Journal of Yeungnam Medical Science

From articles published in Journal of Yeungnam Medical Science during the past 2 years (2022 ~ ).

Original article

Increase in blood glucose level and incidence of diabetic ketoacidosis in children with type 1 diabetes mellitus in the Daegu-Gyeongbuk area during the coronavirus disease 2019 (COVID-19) pandemic: a retrospective cross-sectional study: Mi Seon Lee, Rosie Lee, Cheol Woo Ko, Jung Eun Moon; J Yeungnam Med Sci. 2022;39(1):46-52. Published online August 26, 2021; DOI: https://doi.org/10.12701/yujm.2021.01221

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Background
The coronavirus disease 2019 (COVID-19) outbreak in the Daegu-Gyeongbuk area in 2020 has caused difficulties in the daily life and hospital care of children with type 1 diabetes mellitus (T1DM). We detected an increase in blood sugar levels in these children and the number of patients hospitalized with more severe diabetic ketoacidosis (DKA) compared to those before COVID-19.
Methods
This single-center study was conducted at Kyungpook National University Children’s Hospital. The following patient groups were included; 45 returning patients diagnosed with T1DM and undergoing insulin treatment for more than 2 years and 20 patients newly diagnosed with T1DM before and after COVID-19 were selected by age matching. Returning patients before and after the outbreak were selected, and changes in hemoglobin A1c (HbA1c) levels were retrospectively reviewed. The HbA1c levels and severity of symptoms in newly diagnosed patients during hospitalization were examined.
Results
HbA1c levels in returning patients with T1DM were significantly increased after COVID-19 (before, 7.70%±1.38% vs. after, 8.30%±2.05%; p=0.012). There were 10 and 10 newly diagnosed patients before and after COVID-19, respectively. The proportion of patients with drowsiness and dyspnea at the time of admission was higher after COVID-19 than before (before, 2 of 10 vs. after, 4 of 10). The HbA1c levels were higher in newly diagnosed patients hospitalized after COVID-19 than before (before, 11.15% vs. after, 13.60%; p=0.036).
Conclusion
Due to COVID-19 in the Daegu-Gyeongbuk area, there was an increase in blood glucose levels in children with T1DM and in the incidence of severe DKA in newly diagnosed diabetes mellitus patients.

Citations

Citations to this article as recorded by

Incidence of diabetic ketoacidosis during COVID-19 pandemic: a meta-analysis of 124,597 children with diabetes
Anas Elgenidy, Ahmed K. Awad, Khaled Saad, Mostafa Atef, Hatem Helmy El-Leithy, Ahmed A. Obiedallah, Emad M. Hammad, Faisal-Alkhateeb Ahmad, Ahmad M. Ali, Hamad Ghaleb Dailah, Amira Elhoufey, Samaher Fathy Taha
Pediatric Research.2023; 93(5): 1149. CrossRef
Comments on Rahmati et al., The global impact of COVID‐19 pandemic on the incidence of pediatric new‐onset type 1 diabetes and ketoacidosis: A systematic review and meta‐analysis. J Med Virol. 2022; 1‐16 (doi: 10.1002/jmv.27996)
Joachim Rosenbauer, Anna Stahl‐Pehe, Sabrina Schlesinger, Oliver Kuß
Journal of Medical Virology.2023;[Epub] CrossRef
Impact of the COVID-19 Pandemic on Children and Adolescents with New-Onset Type 1 Diabetes
Clemens Kamrath, Alexander J. Eckert, Reinhard W. Holl, Joachim Rosenbauer, Andrea Scaramuzza
Pediatric Diabetes.2023; 2023: 1. CrossRef
Difficulties in differential diagnosis of carbohydrate metabolism disorders in patients with coronavirus infection in real clinical practice. Case report
Tatyana N. Markova, Mukhamed S. Stas, Valentina V. Chibisova, Anastasia A. Anchutina
Consilium Medicum.2023; 25(4): 241. CrossRef
Endocrinological Involvement in Children and Adolescents Affected by COVID-19: A Narrative Review
Valeria Calcaterra, Veronica Maria Tagi, Raffaella De Santis, Andrea Biuso, Silvia Taranto, Enza D’Auria, Gianvincenzo Zuccotti
Journal of Clinical Medicine.2023; 12(16): 5248. CrossRef
Glycemic control and complications of type 2 diabetes mellitus in children and adolescents during the COVID-19 outbreak
Kyeong Eun Oh, Yu Jin Kim, Ye Rim Oh, Eungu Kang, Hyo-Kyoung Nam, Young-Jun Rhie, Kee-Hyoung Lee
Annals of Pediatric Endocrinology & Metabolism.2023; 28(4): 275. CrossRef
Incidence of Diabetic Ketoacidosis Among Pediatrics With Type 1 Diabetes Prior to and During COVID-19 Pandemic: A Meta-Analysis of Observational Studies
Osamah M. Alfayez, Kholood S. Aldmasi, Nada H. Alruwais, Nouf M. Bin Awad, Majed S. Al Yami, Omar A. Almohammed, Abdulaali R. Almutairi
Frontiers in Endocrinology.2022;[Epub] CrossRef
Comparison of Initial Presentation of Pediatric Diabetes Before and During the Coronavirus Disease 2019 Pandemic Era
Yoonha Lee, Minseung Kim, Kyeongeun Oh, Eungu Kang, Young-Jun Rhie, Jieun Lee, Yong Hee Hong, Young-Lim Shin, Jae Hyun Kim
Journal of Korean Medical Science.2022;[Epub] CrossRef
The global impact of COVID‐19 pandemic on the incidence of pediatric new‐onset type 1 diabetes and ketoacidosis: A systematic review and meta‐analysis
Masoud Rahmati, Maryam Keshvari, Shahrzad Mirnasuri, Dong K. Yon, Seung W. Lee, Jae Il Shin, Lee Smith
Journal of Medical Virology.2022; 94(11): 5112. CrossRef
COVID-19 and diabetes: What do we know so far?
Prakash Gangadaran, Himabindu Padinjarathil, Shri Hari Subhashri Rajendran, Manasi P Jogalekar, Chae Moon Hong, Baladhandapani Aruchamy, Uma Maheswari Rajendran, Sridharan Gurunagarajan, Anand Krishnan, Prasanna Ramani, Kavimani Subramanian
Experimental Biology and Medicine.2022; 247(15): 1330. CrossRef
Stress hyperglycemia, Diabetes mellitus and COVID-19 infection: The impact on newly diagnosed type 1 diabetes
Ioanna Farakla, Theano Lagousi, Michael Miligkos, Nicolas C. Nicolaides, Ioannis-Anargyros Vasilakis, Maria Mpinou, Maria Dolianiti, Elina Katechaki, Anilia Taliou, Vasiliki Spoulou, Christina Kanaka-Gantenbein
Frontiers in Clinical Diabetes and Healthcare.2022;[Epub] CrossRef

