Journal of Yeungnam Medical Science

Volume 29(2); December 2012

Reviews

Obesity and Insulin Resistance in Childhood.: Kwang Hae Choi; Yeungnam Univ J Med. 2012;29(2):73-76. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.73

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Abstract PDF: More and more children are becoming obese and overweight due to several factors that include a high energy density in the diet (a high fat intake) and low energy expenditure. Consequently childhood obesity is becoming a significant health problem. Fat tissue releases many cytokines such as resistin, tumor necrosis factor-alpha, leptin, interleukin-6. These adipocytokines induce obesity-related insulin resistance. Insulin resistance is a key component of obesity-related metabolic problems such as hypertension, type 2 diabetes mellitus, dyslipidemia, non-alcoholic steatohepatitis, acanthosis nigricans and polycystic ovarian syndrome. This review article focused on insulin resistance and its related metabolic diseases.

Effects of AMP-activated Protein Kinase Activating Compounds and Its Mechanism.: Hyoung Chul Choi; Yeungnam Univ J Med. 2012;29(2):77-82. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.77

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AMP-activated protein kinase (AMPK) is an important cellular fuel sensor. Its activation requires phosphorylation at Thr-172, which resides in the activation loop of the alpha1 and alpha2 subunits. Several AMPK upstream kinases are capable of phosphorylating AMPK at Thr-172, including LKB1 and CaMKKbeta (Ca2+/calmodulin-dependent protein kinase kinasebeta). AMPK has been implicated in the regulation of physiological signals, such as in the inhibition of cholesterol fatty acid, and protein synthesis, and enhancement of glucose uptake and blood flow. AMPK activation also exhibits several salutary effects on the vascular function and improves vascular abnormalities. AMPK is modulated by numerous hormones and cytokines that regulate the energy balance in the whole body. These hormone and cytokines include leptin, adiponectin, ghrelin, and even thyroid hormones. Moreover, AMPK is activated by several drugs and xenobiotics. Some of these are in being clinically used to treat type 2 diabetes (e.g., metformin and thiazolidinediones), hypertension (e.g., nifedipine and losartan), and impaired blood flow (e.g., aspirin, statins, and cilostazol). I reviewed the precise mechanisms of the AMPK activation pathway and AMPK-modulating drugs.

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Enhanced Anti-Inflammatory and Non-Alcoholic Fatty Liver Disease (NAFLD) Improvement Effects of Bacillus subtilis-Fermented Fagopyrum tataricum Gaertner
Chan-Hwi Park, Hyun Kang, Sung-Gyu Lee
Fermentation.2024; 10(3): 116. CrossRef
The Effect of Chaenomelis Fructus Extract on Thioacetamide-Induced Liver Fibrosis
Jin A Lee, Se Hui Lee, Mi-Rae Shin, Jeong Sook Noh, Seong-Soo Roh
Journal of the Korean Society of Food Science and Nutrition.2021; 50(8): 757. CrossRef

Original Articles

Usefulness of the BACTEC MGIT 960 System for Mycobacterial Culture and TB Ag MPT64 Immunochromatographic Assay to Identify Mycobacterium tuberculosis.: Seung Hun Lee, Min Jeong Lee, Jeong Mi Lee, Su Jin Yim, Seung Jun Lee, You Eun Kim, Yu Ji Cho, Yi Yeong Jeong, Ho Cheol Kim, Jong Deog Lee, Sun Joo Kim, Young Sil Hwang; Yeungnam Univ J Med. 2012;29(2):83-88. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.83

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Abstract PDF

BACKGROUND
This study was conducted to evaluate the usefulness of the BACTEC MGIT (Mycobacterium Growth Indicator Tube) 960 system for mycobacteria culture and immunochromatographic assay to identify Mycobacterium tuberculosis (MTB) in positive MGIT culture. METHODS: Mycobacteria-culture-positive cases were retrospectively analyzed from December 2010 to July 2011. The detection rates and the recovery times of the mycobacteria between the Ogawa media and the MGIT were compared. An immunochromatographic assay (ICA) (SD BIO-LINE) was also performed in the positive MGIT culture for identification, and the results were compared with those of the Ogawa media in the Korea National Tuberculosis Association. RESULTS: Among the 261 patients (M:F, 168:93; mean age, 61.6+/-17.16 yrs), 450 specimens (sputa, 365; bronchial washing, 61; and pleural effusion, 24) were found positive with mycobacteria. Mycobacteria were grown both on the MGIT and Ogawa media in 310 cases (68.9%); only on the MGIT in 115 cases (22.6%); and only on the Ogawa media in 25 cases (5.5%) (p<0.05).The recovery time was 28.2+/-8.9 days in the Ogawa media and 11.1+/-5.8 days in the MGIT (p<0.05). Among the 127 cases from the positive MGIT culture, all 92 cases that were confirmed as MTB cases bythe Korea National Tuberculosis Association were identified as MTB by ICA, with 100% sensitivity. CONCLUSION: MGIT increases the detection rate and shortens the recovery time of mycobacteria in clinical respiratory specimens, and the TB Ag MPT64 kit using ICA is useful in identifying MTB in a positive MGIT culture.

