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Understanding insomnia as systemic disease
Seokho Yun, Sohye Jo
Yeungnam Univ J Med. 2021;38(4):267-274.   Published online September 13, 2021
DOI: https://doi.org/10.12701/yujm.2021.01424
  • 4,641 View
  • 108 Download
  • 4 Crossref
AbstractAbstract PDF
Sleep plays a critical role in homeostasis of the body and mind. Insomnia is a disease that causes disturbances in the initiation and maintenance of sleep. Insomnia is known to affect not only the sleep process itself but also an individual’s cognitive function and emotional regulation during the daytime. It increases the risk of various neuropsychiatric diseases such as depression, anxiety disorder, and dementia. Although it might appear that insomnia only affects the nervous system, it is also a systemic disease that affects several aspects of the body, such as the cardiovascular, endocrine, and immune systems; therefore, it increases the risk of various diseases such as hypertension, diabetes mellitus, and infection. Insomnia has a wide range of effects on our bodies because sleep is a complex and active process. However, a high proportion of patients with insomnia do not seek treatment, which results in high direct and indirect costs. This is attributed to the disregard of many of the negative effects of insomnia. Therefore, we expect that understanding insomnia as a systemic disease will provide an opportunity to understand the condition better and help prevent secondary impairment due to insomnia.

Citations

Citations to this article as recorded by  
  • Medical service utilization patterns among adults with insomnia: A retrospective cohort study
    Min Kyung Hyun, Jang Won Lee
    European Journal of Integrative Medicine.2023; : 102325.     CrossRef
  • Socio-Ecological Context of Sleep: Gender Differences and Couples’ Relationships as Exemplars
    Andrea N. Decker, Alexandra R. Fischer, Heather E. Gunn
    Current Psychiatry Reports.2022; 24(12): 831.     CrossRef
  • Clinical Spectrum and Trajectory of Innovative Therapeutic Interventions for Insomnia: A Perspective
    Yun-Jo Lo, Viraj Krishna Mishra, Hung-Yao Lo, Navneet Kumar Dubey, Wen-Cheng Lo
    Aging and disease.2022;[Epub]     CrossRef
  • Understanding sleep and sleep disturbances in autism spectrum disorder, and management of insomnia: an update
    Hye-Geum Kim
    Yeungnam University Journal of Medicine.2021; 38(4): 265.     CrossRef
Psychiatric understanding and treatment of patients with amputations
So-Hye Jo, Suk-Hun Kang, Wan-Seok Seo, Bon-Hoon Koo, Hye-Geum Kim, Seok-Ho Yun
Yeungnam Univ J Med. 2021;38(3):194-201.   Published online May 11, 2021
DOI: https://doi.org/10.12701/yujm.2021.00990
  • 9,299 View
  • 290 Download
  • 10 Crossref
AbstractAbstract PDF
Amputation changes the lives of patients and their families. Consequently, the patient must adapt to altered body function and image. During this adaptation process, psychological problems, such as depression, anxiety, and posttraumatic stress disorder, can occur. The psychological difficulties of patients with amputation are often accepted as normal responses that are often poorly recognized by patients, family members, and their primary physicians. Psychological problems can interfere with rehabilitation and cause additional psychosocial problems. Therefore, their early detection and treatment are important. A multidisciplinary team approach, including mental health professionals, is ideal for comprehensive and biopsychosocial management. Mental health professionals could help patients set realistic goals and use adaptive coping styles. Psychiatric approaches should consider the physical, cognitive, psychological, social, and spiritual functions and social support systems before and after amputation. The abilities and limitations of physical, cognitive, psychological, and social functions should also be considered. To improve the patient’s adaptation, psychological interventions such as short-term psychotherapy, cognitive behavioral therapy, mindfulness meditation, biofeedback, and group psychotherapy can be helpful.

