Journal of Yeungnam Medical Science

Original article

Increased risk of adenomatous colon polyps in patients with long-term use of proton pump inhibitors: a single-center retrospective study: Na Rae Lim, Woo Chul Chung; J Yeungnam Med Sci. 2025;42:24. Published online January 21, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.24 [Epub ahead of print]

34 View
7 Download

Abstract PDF: Background
It is unclear whether long-term use of proton pump inhibitors (PPIs) has a potential carcinogenic effect on the colorectum.
Methods
We reviewed a consecutive series of neurosurgery outpatients who underwent two or more colonoscopies between January 2014 and April 2023. Patients in whom the timing of endoscopy was not in accordance with the guidelines and those without a history of previous endoscopy were excluded. In the second colonoscopy, the risk of adenomatous colon polyps was evaluated depending on whether the patient had taken a PPI.
Results
In total, 520 patients were enrolled. In the multivariate analysis related to the risk of adenomatous colon polyps, age and aspirin use for >5 years were identified as significant factors. After excluding patients who had taken aspirin for >5 years, the patients were divided into three groups: those who had taken PPIs for >12 months, those who had taken PPIs for >3 months but <12 months, and those who had not taken PPIs. The risk of adenomatous colon polyps in these groups was 35.2%, 32.8%, and 22.8%, respectively (p=0.10). In the post-hoc analysis, there was a significant difference between patients who took PPIs and those who did not (p=0.03). In the multivariate analysis, a history of PPI use for >12 months was a significant risk factor for the development of advanced colon polyps (p=0.03).
Conclusion
Prolonged PPI use appears to increase the risk of developing adenomatous and advanced colon polyps.

Case report

Unilateral lower extremity lymphedema followed by COVID-19 vaccination in patients with cervical cancer history: two case reports: Jae Ik Jung, Hee Kyung Cho; J Yeungnam Med Sci. 2025;42:23. Published online January 21, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.23 [Epub ahead of print]

141 View
16 Download

Abstract PDF: The coronavirus disease 2019 (COVID-19) pandemic prompted the development of messenger RNA vaccines. Following extensive vaccination campaigns worldwide, several adverse reactions to these vaccines have been reported. This is a case series of unilateral lower extremity lymphedema after COVID-19 vaccination in two patients with a history of cervical cancer. An 82-year-old woman and a 68-year-old woman visited the outpatient clinic with unilateral leg edema after receiving a COVID-19 booster vaccine (BNT162b2; Pfizer-BioNTech) in the deltoid muscle. Both patients had a common history of cervical cancer treated with surgery, chemotherapy, and radiotherapy and were in complete remission. Gynecological evaluations, including laboratory and imaging studies, revealed no specific findings. Lymphoscintigraphy revealed delayed lymphatic drainage with diffuse dermal backflow in a unilateral lower extremity. This case series explores adverse reactions to COVID-19 vaccination in patients who are at high risk of developing lymphedema, providing novel data for similar clinical presentations.

Original articles

Galectin-3 as a possible link between periodontitis and chronic kidney disease: a cross-sectional study: Sri Vidhya Marimuthu, Devi Arul, Muthukumar Santhanakrishnan, Ramprasad Elumalai, Sandhya Suresh, Sathya Selvarajan, Ravindranath Dhulipalla, Ramanarayana Boyapati; J Yeungnam Med Sci. 2025;42:22. Published online January 20, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.22 [Epub ahead of print]

79 View
15 Download

Abstract PDF: Background
Chronic periodontitis is associated with various systemic inflammatory diseases; however, research on its association with chronic kidney disease (CKD) is relatively limited. Because both conditions share common risk factors, systemic inflammation plays a key role in the progression of these diseases. Galectin-3 (Gal-3) is a proinflammatory cytokine that plays an important role in chronic inflammatory diseases and is a potential biomarker. This study aimed to measure salivary Gal-3 levels in patients with periodontitis and CKD to better understand their association and evaluate Gal-3 as a diagnostic biomarker for these conditions.
Methods
Seventy-five patients were categorized into three groups: Group I, patients with CKD and periodontitis (n=25); Group II, patients with chronic periodontitis who were systemically healthy (n=25); and Group III, patients with CKD without chronic periodontitis (n=25). Demographic characteristics and periodontal and renal parameters were recorded for each patient. Saliva samples were collected to evaluate Gal-3 levels using an enzyme-linked immunosorbent assay.
Results
Patients with chronic periodontitis and CKD and those with chronic periodontitis alone (Groups I and II, respectively) showed significantly higher salivary Gal-3 levels than patients with CKD alone (Group III) (p<0.001). Bivariate correlation analysis indicated a strong relationship between clinical parameters and Gal-3 levels across all three groups.
Conclusion
Salivary Gal-3 level is a valuable early diagnostic marker of chronic periodontitis and CKD.

Status of and needs related to community-based practice in public healthcare institutions among Korean medical schools: a cross-sectional study: Songrim Kim, Bongeun Cha, Sun Young Kyung, So Jung Yune, Kyung Hye Park, Kwi Hwa Park; J Yeungnam Med Sci. 2025;42:21. Published online January 6, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.21 [Epub ahead of print]

290 View
44 Download

Abstract PDF: Background
This study analyzed the status of community-based practice in public healthcare institutions in Korean medical schools and identified related needs.
Methods
We conducted an online cross-sectional survey in which 32 of 40 medical schools (80.0%) participated between March and April 2023. We developed questionnaire items aimed at ascertaining the status and perceptions of community-based practice and analyzed the response data using frequency analysis, the Mann-Whitney U test, and content analysis with word clouds.
Results
Of the 32 medical schools analyzed, 23 (71.9%) offered practical courses, and of those, 12 (52.2%) implemented practice lessons within courses. Among 20 schools, 18 (90.0%) required students to complete practical courses and over 50% offered these courses in the third and fourth years of the clerkship phase. Perceptions of community practice showed no significant differences based on whether courses were offered. Many schools have proposed that practice should be a continuous curricular element from the premedical to medical years. The primary challenges facing community-based practice were identified as faculty development, collaboration, and compensation of practice institutions. The following words were extracted from the respondents’ comments: practice, community, institution, student, education, faculty, university, and public.
Conclusion
This study identified the limitations of community-based education provided by Korean medical schools and we report findings that highlight areas of improvement. Notable among these is the need to continuously incorporate community-based practice into medical education while engaging in discussions and conducting research toward developing a comprehensive and systematic curriculum.

Effects of psychological conditions and changes on smoking cessation success after a residential smoking cessation therapy program: a retrospective observational study: Gyu Lee Kim, Yu Hyeon Yi, Jeong Gyu Lee, Young Jin Tak, Seung Hun Lee, Young Jin Ra, Sang Yeoup Lee, Young Hye Cho, Eun Ju Park, Youngin Lee, Jung In Choi; J Yeungnam Med Sci. 2025;42:20. Published online January 2, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.20 [Epub ahead of print]

263 View
39 Download

Abstract PDF: Background
Residential smoking cessation therapy programs offer intensive treatment for heavy smokers who struggle to quit independently, particularly those with high nicotine dependence and health conditions that necessitate urgent cessation. While previous studies have established the effectiveness of such programs and identified various factors influencing smoking cessation success, it remains unclear how changes in smokers’ thoughts and attitudes following residential therapy correlate with their ability to quit smoking. We investigated the relationship between smoking cessation-related characteristics, smoking-related psychological status, and participants’ smoking cessation success after a residential smoking cessation therapy program.
Methods
From January 2017 to December 2018, 291 participants completed the program. All participants completed questionnaires on smoking cessation-related characteristics and smoking-related psychological status before the program and on the 5th day. Six months later, smoking cessation success was assessed using a urine cotinine test.
Results
After 6 months, 222 participants successfully quit smoking, while 69 failed. The success and failure groups exhibited statistically significant differences in age, marital status, total smoking duration, stress, and emotion regulation strategies. Participants who used ineffective emotion regulation strategies more frequently had a lower rate of smoking cessation success (odds ratio [OR], 0.969; 95% confidence interval [CI], 0.948–0.991). Moreover, an increase in the perception of the negative effects of smoking cessation (OR, 0.982; 95% CI, 0.967–0.997) and smoking temptation (OR, 0.960; 95% CI, 0.929–0.993) was associated with higher cessation success.
Conclusion
Emotion regulation strategies, perceptions of the effects of smoking cessation, and smoking temptation were associated with successful smoking cessation.

