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대한내과학회> The Korean Journal of Internal Medicine> Total ankylosis of the bilateral hand and wrist joints in a patient with ankylosing spondylitis

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Total ankylosis of the bilateral hand and wrist joints in a patient with ankylosing spondylitis

Shin-gil Kim , Kyung-ann Lee
  • : 대한내과학회
  • : The Korean Journal of Internal Medicine 36권1호
  • : 연속간행물
  • : 2021년 01월
  • : 226-227(2pages)

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UCI(KEPA)

간행물정보

  • : 의약학분야  > 내과학
  • : KCI등재
  • : SCI
  • : 격월
  • : 1226-3303
  • : 2005-6648
  • : 학술지
  • : 연속간행물
  • : 1986-2021
  • : 2452


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1Clinical implication and risk factor of pneumonia development in mild coronavirus disease 2019 patients

저자 : Hyun Woo Lee , Seo-young Yoon , Jung-kyu Lee , Tae Yeon Park , Deog Kyeom Kim , Hee Soon Chung , Eun Young Heo

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 1호 발행 연도 : 2021 페이지 : pp. 1-10 (10 pages)

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Background/Aims: Although a majority of coronavirus disease 2019 (COVID-19) cases were characterized as mild, data assessing the development of pneumonia in mild COVID-19 patients are limited. We aimed to examine the effect of pneumonia development on the clinical course of mild COVID-19 in hospitalized patients.
Methods: A retrospective cohort study was conducted via medical record review between February 25, 2020 and April 11, 2020 at a single center. The impact of pneumonia development on the time to viral clearance in mild COVID-19 patients was evaluated. Risk factors associated with the development of pneumonia were also identified.
Results: Chest radiographs revealed the development of pneumonia in 26.8% of mild COVID-19 patients. The time to pneumonia development was a median of 8.0 days from the onset of symptoms and 3.5 days after hospital admission. A multivariate analysis for predicting pneumonia development identified age ≥ 65 years (odds ratio [OR], 3.15; 95% confidence interval [CI], 1.14 to 8.73), cough (OR, 2.18; 95% CI, 1.29 to 3.68), dyspnea (OR, 3.58; 95% CI, 1.10 to 11.69), and diarrhea (OR, 2.69; 95% CI, 1.51 to 4.78) as significant variables. The time to negative conversion was longer in mild COVID-19 patients who developed pneumonia (23.6 days vs. 18.4 days, p = 0.003). In Kaplan-Meier estimation and multivariate Cox regression analyses, newly developed pneumonia was significantly related with delayed time to negative conversion (log-rank test, p = 0.02; hazard ratio, 2.90; 95% CI, 1.06 to 7.97).
Conclusions: The development of pneumonia delayed viral clearance in patients with mild COVID-19. Elderly patients or those suffering from diarrhea should be closely monitored, given the increased risk of developing pneumonia.

2Dynamics of viral load and anti-SARS-CoV-2 antibodies in patients with positive RT-PCR results after recovery from COVID-19

저자 : Kyoung-ho Song , Dong-min Kim , Hyunju Lee , Sin Young Ham , Sang-min Oh , Hyeonju Jeong , Jongtak Jung , Chang Kyung Kang , Ji Young Park , Yu Min Kang , Ji-yeon Kim , Jeong Su Park , Kyoung Un Park ,

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 1호 발행 연도 : 2021 페이지 : pp. 11-14 (4 pages)

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Recently, the number of patients with coronavirus disease 2019 (COVID-19) who have tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), via the reverse transcription polymerase chain reaction (RT-PCR) test, after recovery has increased; this has caused a dilemma regarding the medical measures and policies. We evaluated the dynamics of viral load and anti-SARS-CoV-2 antibodies in four patients with positive RT-PCR results after recovery. In all patients, the highest levels of immunoglobulin G (IgG) and IgM antibodies were reached after about a month of the onset of the initial symptoms. Then, the IgG titers plateaued, and the IgM titers decreased, regardless of RT-PCR results. The IgG and IgM levels did not increase after the post-negative positive RT-PCR results in any of the patients. Our results reinforced that the post-negative positive RT-PCR results may be due to the detection of RNA particles rather than reinfection in individuals who have recovered from COVID-19.