Citations

Citations to this article as recorded by  
  • Building a Multidisciplinary Clinic Dedicated to Upper-Extremity Limb Loss
    Anirudh Kulkarni, Margaret Luthringer, Alta Fried, Matt Mikosz, Jamie Mauro, Gina Radice Vella, Tara Lally, Ajul Shah
    The Journal of Hand Surgery.2024;[Epub]     CrossRef
  • Effect of Increasing Assistance From a Powered Prosthesis on Weight-Bearing Symmetry, Effort, and Speed During Stand-Up in Individuals With Above-Knee Amputation
    Grace R. Hunt, Sarah Hood, Lukas Gabert, Tommaso Lenzi
    IEEE Transactions on Neural Systems and Rehabilitation Engineering.2023; 31: 11.     CrossRef
  • The Effect of Motivational Interview-Based Counseling in Individuals With Amputation: A Randomized Controlled Trial in Turkey
    Gülhan Küçük Öztürk, Nuray Şimşek
    Rehabilitation Nursing.2023; 48(5): 160.     CrossRef
  • Psychosocial patient perspectives following major lower-limb amputation due to vascular aetiology: a protocol for a systematic meta-aggregation study
    Sisse Heiden Laursen, Helle Lund Rasmussen, Dinnie Seidelin, Peter Hørslev Pedersen, Tanja Mortensen Chræmmer
    BMJ Open.2023; 13(9): e076794.     CrossRef
  • Quality of life following non-dysvascular lower limb amputation is contextualized through occupations: a qualitative study
    Stephanie R. Cimino, Sander L. Hitzig, Vera Fung, Katie N. Dainty, Crystal MacKay, Joanna E. M. Sale, Amanda L. Mayo, Sara J. T. Guilcher
    Disability and Rehabilitation.2023; : 1.     CrossRef
  • Finger prosthesis: A novel way to restore the form, function, and esthetics
    Nagaveni S. Somayaji, Pallawi Sinha, Jitendra Sharan, Jagadish Prasad Rajaguru, Anand Marya
    Clinical Case Reports.2023;[Epub]     CrossRef
  • Predicting amputation using machine learning: A systematic review
    Patrick Fangping Yao, Yi David Diao, Eric P. McMullen, Marlin Manka, Jessica Murphy, Celina Lin, Noman Naseer
    PLOS ONE.2023; 18(11): e0293684.     CrossRef
  • Understanding Gangrene in the Context of Peripheral Vascular Disease: Prevalence, Etiology, and Considerations for Amputation-Level Determination
    Abhilasha Bhargava, Chandrashekhar Mahakalkar, Shivani Kshirsagar
    Cureus.2023;[Epub]     CrossRef
  • Depression and Anxiety Symptoms Among Lebanese Lower Limb Traumatic Amputees: Association with Education, Employment, Adjustment to Amputation and Prosthesis Satisfaction
    Nour El Hoda Saleh, Fatima Hamiye, Marwa Summaka, Hiba Zein, Rami El Mazbouh, Ibrahim Naim
    Psychiatry.2023; : 1.     CrossRef
  • PEER SUPPORT FOR INDIVIDUALS WITH MAJOR LIMB LOSS: A SCOPING REVIEW
    Mia Costa-Parke, Anna Maria Di Lella, Ashley Walker, Lee Verweel, Crystal MacKay
    CANADIAN PROSTHETICS & ORTHOTICS JOURNAL.2023;[Epub]     CrossRef
Lactate: a multifunctional signaling molecule
Tae-Yoon Lee
Yeungnam Univ J Med. 2021;38(3):183-193.   Published online February 18, 2021
DOI: https://doi.org/10.12701/yujm.2020.00892
  • 18,595 View
  • 487 Download
  • 33 Crossref
AbstractAbstract PDF
Since its discovery in 1780, lactate has long been misunderstood as a waste by-product of anaerobic glycolysis with multiple deleterious effects. Owing to the lactate shuttle concept introduced in the early 1980s, a paradigm shift began to occur. Increasing evidence indicates that lactate is a coordinator of whole-body metabolism. Lactate is not only a readily accessible fuel that is shuttled throughout the body but also a metabolic buffer that bridges glycolysis and oxidative phosphorylation between cells and intracellular compartments. Lactate also acts as a multifunctional signaling molecule through receptors expressed in various cells and tissues, resulting in diverse biological consequences including decreased lipolysis, immune regulation, anti-inflammation, wound healing, and enhanced exercise performance in association with the gut microbiome. Furthermore, lactate contributes to epigenetic gene regulation by lactylating lysine residues of histones, accounting for its key role in immune modulation and maintenance of homeostasis.