Review article

Digital auscultation in clear and present threat of novel respiratory infectious disease: a narrative review: Heeeon Lee, Gun Kim, Jacob Sangwoon Bae; J Yeungnam Med Sci. 2025;42:19. Published online December 30, 2024; DOI: https://doi.org/10.12701/jyms.2025.42.19 [Epub ahead of print]

428 View
57 Download

Abstract PDF: The coronavirus disease 2019 pandemic has underscored the limitations of traditional diagnostic methods, particularly in ensuring the safety of healthcare workers and patients during infectious outbreaks. Smartphone-based digital stethoscopes enhanced with artificial intelligence (AI) have emerged as potential tools for addressing these challenges by enabling remote, efficient, and accessible auscultation. Despite advancements, most existing systems depend on additional hardware and external processing, increasing costs and complicating deployment. This review examines the feasibility and limitations of smartphone-based digital stethoscopes powered by AI, focusing on their ability to perform real-time analyses of audible and inaudible sound frequencies. We also explore the regulatory barriers, data storage challenges, and diagnostic accuracy issues that must be addressed to facilitate broader adoption. The implementation of these devices in veterinary medicine is discussed as a practical step toward refining their applications. With targeted improvements and careful consideration of existing limitations, smartphone-based AI stethoscopes could enhance diagnostic capabilities in human and animal healthcare settings.

Original article

Complete or incomplete revascularization in patients with left main culprit lesion acute myocardial infarction with multivessel disease: a retrospective observational study: Sun Oh Kim, Hong-Ju Kim, Jong-Il Park, Kang-Un Choi, Jong-Ho Nam, Chan-Hee Lee, Jang-Won Son, Jong-Seon Park, Sung-Ho Her, Ki-Yuk Chang, Tae-Hoon Ahn, Myung-Ho Jeong, Seung-Woon Rha, Hyo-Soo Kim, Hyeon-Cheol Gwon, In-Whan Seong, Kyung-Kuk Hwang, Seung-Ho Hur, Kwang-Soo Cha, Seok-Kyu Oh, Jei-Keon Chae, Ung Kim; J Yeungnam Med Sci. 2025;42:18. Published online December 19, 2024; DOI: https://doi.org/10.12701/jyms.2025.42.18 [Epub ahead of print]

5,803 View
84 Download

Abstract PDF: Background
Complete revascularization has demonstrated better outcomes in patients with acute myocardial infarction (AMI) and multivessel disease. However, in the case of left main (LM) culprit lesion AMI with multivessel disease, there is limited evidence to suggest that complete revascularization is better.
Methods
We reviewed 16,831 patients in the Korea Acute Myocardial Infarction Registry who were treated from July 2016 to June 2020, and 399 patients were enrolled with LM culprit lesion AMI treated with percutaneous coronary intervention. We categorized the patients as those treated with complete revascularization (n=295) or incomplete revascularization (n=104). The study endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause death, myocardial infarction, ischemia-driven revascularization, stent thrombosis, and stroke. We performed propensity score matching (PSM) and analyzed the incidence of MACCE at 1 year.
Results
After PSM, the two groups were well balanced. There was no significant difference between the two groups in MACCE at 1 year (12.1% vs. 15.2%; hazard ratio, 1.28; 95% confidence interval, 0.60–2.74; p=0.524) after PSM. The components of MACCE and major bleeding were also not significantly different.
Conclusion
There was no significant difference in clinical outcomes between the groups treated with complete or incomplete revascularization for LM culprit lesion AMI with multivessel disease.

Case Report

Isolated central nervous system relapse in blast crisis of chronic myeloid leukemia: a case report: Hari Priya Raghvan, Caroline Ho Siew Ling, Wee Shiang Yui, Boo Yang Liang, Ehram Jamian, Indhira Subbiah; J Yeungnam Med Sci. 2025;42:17. Published online December 19, 2024; DOI: https://doi.org/10.12701/jyms.2025.42.17

462 View
80 Download

Abstract PDF: Chronic myeloid leukemia (CML) typically progresses from a chronic phase to an accelerated phase, and eventually to a blast crisis, often involving the bone marrow and peripheral blood, if left untreated. Central nervous system (CNS) involvement is an uncommon manifestation of CML, particularly as an isolated CNS relapse. Here, we present a rare case of CML in lymphoid blast crisis with an isolated CNS relapse. A 46-year-old female with underlying CML in lymphoid blast crisis, previously treated with chemotherapy and tyrosine kinase inhibitors, presented with visual disturbances. Imaging and cerebrospinal fluid analysis confirmed leukemic infiltration of the CNS without evidence of a systemic disease. Isolated CNS involvement is an atypical complication of CML and presents significant therapeutic challenges owing to the blood-brain barrier, which limits the efficacy of systemic therapies. Subsequently, the patient was treated with intrathecal chemotherapy targeting the CNS. Despite aggressive treatment, CNS relapse remains a major concern due to the limited penetration of standard therapies into the CNS. This case underscores the importance of early recognition of CNS symptoms in CML patients, particularly in those with blast crisis, and highlights the need for tailored therapeutic strategies to manage this rare and challenging manifestation.

Communications

Differences in pain treatment between the healthcare systems in South Korea and Quebec and proposals for improvements: Min Cheol Chang, Mathieu Boudier-Revéret; J Yeungnam Med Sci. 2025;42:16. Published online December 18, 2024; DOI: https://doi.org/10.12701/jyms.2024.01410

470 View
59 Download

Abstract PDF: After a year of exchange in Montreal, a South Korean academic physiatrist and his Canadian colleague have reflected on the strengths and weaknesses of their respective healthcare systems. They have focused more specifically on physiatrist-delivered pain medicine treatments. This article is written based on personal perspectives. It aims to present the differences between the systems in South Korea and Quebec, highlighting the issues arising from each system and providing perspectives on potential solutions.

Case report

GMNN and DLL1 mutation-related spondylocarpotarsal synostosis: a case report: Joonhwan Lee, Byungju Ryu, Yunhee Kim, Eunyoung Lee; J Yeungnam Med Sci. 2025;42:15. Published online December 11, 2024; DOI: https://doi.org/10.12701/jyms.2024.01137

401 View
63 Download

Abstract PDF: Spondylocarpotarsal synostosis syndrome (SCTS) is a rare genetic disorder characterized by vertebral fusion, short stature, and skeletal anomalies. SCTS is primarily associated with mutations in filamin B. However, in this report, we present a unique case of SCTS in a 28-year-old male who complained of neck and shoulder pain persisting for 1 year. His clinical presentation included radioulnar synostosis, cervical spine anomalies (scoliosis and agenesis of the posterior arch of C1), and a history of polydactyly. Genetic analysis revealed mutations in GMNN and DLL1. To the best of our knowledge, this is the first report on the association of SCTS with these genes.

Original article

Large language model usage guidelines in Korean medical journals: a survey using human-artificial intelligence collaboration: Sangzin Ahn; J Yeungnam Med Sci. 2025;42:14. Published online December 11, 2024; DOI: https://doi.org/10.12701/jyms.2024.00794

618 View
77 Download

Abstract PDF Supplementary Material: Background
Large language models (LLMs), the most recent advancements in artificial intelligence (AI), have profoundly affected academic publishing and raised important ethical and practical concerns. This study examined the prevalence and content of AI guidelines in Korean medical journals to assess the current landscape and inform future policy implementation.
Methods
The top 100 Korean medical journals determined by Hirsh index were surveyed. Author guidelines were collected and screened by a human researcher and AI chatbot to identify AI-related content. The key components of LLM policies were extracted and compared across journals. The journal characteristics associated with the adoption of AI guidelines were also analyzed.
Results
Only 18% of the surveyed journals had LLM guidelines, which is much lower than previously reported in international journals. However, the adoption rates increased over time, reaching 57.1% in the first quarter of 2024. High-impact journals were more likely to have AI guidelines. All journals with LLM guidelines required authors to declare LLM tool use and 94.4% prohibited AI authorship. The key policy components included emphasizing human responsibility (72.2%), discouraging AI-generated content (44.4%), and exempting basic AI tools (38.9%).
Conclusion
While the adoption of LLM guidelines among Korean medical journals is lower than the global trend, there has been a clear increase in implementation over time. The key components of these guidelines align with international standards, but greater standardization and collaboration are needed to ensure the responsible and ethical use of LLMs in medical research and writing.

