Journal of Yeungnam Medical Science

Original articles

DA-6034 ameliorates hepatic steatosis and inflammation in high fat diet-induced obese mice: Hong Min Kim, Mi-Hye Kwon, Eun Soo Lee, Kyung Bong Ha, Choon Hee Chung; J Yeungnam Med Sci. 2024;41(2):103-112. Published online March 15, 2024; DOI: https://doi.org/10.12701/jyms.2023.01389; Funded: National Research Foundation of Korea, Ministry of Science and ICT, Ministry of Education

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Abstract PDF: Background
Nonalcoholic fatty liver disease (NAFLD) is characterized by an increase in hepatic triglyceride content and increased inflammatory macrophage infiltration through the C-C motif chemokine receptor (CCR) 5 pathway in the liver. DA-6034 (7-carboxymethyloxy-3',4',5-trimethoxy flavone), is a synthetic derivative of eupatilin that exhibits anti-inflammatory activity in inflammatory bowel disease. However, the effect of DA-6034 on the inflammatory response in NAFLD is not well elucidated. Therefore, we aimed to determine the effect of DA-6034 on hepatic steatosis and inflammation.
Methods
Forty male C57BL/6J mice were divided into the following four groups: (1) regular diet (RD), (2) RD with DA-6034, (3) high fat diet (HFD), and (4) HFD with DA-6034. All mice were sacrificed 12 weeks after the start of the experiment. The effects of DA-6034 on macrophages were assessed using RAW264.7 cells.
Results
DA-6034 not only reduced hepatic triglyceride levels and lipid accumulation but also macrophage infiltration and proinflammatory cytokines in HFD-fed mice. According to fluorescence-activated cell sorter analysis, DA-6034 reduced the CD8+ T cell fraction in the liver of HFD-fed mice. DA-6034 also reduced CCR5 expression and the migration of liver macrophages in HFD-fed mice and inhibited CCR2 ligand and CCR4 ligand, which stimulated the migration of macrophages.
Conclusion
Overall, DA-6034 attenuates hepatic steatosis and inflammation in obesity by regulating CCR5 expression in macrophages.

Marginal fit of three different nanocomposite inlays fabricated with computer-aided design/computer-aided manufacturing (CAD/CAM) technology: a comparative study: Hyunsuk Choi, Jae-Young Jo, Min-Ho Hong; J Yeungnam Med Sci. 2024;41(2):80-85. Published online January 22, 2024; DOI: https://doi.org/10.12701/jyms.2023.00934; Funded: Catholic University of Pusan, Ministry of Trade, Industry and Energy, Korea Institute for the Advancement of Technology

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Abstract PDF: Background
This study aimed to compare and evaluate the marginal fit of nanocomposite computer-aided design/computer-aided manufacturing (CAD/CAM) inlays. Three types of nanocomposite CAD/CAM blocks (HASEM, VITA Enamic, and Lava Ultimate) were used as materials.
Methods
Class II disto-occlusal inlay restorations were prepared on a typodont mandibular right first molar using diamond rotary instruments. The inlays were fabricated using CAD/CAM technology and evaluated using the silicone replica technique to measure marginal gaps at five locations on each inlay. The data were analyzed by two-way analysis of variance and Tukey post hoc tests ( α=0.05).
Results
There were no significant differences in the marginal gaps based on the type of nanocomposite CAD/CAM inlay used (p=0.209). However, there was a significant difference in the marginal gaps between the measurement regions. The gingival region consistently exhibited a larger marginal gap than the axial and occlusal regions (p<0.001).
Conclusion
Within the limitations of this in vitro study, the measurement location significantly influenced the marginal fit of class II disto-occlusal inlay restorations. However, there were no significant differences in the marginal gaps among the different types of CAD/CAM blocks. Furthermore, the overall mean marginal fits of the class II disto-occlusal inlay restorations made with the three types of nanocomposite CAD/CAM blocks were within the clinically acceptable range.