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A Low Cost/Low Power Open Source Sensor System for Automated Tuberculosis Drug Susceptibility Testing
Kyukwang Kim, Hyeong Kim, Hwijoon Lim, Hyun Myung
Sensors.2016; 16(6): 942. CrossRef

Presumptive Diagnosis of Mycoplasma pneumoniae Pneumonia in Children.: Chang Eon Lee, Su Jin Park, Won Duck Kim; Yeungnam Univ J Med. 2012;29(2):89-95. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.89

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Abstract PDF: BACKGROUND
As Mycoplasma pneumoniae pneumonia has increased in Korea, its relevance to infants, toddlers, and adolescents has magnified as well as. However, it is difficult to perform the serological test and PCR test routinely for diagnosis in actual clinical practice. Thus, the authors conducted this study to help clinicians do presumptive diagnosis of Mycoplasma pneumoniae pneumonia using clinical, radiological, and hematological findings. METHODS: The study population consisted of 224 children between 1 month and 14 years old, hospitalized for radiographically confirmed pneumonia. Patients were divided into two groups of 100 children with Mycoplasma pneumoniae pneumonia, as diagnosed using the ELISA method. Groups with negative result in Mycoplasma IgM antibody test were classified into the viral group (98 patients with respiratory virus) and the bacterial group (46 patients with the bacteria detected in the blood sputum culture or antibiotic treatment except macrolide improved the patient's condition). These groups were compared and analyzed using clinical, hematological,and radiographic differences and scoring system. RESULTS: Clinical, hematological, and radiographic characteristics of Mycoplasma pneumoniae pneumonia have shown the intermediate level results between bacterial pneumonia and viral pneumonia. In terms of scoring system, the mean score of Mycoplasma pneumoniae pneumonia was 4.23, which was the intermediate level between bacterial pneumonia (mean score=6.67) and viral pneumonia (mean score=1.48). CONCLUSION: Results suggest that the combination of the scoring system information can increase the accuracy in the diagnosis even if they may have difficulties on diagnosis, because clinical manifestations, hematological, and radiographic findings are nonspecific.

Case Reports

Long-Term Complete Remission in an Acute Myeloid Leukemia Patient with Isolated Central Nervous System Relapse after Allogeneic Hematopoietic Stem Cell Transplantation.: Myung Jin Kim, Sung Ae Ko, Hyo Jin Jang, Da Eun Jeong, Jeung Min Park, Kyoung Hee Lee, Min Kyoung Kim, Young Kyung Bae, Myung Soo Hyun; Yeungnam Univ J Med. 2012;29(2):96-101. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.96

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Abstract PDF

Allogeneic hematopoietic stem cell transplantation (HSCT) is considered the optimal curative treatment for acute myeloid leukemia (AML), but some patients develop bone marrow relapse due to remnant leukemia, and few patients develop extramedullary relapse without bone marrow relapse. Isolated extramedullary relapse (IMER) is defined as extramedullary relapse without bone marrow relapse. IMER has been reported in various sites, including the skin, soft tissue, and central nervous system(CNS). Isolated CNS relapse is relatively rare and is associated with poor prognosis due to the absence of an optimal treatment for it. Reported herein is a case involving an adult AML woman who suffered from isolated extramedullary relapse in the CNS after allogeneic HSCT. She was treated with intrathecal chemotherapy and whole-brain and spine radiotherapy, followed by systemic chemotherapy. She is currently well, with no evidence of leukemia recurrence for over six years.