Case reports

Development of an automated foot contact area measurement program for podoscopes using ChatGPT-4: a case report: Min Cheol Chang; J Yeungnam Med Sci. 2025;42:13. Published online December 3, 2024; DOI: https://doi.org/10.12701/jyms.2024.01326

473 View
31 Download

Abstract PDF: Accurate measurement of the foot contact area is crucial for diagnosing pes planus (flatfoot) and pes cavus (high arch), which significantly affect pressure distribution across the plantar surface. This study aimed to develop a program using ChatGPT-4 to automate foot contact area measurements using a podoscope, thereby enhancing diagnostic precision. A 53-year-old female volunteer stood on a podoscope to capture images of her feet, which were processed to isolate the foot contours and measure the contact areas. A program developed utilizing ChatCPT-4 was designed to outline the feet, detect contact areas, and calculate their sizes and ratios. The results demonstrated clear visualization of foot contours with automated calculation of the contact area and its ratio to the total foot area. The entire foot area measured 1,091,381.00 pixels, with a contact area of 604,252.50 pixels. The ratio of the ground contact area to the entire foot area was calculated as 55.37%. This method, which employs advanced image-processing techniques powered by ChatGPT-4, demonstrates the potential for integrating artificial intelligence into clinical applications. This approach could improve diagnostic precision and patient outcomes through personalized treatment strategies.

Uncorrectable hypoxemia due to large pulmonary arteriovenous malformation in a patient with myocardial infarction: a case report: Kang-Un Choi, Jang-Won Son; J Yeungnam Med Sci. 2025;42:12. Published online December 2, 2024; DOI: https://doi.org/10.12701/jyms.2024.01193

361 View
18 Download

Abstract PDF: Persistent hypoxemia following myocardial infarction can be challenging to manage and often requires considering uncommon etiologies such as extracardiac shunts. This case report describes a 78-year-old man with persistent hypoxemia post-myocardial infarction, which was ultimately attributed to a large pulmonary arteriovenous malformation (AVM). The patient presented with cardiogenic shock and underwent successful revascularization. Despite clinical improvement, the hypoxemia persisted, prompting further evaluation. Bedside saline contrast echocardiography and computed tomography confirmed the presence of a large pulmonary AVM, explaining the uncorrectable hypoxemia. This case underscores the importance of considering extracardiac shunts in patients with refractory hypoxemia and illustrates the utility of bedside imaging in such situations.

Original article

Impact of artificial intelligence in managing musculoskeletal pathologies in physiatry: a qualitative observational study evaluating the potential use of ChatGPT versus Copilot for patient information and clinical advice on low back pain: Christophe Ah-Yan, Ève Boissonnault, Mathieu Boudier-Revéret, Christopher Mares; J Yeungnam Med Sci. 2025;42:11. Published online November 29, 2024; DOI: https://doi.org/10.12701/jyms.2024.01151

744 View
47 Download

Abstract PDF Supplementary Material: Background
The self-management of low back pain (LBP) through patient information interventions offers significant benefits in terms of cost, reduced work absenteeism, and overall healthcare utilization. Using a large language model (LLM), such as ChatGPT (OpenAI) or Copilot (Microsoft), could potentially enhance these outcomes further. Thus, it is important to evaluate the LLMs ChatGPT and Copilot in providing medical advice for LBP and assessing the impact of clinical context on the quality of responses.
Methods
This was a qualitative comparative observational study. It was conducted within the Department of Physical Medicine and Rehabilitation, University of Montreal in Montreal, QC, Canada. ChatGPT and Copilot were used to answer 27 common questions related to LBP, with and without a specific clinical context. The responses were evaluated by physiatrists for validity, safety, and usefulness using a 4-point Likert scale (4, most favorable).
Results
Both ChatGPT and Copilot demonstrated good performance across all measures. Validity scores were 3.33 for ChatGPT and 3.18 for Copilot, safety scores were 3.19 for ChatGPT and 3.13 for Copilot, and usefulness scores were 3.60 for ChatGPT and 3.57 for Copilot. The inclusion of clinical context did not significantly change the results.
Conclusion
LLMs, such as ChatGPT and Copilot, can provide reliable medical advice on LBP, irrespective of the detailed clinical context, supporting their potential to aid in patient self-management.

Case report

Focal hand dystonia due to hemorrhage of the cervical spinal mass: a case report: Pelin Analay, Hazal Sevinç, Hilmi Berkan Abacıoğlu, Rahşan Göçmen, Bayram Kaymak, Levent Özçakar; J Yeungnam Med Sci. 2025;42:10. Published online November 26, 2024; DOI: https://doi.org/10.12701/jyms.2024.01123

401 View
23 Download

Abstract PDF Supplementary Material: Dystonia is a movement disorder characterized by intermittent or sustained muscle contractions that lead to abnormal postures and/or repetitive movements. Although dystonia is traditionally considered a disorder of the basal ganglia, it has been observed in association with lesions at various sites of the motor and sensory pathways, including spinal cord pathologies such as syringomyelia, tumors, and demyelinating lesions. However, there has been an increasing number of focal dystonia cases due to peripheral injuries, such as soft tissue trauma, mononeuropathy, plexopathy, and radiculopathy. In this report, to the best of our knowledge, we present the first case of a patient who developed focal hand dystonia due to cervical mass hemorrhage. We review the literature and discuss possible mechanisms.

Review articles

Advances and utility of digital twins in critical care and acute care medicine: a narrative review: Gabriele A. Halpern, Marko Nemet, Diksha M. Gowda, Oguz Kilickaya, Amos Lal; J Yeungnam Med Sci. 2025;42:9. Published online November 25, 2024; DOI: https://doi.org/10.12701/jyms.2024.01053

797 View
43 Download

Abstract PDF: Artificial intelligence (AI) has shown promise for revolutionizing healthcare. This narrative review focuses on the evolving discussion of the utility of AI and clinical informatics in critical care and acute care medicine, specifically focusing on digital twin (DT) technology. The improved computational power and iterative validation of these intelligent tools have enhanced medical education, in silico research, and clinical decision support in critical care settings. Integrating DTs into critical care opens vast opportunities, but simultaneously poses complex challenges, from data safety and privacy concerns to potentially increasing healthcare disparities. In medicine, DTs can significantly improve the efficiency of critical care systems. Stakeholder investment is essential for successful implementation and integration of these technologies.

Digital therapeutics in Korea: current status, challenges, and future directions – a narrative review: Hee Jun Shin, Ik Tae Cho, Wan Suk Choi, Hong Rae Kim, Min Bong Kang, Won Jong Yang; J Yeungnam Med Sci. 2025;42:8. Published online November 18, 2024; DOI: https://doi.org/10.12701/jyms.2024.01004

906 View
51 Download

Abstract PDF: Digital therapeutics (DTx) are emerging as a transformative innovation in healthcare offering evidence-based digital interventions for the treatment, management, and prevention of various diseases and disorders. In Korea, DTx have gained significant attention as potential solutions to the increasing burden of chronic diseases and mental health conditions. However, the Korean DTx market faces several challenges that hinder its widespread adoption and integration into the national healthcare system. This study provides a comprehensive analysis of the current state of the DTx market in Korea, identifies the key challenges impeding its growth, and proposes strategies for overcoming these obstacles. This study utilized a literature review and market analysis approach to examine the latest research, industry reports, and regulatory documents related to DTx. The analysis focused on three primary areas: (1) the current regulatory landscape, (2) technological advancements and challenges, and (3) economic and commercial factors influencing DTx adoption in Korea. A comparative analysis of global regulatory practices was also conducted to identify best practices. The findings revealed that while Korea has made significant strides in supporting DTx development, the market remains in its early stages. The key challenges include underdeveloped regulatory frameworks, issues with data quality and security, and a lack of established reimbursement pathways. We recommend developing tailored regulatory frameworks for DTx, enhancing policy support for small and medium-sized enterprises involved in DTx development, and increasing investments in technological infrastructure. By addressing these challenges, Korea could position itself as a leader in the global DTx market, delivering innovative and effective treatments to enhance patient care and outcomes.

Case report

Ischemic monomelic neuropathy following arteriovenous fistula surgery: a case report: Da Woon Kim, You Hyun Jeon, Miju Bae, Sang Heon Song; J Yeungnam Med Sci. 2025;42:7. Published online November 11, 2024; DOI: https://doi.org/10.12701/jyms.2024.00948

497 View
23 Download

Abstract PDF: Ischemic monomelic neuropathy (IMN) is an uncommon complication of arteriovenous fistula (AVF) surgery that presents with pain, motor weakness, and sensory changes without critical ischemia. This report describes a rare case of successful IMN treatment after AVF surgery. A 61-year-old man with diabetic end-stage kidney disease was admitted for left brachiocephalic AVF surgery. Postoperatively, the patient complained of pain, motor weakness, and numbness in the left hand. However, the radial pulse remained palpable, and the overlying skin remained intact. A nerve conduction study above the wrist revealed reduced compound muscle action potential (CMAP) of the left ulnar nerve and no CMAP of the left median nerve. This study also showed the absence of sensory amplitude in both the left median and left ulnar nerves. Therefore, the patient was diagnosed with IMN. Proximalization of the arterial inflow surgery was performed to redistribute blood flow while maintaining the AVF. The patient’s neurological symptoms resolved postoperatively. Various conditions can cause hand pain after AVF surgery; however, IMN has rarely been reported. A multidisciplinary approach is needed to avoid this rare complication in patients presenting with hand pain after AVF surgery.

