Journal of Yeungnam Medical Science

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Dynamic ultrasound examination of the median nerve during follow-up after wrist fracture/surgery: Ahmet Furkan Çolak, Ayşe İrem Yeşiloğlu, Alpaslan Fatih Kaynar, Bayram Kaymak, Levent Özçakar; J Yeungnam Med Sci. 2024;41(1):56-57. Published online January 5, 2024; DOI: https://doi.org/10.12701/jyms.2023.01291

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Communications

The applicability of noncontact sensors in the field of rehabilitation medicine: Yoo Jin Choo, Jun Sung Moon, Gun Woo Lee, Wook-Tae Park, Min Cheol Chang; J Yeungnam Med Sci. 2024;41(1):53-55. Published online December 26, 2023; DOI: https://doi.org/10.12701/jyms.2023.01144

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Abstract PDF: A noncontact sensor field is an innovative device that can detect, measure, or monitor physical properties or conditions without direct physical contact with the subject or object under examination. These sensors use a variety of methods, including electromagnetic, optical, and acoustic technique, to collect information about the target without physical interaction. Noncontact sensors find wide-ranging applications in various fields such as manufacturing, robotics, automobiles, security, environmental monitoring, space industry, agriculture, and entertainment. In particular, they are used in the medical field, where they provide continuous monitoring of patient conditions and offer opportunities in rehabilitation medicine. This article introduces the potential of noncontact sensors in the field of rehabilitation medicine.

Case reports

DaVinci SP-based simultaneous bilateral partial nephrectomy from the midline transperitoneal approach: a case report: Young Hwii Ko, Jong Gyun Ha, Jae Yoon Jang, Yeung Uk Kim; J Yeungnam Med Sci. 2024;41(1):48-52. Published online January 4, 2024; DOI: https://doi.org/10.12701/jyms.2023.01032

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Abstract PDF: While simultaneous bilateral partial nephrectomy with a conventional multiport robot has been consistently reported since the 2010s, the introduction of the DaVinci SP system (Intuitive Surgical, Sunnyvale, CA, USA) could provide a novel way to perform surgery on bilateral kidneys while innovatively reducing the number of incisions. In our first report worldwide, the patient with bilateral small renal mass (2.0 cm for the left and 1.5 cm for the right side) and preoperative normal renal function was placed in the lateral decubitus position on an inverted bed. After tilting the bed to be as horizontal as possible, a 4-cm incision was made in the lower part of the umbilicus for the floating trocar technique. The partial nephrectomy was performed reliably as with the conventional transperitoneal approach, and then the patient could be repositioned to the contralateral side for the same procedure, maintaining all trocars. Total operation time (skin to skin), total console time, and the left- and right-side warm ischemic times were 260, 164, 27, and 23 minutes, respectively, without applying the early declamping technique. The estimated blood loss was 200 mL. The serum creatinine right after the operation, on the first day, 3 days, and 90 days after surgery were 0.92, 0.77, 0.79, and 0.81 mg/dL, respectively. For 90 days after the procedure, no complications or radiologic recurrence were observed. Further clinical studies will reveal the advantages of using the DaVinci SP device for this procedure over traditional multiport surgery, maximizing the benefit of a single port-based approach.

Sciatic neurotmesis and periostitis ossificans progressiva due to a traumatic/unexpected glass injury: a case report: Berkay Yalçınkaya, Hasan Ocak, Ahmet Furkan Çolak, Levent Özçakar; J Yeungnam Med Sci. 2024;41(1):45-47. Published online November 21, 2023; DOI: https://doi.org/10.12701/jyms.2023.01018

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Abstract PDF Supplementary Material: Peripheral nerves may be affected or injured for several reasons. Peripheral nerve damage can result from trauma, surgery, anatomical abnormalities, entrapment, systemic diseases, or iatrogenic injuries. Trauma and iatrogenic injuries are the most common causes. The ulnar, median, and radial nerves are the most injured nerves in the upper extremities, while the sciatic and peroneal nerves are the most injured nerves in the lower extremities. The clinical symptoms of peripheral nerve damage include pain, weakness, numbness/tingling, and paresthesia. Therefore, early diagnosis and appropriate treatment of peripheral nerve injuries are crucial. If a peripheral nerve injury is left untreated, it can lead to severe complications and significant morbidity. The sciatic nerve is one of the most affected nerves. This nerve is generally injured by trauma and iatrogenic causes. Children are more susceptible to trauma than adults. Therefore, sciatic nerve injuries are observed in pediatric patients. When the sciatic nerve is damaged, pain, weakness, sensory loss, and gait disturbances can occur. Therefore, the diagnosis and treatment of sciatic nerve injuries are important to avoid unexpected consequences. Ultrasound can play an important role in the diagnosis of peripheral nerve injury and the follow-up of patients. The aim of this case report is twofold. First, we aimed to emphasize the critical role of ultrasonographic evaluation in the diagnosis of peripheral nerve injuries and pathologies. Second, we aimed to present this case, which has distinguishing features, such as the existence of periostitis ossificans progressiva with sciatic neurotmesis due to a traumatic glass injury.

