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Article ; Online: Pituitary apoplexy as a mimicker of infectious meningitis in an adolescent female patient.

Enns, Justine P / Al-Khindi, Timour / Wu, Catherine / Machaidze, Mamuka / Sung, Joowhan

Annals of internal medicine. Clinical cases

2023 Volume 2, Issue 9

Abstract: Pituitary apoplexy can cause a chemical meningitis and its mimicry in presentation with infectious meningitis poses a diagnostic challenge. Here we report an 18-year-old woman who presented with acute headache, altered mental status, and cerebral spinal ... ...

Abstract	Pituitary apoplexy can cause a chemical meningitis and its mimicry in presentation with infectious meningitis poses a diagnostic challenge. Here we report an 18-year-old woman who presented with acute headache, altered mental status, and cerebral spinal fluid (CSF) pleocytosis, and clinically improved with antibiotics and steroids. Despite an unremarkable head computed tomography scan, brain magnetic resonance imaging showed a pituitary macroadenoma with apoplexy. This is one of the first reports of an adolescent with pituitary apoplexy masquerading as infectious meningitis and underscores the importance of keeping this rare condition, often missed on CT scans, on the differential for CSF pleocytosis.
Language	English
Publishing date	2023-09-05
Publishing country	United States
Document type	Journal Article
ISSN	2767-7664
ISSN (online)	2767-7664
DOI	10.7326/aimcc.2022.1328
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Article: Coronavirus Disease 2019 (COVID-19) Infection Associated With Antiphospholipid Antibodies and Four-Extremity Deep Vein thrombosis in a Previously Healthy Female.

Sung, Joowhan / Anjum, Seher

Cureus

2020 Volume 12, Issue 6, Page(s) e8408

Abstract: Infection caused by novel coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) has been associated with coagulopathy. We present a case of a previously healthy 49-year-old female who was admitted to the hospital for coronavirus ... ...

Abstract	Infection caused by novel coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) has been associated with coagulopathy. We present a case of a previously healthy 49-year-old female who was admitted to the hospital for coronavirus disease 2019 (COVID-19) pneumonia and later found to have extensive deep vein thrombosis (DVT) in all four extremities. This was accompanied by a steep rise in D-dimer levels and positive antiphospholipid antibodies (APLA) on further testing. She clinically improved on hydroxychloroquine and therapeutic anticoagulation. This is one of the first case reports describing APLA-associated DVT in a patient with COVID-19 pneumonia. Transient elevation of APLA from the viral illness may play a role in thrombosis associated with COVID-19.
Keywords	covid19
Language	English
Publishing date	2020-06-02
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.8408
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Article ; Online: Development and validation of a simple risk score for diagnosing COVID-19 in the emergency room.

Sung, Joowhan / Choudry, Naveed / Bachour, Rima

Epidemiology and infection

2020 Volume 148, Page(s) e273

Abstract: As the COVID-19 pandemic continues to escalate and place pressure on hospital system resources, a proper screening and risk stratification score is essential. We aimed to develop a risk score to identify patients with increased risk of COVID-19, allowing ...

Abstract	As the COVID-19 pandemic continues to escalate and place pressure on hospital system resources, a proper screening and risk stratification score is essential. We aimed to develop a risk score to identify patients with increased risk of COVID-19, allowing proper identification and allocation of limited resources. A retrospective study was conducted of 338 patients who were admitted to the hospital from the emergency room to regular floors and tested for COVID-19 at an acute care hospital in the Metropolitan Washington D.C. area. The dataset was split into development and validation sets with a ratio of 6:4. Demographics, presenting symptoms, sick contact, triage vital signs, initial laboratory and chest X-ray results were analysed to develop a prediction model for COVID-19 diagnosis. Multivariable logistic regression was performed in a stepwise fashion to develop a prediction model, and a scoring system was created based on the coefficients of the final model. Among 338 patients admitted to the hospital from the emergency room, 136 (40.2%) patients tested positive for COVID-19 and 202 (59.8%) patients tested negative. Sick contact with suspected or confirmed COVID-19 case (3 points), nursing facility residence (3 points), constitutional symptom (1 point), respiratory symptom (1 point), gastrointestinal symptom (1 point), obesity (1 point), hypoxia at triage (1 point) and leucocytosis (-1 point) were included in the prediction score. A risk score for COVID-19 diagnosis achieved area under the receiver operating characteristic curve of 0.87 (95% confidence interval (CI) 0.82-0.92) in the development dataset and 0.85 (95% CI 0.78-0.92) in the validation dataset. A risk prediction score for COVID-19 can be used as a supplemental tool to assist clinical decision to triage, test and quarantine patients admitted to the hospital from the emergency room.
MeSH term(s)	Aged ; COVID-19/diagnosis ; COVID-19/epidemiology ; Cohort Studies ; Emergency Service, Hospital ; Female ; Hospitalization ; Humans ; Male ; Maryland ; Middle Aged ; Nursing Homes ; Pandemics ; Retrospective Studies ; Risk Assessment/methods ; SARS-CoV-2
Language	English
Publishing date	2020-11-13
Publishing country	England
Document type	Journal Article ; Validation Study
ZDB-ID	632982-2
ISSN	1469-4409 ; 0950-2688
ISSN (online)	1469-4409
ISSN	0950-2688
DOI	10.1017/S0950268820002769
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Article: Extra Oxygen Leads to Bubble Trouble: Portal Vein Gas Embolism from 3% Hydrogen Peroxide Ingestion.

