Pub Date : 2022-02-01DOI: 10.3904/kjm.2022.97.1.28
Dongwoo Shin
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.
{"title":"The Value of Hospital Medicine","authors":"Dongwoo Shin","doi":"10.3904/kjm.2022.97.1.28","DOIUrl":"https://doi.org/10.3904/kjm.2022.97.1.28","url":null,"abstract":"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.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79411762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-01DOI: 10.3904/kjm.2022.97.1.60
Y. Park, D. J. Park
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.
{"title":"Treatment of CD19-Positive Mixed Phenotype Acute Leukemia with Blinatumomab","authors":"Y. Park, D. J. Park","doi":"10.3904/kjm.2022.97.1.60","DOIUrl":"https://doi.org/10.3904/kjm.2022.97.1.60","url":null,"abstract":"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.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78980671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-01DOI: 10.3904/kjm.2022.97.1.33
K. Lim, J. Park
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.
{"title":"Diagnostic Approach to Autoimmune Hepatitis","authors":"K. Lim, J. Park","doi":"10.3904/kjm.2022.97.1.33","DOIUrl":"https://doi.org/10.3904/kjm.2022.97.1.33","url":null,"abstract":"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.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76493668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-01DOI: 10.3904/kjm.2022.97.1.23
Youn Jeong Kim
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.
{"title":"COVID-19 and Long-Term Sequelae","authors":"Youn Jeong Kim","doi":"10.3904/kjm.2022.97.1.23","DOIUrl":"https://doi.org/10.3904/kjm.2022.97.1.23","url":null,"abstract":"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.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77541005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-01DOI: 10.3904/kjm.2022.97.1.50
Younghyun Kim, Ji Yoen Lee, Ina Jeong, Junghyun Kim, J. Kim, Jiyeon Han, E. Jeong, A. Han, J. Joh, Jung-Duck Park
Background/Aims: Although the incidence and mortality of tuberculosis are decreasing in South Korea, the number of applications for financial assistance with the cost of tuberculosis treatment made by individuals from vulnerable groups was 3.8 times higher in 2019 compared to 2017 (Tuberculosis Relief Belt Project, 2019).Methods: We analyzed the data of patients who received financial aid for tuberculosis treatment (in the period 2014-2018) from the Tuberculosis Relief Belt Project, which was designed to assist vulnerable groups. This study analyzed 137 subjects, and the independent variables included patient factors (age, gender, nationality, tuberculosis type, number of comorbidities, and place of residence) and treatment type (outpatient or inpatient). The dependent variable was the treatment outcome.Results: The likelihood of treatment success was significantly lower for patients with one (odds ratio [OR] 0.202), two (OR 0.147), or three or more (OR 0.070) comorbidities compared to those with no comorbidities. This was also the case for patients living alone (OR 0.097), and for those classified as homeless (OR 0.053). Korean patients (OR 8.512) had a significantly higher probability of a successful treatment outcome than foreigners.Conclusions: Appropriate community-based management of individuals with tuberculosis from vulnerable groups, including foreigners, people with comorbidities, people living alone, and people with an unstable residential situation or homeless status, is important.
