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KCI후보

COVID-19와 장기 후유증

COVID-19 and Long-Term Sequelae

김윤정 ( Youn Jeong Kim )
  • : 대한내과학회
  • : 대한내과학회지 (Korean J Med) 97권1호
  • : 연속간행물
  • : 2022년 02월
  • : 23-27(5pages)
대한내과학회지 (Korean J Med)

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After acute corona virus disease 2019 (COVID-19), there have been increasing reports of persistent and long-term symptoms similar to the post- viral syndromes described in survivors of severe acute respiratory syndrome (SARS) or middle east respiratory syndrome (MERS). Here, we provide a comprehensive review of the current literature on long-term COVID-19 focusing on organ- specific sequelae. Many of the recovered COVID-19 patients may be affected by long-term health. The future for COVID-19 survivors remains uncertain, and well conducted long term research will be needed. (Korean J Med 2022;97:23-27)

UCI(KEPA)

간행물정보

  • : 의약학분야  > 내과학
  • : KCI후보
  • :
  • : 격월
  • : 1738-9364
  • : 2289-0769
  • : 학술지
  • : 연속간행물
  • : 1949-2022
  • : 12186


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97권5호(2022년 10월) 수록논문
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KCI후보

1포스트 코로나 신종감염병: 다음 대유행의 주인공은 누구인가?

저자 : 최영화 ( Young Hwa Choi )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 5호 발행 연도 : 2022 페이지 : pp. 277-283 (7 pages)

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Emerging infectious diseases are increasing recently and globally. We have a long list of infectious disease epidemic in the 21th century followed by SARS, MERS, Ebola virus disease, and Zika virus infection. COVID-19 is a still ongoing pandemic. What will be the next pandemic agent? The World Health Organization proposed a research and development blueprint regarding global pandemic in 2016. The United Kingdom maintains a list of high consequence infectious diseases and is monitoring them. The Republic of Korea designates Class 1 infectious diseases capable of causing outbreak or epidemic. This article briefly describes several infectious diseases and its causative pathogen that should receive special attention. (Korean J Med 2022;97:277-283)

KCI후보

2포스트 코로나증후군

저자 : 차재명 ( Jae Myung Cha )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 5호 발행 연도 : 2022 페이지 : pp. 284-291 (8 pages)

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Although acute COVID-19 usually lasts for 12 weeks from the onset of symptoms, some patients experience variable persistent symptoms. Post-COVID-19 syndrome is defined as persistent symptoms and/or long-term complications that appear during or after COVID-19, persist for more than 12 weeks, and cannot be explained by an alternative diagnosis. The common symptoms of post-COVID-19 syndrome include general, pulmonary, hematological, cardiovascular, neuropsychiatric, renal, endocrine, gastroenterological, and dermatological symptoms. As the natural course and pathophysiology of COVID-19 are not yet clear, close monitoring is needed for various sequelae in multiple organs that occur in post-COVID-19 syndrome. In particular, patients who have been hospitalized in the intensive care unit or who have recovered from severe COVID-19 require close monitoring for the development of post-COVID-19 syndrome. Multidisciplinary collaboration is essential to provide integrated outpatient care for patients with post-COVID-19 syndrome. (Korean J Med 2022;97:284-291)

KCI후보

3새로운 권고안(2021 Korean Thyroid Imaging Reporting and Data System)을 이용한 갑상선 결절의 평가

저자 : 정소령 ( So Lyung Jung )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 5호 발행 연도 : 2022 페이지 : pp. 292-302 (11 pages)