Original article

Comparison of ganglion cell-inner plexiform layer thickness among patients with intermittent exotropia according to fixation preference: a retrospective observational study: Yeon Ju Lim, Soo Jung Lee; J Yeungnam Med Sci. 2025;42:6. Published online October 25, 2024; DOI: https://doi.org/10.12701/jyms.2024.00864

453 View
26 Download

Abstract PDF: Background
This study was performed to compare the thickness of the ganglion cell-inner plexiform layer (GCIPL) depending on the presence or absence of fixation preference in patients with intermittent exotropia (IXT) with refractive values close to emmetropia and with no amblyopia.
Methods
The study recruited pediatric patients diagnosed with IXT with a spherical equivalent within ±1.25 diopter and no amblyopia. The patients were categorized into two groups: a monocular exotropia group with fixation preference and an alternating exotropia group without fixation preference. GCIPL thickness was measured using spectral domain optical coherence tomography, and the macula was divided into nine sectors according to the Early Treatment Diabetic Retinopathy Study (ETDRS). GCIPL thickness in each sector was compared between the monocular and alternating exotropia groups.
Results
In the monocular exotropia group, GCIPL thickness was significantly thinner in the dominant eye than in the nondominant eye in the S1 sector (91.2±7.4 μm vs. 93.3±5.2 μm, p=0.019). However, in the alternating exotropia group, there were no significant differences between the eyes across all ETDRS sectors. When comparing the interocular differences in GCIPL thickness between the two groups, the monocular exotropia group (absolute value of the dominant eye minus the nondominant eye) exhibited significantly greater differences in several ETDRS sectors than the alternating exotropia group (absolute value of the right eye minus the left eye).
Conclusion
The significant interocular difference in GCIPL thickness in the monocular exotropia group suggests that fixation preference may influence the anatomical structure of the macula in patients with IXT.

Focused Review articles

Pathology and diagnostic approaches to well-differentiated hepatocellular lesions: a narrative review: Joon Hyuk Choi, Swan N. Thung; J Yeungnam Med Sci. 2025;42:5. Published online October 24, 2024; DOI: https://doi.org/10.12701/jyms.2024.00766

1,012 View
96 Download

Abstract PDF: Well-differentiated hepatocellular lesions (WDHLs) are liver tumors or nonneoplastic lesions in which the cells closely resemble normal hepatocytes. These lesions often include focal nodular hyperplasia, hepatocellular adenoma, macroregenerative nodule, dysplastic nodule, and well-differentiated hepatocellular carcinoma. The diagnosis of these lesions remains challenging because of their morphological similarities, particularly when examined using needle biopsy. The accurate diagnosis of WDHLs is crucial for patient management and prognosis. This review addresses the histopathological characteristics and diagnostic approaches of WDHLs.

Clinical significance of exosomal noncoding RNAs in hepatocellular carcinoma: a narrative review: Jae Sung Yoo, Min Kyu Kang; J Yeungnam Med Sci. 2025;42:4. Published online February 8, 2024; DOI: https://doi.org/10.12701/jyms.2023.01186

1,936 View
61 Download

Abstract PDF: Hepatocellular carcinoma (HCC) is one of the most lethal malignancies worldwide, with poor prognosis owing to its high frequency of recurrence and metastasis. Moreover, most patients are diagnosed at an advanced stage owing to a lack of early detection markers. Exosomes, which are characterized by their cargos of stable intracellular messengers, such as DNA, RNA, proteins, and lipids, play a crucial role in regulating cell differentiation and HCC development. Recently, exosomal noncoding RNAs (ncRNAs), including microRNAs, long ncRNAs, and circular RNAs, have become increasingly important diagnostic, prognostic, and predictive markers of HCC. Herein, we discuss the clinical implications of exosomal ncRNAs, specifically those within the HCC regulatory network.

Overview of hepatocarcinogenesis focusing on cellular origins of liver cancer stem cells: a narrative review: Jong Ryeol Eun; J Yeungnam Med Sci. 2025;42:3. Published online November 11, 2024; DOI: https://doi.org/10.12701/jyms.2024.01088

774 View
63 Download

Abstract PDF: Hepatocellular carcinoma (HCC) accounts for 85% to 90% of primary liver cancers and generally has a poor prognosis. The hierarchical model, which posits that HCC originates from liver cancer stem cells (CSCs), is now widely accepted, as it is for other cancer types. As CSCs typically reside in the G0 phase of the cell cycle, they are resistant to conventional chemotherapy. Therefore, to effectively treat HCC, developing therapeutic strategies that target liver CSCs is essential. Clinically, HCCs exhibit a broad spectrum of pathological and clinical characteristics, ranging from well-differentiated to poorly differentiated forms, and from slow-growing tumors to aggressive ones with significant metastatic potential. Some patients with HCC also show features of cholangiocarcinoma. This HCC heterogeneity may arise from the diverse cellular origins of liver CSCs. This review explores the normal physiology of liver regeneration and provides a comprehensive overview of hepatocarcinogenesis, including cancer initiation, isolation of liver CSCs, molecular signaling pathways, and microRNAs. Additionally, the cellular origins of liver CSCs are reviewed, emphasizing hematopoietic and mesenchymal stem cells, along with the well-known hepatocytes and hepatic progenitor cells.

Editorials

Advances in hepatocellular carcinoma: hepatocarcinogenesis, role of exosomal noncoding RNAs, and diagnostic pathology: Joon Hyuk Choi; J Yeungnam Med Sci. 2025;42:2. Published online November 7, 2024; DOI: https://doi.org/10.12701/jyms.2024.01221

418 View
23 Download

PDF

Appreciation to peer reviewers in 2024: So-Young Park; J Yeungnam Med Sci. 2025;42:1. Published online December 31, 2024; DOI: https://doi.org/10.12701/jyms.2025.42.1

28,622 View
41 Download

PDF Supplementary Material

Imagery

Following the snow-covered path to home: J Yeungnam Med Sci. 2025;42:i. Published online November 13, 2024; DOI: https://doi.org/10.12701/jyms.2024.01382

25,996 View
20 Download

PDF

Case reports

A 32-year-old man with plexiform schwannoma of the thyroid gland: a case report: Il Rae Park, Min Chong Kim, Seung Min Chung, Si Youn Song; J Yeungnam Med Sci. 2024;41(4):312-317. Published online September 10, 2024; DOI: https://doi.org/10.12701/jyms.2024.00556

726 View
48 Download

Abstract PDF: Plexiform schwannomas representing a rare subset, comprise 5% of all schwannomas. However, their occurrence in the thyroid gland is exceptionally rare. A 32-year-old male presented with an incidentally discovered, asymptomatic thyroid mass. Imaging revealed an approximately 5 cm heterogeneous solid mass on the right thyroid lobe extending to the upper mediastinum and directly invading the upper trachea. Under the suspicion of thyroid malignancy, the patient underwent right thyroidectomy. Histological examination confirmed a plexiform schwannoma with S100-positive spindle cells. Currently, the patient is undergoing outpatient follow-up, with no reported complications. To our knowledge, this is the first documented case of plexiform schwannoma of the thyroid gland within the English literature. This case highlights the diverse and unpredictable clinical manifestations of thyroid masses, emphasizing the importance of a multidisciplinary approach for diagnosing and managing rare entities, such as thyroid gland schwannomas.

