Journal of Yeungnam Medical Science

Volume 37(4); October 2020

Editorial

Advances in the science and treatment of respiratory diseases: Jin Hong Chung; Yeungnam Univ J Med. 2020;37(4):251-252. Published online September 2, 2020; DOI: https://doi.org/10.12701/yujm.2020.00661

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Review articles

An update on the role of bronchoscopy in the diagnosis of pulmonary disease: June Hong Ahn; Yeungnam Univ J Med. 2020;37(4):253-261. Published online August 28, 2020; DOI: https://doi.org/10.12701/yujm.2020.00584

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Abstract PDF

Bronchoscopy has evolved over the past few decades and has been used by respiratory physicians to diagnose various airway and lung diseases. With the popularization of medical check-ups and growing interest in health, early diagnosis of lung diseases is essential. With the development of endobronchial ultrasound, ultrathin bronchoscopy, and electromagnetic navigational bronchoscopy, bronchoscopy has been able to widen its scope in diagnosing pulmonary diseases. In this review, we have described the brief history, role, and complications of bronchoscopy used in diagnosing pulmonary lesions, from simple flexible bronchoscopy to bronchoscopy combined with several up-to-date technologies.

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Disposable Versus Reusable Bronchoscopes: A Narrative Review of Cost-effectiveness, Risk of Cross-contamination and Environmental Impact
Illaa Smesseim, Johannes M.A. Daniels, Jouke Annema, Peter I. Bonta, Dirk-Jan Slebos
Archivos de Bronconeumología.2024; 60(4): 250. CrossRef
Flexible bronchoscopy indications and outcomes between indigenous and non‐indigenous patients in the Northern Territory of Australia
Mohammad M. Seyedshahabedin, Timothy P. Howarth, Lin Mo, Edwina Biancardi, Subash S. Heraganahally
Internal Medicine Journal.2023; 53(9): 1634. CrossRef
Endobronchial ultrasound‐guided re‐biopsy of non–small cell lung cancer with acquired resistance after EGFR tyrosine kinase inhibitor treatment
Kyung Soo Hong, Jinmo Cho, Jong Geol Jang, Min Hye Jang, June Hong Ahn
Thoracic Cancer.2023; 14(4): 363. CrossRef
Observational findings of transbronchial lung biopsy in patients with interstitial lung disease: a retrospective study in Aleppo University Hospital
Fateh Kashkash, Abdullah Khorri
Annals of Medicine & Surgery.2023; 85(2): 146. CrossRef
Invasive Diagnostic Procedures from Bronchoscopy to Surgical Biopsy—Optimization of Non-Small Cell Lung Cancer Samples for Molecular Testing
Nensi Lalić, Aleksandra Lovrenski, Miroslav Ilić, Olivera Ivanov, Marko Bojović, Ivica Lalić, Spasoje Popević, Mihailo Stjepanović, Nataša Janjić
Medicina.2023; 59(10): 1723. CrossRef
Utility of Radial Probe Endobronchial Ultrasound Guided Transbronchial Lung Biopsy in Bronchus Sign Negative Peripheral Pulmonary Lesions
Kyung Soo Hong, Kwan Ho Lee, Jin Hong Chung, Kyeong-Cheol Shin, Hyun Jung Jin, Jong Geol Jang, June Hong Ahn
Journal of Korean Medical Science.2021;[Epub] CrossRef
Radial Probe Endobronchial Ultrasound Using Guide Sheath-Guided Transbronchial Lung Biopsy in Peripheral Pulmonary Lesions without Fluoroscopy
Kyung Soo Hong, Heeyun Ahn, Kwan Ho Lee, Jin Hong Chung, Kyeong-Cheol Shin, Hyun Jung Jin, Jong Geol Jang, Seok Soo Lee, Min Hye Jang, June Hong Ahn
Tuberculosis and Respiratory Diseases.2021; 84(4): 282. CrossRef
Advances in the science and treatment of respiratory diseases
Jin Hong Chung
Yeungnam University Journal of Medicine.2020; 37(4): 251. CrossRef

Biological treatments for severe asthma: Hyun Jung Jin; Yeungnam Univ J Med. 2020;37(4):262-268. Published online September 11, 2020; DOI: https://doi.org/10.12701/yujm.2020.00647

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Abstract PDF

Severe asthma patients comprise about 3% to 13% of all asthma patients, but they have higher hospital utilization rates and higher medical costs than those of nonsevere asthma patients. Treatment methods for severe asthma patients are still lacking; however, the recent development of biologics is expected to have a positive effect. The biological therapies developed so far are mainly aimed at treating asthma patients with type 2 inflammation. These biologics have been found to reduce symptoms of asthma, improve lung function, reduce the use of oral corticosteroids, and improve quality of life of patients. This article reviews the mechanism of action and indications for approved biologics and discusses what should be considered when choosing biologics.