Review articles

The mechanism of action of pulsed radiofrequency in reducing pain: a narrative review: Donghwi Park, Min Cheol Chang; J Yeungnam Med Sci. 2022;39(3):200-205. Published online April 7, 2022; DOI: https://doi.org/10.12701/jyms.2022.00101

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Abstract PDF

Pain from nervous or musculoskeletal disorders is one of the most common complaints in clinical practice. Corticosteroids have a high pain-reducing effect, and their injection is generally used to control various types of pain. However, they have various adverse effects including flushing, hyperglycemia, allergic reactions, menstrual changes, immunosuppression, and adrenal suppression. Pulsed radiofrequency (PRF) is known to have a pain-reducing effect similar to that of corticosteroid injection, with nearly no major side effects. Therefore, it has been widely used to treat various types of pain, such as neuropathic, joint, discogenic, and muscle pain. In the current review, we outlined the pain-reducing mechanisms of PRF by reviewing previous studies. When PRF was first introduced, it was supposed to reduce pain by long-term depression of pain signaling from the peripheral nerve to the central nervous system. In addition, deactivation of microglia at the level of the spinal dorsal horn, reduction of proinflammatory cytokines, increased endogenous opioid precursor messenger ribonucleic acid, enhancement of noradrenergic and serotonergic descending pain inhibitory pathways, suppression of excitation of C-afferent fibers, and microscopic damage of nociceptive C- and A-delta fibers have been found to contribute to pain reduction after PRF application. However, the pain-reducing mechanism of PRF has not been clearly and definitely elucidated. Further studies are warranted to clarify the pain-reducing mechanism of PRF.

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A narrative review of pulsed radiofrequency for the treatment of carpal tunnel syndrome
Himanshu Gupta, Colm Vance, Vishal Bansal, Ahilraj Siva
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Pulsed Radiofrequency for Auriculotemporal Neuralgia: A Case Report
Yan Tereshko, Enrico Belgrado, Christian Lettieri, Simone Dal Bello, Giovanni Merlino, Gian Luigi Gigli, Mariarosaria Valente
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Transforaminal pulsed radiofrequency and epidural steroid injection on chronic lumbar radiculopathy: A prospective observational study from a tertiary care hospital in Vietnam
Viet-Thang Le, Phuoc Trong Do, Vu Duc Nguyen, Luan Trung Nguyen Dao, Ipek Saadet Edipoglu
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Comparison of two distinct needle tip positions in pulsed radiofrequency for herpes zoster‐related pain
Shao‐jun Li, Dan Feng
CNS Neuroscience & Therapeutics.2023; 29(7): 1881. CrossRef
Previous Lumbar Spine Surgery Decreases the Therapeutic Efficacy of Dorsal Root Ganglion Pulsed Radiofrequency in Patients with Chronic Lumbosacral Radicular Pain
Jiri Jandura, Milan Vajda, Roman Kostysyn, Jiri Vanasek, Eva Cermakova, Jan Zizka, Pavel Ryska
Journal of Personalized Medicine.2023; 13(7): 1054. CrossRef
Spinal Injections: A Narrative Review from a Surgeon’s Perspective
Dong Ah Shin, Yoo Jin Choo, Min Cheol Chang
Healthcare.2023; 11(16): 2355. CrossRef
Pulsed Radiofrequency 2 Hz Preserves the Dorsal Root Ganglion Neuron Physiological Ca2+ Influx, Cytosolic ATP Level, Δψm, and pERK Compared to 4 Hz: An Insight on the Safety of Pulsed Radiofrequency in Pain Management
Ristiawan Muji Laksono, Taufiq Agus Siswagama, Fa'urinda Riam Prabu Nery, Walter van der Weegen, Willy Halim
Journal of Pain Research.2023; Volume 16: 3643. CrossRef
Summary of the 48th KORSIS Symposium in 2023
Min Cheol Chang
International journal of Pain.2023; 14(2): 96. CrossRef
The blind spot and challenges in pain management
Min Cheol Chang
Journal of Yeungnam Medical Science.2022; 39(3): 179. CrossRef
Use of QR Codes for Promoting a Home-Based Therapeutic Exercise in Patients with Lumbar Disc Herniation and Lumbar Spinal Stenosis: A Prospective Randomized Study
Min Cheol Chang, Donghwi Park, Yoo Jin Choo
Journal of Pain Research.2022; Volume 15: 4065. CrossRef

