, cancer, chronic obstructive pulmonary disease, and a higher Charlson comorbidity index were associated with a higher risk of severe complications in patients with cirrhosis and COVID-19. Conclusions: Our study suggests that LC was not independently associated with the development of severe complications, including mortality, in patients with COVID-19. Our results need to be evaluated through a large, prospective study.
Kim, Dongsub,Lee, Sodam,Kang, Sang-Hee,Park, Mi-Sun,Yoo, So-Young,Jeon, Tae Yeon,Choi, JoonSik,Kim, Bora,Choi, Jong Rim,Cho, Sun Young,Chung, Doo Ryeon,Choe, Yon Ho,Kim, Yae-Jean The Korean Pediatric Society 2018 Clinical and Experimental Pediatrics (CEP) Vol.61 No.11
Purpose: Tuberculosis (TB) is one of the most important diseases that cause significant mortality and morbidity in young children. Data on TB transmission from an infected child are limited. Herein, we report a case of disseminated TB in a child and conducted a contact investigation among exposed individuals. Methods: A 4-year-old child without Bacille Calmette-$Gu{\acute{e}}rin$ vaccination was diagnosed as having culture-proven disseminated TB. The child initially presented with symptoms of inflammatory bowel disease, and nosocomial and kindergarten exposures were reported. The exposed individuals to the index case were divided into 3 groups, namely household, nosocomial, or kindergarten contacts. Evaluation was performed following the Korean guidelines for TB. Kindergarten contacts were further divided into close or casual contacts. Chest radiography and tuberculin skin test or interferon-gamma-releasing assay were performed for the contacts. Results: We examined 327 individuals (3 household, 10 nosocomial, and 314 kindergarten contacts), of whom 18 (5.5%), the brother of the index patient, and 17 kindergarten children were diagnosed as having latent TB infection (LTBI). LTBI diagnosis was more frequent in the children who had close kindergarten contact with the index case (17.1% vs. 4.4%, P=0.007). None of the cases had active TB. Conclusion: This is the first reported case of TB transmission among young children from a pediatric patient with disseminated TB in Korea. TB should be emphasized as a possible cause of chronic diarrhea and failure to thrive in children. A national TB control policy has been actively applied to identify Korean children with LTBI.
A Case with Multiple Fungal Coinfections in a Patient who Presented with Pancoast Syndrome
( Hyungsuk Jin ),( Dongsub Kim ),( Joon-sik Choi ),( Hee Jae Huh ),( Nam Yong Lee ),( Joungho Han ),( Hee Won Cho ),( Youngeun Ma ),( Tae Yeon Jeon ),( So-young Yoo ),( Keon Hee Yoo ),( Hong Hoe Koo ) 대한소아감염학회 2021 Pediatric Infection and Vaccine Vol.28 No.1
소아암 환자에서 발생하는 침습성 진균 감염은 사망과 후유증에 이르는 중대한 감염이다. 18세 남자 환자가 호중구감소 기간 동안 입원하여 치료받던 중 우측 견관절과 우측 팔에 감각이상과 신경쇠약을 호소하였고, 우측폐상엽의 폐렴이 진단되었다. 기관지의 조직학적 소견과 폐 수술검체에서 시행한 polymerase chain reaction (PCR)로 털곰팡이증을 확진하였으며, 흉수액의 PCR로 페니실리움 디쿰벤스 감염, 갈락토마난 항원법으로 아스페르길루스증을 추정하였다. 환자는 백혈병이 치료되지 못하고 Staphylococcus epidermidis 패혈증이 합병되어 사망하였다. 본 증례에서는 판코스트 증후군의 증상을 보인 환자에서 진단된 다발성 폐진균증을 보고 하는 바이다. Invasive fungal infection (IFI) is a serious threat to pediatric patients with cancer given high morbidity and mortality. We present an 18-year-old male with precursor T-cell lymphoblastic leukemia who developed Pancoast syndrome, presented with paresthesia and numbness in the right shoulder and arm during a neutropenic fever period. He was diagnosed with pneumonia in the right upper lung field. He was later found to have an invasive pulmonary fungal infection caused by multiple fungi species, including Rhizomucor, confirmed by histology and polymerase chain reaction (PCR) (proven infection), Penicillium decumbens diagnosed by PCR, and Aspergillus suspected from galactomannan assay (probable infection). Unfortunately, the patient's condition further worsened owing to the aggravation of leukemia, chemotherapy-induced neutropenia, and bacterial coinfection, leading to multiorgan failure and death. Here, we report a case of IFI caused by multiple fungal species that presented as Pancoast syndrome.
현장센서를 활용한 태양광 단기 발전량 예측의 매개변수 추정 기법
전기량(Gi-Ryang Jeon),방철환(Chulhwan Bang),김동섭(Dongsub Kim) 대한전기학회 2020 대한전기학회 학술대회 논문집 Vol.2020 No.11
본 논문은 태양광 발전설비 측에 임시로 설치한 센서를 통하여 단기 발전량 예측에 핵심적으로 작용하는 매개변수를 추정하는 방법을 제안한다. 제안하는 방법은 현장에서 경사일사량, 모듈온도 등의 추가적인 정보를 취득하여, 일사량 예보로부터 태양광 발전의 물리적인 상호작용을 반영하는 2차변수를 추정하고 이를 발전량 예측에 활용한다. 실험 결과 일사예보와 발전실적만을 이용하는 기존의 방법보다 예측정확도가 개선된 것을 검증하였으며, 학습된 가중치로부터 발전효율까지 효과적으로 추정할 수 있었다.
Natural History of Asymptomatic Esophageal Subepithelial Tumors of 30 mm or Less in Size
Kang Seokin,Kim Do Hoon,Kim Yuri,Jeon Dongsub,Na Hee Kyong,Lee Jeong Hoon,Ahn Ji Yong,Jung Kee Wook,Choi Kee Don,Song Ho June,Lee Gin Hyug,Jung Hwoon-Yong 대한의학회 2022 Journal of Korean medical science Vol.37 No.23
Background: No definite guidelines for the management of small esophageal subepithelial tumors (SETs) have been established, because there are limited data and studies on their natural history. We aimed to assess the natural history and propose optimal management strategies for small esophageal SETs. Methods: Patients diagnosed as esophageal SETs ≤ 30 mm in size between 2003 and 2017 using endoscopic ultrasound (EUS) with a minimal follow-up of 3 months were enrolled, and their esophagogastroduodenoscopy (EGD) and EUS were retrospectively reviewed. Results: Of 275 esophageal SETs in 262 patients, the initial size was < 10 mm, 10–20 mm, and 20–30 mm in 104 (37.8%), 105 (38.2%), and 66 (24.0%) lesions, respectively. Only 22 (8.0%) SETs showed significant changes in size and/or echogenicity and/or morphology at a median of 40 months (range, 4–120 months). Tissues of 6 SETs showing interval changes were obtained using EUS-guided fine needle aspiration biopsy; 1 was identified as a gastrointestinal stromal tumor (GIST) and was surgically resected, while the other 5 were leiomyomas and were regularly observed. Eight SETs showing interval changes were resected surgically or endoscopically without pathological confirmation; 1 was a GIST, 2 were granular cell tumors, and the other 5 were leiomyomas. Conclusion: Regular follow-up with EGD or EUS may be necessary for esophageal SETs ≤ 30 mm in size considering that small portion of them has a possibility of malignant potential. When esophageal SETs ≤ 30 mm show significant interval changes, pathological confirmation may precede treatment to avoid unnecessary resection.