Clinical Course and Outcomes of Patients with Severe Acute Respiratory Syndrome Coronavirus 2 Infection: a Preliminary Report of the First 28 Patients from the Korean Cohort Study on COVID-19

Eu Suk Kim,Bum Sik Chin,강창경,Nam Joong Kim,Yu Min Kang,Jae-Phil Choi,Dong Hyun Oh,Jeong-Han Kim,Boram Koh,Seong Eun Kim,Na Ra Yun,Jae Hoon Lee,Jin Yong Kim,Yeonjae Kim,Ji Hwan Bang,송경호,Hong Bin Kim,Ki- 대한의학회 2020 Journal of Korean medical science Vol.35 No.13

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected pneumonia emerged in Wuhan, China in December 2019. In this retrospective multicenter study, we investigated the clinical course and outcomes of novel coronavirus disease 2019 (COVID-19) from early cases in Republic of Korea. Methods: All of the cases confirmed by real time polymerase chain reaction were enrolled from the 1st to the 28th patient nationwide. Clinical data were collected and analyzed for changes in clinical severity including laboratory, radiological, and virologic dynamics during the progression of illness. Results: The median age was 40 years (range, 20–73 years) and 15 (53.6%) patients were male. The most common symptoms were cough (28.6%) and sore throat (28.6%), followed by fever (25.0%). Diarrhea was not common (10.7%). Two patients had no symptoms. Initial chest X-ray (CXR) showed infiltration in 46.4% of the patients, but computed tomography scan confirmed pneumonia in 88.9% (16/18) of the patients. Six patients (21.4%) required supplemental oxygen therapy, but no one needed mechanical ventilation. Lymphopenia was more common in severe cases. Higher level of C-reactive protein and worsening of chest radiographic score was observed during the 5–7 day period after symptom onset. Viral shedding was high from day 1 of illness, especially from the upper respiratory tract (URT). Conclusion: The prodromal symptoms of COVID-19 were mild and most patients did not have limitations of daily activity. Viral shedding from URT was high from the prodromal phase. Radiological pneumonia was common from the early days of illness, but it was frequently not evident in simple CXR. These findings could be plausible explanations for the easy and rapid spread of SARS-CoV-2 in the community.

Utility of QuantiFERON-TB In-Tube Test for Differentiating Active Tuberculosis from Latent Tuberculosis Infection in an Intermediate Burden Country

Choi, Suk Hoon,Chin, Bum Sik,Han, Sang Hoon,Lee, Han Sung,Kim, Chang Oh,Jeong, Su Jin,Choi, Hee Kyung,Kim, Myung Soo,Choi, Jun Yong,Song, Young Goo,Kim, June Myung 대한감염학회 2008 감염과 화학요법 Vol.40 No.6

Background : The aim of the present study was to assess the contribution of a QuantiFERON-TB Gold In-Tube test (QFT-IT) in differentiating active tuberculosis (TB) from latent tuberculosis infection (LTBI) by quantifying interferon-r levels. Materials and Methods : We retrospectively reviewed clinical records of 314 patients older than 15 years who had performed QFT-IT between July 2006 and August 2007 at a tertiary care teaching hospital. Results : Subjects with active TB (n=81, culture confirmed active TB in 40 subjects) and LTBI (n=76) were included. Mean±SD IFN-r levels were 4.961±3.98 lU/mL (range -0.08-10) for all subjects with active TB, 4.54±4.05 lU/mL (range -0.08-10) for culture confirmed active TB, and 4.11±3.57 lU/mL (range 0.35-10) for subjects with LTBI. The quantitative results of QFT-IT on IFN-7 levels between all the subjects with active TB and those with LTBI were not statistically significant (P=0.16). The result was similar when compared between those with culture confirmed active TB and those with LTBI, showing little statistical significance (P=0.554). Conclusion : The production of IFN-7 measured by QFT-IT showed no correlation between its level and the activity of Mycobacterium tuberculosis infection. These results suggest that measuring IFN-r using QFT-IT might not be useful for distinguishing active TB from LTBI.