Current diagnosis and treatment of vestibular neuritis: a narrative review: Chang Hoon Bae, Hyung Gyun Na, Yoon Seok Choi; J Yeungnam Med Sci. 2022;39(2):81-88. Published online August 9, 2021; DOI: https://doi.org/10.12701/yujm.2021.01228

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Abstract PDF

Vertigo is the sensation of self-motion of the head or body when no self-motion is occurring or the sensation of distorted self-motion during an otherwise normal head movement. Representative peripheral vertigo disorders include benign paroxysmal positional vertigo, Ménière disease, and vestibular neuritis. Vestibular neuritis, also known as vestibular neuronitis, is the third most common peripheral vestibular disorder after benign paroxysmal positional vertigo and Ménière disease. The cause of vestibular neuritis remains unclear. However, a viral infection of the vestibular nerve or ischemia of the anterior vestibular artery is known to cause vestibular neuritis. In addition, recent studies on immune-mediated mechanisms as the cause of vestibular neuritis have been reported. The characteristic clinical features of vestibular neuritis are abrupt true-whirling vertigo lasting for more than 24 hours, and no presence of cochlear symptoms and other neurological symptoms and signs. To accurately diagnose vestibular neuritis, various diagnostic tests such as the head impulse test, bithermal caloric test, and vestibular-evoked myogenic potential test are conducted. Various treatments for vestibular neuritis have been reported, which are largely divided into symptomatic therapy, specific drug therapy, and vestibular rehabilitation therapy. Symptomatic therapies include generalized supportive care and administration of vestibular suppressants and antiemetics. Specific drug therapies include steroid therapy, antiviral therapy, and vasodilator therapy. Vestibular rehabilitation therapies include generalized vestibular and customized vestibular exercises.

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Vestibular function is associated with immune inflammatory response
Zhaohui Song, Yuchuan Ding, Nathan Sim, Ho Jun Yun, Jing Feng, Pan Gu, Xiaokun Geng
Reviews in the Neurosciences.2024; 35(3): 293. CrossRef
Prevalence of Scarpa’s ganglion enhancement on high-resolution MRI imaging
Clayton Siminski, John C Benson, Matthew L Carlson, John I Lane
The Neuroradiology Journal.2024;[Epub] CrossRef
Vestibular rehabilitation for peripheral vestibular hypofunction: an interdisciplinary consensus
N.L. Kunelskay, G.E. Ivanova, E.V. Baybakova, A.L. Guseva, V.A. Parfenov, M.V. Zamergrad, O.V. Zaitseva, O.A. Melnikov, A.A. Shmonin, M.N. Maltseva
Vestnik otorinolaringologii.2024; 89(1): 52. CrossRef
Vertigo in the Setting of COVID-19 Infection: A Case Report
Sanjana Devaragudi, Mohit Gupta
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Hospital Admission Profile Related to Inner Ear Diseases in England and Wales
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Symptom of vertigo and dizziness in patients with COVID-19
E. V. Isakova
Russian neurological journal.2023; 28(4): 5. CrossRef
VESTIBULAR NEURONITIS: A CLINICAL EXAMPLE OF THE COURSE OF THE DISEASE USING BIOFEEDBACK (BOS)
Geraskina M.M., Razzhivina K.S., Ustinov S.A.
"Medical & pharmaceutical journal "Pulse".2023; : 30. CrossRef
Acute vestibular neuritis: A rare complication after the adenoviral vector-based COVID-19 vaccine
Hamze Shahali, Ramin Hamidi Farahani, Parham Hazrati, Ebrahim Hazrati
Journal of NeuroVirology.2022; 28(4-6): 609. CrossRef
A Holistic Approach to a Dizzy Patient: A Practical Update
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Identification of hub genes and pathophysiological mechanism related to acute unilateral vestibulopathy by integrated bioinformatics analysis
Yajing Cheng, Jianrong Zheng, Ying Zhan, Cong Liu, Bihua Lu, Jun Hu
Frontiers in Neurology.2022;[Epub] CrossRef