Ruptured triple hormone-secreting adrenal cortical carcinoma with hyperaldosteronism, hypercortisolism, and elevated normetanephrine: a case report: Sin Yung Woo, Seongji Park, Kun Young Kwon, Dong-Mee Lim, Keun-Young Park, Jong-Dai Kim; J Yeungnam Med Sci. 2024;41(4):306-311. Published online September 6, 2024; DOI: https://doi.org/10.12701/jyms.2024.00626

852 View
48 Download

Abstract PDF: We report a case of a ruptured triple hormone-secreting adrenal mass with hyperaldosteronism, hypercortisolism, and elevated normetanephrine levels, diagnosed as adrenal cortical carcinoma (ACC) by histology. A 53-year-old male patient who initially presented with abdominal pain was referred to our hospital for angiocoagulation of an adrenal mass rupture. Abdominal computed tomography revealed a heterogeneous 19×11×15 cm right adrenal mass with invasion into the right lobe of the liver, inferior vena cava, retrocaval lymph nodes, and aortocaval lymph nodes. Angiocoagulation was performed. Laboratory evaluation revealed excess cortisol via a positive 1-mg overnight dexamethasone suppression test, primary hyperaldosteronism via a positive saline infusion test, and plasma normetanephrine levels three times higher than normal. An adrenal mass biopsy was performed for pathological confirmation to commence palliative chemotherapy because surgical management was not deemed appropriate considering the extent of the tumor. Pathological examination revealed stage T4N1M1 ACC. The patient started the first cycle of adjuvant mitotane therapy along with adjuvant treatment with doxorubicin, cisplatin, and etoposide, and was discharged. Clinical cases of dual cortisol- and aldosterone-secreting ACCs or ACCs presenting as pheochromocytomas have occasionally been reported; however, both are rare. Moreover, to the best of our knowledge, a triple hormone-secreting ACC has not yet been reported. Here, we report a rare case and its management. This case report underscores the necessity of performing comprehensive clinical and biochemical hormone evaluations in patients with adrenal masses because ACC can present with multiple hormone elevations.

Cytomegalovirus retinitis with panretinal occlusive vasculopathy concealed by hypertensive uveitis: a case report: Seongyong Jeong; J Yeungnam Med Sci. 2024;41(4):300-305. Published online August 30, 2024; DOI: https://doi.org/10.12701/jyms.2024.00584

847 View
58 Download

Abstract PDF: Cytomegalovirus (CMV) retinitis is a rare disease, and overlapping manifestations involving the anterior segment are extremely uncommon. We report a patient who initially presented with persistent corneal edema and was later diagnosed with CMV retinitis. A 72-year-old man with uncontrolled intraocular pressure (IOP) in his right eye visited a tertiary hospital. At initial presentation, the IOP was 36 mmHg and the fundus was not clear due to corneal edema. Spectral domain optical coherence tomography revealed paracentral acute middle maculopathy (PAMM). Panretinal obstructive vasculopathy was observed on ultra-widefield fluorescein angiography. Three weeks later, trabeculectomy was performed to resolve the persistently high IOP. Once corneal edema improved, a white patch-like peripheral lesion and silver wire-like retinal vasculature were observed. Polymerase chain reaction of the aqueous humor was positive for CMV. Oral valganciclovir and intravitreal ganciclovir were administered as antiviral therapies. Despite treatment for 4 months, the final visual acuity was no light perception, with persistent corneal edema and neovascularization of the iris. We describe a rare case of the simultaneous occurrence of hypertensive uveitis and CMV retinitis. The presence of PAMM could be an initial identifiable sign of CMV retinitis, even in the presence of media opacity.

Myxoid lipoma in the perioral mandibular region: two case reports: Jin-Ju Kwon, Sang-Hun Shin; J Yeungnam Med Sci. 2024;41(4):296-299. Published online August 2, 2024; DOI: https://doi.org/10.12701/jyms.2024.00577

765 View
42 Download

Abstract PDF: Lipomas are one of the most common mesenchymal tumors in the human body, exhibiting a heightened prevalence between the ages of 40 and 60 years. However, primary intraoral lipomas are rare. Myxoid lipoma, which is characterized by abundant mucoid components, is a particularly rare histological subtype of lipoma. This study presents two cases of myxoid lipoma that occurred outside the common age range for occurrence, one in the right submandibular area of a 67-year-old male and the other in the lower lip of a 3-year-old child. Through these case reports, the aim was to introduce myxoid lipoma, a rare subtype affecting facial areas, and provide a brief review to assist in the differential diagnosis, emphasizing the importance of pathological assessment. Even in age groups and anatomical locations not typically associated with lipomas, it is crucial to emphasize the necessity of careful evaluation.

Original article

Outcomes in patients with out-of-hospital cardiac arrest according to prehospital advanced airway management timing: a retrospective observational study: Sang-Hun Lee, Hyun Wook Ryoo; J Yeungnam Med Sci. 2024;41(4):288-295. Published online July 18, 2024; DOI: https://doi.org/10.12701/jyms.2024.00332

1,834 View
64 Download

Abstract PDF: Background
In patients with out-of-hospital cardiac arrest (OHCA), guidelines recommend advanced airway (AA) management at the advanced cardiovascular life support stage; however, the ideal timing remains controversial. Therefore, we evaluated the prognosis according to the timing of AA in patients with OHCA.
Methods
We conducted a retrospective observational study of patients with OHCA at six major hospitals in Daegu Metropolitan City, South Korea, from August 2019 to June 2022. We compared groups with early and late AA and evaluated prognosis, including recovery of spontaneous circulation (ROSC), survival to discharge, and neurological evaluation, according to AA timing.
Results
Of 2,087 patients with OHCA, 945 underwent early AA management and 1,142 underwent late AA management. The timing of AA management did not influence ROSC in the emergency department (5–6 minutes: adjusted odds ratio [aOR], 0.97; p=0.914; 7–9 minutes: aOR, 1.37; p=0.223; ≥10 minutes: aOR, 1.32; p=0.345). The timing of AA management also did not influence survival to discharge (5–6 minutes: aOR, 0.79; p=0.680; 7–9 minutes: aOR, 1.04; p=0.944; ≥10 minutes: aOR, 1.86; p=0.320) or good neurological outcomes (5–6 minutes: aOR, 1.72; p=0.512; 7–9 minutes: aOR, 0.48; p=0.471; ≥10 minutes: aOR, 0.96; p=0.892).
Conclusion
AA timing in patients with OHCA was not associated with ROSC, survival to hospital discharge, or neurological outcomes.

Review articles

Invasive strategies for rhythm control of atrial fibrillation: a narrative review: Hong-Ju Kim, Chan-Hee Lee; J Yeungnam Med Sci. 2024;41(4):279-287. Published online September 20, 2024; DOI: https://doi.org/10.12701/jyms.2024.00703

1,059 View
39 Download

Abstract PDF: Atrial fibrillation (AF) is the most common sustained tachyarrhythmia and its increasing prevalence has resulted in a growing healthcare burden. A recent landmark randomized trial, the EAST-AFNET 4 (Early Treatment of Atrial Fibrillation for Stroke Prevention Trial), highlighted the importance of early rhythm control in AF, which was previously underemphasized. Rhythm control therapy includes antiarrhythmic drugs, direct-current cardioversion, and catheter ablation. Currently, catheter ablation is indicated for patients with AF who are either refractory or intolerant to antiarrhythmic drugs or who exhibit decreased left ventricular systolic function. Catheter ablation can be categorized according to the energy source used, including radiofrequency ablation (RFA), cryoablation, laser ablation, and the recently emerging pulsed field ablation (PFA). Catheter ablation techniques can also be divided into the point-by-point ablation method, which ablates the pulmonary vein (PV) antrum one point at a time, and the single-shot technique, which uses a spherical catheter to ablate the PV antrum in a single application. PFA is known to be applicable to both point-by-point and single-shot techniques and is expected to be promising owing to its tissue specificity, resulting in less collateral damage than catheter ablation involving thermal energy, such as RFA and cryoablation. In this review, we aimed to outline catheter ablation for rhythm control in AF by reviewing previous studies.

Screening and treatment of endocrine hypertension focusing on adrenal gland disorders: a narrative review: Seung Min Chung; J Yeungnam Med Sci. 2024;41(4):269-278. Published online September 19, 2024; DOI: https://doi.org/10.12701/jyms.2024.00752

1,344 View
101 Download

Abstract PDF: Most cases of high blood pressure have no identifiable cause, termed essential hypertension; however, in approximately 15% of cases, hypertension occurs due to secondary causes. Primary aldosteronism (PA) and pheochromocytoma and paraganglioma (PPGL) are representative endocrine hypertensive diseases. The differentiation of endocrine hypertension provides an opportunity to cure and prevent target organ damage. PA is the most common cause of secondary hypertension, which significantly increases the risk of cardiovascular disease compared to essential hypertension; thus, patients with clinical manifestations suggestive of secondary hypertension should be screened for PA. PPGL are rare but can be fatal when misdiagnosed. PPGL are the most common hereditary endocrine tumors; therefore, genetic testing using next-generation sequencing panels is recommended. Herein, we aimed to summarize the characteristic clinical symptoms of PA and PPGL and when and how diagnostic tests and treatment strategies should be performed.