{"title":"Factors Related to Successful Tuberculosis Treatment in Vulnerable Groups","authors":"Younghyun Kim, Ji Yoen Lee, Ina Jeong, Junghyun Kim, J. Kim, Jiyeon Han, E. Jeong, A. Han, J. Joh, Jung-Duck Park","doi":"10.3904/kjm.2022.97.1.50","DOIUrl":"https://doi.org/10.3904/kjm.2022.97.1.50","url":null,"abstract":"Background/Aims: Although the incidence and mortality of tuberculosis are decreasing in South Korea, the number of applications for financial assistance with the cost of tuberculosis treatment made by individuals from vulnerable groups was 3.8 times higher in 2019 compared to 2017 (Tuberculosis Relief Belt Project, 2019).Methods: We analyzed the data of patients who received financial aid for tuberculosis treatment (in the period 2014-2018) from the Tuberculosis Relief Belt Project, which was designed to assist vulnerable groups. This study analyzed 137 subjects, and the independent variables included patient factors (age, gender, nationality, tuberculosis type, number of comorbidities, and place of residence) and treatment type (outpatient or inpatient). The dependent variable was the treatment outcome.Results: The likelihood of treatment success was significantly lower for patients with one (odds ratio [OR] 0.202), two (OR 0.147), or three or more (OR 0.070) comorbidities compared to those with no comorbidities. This was also the case for patients living alone (OR 0.097), and for those classified as homeless (OR 0.053). Korean patients (OR 8.512) had a significantly higher probability of a successful treatment outcome than foreigners.Conclusions: Appropriate community-based management of individuals with tuberculosis from vulnerable groups, including foreigners, people with comorbidities, people living alone, and people with an unstable residential situation or homeless status, is important.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89290566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Correspondence to Chulhui Lim, Esq. Lim Chulhui’s Law and Tax Firm, 6-9 Beobwon-ro 3-gil, Seocho-gu, Seoul 06595, Korea Tel: +82-2-591-5437, Fax: +82-2-591-5442, E-mail: dihairein@gmail.com Copyright c 2022 The Korean Association of Internal Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 임의비급여진료는 요양급여대상진료이다
{"title":"Arbitrary Uninsured Benefits are Insured Benefits","authors":"C. Lim","doi":"10.3904/kjm.2022.97.1.1","DOIUrl":"https://doi.org/10.3904/kjm.2022.97.1.1","url":null,"abstract":"Correspondence to Chulhui Lim, Esq. Lim Chulhui’s Law and Tax Firm, 6-9 Beobwon-ro 3-gil, Seocho-gu, Seoul 06595, Korea Tel: +82-2-591-5437, Fax: +82-2-591-5442, E-mail: dihairein@gmail.com Copyright c 2022 The Korean Association of Internal Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 임의비급여진료는 요양급여대상진료이다","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88471266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-01DOI: 10.3904/kjm.2021.96.6.463
Si-Ho Kim, Soo-Youn Lee, C. Kang
Vancomycin and teicoplanin are representative glycopeptide antibiotics with activities against gram-positive cocci. The area under the drug concentration–time curve (AUC)/minimal inhibitory concentration (MIC) has been extensively used as an indicator of the bacteriological response to glycopeptide antibiotics, and the trough concentration has been used as a surrogate marker for the AUC/MIC. However, the guidelines for therapeutic drug monitoring (TDM) are being revised in accordance with increasing pharmacokinetic understanding of glycopeptide antibiotics. This review describes the pharmacokinetic/pharmacodynamic characteristics of glycopeptide antibiotics and discusses their optimal use with appropriate TDM.
{"title":"Appropriate Use of Glycopeptide Antibiotics and Therapeutic Drug Monitoring for Invasive Infections","authors":"Si-Ho Kim, Soo-Youn Lee, C. Kang","doi":"10.3904/kjm.2021.96.6.463","DOIUrl":"https://doi.org/10.3904/kjm.2021.96.6.463","url":null,"abstract":"Vancomycin and teicoplanin are representative glycopeptide antibiotics with activities against gram-positive cocci. The area under the drug concentration–time curve (AUC)/minimal inhibitory concentration (MIC) has been extensively used as an indicator of the bacteriological response to glycopeptide antibiotics, and the trough concentration has been used as a surrogate marker for the AUC/MIC. However, the guidelines for therapeutic drug monitoring (TDM) are being revised in accordance with increasing pharmacokinetic understanding of glycopeptide antibiotics. This review describes the pharmacokinetic/pharmacodynamic characteristics of glycopeptide antibiotics and discusses their optimal use with appropriate TDM.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74822120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-01DOI: 10.3904/kjm.2021.96.6.501
Hyungwoo Cho, S. Kim, Kyoungmin Lee, J. Park, C. Suh
Background/Aims: The first autologous peripheral blood stem cell transplantation (ASCT) in Korea was performed for a small-cell lung cancer patient at Asan Medical Center (AMC) in 1993. Recently, lymphoma and myeloma have been the main indications; there has been progress in the treatments for these lymphoid malignancies. We explored the real-world experience of ASCT for lymphoma and myeloma at AMC over a 25-year period.Methods: We used the AMC ASCT registry, which has collected ASCT data prospectively since January 1993. Data for Hodgkin lymphoma, non-Hodgkin lymphoma, and multiple myeloma patients were analyzed. Patients transplanted up to December 2018 were included to assess adequate survival data. The ASCT time period was divided arbitrarily into 1994-1999, 2000-2009, and 2010-2018. In cases of multiple myeloma, we analyzed the 1st ASCT data only.Results: Survival of these lymphoid malignancy patients after ASCT has progressively improved. The increase in survival may be related to advances in various medical skills supporting ASCT. However, overall survival has improved much more than progression-free survival. This suggests that better salvage therapies after ASCT failure have mainly affected the improvement in overall survival. The hematopoietic cell transplantation-specific comorbidity index could not be used as a survival indicator in this analysis.Conclusions: This real-world experience study showed that the survival of lymphoid malignancy patients treated with ASCT has improved over the past 25 years.
