Tuberculosis of the sigmoid colon is a rare disorder. An 80-year-old man visited Bongseng Memorial Hospital for medical examination. A colonoscopy was performed, and a lesion in the sigmoid colon that was suspected to be colon cancer was found. A biopsy was performed, and tuberculous enteritis with chronic granulomatous inflammation was diagnosed. Intestinal tuberculosis is most frequent in the ileocecal area, followed by the ascending colon, transverse colon, duodenum, stomach, and sigmoid colon, in descending order. Hence, we report a case of intestinal tuberculosis in the sigmoid colon, which is rare and almost indistinguishable from colon cancer.

Background: There is little data on allograft survival based on deceased donor characteristics outside the United States. Conservative use of deceased donors based on concern for longer term allograft outcomes likely increases the discard rate of deceased donor kidneys despite a severe international deficit of kidney donors. Using South Korea as a model, we analyzed deceased donor characteristics using 1-year creatinine in the recipient as a surrogate marker for longer term outcomes. Methods: We analyzed a total 2,858 cases contained within the Korean Organ Transplant Registry data which had conducted deceased donor renal transplant from 2009 to 2017. Univariate, multivariate linear regression analysis and five-fold cross validation was performed to make a formula for estimating the serum creatinine of the recipient for 1 year after deceased donor kidney transplant. Results: Univariate analysis indicated a number of different factors were significant in determining outcome, however only donor age, donor serum creatinine and current smoking status without hypertension were statistically significant in a multivariate model for predicting serum creatinine of the recipient after 1 year of kidney transplant. We also found that serum creatinine at 1 year predicted 3-year outcomes in a log-rank test. Conclusions: Currently deceased donor kidney transplant outcomes are extremely good in South Korea (despite a much longer period on dialysis prior to transplant) compared to the United States. Given significant differences in cultural, economic, medical and racial characteristics compared to the US the Korean prediction model obtained from this study relies on checking only three donor factors, and thus can be obtained relatively quickly and conveniently and yet provides more information to the recipient candidates before transplant. In particular, we also believe this study indicates that there is underutilization of potential decreased donors in Korea and that a wider pool of deceased donors could be used safely.

From January to April 2022, during the secondary wave of in Korea, the Korean government mandated 7 days of quarantine for COVID-19 patients. Most patients complained of mild symptoms during the quarantine period and returned to their daily lives after that period. In our hospital, we identified 126 COVID-19 infections in kidney transplant recipients through their contact. We observed the delayed pattern of COVID-19 pneumonia in 11 (8.7%) kidney transplant patients after the legal isolation period. There were nine (72.7%) women, median ages were 66 years (range, 60-79) and median time after renal transplantation was 3.4 years (range, 0.4-29.3). There were eight cases of living donor kidney transplantation and two cases of ABO blood type incompatible kidney transplantation. Most of the immunosuppressants were administered steroids, tacrolimus, and mycophenolate. Half of the patients had diabetes. All patients were vaccinated against COVID-19 more than twice. The patient was hospitalized for a median of 14 days (range, 9-26) after confirmed COVID-19 infection, and the total length of hospitalization was a median of 8 days (range, 6-36). Among the patients, 63.6% of dyspnea, 36.3% of fever, and 81.8% of respiratory symptoms were observed. During hospitalization, maintenance dialysis was started in two patients, and acute renal failure was observed in three patients. One confirmed an increase in FK-506 related to Paxlovid administration, but two had an increase in FK-506 for unknown reasons. All patients were given steroids and antibiotics, and nine (81.8%) were given remdesivir. Two patients completely stopped immunosuppressants during hospitalization, and 7 (63.6%) patients stopped mycophenolate. In COVID-19 infection, delayed patterns of pneumonia are more frequent in kidney transplant recipients than in the general population. Even after the general course of infection, according to his symptoms and CT ratio of PCR, the patient should be considered for additional administration of antiviral drugs.

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