Sung, Joowhan / Cossarini, Francesca / Palaiodimos, Leonidas / Benson, Benjamin / Meholli, Mimoza

Cureus

2018 Volume 10, Issue 2, Page(s) e2136

Abstract: Hydrogen peroxide ingestion can cause gastric irritation and gas embolism; however, most reported cases are from the highly concentrated (≥35%) solution used in the industry and data on household-used 3% solution ingestion is scarce. We report a case of ... ...

Abstract	Hydrogen peroxide ingestion can cause gastric irritation and gas embolism; however, most reported cases are from the highly concentrated (≥35%) solution used in the industry and data on household-used 3% solution ingestion is scarce. We report a case of a portal vein gas embolism after ingestion of 3% hydrogen peroxide. The patient was managed conservatively with antacids and improved in 48 hours. Endoscopy and hyperbaric treatment were considered but not pursued. This is the fifth reported case of gas embolism after 3% hydrogen peroxide ingestion and stands in line with other reports where the patients improved with conservative management.
Language	English
Publishing date	2018-02-01
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.2136
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Article ; Online: Development and Validation of a Simple Risk Score for Diagnosing COVID-19 in the Emergency Room

Sung, Joowhan / Choudry, Naveed / Bachour, Rima

medRxiv

Abstract	As the COVID-19 pandemic continues to escalate and place pressure on hospital system resources, a proper screening and risk stratification score is essential. We aimed to develop a risk score to identify patients with increased risk of COVID-19, allowing proper identification and allocation of limited resources. A retrospective study was conducted of 338 patients who were admitted to the hospital from the emergency room and tested for COVID-19 at an acute care hospital in the Metropolitan Washington D.C. area. The dataset was split into development and validation sets with a ratio of 6:4. Demographics, presenting symptoms, sick contact, triage vital signs, initial laboratory and chest X-ray results were analyzed to develop a prediction model for COVID-19 diagnosis. Multivariable logistic regression was performed in a stepwise fashion to develop a prediction model, and a scoring system was created based on the coefficients of the final model. Among 338 patients admitted to the hospital from the emergency room, 136 (40.2%) patients tested positive for COVID-19 and 202 (59.8%) patients tested negative. Nursing facility residence (2 points), sick contact (2 points), constitutional symptom (1 point), respiratory symptom (1 point), gastrointestinal symptom (1 point), obesity (1 point), hypoxia at triage (1 point), and leukocytosis (-1 point) were included in the prediction score. A risk score for COVID-19 diagnosis achieved AUROC of 0.87 (95% CI 0.83-0.92) in the development dataset and 0.83 (95% CI 0.76-0.90) in the validation dataset. A risk prediction score for COVID-19 can be used as a supplemental tool to assist clinical decision to triage, test, and quarantine patients admitted to the hospital from the emergency room.
Keywords	covid19
Language	English
Publishing date	2020-08-14
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2020.08.11.20173112
Database	COVID19

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Article ; Online: Cytolytic circumsporozoite-specific memory CD4

Furtado, Raquel / Paul, Mahinder / Zhang, Jinghang / Sung, Joowhan / Karell, Paul / Kim, Ryung S / Caillat-Zucman, Sophie / Liang, Li / Felgner, Philip / Bauleni, Andy / Gama, Syze / Buchwald, Andrea / Taylor, Terrie / Seydel, Karl / Laufer, Miriam / Delahaye, Fabien / Daily, Johanna P / Lauvau, Grégoire

Nature communications

2023 Volume 14, Issue 1, Page(s) 7726

Abstract: Clinical immunity against Plasmodium falciparum infection develops in residents of malaria endemic regions, manifesting in reduced clinical symptoms during infection and in protection against severe disease but the mechanisms are not fully understood. ... ...