Longitudinal Changes in Forced Expiratory Volume in 1 s in Patients with Eosinophilic Chronic Obstructive Pulmonary Disease

( Yong Suk Jo ),( Chin Kook Rhee ),( Ji-yong Moon ),( Yong Bum Park ),( Yee Hyung Kim ),( Soo-jung Um ),( Woo Jin Kim ),( Hyoung Kyu Yoon ),( Kwang Ha Yoo ),( Ki-suck Jung ) 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.-

Background Data on changes in lung function in eosinophilic chronic obstructive pulmonary disease (COPD) are limited. We investigated the longitudinal changes in forced expiratory volume in 1 s (FEV1) and effects of inhaled corticosteroid (ICS) in Korean COPD patients. Methods Stable COPD patients in the Korean COPD subgroup study (KOCOSS) cohort, aged 40 years or older, were included and classified as eosinophilic and non-eosinophilic COPD based on blood counts of eosinophils (greater or lesser than 300 cells/ μL). FEV1 changes were analyzed over a 3-year follow-up period. Results Of 627 patients who underwent spirometry at least twice during the follow up, 150 and 477 patients were classified as eosinophilic and non-eosinophilic, respectively. ICS-containing inhalers were prescribed to 40% of the patients in each group. Exacerbations were more frequent in the eosinophilic group (adjusted odds ratio: 1.49; 95% confidence interval: 1.10-2.03). An accelerated FEV1 decline was observed in the non-eosinophilic group (adjusted annual rate of FEV1 change: -12.2 mL/y and -19.4 mL/y for eosinophilic and non-eosinophilic groups, respectively, Figure 1). In eosinophilic COPD, the adjusted rate of annual FEV1 decline was not significant regardless of ICS therapy, but the decline rate was greater in ICS users (-19.2 mL/y and -4.5 mL/y, with and without ICS therapy, respectively, Table 1). Conclusions The annual rate of decline in FEV1 was favorable in eosinophilic COPD compared to non-eosinophilic COPD, and ICS therapy had no beneficial effects on changes in FEV1.

Responses of Photosynthetic Efficiency and Ascorbate Peroxidase Induced by Salt Stress in Rice (Oryza sativa L.)

Jeung Suk Koo(구정숙),Kyoung Nam Im(임경남),Hyun-Sik Chun(전현식),Chin Bum Lee(이진범) 한국생명과학회 2010 생명과학회지 Vol.20 No.8

Salt stress가 벼 잎 내 광합성 효율과 ascorbate peroxidase (APX) 활성에 미치는 영향을 조사하였다. 염 농도가 증가(NaCl, 100-300 mM) 할수록 Fv/Fm 값이 감소한 반면, H₂O₂ 양과 APX 활성은 증가하였다. APX isoforms 중 APX 1 (stromal)은 300 mM NaCl 처리 시 활성이 거의 나타나지 않는 반면, chilling이나 drought 처리 시에는 변화가 없었다. 또한 gel 상에서의 서로 다른 APX isoforms의 활성이 유전자 발현에서도 확인이 되는지를 알아보기 위해 RT-PCR을 수행하였다. 구획별 APX isoforms의 RT-PCR 수행 결과, cytosolic/thylakoid bound APX 발현양은 증가한 반면, stromal APX 발현은 매우 감소하였다. 이러한 실험 결과는 salt에 의해 구획별로 APX 활성이 영향을 받음을 나타낸다. We investigated changes in photosynthesis and activity of ascorbate peroxidase (APX) that scavenges ROS as responses to oxidative stress induced by salinity in rice (Oryza sativa L.). Photosynthetic efficiency of rice leaves, monitored in terms of Fv/Fm, declined with the increase of salt concentration (100-300 mM NaCl). Salinity caused an increase of H₂O₂ in leaves of rice, with an increase of APX activity. Among total APX isoforms, an isoform of stromal-APX 1 in leaves of rice was completely inactivated by 300 mM NaCl, but was not affected by chilling or drought. The results suggest that salt stress acts in quite a different mechanism in relation to the activity of stromal-APX from that of other stresses such chilling and drought. We carried out RT-PCR for analysis of genes expression of APX isoforms as affected by salt stress. The expression of cytosolic APX / thylakoid-bound APX genes in leaves of rice exposed to salt stress was increased, while stromal APX gene expression rapidly declined.