Citations

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  • B cells from old mice induce the generation of inflammatory T cells through metabolic pathways
    Kevin Li, Maria Romero, Macarena Cañardo, Denisse Garcia, Alain Diaz, Bonnie B. Blomberg, Daniela Frasca
    Mechanisms of Ageing and Development.2023; 209: 111742.     CrossRef
  • The function and mechanism of lactate and lactylation in tumor metabolism and microenvironment
    Yan Zhang, Qiu Peng, Jinhua Zheng, Yuzhong Yang, Xuemei Zhang, Aiyu Ma, Yuxia Qin, Zailong Qin, Xiang Zheng
    Genes & Diseases.2023; 10(5): 2029.     CrossRef
  • Lactate: a pearl dropped in the ocean—an overlooked signal molecule in physiology and pathology
    Yue Wu, Wanqi Ma, Wei Liu, Shuping Zhang
    Cell Biology International.2023; 47(2): 295.     CrossRef
  • Insights on the role of l-lactate as a signaling molecule in skin aging
    Salvatore Chirumbolo, Dario Bertossi, Pierre Magistretti
    Biogerontology.2023; 24(5): 709.     CrossRef
  • Role of L-lactate as an energy substrate in primary rat podocytes under physiological and glucose deprivation conditions
    Maria Szrejder, Marlena Typiak, Piotr Pikul, Irena Audzeyenka, Patrycja Rachubik, Dorota Rogacka, Magdalena Narajczyk, Agnieszka Piwkowska
    European Journal of Cell Biology.2023; 102(2): 151298.     CrossRef
  • Utilization of delactosed whey permeate for the synthesis of ethyl acetate with Kluyveromyces marxianus
    Andreas Hoffmann, Alexander Franz, Thomas Walther, Christian Löser
    Applied Microbiology and Biotechnology.2023; 107(5-6): 1635.     CrossRef
  • Lactate, histone lactylation and cancer hallmarks
    Xinyu Lv, Yingying Lv, Xiaofeng Dai
    Expert Reviews in Molecular Medicine.2023;[Epub]     CrossRef
  • Aging and memory are altered by genetically manipulating lactate dehydrogenase in the neurons or glia of flies
    Ariel K. Frame, J. Wesley Robinson, Nader H. Mahmoudzadeh, Jason M. Tennessen, Anne F. Simon, Robert C. Cumming
    Aging.2023;[Epub]     CrossRef
  • Human beta defensin-2 loaded PLGA nanoparticles impregnated in collagen-chitosan composite scaffold for the management of diabetic wounds
    Bharat Kumar Reddy Sanapalli, Vidyasrilekha Yele, Mantosh Kumar Singh, Shilpa.N. Thumbooru, Madhukiran Parvathaneni, Veera Venkata Satyanarayana Reddy Karri
    Biomedicine & Pharmacotherapy.2023; 161: 114540.     CrossRef
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    Christina Thoda, Maria Touraki
    Applied Sciences.2023; 13(8): 4726.     CrossRef
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  • High-concentrate diet elevates histone lactylation mediated by p300/CBP through the upregulation of lactic acid and induces an inflammatory response in mammary gland of dairy cows
    Lairong Wang, Yan Wang, Meijuan Meng, Nana Ma, Guozhen Wei, Ran Huo, Guangjun Chang, Xiangzhen Shen
    Microbial Pathogenesis.2023; 180: 106135.     CrossRef
  • ANT2 Accelerates Cutaneous Wound Healing in Aged Skin by Regulating Energy Homeostasis and Inflammation
    Seung-Hwa Woo, Yun Jeong Mo, Yun-Il Lee, Ji Hwan Park, Daehee Hwang, Tae Jun Park, Hee Young Kang, Sang Chul Park, Young-Sam Lee
    Journal of Investigative Dermatology.2023; 143(11): 2295.     CrossRef
  • Exogenous lactate administration: A potential novel therapeutic approach for neonatal hypoxia-ischemia
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  • An adult Drosophila glioma model to highlight metabolic dysfunctions and evaluate the role of the serotonin 5‐HT7 receptor as a potential therapeutic target
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    Dalia Barayan, Fadi Khalaf, Carly M. Knuth, Abdikarim Abdullahi, Sarah Rehou, Robert A. Screaton, Marc G. Jeschke
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  • Lactylation driven by lactate metabolism in the disc accelerates intervertebral disc degeneration: A hypothesis
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    Sabine A. Eming, Peter J. Murray, Edward J. Pearce
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Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL)
Jun-Ho Lee
Yeungnam Univ J Med. 2021;38(3):175-182.   Published online January 19, 2021
DOI: https://doi.org/10.12701/yujm.2020.00801
  • 6,831 View
  • 171 Download
  • 8 Crossref
AbstractAbstract PDF
Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is a rare T-cell non-Hodgkin lymphoma characterized as CD30 positive and anaplastic lymphoma kinase (ALK) negative. In 2016, the World Health Organization declared BIA-ALCL as a new disease entity. The first case of BIA-ALCL was reported in 1997, and as of July 2019, the United States Food and Drug Administration had cited a total of 573 United States and global medical device reports of BIA-ALCL, including 33 deaths. In all clinical case reports, except for those with unknown clinical history, the patient had received at least one textured surface breast implant. Although the etiology is not yet clear, chronic inflammation has been proposed as a potential precursor to tumorigenesis. The most common presentation of BIA-ALCL is peri-implant fluid collection following aesthetic or reconstructive implantation with textured surface breast implants. It can be accompanied by breast swelling, asymmetry, pain, skin lesions, lymphadenopathy, and B-type symptoms. Most cases are detected on average 7 to 10 years after implantation. Diagnostic specimens can be obtained with fine-needle aspiration or biopsy. BIA-ALCL is CD30 positive, epithelial membrane antigen positive, and ALK negative. It can be cured with complete surgical excision at the T1–T3 stage.

