Journal of Yeungnam Medical Science

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

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

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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.

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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

Editorial

Appreciation to peer reviewers in 2022: So-Young Park; J Yeungnam Med Sci. 2023;40(1):1-3. Published online January 13, 2023; DOI: https://doi.org/10.12701/jyms.2022.00920

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Journal of Yeungnam Medical Science is indexed in Emerging Sources Citation Index (ESCI)
So-Young Park
Journal of Yeungnam Medical Science.2023; 40(4): 317. CrossRef

Review article

Advances in management of pediatric chronic immune thrombocytopenia: a narrative review: Jae Min Lee; J Yeungnam Med Sci. 2023;40(3):241-246. Published online January 9, 2023; DOI: https://doi.org/10.12701/jyms.2022.00745

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Abstract PDF

Immune thrombocytopenia (ITP) is a disease in which thrombocytopenia occurs because of immune-mediated platelet destruction and decreased platelet production. Although many pediatric patients with ITP experience spontaneous remission or reach remission within 12 months of first-line therapy, approximately 20% progress to chronic ITP. Patients who do not respond to first-line treatment or experience frequent relapses are of great concern to physicians. This review summarizes recent treatments for second-line treatment of pediatric chronic ITP.

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Beta-Thalassemia with Initial Presentation as Immune Thrombocytopenia: A Case Report
Hyun Sik Kang
Clinical Pediatric Hematology-Oncology.2023; 30(1): 42. CrossRef

Case reports

Thallium poisoning: a case report: Oscar Jimenez, Hector Cáceres, Luis Gimenez, Luciana Soto, Micaela Montenegro, Jhon Alexander Avila Rueda; J Yeungnam Med Sci. 2023;40(3):311-314. Published online December 15, 2022; DOI: https://doi.org/10.12701/jyms.2022.00647

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Thallium poisoning is usually accidental. We present a case of a 51-year-old woman who was evaluated in June 2018 for myalgia, vertigo, asthenia, and abdominal pain. Physical examination revealed temporal-spatial disorientation, jaundice, and asterixis. The laboratory reported the following: bilirubin, 10.3 mg/dL; aspartate transaminase, 78 U/L; alanine transaminase, 194 U/L; albumin, 2.3 g/dL; prothrombin time, 40%; and platelet count, 60,000/mm3. Serology performed for hepatitis A, B, and C; Epstein-Barr virus; cytomegalovirus; and human immunodeficiency virus was negative, and a collagenogram was negative. Physical reevaluation revealed alopecia on the scalp, armpits, and eyebrows; macules on the face; plantar hyperkeratosis; and ulcers on the lower limbs. Tests for lead, arsenic, copper, and mercury were carried out, which were normal; however, elevated urinary thallium (540 µg/g; range, 0.4–10 µg/g) was observed. The patient was treated with ᴅ-penicillamine 1,000 mg/day and recovered her urinary thallium levels were within normal range at annual follow-up. Thallium poisoning is extremely rare and can be fatal in small doses. An adequate clinical approach can facilitate early diagnosis.

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Іmprovement of the differential diagnostics of acute oral and inhalation poisoning by thalium compounds, pathohistology and treatment strategy (based on group cases)
G.M. Balan, B.S. Sheyman, P.G. Zhminko, D.O. Dziuba, O.N. Rozhkova, N.V. Kurdil, A.H. Kudriavtseva, V.S. Lisovska, N.P. Chermnykh
Ukrainian Journal of Modern Toxicological Aspects.2023; 95(2): 66. CrossRef

Porokeratosis ptychotropica: a case report: Young-Wook Ryoo, Yura Kim, Ji-Min Yun, Sung-Ae Kim; J Yeungnam Med Sci. 2023;40(4):423-425. Published online December 5, 2022; DOI: https://doi.org/10.12701/jyms.2022.00549

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Porokeratosis ptychotropica is an uncommon form of porokeratosis, which was initially described in 1995. It is clinically characterized by symmetrical reddish to brown-colored hyperkeratotic, verrucous, or psoriasiform plaques on the perianal and gluteal regions. The lesions tend to integrate and expand centrally, with small peripheral satellite lesions. Early skin biopsy and appropriate diagnosis are essential because malignant change occurs in 7.5% of porokeratotic lesions. Conventional treatment options include topical steroid, retinoid, imiquimod, 5-fluorouracil, isotretinoin, excimer laser, photodynamic therapy, intralesional steroid or bleomycin injection, cryotherapy, carbon dioxide (CO2) laser, and dermatome and excision, but none seem to achieve complete clearance. A 68-year-old woman presented with diffuse hyperkeratotic scaly lichenoid plaques on the buttocks that had persisted for several years. A skin biopsy of the buttocks revealed multiple cornoid lamellae and intense hyperkeratosis. There were some dyskeratotic cells beneath the cornoid lamellae and the granular layer was absent. Porokeratosis ptychotropica was diagnosed based on the characteristic clinical appearance and typical histopathological manifestations. She was treated with a CO2 laser in one session and topical application of urea and imiquimod cream for 1 month. The lesions slightly improved at the 1-month follow-up. We herein present a rare case of porokeratosis ptychotropica.