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Post-transplant leukemia relapse in organs: biology. and behavior in 585 reports
Isabel Cunningham
Critical Reviews in Oncology/Hematology.2021; 157: 103170. CrossRef

A Case of Idiopathic Collapsing Glomerulopathy Showing Aggravation on a Chronic Progressive Course.: Jung Min Park, Mun Ju Hwang, Yo Han Jeong, Hansol Lee, Jong Won Park, Yong Jin Kim; Yeungnam Univ J Med. 2012;29(2):102-105. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.102

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Abstract PDF: Collapsing glomerulopathy (CG) has become an important cause of end-stage renal disease (ESRD). First delineated from other proteinuric glomerular lesions in the 1980s, CG is now recognized as a common, distinct pattern of proliferative parenchymal injury that portends a rapid loss of renal function and poor responses to empirical therapy. The first cases in the literature trace back to human-immunodeficiency-virus (HIV)-negative patients who underwent biopsy in 1979. A 45-year-old male patient complained of hematuria and proteinuria eight years ago. He showed an abrupt serum creatinine increase from 1.75 to 2.65mg/dL in the last preceding months. Afterwards, his serum creatinine progressively increased up to 6.82mg/dL. Moreover, his 24 h urine protein level was determined to have reached 6,171 mg/day, as opposed to 670 mg/day a year earlier. Consequently, renal biopsy was performed, and its result showed collapsing glomerulopathy, compatible with the diagnosis. He has undergone continuous ambulatory peritoneal dialysis as renal replacement therapy. Thus, it is reported herein that a patient clinically diagnosed with chronic kidney disease eight years ago showed a sudden renal-function decrease and was clinicopathologically diagnosed with collapsing glomerulopathy based on the results of his renal biopsy.

Simultaneous Actinomycosis with Mucormycosis in Maxillary Sinus.: Han Sol Lee, Min Jung Kim, Seung Il Bae, Jung Min Park, Myung Soo Hyun, Choong Ki Lee, Jian Hur; Yeungnam Univ J Med. 2012;29(2):106-109. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.106

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Abstract PDF: Actinomycosis is a rare subacute-to-chronic infection that causes sinus fistula, tract, or abscess due to the invasion surrounding the soft tissue. Actinomyces colonize the mouth, colon, and vagina. Mucosal disruption may lead to infection at virtually any site in the body. Cervicofacial infection accounts for 50-60% of all actinomycosis cases. The mandible and nasopharynx are the sites of predilection, but maxillary sinus infection is rare. Reported herein is a case involving a 57-year-old female with acute myeloid leukemia who had simultaneous actinomycosis with mucormycosis in the maxillary sinus.

A Case of Small Bowel Intussusception Caused by Jejunal Hamartoma Confused as Hepatitis A in an Adult.: Joon Hur, Gu Min Cho, Young Ook Eum, Ji Young Park, Mi Sung Kim, Byung Seong Ko, Hyang Mi Shin, Seung Myoung Son; Yeungnam Univ J Med. 2012;29(2):110-112. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.110

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Abstract PDF: Intussusception in adult is a rare disease and laparotomy is usually considered because of the probability of malignancy. Especially with obstruction symptom or sign, it might be needed emergency operation. This case was a simultaneous development of small bowel intussusception and acute hepatitis A. The patient had abdominal pain and vomiting. Intitial laboratory examination with elevated aminotransferase revealed that the diagnosis was acute hepatitis. As managing acute hepatitis, the abdominal pain was not improved and the patient had tenderness on periumbilical area on physical examination. A jejunal intussusception with a lead point was proved on the abdominal computed tomography scan. Fortunately, symptom of intussusception was relieved while nulli per os (NPO) and intravenous hydration. After recovery of acute hepatitis, laparotomy was done. The lead point was 2.5x3.0 cm sized hamartoma. This was the case that the symptom of intussusception was confused with that of acute hepatitis.

A Case of Primary Aldosteronism Accompanied by Hypokalemic Rhabdomyolysis.: Hong Ik Kim, Sang Ah Baek, Hyun Sik Hwang, Woo Hyun Lee, Gun Woo Kang, In Hee Lee; Yeungnam Univ J Med. 2012;29(2):113-117. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.113

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Abstract PDF

Primary aldosteronism is characterized by hypertension, hypokalemia, and metabolic alkalosis, associated with excessive aldosterone production and suppressed plasma renin activity. Hypokalemia-induced rhabdomyolysis has been rarely reported in primary aldosteronism patients. This paper reports a case of primary aldosteronism presented with rhabdomyolysis due to severe hypokalemia. A 48-year-old male with a three-year history of hypertension presented himself at the authors' hospital with generalized weakness and myalgia in both legs over a period of several days. His laboratory findings showed hypokalemia (1.8 mEq/L) with elevations of his serum creatine phosphokinase and serum myoglobin. His plasma aldosterone level was also elevated, and his plasma renin activity was reduced. An abdominal computed tomography revealed a 2.0 cm hypodense mass in the left adrenal gland, which suggested adrenal adenoma. The accordingly underwent laparoscopic adrenalectomy. Three months later, his plasma potassium level and blood pressure became normal without the use of medications.