Original articles

Incidence and severity of medication-related osteonecrosis of the jaw in patients with osteoporosis using data from a Korean nationwide sample cohort in 2002 to 2019: a retrospective study: Su-Youn Ko, Tae-Yoon Hwang, Kiwook Baek, Chulyong Park; J Yeungnam Med Sci. 2024;41(1):39-44. Published online January 3, 2024; DOI: https://doi.org/10.12701/jyms.2023.01116

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Abstract PDF: Background
Medication-related osteonecrosis of the jaw (MRONJ) is a significant concern, particularly among patients taking bisphosphonates (BPs), denosumab, and selective estrogen receptor modulators (SERMs) for osteoporosis. Despite the known risks, large-scale cohort studies examining the incidence and severity of MRONJ are lacking. We aimed to ascertain the incidence and risk of MRONJ among these patients, whom we stratified by age groups, medication types, and duration of use.
Methods
We utilized data from the National Health Insurance Service’s sample cohort database, focusing on patients aged 40 years and above diagnosed with osteoporosis. The patients were divided into three groups: those prescribed BPs only, those prescribed SERMs only, and those prescribed both.
Results
The overall incidence rate of MRONJ was 0.17%. A significantly higher incidence rate was observed among those taking osteoporosis medications, particularly among females with a relative risk of 4.99 (95% confidence interval, 3.21–7.74). The SERM group also had an incidence rate comparable to that of the BP group. Severity was assessed based on the invasiveness of the treatment methods, with 71.3% undergoing invasive treatment in the medication group.
Conclusion
This study provides valuable insights into the incidence and severity of MRONJ among a large cohort of patients with osteoporosis. It underscores the need for comprehensive guidance on MRONJ risks across different medication groups and sets the stage for future research focusing on specific populations and treatment outcomes.

The characteristics of elderly suicidal attempters in the emergency department in Korea: a retrospective study: Ji-Seon Jang, Wan-Seok Seo, Bon-Hoon Koo, Hey-Geum Kim, Seok-Ho Yun, So-Hey Jo, Dae-Seok Bai, Young-Gyo Kim, Eun-Jin Cheon; J Yeungnam Med Sci. 2024;41(1):30-38. Published online December 29, 2023; DOI: https://doi.org/10.12701/jyms.2023.01004

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Abstract PDF Supplementary Material: Background
Although Korea ranks first in the suicide rate of elderly individuals, there is limited research on those who attempt suicide, with preventive measures largely based on population-based studies. We compared the demographic and clinical characteristics of elderly individuals who attempted suicide with those of younger adults who visited the emergency department after suicide attempts and identified the factors associated with lethality in the former group.
Methods
Individuals who visited the emergency department after a suicide attempt from April 1, 2017, to January 31, 2020, were included. Participants were classified into two groups according to age (elderly, ≥65 years; adult, 18–64 years). Among the 779 adult patients, 123 were elderly. We conducted a chi-square test to compare the demographic and clinical features between these groups and a logistic regression analysis to identify the risk factors for lethality in the elderly group.
Results
Most elderly participants were men, with no prior psychiatric history or suicide attempts, and had a higher prevalence of underlying medical conditions and attributed their attempts to physical illnesses. Being sober and planning suicide occurred more frequently in this group. In the elderly group, factors that increased the mortality rate were biological male sex (p<0.05), being accompanied by family members (p<0.05), and poisoning as a suicide method (p<0.01).
Conclusion
Suicide attempts in elderly individuals have different characteristics from those in younger adults and are associated with physical illness. Suicides in the former group are unpredictable, deliberate, and fatal. Therefore, tailored prevention and intervention strategies addressing the characteristics of those who are elderly and attempt suicide are required.

Review articles

Breakthrough pain and rapid-onset opioids in patients with cancer pain: a narrative review: Jinseok Yeo; J Yeungnam Med Sci. 2024;41(1):22-29. Published online June 30, 2023; DOI: https://doi.org/10.12701/jyms.2023.00367

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Abstract PDF: Breakthrough pain is transitory pain that occurs despite the use of opioids for background pain control. Breakthrough pain occurs in 40% to 80% of patients with cancer pain. Despite effective analgesic therapy, patients and their caregivers often feel that their pain is not sufficiently controlled. Therefore, an improved understanding of breakthrough pain and its management is essential for all physicians caring for patients with cancer. This article reviews the definition, clinical manifestations, accurate diagnostic strategies, and optimal treatment options for breakthrough pain in patients with cancer. This review focuses on the efficacy and safety of rapid-onset opioids, which are the primary rescue drugs for breakthrough pain.