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The rate of detection of thyroid nodules and carcinomas has increased with the widespread use of ultrasonography (US), which is the primary imaging modality for the detection and risk stratification of thyroid nodules. The appropriate diagnosis and management of these patients is based on the risk factors related to the patients as well as the thyroid nodules. The Korean Society of Thyroid Radiology (KSThR) published consensus recommendations for US-based management of thyroid nodules in 2011 and revised them in 2016. These guidelines have been used as the standard guidelines in Korea. However, recent advances in the diagnosis and management of thyroid nodules have necessitated the revision of the original recommendations. The task force of the KSThR has revised the Korean Thyroid Imaging Reporting and Data System and recommendations for US lexicon, biopsy criteria, US criteria of extrathyroidal extension, optimal thyroid computed tomography protocol, and US follow-up of thyroid nodules before and after biopsy. The biopsy criteria were revised to reduce unnecessary biopsies for benign nodules while maintaining an appropriate sensitivity for the detection of malignant tumors. The goal of these recommendations is to provide the optimal scientific evidence and expert opinion consensus regarding US-based diagnosis and management of thyroid nodules. (Korean J Med 2022;97:292-302)

KCI후보

4성공적인 입원전담전문의 시스템의 정착과 성장을 위한 경영 전략

저자 : 이종찬 ( Jongchan Lee )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 5호 발행 연도 : 2022 페이지 : pp. 303-307 (5 pages)

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Appropriate management strategies are required to establish, maintain, and promote the growth the hospitalist system. Herein, we discuss strategies for the successful operation of the hospitalist system from the business point of view, particularly in terms of human resources and organizational management. Hospital executives should establish the vision, mission, value, and key value drivers of the hospitalist system from its inception, as well as decide its size and operation pattern according to the situation of each medical institution. Hospitalists are employed through the process of recruitment to increase the number of applicants and allow the selection of suitable candidates. Once the hospitalist system is constructed and operational, the focus must shift toward its growth. The goals and strategies for growth should be decided, leaders must be selected, and assistants must be employed. In the future, the hospitalist system is expected to play an essential role in improving the quality of medical care. Therefore, medical institutions should strategically introduce, maintain, and promote the growth of the hospitalist system. (Korean J Med 2022;97:303-307)

KCI후보

5혈액종양의 세계보건기구 분류에 근거한 급성골수성백혈병의 진단적 접근

저자 : 조영욱 ( Young-uk Cho )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 5호 발행 연도 : 2022 페이지 : pp. 308-318 (11 pages)

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Acute myeloid leukemias (AMLs) are heterogeneous hematologic neoplasms characterized by myeloblast or promyelocyte proliferation without normal differentiation. The World Health Organization (WHO) classifies AMLs on the basis of chromosomal and genetic aberrations, with different prognoses for each subtype. Therefore, accurate diagnosis and classification of AMLs is critical for timely and appropriate treatment. Initial diagnostic workup includes morphologic assessment of the bone marrow aspirate and trephine biopsies, immunophenotyping using flow cytometry or immunohistochemistry stains, chromosomal analysis using the G-banding technique or fluorescence in situ hybridization, and mutation analysis using polymerase chain reaction, direct sequencing, or next-generation sequencing. The present study provides an algorithm for AML diagnosis and classification based on the WHO criteria and describes different clinicopathological stages of the workup. (Korean J Med 2022;97:308-318)

KCI후보

6분자종양위원회의 임상적 실제

저자 : 이수현 ( Soohyeon Lee )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 5호 발행 연도 : 2022 페이지 : pp. 319-322 (4 pages)

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Due to rapid technical advances, steeply declining sequencing costs, and the ever-increasing number of targeted therapies, it is expected that extensive tumor DNA or RNA sequencing will be applied in standard of care. Clinicians will thus be confronted with increasingly complex genetic information and multiple test-platforms to choose from. General medical training, meanwhile, can hardly keep up with the pace of innovation. Consequently, there is a rapidly growing gap between clinical knowledge and genetic potential in cancer care. Multidisciplinary Molecular Tumor Boards (MTBs) have been suggested as a means to address this disparity, as a multidisciplinary approach to keep pace with the growing knowledge of complex molecular alterations in patients with advanced solid cancer. MTBs are designated to interpret these data and provide clinical recommendations. Not all patients with cancer have access to advice of an MTB. We aimed to determine the current status, opportunities, and challenges of the organization of MTBs in the Korea. (Korean J Med 2022;97:319-322)