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  • Smooth vs Textured Expanders: Patient Factors and Anatomic Plane Are Greater Factors in Determining First-Stage Breast Reconstruction Outcomes
    Emma S Dahmus, Amanda E Ruffino, Joshua D Madera, Alexandra Long, Shengxuan Wang, Christian A Kauffman, Sean Devitt, Christopher Sanders, Joseph DeSantis
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  • Place and objectives of ultrasound examination of the mammary glands after augmentation mammoplasty with silicone endoprostheses in the instrumental algorithm of patients with suspected BIA-ALCL (literature review)
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  • Evaluation of Different Breast Implant Shapes in the Same Patient: Is There Really a Difference between Round and Anatomical Implants?
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The role of microRNAs in cell death pathways
Ji Hoon Jang, Tae-Jin Lee
Yeungnam Univ J Med. 2021;38(2):107-117.   Published online January 13, 2021
DOI: https://doi.org/10.12701/yujm.2020.00836
  • 9,542 View
  • 207 Download
  • 11 Crossref
AbstractAbstract PDF
MicroRNAs (miRNAs) are a class of noncoding RNAs that negatively regulate target messenger RNAs. In multicellular eukaryotes, numerous miRNAs perform basic cellular functions, including cell proliferation, differentiation, and death. Abnormal expression of miRNAs weakens or modifies various apoptosis pathways, leading to the development of human cancer. Cell death occurs in an active manner that maintains tissue homeostasis and eliminates potentially harmful cells through regulated cell death processes, including apoptosis, autophagic cell death, and necroptosis. In this review, we discuss the involvement of miRNAs in regulating cell death pathways in cancers and the potential therapeutic functions of miRNAs in cancer treatment.

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    Frontiers in Neurology.2021;[Epub]     CrossRef
F-18 fluorodeoxyglucose positron emission tomography/computed tomography in the infection of heart
Eunjung Kong
Yeungnam Univ J Med. 2021;38(2):95-106.   Published online October 15, 2020
DOI: https://doi.org/10.12701/yujm.2020.00479
  • 6,407 View
  • 104 Download
  • 2 Crossref
AbstractAbstract PDF
Infections involving the heart are becoming increasingly common, and a timely diagnosis of utmost importance, despite its challenges. F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is a recently introduced diagnostic tool in cardiology. This review focuses on the current evidence for the use of FDG PET/CT in the diagnosis of infective endocarditis, cardiac implantable device infection, left ventricular assist device infection, and secondary complications. The author discusses considerations when using FDG PET/CT in routine clinical practice, patient preparation for reducing physiologic myocardial uptake, acquisition of images, and interpretation of PET/CT findings. This review also functions to highlight the need for a standardized acquisition protocol.