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The role of peripheral eosinophilia in diagnosing lung disorders: experience from a single pneumonological center
Justyna Fijołek, Elzbieta Wiatr, Dorota Piotrowska-Kownacka, Kazimierz Roszkowski-Sliz
Multidisciplinary Respiratory Medicine.2021;[Epub] CrossRef
Advances in the science and treatment of respiratory diseases
Jin Hong Chung
Yeungnam University Journal of Medicine.2020; 37(4): 251. CrossRef

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

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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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Targeting Growth Factor and Cytokine Pathways to Treat Idiopathic Pulmonary Fibrosis
Hongbo Ma, Shengming Liu, Shanrui Li, Yong Xia
Frontiers in Pharmacology.2022;[Epub] CrossRef
Vitamin D3 alleviates pulmonary fibrosis by regulating the MAPK pathway via targeting PSAT1 expression in vivo and in vitro
Wenxiang Zhu, Qi Ding, Lu Wang, Gonghao Xu, Yirui Diao, Sihao Qu, Sheng Chen, Yuanyuan Shi
International Immunopharmacology.2021; 101: 108212. CrossRef
Advances in the science and treatment of respiratory diseases
Jin Hong Chung
Yeungnam University Journal of Medicine.2020; 37(4): 251. CrossRef
Effects of Pirfenidone and Nintedanib on Markers of Systemic Oxidative Stress and Inflammation in Patients with Idiopathic Pulmonary Fibrosis: A Preliminary Report
Alessandro G. Fois, Elisabetta Sotgiu, Valentina Scano, Silvia Negri, Sabrina Mellino, Elisabetta Zinellu, Pietro Pirina, Gianfranco Pintus, Ciriaco Carru, Arduino A. Mangoni, Angelo Zinellu
Antioxidants.2020; 9(11): 1064. CrossRef

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

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Abstract 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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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

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Abstract 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.

Citations

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Barriers to and facilitators of populational adherence to prevention and control measures of COVID-19 and other respiratory infectious diseases: a qualitative evidence synthesis
Tácito Zaildo, Thayla Amorim Santino, Gabriela Chaves, Baldomero Antonio Kato da Silva, João Carlos Alchieri, Cecilia M. Patino, Sarah Leite, Kleber Giovanni Luz, Ricardo Oliveira Guerra, Tito Hugo Soares da Penha, Gabriel Rodrigues da Silva, Ada Cristina
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Da Hae Kim, Thi Mai Nguyen, Jin Hee Kim
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Advances in the science and treatment of respiratory diseases
Jin Hong Chung
Yeungnam University Journal of Medicine.2020; 37(4): 251. CrossRef

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

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Abstract 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.

Original articles

Usefulness of intraoperative determination of central lymph node metastasis by palpation in papillary thyroid cancer: Wan Wook Kim, Jeeyeon Lee, Jin Hyang Jung, Ho Yong Park, Won Hwa Kim, Hye Jung Kim, Ji-Young Park, Ralph P. Tufano; Yeungnam Univ J Med. 2020;37(4):302-307. Published online April 22, 2020; DOI: https://doi.org/10.12701/yujm.2020.00122

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Abstract PDF: Background
This study evaluated the usefulness of judgment of central lymph node (LN) metastasis by surgeon’s palpation in papillary thyroid cancer.
Methods
This study included 127 patients who underwent thyroidectomy and central compartment node dissection between October 2014 and February 2015. The criterion for suspicious LNs was hardness.
Results
Of the 20.5% (28/127) of suspicious for metastatic LNs according to surgeon determination, 92.8% (26/28) were confirmed to be metastatic in the final pathological examinations. Metastatic LNs were found in 38 (38.3%) of 99 patients without suspicious LNs, 29 of whom (76.3%) had micrometastases. The sensitivity, specificity, and positive and negative predictive values for the determination of LN metastasis by a surgeon were 40.6%, 96.8%, 92.9%, and 61.6%, respectively.
Conclusion
Determination of central LN metastasis by a surgeon’s palpation may be useful to evaluate LNs owing to the high specificity and positive predictive values, especially in macrometastasis or high-risk LN disease.