Abstract	Clinical immunity against Plasmodium falciparum infection develops in residents of malaria endemic regions, manifesting in reduced clinical symptoms during infection and in protection against severe disease but the mechanisms are not fully understood. Here, we compare the cellular and humoral immune response of clinically immune (0-1 episode over 18 months) and susceptible (at least 3 episodes) during a mild episode of Pf malaria infection in a malaria endemic region of Malawi, by analysing peripheral blood samples using high dimensional mass cytometry (CyTOF), spectral flow cytometry and single-cell transcriptomic analyses. In the clinically immune, we find increased proportions of circulating follicular helper T cells and classical monocytes, while the humoral immune response shows characteristic age-related differences in the protected. Presence of memory CD4
MeSH term(s)	Humans ; Plasmodium falciparum ; Malaria, Falciparum/prevention & control ; Malaria/prevention & control ; Th1 Cells ; Protozoan Proteins ; Clone Cells ; Malaria Vaccines
Chemical Substances	Protozoan Proteins ; Malaria Vaccines
Language	English
Publishing date	2023-11-25
Publishing country	England
Document type	Journal Article
ZDB-ID	2553671-0
ISSN	2041-1723 ; 2041-1723
ISSN (online)	2041-1723
ISSN	2041-1723
DOI	10.1038/s41467-023-43376-y
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Article ; Online: Evidence for Tuberculosis in Individuals With Xpert Ultra "Trace" Sputum During Screening of High-Burden Communities.

Sung, Joowhan / Nantale, Mariam / Nalutaaya, Annet / Biché, Patrick / Mukiibi, James / Kamoga, Caleb E / Akampurira, Joab / Kayondo, Francis / Kiyonga, Rogers / Mukiibi, Michael / Nakasolya, Olga / McGeehan, Molly / Dowdy, David W / Katamba, Achilles / Kendall, Emily A

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2023 Volume 78, Issue 3, Page(s) 723–729

Abstract: Background: "Trace" results on Xpert MTB/RIF Ultra ("Ultra"; Cepheid) -a molecular diagnostic test for tuberculosis (TB)-are often interpreted as an indication for TB treatment, but may also represent detection of nonviable bacilli or analytical error. ... ...

Abstract	Background: "Trace" results on Xpert MTB/RIF Ultra ("Ultra"; Cepheid) -a molecular diagnostic test for tuberculosis (TB)-are often interpreted as an indication for TB treatment, but may also represent detection of nonviable bacilli or analytical error. In community-screening settings where individual TB risk is low, there is limited guidance on how to interpret Ultra-trace results. Methods: We conducted systematic Ultra TB screening of adults and adolescents (≥15 years) in Kampala, Uganda, through door-to-door and event-based sputum collection. We enrolled individuals with trace-positive sputum for detailed clinical, radiographic, and microbiological (including 2 sputum cultures, repeat Ultra, and for people with HIV, urine lipoarabinomannan) evaluation, and compared those findings with similar evaluations in controls with Ultra-negative and Ultra-positive (non-trace) sputum. Results: Of 21 957 people screened with Ultra, 211 (1.0%) tested positive, including 96 (46% of positives) with trace results. Of 92 people enrolled with trace-positive sputum; 12% (11/92) were HIV-positive and 14% (13/92) had prior TB. The prevalence of TB among participants with trace-positive sputum results was 14% (13/92) by culture, 24% (22/92) using broader microbiological criteria, and 26% (24/92) after accounting for clinical diagnosis. The prevalence of cough and of abnormal chest computed tomography (CT) findings were 32% and 26%, respectively, if Ultra-negative; 34% and 54% if trace-positive/non-microbiologically confirmed; 72% and 95% if trace-positive/microbiologically confirmed; and 71% and 93% if Ultra-positive (more than trace). Conclusions: Most individuals with trace-positive sputum in Ugandan communities did not have microbiologically confirmed TB but had more symptoms and chest CT abnormalities than people with Ultra-negative sputum.
MeSH term(s)	Adult ; Adolescent ; Humans ; Tuberculosis, Pulmonary/diagnosis ; Tuberculosis, Pulmonary/epidemiology ; Tuberculosis, Pulmonary/drug therapy ; Mycobacterium tuberculosis/genetics ; Sputum/microbiology ; Sensitivity and Specificity ; Uganda/epidemiology ; Tuberculosis/diagnosis ; Tuberculosis/epidemiology
Language	English
Publishing date	2023-09-30
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciad595
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Article ; Online: A case report of purulent pericarditis caused by Candida albicans: Delayed complication forty-years after esophageal surgery.