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Porokeratoses—A Comprehensive Review on the Genetics and Metabolomics, Imaging Methods and Management of Common Clinical Variants
Paweł Pietkiewicz, Katarzyna Korecka, Natalia Salwowska, Ihor Kohut, Adarsha Adhikari, Monika Bowszyc-Dmochowska, Anna Pogorzelska-Antkowiak, Cristian Navarrete-Dechent
Metabolites.2023; 13(12): 1176. CrossRef

Effect of pulmonary rehabilitation on patients with acute COVID-19: a single-center case series: Son Mi Lee, Min Woo Kim, Donghyun Shin, Songi Han, Ju Sun Oh; J Yeungnam Med Sci. 2023;40(3):297-301. Published online November 1, 2022; DOI: https://doi.org/10.12701/jyms.2022.00591

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Abstract PDF

The coronavirus disease 2019 (COVID-19) pandemic has been ongoing for more than 2 years. Many patients who recover from severe acute respiratory syndrome coronavirus 2 infection continue to have aftereffects such as dyspnea and fatigue, which may lead to functional decline. Therefore, the need for managing these symptoms using methods such as pulmonary rehabilitation (PR) has emerged. The purpose of this study was to report the effectiveness of PR in five patients with acute COVID-19. PR was performed in patients with persistent dyspnea and oxygen demand after COVID-19. All five patients were able to maintain an independent functional status before COVID-19. However, after acute COVID-19, they were unable to walk independently and needed assistance for activities of daily living due to dyspnea and fatigue. Therefore, they were referred to rehabilitation units, and PR was performed. The modified Medical Research Council dyspnea scale, maximal expiratory pressure (MEP), 6-minute walking test, forced vital capacity, and grip strength were assessed before and after PR, and the results were compared. After PR, the parameters improved, except for the MEP in one patient (patient 3) and the grip strength in another patient (patient 4). After PR, two out of five patients returned to work and the other three returned home. Therefore, we conclude that PR is necessary for patients with acute COVID-19 with activity limitations.

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Effect of Chest Physiotherapy Technique on Bilateral Bronchial Pneumonia Secondary to Acute Respiratory Distress Syndrome: A Case Report
Urvini R Lokhande, H V Sharath, Vaishnavi M Thakre
Cureus.2023;[Epub] CrossRef

Resident fellow section: Teaching images

Right arm pain after strength training: ultrasound imaging for pectoralis major tendon strain: Ting-Yu Lin, Ke-Vin Chang, Wei-Ting Wu, Levent Özçakar; J Yeungnam Med Sci. 2023;40(1):109-111. Published online October 25, 2022; DOI: https://doi.org/10.12701/jyms.2022.00626

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MSK Ultrasound: A Powerful Tool for Evaluating and Diagnosing Pectoralis Major Injuries in Healthcare Practice
Robert C. Manske, Chris Wolfe, Phil Page, Michael Voight
International Journal of Sports Physical Therapy.2024;[Epub] CrossRef

Case report

Transient osteoporosis of the hip with a femoral neck fracture during follow-up: a case report: Yusuke Tabata, Shuhei Matsui, Masabumi Miyamoto, Koichiro Omori, Yoichiro Tabata, Tokifumi Majima; J Yeungnam Med Sci. 2023;40(2):212-217. Published online September 26, 2022; DOI: https://doi.org/10.12701/jyms.2022.00479

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Abstract PDF

We report a case of transient osteoporosis of the hip with a femoral neck fracture found during follow-up. A 53-year-old man presented with left hip pain without trauma. The pain did not improve after 2 weeks and he was brought to our hospital by ambulance. Magnetic resonance imaging (MRI) of the left hip joint showed diffuse edema in the bone marrow, which was identified by low signal intensity on T1-weighted images, high signal intensity on T2-weighted images, and increased signal intensity on short tau inversion recovery. This edema extended from the femoral head and neck to the intertrochanteric area. He was diagnosed with transient osteoporosis of the left hip. Rest gradually improved his pain; however, 3 weeks later, his left hip pain worsened without trauma. X-ray, computed tomography, and MRI results of the hip joint demonstrated a left femoral neck fracture, and osteosynthesis was performed. Differential diagnoses included avascular necrosis of the femoral head, infection, complex regional pain syndrome, rheumatoid arthritis, leukemia, and other cancers. Transient osteoporosis of the hip generally has a good prognosis with spontaneous remission within a few months to 1 year. However, a sufficient length of follow-up from condition onset to full recovery is necessary to avoid all probable complications such as fractures.