Photochemical Damage and Responses of Antioxidant Enzymes in Rice Leaves Induced to Light-Chilling

Jeung Suk Koo(구정숙),Yeon Sik Choo(추연식),Chin Bum Lee(이진범) 한국생명과학회 2009 생명과학회지 Vol.19 No.4

대부분의 열대 식물은 chilling에 민감하게 반응한다. 대표적 열대 식물인 벼 잎에 대한 light-chilling 처리와 이 후의 회복기(post-chilling) 동안 일어나는 반응들을 알아보았다. Chilling 시 벼 잎에서의 광합성 효율(Fv/Fm)은 대조구보다 50% 감소하였고, 상대적으로 H₂O₂ 양은 48% 증가하였다. 항산화 효소들 중 SOD와 GR 활성은 chilling과 post-chilling 시 증가하였다. 특히 SOD isoforms의 경우 CuZn-SOD와 Mn-SOD 가 발현된 반면 Fe-SOD는 발현되지 않았다. CAT 활성은 chilling 시 감소하였으며, 반면에 APX는 크게 증가하였다. Chilling 시 CAT의 isoforms의 변화를 보면, CAT-2와 -3의 활성이 감소한 것과 대조적으로 post-chilling 시 이들 isoforms의 활성은 증가하였다. 이처럼 APX와 CAT 활성은 벼 잎이 chilling stress를 겪게 될 때 상반되는 변화를 보여주었다. We investigated photooxidation and responses of antioxidant enzymes involved in scavenging reactive oxygen species (ROS) after light-chilling (4℃) for 2 days and post chilling (25℃) in rice leaves. Chilling leaves indicated a 50% reduction in photosynthetic efficiency (Fv/Fm ratio) and a 48% increase of H₂O₂, respectively, compared to the control group. In comparison with the control, activities of superoxide dismutase (SOD) and glutathione reductase (GR) increased at light-chilling and post-chilling. CuZn-SOD and Mn-SOD among SOD forms were detected in rice leaves, while Fe-SOD was not found. The increase of SOD and GR activity may serve as a basis for defense against chilling injury as it dismutase superoxide generated by light-chilling. Catalase (CAT) activity decreased during light-chilling, while activity of APX showed remarkable increase during light-chilling in rice leaves. Among CAT isoforms analyzed by 10% native PAGE, activities of isoform -2 and -3 were inhibited during light-chilling. From the elevated APX activity and decreased CAT activity, we suggest that these two enzymes show mutual supplementary relationships, indicating different tendency during light-chilling.

