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S-369 Organizing pneumonia in a patient with Middle East respiratory syndrome coronavirus in fection
( Hanna Lee ),( Jeongha Mok ),( Insu Kim ) 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1
We report on a rare case of successful treatment of suspected organizing pneumonia in a patient with Middle East respiratory syndrome coronavirus (MERS-CoV) infection. A 54-year-old man with MERS-CoV infection was transeffered to our hospital. He had a history of hypertension, diabetes, hepatitis B infection, and liver cirrhosis. We initiated anti-viral drugs and supportive care. The patient’s fever and chills disappeared 3 days after admission and the results of serial follow-up reverse transcription-polymerase chain reaction testing for MERS-CoV was negative soon thereafter. He was discharged from the hospital 14 days after admission with no symptoms. However, he presented with a fever 7 days after discharge and was re-hospitalized. Chest radiographs showed newly developed consolidative opacity. His fever persisted for 3 days after commencing empirical antibiotics. Contrast-enhanced computed tomography (CT) of the chest showed focal patchy airspace consolidation and ground-glass opacities (GGOs) in a subpleural lesion of the right lower and left upper lobes, which was indicative of organizing pneumonia. We initiated empirical corticosteroid treatment for this illness, and his fever markedly subsided 1 day later. A chest radiograph showed improvement in the lung lesions, and he was discharged from the hospital 10 days after re-admission. The corticosteroid dose was gradually tapered over 2 months at the outpatient clinic, and a follow-up CT scan showed complete resolution of the consolidation and GGOs.
( Eunki Chung ),( Dawoon Jeong ),( Jeongha Mok ),( Doosoo Jeon ),( Hee-yeon Kang ),( Heejin Kim ),( Heesun Kim ),( Hongjo Choi ),( Young Ae Kang ) 대한내과학회 2024 The Korean Journal of Internal Medicine Vol.39 No.2
Background/Aims: To determine whether metformin, which is considered a host-directed therapy for tuberculosis (TB), is effective in improving the prognosis of patients with TB and diabetes mellitus (DM), who have higher mortality than those without DM. Methods: This cohort study included patients who were registered as having TB in the National Tuberculosis Surveillance System. The medical and death records of matched patients were obtained from the National Health Information Database and Statistics Korea, respectively, and data from 2011 to 2017 were collected retrospectively. We classified patients according to metformin use among participants who used diabetes drugs for more than 28 days. The primary outcome was all-cause mortality during TB treatment. Double propensity score adjustment was applied to reduce the effects of confounding and multivariable Cox proportional hazard models were used to estimate adjusted hazard ratio (aHR) with 95% confidence interval (CI). Results: The all-cause mortality rate during TB treatment was lower (9.5% vs. 12.4%, p < 0.01) in the metformin user group. The hazard of death due to all causes after double propensity score adjustment was also lower in the metformin user group (aHR 0.76, 95% CI 0.67-0.86, p < 0.01). There was no significant difference in mortality between metformin users and non-users for TB-related deaths (p = 0.22); however, there was a significant difference in the non-TB-related deaths (p < 0.01). Conclusions: Metformin use in patients with TB-DM co-prevalence is associated with reduced all-cause mortality, suggesting the potential for metformin adjuvant therapy in these patients.
( Soo Han Kim ),( Jeongha Mok ),( Kyoungjune Pak ),( Jung Seop Eom ) 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.-
Background Ultrathin bronchoscope (UB) is a useful tool for the diagnosis of peripheral pulmonary lesions (PPLs), since it can be advanced to more peripheral bronchi compared to thin bronchoscope. We aimed to perform a meta-analysis to investigate the diagnostic yield of UB for PPLs. Method We performed a systematic search of the PubMed and Embase databases through May 2021 to determine the diagnostic yield of UB for PPLs. Diagnostic yield was calculated by dividing the number of successful diagnoses by the total number of lesions. Meta analysis was performed using Review Manager (Version 5.4) and R (version 4.1.0). Subgroup analysis and metaregression was used to identify related factors for diagnostic yield. Results 19 studies with a total of 2,004 PPLs were included. The pooled diagnostic yield of UB was 0.65 (95% CI, 0.60-0.70). Significant heterogeneity was observed among studies (I2 = 79.4%, heterogeneity p< 0.0001). In sub-group analysis regarding the diagnostic yield, UB with 1.2 mm channel size showed 0.60 (95% CI, 0.57-0.63), whereas UB with 1.7mm channel size showed 0.71 (95% CI, 0.67-0.74) (p=0.0171). In addition, there was significant difference in diagnostic yield based on lesion size (≤20mm vs >20mm), final diagnosis (benign vs malignant), bronchus sign, and lesion location from hilum (peripheral vs others), whereas no significant difference was found based on prevalence of malignancy (<75% vs ≥75%) and lobar location (upper lobe vs others). Conclusion UB is an excellent tool for the diagnosis of PPLs. The diagnostic yield of UB with 1.7mm channel size was significantly higher compared to that with 1.2mm channel size, which might be attributed to availability of radial endobronchial ultrasound in 1.7mm channel size.
( Soo Han Kim ),( Eun Jung Jo ),( Jeongha Mok ),( Kwangha Lee ),( Ki Uk Kim ),( Hye-kyung Park ),( Min Ki Lee ),( Jung Seop Eom ),( Mi-hyun Kim ) 대한내과학회 2023 The Korean Journal of Internal Medicine Vol.38 No.2
Background/Aims: Despite the obvious benefits of adding immune checkpoint inhibitors to platinum-etoposide chemotherapy in patients with extensive-stage small-cell lung cancer (ES-SCLC), real-world data remain scarce. Methods: This retrospective study included 89 patients with ES-SCLC treated with platinum-etoposide chemotherapy alone (chemo-only group; n = 48) or in combination with atezolizumab (atezolizumab group; n = 41) and compared the survival outcomes between these two groups. Results: Overall survival (OS) was significantly longer in the atezolizumab group than in the chemo-only group (15.2 months vs. 8.5 months; p = 0.047), whereas the median progression-free survival was almost the same (5.1 months vs. 5.0 months) in both groups (p = 0.754). Subsequent multivariate analysis revealed that thoracic radiation (hazard ratio [HR], 0.223; 95% confidence interval [CI], 0.092-0.537; p = 0.001) and atezolizumab administration (HR, 0.350; 95% CI, 0.184-0.668; p = 0.001) were favorable prognostic factors for OS. In the thoracic radiation subgroup, patients who received atezolizumab demonstrated favorable survival outcomes and no grade 3-4 adverse events (AEs). Conclusions: The addition of atezolizumab to platinum-etoposide resulted in favorable outcomes in this real-world study. Thoracic radiation was associated with improved OS and acceptable AE risk in combination with immunotherapy in patients with ES-SCLC.