Role of gene therapy in treatment of cancer with craniofacial regeneration—current molecular strategies, future perspectives, and challenges: a narrative review: Himanshu Singh; J Yeungnam Med Sci. 2024;41(1):13-21. Published online May 23, 2023; DOI: https://doi.org/10.12701/jyms.2023.00073

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Abstract PDF: Gene therapy involves the introduction of foreign genetic material into host tissue to alter the expression of genetic products. Gene therapy represents an opportunity to alter the course of various diseases. Hence, genetic products utilizing safe and reliable vectors with improved biotechnology will play a critical role in the treatment of various diseases in the future. This review summarizes various important vectors for gene therapy along with modern techniques for potential craniofacial regeneration using gene therapy. This review also explains current molecular approaches for the management and treatment of cancer using gene therapy. The existing literature was searched to find studies related to gene therapy and its role in craniofacial regeneration and cancer treatment. Various databases such as PubMed, Science Direct, Scopus, Web of Science, and Google Scholar were searched for English language articles using the keywords “gene therapy,” “gene therapy in present scenario,” “gene therapy in cancer,” “gene therapy and vector,” “gene therapy in diseases,” and “gene therapy and molecular strategies.”

Octacalcium phosphate, a promising bone substitute material: a narrative review: Jooseong Kim, Sukyoung Kim, Inhwan Song; J Yeungnam Med Sci. 2024;41(1):4-12. Published online May 9, 2023; DOI: https://doi.org/10.12701/jyms.2023.00010

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Abstract PDF

Biomaterials have been used to supplement and restore function and structure by replacing or restoring parts of damaged tissues and organs. In ancient times, the medical use of biomaterials was limited owing to infection during surgery and poor surgical techniques. However, in modern times, the medical applications of biomaterials are diversifying owing to great developments in material science and medical technology. In this paper, we introduce biomaterials, focusing on calcium phosphate ceramics, including octacalcium phosphate, which has recently attracted attention as a bone graft material.

Citations

Citations to this article as recorded by

Development of Hydroxyapatite Coatings for Orthopaedic Implants from Colloidal Solutions: Part 1—Effect of Solution Concentration and Deposition Kinetics
Bríd Murphy, Mick A. Morris, Jhonattan Baez
Nanomaterials.2023; 13(18): 2577. CrossRef

Editorial

Appreciation to peer reviewers in 2023: So-Young Park; J Yeungnam Med Sci. 2024;41(1):1-3. Published online January 4, 2024; DOI: https://doi.org/10.12701/jyms.2023.01361

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Imagery

"Nostalgia": J Yeungnam Med Sci. 2024;41(1):i. Published online March 17, 2023; DOI: https://doi.org/10.12701/jyms.2023.00213

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Case report

Primary diffuse large B-cell lymphoma of the vulva: a case report: Sun Yeon Kim, Ju Hwan Koo, Juhun Lee, Yu Jin Koo, Mi Jin Gu, Dae Hyung Lee; J Yeungnam Med Sci. 2023;40(Suppl):S87-S92. Published online April 25, 2023; DOI: https://doi.org/10.12701/jyms.2023.00108

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Abstract PDF: Diffuse large B-cell lymphoma (DLBCL) is a subtype of non-Hodgkin lymphoma (NHL) and is estimated to account for approximately 30% of all NHL cases. NHL can also occur in the female genital tract and accounts for approximately 1.5% of all NHL cases. Many doctors have difficulty diagnosing or treating vulvar DLBCL because of its very low prevalence. A 55-year-old woman presented with a solid mass on the right side of the vulva. No significantly enlarged lymph nodes were observed in the inguinal region. She underwent excisional biopsy at our institution. DLBCL was diagnosed based on histological examination. According to the Hans algorithm, the lesion was diagnosed as a non-germinal center B-cell-like subtype. The patient was referred to a hematologic oncologist. The disease stage was classified as IE according to the Ann Arbor staging classification. The patient received four cycles of chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone and localized radiation therapy with 36 Gy in 20 fractions. She showed complete remission and maintained this status on the latest computed tomography scan. Gynecologists should rule out lymphoma in patients presenting with a vulvar mass.

