Journal of Yeungnam Medical Science

Most downloaded articles are from the articles published in 2023 during the last 3 months.

Focused Review article

Orthopedics and Sports Medicine
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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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.

Citations

Citations to this article as recorded by

Responsive to adaptive supramolecular hydrogels for diabetic wound treatment
Shalini Balakrishnan, Revathy Remesh, Krishnan Kartha Kalathil, Anie Y
Supramolecular Materials.2025; 4: 100081. CrossRef
Nanotechnology-enabled approaches for combating diabetic foot ulcer
Padakanti Sandeep Chary, Anuradha Urati, Samia Shaikh, Rati Yadav, Valmala Bhavana, Naveen Rajana, Neelesh Kumar Mehra
Journal of Drug Delivery Science and Technology.2025; 105: 106593. CrossRef
Natural products in the treatment of diabetic foot infection
Mohsen Nazari, Leili Shokoohizadeh, Mohammad Taheri
European Journal of Medical Research.2025;[Epub] CrossRef
Comprehensive review on diabetic foot ulcers and neuropathy: Treatment, prevention and management
Kehkashan Parveen, Malik Asif Hussain, Sadaf Anwar, Halima Mustafa Elagib, Mohd Adnan Kausar
World Journal of Diabetes.2025;[Epub] CrossRef
Enhanced therapy for diabetic neuropathy utilizing venlafaxine hydrochloride-loaded transferosome-based transdermal gel
Kajol Patil, Pramod S. Salve, Ujban Md Hussain Hussain, Amol Tatode, Mohammad Qutub
Nano Trends.2025; 9: 100085. CrossRef
Antioxidants improve the viability of diabetic bone marrow MSCs without rescuing their pro-regenerative secretome function
Michelle Maartens, Mare Vlok, Mari van de Vyver
Molecular and Cellular Endocrinology.2025; 601: 112519. CrossRef
Risk Factors Associated with Diabetic Foot Ulcers: A Multivariate Analysis
Ajeet Saoji, Nitesh Upadhyay, Prachi Saoji, Kartik Khurana
Biomedical and Biotechnology Research Journal.2025; 9(1): 67. CrossRef
Bacteriological profile of diabetic foot ulcers and analysis of serum meteorin levels
Esra Erdogan, Azize Yetisgen, Lezzan Keskin, Elif Seren Tanriverdi, Isilay Gokce Benk Ugur
Molecular Biology Reports.2025;[Epub] CrossRef
DİABETİK ANGİOPATİYALARIN ULTRASƏS DOPLEROQRAFİYASI İLƏ QİYMƏTLƏNDİRİLMƏSİ
G.S. Əliyeva, C.T. Əliyeva, A.T. Bədəlova
Azerbaijan Medical Journal.2025; (1): 150. CrossRef
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
Treatment of Morganella morganii-Associated Non-healing Diabetic Foot Ulcer With Vaporous Hyperoxia Therapy: A Case Report
Afrah S Abedi, Jacob L McElroy, Vladimir Valencia, Rachel M Worcester, Zhi J Yu
Cureus.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
Systematic review of translational insights: Neuromodulation in animal models for Diabetic Peripheral Neuropathy
Rahul Mittal, Keelin McKenna, Grant Keith, Evan McKenna, Rahul Sinha, Joana R. N. Lemos, Khemraj Hirani, Mohammad Sarif Mohiuddin
PLOS ONE.2024; 19(8): e0308556. CrossRef
Effect of Treatment of Neuropathic and Ischemic Diabetic Foot Ulcers with the Use of Local Ozone Therapy Procedures—An Observational Single Center Study
Jarosław Pasek, Sebastian Szajkowski, Grzegorz Cieślar
Clinics and Practice.2024; 14(5): 2139. CrossRef
High glucose combined with lipopolysaccharide stimulation inhibits cell proliferation and migration of human HaCaT keratinocytes by impacting redox homeostasis and activating the polyol pathway
Zhenhui Xie, Shufan Zhou, Songtao Tang, Qiu Zhang, Lei Liu
Molecular Biology Reports.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

Review article

Pediatrics, Perinatology, and Child Health
Essential micronutrients in children and adolescents with a focus on growth and development: a narrative review: Sukjin Hong; J Yeungnam Med Sci. 2025;42:25. Published online February 1, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.25