The use of platelet-rich plasma in management of musculoskeletal pain: a narrative review: Aung Chan Thu; J Yeungnam Med Sci. 2022;39(3):206-215. Published online June 8, 2022; DOI: https://doi.org/10.12701/jyms.2022.00290

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Abstract PDF

Musculoskeletal pain is the most common pain reported by patients. Platelet-rich plasma (PRP) is widely used to treat musculoskeletal pain. However, the efficacy of PRP to treat this pain remains controversial. This review highlights the application of PRP in the treatment of musculoskeletal pain. PRP treatment appears to reduce pain and improve function in patients with musculoskeletal pain. However, there are limitations to the currently published studies. These limitations include the PRP preparation methods, type of activators, types of pathology to be treated, methods and times of administration, and association of PRP with other treatments.

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Restraint stress-associated gastrointestinal injury and implications from the Evans blue-fed restraint stress mouse model
Der-Shan Sun, Te-Sheng Lien, Hsin-Hou Chang
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Injections of Platelet-Rich Plasma: An Emerging Novel Biological Cure for Low Back Pain?
Adarsh Jayasoorya , Nitin Samal, Gajanan Pisulkar, Kaustav Datta, Kevin Kawde
Cureus.2024;[Epub] CrossRef
Platelet-Rich Plasma in the Management of Temporomandibular Joint Pain in Young Adults With Temporomandibular Disorder
Santosh Kumar Mathpati, Gourav Jain, Vijay Mishra, Atul K Singh, Rahul Mishra, Bipin K Yadav
Cureus.2024;[Epub] CrossRef
Potentials and impact of platelet-rich plasma (PRP) on the regenerative properties of muscle tissue
V. H. Dzhyvak, I. M. Klishch, O. I. Khlibovska, S. S. Levenets
Biopolymers and Cell.2024; 40(1): 3. CrossRef
Injectable Lyophilized Chitosan-Thrombin-Platelet-Rich Plasma (CS-FIIa-PRP) Implant to Promote Tissue Regeneration: In Vitro and Ex Vivo Solidification Properties
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Polymers.2023; 15(13): 2919. CrossRef
Systematic Review of Platelet-Rich Plasma for Low Back Pain
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Biomedicines.2023; 11(9): 2404. CrossRef
Potential Mechanism of Platelet-rich Plasma Treatment on Testicular Problems Related to Diabetes Mellitus
Rista Dwi Hermilasari, Dicky Moch Rizal, Yohanes Widodo Wirohadidjojo
Prague Medical Report.2023; 124(4): 344. CrossRef
The blind spot and challenges in pain management
Min Cheol Chang
Journal of Yeungnam Medical Science.2022; 39(3): 179. CrossRef

Pain in amyotrophic lateral sclerosis: a narrative review: Soyoung Kwak; J Yeungnam Med Sci. 2022;39(3):181-189. Published online June 8, 2022; DOI: https://doi.org/10.12701/jyms.2022.00332

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Abstract PDF

Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative condition characterized by loss of motor neurons, resulting in motor weakness of the limbs and/or bulbar muscles. Pain is a prevalent but neglected symptom of ALS, and it has a significant negative impact on the quality of life of patients and their caregivers. This review outlines the epidemiology, clinical characteristics, underlying mechanisms, and management strategies of pain in ALS to improve clinical practice and patient outcomes related to pain. Pain is a prevalent symptom among patients with ALS, with a variable reported prevalence. It may occur at any stage of the disease and can involve any part of the body without a specific pattern. Primary pain includes neuropathic pain and pain from spasticity or cramps, while secondary pain is mainly nociceptive, occurring with the progression of muscle weakness and atrophy, prolonged immobility causing degenerative changes in joints and connective tissue, and long-term home mechanical ventilation. Prior to treatment, the exact patterns and causes of pain must first be identified, and the treatment should be tailored to each patient. Treatment options can be classified into pharmacological treatments, including nonsteroidal anti-inflammatory drugs, antiepileptic drugs, drugs for cramps or spasticity, and opioid; and nonpharmacological treatments, including positioning, splints, joint injections, and physical therapy. The development of standardized and specific assessment tools for pain-specific to ALS is required, as are further studies on treatments to reduce pain, diminish suffering, and improve the quality of life of patients with ALS.