Original articles

Analysis of single nucleotide polymorphisms associated with the vitamin D pathway in the placentas of women with gestational diabetes mellitus: a laboratory study: Mi Ju Kim, Hyun Mi Kim, Hyun-Hwa Cha, Won Joon Seong; J Yeungnam Med Sci. 2023;40(Suppl):S9-S16. Published online May 8, 2023; DOI: https://doi.org/10.12701/jyms.2023.00150

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Abstract PDF: Background
The aim of this study was to analyze the single nucleotide polymorphisms (SNPs) of genes known to be involved in vitamin D metabolism in the placenta using the placental tissue of mothers diagnosed with gestational diabetes mellitus (GDM) to determine whether the SNPs and occurrence of GDM are related.
Methods
We enrolled 80 women of the same gestational age, 40 with and 40 without GDM. The placenta was obtained from each woman after delivery and SNP genotyping was performed on seven SNPs in the CYP27B1 (rs10877012), CYP24A1 (rs2248359, rs6013897, and rs2209314), and GC (rs2282679, rs16847024, and rs3733359) genes. Maternal serum 25-hydroxyvitamin D levels were measured during the first trimester of pregnancy and before delivery.
Results
At the time of delivery, vitamin D levels were lower (21.05±12.05 mg/dL vs. 31.31±20.72 mg/dL, p=0.012) and the frequency of vitamin D deficiency was higher (60.7% vs. 32.5%, p=0.040) in the GDM group. In women with GDM, the G allele of rs10877012 was more common (86.3% vs. 65.0%, p=0.002). The rs10877012 GG genotype was more common in the GDM group (72.5% vs. 42.5%, p=0.007) and the rs10877012 TT genotype was more common in the control group (12.5% vs. 0%, p=0.007).
Conclusion
Mothers with GDM have lower serum concentrations of vitamin D before delivery than healthy controls and vitamin D deficiency is common. A polymorphism in CYP27B1 (rs10877012), is considered to be a cause of GDM pathogenesis.

Cytotoxicity of dental self-curing resin for a temporary crown: an in vitro study: Jae-wan Ko, Joon Sakong, Sohee Kang; J Yeungnam Med Sci. 2023;40(Suppl):S1-S8. Published online April 26, 2023; DOI: https://doi.org/10.12701/jyms.2023.00080

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Abstract PDF: Background
Residual monomer tests using high-performance liquid chromatography and cytotoxicity tests were performed to analyze the effect on the oral mucosa of a self-curing resin for provisional crown production.
Methods
A cytotoxicity test was performed to confirm whether leaked residual monomers directly affected oral mucosal cells. The cytotoxicity of the liquid and solid resin polymers was measured using a water-soluble tetrazolium (WST) test and microplate reader.
Results
In the WST assay using a microplate reader, 73.4% of the cells survived at a concentration of 0.2% liquid resin polymer. The cytotoxicity of the liquid resin polymer was low at ≤0.2%. For the solid resins, when 100% of the eluate was used from each specimen, the average cell viability was 91.3% for the solid resin polymer and 100% for the hand-mixed self-curing resin, which is higher than the cell viability standard of 70%. The cytotoxicity of the solid resin polymer was low.
Conclusion
Because the polymerization process of the self-curing resin may have harmful effects on the oral mucosa during the second and third stages, the solid resin should be manufactured indirectly using a dental model.

Case report

Thyroid storm caused by metastatic papillary thyroid carcinoma tissue after total thyroidectomy: a case report: So Hee Kwon, Min-Ji Kim, Sin Yeong Jung, Jae-Han Jeon; J Yeungnam Med Sci. 2023;40(Suppl):S93-S97. Published online May 17, 2023; DOI: https://doi.org/10.12701/jyms.2023.00199

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Abstract PDF

Thyroid storm is a life-threatening form of thyrotoxicosis and an endocrinological emergency. We present a case of thyroid storm in a patient with metastatic papillary thyroid cancer. A 67-year-old woman with a history of total thyroidectomy 4 years prior to presentation was admitted with deteriorating mental status, fever, and tachycardia. Laboratory tests revealed severe thyrotoxicosis. Although the patient had no residual thyroid tissue after total thyroidectomy, she had a previously diagnosed metastatic thyroid cancer lesion in the pelvic bone. Despite initial treatment with a standard thyroid storm regimen, the patient died 6 days after hospitalization. The patient had no history of Graves disease; however, a thyroxine receptor antibody was detected postmortem. The patient had a history of exposure to an iodine contrast agent, which is a rare cause of thyrotoxicosis. Thyroxine production from a differentiated thyroid carcinoma is rare but can be a source of clinically significant thyrotoxicosis in patients post-thyroidectomy. Overlapping Graves disease is a common stimulus; however, other causes, such as exogenous iodine, cannot be excluded. This case demonstrates that in the setting of metastatic thyroid carcinoma, thyrotoxicosis cannot be completely ruled out as a cause of suspicious symptoms, even in patients with a history of total thyroidectomy.

Citations

Citations to this article as recorded by

Data Analysis and Systematic Scoping Review on the Pathogenesis and Modalities of Treatment of Thyroid Storm Complicated with Myocardial Involvement and Shock
Eman Elmenyar, Sarah Aoun, Zain Al Saadi, Ahmed Barkumi, Basar Cander, Hassan Al-Thani, Ayman El-Menyar
Diagnostics.2023; 13(19): 3028. CrossRef

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