Clinical outcomes of hysterectomy for benign diseases in the female genital tract: 6 years’ experience in a single institute: Hyo-Shin Kim, Yu-Jin Koo, Dae-Hyung Lee; Yeungnam Univ J Med. 2020;37(4):308-313. Published online April 24, 2020; DOI: https://doi.org/10.12701/yujm.2020.00185

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Abstract PDF

Background
Hysterectomy is one of the major gynecologic surgeries. Historically, several surgical procedures have been used for hysterectomy. The present study aims to evaluate the surgical trends and clinical outcomes of hysterectomy performed for benign diseases at the Yeungnam University Hospital.
Methods
We retrospectively reviewed patients who underwent a hysterectomy for benign diseases from 2013 to 2018. Data included the patients’ demographic characteristics, surgical indications, hysterectomy procedures, postoperative pathologies, and perioperative outcomes.
Results
A total of 809 patients were included. The three major indications for hysterectomy were uterine leiomyoma, pelvic organ prolapse, and adenomyosis. The most common procedure was total laparoscopic hysterectomy (TLH, 45.2%), followed by open hysterectomy (32.6%). During the study period, the rate of open hysterectomy was nearly constant (29.4%–38.1%). The mean operative time was the shortest in the single-port laparoscopic assisted vaginal hysterectomy (LAVH, 89.5 minutes), followed by vaginal hysterectomy (VH, 96.8 minutes) and TLH (105 minutes). The mean decrease in postoperative hemoglobin level was minimum in single-port LAVH (1.8 g/dL) and VH (1.8 g/dL). Conversion to open surgery or multi-port surgery occurred in five cases (0.6%). Surgical complications including wound dehiscence, organ injuries, and conditions requiring reoperation were observed in 52 cases (6.4%).
Conclusion
Minimally invasive approach was used for most hysterectomies for benign diseases, but the rate of open hysterectomy has mostly remained constant. Single-port LAVH and VH showed the most tolerable outcomes in terms of operative time and postoperative drop in hemoglobin level in selected cases.

Citations

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Analysis of Different Routes of Hysterectomy Based on a Prospective Algorithm and Their Complications in a Tertiary Care Institute
Subrat Panda, Ananya Das, Rituparna Das, Nalini Sharma, Wansalan Shullai, Vinayak Jante, Anusuya Sharma, Kaushiki Singh, Prateeti Baruah, Ruksana Makakmayum, Imtiaz Wani
Minimally Invasive Surgery.2022; 2022: 1. CrossRef

Risk factors affecting amputation in diabetic foot: Jun Ho Lee, Ji Sung Yoon, Hyoung Woo Lee, Kyu Chang Won, Jun Sung Moon, Seung Min Chung, Yin Young Lee; Yeungnam Univ J Med. 2020;37(4):314-320. Published online May 6, 2020; DOI: https://doi.org/10.12701/yujm.2020.00129

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Abstract PDF

Background
A diabetic foot is the most common cause of non-traumatic lower extremity amputations (LEA). The study seeks to assess the risk factors of amputation in patients with diabetic foot ulcers (DFU).
Methods
The study was conducted on 351 patients with DFUs from January 2010 to December 2018. Their demographic characteristics, disease history, laboratory data, ankle-brachial index, Wagner classification, osteomyelitis, sarcopenia index, and ulcer sizes were considered as variables to predict outcome. A chi-square test and multivariate logistic regression analysis were performed to test the relationship of the data gathered. Additionally, the subjects were divided into two groups based on their amputation surgery.
Results
Out of the 351 subjects, 170 required LEA. The mean age of the subjects was 61 years and the mean duration of diabetes was 15 years; there was no significant difference between the two groups in terms of these averages. Osteomyelitis (hazard ratio [HR], 6.164; 95% confidence interval [CI], 3.561−10.671), lesion on percutaneous transluminal angioplasty (HR, 2.494; 95% CI, 1.087−5.721), estimated glomerular filtration rate (eGFR; HR, 0.99; 95% CI, 0.981−0.999), ulcer size (HR, 1.247; 95% CI, 1.107−1.405), and forefoot ulcer location (HR, 2.475; 95% CI, 0.224−0.73) were associated with risk of amputation.
Conclusion
Osteomyelitis, peripheral artery disease, chronic kidney disease, ulcer size, and forefoot ulcer location were risk factors for amputation in diabetic foot patients. Further investigation would contribute to the establishment of a diabetic foot risk stratification system for Koreans, allowing for optimal individualized treatment.

