Sun Min Lee

Molecular characterization of Enterococcus faecium isolated from hospitalized patients in Korea

Aims:  Multilocus sequence typing (MLST) was performed for vancomycin‐resistant Enterococcus faecium (VREF) from diverse geographical areas in Korea to obtain insights into the genetic relationships with other molecular profiles. To understand the diversity of lineages, vancomycin‐susceptible E. faecium (VSEF) were included.

Clinical utility of QuantiFERON-TB GOLD In-Tube and tuberculin skin test in patients with tuberculous pleural effusions.

Interferon gamma release assays are used for diagnosing latent tuberculosis (TB); however, their role in diagnosing tuberculous pleural effusion (TPE) is not defined. The aim of this study was to evaluate the usefulness of the QuantiFERON-TB Gold In-Tube assay (QFT-IT) and compare this assay with the tuberculin skin test (TST) for diagnosing TPE in settings where tuberculosis is endemic and bacillus Calmette-Guérin vaccination is mandatory. The TST and QFT-IT test were conducted prospectively with 101 patients presenting with clinically suspected TPE. Of the 97 evaluable subjects, 54 had TPE. The sensitivity, specificity, positive predictive value, and negative predictive value were, respectively, 76.9%, 61.1%, 74.1%, and 64.7% for QFT-IT; 72.5%, 71.7%, 77.1%, and 66.7% for TST; and 83.7%, 45.7%, 68.3%, and 66.7% for QFT-IT plus TST. Thus, the QFT-IT test may be more useful than the TST for diagnosing TPE. Although the combination of QFT-IT and TST had higher sensitivity, it had poor specificity owing to the high prevalence of latent TB in our setting.

The Imbalance between Coagulation and Fibrinolysis is Related to the Severity of the Illness and the Prognosis in Sepsis

Objectives The coagulation and fibrinolytic system appears to be activated by the septic process independently, leading to the syndrome of disseminated intravascular coagulation(DIC). In this study, we investigated the changes within the hemostatic system related to the severity of the illness and the prognosis in patients with sepsis. Methods Plasma thrombin-antithrombin III (TAT) and plasmin-α2-antiplasmin (PAP) complexes were measured using ELISA methods in 32 patients with sepsis and 20 controls and were analyzed according to the APACHE III scores and survival of the patients. Results Plasma TAT and PAP in patients with sepsis were significantly higher than controls. Nonsurvivors showed greater levels of TAT(21.7±22.3ng/mL) and lower levels of PAP(628.4±378.1ng/mL) than survivors (TAT: 11.1±11.2ng/mL; PAP: 857.1±364.1ng/mL). The imbalance between coagulation and fibrinolysis described as TAT/PAP ratio was closely related with APACHE III scores in patients with sepsis(r=0.47) and the TAT/PAP ratio in nonsurvivors was significantly higher compared with survivors(34.4±21.4 vs. 14.4±13.8). Conclusion In sepsis, both coagulation and the fibrinolysis system are activated and the imbalance between coagulation and fibrinolysis predisposes to the hypercoagulation state and is closely related to the severity of the disease and the prognosis.

Prevalence, incidence, and mortality of sarcoidosis in Korea, 2003–2015: A nationwide population-based study

BACKGROUND The prevalence and incidence of sarcoidosis, a granulomatous disorder involving multiple organ systems, varies among geographical regions and ethnicities. This study evaluated the incidence, prevalence, and mortality of sarcoidosis in a large nationwide population-based cohort in Korea. METHODS We used data of the National Health Insurance Service database, which is an extensive health-related database including most Korean residents. Adults with a primary diagnosis of sarcoidosis, as determined by International Classification of Disease-Tenth Revision coding (D86), were identified between 2003 and 2015. The incidence, prevalence, and mortality of sarcoidosis were analysed by sex and age. RESULTS A total of 6376 individuals had a primary diagnosis of sarcoidosis. Their mean age was 48.8 years, and 58.6% were women. The age-adjusted incidence and prevalence of sarcoidosis were 1.3 and 3.4 per 100,000 population respectively; both tended to increase between 2003 and 2015. The all-cause mortality rate was 13.1 per 1000 sarcoidosis patients. The standardised mortality ratio of sarcoidosis patients to the general population was 1.7 (95% confidence interval, 1.5 to 1.8). CONCLUSIONS This is the largest epidemiologic study of sarcoidosis in an Asian population to date. In Korea, the annual incidence and prevalence of sarcoidosis were relatively low but tended to increase over the 13 years of the study period. Importantly, the overall mortality rate of patients with sarcoidosis was higher than that of the general population.

Factors associated with the diagnostic yield of computed tomography-guided transbronchial lung biopsy

Computed tomography (CT) may be useful for increasing the diagnostic yield of transbronchial lung biopsy (TBLB). However, only a few studies with small sample sizes have reported the diagnostic utility of CT‐guided TBLB and the factors affecting the diagnostic accuracy of CT‐guided TBLB are not well known. We evaluated the diagnostic yield of CT‐guided TBLB and associated factors.

A Case of the Hepatic Hydrothorax in the Absence of Ascites Confirmed by Tc-99m Macroaggregated Serum Albumin Scan

Pleural effusion due to hepatic cirrhosis with ascites is well known, although hepatic hydrothorax in the absence of ascites is a rare condition, the pathogenesis of which is still unknown. We report a case of hepatic hydrothorax without ascites confirmed by the intraperitoneal injection of Tc-99m mecroaggregated serum albumin (Tc-99m MAA) that demonstrated the passage of Tc-99m MAA into the right pleural cavity.