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Hip effusion/synovitis influences results after multiple drilling core decompression for bone marrow edema syndrome of hip
Hua-zhang Xiong, Yan-li Peng, Yu-hong Deng, Ying Jin, Ming-hong Tu, Shu-hong Wu
BMC Surgery.2023;[Epub] CrossRef

Original articles

Experience of operating a medical humanities course at one medical school during the COVID-19: a retrospective study: Yu Ra Kim, Hye-won Shin, Young Hwan Lee, Seong-Yong Kim; J Yeungnam Med Sci. 2023;40(2):179-186. Published online September 23, 2022; DOI: https://doi.org/10.12701/jyms.2022.00451

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Abstract PDF

Background
This study summarizes the experience of operating a ‘Medical Humanities’ course, which was taught remotely to maintain activities and discussions at medical schools in Daegu, Korea during the sudden and unexpected coronavirus disease 2019 (COVID-19).
Methods
The subjects of this study were 73 first- and 79 second-grade medical students who took the medical humanities (1) and (2) courses among first- and second-grade students of Yeungnam University College of Medicine in 2020. Of the 152 students who agreed to the online survey, 123 completed the survey. Self-, environmental, and program evaluations were conducted on the study subjects, and differences according to grade and gender were analyzed.
Results
As a result of the study, a significant difference between self-evaluation and environmental evaluation was confirmed. Self-evaluation was determined to be higher in the first grade than in the second grade. The environmental evaluation showed that male students were more satisfied than female students and students generally had difficulties in the classroom environment. Of the applications used in class, the highest satisfaction was observed with KakaoTalk (Kakao Corp.) and Zoom (Zoom Video Communications Inc.). At the end of COVID-19, the students preferred online classes.
Conclusion
If the learning environment for online classes is well prepared and systematic provisions are made, such as class operations that are suitable for the subject, effective education and learning can be achieved by taking advantage of both face-to-face and online classes.

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Study on the Learning Environment of Medical Students in the COVID-19
Yu Ra Kim, Hye Jin Park, Saeyoon Kim
Keimyung Medical Journal.2023; 42(2): 80. CrossRef

A study on the mental health of students at a medical school during COVID-19 outbreak: a retrospective study: Yu Ra Kim, Hye Jin Park, Bon-Hoon Koo, Ji Young Hwang, Young Hwan Lee; J Yeungnam Med Sci. 2022;39(4):314-321. Published online August 16, 2022; DOI: https://doi.org/10.12701/jyms.2022.00437

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Abstract PDF

Background
In this study, the degree of anxiety, depression, and stress caused by coronavirus disease 2019 (COVID-19) was identified, as well as the need for psychological prevention measures among medical students in the Daegu region that was designated the first special disaster area due to the spread of COVID-19.
Methods
The subjects of this study were 318 medical students in Daegu who voluntarily participated in an online test using the Hospital Anxiety and Depression Scale and Impact of Event Scale-Revised Korean version. As a result of the test, risk students received immediate telephone counseling, and the effect of this telephone counseling was analyzed.
Results
There were no differences in depression, anxiety, or stress according to gender and grade. As a result of immediate telephone counseling for risk students, significant differences were found in depression, anxiety, and stress, and the counseling was found to be effective.
Conclusion
For medical students who are easily exposed to stress, the importance of psychological prevention measures and effectiveness of non-face-to-face counseling should be recognized. In the field of medical education, we must do our best to build a system that can be used immediately at the appropriate time for these programs.