3Acute pancreatitis and diabetes mellitus: a review

저자 : Allyson Richardson , Walter G. Park

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 1호 발행 연도 : 2021 페이지 : pp. 15-24 (10 pages)

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Diabetes following acute pancreatitis (AP) is becoming increasingly recognized. It is unclear what subtype of diabetes mellitus (DM) occurs; however, type 3c diabetes mellitus (T3cDM) is gaining increasing recognition. T3cDM has differing pathophysiology than other subtypes of DM and therefore differing disease course and treatment. Current studies have examined the incidence and prevalence of DM following AP, and meta-analyses have shown around 15% develop DM at 1 year with an increasing proportion developing DM at 5 years. It has been observed that some patients have transient hyperglycemia following AP episode with a subset developing persistent impaired glucose metabolism; however, the exact timeline is not well defined. The data on risk factors for developing DM after AP is limited and mixed; however, it is likely that severity of AP may impact the propensity to develop DM. Screening guidelines have not been established following AP; however, screening 1-year post-event will likely capture a sizable proportion of newly developed DM. The endocrine and exocrine pancreas are closely linked, and studies have found significant overlap in dysfunction of both after AP. Finally, there are some data to suggest that diabetes predisposes patients to structural changes in the pancreas and increased risk of developing AP.

4Gallstone pancreatitis: general clinical approach and the role of endoscopic retrograde cholangiopancreatography

저자 : Shanker Kundumadam , Evan L. Fogel , Mark Andrew Gromski

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 1호 발행 연도 : 2021 페이지 : pp. 25-31 (7 pages)

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Gallstones account for majority of acute pancreatitis in the Western world. Increase in number and smaller size of the stones increases the risk for biliary pancreatitis. In addition to features of acute pancreatitis, these patients also have cholestatic clinical picture. Fluid therapy and enteral nutrition are vital components in management of any case of acute pancreatitis. During initial evaluation, a right upper quadrant ultrasonogram is particularly important. On a case-by-case basis, further advanced imaging studies such as magnetic resonance cholangiopancreatography or endoscopic ultrasound may be warranted. Acute management also involves monitoring for local and systemic complications. Patients are triaged based on predictors of ongoing biliary obstruction in order to identify who would need endoscopic retrograde cholangiopancreatography. Index cholecystectomy is safe and recommended, with exception of cases with significant local and systemic complications where delayed cholecystectomy may be safer.

5The role of endoscopic therapy in the minimally invasive management of pancreatic necrosis

저자 : Jeffrey James Easler

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 1호 발행 연도 : 2021 페이지 : pp. 32-44 (13 pages)

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Pancreatic necrosis is among the most frequently encountered local complications of acute pancreatitis and associates with severe disease. Infected pancreatic necrosis further enhances the risk for morbidity and mortality. Pancreatic fluid collections that result from pancreatic necrosis evolve from acute necrotic collections to walled off necrosis and are defined by their distinct characteristics on cross sectional imaging. A variety of interventions spanning multiple disciplines are available for the drainage and debridement of pancreatic necrosis. Prospective, randomized trials have identified management strategies that incorporate minimally invasive interventions as having the best outcomes for patients with symptomatic pancreatic necrosis. The scientific literature has confidently positioned endoscopic drainage and necrosectomy among the most effective interventions for patients with symptomatic walled off necrosis. Innovations such as the use of metallic stents, chemical debridement and multiple modalities for drainage of pancreatic necrosis show promise in improving outcomes for patients managed with endoscopic interventions.

6The 2020 revision of the guidelines for the management of myeloproliferative neoplasms

저자 : Sung-yong Kim , Sung Hwa Bae , Soo-mee Bang , Ki-seong Eom , Junshik Hong , Seongsoo Jang , Chul Won Jung , Hee-jin Kim , Ho Young Kim , Min Kyoung Kim , Soo-jeong Kim , Yeung-chul Mun , Seung-hyun Nam ,

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 1호 발행 연도 : 2021 페이지 : pp. 45-62 (18 pages)

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In 2016, the World Health Organization revised the diagnostic criteria for myeloproliferative neoplasms (MPNs) based on the discovery of disease-driving genetic aberrations and extensive analysis of the clinical characteristics of patients with MPNs. Recent studies have suggested that additional somatic mutations have a clinical impact on the prognosis of patients harboring these genetic abnormalities. Treatment strategies have also advanced with the introduction of JAK inhibitors, one of which has been approved for the treatment of patients with myelofibrosis and those with hydroxyurea-resistant or intolerant polycythemia vera. Recently developed drugs aim to elicit hematologic responses, as well as symptomatic and molecular responses, and the response criteria were refined accordingly. Based on these changes, we have revised the guidelines and present the diagnosis, treatment, and risk stratification of MPNs encountered in Korea.