Review article

Comprehensive overview of the role of mitochondrial dysfunction in the pathogenesis of acute kidney ischemia-reperfusion injury: a narrative review: Min-Ji Kim, Chang Joo Oh, Chang-Won Hong, Jae-Han Jeon; J Yeungnam Med Sci. 2024;41(2):61-73. Published online February 14, 2024; DOI: https://doi.org/10.12701/jyms.2023.01347; Funded: Kyungpook National University

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Abstract PDF: Acute kidney ischemia-reperfusion (IR) injury is a life-threatening condition that predisposes individuals to chronic kidney disease. Since the kidney is one of the most energy-demanding organs in the human body and mitochondria are the powerhouse of cells, mitochondrial dysfunction plays a central role in the pathogenesis of IR-induced acute kidney injury. Mitochondrial dysfunction causes a reduction in adenosine triphosphate production, loss of mitochondrial dynamics (represented by persistent fragmentation), and impaired mitophagy. Furthermore, the pathological accumulation of succinate resulting from fumarate reduction under oxygen deprivation (ischemia) in the reverse flux of the Krebs cycle can eventually lead to a burst of reactive oxygen species driven by reverse electron transfer during the reperfusion phase. Accumulating evidence indicates that improving mitochondrial function, biogenesis, and dynamics, and normalizing metabolic reprogramming within the mitochondria have the potential to preserve kidney function during IR injury and prevent progression to chronic kidney disease. In this review, we summarize recent advances in understanding the detrimental role of metabolic reprogramming and mitochondrial dysfunction in IR injury and explore potential therapeutic strategies for treating kidney IR injury.

Resident fellow section: Teaching images

Ultrasound assessment of a supraclavicular lipoma entrapping the brachial plexus: a diagnostic insight: Wei-Ting Wu, Ke-Vin Chang, Kamal Mezian, Vincenzo Ricci, Levent Özçakar; J Yeungnam Med Sci. 2024;41(1):58-60. Published online December 29, 2023; DOI: https://doi.org/10.12701/jyms.2023.01284; Funded: National Taiwan University Hospital Bei-Hu Branch, Ministry of Science and Technology, Taiwan, National Science and Technology, Taiwan, Taiwan Society of Ultrasound in Medicine

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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; Funded: National Research Foundation of Korea, Ministry of Science and ICT

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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.

Original article

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; Funded: Yeungnam University

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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.

Review article

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; Funded: National Research Foundation of Korea, Ministry of Education

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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

Original article

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; Funded: Kyungpook National University Research Fund

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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.

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; Funded: National Research Foundation of Korea, Ministry of Science and ICT

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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

Resident fellow section: Teaching images

Ultrasound-guided diagnosis/intervention for ischiofemoral impingement syndrome: Wei-Ting Wu, Ke-Vin Chang, Levent Özçakar; J Yeungnam Med Sci. 2023;40(Suppl):S134-S136. Published online July 12, 2023; DOI: https://doi.org/10.12701/jyms.2023.00500; Funded: National Taiwan University Hospital, Ministry of Science and Technology, Taiwan, Taiwan Society of Ultrasound in Medicine

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Original articles

Classification of dental implant systems using cloud-based deep learning algorithm: an experimental study: Hyun Jun Kong; J Yeungnam Med Sci. 2023;40(Suppl):S29-S36. Published online July 26, 2023; DOI: https://doi.org/10.12701/jyms.2023.00465; Funded: Wonkwang University

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Abstract PDF

Background
This study aimed to evaluate the accuracy and clinical usability of implant system classification using automated machine learning on a Google Cloud platform.
Methods
Four dental implant systems were selected: Osstem TSIII, Osstem USII, Biomet 3i Os-seotite External, and Dentsply Sirona Xive. A total of 4,800 periapical radiographs (1,200 for each implant system) were collected and labeled based on electronic medical records. Regions of interest were manually cropped to 400×800 pixels, and all images were uploaded to Google Cloud storage. Approximately 80% of the images were used for training, 10% for validation, and 10% for testing. Google automated machine learning (AutoML) Vision automatically executed a neural architecture search technology to apply an appropriate algorithm to the uploaded data. A single-label image classification model was trained using AutoML. The performance of the mod-el was evaluated in terms of accuracy, precision, recall, specificity, and F1 score.
Results
The accuracy, precision, recall, specificity, and F1 score of the AutoML Vision model were 0.981, 0.963, 0.961, 0.985, and 0.962, respectively. Osstem TSIII had an accuracy of 100%. Osstem USII and 3i Osseotite External were most often confused in the confusion matrix.
Conclusion
Deep learning-based AutoML on a cloud platform showed high accuracy in the classification of dental implant systems as a fine-tuned convolutional neural network. Higher-quality images from various implant systems will be required to improve the performance and clinical usability of the model.