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Primary Aldosteronism Presenting as Hypokalemia and Rhabdomyolysis
Kee Hong Park, Soo-Kyung Kim, Eun Bin Cho, Heejeong Jeong, Nack-Cheon Choi, Oh-Young Kwon, Byeong Hoon Lim, Jong Ryeal Hahm, Ki-Jong Park
Korean Journal of Clinical Neurophysiology.2016; 18(1): 21. CrossRef

Early Stage Loeffler's Endocarditis Detected by Transthoracic Echocardiography.: Min Kyu Kang, Won Jong Park, Sung Yun Jung, Su Mi Kim, Tae Hun Kwon, Young Ha Ryu, Jang Won Son, Dong Gu Shin; Yeungnam Univ J Med. 2012;29(2):118-120. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.118

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Abstract PDF: Loeffler's endocarditis involves progressive eosinophilic infiltration of the endocardium, which leads to apical thrombotic obliteration of the ventricle and endomyocardial fibrosis, that may finally represent a characteristic feature of restrictive cardiomyopathy. This paper presents a case of a 44-year-old male with symptoms of dyspnea and peripheral hypereosinophilia, who was diagnosed with early stage Loeffler's endocarditis via multicardiac imaging modalities.

A Case of Neurotoxicity Induced by Valaciclovir in a Continuous Ambulatory Peritoneal Dialysis Patient.: Joon Seok Kim, Jee Eun Yang, Bo Young Lee, Seohyun Lee, Hee Jung Park, Sunpyo Lee, Sang Koo Lee; Yeungnam Univ J Med. 2012;29(2):121-124. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.121

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Abstract PDF

Valaciclovir is metabolized to acyclovir after ingestion and thereafter exerts its antiviral activity. Because of its superior pharmacokinetic profile, it has quickly replaced acyclovir in the treatment of herpesvirus infection. Neurotoxicity caused by valaciclovir has been reported, however, among patients with pre-existing impaired renal function. This paper reports a case of neurotoxicity of valaciclovir in a patient with end-stage renal disease who was undergoing continuous ambulatory peritoneal dialysis (CAPD). A 67-year-old female on CAPD took 500 mg of valaciclovir twice for herpes zoster. After she took her second dose orally, she developed confusion and disorientation, along with involuntary movements. Her mental confusion progressed to a coma. Discontinuation of valaciclovir showed no rapid improvement. There- fore, hemodialysis was started. After two sessions of hemodialysis, the patient became alert; and after four sessions of hemodialysis, her neurological abnormalities were completely reversed. In conclusion, valaciclovir can induce life-threatening neurotoxicity, especially in CAPD patients, even with appropriate dose reduction, which can be effectively managed by hemodialysis.

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Comparison of Renal Function Indicators According to Hydration Volume in Patients Receiving Intravenous Acyclovir With CNS Infection
Sanghee Kim, Youngsoon Byun
Biological Research For Nursing.2015; 17(1): 55. CrossRef
Valacyclovir-Induced Neurotoxicity in a Maintenance Hemodialysis Patient
June Seong Hwang, Hyo Yoep Song, Hoon Gil Jo, Song I Lee, Byung Hun Lim, Jung Sub Song, Seon Ho Ahn
Journal of the Korean Geriatrics Society.2014; 18(2): 85. CrossRef

Retroperitoneal Hemorrhage after Thrombolysis in ST Elevation Myocardial Infarction.: Min Young Moon, Jong Young Lee, Sung Hyun Won, Jeong Seok Kim, Kwang Woo Nam, Chang Lae Kim, Jin Seo Lee, Won Jun Ji; Yeungnam Univ J Med. 2012;29(2):125-128. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.125

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Abstract PDF: Bleeding is the most common and serious complication of thrombolysis in ST elevation myocardial infarction. Most bleeding cases are associated with an intervention or operation, but spontaneous bleeding such as gastro-intestinal bleeding or intracranial hemorrhage can happen. This is a report on the case of a 76-year-old female patient with retroperitoneal hemorrhage due to spontaneous right colic artery branch bleeding after thrombolysis in ST elevation myocardial infarction.