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Can antioxidants be effective therapeutics for type 2 diabetes?
Soyoung Park, So-Young Park
Yeungnam Univ J Med. 2021;38(2):83-94.   Published online October 8, 2020
DOI: https://doi.org/10.12701/yujm.2020.00563
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AbstractAbstract PDF
The global obesity epidemic and the growing elderly population largely contribute to the increasing incidence of type 2 diabetes. Insulin resistance acts as a critical link between the present obesity pandemic and type 2 diabetes. Naturally occurring reactive oxygen species (ROS) regulate intracellular signaling and are kept in balance by the antioxidant system. However, the imbalance between ROS production and antioxidant capacity causes ROS accumulation and induces oxidative stress. Oxidative stress interrupts insulin-mediated intracellular signaling pathways, as supported by studies involving genetic modification of antioxidant enzymes in experimental rodents. In addition, a close association between oxidative stress and insulin resistance has been reported in numerous human studies. However, the controversial results with the use of antioxidants in type 2 diabetes raise the question of whether oxidative stress plays a critical role in insulin resistance. In this review article, we discuss the relevance of oxidative stress to insulin resistance based on genetically modified animal models and human trials.

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Pathophysiology and protective approaches of gut injury in critical illness
Chang Yeon Jung, Jung Min Bae
Yeungnam Univ J Med. 2021;38(1):27-33.   Published online September 23, 2020
DOI: https://doi.org/10.12701/yujm.2020.00703
  • 6,934 View
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  • 5 Crossref
AbstractAbstract PDF
The gut is a complex organ that has played an important role in digestion, absorption, endocrine functions, and immunity. The gut mucosal barriers consist of the immunologic barrier and nonimmunologic barrier. During critical illnesses, the gut is susceptible to injury due to the induction of intestinal hyperpermeability. Gut hyperpermeability and barrier dysfunction may lead to systemic inflammatory response syndrome. Additionally, gut microbiota are altered during critical illnesses. The etiology of such microbiome alterations in critical illnesses is multifactorial. The interaction or systemic host defense modulation between distant organs and the gut microbiome is increasingly studied in disease research. No treatment modality exists to significantly enhance the gut epithelial integrity, permeability, or mucus layer in critically ill patients. However, multiple helpful approaches including clinical and preclinical strategies exist. Enteral nutrition is associated with an increased mucosal barrier in animal and human studies. The trophic effects of enteral nutrition might help to maintain the intestinal physiology, prevent atrophy of gut villi, reduce intestinal permeability, and protect against ischemia-reperfusion injury. The microbiome approach such as the use of probiotics, fecal microbial transplantation, and selective decontamination of the digestive tract has been suggested. However, its evidence does not have a high quality. To promote rapid hypertrophy of the small bowel, various factors have been reported, including the epidermal growth factor, membrane permeant inhibitor of myosin light chain kinase, mucus surrogate, pharmacologic vagus nerve agonist, immune-enhancing diet, and glucagon-like peptide-2 as preclinical strategies. However, the evidence remains unclear.

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Updates on the treatment of adhesive capsulitis with hydraulic distension
Jang Hyuk Cho
Yeungnam Univ J Med. 2021;38(1):19-26.   Published online August 31, 2020
DOI: https://doi.org/10.12701/yujm.2020.00535
  • 8,605 View
  • 227 Download
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AbstractAbstract PDF
Adhesive capsulitis of the shoulder joint is a common disease characterized by pain at the insertional area of the deltoid muscle and decreased range of motion. The pathophysiological process involves fibrous inflammation of the capsule and intraarticular adhesion of synovial folds leading to capsular thickening and contracture. Regarding the multidirectional limitation of motion, a limitation in external rotation is especially prominent, which is related to not only global fibrosis but also to a localized tightness of the anterior capsule. Ultrasound and magnetic resonance imaging studies can be applied to rule out other structural lesions in the diagnosis of adhesive capsulitis. Hydraulic distension of the shoulder joint capsule provides pain relief and an immediate improvement in range of motion by directly expanding the capsule along with the infusion of steroids. However, the optimal technique for hydraulic distension is still a matter of controversy, with regards to the infusion volume and rupture of the capsule. By monitoring the real-time pressure-volume profile during hydraulic distension, the largest possible fluid volume can be infused without rupturing the capsule. The improvement in clinical outcomes is shown to be greater in capsule-preserved hydraulic distension than in capsule-ruptured distension. Moreover, repeated distension is possible, which provides additional clinical improvement. Capsule-preserved hydraulic distension with maximal volume is suggested to be an efficacious treatment option for persistent adhesive capsulitis.