Citations

Citations to this article as recorded by

Accuracy of Artificial Intelligence Models in Dental Implant Fixture Identification and Classification from Radiographs: A Systematic Review
Wael I. Ibraheem
Diagnostics.2024; 14(8): 806. CrossRef
A Comparative Analysis of Deep Learning-Based Approaches for Classifying Dental Implants Decision Support System
Mohammed A. H. Lubbad, Ikbal Leblebicioglu Kurtulus, Dervis Karaboga, Kerem Kilic, Alper Basturk, Bahriye Akay, Ozkan Ufuk Nalbantoglu, Ozden Melis Durmaz Yilmaz, Mustafa Ayata, Serkan Yilmaz, Ishak Pacal
Journal of Imaging Informatics in Medicine.2024;[Epub] CrossRef
Advancements in artificial intelligence algorithms for dental implant identification: A systematic review with meta-analysis
Ahmed Yaseen Alqutaibi, Radhwan S. Algabri, Dina Elawady, Wafaa Ibrahim Ibrahim
The Journal of Prosthetic Dentistry.2023;[Epub] CrossRef

Diagnostic performance of F-18 FDG PET or PET/CT for detection of recurrent gastric cancer: a systematic review and meta-analysis: Chang In Choi, Jae Kyun Park, Tae Yong Jeon, Dae-Hwan Kim; J Yeungnam Med Sci. 2023;40(Suppl):S37-S46. Published online August 17, 2023; DOI: https://doi.org/10.12701/jyms.2023.00220; Funded: Pusan National University

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Abstract PDF: Background
This systematic review and meta-analysis investigated the diagnostic performance of F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) or PET/computed tomography (PET/CT) for the detection of disease recurrence after curative resection of gastric cancer.
Methods
The PubMed and Embase databases, from the earliest available date of indexing through November 30, 2019, were searched for studies evaluating the diagnostic performance of F-18 FDG PET or PET/CT to detect recurrent disease after gastric cancer surgery.
Results
Across 17 studies (1,732 patients), the pooled sensitivity for F-18 FDG PET or PET/CT was 0.82 (95% confidence interval [CI], 0.74–0.88) with heterogeneity of I2=76.5 (p<0.001), and the specificity was 0.86 (95% CI, 0.78–0.91) with heterogeneity of I2=94.2 (p<0.001). Likelihood ratio (LR) tests gave an overall positive LR of 6.0 (95% CI, 3.6–9.7) and negative LR of 0.2 (95% CI, 0.14–0.31). The pooled diagnostic odds ratio was 29 (95% CI, 13–63). The summary receiver operating characteristic curve indicates that the area under the curve was 0.91 (95% CI, 0.88–0.93).
Conclusion
The current meta-analysis showed good sensitivity and specificity of F-18 FDG PET or PET/CT for detecting recurrent disease after curative resection of gastric cancer despite heterogeneity in ethnicity, recurrence rate, histology, and interpretation method.

Incidence and risk factors of deep vein thrombosis and pulmonary thromboembolism after spinal cord disease at a rehabilitation unit: a retrospective study: Yoonhee Kim, Minjae Jeong, Myung Woo Park, Hyun Iee Shin, Byung Chan Lee, Du Hwan Kim; J Yeungnam Med Sci. 2023;40(Suppl):S56-S64. Published online September 20, 2023; DOI: https://doi.org/10.12701/jyms.2023.00689; Funded: Health Fellowship Foundation