Advances, challenges, and prospects of electroencephalography-based biomarkers for psychiatric disorders: a narrative review: Seokho Yun; J Yeungnam Med Sci. 2024;41(4):261-268. Published online September 9, 2024; DOI: https://doi.org/10.12701/jyms.2024.00668

1,243 View
64 Download
1 Crossref

Abstract PDF

Owing to a lack of appropriate biomarkers for accurate diagnosis and treatment, psychiatric disorders cause significant distress and functional impairment, leading to social and economic losses. Biomarkers are essential for diagnosing, predicting, treating, and monitoring various diseases. However, their absence in psychiatry is linked to the complex structure of the brain and the lack of direct monitoring modalities. This review examines the potential of electroencephalography (EEG) as a neurophysiological tool for identifying psychiatric biomarkers. EEG noninvasively measures brain electrophysiological activity and is used to diagnose neurological disorders, such as depression, bipolar disorder (BD), and schizophrenia, and identify psychiatric biomarkers. Despite extensive research, EEG-based biomarkers have not been clinically utilized owing to measurement and analysis constraints. EEG studies have revealed spectral and complexity measures for depression, brainwave abnormalities in BD, and power spectral abnormalities in schizophrenia. However, no EEG-based biomarkers are currently used clinically for the treatment of psychiatric disorders. The advantages of EEG include real-time data acquisition, noninvasiveness, cost-effectiveness, and high temporal resolution. Challenges such as low spatial resolution, susceptibility to interference, and complexity of data interpretation limit its clinical application. Integrating EEG with other neuroimaging techniques, advanced signal processing, and standardized protocols is essential to overcome these limitations. Artificial intelligence may enhance EEG analysis and biomarker discovery, potentially transforming psychiatric care by providing early diagnosis, personalized treatment, and improved disease progression monitoring.

Citations

Citations to this article as recorded by

Zipper Pattern: An Investigation into Psychotic Criminal Detection Using EEG Signals
Gulay Tasci, Prabal Datta Barua, Dahiru Tanko, Tugce Keles, Suat Tas, Ilknur Sercek, Suheda Kaya, Kubra Yildirim, Yunus Talu, Burak Tasci, Filiz Ozsoy, Nida Gonen, Irem Tasci, Sengul Dogan, Turker Tuncer
Diagnostics.2025; 15(2): 154. CrossRef

Recent updates on classification and unsolved issues of diverticular disease: a narrative review: Kyeong Ok Kim; J Yeungnam Med Sci. 2024;41(4):252-260. Published online August 30, 2024; DOI: https://doi.org/10.12701/jyms.2024.00542

2,182 View
120 Download

Abstract PDF: Recently, a paradigm shift has occurred in the classification of diverticular disease and the understanding of its pathogenesis. Diverticular disease is now defined as a variety of clinically significant conditions such as diverticulitis, diverticular bleeding, symptomatic uncomplicated diverticular disease, and segmental colitis associated with diverticulosis. Low-grade inflammation, visceral hypersensitivity, abnormal intestinal motility, and genetic factors have emerged as the key contributors to the pathogenesis of diverticular disease. Routine antibiotic use is no longer recommended for all cases of diverticulitis, and simple recurrence is not an indication for surgical treatment. Early colonoscopy with proper preparation is recommended for the treatment of diverticular bleeding, although recent studies have not shown significant efficacy in preventing recurrence. The roles of dietary fiber, nonabsorbable antibiotics, 5-aminosalicylates, and probiotics in the prevention of diverticular disease are controversial and require further investigation.

Postoperative conditions of rehabilitative interest in lung transplantation: a systematic review: Massimiliano Polastri, Esra Pehlivan, Robert M. Reed, Allaina Eden; J Yeungnam Med Sci. 2024;41(4):235-251. Published online August 22, 2024; DOI: https://doi.org/10.12701/jyms.2024.00521

52,782 View
156 Download
1 Crossref

Abstract PDF

Lung transplantation is an elective treatment option for end-stage respiratory diseases in which all medical therapy options have been exhausted. The current study aimed to identify updated information on the postoperative conditions that may impair rehabilitation after lung transplantation and to provide specific considerations of their clinical relevance during the recovery process. The present study is a systematic review conducted by searching three primary databases: the United States National Library of Medicine PubMed system, Scopus, and the Cochrane Library. The databases were searched for articles published from database inception until May 2024; at the end of the selection process, 27 documents were included in the final analysis. The retrieved material identified 19 conditions of rehabilitative interest that potentially affect the postoperative course: graft dysfunction, dysphagia, postsurgical pain, cognitive impairment, chronic lung allograft dysfunction-bronchiolitis obliterans syndrome, phrenic nerve injury, delayed extracorporeal membrane oxygenation weaning, airway clearance, refractory hypoxemia, mediastinitis, reduced oxidative capacity, sternal dehiscence, coronavirus disease 2019 (COVID-19), gastroparesis, ossification of the elbow, Takotsubo cardiomyopathy, airway dehiscence, recurrent pleural effusion, and scapular prolapse. Although some patients are not amenable to rehabilitation techniques, others can significantly improve with rehabilitation.

Citations

Citations to this article as recorded by

Seven-day rehabilitation services in hospital settings: benefits and drawbacks
Massimiliano Polastri, Luciana Scuotto
International Journal of Therapy and Rehabilitation.2024; 31(12): 1. CrossRef

Imagery

Cosmos in full autumn: J Yeungnam Med Sci. 2024;41(4):i. Published online January 24, 2024; DOI: https://doi.org/10.12701/jyms.2024.00052

52,007 View
23 Download

PDF

Correction

Correction to “Marginal fit of three different nanocomposite inlays fabricated with computer-aided design/computer-aided manufacturing (CAD/CAM) technology: a comparative study”: Hyunsuk Choi, Jae-Young Jo, Min-Ho Hong; J Yeungnam Med Sci. 2024;41(3):233-233. Published online July 1, 2024; DOI: https://doi.org/10.12701/jyms.2023.00934.e1; Corrects: J Yeungnam Med Sci 2024;41(2):80

989 View
26 Download

PDF

Case report

Solar retinopathy related to antidepressant use in a patient with major depressive disorder: a case report: Eun-Jin Cheon; J Yeungnam Med Sci. 2024;41(3):228-232. Published online May 23, 2024; DOI: https://doi.org/10.12701/jyms.2024.00213

1,962 View
37 Download

Abstract PDF: This case report is a unique case of solar retinopathy following antidepressant-induced mydriasis and highlights the need for comprehensive ophthalmic evaluation in patients treated with medications having mydriatic effects. A 49-year-old female patient who had received long-term antidepressant therapy presented with bilateral visual impairment after prolonged sun exposure. Fundoscopy confirmed solar retinopathy, which was attributed to drug-induced mydriasis. Medication adjustments and sun protection strategies led to full visual recovery, underscoring the importance of interdisciplinary awareness. This case emphasizes the challenges associated with the simultaneous management of psychiatric and ophthalmic conditions and highlights the need for routine ophthalmic evaluation of patients prescribed antidepressants with reported ocular side effects.

Original articles

How much does clinical prediagnosis correlate with electrophysiological findings?: a retrospective study: Selda Çiftci İnceoğlu, Aylin Ayyıldız, Figen Yılmaz, Banu Kuran; J Yeungnam Med Sci. 2024;41(3):220-227. Published online July 5, 2024; DOI: https://doi.org/10.12701/jyms.2024.00381

1,313 View
47 Download

Abstract PDF: Background
Electrodiagnostic testing (EDX) is important in the diagnosis and follow-up of neuropathic and myopathic diseases. This study aimed to demonstrate the compatibility between clinical prediagnosis and electrophysiological findings.
Methods
EDX results from 2004 to 2020 at the physical medicine and rehabilitation (PM&R) clinic were screened. Tests with missing data, reevaluation studies, and cases of peripheral facial paralysis were excluded. The clinical prediagnosis and EDX results were recorded, and their compatibility was evaluated.
Results
A total of 2,153 tests were included in this study. The mean age was 49.0±13.9 years and 1,533 of them (71.2%) were female. The most frequently referred clinic was the PM&R clinic (90.0%). Numbness (73.6%) was the most common complaint, followed by pain (15.3%) and weakness (13.9%). The most common prediagnosis was entrapment neuropathy (55.3%), radiculopathy (16.1%), and polyneuropathy (15.7%). Carpal tunnel syndrome was the most frequently identified type of entrapment neuropathy (78.3%). Six hundred and seventy EDX results (31.1%) were within normal limits. While the EDX results were consistent with the prediagnosis in 1,328 patients (61.7%), a pathology different from the prediagnosis was detected in 155 patients (7.2%). In the discrepancy group, the most common pathologies were entrapment neuropathy (51.7%), polyneuropathy (17.3%), and radiculopathy (15.1%). The most common neuropathy type was carpal tunnel syndrome (79.3%).
Conclusion
After adequate anamnesis and physical and neurological examinations, requesting further appropriate tests will increase the prediagnosis accuracy and prevent unnecessary expenditure of time and labor.