KCI후보

7심장 내 이물질로 인한 반복적인 뇌경색 발생에 관한 증례

저자 : 유지웅 ( Jiwung Ryu ) , 김중선 ( Jung-sun Kim ) , 서지원 ( Jiwon Seo )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 5호 발행 연도 : 2022 페이지 : pp. 323-327 (5 pages)

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We present a case of recurrent ischemic stroke in a 68-year-old man with a linear foreign body in the right atrium and ventricle and a patent foramen ovale (PFO). The patient developed atrial fibrillation despite taking warfarin at a therapeutic dose and had a third acute stroke. We planned left atrial appendage (LAA) occlusion via the PFO, followed by PFO closure and foreign body removal. The percutaneous LAA occlusion and PFO closure were successful. However, it was difficult to remove the radiolucent foreign body. We inserted an Omni™ catheter via the right jugular vein to contact the foreign body in the right atrium directly, grasped its distal end with a snare, and successfully extracted it. The patient was followed-up in the outpatient clinic and had no recurrent stroke. (Korean J Med 2022;97:323-327)

KCI후보

8MTHFR 유전자 변이와 헤파린 유도 혈소판감소증이 동반된 환자에서의 성공적 생체 신장 이식 1예

저자 : 강동혁 ( Donghyuk Kang ) , 이한비 ( Hanbi Lee ) , 정병하 ( Byung Ha Chung ) , 최범순 ( Bum Soon Choi ) , 양철우 ( Chul Woo Yang ) , 고은정 ( Eun Jeong Ko )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 5호 발행 연도 : 2022 페이지 : pp. 328-333 (6 pages)

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본 증례는 혈전 발생 위험도가 높은 MTHFR 유전자 변이와 헤파린유도 혈소판 감소증 두 질환을 동시에 가진 말기신부전 환자에서 신장 이식을 진행함에 있어, 수술 전후 혈전증 및 출혈을 최소화하는 개별화된 특수 항응고 치료 프로토콜을 적용하여 특이 합병증 없이 신장이식에 성공한 바, 이에 문헌고찰과 함께 보고하는 바이다.


Perioperative anticoagulation in a kidney transplant recipient with heparin-induced thrombocytopenia is challenging due to paradoxical hypercoagulability. A 49-year-old man with end-stage kidney disease and a previous stroke history was referred for living donor kidney transplantation. After the fifth dialysis session, the platelet count decreased to 10,000/μL, and heparin was immediately discontinued. Five days later, pulmonary thromboembolism with deep vein thrombosis was identified. Anti-heparin PF4 antibody, elevated serum homocysteine, and methylenetetrahydrofolate reductase gene mutations were discovered. Subsequent coronary angiography revealed three-vessel disease. Apixaban, folate, aspirin, and clopidogrel were administered and an inferior vena cava filter was implanted. Thereafter, coronary artery bypass graft surgery was performed using argatroban-bridging without complications. Kidney transplantation was performed 3 months later using the argatroban protocol. The graft kidney functioned well without any complications. In conclusion, we successfully conducted kidney transplantation in a thrombophilic patient with a methylenetetrahydrofolate reductase deficiency and heparin-induced thrombocytopenia by establishing an individualized perioperative anticoagulation protocol. (Korean J Med 2022;97:328-333)

1
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1임의비급여진료는 요양급여대상진료이다

저자 : 임철희 ( Chulhui Lim )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 1호 발행 연도 : 2022 페이지 : pp. 1-4 (4 pages)

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22021 대한부정맥학회 심방세동 전극도자 및 수술적 절제술 지침

저자 : 임우현 ( Woo-hyun Lim ) , 심재민 ( Jaemin Shim ) , 이지현 ( Ji-hyun Lee ) , 정보영 ( Boyoung Joung )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 1호 발행 연도 : 2022 페이지 : pp. 5-22 (18 pages)