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Health-related quality of life across disease stages in patients with amyotrophic lateral sclerosis: results from a real-world survey
Katie Stenson, T. E. Fecteau, L. O’Callaghan, P. Bryden, J. Mellor, J. Wright, L. Earl, O. Thomas, H. Iqbal, S. Barlow, S. Parvanta
Journal of Neurology.2024;[Epub] CrossRef
Amyotrophic Lateral Sclerosis and Pain: A Narrative Review from Pain Assessment to Therapy
Vincenzo Pota, Pasquale Sansone, Sara De Sarno, Caterina Aurilio, Francesco Coppolino, Manlio Barbarisi, Francesco Barbato, Marco Fiore, Gianluigi Cosenza, Maria Beatrice Passavanti, Maria Caterina Pace, Enzo Emanuele
Behavioural Neurology.2024; 2024: 1. CrossRef
Likely Pathogenic Variants of Cav1.3 and Nav1.1 Encoding Genes in Amyotrophic Lateral Sclerosis Could Elucidate the Dysregulated Pain Pathways
Zsófia Flóra Nagy, Balázs Sonkodi, Margit Pál, Péter Klivényi, Márta Széll
Biomedicines.2023; 11(3): 933. CrossRef
Palliative Care in Amyotrophic Lateral Sclerosis
Sebastiano Mercadante, Lou'i Al-Husinat
Journal of Pain and Symptom Management.2023; 66(4): e485. CrossRef
The blind spot and challenges in pain management
Min Cheol Chang
Journal of Yeungnam Medical Science.2022; 39(3): 179. CrossRef
Synucleinopathy in Amyotrophic Lateral Sclerosis: A Potential Avenue for Antisense Therapeutics?
Bradley Roberts, Frances Theunissen, Francis L. Mastaglia, P. Anthony Akkari, Loren L. Flynn
International Journal of Molecular Sciences.2022; 23(16): 9364. CrossRef
Herbal medicine and acupuncture relieved progressive bulbar palsy for more than 3 years: A case report
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Medicine.2022; 101(45): e31446. CrossRef

Home mechanical ventilation in children with chronic respiratory failure: a narrative review: Soyoung Kwak; J Yeungnam Med Sci. 2023;40(2):123-135. Published online May 27, 2022; DOI: https://doi.org/10.12701/jyms.2022.00227

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Abstract PDF

Advances in perinatal and pediatric intensive care and recent advances in mechanical ventilation during the last two decades have resulted in an exponential increase in the number of children undergoing home mechanical ventilation (HMV) treatment. Although its efficacy in chronic respiratory failure is well established, HMV in children is more complex than that in adults, and there are more considerations. This review outlines clinical considerations for HMV in children. The goal of HMV in children is not only to correct alveolar hypoventilation but also to maximize development as much as possible. The modes of ventilation and ventilator settings, including ventilation masks, tubing, circuits, humidification, and ventilator parameters, should be tailored to the patient’s individual characteristics. To ensure effective HMV, education for the parent and caregiver is important. HMV continues to change the scope of treatment for chronic respiratory failure in children in that it decreases respiratory morbidity and prolongs life spans. Further studies on this topic with larger scale and systemic approach are required to ensure the better outcomes in this population.

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Indications and practice of home invasive mechanical ventilation in children
Secahattin Bayav, Nazan Çobanoğlu
Pediatric Pulmonology.2024;[Epub] CrossRef
Rehabilitation in children with home invasive mechanical ventilation
Aysun Genç, Birkan Sonel Tur
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Transitioning children using home invasive mechanical ventilation from hospital to home: Discharge criteria, disparities, and ethical considerations
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Mask interfaces and devices for home noninvasive ventilation in children
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The follow‐up of children on home invasive mechanical ventilation after hospital discharge
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Identifying and managing psychosocial problems in children on home invasive mechanical ventilation
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Hepatic ischemia-reperfusion injury with respect to oxidative stress and inflammatory response: a narrative review: Eun Kyung Choi, Dong Gun Lim; J Yeungnam Med Sci. 2023;40(2):115-122. Published online March 21, 2022; DOI: https://doi.org/10.12701/jyms.2022.00017

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Abstract PDF

Hepatic ischemia-reperfusion injury is a major complication of liver transplantation, trauma, and shock. This pathological condition can lead to graft dysfunction and rejection in the field of liver transplantation and clinical hepatic dysfunction with increased mortality. Although the pathological mechanisms of hepatic ischemia-reperfusion injury are very complex, and several intermediators and cells are involved in this phenomenon, oxidative stress and inflammatory responses are the key processes that aggravate hepatic injury. This review summarizes the current understanding of oxidative stress and inflammatory responses and, in that respect, addresses the therapeutic approaches to attenuate hepatic ischemia-reperfusion injury.