Sung, Joowhan / Perez, Irving Enrique / Feinstein, Addi / Stein, David Kidd

Medicine

2018 Volume 97, Issue 28, Page(s) e11286

Abstract: Rationale: Candida pericarditis is a rare condition with high mortality. Risk factors include thoracic surgery and immunosuppression. We report a case of candida pericarditis which developed forty-years after esophageal reconstruction surgery.: ... ...

Abstract	Rationale: Candida pericarditis is a rare condition with high mortality. Risk factors include thoracic surgery and immunosuppression. We report a case of candida pericarditis which developed forty-years after esophageal reconstruction surgery. Patient concerns: A 42-year-old female presented with nausea, abdominal discomfort, and chest pain, and was found to have a cardiac tamponade secondary to candida pericarditis. Her notable risk factor was colonic interposition done during her infancy for esophageal atresia. Diagnoses: The patient underwent emergent pericardial window where 500cc of purulent fluid was drained. The pericardial fluid culture grew Candida albicans. Interventions: Esophagram did not show any visible leak and the patient improved with surgical drainage and antifungal treatment with Caspofungin. Caspofungin was continued intravenously for a total of four weeks and was switched to fluconazole. Outcomes: An Echocardiogram performed one month after pericardial window revealed trivial pericardial effusion. Serum beta-D-glucan at the time was negative. Lessons: This report highlights that candida pericarditis infection could occur as a late complication of colonic interposition. We also demonstrate the utility of using an echinocandin in treating this entity.
MeSH term(s)	Adult ; Antifungal Agents/administration & dosage ; Candida albicans/isolation & purification ; Caspofungin ; Colon/transplantation ; Drainage/methods ; Echinocandins/administration & dosage ; Esophageal Atresia/surgery ; Female ; Fluconazole/administration & dosage ; Humans ; Lipopeptides/administration & dosage ; Long Term Adverse Effects/diagnosis ; Long Term Adverse Effects/etiology ; Long Term Adverse Effects/microbiology ; Mycoses/diagnosis ; Mycoses/etiology ; Mycoses/therapy ; Pericarditis/diagnosis ; Pericarditis/etiology ; Pericarditis/microbiology ; Pericarditis/therapy ; Reconstructive Surgical Procedures/adverse effects ; Reconstructive Surgical Procedures/methods ; Suppuration/microbiology ; Treatment Outcome
Chemical Substances	Antifungal Agents ; Echinocandins ; Lipopeptides ; Fluconazole (8VZV102JFY) ; Caspofungin (F0XDI6ZL63)
Language	English
Publishing date	2018-07-10
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000011286
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Article ; Online: Viewing region maximization of an integral floating display through location adjustment of viewing window.

Kim, Joowhan / Min, Sung-Wook / Lee, Byoungho

Optics express

2009 Volume 15, Issue 20, Page(s) 13023–13034

Abstract: Integral floating display is a recently proposed three-dimensional (3D) display method which provides a dynamic 3D image in the vicinity to an observer. It has a viewing window only through which correct 3D images can be observed. However, the positional ...

Abstract	Integral floating display is a recently proposed three-dimensional (3D) display method which provides a dynamic 3D image in the vicinity to an observer. It has a viewing window only through which correct 3D images can be observed. However, the positional difference between the viewing window and the floating image causes limited viewing zone in integral floating system. In this paper, we provide the principle and experimental results of the location adjustment of the viewing window of the integral floating display system by modifying the elemental image region for integral imaging. We explain the characteristics of the viewing window and propose how to move the viewing window to maximize the viewing zone.
Language	English
Publishing date	2009-08-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	1491859-6
ISSN	1094-4087 ; 1094-4087
ISSN (online)	1094-4087
ISSN	1094-4087
DOI	10.1364/oe.15.013023
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