Citations

Citations to this article as recorded by

Efficacy of Chinese and Western Medical Techniques in Treating Diabetic Foot Ulcers With Necrotizing Fasciitis of the Lower Leg
Yongchong Chen, Yunzhu Wang, TaiAn Zhang, Chao Meng, Qing Li, Bohui Zhang, Kai Zhang, Chunfang Qin
The International Journal of Lower Extremity Wounds.2024; 23(1): 70. CrossRef
Classification of foot ulcers in people with diabetes: A systematic review
Matilde Monteiro‐Soares, Emma J. Hamilton, David A. Russell, Gulapar Srisawasdi, Edward J. Boyko, Joseph L. Mills, William Jeffcoate, Fran Game
Diabetes/Metabolism Research and Reviews.2024;[Epub] CrossRef
Renal function is highly associated with podiatric risk in diabetic patients
Jean-Baptiste Bonnet, Ilan Szwarc, Antoine Avignon, Sébastien Jugant, Ariane Sultan
Clinical Kidney Journal.2023; 16(11): 2156. CrossRef
Risk factor analysis for diabetic foot ulcer‐related amputation including Controlling Nutritional Status score and neutrophil‐to‐lymphocyte ratio
Yandan Zhu, Hongtao Xu, Yuzhen Wang, Xia Feng, Xinyu Liang, Liying Xu, Zhiqiang Liang, Zhongjia Xu, Yawen Li, Yi Le, Manchen Zhao, Jianfei Yang, Ji Li, Yemin Cao
International Wound Journal.2023; 20(10): 4050. CrossRef
The association between estimated glomerular filtration rate and prognosis in patients with diabetic foot osteomyelitis
Jinghang Zhang, Dong Chen, Xuemei Li, Min Ding, Jun Xu, Meijun Wang, Bai Chang
International Wound Journal.2022; 19(7): 1650. CrossRef
Renal Function Status in Patients with Diabetes Mellitus Having Diabetic Foot Infection and Role of Antibiotics
Shabab Hussain, . Arrham, Syeda Javeriya Saeed, Ahmad Murtaza Anwar, Asif Khan, Saifullah Brohi
Pakistan Journal of Health Sciences.2022; : 189. CrossRef
Re-understanding and focusing on normoalbuminuric diabetic kidney disease
Na An, Bi-tao Wu, Yu-wei Yang, Zheng-hong Huang, Jia-fu Feng
Frontiers in Endocrinology.2022;[Epub] CrossRef
The effects of curcumin intake on wound healing and metabolic status in patients with diabetic foot ulcer: A randomized, double‐blind, placebo‐controlled trial
Mehrdad Mokhtari, Reza Razzaghi, Mansooreh Momen‐Heravi
Phytotherapy Research.2021; 35(4): 2099. CrossRef
Prevalence of Sarcopenia and Its Association With Diabetes: A Meta-Analysis of Community-Dwelling Asian Population
Seung Min Chung, Jun Sung Moon, Min Cheol Chang
Frontiers in Medicine.2021;[Epub] CrossRef
Clinical outcomes among patients with chronic kidney disease hospitalized with diabetic foot disorders: A nationwide retrospective study
Michael Salim
Endocrinology, Diabetes & Metabolism.2021;[Epub] CrossRef

Perioperative outcomes of interrupted anticoagulation in patients with non-valvular atrial fibrillation undergoing non-cardiac surgery: Bo Eun Park, Myung Hwan Bae, Hyeon Jeong Kim, Yoon Jung Park, Hong Nyun Kim, Se Yong Jang, Jang Hoon Lee, Dong Heon Yang, Hun Sik Park, Yongkeun Cho, Shung Chull Chae; Yeungnam Univ J Med. 2020;37(4):321-328. Published online July 16, 2020; DOI: https://doi.org/10.12701/yujm.2020.00353