{"title":"Real-world Experience of Improvement in the Survival of Lymphoma and Myeloma Patients with Autologous Stem Cell Transplantation over a 25-year Period","authors":"Hyungwoo Cho, S. Kim, Kyoungmin Lee, J. Park, C. Suh","doi":"10.3904/kjm.2021.96.6.501","DOIUrl":"https://doi.org/10.3904/kjm.2021.96.6.501","url":null,"abstract":"Background/Aims: The first autologous peripheral blood stem cell transplantation (ASCT) in Korea was performed for a small-cell lung cancer patient at Asan Medical Center (AMC) in 1993. Recently, lymphoma and myeloma have been the main indications; there has been progress in the treatments for these lymphoid malignancies. We explored the real-world experience of ASCT for lymphoma and myeloma at AMC over a 25-year period.Methods: We used the AMC ASCT registry, which has collected ASCT data prospectively since January 1993. Data for Hodgkin lymphoma, non-Hodgkin lymphoma, and multiple myeloma patients were analyzed. Patients transplanted up to December 2018 were included to assess adequate survival data. The ASCT time period was divided arbitrarily into 1994-1999, 2000-2009, and 2010-2018. In cases of multiple myeloma, we analyzed the 1st ASCT data only.Results: Survival of these lymphoid malignancy patients after ASCT has progressively improved. The increase in survival may be related to advances in various medical skills supporting ASCT. However, overall survival has improved much more than progression-free survival. This suggests that better salvage therapies after ASCT failure have mainly affected the improvement in overall survival. The hematopoietic cell transplantation-specific comorbidity index could not be used as a survival indicator in this analysis.Conclusions: This real-world experience study showed that the survival of lymphoid malignancy patients treated with ASCT has improved over the past 25 years.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"96 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74443787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-01DOI: 10.3904/kjm.2021.96.6.455
Mi-yeon Yu, G. Kim
Chronic kidney disease (CKD) can be progressive, and its prognosis is worse because of increased mortality when it is associated with diabetes and cardiac disease. The outcomes of diabetic kidney disease (DKD) need to be improved, despite multifactorial interventions including glucose and blood pressure (BP) control, and the use of renin-angiotensin system (RAS) inhibitors, statins, and aspirin. Recent clinical trials suggest that sodium-glucose cotransporter-2 (SGLT2) inhibitors offer additional cardiorenal protection in DKD and non-diabetic CKD on top of RAS inhibition. The action of SGLT2 inhibitors is derived from the proximal tubule of the kidney, but their systemic effects beyond glucose-lowering involve hemodynamic and non-hemodynamic mechanisms. First, SGLT2 inhibitors restore tubuloglomerular feedback and relieve glomerular hypertension and albuminuria. Second, natriuresis and renal glycosuria lead to fluid and weight loss, resulting in BP lowering and prevention of heart failure. Third, SGLT2 inhibitors have anti-inflammatory and anti-oxidative actions that can reduce renal and cardiac inflammation and fibrosis, probably via adenosine monophosphate-activated protein kinase and sirtuin-1 activation. Finally, the proximal tubular workload is relieved, accompanied by increased erythropoiesis. Hypoxia-inducible factor 1 may be stimulated by renal outer medullary hypoxia when tubular sodium transport shifts from the proximal convoluted tubule to the proximal straight tubule and thick ascending limb, due to SGLT2 inhibition. These effects may also be beneficial in non-diabetic CKD, and we anticipate that SGLT2 inhibitors will prove effective for albuminuria reduction and preservation of kidney function in primary kidney diseases, including glomerulonephritis.