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Classification of endometriosis
Soo-Young Lee, Yu-Jin Koo, Dae-Hyung Lee
Yeungnam Univ J Med. 2021;38(1):10-18.   Published online August 7, 2020
DOI: https://doi.org/10.12701/yujm.2020.00444
  • 22,014 View
  • 705 Download
  • 43 Crossref
AbstractAbstract PDF
Endometriosis is a chronic disease associated with pelvic pain and infertility. Several classification systems for the severity of endometriosis have been proposed. Of these, the revised American Society for Reproductive Medicine classification is the most well-known. The ENZIAN classification was developed to classify deep infiltrating endometriosis and focused on the retroperitoneal structures. The endometriosis fertility index was developed to predict the fertility outcomes in patients who underwent surgery for endometriosis. Finally, the American Association of Gynecological Laparoscopists classification is currently being developed, for which 30 endometriosis experts are analyzing and researching data by assigning scores to categories considered important; however, it has not yet been fully validated and published. Currently, none of the classification systems are considered the gold standard. In this article, we review the classification systems, identify their pros and cons, and discuss what improvements need to be made to each system in the future.

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Gallbladder polyps: evolving approach to the diagnosis and management
Kook Hyun Kim
Yeungnam Univ J Med. 2021;38(1):1-9.   Published online May 15, 2020
DOI: https://doi.org/10.12701/yujm.2020.00213
  • 22,390 View
  • 468 Download
  • 6 Crossref
AbstractAbstract PDF
Gallbladder (GB) polyp is a mucosal projection into the GB lumen. With increasing health awareness, GB polyps are frequently found using ultrasonography during health screening. The prevalence of GB polyps ranges between 1.3% and 9.5%. Most patients are asymptomatic and have benign characteristics. Of the nonneoplastic polyps, cholesterol polyps are most common, accounting for 60%–70% of lesions. However, a few polyps have malignant potential. Currently, the guidelines recommend laparoscopic cholecystectomy for polyps larger than 1 cm in diameter due to their malignan potential. The treatment algorithm can be influenced by the size, shape, and numbers of polyps, old age (>50 years), the presence of primary sclerosing cholangitis, and gallstones. This review summarizes the commonly recognized concepts on GB polyps from diagnosis to an algorithm of treatment.

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Frailty and elderly in urology: implications for postoperative complications
Phil Hyun Song
Yeungnam Univ J Med. 2020;37(4):296-301.   Published online October 8, 2020
DOI: https://doi.org/10.12701/yujm.2020.00752
  • 4,926 View
  • 56 Download
AbstractAbstract PDF
The geriatric population is at a greater risk of postoperative complications than young adults. This risk is associated with the physiologic decline seen in this population known as frailty. Unlike fitter patients, frail patients who undergo operative treatment have a greater likelihood of developing postoperative complications and endure prolonged hospital stays. This circumstance is comparable to the urological status. Therefore, tolerable measurement of frailty as a domain of preoperative health status has been suggested to ascertain vulnerability in elderly patients. In this review, we will elaborate on the concept of frailty and examine its importance with respect to surgical complications, focusing on the urological status.
Novel respiratory infectious diseases in Korea
Hyun Jung Kim
Yeungnam Univ J Med. 2020;37(4):286-295.   Published online September 23, 2020
DOI: https://doi.org/10.12701/yujm.2020.00633
  • 6,439 View
  • 76 Download
  • 4 Crossref
AbstractAbstract PDF
Respiratory infections are very common and highly contagious. Respiratory infectious diseases affect not only the person infected but also the family members and the society. As medical sciences advance, several diseases have been conquered; however, the impact of novel infectious diseases on the society is enormous. As the clinical presentation of respiratory infections is similar regardless of the pathogen, the causative agent is not distinguishable by symptoms alone. Moreover, it is difficult to develop a cure because of the various viral mutations. Various respiratory infectious diseases ranging from influenza, which threaten the health of mankind globally, to the coronavirus disease 2019, which resulted in a pandemic, exist. Contrary to human expectations that development in health care and improvement in hygiene will conquer infectious diseases, humankind’s health and social systems are threatened by novel infectious diseases. Owing to the development of transport and trading activity, the rate of spread of new infectious diseases is increasing. As respiratory infections can threaten the members of the global community at any time, investigations on preventing the transmission of these diseases as well as development of effective antivirals and vaccines are of utmost importance and require a worldwide effort.

