Timing and predictors of death during treatment in patients with multidrug/rifampin-resistant tuberculosis in South Korea

( Eunjeong Son ),( Hongjo Choi ),( Jeongha Mok ),( Young Ae Kang ),( Dawoon Jeong ),( Doosoo Jeon ) 대한내과학회 2024 The Korean Journal of Internal Medicine Vol.39 No.4

Background/Aims: This study aimed to investigate the timing and predictors of death during treatment among patients with multidrug/rifampin-resistant tuberculosis (MDR/RR-TB) in South Korea. Methods: This was a retrospective cohort study that included MDR/RR-TB cases notified between 2011 and 2017 in South Korea. Results: Among 7,226 MDR/RR-TB cases, 699 (9.7%) died at a median of 167 days (IQR 51-358 d) from the initiation of MDR-TB treatment. The cumulative proportion of all-cause death was 35.5% at 90 days and 52.8% at 180 days from treatment initiation. TB-related deaths occurred at a median of 133 days (IQR 32-366 d), which was significantly earlier than the median of 184 days (IQR 68-356 d) for non-TB-related deaths (p = 0.002). In a multivariate analysis, older age was the factor most strongly associated with death, with those aged ≥ 75 years being 68 times more likely to die (aHR 68.11, 95% CI 21.75-213.26), compared those aged ≤ 24 years. In addition, male sex, comorbidities (cancer, human immunodeficiency virus, and end stage renal disease), the lowest household income class, and TB-specific factors (previous history of TB treatment, smear positivity, and fluoroquinolone resistance) were identified as independent predictors of all-cause death. Conclusions: This nationwide study highlights increased deaths during the intensive phase and identifies high-risk groups including older people and those with comorbidities or socioeconomic vulnerabilities. An integrated and comprehensive strategy is required to reduce mortality in patients with MDR/RR-TB, particularly focusing on the early stages of treatment and target populations.

The Role of Neutrophil Gelatinase-associated Lipocalin (NGAL) as Outcome Prediction in Severe Acute Respiratory Failure: A Pilot Study

( Eunjeong Son ),( Hye Ju Yeo ),( Woo Hyun Cho ),( Taehwa Kim ),( Seung Eun Lee ),( Doosoo Jeon ),( Yun Seong Kim ),( Jin Ook Jang ),( Jin Ho Jang ) 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.-

Purpose Plasma neutrophil gelatinase-associated lipocalin (NGAL) is released from activated human neutrophil granules. Its concentration raises in many acute inflammatory state such as chronic obstructive pulmonary disease-acute exacerbation, low respiratory tract infection and acute kidney injury. But, the usefulness of plasma NGAL concentration for predicting the outcome of severe acute respiratory failure is unknown. In this study, we evaluated plasma NGAL as a potential prognostic biomarker in patients with severe acute respiratory failure. Method We prospectively collected blood samples from acute respiratory failure patients admitted to the intensive care unit (ICU) between March 2016 and June 2020. Plasma NGAL and inflammatory markers such as TNF-α, IL-1β levels of patients were measured on days 1, 3, 7 of hospitalization. We retrospectively reviewed patient medical records and analyzed correlations between the plasma NGAL concentration and hospital outcomes. Result A total of 46 severe acute respiratory failure patients were included in this study; 32 (69.6%) patients are survivors and 14 (30.4%) patients are non-survivors. In the survivor group, the concentration of plasma NGAL on days 7 of hospitalization decreased compared to the day 1 plasma NGAL concentration (p=0.002), but there was no significant decrease in the non-survivor group (p=0.794). The day 7 plasma NGAL concentration was associated with hospital mortality (p=0.042). Conclusion Acute respiratory failure patients with high plasma NGAL levels on days 7 of hospitalization have a high mortality rate. Therefore, plasma NGAL is useful for predicting outcomes of severe acute respiratory failure.

Various expression patterns of pregnancy-associated plasma protein-A

Jeon, Eunjeong,Lee, Jihwan,Son, Junkyu,Kim, Doosan,Lim, Dajeong,Han, Man-Hye,Hwang, Seongsoo The Korean Society of Animal Reproduction and Biot 2022 한국동물생명공학회지 Vol.37 No.3

Pregnancy-associated plasma protein-A (PAPP-A) is known as an important biomarker for fetal abnormality during first trimester and has a pivotal role in follicle development and corpus luteum formation. And also, it is being revealed that an expression of PAPP-A in various cells and tissues such as cancer and lesion area. PAPP-A is the major IGF binding protein-4 (IGFBP-4) protease. Cleavage of IGFBP-4 results in loss of binding affinity for IGF, causing increased IGF bioavailability for proliferation, survival, and migration. Additionally, PAPP-A can be used as a promising therapeutic target for healthy longevity. Despite growing interest, almost nothing is known about how PAPP-A expression is regulated in any tissue. This review will focus on what is currently known about the zinc metalloproteinase, PAPP-A, and its role in cells and tissues. PAPP-A is expressed in proliferating cells such as fetus in uterus, granulosa cells in follicle, dermis in wound, cancer cells, and Sertoli cells in testis. They have common characteristics of proliferation faster than normal cells with stimulating IGFs action and inhibiting IGFBPs. The PAPP-A functions and expression studies in livestock have not yet been conducted much. Further studies are needed to use PAPP-A as a marker for healthy longevity in animal science.