{"title":"SGLT2 Inhibition for Diabetic and Non-diabetic Kidney Disease","authors":"Mi-yeon Yu, G. Kim","doi":"10.3904/kjm.2021.96.6.455","DOIUrl":"https://doi.org/10.3904/kjm.2021.96.6.455","url":null,"abstract":"Chronic kidney disease (CKD) can be progressive, and its prognosis is worse because of increased mortality when it is associated with diabetes and cardiac disease. The outcomes of diabetic kidney disease (DKD) need to be improved, despite multifactorial interventions including glucose and blood pressure (BP) control, and the use of renin-angiotensin system (RAS) inhibitors, statins, and aspirin. Recent clinical trials suggest that sodium-glucose cotransporter-2 (SGLT2) inhibitors offer additional cardiorenal protection in DKD and non-diabetic CKD on top of RAS inhibition. The action of SGLT2 inhibitors is derived from the proximal tubule of the kidney, but their systemic effects beyond glucose-lowering involve hemodynamic and non-hemodynamic mechanisms. First, SGLT2 inhibitors restore tubuloglomerular feedback and relieve glomerular hypertension and albuminuria. Second, natriuresis and renal glycosuria lead to fluid and weight loss, resulting in BP lowering and prevention of heart failure. Third, SGLT2 inhibitors have anti-inflammatory and anti-oxidative actions that can reduce renal and cardiac inflammation and fibrosis, probably via adenosine monophosphate-activated protein kinase and sirtuin-1 activation. Finally, the proximal tubular workload is relieved, accompanied by increased erythropoiesis. Hypoxia-inducible factor 1 may be stimulated by renal outer medullary hypoxia when tubular sodium transport shifts from the proximal convoluted tubule to the proximal straight tubule and thick ascending limb, due to SGLT2 inhibition. These effects may also be beneficial in non-diabetic CKD, and we anticipate that SGLT2 inhibitors will prove effective for albuminuria reduction and preservation of kidney function in primary kidney diseases, including glomerulonephritis.","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"2015 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87039040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-01DOI: 10.3904/kjm.2021.96.6.443
Tae Suk Kim, Inhyeok Yim, Choong-hyo Kim
Correspondence to Choong-Hyo Kim, M.D., Ph.D. Department of Neurosurgery, Kangwon National University Hospital, Kangwon National University School of Medicine, 156 Baengnyeong-ro, Chuncheon 24289, Korea Tel: +82-33-258-9209, Fax: +82-33-258-2404, E-mail: jeuelkim@gmail.com Copyrightc 2021 The Korean Association of Internal Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Perspectives
{"title":"Status and Improvement of the Management of Patients with Mild Symptoms of COVID-19 in Regional Outbreak: Focused on Community Treatment Center","authors":"Tae Suk Kim, Inhyeok Yim, Choong-hyo Kim","doi":"10.3904/kjm.2021.96.6.443","DOIUrl":"https://doi.org/10.3904/kjm.2021.96.6.443","url":null,"abstract":"Correspondence to Choong-Hyo Kim, M.D., Ph.D. Department of Neurosurgery, Kangwon National University Hospital, Kangwon National University School of Medicine, 156 Baengnyeong-ro, Chuncheon 24289, Korea Tel: +82-33-258-9209, Fax: +82-33-258-2404, E-mail: jeuelkim@gmail.com Copyrightc 2021 The Korean Association of Internal Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Perspectives","PeriodicalId":84452,"journal":{"name":"Chungang uihak = The Korean central journal of medicine","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81461894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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