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The effect of metformin on culture conversion in tuberculosis patients with diabetes mellitus
( Ye-jin Lee ),( Sung Koo Han ),( Ju Hee Park ),( Jung Kyu Lee ),( Deog Keom Kim ),( Hee Soon Chung ),( Eun Young Heo ) 대한내과학회 2018 The Korean Journal of Internal Medicine Vol.33 No.5
Background/Aims: Patients with diabetes mellitus (DM) and tuberculosis (TB) have increased morbidity and a high risk of treatment failure or recurrence. It is important to manage both diseases simultaneously. Among anti-diabetic drugs, metformin inhibits intracellular growth of mycobacteria. Therefore, we examined the effects of metformin on TB treatment, especially in patients with DM. Methods: This retrospective cohort study included patients with culture-positive pulmonary TB diagnosed between 2011 and 2012. The primary study outcome was sputum culture conversion after 2 months of treatment. Results: Of 499 patients diagnosed with culture-positive pulmonary TB, 105 (21%) had DM at diagnosis. Among them, 62 (59.5%) were treated with metformin. Baseline characteristics, except for the presence of chronic renal disease, were not significantly different between the metformin and non-metformin groups. Metformin treatment had no significant effect on sputum culture conversion (p = 0.60) and recurrence within 1 year after TB treatment completion (p = 0.39). However, metformin improved the sputum culture conversion rate in patients with cavitary pulmonary TB, who have higher bacterial loads (odds ratio, 10.8; 95% confidence interval, 1.22 to 95.63). Conclusions: Among cavitary pulmonary TB patients with DM, metformin can be an effective adjunctive anti-TB agent to improve sputum culture conversion after 2 months of treatment.
( Sung Woo Moon ),( Ji Ye Jung ),( Young Ae Kang ),( Moo Suk Park ),( Young Sam Kim ),( Se Kyu Kim ),( Joon Chang ),( Hyo Chae Park ),( Chang Young Lee ),( Song Yee Kim ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Primary graft dysfunction (PGD) is a severe type of acute lung injury after lung transplantation and is reported to be associated with early morbidity and mortality.We were to investigate donor, recipient, and perioperative risk factors and outcome of PGD. Methods: We performed a retrospective study using data collected in one tertiary care hospital in South Korea. The patients who underwent lung transplantation between January 2010 and March 2014 were enrolled. The primary outcome was grade 3 PGD (PaO2/ fiO2 < 200 and presence of diffuse infi ltrates on chest radiograph of allograft at 48 or 72 hours after transplant) and PGD grade was defi ned according to International Society for Heart and Lung Transplantation criteria. Results: A total of 61 patients were enrolled and 16 subjects (26.2%) developed grade 3 PGD. In univariate study, higher body mass index (BMI) in recipients, any history of recipient smoking, extracorporeal membrane oxygenation usage before transplantation in recipients, and ischemic time during operation were associated with PGD. Primary recipient diagnosis, transplant type, mean pulmonary artery pressure, donor-smoking history were not related with PGD. In multivariate model, independent risk factors for PGD were BMI in recipients (Odds ratio [OR], 1.290; P=0.048) and total ischemic time during operation (OR, 1.013; P=0.009). PGD was signifi cantly associated with higher re-operation rate (OR, 3.500; P=0.042), longer days of ventilator apply (median 6 days vs.14.5 days; P=0.044), longer intensive care unit stay (median 9 days vs. 17 days; P=0.041) and higher rate of renal replacement therapy (OR, 7.708; P=0.002) after transplantation. Conclusions: We identifi ed risk factors and outcome of grade 3 PGD after lung transplantation. Our fi ndings can be used to develop predictive models for PGD that may allow for modifi cation of risk factors.