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International Immunopharmacology.2022; 113: 109185. CrossRef
Molecularly Designed Ion-Imprinted Nanoparticles for Real-Time Sensing of Cu(II) Ions Using Quartz Crystal Microbalance
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Biomimetics.2022; 7(4): 191. CrossRef

Ocular adnexal mucosa-associated lymphoid tissue lymphoma: a narrative review: Hyun Uk Chung, Jun Hyuk Son; J Yeungnam Med Sci. 2022;39(1):3-11. Published online September 15, 2021; DOI: https://doi.org/10.12701/yujm.2021.01263

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Abstract PDF

Lymphoma is the most common primary tumor of the orbit, accounting for 55% of all orbital malignancies. When divided into histopathological subtypes, extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) comprises the largest proportion. Clinical manifestations are unspecific, but in patients with slow-growing painless orbital mass, or red conjunctival lesion suggestive of ‘salmon patch’, ocular adnexa lymphoma (OAL) should be suspected. Although the pathogenetic mechanism of ocular adnexal MALT lymphoma (OAML) is not yet fully understood, the relationship between OAML and Chlamydia psittaci has been hypothesized recently, similar to that between gastric MALT lymphoma and Helicobacter pylori. This suggests a new treatment option for OAML; bacterial eradication therapy with systemic antibiotics. Several other treatment methods for OAML have been introduced, but no treatment guidelines have been established yet. In this article, we summarize the current knowledge on the clinical features, pathogenesis, diagnostic methods, therapeutic strategies, and prognosis of OAML.

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The Possible Role of Pathogens and Chronic Immune Stimulation in the Development of Diffuse Large B-Cell Lymphoma
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Radiomics analysis of T1WI and T2WI magnetic resonance images to differentiate between IgG4-related ophthalmic disease and orbital MALT lymphoma
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Original article

Impact of an emergency department resident strike during the coronavirus disease 2019 (COVID-19) pandemic in Daegu, South Korea: a retrospective cross-sectional study: Yo Han Cho, Jae Wan Cho, Hyun Wook Ryoo, Sungbae Moon, Jung Ho Kim, Sang-Hun Lee, Tae Chang Jang, Dong Eun Lee; J Yeungnam Med Sci. 2022;39(1):31-38. Published online August 10, 2021; DOI: https://doi.org/10.12701/yujm.2021.01130

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Abstract PDF

Background
To prepare for future work stoppages in the medical industry, this study aimed to identify the effects of healthcare worker strikes on the mortality rate of patients visiting the emergency department (ED) at six training hospitals in Daegu, Korea.
Methods
We used a retrospective, cross-sectional, multicenter design to analyze the medical records of patients who visited six training hospitals in Daegu (August 21–September 8, 2020). For comparison, control period 1 was set as the same period in the previous year (August 21–September 8, 2019) and control period 2 was set as July 1–19, 2020. Patient characteristics including age, sex, and time of ED visit were investigated along with mode of arrival, length of ED stay, and in-hospital mortality. The experimental and control groups were compared using t-tests, and Mann-Whitney U-test, chi-square test, and Fisher exact tests, as appropriate. Univariate logistic regression was performed to identify significant factors, followed by multivariate logistic regression analysis.
Results
During the study period, 31,357 patients visited the ED, of which 7,749 belonged to the experimental group. Control periods 1 and 2 included 13,100 and 10,243 patients, respectively. No significant in-hospital mortality differences were found between study periods; however, the results showed statistically significant differences in the length of ED stay.
Conclusion
The ED resident strike did not influence the mortality rate of patients who visited the EDs of six training hospitals in Daegu. Furthermore, the number of patients admitted and the length of ED stay decreased during the strike period.

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New England Journal of Medicine.2024; 390(3): 279. CrossRef
Experience of operating a medical humanities course at one medical school during the COVID-19: a retrospective study
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Journal of Yeungnam Medical Science.2023; 40(2): 179. CrossRef
A deliberative framework to assess the justifiability of strike action in healthcare
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Review article

Long-term management of Graves disease: a narrative review: Hyo-Jeong Kim; J Yeungnam Med Sci. 2023;40(1):12-22. Published online November 4, 2022; DOI: https://doi.org/10.12701/jyms.2022.00444

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Abstract PDF

Graves disease (GD) is the most common cause of hyperthyroidism, accounting for more than 90% of cases in Korea. Patients with GD are treated with any of the following: antithyroid drugs (ATDs), radioactive iodine (RAI) therapy, or thyroidectomy. Most patients begin treatment with ATDs, and clinical guidelines suggest that the appropriate treatment period is 12 to 18 months. While RAI treatment and surgery manage thyrotoxicosis by destroying or removing thyroid tissue, ATDs control thyrotoxicosis by inhibiting thyroid hormone synthesis and preserving the thyroid gland. Although ATDs efficiently control thyrotoxicosis symptoms, they do not correct the main etiology of GD; therefore, frequent relapses can follow. Recently, a large amount of data has been collected on long-term ATDs for GD, and low-dose methimazole (MMZ) is expected to be a good option for remission. For the long-term management of recurrent GD, it is important to induce remission by evaluating the patient’s drug response, stopping ATDs at an appropriate time, and actively switching to surgery or RAI therapy, if indicated. Continuing drug treatment for an extended time is now encouraged in patients with a high possibility of remission with low-dose MMZ. It is also important to pay attention to the quality of life of the patients. This review aimed to summarize the appropriate treatment methods and timing of treatment transition in patients who relapsed several times while receiving treatment for GD.