진균혈증의 진단에 있어서 혈청 (1→3)-β-D-glucan 측정의 유용성

최석훈,한상훈,진범식,박윤선,조병철,김희만,김윤재,이꽃실,장경희,송영구,김준명 대한감염학회 2003 감염과 화학요법 Vol.35 No.4

목적 : 진균혈증의 신속한 진단은 진균혈증 치료의 핵심이다. 그러나 진균혈증의 전통적인 진단법은 어렵기 때문에 진단을 지연시킬 수 있다. 진균혈증의 진단에서 β-glucan의 임상적 유용성을 알아보기 위하여 본 연구자들은 진균혈증 환자의 혈청 β-glucan의 농도를 측정하기 위하여 대조군으로써 균혈증 환자와 건강한 성인과 비교하였다. 방법 : 2001년 8월에서 2002년 10월까지 16명의 진균혈증 환자, 13명의 균혈증 환자, 그리고 18명의 정상 성인의 혈청 β-glucan 농도를 측정하였다. 본 연구자들은 β-glucan 농도를 β-Glucan Test(Wako Pure Chemical Industries, Ltd., Osaka, Japan)를 이용하여 측정하였다. 진균혈증 환자와 다른 환자들 사이의 혈청 β-glucan 농도 비교는 t-검정을 이용하였다. 결과 : 진균혈증 환자 중에서 남자는 10명(62.5%)이었고, 여자는 6명(37.5%)이었으며, 평균연령은 52.9±16.2세였다. 균혈증 환자 중에서 남자는 6명(46.2%)이었고, 여자는 7명(53.8%)였으며, 평균연령은 52.3±17.1세였다. 정상 성인 중에서 남자는 15명(83.3%)이었고, 여자는 3명(16.7%)였다. 평균연령은 23.8±2.1세였다. Cut-off value는 11 pg/mL이었다. 총 16명의 진균혈증 환자 중에서 13명의 혈청 β-glucan의 농도가 cut-off value 이상이었고(범위:11.5-863 pg/mL, 민감도:81.3%, 특이도:100%), 평균 농도는 217.8±273.8 pg/mL이었다. 총 13명의 균혈증 환자의 혈청 β-glucan 농도는 전부 cut-off 이하였고, 평균 혈청 β-glucan 농도는 0.1±0.3pg/mL이었다. 총 18명의 정상 성인의 혈청 β-glucan의 농도는 전부 cut-off value 이하였고, 평균 혈청 β-glucan 농도는 0 pg/mL이었다. 진균혈증 환자의 혈청 β-glucan의 농도는 통계학적으로 유의하게 대조군인 균혈증 환자와 건강한 성인의 농도보다 높았다(P-value : 0.006 및 0.006). 결론 : 결론적으로 진균혈증 환자의 진단에서 혈청 β-glucan의 농도 측정은 임상적으로 의미가 있다. 그러나 본 연구가 임상적으로 더욱 유용하기 위하여는 혈청 β-glucan 농도 측정을 통한 진균혈증의 조기진단이 진균혈증 환자의 예후에 미치는 영향과 혈청 β-glucan 농도와 진균혈증 환자의 항진균제에 대한 치료반응과의 연관을 밝히는 연구가 진행되어야 할 것이다(본 연구는 WAKO사의 β-glucan Test (Wako Pure Chemical Industries, Ltd., Osaka, Japan)의 제공으로 이루어졌음) Background : Early recognition of fungemia is essential for successful treatment. However, methods to culture fungus specimen taken from fungemia patients are difficult and time consuming. To assess the clincal usefulness of β-D-glucan in the detection of fungemia. we compared serum (1→3)-β-D-glucan concentrations in fungemia, bacteremia, and healthy persons. Methods : From August 2001 to October 2002, serum (1→3)-β-D-glucan concentrations were measured by turbidometric assay in 16 fungemia patients, 13 bacteremia patients and 18 healthy persons. Differences in (1→3-β-D-glucan concentrations between fungemia patients and other groups were compared by t-test. Results : Fungemia patients were composed of 10 male and 6 female patients, and mean age was 52.9±16.2 years. The cut-off value for a positive result was 11 pg/mL. thirteen out of 16 fungemia patients had concentrations above the cul-off value (range: 11.5-863 pg/mL, sensitivity: 81.3%, specificity: 100%), and mean concentration in fungemia was 217.8±273.8 pg/mL. Mean concentration in bacteremia was 0.1±0.3 pg/mL, and all the patients with bacteremia had the concentrations below the cut-off value. Mean concentration in the healthy persons was 0 pg/mL and all healthy persons had concentration below the cut-off value. The concentration in fungemia was statistically significantly higher than those of the other two groups(p-value: respectively 0.006, 0.006) Conclusion : We concluded that serum (1→3)-β-D-glucan is useful for the diagnosis of fungemia. Further study on the usefullness of serum (1→3)-β-D-glucan for early detection of fungemia and therapeutic monitoring is warranted.

만성 신부전으로 발현된 Erdheim-Chester disease

황현석 ( Hyun Suk Hwang ),지병수 ( Byoung Su Ji ),이진국 ( Chin Kook Lee ),김진영 ( Jin Young Kim ),최범순 ( Bum Soon Choi ),양철우 ( Chul Woo Yang ),김용수 ( Yong Soo Kim ) 대한내과학회 2007 대한내과학회지 Vol.73 No.2

Erdheim-Chester disease is a rare non-langerhans cell histiocytic disorder of an unknown cause that may associate with multisystem, rapidly fatal, infiltrative disease. We report here on a case of Erdheim-Chester disease in a 45-year-old man who presented with chronic renal failure. The patient visited a local clinic due to renal failure that was accidentally diagnosed on a routine health examination. At that time, abdominal computed tomography revealed retroperitoneal fibrosis and bilateral hydronephrosis. However, he did not visit hospital for further evaluation. After 1 year, he visited our clinic due to exertional dyspnea that had developed several months previously. The chest and abdominal CT showed interstitial pneumonitis and pleural effusion and there was progressed hydronephrosis and perirenal fibrosis. He was diagnosed with Erdheim-Chester disease based on the characteristic findings of pleural biopsy (interstitial fibrosis, infiltration of macrophge, CD68-positive but S-100 negative). The patient was treated with insertion of a double J catheter and immunesuppression with prednisolone and azathioprine. Erdheim-Chester disease is a rare disease, but it should be considered in those patients displaying chronic renal failure with retroperitoneal fibrosis.(Korean J Med 73:216-222, 2007)