A Case of Successful Recovery from High Dose Intravenous Nicorandil Infusion in Refractory Coronary Vasospasm with Hemodynamic Collapse.: Won Jun Koh, Jeong Hyeon Cho, Ji Hyun Lee, Won Sik Kang, Min Kyung Lee, Jun Hyoung Kim, Deok Kyu Cho; Yeungnam Univ J Med. 2012;29(2):129-131. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.129

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Abstract PDF: A 70-year-old male came to the emergency room of the authors' hospital because of sudden cardiac arrest due to inferior wall ST elevation myocardial infarction. His coronary angiography revealed multiple severe coronary spasms in his very long left anterior descending artery. After an injection of intracoronary nitroglycerine, his stenosis improved. The cardiac arrest relapsed, however, accompanied by ST elevation of the inferior leads, while the patient was on diltiazem and nitrate medication to prevent coronary spasm. Recovery was not achieved even with cardiac massage, intravenous injection of epinephrine and atropine, and intravenous infusion of nitroglycerine. The patient eventually recovered through high-dose nicorandil intravenous infusion without ST elevation of his inferior leads. Therefore, intravenous infusion of a high dose of nicorandil must be considered a treatment option for cardiac arrest caused by refractory coronary vasospasm.

A Case of Adrenocortical Carcinoma Secreting Cortisol and Aldosterone.: Jiyoon Ha, Min Kyung Kim, Yoon Jin Cha, Seung Kyu Kim, Gi Young Yun, Kwangwon Rhee, Joon Seong Park, Eun Suk Cho, Chul Woo Ahn, Jong Suk Park; Yeungnam Univ J Med. 2012;29(2):132-135. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.132

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Abstract PDF: Adrenocortical carcinomas are rare and frequently aggressive tumors that may be functional (hormone-secreting) and may cause Cushing's syndrome or virilization, or non-functional and manifest as an abdominal mass. This paper reports the case of a 77-year-old woman with cortisol- and aldosterone-secreting adrenal carcinoma. The patient complained of general weakness, a moon face, and weight gain. She also had hypokalemia and hypertension. Her endocrinological data showed excessive aldosterone production and non-suppressible cortisol production in a low-dose dexamethasone suppresion test. Her abdominal CT showed a right adrenal mass. She underwent right adrenalectomy, and her histology revealed the presence of adrenocortical carcinoma. After adrenalectomy, her hypokalemia returned to normal and she is being treated with hydrocortisone.

A Case of Biliary Papillomatosis with Cystic Dilatation of Bile Duct.: Yoo Mi Park, Kwangwon Rhee, Sun Och Yoon, Ji Yoon Ha, So Young Park, Jung Ho Lee, Sung Ill Jang; Yeungnam Univ J Med. 2012;29(2):136-140. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.136

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Abstract PDF: A 61-year-old male who complained of right upper quadrant pain was referred to the authors for evaluation after his computed tomography suggested biliary adenocarcinoma. The lesion consisted of multiple cysts with papillary mass and peri-ampullay mass. The patient underwent an operation due to a clinical suspicion of biliary cystadenocarcinoma, but the pathology confirmed biliary papillomatosis (BP) after diagnosing intrahepatic papillary neoplasm with high-grade dysplasia and invasive adenocarcinoma with papillary neoplasm from the distal common bile duct to the duodenum. BP is a disease characterized by multiple papillary masses. Its cause has yet to be discovered. It commonly manifests as bile duct dilation but rarely as a ductal cystic change. Under computed tomography or magnetic resonance imaging, both the BP and the cystic neoplasm can show bile duct dilation and a papillary mass, which makes their differential diagnosis difficult. A confirmative diagnosis can be made through a pathologic examination. BP is classified as a benign disease that can become malignant and may recur, though rarely. Its treatment of choice is surgical resection. Laser ablation or photodynamic therapy can be used for unresectable lesions. In the case featured in this paper, biliary papillomatosis was difficult to differentiate from cystic adenocarcinoma due to diffusely scattered multiple large cystic lesions in the liver, and it was histologically confirmed to have become malignant with cystic duct dilation after the operation. This case is reported herein with a literature review.

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