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Diagnosis and treatment of multidrug-resistant tuberculosis
Jong Geol Jang, Jin Hong Chung
Yeungnam Univ J Med. 2020;37(4):277-285.   Published online September 4, 2020
DOI: https://doi.org/10.12701/yujm.2020.00626
  • 15,591 View
  • 517 Download
  • 37 Crossref
AbstractAbstract PDF
Tuberculosis (TB) is still a major health problem worldwide. Especially, multidrug-resistant TB (MDR-TB), which is defined as TB that shows resistance to both isoniazid and rifampicin, is a barrier in the treatment of TB. Globally, approximately 3.4% of new TB patients and 20% of the patients with a history of previous treatment for TB were diagnosed with MDR-TB. The treatment of MDR-TB requires medications for a long duration (up to 20–24 months) with less effective and toxic second-line drugs and has unfavorable outcomes. However, treatment outcomes are expected to improve due to the introduction of a new agent (bedaquiline), repurposed drugs (linezolid, clofazimine, and cycloserine), and technological advancement in rapid drug sensitivity testing. The World Health Organization (WHO) released a rapid communication in 2018, followed by consolidated guidelines for the treatment of MDR-TB in 2019 based on clinical trials and an individual patient data meta-analysis. In these guidelines, the WHO suggested reclassification of second-line anti-TB drugs and recommended oral treatment regimens that included the new and repurposed agents. The aims of this article are to review the treatment strategies of MDR-TB based on the 2019 WHO guidelines regarding the management of MDR-TB and the diagnostic techniques for detecting resistance, including phenotypic and molecular drug sensitivity tests.

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Therapeutic potential of targeting kinase inhibition in patients with idiopathic pulmonary fibrosis
Suji Kim, Jae Hyang Lim, Chang-Hoon Woo
Yeungnam Univ J Med. 2020;37(4):269-276.   Published online July 22, 2020
DOI: https://doi.org/10.12701/yujm.2020.00458
  • 8,631 View
  • 240 Download
  • 4 Crossref
AbstractAbstract PDF
Fibrosis is characterized by excessive accumulation of extracellular matrix components. The fibrotic process ultimately leads to organ dysfunction and failure in chronic inflammatory and metabolic diseases such as pulmonary fibrosis, advanced kidney disease, and liver cirrhosis. Idiopathic pulmonary fibrosis (IPF) is a common form of progressive and chronic interstitial lung disease of unknown etiology. Pathophysiologically, the parenchyma of the lung alveoli, interstitium, and capillary endothelium becomes scarred and stiff, which makes breathing difficult because the lungs have to work harder to transfer oxygen and carbon dioxide between the alveolar space and bloodstream. The transforming growth factor beta (TGF-) signaling pathway plays an important role in the pathogenesis of pulmonary fibrosis and scarring of the lung tissue. Recent clinical trials focused on the development of pharmacological agents that either directly or indirectly target kinases for the treatment of IPF. Therefore, to develop therapeutic targets for pulmonary fibrosis, it is essential to understand the key factors involved in the pathogenesis of pulmonary fibrosis and the underlying signaling pathway. The objective of this review is to discuss the role of kinase signaling cascades in the regulation of either TGF--dependent or other signaling pathways, including Rho-associated coiled-coil kinase, c-jun N-terminal kinase, extracellular signal-regulated kinase 5, and p90 ribosomal S6 kinase pathways, and potential therapeutic targets in IPF.

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JYMS : Journal of Yeungnam Medical Science