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Abstract PDF

Background
This study aimed to investigate the incidences of and risk factors for perioperative events following anticoagulant discontinuation in patients with non-valvular atrial fibrillation (NVAF) undergoing non-cardiac surgery.
Methods
A total of 216 consecutive patients who underwent cardiac consultation for suspending perioperative anticoagulants were enrolled. A perioperative event was defined as a composite of thromboembolism and major bleeding.
Results
The mean anticoagulant discontinuation duration was 5.7 (±4.2) days and was significantly longer in the warfarin group (p<0.001). Four perioperative thromboembolic (1.85%; three strokes and one systemic embolization) and three major bleeding events (1.39%) were observed. The high CHA2DS2-VASc and HAS-BLED scores and a prolonged preoperative anticoagulant discontinuation duration (4.4±2.1 vs. 2.9±1.8 days; p=0.028) were associated with perioperative events, whereas the anticoagulant type (non-vitamin K antagonist oral anticoagulants or warfarin) was not. The best cut-off levels of the HAS-BLED and CHA2DS2-VASc scores were 3.5 and 2.5, respectively, and the preoperative anticoagulant discontinuation duration for predicting perioperative events was 2.5 days. Significant differences in the perioperative event rates were observed among the four risk groups categorized according to the sum of these values: risk 0, 0%; risk 1, 0%; risk 2, 5.9%; and risk 3, 50.0% (p<0.001). Multivariate logistic regression analysis showed that the HAS-BLED score was an independent predictor for perioperative events.
Conclusion
Thromboembolic events and major bleeding are not uncommon during perioperative anticoagulant discontinuation in patients with NVAF, and interrupted anticoagulation strategies are needed to minimize these.

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Bleeding risk in female patients undergoing intravesical injection of onabotulinumtoxinA for overactive bladder: a Danish retrospective cohort study
Meryam El Issaoui, Sophia Elissaoui, Marlene Elmelund, Niels Klarskov
International Urogynecology Journal.2023; 34(10): 2581. CrossRef

Case reports

Negative myoclonus associated with tramadol use: Seong Yoon Bae, Se-Jin Lee; Yeungnam Univ J Med. 2020;37(4):329-331. Published online April 23, 2020; DOI: https://doi.org/10.12701/yujm.2020.00108

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Abstract PDF

Negative myoclonus (NM) is a shock-like jerky involuntary movement caused by a sudden, brief interruption of tonic muscle contraction. NM is observed in patients diagnosed with epilepsy, metabolic encephalopathy, and drug toxicity and in patients with brain lesions. A 55-year-old man presented with NM in both his arms and neck. He has taken medications containing tramadol at a dose of 80–140 mg/day for 5 days due to common cold. He had no history of seizures. Acute lesions were not observed during magnetic resonance imaging, and abnormal findings in his laboratory tests were not noted. His NM resolved completely after the discontinuation of tramadol and the oral administration of clonazepam. Our case report suggests that tramadol can cause NM in patients without seizure history or metabolic disorders, even within its therapeutic dose.

Citations

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Tramadol Induced Jerks
Waiz Wasey, Imad Aziz, Sharefi Saleh, Naila Manahil, Neha Wasey
Cureus.2021;[Epub] CrossRef

Prevention of thiopurine-induced early leukopenia in a Korean pediatric patient with Crohn’s disease who turned out to possess homozygous mutations in NUDT15 R139C: Jaewoan Bae, Byung-Ho Choe, Ben Kang; Yeungnam Univ J Med. 2020;37(4):332-336. Published online May 22, 2020; DOI: https://doi.org/10.12701/yujm.2020.00178

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Abstract PDF

Homozygous mutations in NUDT15 R139C are known as the major factor associated with thiopurine-induced early leukopenia, particularly in Asian patients. Therefore, NUDT15 genotyping is currently recommended before thiopurine treatment to identify patients who are NUDT15 poor metabolizers and consider the use of an alternative immunomodulatory therapy. We report a case of a 12-year-old Korean girl with Crohn’s disease (CD), in whom thiopurine-induced leukopenia was prevented by initiation of azathioprine (AZA) therapy at a low dose (0.5 mg/kg/day) and early detection of significant hair loss and white blood cell (WBC) count decrease at 17 days from the start of AZA treatment. The WBC count dropped from 8,970/μL to 3,370/μL in 2 weeks, and AZA treatment was stopped because of concerns of potential leukopenia in the near future. Her WBC count recovered to 5,120/μL after 3 weeks. Gene analysis later revealed that she had a homozygous mutation in NUDT15 R139C, resulting in a poor metabolizing activity of NUDT15. In situations when NUDT15 genotyping is unavailable, initiation of AZA therapy at 0.5 mg/kg/day with close observation of hair loss and WBC counts within 2 weeks may be an alternative way to prevent thiopurine-induced early leukopenia in Asian children with CD.