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Rhythm control therapy is used in atrial fibrillation (AF) management to improve AF-related symptoms along with rate control. AF catheter ablation is effective in maintaining sinus rhythm and has an acceptable complication rate. Compared with antiarrhythmic drugs, AF catheter ablation is superior with respect to arrhythmia-free survival and improvement in the quality of life. Therefore, AF ablation is recommended for rhythm control after the failure of antiarrhythmic drugs and is sometimes considered a first-line therapy for AF patients. Radiofrequency and cryoballoon ablation show similar efficacy, with slightly different complication profiles. Surgery for AF is also an effective rhythm control therapy and should be considered in patients undergoing cardiac surgery or in those with failed catheter ablation. For patients undergoing AF catheter ablation, performing ablation under uninterrupted warfarin or non-vitamin K oral anticoagulant treatment is recommended for periprocedural stroke risk management. Here, we review existing data and discuss the general principles of AF catheter and surgical ablation in patients with AF. (Korean J Med 2022;97:5-22)

KCI후보

3COVID-19와 장기 후유증

저자 : 김윤정 ( Youn Jeong Kim )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 1호 발행 연도 : 2022 페이지 : pp. 23-27 (5 pages)

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After acute corona virus disease 2019 (COVID-19), there have been increasing reports of persistent and long-term symptoms similar to the post- viral syndromes described in survivors of severe acute respiratory syndrome (SARS) or middle east respiratory syndrome (MERS). Here, we provide a comprehensive review of the current literature on long-term COVID-19 focusing on organ- specific sequelae. Many of the recovered COVID-19 patients may be affected by long-term health. The future for COVID-19 survivors remains uncertain, and well conducted long term research will be needed. (Korean J Med 2022;97:23-27)

KCI후보

4현대의료에서의 입원의학의 가치

저자 : 신동호 ( Dong-ho Shin )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 1호 발행 연도 : 2022 페이지 : pp. 28-32 (5 pages)

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In healthcare, value is defined as the measured improvement in a person's health outcomes for the cost of achieving that improvement. In the era of value in healthcare, hospital medicine successfully embraced strategies to improve hospital safety and to reduce medical error, length of stay and medical cost. As a specialist in general care and hospital system, hospitalists should learn topics of hospital medicine including safety, quality improvement, co-management, professionalism and leadership. (Korean J Med 2022;97:28-32)

KCI후보

5자가면역간염의 진단적 접근

저자 : 임기영 ( Kiyoung Lim ) , 박정길 ( Jung Gil Park )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 1호 발행 연도 : 2022 페이지 : pp. 33-41 (9 pages)

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Autoimmune hepatitis (AIH) is a chronic liver disease caused by unknown etiology, characterized by elevated liver enzyme, hypergammaglobulinemia, circulating autoantibodies, and histological interface hepatitis. As untreated AIH often leads to decompensated cirrhosis and even death, prompt and timely diagnosis is essential. However, about 1/3 of patients with AIH have cirrhosis at diagnosis. On the other hand, new onset acute or acute exacerbation of previous undiagnosed AIH can be presented as acute hepatitis. Thus, any patients with acute or chronic liver disease with hypergammagloblinemia without other cause should be considered to evaluate circulating non-organ specific autoantibodies for diagnosis of AIH. In case of suspected AIH, liver biopsy should be considered to evaluate its histological characteristics including interface hepatitis, plasma cell infiltration, emperipolesis, and rosettes. When the diagnosis is made, prompt treatment with prednisolone followed by combined azathioprine should be considered to improve its prognosis. (Korean J Med 2022;97:33-41)

KCI후보

6저선량 흉부 단층촬영을 이용한 폐암검진

저자 : 김연욱 ( Yeon Wook Kim )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 1호 발행 연도 : 2022 페이지 : pp. 42-49 (8 pages)

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Early detection and treatment is important to reduce mortality from lung cancer. Based on the positive results of lung cancer-related mortality reduction from large randomized trials of low-dose chest computed tomography (LDCT)-based screening in high-risk populations, LDCT-based screening programs have been implemented in several countries including Republic of Korea. This review focus on the current evidence and state of the art of LDCT-based lung cancer screening, and further discuss the ongoing efforts to develop more efficient screening programs worldwide. This article includes recent updates on the identification of high-risk population eligible for screening and management for screen-detected nodules. Additionally, aspects on future research direction would be addressed. (Korean J Med 2022;97:42-49)