Aortic valve replacement through right anterior mini-thoracotomy in patients with chronic severe aortic regurgitation: a retrospective single-center study: Eun Yeung Jung, Ji Eun Im, Ho-Ki Min, Seok Soo Lee; J Yeungnam Med Sci. 2024;41(3):213-219. Published online June 12, 2024; DOI: https://doi.org/10.12701/jyms.2024.00290

1,539 View
38 Download

Abstract PDF: Background
Aortic valve replacement (AVR) has recently been performed at many centers using a minimally invasive approach to reduce postoperative mortality, morbidity, and pain. Most previous reports on minimally invasive AVR (MiAVR) have mainly focused on aortic stenosis, and those exclusively dealing with aortic regurgitation (AR) are few. The purpose of this study was to investigate early surgical results and review our experience with patients with chronic severe AR who underwent AVR via right anterior mini-thoracotomy (RAT).
Methods
Data were retrospectively collected in this single-center study. Eight patients who underwent RAT AVR between January 2020 and January 2024 were enrolled. Short-term outcomes, including the length of hospital stay, in-hospital mortality, postoperative complications, and echocardiographic data, were analyzed.
Results
No in-hospital mortalities were observed. Postoperative atrial fibrillation occurred temporarily in three patients (37.5%). However, none required permanent pacemaker implantation or renal replacement therapy. The median values of ventilator time, length of intensive care unit stay, and hospital stay were 17 hours, 34.5 hours, and 9 days, respectively. Preoperative and postoperative measurements of left ventricular ejection fraction were similar. However, the left ventricular end systolic and diastolic diameters significantly decreased postoperatively from 42 mm to 35.5 mm (p=0.018) and 63 mm to 51 mm (p=0.012), respectively.
Conclusion
MiAVR via RAT is a safe and reproducible procedure with acceptable morbidity and complication rates in patients with chronic severe AR. Despite some limitations such as a narrow surgical field and demanding learning curve, MiAVR is a competent method for AR.

Enhancing ketamine anesthesia with midazolam and fentanyl for children’s ear surgery: a prospective randomized study: Seong Min Han, So Young Kwon, Jang Hyeok In, Jin Deok Joo; J Yeungnam Med Sci. 2024;41(3):207-212. Published online May 23, 2024; DOI: https://doi.org/10.12701/jyms.2024.00276

2,097 View
64 Download

Abstract PDF: Background
Myringotomy with tympanostomy tube insertion (MTI) is a superficial surgical procedure used to prevent hearing loss in children with serous otitis media. Intravenous anesthesia, often ketamine, is preferred for this procedure because of its ability to induce sedation without compromising airway reflexes. However, ketamine alone may be insufficient and potentially lead to spontaneous movement during surgery. This study evaluated the effectiveness of midazolam and fentanyl as adjuvants to ketamine in reducing spontaneous movement during MTI and enhancing the quality of recovery.
Methods
This study involved two groups of 30 patients each: one group received intravenous ketamine (1.5 mg/kg) with an equal volume of normal saline (K group), while the other received a combination of midazolam, fentanyl, and ketamine (0.05 mg/kg, 1 μg/kg, and 1.5 mg/kg, respectively; MFK group). We assessed side effects, intraoperative patient movement, surgeon satisfaction, and emergence agitation scores.
Results
The MFK group exhibited significantly lower scores for patient movement (p<0.01) and emergence agitation (p<0.01) and markedly higher surgeon satisfaction scores (p<0.01) than the K group.
Conclusion
Administering a midazolam-fentanyl-ketamine combination effectively reduced spontaneous movement during surgery and emergence agitation during recovery without prolonging discharge times in children undergoing MTI.

Factors associated with musculoskeletal pain in professional dancers, including lapse period of group practice due to the COVID-19 outbreak: repeated-measures analysis: Kiook Baek, Yu-Mi Choi, Joon Sakong; J Yeungnam Med Sci. 2024;41(3):196-206. Published online May 17, 2024; DOI: https://doi.org/10.12701/jyms.2024.00171

1,995 View
42 Download

Abstract PDF Supplementary Material: Background
This study investigated the prevalence and associated factors of musculoskeletal pain among professional dancers who experienced a lapse in group practice due to coronavirus disease 2019.
Methods
General characteristics, practice time, region of musculoskeletal pain due to injury using the visual numeric scale (VNS), and causative motion were surveyed among professional dancers. Pain of VNS 0 to 3 was categorized as “no or minor,” 4 to 6 was categorized as “moderate,” and 7 to 10 was categorized as “severe.” The causal motions of musculoskeletal pain were analyzed according to body region. Factors other than motion associated with pain were also analyzed.
Results
In total, 368 participants were included. In the univariate analysis, age and practice time were positively associated with “moderate” pain. Practice time, dance experience, and postural accuracy were positively associated with “severe” pain, as was performing Korean traditional dance. In the multivariable analysis, practice time, group practice, and age were positively associated with pain of VNS 4 to 10, and practice time, group practice, and Korean traditional dance were positively associated with pain of VNS 7 to 10.
Conclusion
Among the factors related to dancer training, practice time, group practice, and dance type affect the occurrence of pain.

Effect of pitavastatin on erythrocyte membrane fatty acid content in patients with chronic kidney disease: two-arm parallel randomized controlled trial: Minna Kim, Seong Eun Kim, Su Mi Lee, Won Suk An; J Yeungnam Med Sci. 2024;41(3):188-195. Published online May 8, 2024; DOI: https://doi.org/10.12701/jyms.2024.00094

2,232 View
88 Download

Abstract PDF Supplementary Material: Background
Statins reduce the risk of cardiovascular events in patients with chronic kidney disease (CKD). Although diabetes mellitus (DM) is a reported side effect of statin treatment, some studies have indicated that pitavastatin does not cause DM. The present study investigated the effect of pitavastatin on the fatty acid (FA) content of erythrocyte membranes, which affects the occurrence of DM and cardiovascular diseases. In addition, changes in adiponectin and glycated hemoglobin (HbA1c) levels were evaluated after pitavastatin treatment.
Methods
A total of 45 patients were enrolled, 28 of whom completed the study. Over 24 weeks, 16 patients received 2 mg pitavastatin and 12 patients received 10 mg atorvastatin. Dosages were adjusted after 12 weeks if additional lipid control was required. There were 10 and nine patients with DM in the pitavastatin and atorvastatin groups, respectively. Erythrocyte membrane FAs and adiponectin levels were measured using gas chromatography and enzyme-linked immunosorbent assay, respectively.
Results
In both groups, saturated FAs, palmitic acid, trans-oleic acid, total cholesterol, and low-density lipoprotein cholesterol levels were significantly lower than those at baseline. The arachidonic acid (AA) content in the erythrocyte membrane increased significantly in the pitavastatin group, but adiponectin levels were unaffected. HbA1c levels decreased in patients treated with pitavastatin. No adverse effects were associated with statin treatment.
Conclusion
Pitavastatin treatment in patients with CKD may improve glucose metabolism by altering erythrocyte membrane AA levels. In addition, pitavastatin did not adversely affect glucose control in patients with CKD and DM.

Review articles

Ultrasound imaging and guidance in the management of myofascial pain syndrome: a narrative review: Wei-Ting Wu, Ke-Vin Chang, Vincenzo Ricci, Levent Özçakar; J Yeungnam Med Sci. 2024;41(3):179-187. Published online June 17, 2024; DOI: https://doi.org/10.12701/jyms.2024.00416

3,498 View
301 Download
3 Web of Science
3 Crossref

Abstract PDF

Myofascial pain syndrome (MPS) is a common musculoskeletal disorder characterized by muscle pain, tenderness, and trigger points. Ultrasonography has emerged as a key tool for diagnosing and treating MPS owing to its ability to provide precise, minimally invasive guidance. This review discusses the use of ultrasonography in various approaches to evaluate and manage MPS. Studies have shown that shear-wave sonoelastography can effectively assess muscle elasticity and offer insights into trapezius stiffness in patients with MPS. Ultrasound-guided interfascial hydrodissection, especially with visual feedback, has demonstrated effectiveness in treating trapezius MPS. Similarly, ultrasound-guided rhomboid interfascial plane blocks and perimysium dissection for posterior shoulder MPS have significantly reduced pain and improved quality of life. The combination of extracorporeal shockwave therapy with ultrasound-guided lidocaine injections has been particularly successful in reducing pain and stiffness in trapezius MPS. Research regarding various guided injections, including dry needling, interfascial plane blocks, and fascial hydrodissection, emphasizes the importance of ultrasonography for accuracy and safety. Additionally, ultrasound-guided delivery of local anesthetics and steroids to the quadratus lumborum muscle has shown lasting pain relief over a 6-month period. Overall, these findings highlight the pivotal role of ultrasonography in the assessment and treatment of MPS.