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Abstract PDF

Background
Deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) are major complications of spinal cord disease. However, studies of their incidence in Korean patients are limited. Thus, this study investigated the incidence and risk factors of DVT and PTE in Korean patients with spinal cord disease.
Methods
We retrospectively analyzed the medical records of 271 patients with spinal cord disease who were admitted to a rehabilitation unit within 3 months of disease onset at a tertiary hospital. The presence of DVT and PTE was mainly determined using Doppler ultrasonography and chest embolism computed tomography. Risk factor analysis included variables such as sex, age, obesity, completeness of motor paralysis, neurological level of injury, cause of injury, lower extremity fracture, active cancer, and functional ambulation category (FAC) score.
Results
The incidences of DVT and PTE in the patients with spinal cord disease were both 6.3%. Risk factor analysis revealed that age of ≥65 years (p=0.031) and FAC score of ≤1 (p=0.023) were significantly associated with DVT development. Traumatic cause of injury (p=0.028) and DVT (p<0.001) were significant risk factors of PTE.
Conclusion
Patients with spinal cord disease developed DVT and PTE within 3 months of disease onset with incidence rates of 6.3% and 6.3%, respectively. Age of ≥65 years and an FAC of score ≤1 were risk factors for DVT. Traumatic cause of injury and DVT were risk factors for PTE. However, given the inconsistent results of previous studies, the risk factors for DVT and PTE remain inconclusive. Therefore, early screening for DVT and PTE should be performed in patients with acute-to-subacute spinal cord disease regardless of the presence or absence of these risk factors.

Citations

Citations to this article as recorded by

Coagulation parameters correlate to venous thromboembolism occurrence during the perioperative period in patients with spinal fractures
Yong Jiao, Xiaohong Mu
Journal of Orthopaedic Surgery and Research.2023;[Epub] CrossRef

Case report

Intravesical bacillus Calmette–Guérin-induced myopathy presenting as rhabdomyolysis: a case report: Chae Hun Lee, Byeong Joo Choi, Jung Hun Kim, Tae Woong Yang, Gi Jeong Kim, Ha Young Shin, Se Hoon Kim, Seung Woo Kim; J Yeungnam Med Sci. 2023;40(4):430-434. Published online February 13, 2023; DOI: https://doi.org/10.12701/jyms.2022.00850; Funded: National Research Foundation of Korea, Ministry of Science, ICT and Future Planning

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Abstract PDF: Intravesical bacillus Calmette–Guérin (BCG) instillation is an adjuvant treatment for non–muscle-invasive urinary bladder cancer. Although most complications associated with BCG immunotherapy are mild and self-limiting, rare albeit serious complications have been reported. Only a few cases of BCG-related rhabdomyolysis have been reported. In this study, we present the case of a 72-year-old woman who developed severe weakness and hyperCKemia following intravesical BCG instillation. A muscle biopsy was performed, and a diagnosis of drug-induced myopathy was made.

Original article

Association between fatty liver disease and hearing impairment in Korean adults: a retrospective cross-sectional study: Da Jung Jung; J Yeungnam Med Sci. 2023;40(4):402-411. Published online June 26, 2023; DOI: https://doi.org/10.12701/jyms.2023.00304; Funded: Korea Health Industry Development Institute, Ministry of Health and Welfare

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Abstract PDF: Background
We hypothesized that fatty liver disease (FLD) is associated with a high prevalence of hearing loss (HL) owing to metabolic disturbances. This study aimed to evaluate the association between FLD and HL in a large sample of the Korean population.
Methods
We used a dataset of adults who underwent routine voluntary health checkups (n=21,316). Fatty liver index (FLI) was calculated using Bedogni’s equation. The patients were divided into two groups: the non-FLD (NFLD) group (n=18,518, FLI <60) and the FLD group (n=2,798, FLI ≥60). Hearing thresholds were measured using an automatic audiometer. The average hearing threshold (AHT) was calculated as the pure-tone average at four frequencies (0.5, 1, 2, and 3 kHz). HL was defined as an AHT of >40 dB.
Results
HL was observed in 1,370 (7.4%) and 238 patients (8.5%) in the NFLD and FLD groups, respectively (p=0.041). Compared with the NFLD group, the odds ratio for HL in the FLD group was 1.16 (p=0.040) and 1.46 (p<0.001) in univariate and multivariate logistic regression analyses, respectively. Linear regression analyses revealed that FLI was positively associated with AHT in both univariate and multivariate analyses. Analyses using a propensity score-matched cohort showed trends similar to those using the total cohort.
Conclusion
FLD and FLI were associated with poor hearing thresholds and HL. Therefore, active monitoring of hearing impairment in patients with FLD may be helpful for early diagnosis and treatment of HL in the general population.

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