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Commentary: Azathioprine as an adjuvant therapy in severe Graves’ disease: a randomized controlled open-label clinical trial
Madhukar Mittal, Azher Rizvi
Frontiers in Endocrinology.2024;[Epub] CrossRef
Total Thyroidectomy – A Cost-effective Alternative to Anti-Thyroid Drugs in the Management of Grave's Disease
Erivelto Volpi, Leonardo M. Volpi
Clinical Thyroidology.2023; 35(5): 183. CrossRef
Evaluation of the Abbott Alinity i Thyroid-Stimulating Hormone Receptor Antibody (TRAb) Chemiluminescent Microparticle Immunoassay (CMIA)
Deborah J. W. Lee, Soon Kieng Phua, Yali Liang, Claire Chen, Tar-Choon Aw
Diagnostics.2023; 13(16): 2707. CrossRef
Mechanisms and Treatment Options for Hyperthyroid-Induced Osteoporosis: A Narrative Review
Robert M Branstetter, Rahib K Islam, Collin A Toups, Amanda N Parra, Zachary Lee, Shahab Ahmadzadeh, Giustino Varrassi, Sahar Shekoohi, Alan D Kaye
Cureus.2023;[Epub] CrossRef

Original article

A comparative study of the psychological impacts of tasks related and unrelated to COVID-19 on nurses: a cross-sectional study: Hyun Ji Kim, Geon Ho Lee; J Yeungnam Med Sci. 2022;39(3):216-222. Published online November 3, 2021; DOI: https://doi.org/10.12701/yujm.2021.01361

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Abstract PDF

Background
This study assessed the psychological impact of the outbreak of coronavirus disease 2019 (COVID-19) on university hospital nurses. It provides an assessment of mental health issues, including depression, anxiety, distress, and burnout of nurses dealing directly and indirectly with COVID-19.
Methods
In a web-based, cross-sectional study, 111 nurses from Daegu Catholic University Hospital in Korea were enrolled from August 4 to August 9, 2020. Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Impact of Event Scale-Revised, and Maslach Burnout Inventory were used to assess the psychological symptoms of depression, anxiety, psychological distress, and burnout among the study participants.
Results
Of 111 nurses, 35 (31.5%), nine (8.1%), 26 (23.4%), and 49 (44.1%) experienced depression, anxiety, distress, and burnout, respectively. Nurses who performed COVID-19–related tasks were more likely to have moderate depression (related vs. unrelated, 52.0% vs. 25.6%; p=0.037). There were no differences in anxiety, distress, and burnout between nurses with and without COVID-19–related tasks. More than 50% of the participants showed receptive and positive attitudes toward caring for COVID-19 patients.
Conclusion
Nurses who performed COVID-19–related tasks had a higher risk of depression. There were no significant differences in anxiety, distress, and burnout between the two groups. Since nurses who perform COVID-19–related tasks are more prone to psychological distress, continued psychiatric interventions are required for infectious disease outbreaks with a high mortality rate for healthcare workers who are emotionally vulnerable.

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Key predictors of psychological distress and wellbeing in Australian frontline healthcare workers during COVID-19 (Omicron wave)
Brian En Chyi Lee, Mathew Ling, Leanne Boyd, Craig A. Olsson, Jade Sheen
Frontiers in Psychology.2023;[Epub] CrossRef
Depression and burnout among Chinese nurses during COVID-19 pandemic: a mediation and moderation analysis model among frontline nurses and nonfrontline nurses caring for COVID-19 patients
Jingjun Wang, Xia Huang, Mengmeng Wang, Lei Huang, Ya Wang
BMC Psychiatry.2023;[Epub] CrossRef
Frontline nurses' burnout and its associated factors during the COVID-19 pandemic in South Korea
Eun-Young Noh, Yeon-Hwan Park, Young Jun Chai, Hyun Jeong Kim, Eunjin Kim
Applied Nursing Research.2022; 67: 151622. CrossRef
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International Journal of Environmental Research and Public Health.2022; 19(21): 13775. CrossRef

Case report

Adrenal insufficiency development during chemotherapy plus anti-programmed death receptor-1 monoclonal antibody (tislelizumab) therapy in patients with advanced gastric cancer: two case reports: Jin Ho Baek; J Yeungnam Med Sci. 2022;39(1):62-66. Published online April 19, 2021; DOI: https://doi.org/10.12701/yujm.2021.00934

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Abstract PDF

Immune checkpoint inhibitor (ICI)-associated adrenal insufficiency is rare but may become a serious adverse event in patients treated with ICIs. The present case report documents two cases of adrenal insufficiency developed during chemotherapy plus tislelizumab (百泽安, Baize’an; BeiGene Ltd.) therapy in patients with advanced gastric cancer. Adrenal insufficiency developed after 6 and 13 cycles of treatment and was well controlled with hydrocortisone. The patients also developed hypothyroidism, which was managed with levothyroxine. Two patients showed a partial response, and one patient out of two achieved a near-complete response, sustaining over 11 months. Increased awareness of ICI-related adrenal insufficiency is crucial for early detection and prompt management of patients treated with ICIs.