Citations

Citations to this article as recorded by

Blood Flow of the Infraspinatus Muscle in Individuals With and Without Shoulder Pain and Myofascial Trigger Points
Jace Brown, Gary Kearns, Emily Hedges, Samantha Samaniego, Sharon Wang‐Price
Journal of Ultrasound in Medicine.2025; 44(1): 127. CrossRef
Integrating Ultrasound-Guided Multifidus Injections with Repeated Peripheral Magnetic Stimulation for Low Back Pain: A Feasibility Study
Wei-Ting Wu, Ke-Vin Chang, Levent Özçakar
Journal of Pain Research.2024; Volume 17: 2873. CrossRef
Ultrasound-guided fascial plane blocks in chronic pain: a narrative review
Francesco Marrone, Carmine Pullano, Alessandro De Cassai, Pierfrancesco Fusco
Journal of Anesthesia, Analgesia and Critical Care.2024;[Epub] CrossRef

Failed back surgery syndrome—terminology, etiology, prevention, evaluation, and management: a narrative review: Jinseok Yeo; J Yeungnam Med Sci. 2024;41(3):166-178. Published online June 10, 2024; DOI: https://doi.org/10.12701/jyms.2024.00339

3,635 View
183 Download
1 Web of Science
1 Crossref

Abstract PDF

Amid the worldwide increase in spinal surgery rates, a significant proportion of patients continue to experience refractory chronic pain, resulting in reduced quality of life and escalated healthcare demands. Failed back surgery syndrome (FBSS) is a clinical condition characterized by persistent or recurrent pain after one or more spinal surgeries. The diverse characteristics and stigmatizing descriptions of FBSS necessitate a reevaluation of its nomenclature to reflect its complexity more accurately. Accurate identification of the cause of FBSS is hampered by the complex nature of the syndrome and limitations of current diagnostic labels. Management requires a multidisciplinary approach that may include pharmacological treatment, physical therapy, psychological support, and interventional procedures, emphasizing realistic goal-setting and patient education. Further research is needed to increase our understanding, improve diagnostic accuracy, and develop more effective management strategies.

Citations

Citations to this article as recorded by

Using Key Predictors in an SVM Model for Differentiating Spinal Fractures and Herniated Intervertebral Discs in Preoperative Anesthesia Evaluation
Shih-Ying Yang, Shih-Yen Hsu, Yi-Kai Su, Nan-Han Lu, Kuo-Ying Liu, Tai-Been Chen, Kon-Ning Chiu, Yung-Hui Huang, Li-Ren Yeh
Diagnostics.2024; 14(21): 2456. CrossRef

Focused Review articles

Effective and appropriate use of weight loss medication in pediatric obesity: a narrative review: Yoojin Lindsey Chung; J Yeungnam Med Sci. 2024;41(3):158-165. Published online July 2, 2024; DOI: https://doi.org/10.12701/jyms.2024.00353

2,830 View
102 Download
1 Web of Science
1 Crossref

Abstract PDF

Over the past few decades, there has been a notable increase in the incidence of pediatric obesity, which is a significant public health concern. Children who are obese have a greater risk of type 2 diabetes, hypertension, dyslipidemia, polycystic ovary syndrome, obstructive sleep apnea, and adult obesity. Lifestyle modification therapy is typically the initial approach to treat pediatric obesity. For patients who do not achieve success with lifestyle modification therapy alone, pharmacotherapy is the next logical treatment option. When selecting an anti-obesity medication (AOM), it is essential to first ascertain the medical background of the patient, including current medications and obesity-associated comorbidities. Evaluation of obesity phenotypes in patients may also be beneficial. AOMs for pediatric obesity include metformin, orlistat, glucagon-like peptide 1 agonists, phentermine, and the phentermine/topiramate combination. Sufficient lifestyle modification therapy should be administered before considering pharmacotherapy and continued after the initiation of AOM. To ensure healthy development, monitoring growth and puberty development during anti-obesity treatments is essential.

Citations

Citations to this article as recorded by

Exploring comprehensive insights into pediatric obesity
Yong Hee Hong
Journal of Yeungnam Medical Science.2024; 41(3): 139. CrossRef

What is the disease burden from childhood and adolescent obesity?: a narrative review: Eun Byoul Lee; J Yeungnam Med Sci. 2024;41(3):150-157. Published online June 27, 2024; DOI: https://doi.org/10.12701/jyms.2024.00360

2,753 View
69 Download
1 Web of Science
1 Crossref

Abstract PDF

The prevalence of childhood and adolescent obesity has increased and exacerbated during the coronavirus disease 2019 pandemic, both in Korea and globally. Childhood and adolescent obesity poses significant risks for premature morbidity and mortality. The development of serious comorbidities depends not only on the duration of obesity but also on the age of onset. Obesity in children and adolescents affects almost all organ systems, including the endocrine, cardiovascular, gastrointestinal, reproductive, nervous, and immune systems. Obesity in children and adolescents affects growth, cognitive function, and psychosocial interactions during development, in addition to aggravating known adult comorbidities such as type 2 diabetes mellitus, hypertension, dyslipidemia, nonalcoholic fatty liver disease, obstructive sleep apnea, and cancer. Childhood and adolescent obesity are highly associated with increased cardiometabolic risk factors and prevalence of metabolic syndrome. The risk of cardiovascular and metabolic diseases in later life can be considerably decreased by even a small weight loss before the onset of puberty. Childhood and adolescent obesity is a disease that requires treatment and is associated with many comorbidities and disease burdens. Therefore, early detection and therapeutic intervention are crucial.

Citations

Citations to this article as recorded by

Exploring comprehensive insights into pediatric obesity
Yong Hee Hong
Journal of Yeungnam Medical Science.2024; 41(3): 139. CrossRef

The prevalence and prevention strategies of pediatric obesity: a narrative review: Mi Seon Lee; J Yeungnam Med Sci. 2024;41(3):141-149. Published online July 5, 2024; DOI: https://doi.org/10.12701/jyms.2024.00346

2,522 View
86 Download
1 Web of Science
2 Crossref

Abstract PDF

Pediatric obesity has rapidly increased globally over the past few decades, including in Korea. We aimed to discuss trends in the prevalence of pediatric obesity and effective prevention strategies. Its prevalence has markedly increased in most high-income nations. According to recent reports, this increase has slowed in developed countries, but the levels remain alarmingly high. In Korea, the rate of pediatric obesity has surged notably since the 1990s; however, since the 2000s, this increase has become more gradual. According to recently published 2017 growth charts, the prevalence of pediatric obesity in Korea varies slightly depending on the data source. The National School Health Examination data showed that pediatric obesity gradually increase from 11.5% in 2014 to 15.1% in 2019, and after the coronavirus disease 2019 pandemic, it sharply increased to 19% in 2021. Based on data from the Korea National Health and Nutrition Examination Survey, the prevalence of pediatric obesity gradually increased from 10.8% in 2017 to 13.6% in 2019. This trend, which accelerated sharply to 15.9% in 2020 and 19.3% in 2021, was especially severe in boys and older children. Pediatric obesity not only affects health during childhood but also increases the risk of developing obesity and associated health conditions in adulthood. Despite ongoing research on treatment options, obesity prevention and control remain challenging. Hence, prioritizing early intervention and prevention of pediatric obesity through healthy eating habits and lifestyles is crucial. This requires intervention at the individual, family, school, and community levels.

Citations

Citations to this article as recorded by

Exploring comprehensive insights into pediatric obesity
Yong Hee Hong
Journal of Yeungnam Medical Science.2024; 41(3): 139. CrossRef
Title: A Qualitative Systematic Review of Parental Perceptions, Motivators, and Barriers to Management of Childhood Obesity
Sarah Musa, Ayman Al-Dahshan, Vahe Kehyayan
Diabetes, Metabolic Syndrome and Obesity.2024; Volume 17: 4749. CrossRef

Editorial

Exploring comprehensive insights into pediatric obesity: Yong Hee Hong; J Yeungnam Med Sci. 2024;41(3):139-140. Published online July 9, 2024; DOI: https://doi.org/10.12701/jyms.2024.00500

1,651 View
40 Download

PDF

Imagery

Trumpet creepers in summer alleyway: J Yeungnam Med Sci. 2024;41(3):i. Published online January 24, 2024; DOI: https://doi.org/10.12701/jyms.2024.00045

2,366 View
34 Download

PDF

First
Prev
Page of 36
Next
Last

Article category