심장 및 대동맥 수술 환자에서 포괄적 혈액보존법 시행군과 비시행군에서의 동종수혈의 용량 및 치료비용의 비교

김상범,박한석,진영준 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.36 No.1

Background : To reduce the amount of homologous transfusion with its inherent problems of transmission of viral hepatitis, acquired immune deficiency syndrome and others, many institutions use comprehensive blood conservation methods (CBCM) in open heart and major aortic operations. The purpose of this study is to compare the amount and cost of homologous transfusion and the efficacy of coagulation between patients with or without CBCM adoption. Methods : We prospectively assessed available CBCM of our institution in 20 patients, comparing the requirements of blood products, their cost and the efficacy of blood coagulation with those of another 20 patients similar in age, types of operation, operation difficulty and duration of bypass time retrospectively. Result : Fewer whole blood and platelet concentrates were transfused in patients with CBCM (p<0.05). There are no significant differences in the amount of used packed red blood cell and fresh frozen plasma between two groups. Partial thromboplastin time s significantly short in patient with CBCM (p<0.05). The prevalence of complications and mean extra-financial cost for using cellsaver, platelete pheresis and homologous blood products are low in patients with CBCM. Conclusions : The CBCM requires additional cost won but CBCM reduces the requirements of homologous blood effectively. (Korean J Anesthesiol 1999; 36: 62∼68)

Changes in ROS-Scavenging Enzyme Activity in Rice (Oryza sativa L.) Exposed to High Salinity

Koo, Jeung-Suk,Choo, Yeon-Sik,Lee, Chin-Bum The Ecological Society of Korea 2007 Journal of Ecology and Environment Vol.30 No.4

We studied changes in the biochemical and physiological status and ROS-scavenging enzyme (superoxide dismutase, catalase and peroxidase) activity in leaves and roots of rice (Oryza sativa L.) plants exposed to high salinity. Under salt stress, the reduction in RWC (relative water content) in leaves was relatively severe in comparison with that of roots. The proline content was also significantly higher in leaves of rice plants following salt treatment. The activities of CAT and POX in roots increased with increasing NaCl concentration, but the activity of SOD decreased. These results suggest that the increase of endogenous proline is closely associated with the increase of CAT and POX activities, which may play important roles in salt tolerance. Therefore, we conclude that the alleviation of oxidative damage and increased resistance to salinity may result from the presence of efficient antioxidative systems.

Recommendations for Adult Immunization by the Korean Society of Infectious Diseases, 2023: Minor Revisions to the 3rd Edition

Choi Won Suk,Song Joon Young,Kwon Ki Tae,Lee Hyo-Jin,Choo Eun Ju,Baek Ji Hyeon,Chin Bum Sik,Kim Woo Joo,Lee Mi Suk,Park Wan Beom,Han Sang Hoon,Choi Jun Yong,Yeom Joon-Sup,Lee Jin-Soo,Choi Hee-Jung,Cho 대한감염학회 2024 Infection and Chemotherapy Vol.56 No.2

The Korean Society of Infectious Diseases has been regularly developing guidelines for adult immunization since 2007. In 2023, the guidelines for the following seven vaccines were revised: influenza, herpes zoster, pneumococcal, tetanus-diphtheria-pertussis (Tdap), human papillomavirus (HPV), meningococcal, and rabies vaccines. For the influenza vaccine, a recommendation for enhanced vaccines for the elderly was added. For the herpes zoster vaccine, a recommendation for the recombinant zoster vaccine was added. For the pneumococcal vaccine, the current status of the 15-valent pneumococcal conjugate vaccine and 20-valent PCV was described. For the Tdap vaccine, the possibility of using Tdap instead of tetanus-diphtheria vaccine was described. For the HPV vaccine, the expansion of the eligible age for vaccination was described. For the meningococcal vaccine, a recommendation for the meningococcal B vaccine was added. For the rabies vaccine, the number of pre-exposure prophylaxis doses was changed. This manuscript documents the summary and rationale of the revisions for the seven vaccines. For the vaccines not mentioned in this manuscript, the recommendations in the 3rd edition of the Vaccinations for Adults textbook shall remain in effect.