일-가정양립지원정책이 아동양육 취업여성의 근로지속의사에 미치는 영향

손제희(Son, Jehee),김은정(Kim, Eunjeong) 한국생활과학회 2014 한국생활과학회지 Vol.23 No.3

멀티 스케일 모델을 적용한 선재 공정의 미세결함 형상 변화 예측

곽은정(Eunjeong Kwak),강경필(Gyeongpil Kang),이경훈(Kyunghoon Lee),손일헌(Il-Heon Son) 한국소성가공학회 2009 한국소성가공학회 학술대회 논문집 Vol.2009 No.10

Multiple scale modeling has been applied to predict defect shape change during the wire rod rolling process. The size difference between bloom and defect prevent using usual FEM approaches due to the enormous number of elements required to depict the defect. The newly developed multiple scale model can visualize defect shape changes during the multi stands rolling process. The defect positioned at the top and side of bloom are smoothed out but the one at the middle evolved as folding or remained as crack. This approach can be used for defect control with roll shape design and initial bloom shape.

비소세포폐암환자에서 백금착화합물을 포함한 항암화학요법의 비교

신은정,유순호,이병구,손인자,이숙향 한국병원약사회 2001 병원약사회지 Vol.18 No.3

Non-small cell lung cancer (NSCLC) remains the leading cause of cancer related death and 5-year survival rate is approximately 10-15%. Platinum-based chemotherapy has been demonstrated to improve survival in advanced NSCLC. Platinum-based paclitaxel and gemcitabine combination therapy considered moderately active regimen in patients with advanced NSCLC and warrants comparison with existing Platinum-based regimen in randomized trial. The aim of this study was to evaluate toxicity and efficacy of Platinum-based paclitaxel and gemcitabine combination therapy. The medical charts of fifty-six patients with NSCLC, who met selection criteria from January 2000 to March 2001, were reviewed retrospectively. They received one of three regimens greater than 2 cycles up to 7 cycles; paclitaxel (140㎎/㎡) and cisplatin (60㎎/㎡), paclitaxel (120㎎/㎡) and carboplatin (300㎎/㎡), gemcitabine (1000㎎/㎡) and cisplatin (60㎎/㎡). Data collection and analysis included baseline characteristics, hematologic and non-hematologic toxicity profiles according to WHO toxicity criteria and overall response according to clinician's opinion on basis of clinical results. As results, WHO grade above 2 hematologic toxicity occurred high in gemcitabine/cisplatin arm (9.6%) compared with other two arms (paclitaxel/cisplatin 2.8% vs. paclitaxel/carboplatin 5.8%). WHO grade above 2 non-hematologic GI toxicity occurred high in paclitaxel/carboplatin arm (5.2%) compared with other two arms(paclitaxel/cisplatin 3.4% vs. gemcitabine/cisplatin 2.5%). WHO grade above 2 non-hematologic excluding GI toxicity occurred high in paclitaxel/cisplatin arm(8.8%) compared with other two arms(paclitaxel/carboplatin 7.9% vs. gemcitabine/cisplatin 2.6%). Common side effects included nausea/vomiting, peripheral neuropathy and alopecia. Comparing toxicity profiles for the three regimens revealed no significant difference. Overall response rate was 22% for paclitaxel/cisplatin arm, 31% for paclitaxel/carboplatin arm, and 15% for gemcitabine/cisplatin arm. Comparing response rate for the three arms revealed no significant difference. The median survival period was 12.2 months for paclitaxel/cisplatin arm, 18.3 months for paclitaxel/carboplatin arm, and 8.3 months for gemcitabine/cisplatin arm. Comparing survival for the three arms revealed no significant difference. There were several limitations of this study, uncontrolled baseline disease, baseline toxicity, number of patient and number of effective cycles for the treatment group. Further well-designed study is required and pharmacist's role in ADR monitoring should be emphasized.

Head-to-Head Comparison between Xpert MTB/RIF Assay and Real-Time Polymerase Chain Reaction Assay Using Bronchial Washing Specimens for Tuberculosis Diagnosis

전두수,Eunjeong Son,Jinook Jang,Taehwa Kim,Jin Ho Jang,Jae Heun Chung,설희윤,여혜주,Seong Hoon Yoon,이승은,조우현,김윤성 대한결핵및호흡기학회 2022 Tuberculosis and Respiratory Diseases Vol.85 No.1