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Study on the Learning Environment of Medical Students in the COVID-19
Yu Ra Kim, Hye Jin Park, Saeyoon Kim
Keimyung Medical Journal.2023; 42(2): 80. CrossRef

Novel cystography parameter to predict early recovery from urinary continence after radical prostatectomy for prostate cancer: a retrospective study: Yeong Uk Kim; J Yeungnam Med Sci. 2023;40(3):252-258. Published online July 21, 2022; DOI: https://doi.org/10.12701/jyms.2022.00311

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Abstract PDF

Background
The purpose of this study was to investigate whether postoperative cystography findings can predict early and long-term recovery from incontinence after radical prostatectomy (RP), compared with the other cystography parameters.
Methods
I retrospectively reviewed 118 patients who underwent robot-assisted RP (RARP) for localized prostate cancer at single institution between January 2016 and April 2021. One hundred and seven patients were included in the study. Postoperative cystography was routinely performed 7 days after surgery. The bladder neck to pubic symphysis ratio, vesicourethral angle, and bladder neck anteroposterior length (BNAP) ratio (the bladder neck-posterior margin distances divided by the anteroposterior lengths) were evaluated. Continence was defined as cessation of pad use. The association between these variables and urinary incontinence was also analyzed.
Results
The urinary incontinence recovery rates 1, 3, 6, and 12 months after RARP were 43.92%, 66.35%, 87.85%, and 97.19%, respectively. Multivariate logistic regression analysis demonstrated that a lower BNAP ratio and wider vesicourethral angle were significantly associated with continence restoration at 1, 3, and 6 months after surgery. In addition, in terms of days of pad usage, lower BNAP ratio, wider vesicourethral angle, and bladder neck preservation were significantly associated with recovery from urinary incontinence within 12 months as assessed by Cox proportional hazard analysis.
Conclusion
This study demonstrated that vesicourethral angle and BNAP ratio were independent predictors of early recovery from post-prostatectomy incontinence. I suggest that both the sagittal and coronal views of postoperative cystography help anticipate early continence restoration after RARP.

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A single‐center retrospective comparative analysis of urinary continence in robotic prostatectomy with a combination of umbilical ligament preservation and Hood technique
Hiroaki Shimmura, Taro Banno, Kazutaka Nakamura, Anju Murayama, Haruki Shigeta, Toyoaki Sawano, Yukiko Kouchi, Akihiko Ozaki, Fumito Yamabe, Junpei Iizuka, Toshio Takagi
International Journal of Urology.2023; 30(10): 889. CrossRef

The effect and therapeutic compliance of adjuvant therapy in patients with cholangiocarcinoma after R0 resection: a retrospective study: Han Taek Jeong, Joonkee Lee, Hyeong Ho Jo, Ho Gak Kim, Jimin Han; J Yeungnam Med Sci. 2023;40(1):65-77. Published online May 26, 2022; DOI: https://doi.org/10.12701/jyms.2022.00213

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Abstract PDF

Background
This study aimed to compare clinical outcomes between surveillance and adjuvant therapy (AT) groups after R0 resection for cholangiocarcinoma (CCA).
Methods
A total of 154 patients who underwent R0 resection for CCA at the Daegu Catholic University Medical Center between January 2010 and December 2019 were included. Overall survival (OS) and progression-free survival (PFS) were analyzed.
Results
The median follow-up duration was 899 days. There were 109 patients in the AT group and 45 patients in the surveillance group. The patients in the AT group were younger (67 years vs. 74 years, p<0.001) and included more males (64.2% vs. 46.7%, p=0.044). The proportion of patients with stage III CCA was larger in the AT group than in the surveillance group (13.8% vs. 2.2%, p=0.005). In addition, AT did not improve OS (5-year OS rate, 69.3% in the AT group vs. 64.2% in the surveillance group, p=0.806) or PFS (5-year PFS rate, 42.6% in the AT group vs. 48.9% in the surveillance group, p=0.113). In multivariate analysis using the Cox proportional hazards model, stage III CCA (hazard ratio [HR], 10.81; 95% confidence interval [CI], 2.92–40.00; p<0.001) was a significant predictor of OS. American Society of Anesthesiologists classification II (HR, 0.50; 95% CI, 0.31–0.81; p=0.005), and American Joint Committee on Cancer stages II (HR, 3.14; 95% CI, 1.25–7.89; p=0.015) and III (HR, 8.08; 95% CI, 2.80–23.32; p<0.001) were independent predictors of PFS.
Conclusion
AT after R0 resection for CCA did not improve OS or PFS.