( Sung Woo Moon ),( Kyung Soo Chung ),( Ji Ye Jung ),( Young Ae Kang ),( Moo Suk Park ),( Young Sam Kim ),( Joon Chang ),( Se Kyu Kim ),( Hyo Chae Paik ),( Jun Won Cheong ),( Song Yee Kim ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Introduction: Hemophagocytic lymphohistiocytosis (HLH) is a rare but life-threatening complication after solid organ transplantation. HLH has been reported as problem related with kidney and liver transplant, and there are limited reports of HLH after lung transplantation. Case: A 60-year-old man with idiopathic pulmonary fibrosis underwent bilateral lung transplantation. After lung transplantation, acute rejection was suspected and high dose steroid therapy was done. Since postoperative day(POD) 25, thrombocytopenia( platelet 112*1000/uL) and leukopenia(2530/uL)) were presented. The patient complained of intermittent symptom of low-grade fever, chest discomfort and dyspnea. Echocardiography showed stress induced cardiomyopathy and results of peripheral blood smear was nonspeci. c. Pneumonia was developed and patient was treated with antibiotics. Hyperbilirubinemia(total bilirubin 2.1 mg/dL) started to present at POD 50. Results of abdomen sonography was nonspeci. C except for mild splenomegaly (11.4cm). By POD 80, bilirubin was getting higher(total bilirubin 33.3mg/dL, direct bilirubin 25.7mg/dL, gamma glutamyl transpeptidase 260IU/L) and leukopenia and thrombocytopenia was getting aggravated (white blood cell 2080/uL and platelet 57* 1000/uL). The . brinogen was mildly elevated (4210m/dL), triglyceride was normal (127 mg/dL), the ferritin was elevated (4518 ng/mL) and soluble interleukin-2 receptor was elevated (8730U/ml). However, the finding of peripheral blood smear was still nonspeci. c. The cause of pancytopenia, low grade fever and hyperbilirubinemia was unclear, and we conducted bone marrow biopsy on POD 82. The finding showed that histiocytes were frequently seen with occasional hemophagocytes. Taken together, cytopenia, bone marrow hemophagocytes, elevated soluble interleukin-2 receptor and elevated ferritin were positive among laboratory tests listed in diagnostic criteria of HLH. We managed with etoposide and high dose steroid, but patient deteriorated and died on POD 87. Summary: HLH is a significant diagnostic and therapeutic challenge in lung transplantation and is potentially lethal complication. Therefore, clinicians should consider HLH as possible diagnosis in clinical context.
( Sung Woo Moon ),( Ji Ye Jung ),( Young Ae Kang ),( Moo Suk Park ),( Young Sam Kim ),( Se Kyu Kim ),( Joon Chang ),( Hyo Chae Park ),( Chang Young Lee ),( Song Yee Kim ) 대한결핵 및 호흡기학회 2014 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.118 No.-
Background: Primary graft dysfunction (PGD) is a severe type of acute lung injury after lung transplantation and is reported to be associated with early morbidity and mortality. We were to investigate donor, recipient, and perioperative risk factors and outcome of PGD. Methods: We performed a retrospective study using data collected in one tertiary care hospital in South Korea. The patients who underwent lung transplantation between January 2010 and March 2014 were enrolled. The primary outcome was grade 3 PGD (PaO2/FiO2 < 200 and presence of diffuse infiltrates on chest radiograph of allograft at 48 or 72 hours after transplant) and PGD grade was defined according to International Society for Heart and Lung Transplantation criteria. Results: A total of 61 patients were enrolled and 16 subjects (26.2%) developed grade 3 PGD. In univariate study, higher body mass index (BMI) in recipients, any history of recipient smoking, extracorporeal membrane oxygenation usage before transplantation in recipients, and ischemic time during operation were associated with PGD. Primary recipient diagnosis, transplant type, mean pulmonary artery pressure, donor-smoking history were not related with PGD. In multivariate model, independent risk factors for PGD were BMI in recipients (Odds ratio [OR], 1.290; P=0.048) and total ischemic time during operation (OR, 1.013; P=0.009). PGD was significantly associated with higher re-operation rate (OR, 3.500; P=0.042), longer days of ventilator apply (median 6 days vs.14.5 days; P=0.044), longer intensive care unit stay (median 9 days vs. 17 days; P=0.041) and higher rate of renal replacement therapy (OR, 7.708; P=0.002) after transplantation. Conclusions: We identified risk factors and outcome of grade 3 PGD after lung transplantation. Our findings can be used to develop predictive models for PGD that may allow for modification of risk factors.
Study on the Environmental Risk Assessment of Transgenic Chinese Cabbage
Ye Sun Chung,Young Doo Park,Eun Taek Woo,Kuen Woo Park,Kyu Hwan Chung,Sang Yong Lee,Mun Il Ryoo,Jong Ok Ka,Min Jea Kim,Dong Ho Lee,Youn Hyung Lee,Dong Jin Lee,Chan Lee,Dae Yeul Son,Tae Sung Park,Hong 한국원예학회 2008 한국원예학회 기타간행물 Vol.- No.-