KCI후보

7취약계층 결핵 환자의 치료 성공 관련 요인

저자 : 김영현 ( Younghyun Kim ) , 이지연 ( Ji Yeon Lee ) , 정인아 ( Ina Jeong ) , 김정현 ( Junghyun Kim ) , 김주혜 ( Joohae Kim ) , 한지연 ( Jiyeon Han ) , 정은진 ( Eunjin Jeong ) , 한아연 ( Ah Yeon Han ) , 조준성 ( Joon-sung Joh ) , 박정덕 ( Jung-duck Park )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 1호 발행 연도 : 2022 페이지 : pp. 50-59 (10 pages)

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목적: 우리나라 결핵의 발생률과 사망률은 감소하고 있는 추세이나 취약계층 결핵 환자 치료비 지원자 수는 2017년에 비해 2019년에 3.8배 증가하였다(결핵안심벨트 지원사업, 2019). 이 연구의 목적은 취약계층 결핵 환자의 치료 성공 여부에 영향을 미치는 요인을 규명해 보는 것이다.
방법: 취약계층 결핵 환자 지원사업인 결핵안심벨트 사업에서 치료비 지원을 받은 환자의 2014-2018년 자료를 분석하였다. 연구 분석 대상자는 137명이고 독립변수는 환자의 개인요인(연령, 성별, 국적, 결핵 종류, 내성결핵 여부, 동반 질환 수, 주거 형태)과 치료 형태요인(외래, 입원)이며 종속변수는 치료 성공 여부이다.
결과: 동반 질환 수는 없음보다 동반 질환 1개(OR 0.202), 2개(OR 0.147), 3개 이상(OR 0.070)일 때 모두 치료 성공 가능성이 낮아지고 통계적으로 유의한 것으로 나타났으며, 주거 형태는 동거(시설, 일터, 지인 집)를 기준으로 독거(OR 0.097)와 노숙(OR 0.053)이 치료 성공 가능성이 낮아지고 통계적으로 유의하게 나타났다. 국적은 외국인에 비해 내국인(OR 8.512)이 치료 성공 가능성이 높아지고 통계적으로 유의하게 나타났다.
결론: 동반 질환이 있는 취약계층 결핵 환자의 관리가 강조되어야 할 것으로 판단되고, 주거 형태가 불안정한 독거생활을 하는 결핵 환자나 노숙인 결핵 환자의 경우 결핵 환자시설로의 입소를 지원하기 위한 지역사회기반의 마련 및 외국인 거주자에 대한 대처방안이 취약계층 결핵 환자의 효율적인 관리를 위해 필요하다고 판단된다.

KCI후보

8CD19 양성 혼합표현형급성백혈병의 블리나투모맙 치료 1예

저자 : 박영훈 ( Young Hoon Park ) , 박동진 ( Dong Jin Park )

발행기관 : 대한내과학회 간행물 : 대한내과학회지 (Korean J Med) 97권 1호 발행 연도 : 2022 페이지 : pp. 60-63 (4 pages)

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Mixed phenotype acute leukemia (MPAL) encompasses a rare group of acute leukemia with blasts expressing markers specific to several lineages, which accounts for 2-5% of all newly diagnosed cases of acute leukemia. At present, patients with MPAL are treated with acute lymphoblastic leukemia (ALL)-directed chemotherapy. However, the prognosis of MPAL, especially in cases of relapsed/refractory (R/R) disease, remains poor. Blinatumomab, a bispecific T cell-engaging antibody, has shown encouraging outcomes in R/R B cell ALL positive for CD19. Here, we report a patient with CD19+ MPAL who achieved complete remission after treatment with blinatumomab, which may be a therapeutic option for patients with relapsed CD19+ MPAL. To our knowledge, this is the first case report of MPAL treated with blinatumomab in Korea. (Korean J Med 2022;97:60-63)

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