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Identification of Candidate Genes for Min Pig Villi Hair Traits by Genome-Wide Association of Copy Number Variation
Xinmiao He, Ming Tian, Wentao Wang, Yanzhong Feng, Zhongqiu Li, Jiahui Wang, Yan Song, Jinfeng Zhang, Di Liu
Veterinary Sciences.2023; 10(5): 307. CrossRef
Case report: NUDT15 polymorphism and severe azathioprine-induced myelosuppression in a young Chinese female with systematic lupus erythematosus: a case analysis and literature review
Juan Gu, Yupei Lin, Yuhe Wang
Frontiers in Pharmacology.2023;[Epub] CrossRef
KASL clinical practice guidelines for management of autoimmune hepatitis 2022

Clinical and Molecular Hepatology.2023; 29(3): 542. CrossRef

Ureterosciatic hernia causing obstructive uropathy successfully managed with minimally invasive procedures: Yeong Uk Kim, Jae Ho Cho, Phil Hyun Song; Yeungnam Univ J Med. 2020;37(4):337-340. Published online July 29, 2020; DOI: https://doi.org/10.12701/yujm.2020.00402

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Abstract PDF

Ureterosciatic hernia is extremely rare. In ureteral herniation, ureter prolapses occur through either the greater or lesser sciatic foramen. Atrophy of the piriformis muscle, hip joint diseases, and defects in the parietal pelvic fascia are predisposing factors for the development of ureterosciatic hernia. Most symptomatic patients have been treated surgically, with conservative treatment reserved only for asymptomatic patients. To the best of our knowledge, long-term follow-up outcomes after ureterosciatic hernia management are sparse. In this paper, we report the case of a 68-year-old woman who presented with colicky left abdominal pain. After computed tomography (CT) scan and anterograde pyelography, she was diagnosed ureterosciatic hernia with obstructive uropathy. We performed ureteral balloon dilatation and double-J ureteral stent placement. After this minimally invasive procedure, CT scan demonstrated that the left ureter had returned to its normal anatomical position without looping into the sciatic foramen. The patient remained asymptomatic with no adverse events 7 years after the minimally invasive procedures. This brief report describes ureterosciatic hernia successfully managed with minimally invasive procedures with long-term follow-up outcomes.

Citations

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Ureterosciatic Hernia in Focus: A Narrative Review of the Literature
Mohamed Mustafa, Afiq Pouzi, Peter Senada, Lokesh Suraparaju, Suresh Gupta
Cureus.2023;[Epub] CrossRef
Urosepsis secondary to ureterosciatic hernia corrected with ureteral stent placement: a case report and literature review
Kohei Kakimoto, Mayu Hikone, Ko Nagai, Jun Yamakawa, Kazuhiro Sugiyama, Yuichi Hamabe
International Journal of Emergency Medicine.2021;[Epub] CrossRef

Clinical characteristics of hereditary neuropathy with liability to pressure palsy presenting with monoparesis in the emergency department: Changho Kim, Jin-Sung Park; Yeungnam Univ J Med. 2020;37(4):341-344. Published online July 31, 2020; DOI: https://doi.org/10.12701/yujm.2020.00472

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Abstract PDF: Hereditary neuropathy with liability to pressure palsy (HNPP) is a rare neurological genetic disease caused by deletion of the peripheral myelin protein 22 gene and presents in childhood or young adulthood. We report four cases of HNPP with typical and rare presentations, reflecting the broad clinical spectrum of this disease. Two patients presented with mononeuropathies that are frequently observed in HNPP; the remaining two presented with bilateral neuropathy or mononeuropathy anatomically present in the deep layer. This reflects the broad clinical presentation of HNPP, and clinicians should differentiate these conditions in young patients with monoparesis or bilateral paresis. Although HNPP is currently untreatable, early diagnosis in the emergency department can lead to early detection, eventually resulting in less provocation and recurrence which may cause early motor nerve degeneration.

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