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Robotic Complete ALPPS (rALPPS)—First German Experiences
Jörg Arend, Mareike Franz, Alexander Rose, Christine March, Mirhasan Rahimli, Aristotelis Perrakis, Eric Lorenz, Roland Croner
Cancers.2024; 16(5): 1070. CrossRef

Case report

Prolonged oral sildenafil use-induced Mondor disease: a case report: Han Sol Chung, You Ho Mun; J Yeungnam Med Sci. 2022;39(3):262-265. Published online May 24, 2022; DOI: https://doi.org/10.12701/jyms.2022.00220

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Abstract PDF

Penile Mondor disease (MD) is a palpable, painful, subcutaneous induration caused by superficial dorsal penile vein thrombosis. We report a case of penile MD that was suspected to be related to prolonged oral sildenafil use. A 46-year-old man visited our emergency department with sustained penile pain and swelling that began 7 hours after sexual intercourse. He had used oral sildenafil intermittently for 11 years and engaged in sexual intercourse the previous night after taking sildenafil. Examination revealed no evidence of intercourse-related trauma to the genital area or an increase in penile skin temperature. However, penile swelling and tenderness over the protruding dorsal penile vein were noted. A color Doppler ultrasound examination was performed immediately, which showed hyperechoic thrombosis in the right superficial dorsal penile vein that was dilated, with soft tissue swelling and no detectable flow signal in the thrombotic lesion. The patient was diagnosed as having penile MD. The patient was treated conservatively. Some reports have indicated the involvement of sildenafil in thrombogenesis. Physicians should be aware that prolonged oral sildenafil use may be associated with penile MD.

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A case with Penile Mondor’s disease
Hülya Cenk, Gülbahar Saraç, İrem Mantar Yanatma
TURKDERM.2023; : 151. CrossRef

Review article

Ultrasound-guided interventions for controlling the thoracic spine and chest wall pain: a narrative review: Donghwi Park, Min Cheol Chang; J Yeungnam Med Sci. 2022;39(3):190-199. Published online April 26, 2022; DOI: https://doi.org/10.12701/jyms.2022.00192

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Abstract PDF

Ultrasound-guided injection is useful for managing thoracic spine and chest wall pain. With ultrasound, pain physicians perform the injection with real-time viewing of major structures, such as the pleura, vasculature, and nerves. Therefore, the ultrasound-guided injection procedure not only prevents procedure-related adverse events but also increases the accuracy of the procedure. Here, ultrasound-guided interventions that could be applied for thoracic spine and chest wall pain were described. We presented ultrasound-guided thoracic facet joint and costotransverse joint injections and thoracic paravertebral, intercostal nerve, erector spinae plane, and pectoralis and serratus plane blocks. The indication, anatomy, Sonoanatomy, and technique for each procedure were also described. We believe that our article is helpful for clinicians to conduct ultrasound-guided injections for controlling thoracic spine and chest wall pain precisely and safely.

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The blind spot and challenges in pain management
Min Cheol Chang
Journal of Yeungnam Medical Science.2022; 39(3): 179. CrossRef

Original article

The impact of quality of life measured by WHOQOL-BREF on mortality in maintenance hemodialysis patients: a single center retrospective cross-sectional study: Seong Gyu Kim, In Hee Lee; J Yeungnam Med Sci. 2023;40(1):49-57. Published online April 18, 2022; DOI: https://doi.org/10.12701/jyms.2022.00080

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Abstract PDF

Background
Several previous studies have reported that quality of life (QoL) in hemodialysis patients affects mortality. However, the 36-item Short Form Health Survey, which has been used mainly in previous studies, is complicated in terms of questionnaire composition and interpretation. This study aimed to identify the impact of QoL on mortality in hemodialysis patients using an easier and simpler diagnostic tool.
Methods
This retrospective study included 160 hemodialysis patients. QoL was evaluated using the World Health Organization Quality of Life Questionnaire-Brief version (WHOQOL-BREF). Psychosocial factors were evaluated using the Hospital Anxiety and Depression Scale, Multidimensional Scale of Perceived Social Support, Montreal Cognitive Assessment, and Pittsburgh Sleep Quality Index. We also evaluated medical factors, such as dialysis adequacy and laboratory results.
Results
The mean hemodialysis vintage was 70.7±38.0 months. The proportion of patients who were elderly was higher in the mortality group than in the surviving group, and the Charlson Comorbidity Index score was also higher in the former group. Of the four domains of the WHOQOL-BREF, the physical health and psychological scores of the mortality group were significantly lower than those of the survival group. When the score in the physical health domain or psychological domain was ≤10, the 10-year mortality rate after hemodialysis initiation increased by approximately 2.3- and 2-fold, respectively.
Conclusion
QoL may have a significant effect on mortality in patients undergoing hemodialysis. The WHOQOL-BREF is an instrument that can measure QoL relatively easily and can be used to improve the long-term prognosis of patients undergoing hemodialysis.

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Application of standardized management and effect evaluation of chronic obstructive pulmonary disease patients using the big data center of the Internet of Things
Xiaoping Chen, Fei He, Yan Jiang, Xuezhen Chen, Yubing Yan
DIGITAL HEALTH.2024;[Epub] CrossRef

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