7A new perspective on calcium channel blockers in vasospastic angina

저자 : Hack-lyoung Kim

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 1호 발행 연도 : 2021 페이지 : pp. 63-64 (2 pages)

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8Corticosteroids in acute respiratory distress syndrome: outcomes obscured by mortality

저자 : Dong Kyu Oh

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 1호 발행 연도 : 2021 페이지 : pp. 65-66 (2 pages)

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9Gastroprotective effects of irsogladine maleate on ethanol/hydrochloric acid induced gastric ulcers in mice

저자 : Seong Chun Kwon , Ji Hoon Kim

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 1호 발행 연도 : 2021 페이지 : pp. 67-75 (9 pages)

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Background/Aims: This study was conducted to investigate the inhibitory effect of irsogladine maleate (IM) on gastric ulcers induced by ethanol and hydrochloric acid (HCl).
Methods: Mice were pretreated with IM for 1 hours before ulcer induction. Gastric ulcers were induced by oral administration of an ethanol/HCl mixture. To clarify the action mechanism of IM, the roles of 3ʹ5ʹ-cyclic adenosine monophosphate (cAMP), nitric oxide (NO), adenosine triphosphate-sensitive potassium (KATP) channels, prostaglandins and transient receptor potential cation channel subfamily V member 1 (TRPV1) were investigated, and lipid peroxidation in the stomach of IM-treated and -untreated animals was also measured.
Results: IM significantly reduced the extent of ethanol/HCl mixture-induced gastric ulceration. It exhibited dose-related gastroprotection against the ethanol/HCl-induced lesions, while pretreatment with glibenclamide but not N(ω)-nitro-L-arginine methyl ester, reversed this action. While pretreatment with the TRPV1 antagonist capsazepine failed to effectively block the gastroprotective effect of IM, the non-selective cyclooxygenase inhibitor indomethacin almost abolished it. IM also decreased the level of thiobarbituric acid reactive substances.
Conclusions: We concluded that IM exhibited significant gastroprotective effects in an ethanol/HCl-induced ulcer model, which appear to be mediated, at least in part, by NO, cAMP, endogenous prostaglandins, KATP channel opening, activation of TRPV1 channels, and antioxidant properties.

10Role of tenofovir disoproxil fumarate in prevention of perinatal transmission of hepatitis B virus from mother to child: a systematic review and meta-analysis

저자 : Young-sun Lee , Ha Seok Lee , Ji Hoon Kim , Sung Won Chang , Myung Han Hyun , Haein Bak , Sehwa Kim , Min-jin Lee , Chan Uk Lee , Young Kul Jung , Yeon Seok Seo , Hyung Joon Yim , Jong Eun Yeon , Soon H

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 36권 1호 발행 연도 : 2021 페이지 : pp. 76-86 (11 pages)

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Background/Aims: To prevent the perinatal transmission of hepatitis B virus (HBV) from mother to child, administration of an antiviral agent during pregnancy has been attempted in women who are either hepatitis B e antigen positive or have a high viral load. In this systematic review and meta-analysis with randomized controlled trials, we analyzed the efficacy and safety of tenofovir disoproxil fumarate (TDF) in preventing the perinatal transmission of HBV in pregnant women who have high HBV DNA titers.
Methods: Multiple comprehensive databases (PubMed, EMBASE, and Cochrane databases) were searched for studies evaluating the efficacy of TDF for the prevention of perinatal transmission of HBV.
Results: Two studies (one open label study and one double blind study) were included and analyzed. Intention-to-treat analysis (527 pregnancies) showed that the preventive effect of TDF was not significant (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.13 to 2.17; p = 0.38, I2 = 81%). However, the per-protocol analysis showed that TDF significantly reduced perinatal transmission (OR, 0.10; 95% CI, 0.01 to 0.77; p = 0.03, I2 = 0%). There was no significant difference between the TDF group and the control group with respect to maternal and fetal safety outcomes.
Conclusions: In pregnant women who have high HBV DNA titers, TDF can reduce the perinatal transmission from mother to child without significant adverse events.

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