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Yisi Deng, Manling Huang, Runpei Deng, Jun Wang
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Severe thyrotoxicosis induced by tislelizumab: a case report and literature review
Liman Huo, Chao Wang, Haixia Ding, Xuelian Shi, Bin Shan, Ruoying Zhou, Ping Liang, Juan Hou
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Immune-related adverse events with severe pain and ureteral expansion as the main manifestations: a case report of tislelizumab-induced ureteritis/cystitis and review of the literature
Qihao Zhou, Zhiquan Qin, Peiyuan Yan, Qunjiang Wang, Jing Qu, Yun Chen
Frontiers in Immunology.2023;[Epub] CrossRef
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Focused Review article

The pathophysiology of diabetic foot: a narrative review: Jiyoun Kim; J Yeungnam Med Sci. 2023;40(4):328-334. Published online October 5, 2023; DOI: https://doi.org/10.12701/jyms.2023.00731

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Abstract PDF

An aging population and changes in dietary habits have increased the incidence of diabetes, resulting in complications such as diabetic foot ulcers (DFUs). DFUs can lead to serious disabilities, substantial reductions in patient quality of life, and high financial costs for society. By understanding the etiology and pathophysiology of DFUs, their occurrence can be prevented and managed more effectively. The pathophysiology of DFUs involves metabolic dysfunction, diabetic immunopathy, diabetic neuropathy, and angiopathy. The processes by which hyperglycemia causes peripheral nerve damage are related to adenosine triphosphate deficiency, the polyol pathway, oxidative stress, protein kinase C activity, and proinflammatory processes. In the context of hyperglycemia, the suppression of endothelial nitric oxide production leads to microcirculation atherosclerosis, heightened inflammation, and abnormal intimal growth. Diabetic neuropathy involves sensory, motor, and autonomic neuropathies. The interaction between these neuropathies forms a callus that leads to subcutaneous hemorrhage and skin ulcers. Hyperglycemia causes peripheral vascular changes that result in endothelial cell dysfunction and decreased vasodilator secretion, leading to ischemia. The interplay among these four preceding pathophysiological factors fosters the development and progression of infections in individuals with diabetes. Charcot neuroarthropathy is a chronic and progressive degenerative arthropathy characterized by heightened blood flow, increased calcium dissolution, and repeated minor trauma to insensate joints. Directly and comprehensively addressing the pathogenesis of DFUs could pave the way for the development of innovative treatment approaches with the potential to avoid the most serious complications, including major amputations.

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Diabetic foot – prevention and control challenges
Vitorino Modesto dos Santos, Taciana Arruda Modesto Sugai, Lister Arruda Modesto dos Santos
Belize Journal of Medicine.2024;[Epub] CrossRef
Integrated genetic analysis of diabetic complications: Bioinformatics insights into foot ulcers, neuropathy and peripheral artery disease
Jiaru Liang, Xiaoyang Gong, Xuyang Hu, Chong You, Jiaqi Zhou, Yuling Gao, Junwei Zong, Yong Liu
International Wound Journal.2024;[Epub] CrossRef
Unveiling the challenges of diabetic foot infections: diagnosis, pathogenesis, treatment, and rehabilitation
Chul Hyun Park
Journal of Yeungnam Medical Science.2023; 40(4): 319. CrossRef

Original article

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

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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.

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Wael I. Ibraheem
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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

Review article

Hepatic encephalopathy on magnetic resonance imaging and its uncertain differential diagnoses: a narrative review: Chun Geun Lim, Myong Hun Hahm, Hui Joong Lee; J Yeungnam Med Sci. 2023;40(2):136-145. Published online January 10, 2023; DOI: https://doi.org/10.12701/jyms.2022.00689

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Abstract PDF

Hepatic encephalopathy (HE) is a severe neuropsychiatric abnormality in patients with either acute or chronic liver failure. Typical brain magnetic resonance imaging findings of HE are bilateral basal ganglia high signal intensities due to manganese deposition in chronic liver disease and hyperintensity in T2, fluid-attenuated inversion recovery, or diffusion-weighted imaging (DWI) with hemispheric white matter changes including the corticospinal tract. Low values on apparent diffusion coefficient mapping of the affected area on DWI, indicating cytotoxic edema, can be observed in acute HE. However, neuropsychological impairment in HE ranges from mild deficits in psychomotor abilities affecting quality of life to stupor or coma with higher grades of hepatic dysfunction. In particular, the long-lasting compensatory mechanisms for the altered metabolism in chronic liver disease make HE imaging results variable. Therefore, the clinical relevance of imaging findings is uncertain and differentiating HE from other metabolic diseases can be difficult. The recent introduction of concepts such as “acute-on-chronic liver failure (ACLF),” a new clinical entity, has led to a change in the clinical view of HE. Accordingly, there is a need to establish a corresponding concept in the field of neuroimaging diagnosis. Herein, we review HE from a historical and etiological perspective to increase understanding of brain imaging and help establish an imaging approach for advanced new concepts such as ACLF. The purpose of this manuscript is to provide an understanding of HE by reviewing neuroimaging findings based on pathological and clinical concepts of HE, thereby assisting in neuroimaging interpretation.

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