Background: With the introduction of Xpert MTB/RIF assay (Xpert), its incorporation into tuberculosis (TB) diagnosticalgorithm has become an important issue. The aim of this study was to evaluate the performance of the Xpert assay incomparison with a commercial polymerase chain reaction (PCR) assay. Methods: Medical records of patients having results of both Xpert and AdvanSure TB/NTM real-time PCR (AdvanSure)assays using the same bronchial washing specimens were retrospectively reviewed. Results: Of the 1,297 patients included in this study, 205 (15.8%) were diagnosed with pulmonary TB. Usingmycobacterial culture as the reference method, sensitivity of the Xpert assay using smear-positive specimens was 97.5%,which was comparable to that of the AdvanSure assay (96.3%, p=0.193). However, the sensitivity of the Xpert assay usingsmear-negative specimens was 70.6%, which was significantly higher than that of the AdvanSure assay (52.9%, p=0.018). Usng phenotypic drug susceptibility testing as the reference method, sensitivity and specificity for detecting rifampicinresistance were 100% and 99.1%, respectively. Moreover, a median turnaround time of the Xpert assay was 1 day, whichwas significantly shorter than 3 days of the AdvanSure assay (p<0.001). Conclusion: In comparison with the AdvanSure assay, the Xpert assay had a higher sensitivity using smear-negativespecimens, a shorter turnaround time, and could reliably predict rifampin resistance. Therefore, the Xpert assay might bepreferentially recommended over TB-PCR in Korean TB diagnostic algorithm.

뇌 전이 융모 상피암 환자의 임상적 고찰

백은정,정재근,손우익,송종철,김미란,정대영,김승조 가톨릭 중앙의료원 가톨릭 암센터 1993 가톨릭 암센터 論集 Vol.7 No.1

The Experiences of Cancer-Related Fatigue in Post-Treatment Cancer Survivors

Haeng-Mi Son,Eun Young Park,EunJeong Kim 한국간호과학회 2019 한국간호과학회 학술대회 Vol.2019 No.10

제주 이주민의 성공적인 정착을 위한 문화융합척도개발의 기초연구

김주호(Kim, Jooho),손주영(Son, Jooyoung),이은정(Yi, Eunjeong) 대한관광경영학회 2020 觀光硏究 Vol.35 No.4

아름다운 자연경관과 함께 높은 생태학적 가치로 인해 대내외적으로 높은 브랜드 가치를 인정받고 있는 제주도는 최근 들어 정착에 실패하고 다시 도심으로 돌아가는 이주민의 증가로 인해 지역경제발전에 상당한 타격을 입고 있다. 본 연구는 ‘뜨는’ 제주를 찾아온 이주민들이 지역사회에 적응하지 못하고 다시 제주를 ‘뜨는’ 원인을 심리, 사회, 문화 등의 통합적 차원에서 분석하고 타 지역과 차별화되는 제주 특유의 상황적 요인을 구체적으로 파악하고자 3차에 걸쳐 실시되었다. 1차 연구는 정성적연구방법(qualitative research)을 통해 이주민들이 직면하는 제주 적응상의 어려움을 크게 교육환경, 의료환경, 쇼핑·문화, 지역정서, 교통, 상업활동, 이주민정책 등의 7개 영역으로 구분하고 각 영역에서의 문제점을 체계적으로 정리하였다. 2차 정량적 연구(quantitative research)에서는 7개 영역 중 ‘교육환경’, ‘쇼핑ㆍ문화’, ‘지역정서’, ‘상업활동’, ‘이주민정책’ 등의 5개 영역에서 이주민과 토착민 간의 차이점과 이주민과 토착민 간의 사회적 거리감과 사회적 관계형성의 어려움을 검증하였다. 3차 연구는 1차 연구 및 2차 연구의 결과물에 다양한 참고문헌과 전문가 의견을 종합하여 ‘제주 이주민의 성공적 정착을 위한 문화융합 척도개발’의 주요 구성요소를 교육환경, 의료시설, 문화와 여가, 지역정서, 주거와 교통, 경제활동, 복지와 안전, 이주민 정책 등 8개 영역으로 구분하고 총 36개의 하위 구성요소를 도출하였다. 본 연구가 제주 이주민의 지역사회 정착을 위한 효과적인 이주민정책수립의 기초자료로서 유용하게 사용되기를 기대한다. Jeju Island has recently suffered considerable damage to regional economic development due to the increase in migrants who fail to settle down. The purpose of this study is to analyze the causes of migrants who came to Jeju and are leaving Jeju again from failing to adapt to the community, from psychological, social, and cultural perspectives. Tree stepwise research was conducted in order to grasp the specific situational factors of Jeju that are different from other regions. The first study is a qualitative research in which the difficulties of adaptation to Jeju that migrants face are largely divided into 7 problem areas: educational environment, medical environment, shopping and cultural environment, regional sentiments, transportation, commercial activities, and migrant policies. The second study is a quantitative study that finds significant differences in 5 of the 7 areas which include, educational environment , shopping · culture , regional sentiments , commercial activities , and migration policy between migrants and Jeju natives. Also, the social distance between them and the difficulties in forming social relationships are statistically confirmed. The third study synthesizes various references and expert opinions on the results of the first and second studies and identifies the main components of ‘developing cultural convergence index for successful settlement of Jeju migrants.’ The main components are divided into 8 areas and a total of 36 sub-components were derived. We hope that this study will be useful as a basic data for making effective migrant policies in the successful settlement in Jeju.