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Abstract PDF: This comprehensive review examines the crucial role of micronutrients in the health of children and adolescents, focusing on their growth and development. Micronutrients, including vitamins and trace elements, are essential for various biochemical processes and biological functions. We explored the roles, assessment methods, deficiency patterns, and intervention strategies for six essential micronutrients: iron, zinc, vitamin A, vitamin D, iodine, and folate. These nutrients were selected based on their fundamental importance in pediatric development. By analyzing the current literature from PubMed, Embase, and Web of Science databases, we synthesized findings regarding the impact of these micronutrients on health outcomes in children and adolescents, examining both regional and global prevalence data, with particular attention paid to Korean population data. This review provides evidence-based insights into the assessment and management of micronutrient status in children and adolescents and offers recommendations for clinical practice.

Focused Review article

Orthopedics and Sports Medicine
Management of diabetic foot ulcers: a narrative review: Jahyung Kim, Otgonsaikhan Nomkhondorj, Chi Young An, Ye Chan Choi, Jaeho Cho; J Yeungnam Med Sci. 2023;40(4):335-342. Published online September 22, 2023; DOI: https://doi.org/10.12701/jyms.2023.00682

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Abstract PDF

Diabetic foot ulcers (DFUs) are among the most serious complications of diabetes and are a source of reduced quality of life and financial burden for the people involved. For effective DFU management, an evidence-based treatment strategy that considers the patient's clinical context and wound condition is required. This treatment strategy should include conventional practices (surgical debridement, antibiotics, vascular assessment, offloading, and amputation) coordinated by interdisciplinary DFU experts. In addition, several adjuvant therapies can be considered for nonhealing wounds. In this narrative review, we aim to highlight the current trends in DFU management and review the up-to-date guidelines.

Citations

Citations to this article as recorded by

Clinical Efficacy of Type I Collagen Skin Substitutes Versus Human Amnion/Chorion in Treating Diabetic Foot Ulcers Using 55 Patient Randomized Controlled Independent Two Trials, One in India and the Other in the USA
Subramanian Gunasekaran
Biomedical Materials & Devices.2025;[Epub] CrossRef
A feature explainability-based deep learning technique for diabetic foot ulcer identification
Pramod Singh Rathore, Abhishek Kumar, Amita Nandal, Arvind Dhaka, Arpit Kumar Sharma
Scientific Reports.2025;[Epub] CrossRef
The hidden impact: frailty and malnutrition in patients with diabetic foot ulcers
Levent Demir, Mustafa Avcı, Murat Kahraman, Selahattin Kılıç
Journal of Health Sciences and Medicine.2025; 8(2): 262. CrossRef
Kick-Starting Wound Healing: A Review of Pro-Healing Drugs
Bethany L. Patenall, Kristyn A. Carter, Matthew R. Ramsey
International Journal of Molecular Sciences.2024; 25(2): 1304. CrossRef
Sequence analysis of microbiota in clinical human cases with diabetic foot ulcers from China
Ying Li, Li Zhang, Meifang He, Yuebin Zhao
Heliyon.2024; 10(14): e34368. CrossRef
The future of diabetic wound healing: unveiling the potential of mesenchymal stem cell and exosomes therapy
Sara Memarpour
American Journal of Stem Cells.2024; 13(2): 87. CrossRef
Etiopathophysiology, Novel and Advanced Therapy Options, Management and Care Plan to Prevent Lower Limb Amputations for Diabetic Foot Ulcer
Richa Dayaramani, Nipa Gandhi, Areeg Anwar Ali Shamsher, Nour Aymn Ahmad
Research Journal of Pharmacy and Technology.2024; : 5141. 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 articles

Neurology
Magnesium as an adjunct to nimodipine in subarachnoid hemorrhage: a meta-analysis: Riva Satya Radiansyah, Yuri Pamungkas, Ilham Ikhtiar; J Yeungnam Med Sci. 2025;42:26. Published online February 2, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.26

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Abstract PDF: Background
Subarachnoid hemorrhage (SAH) is a devastating neurological condition with high morbidity and mortality rates. Although nimodipine is widely used in the management of SAH, the potential benefits of magnesium as adjunct therapy remain unclear. This meta-analysis aimed to evaluate the efficacy and safety of combining magnesium with nimodipine for the management of SAH.
Methods
A comprehensive literature search was conducted using PubMed, ScienceDirect, Google Scholar, and the Cochrane Library. Randomized controlled trials and prospective cohort studies comparing magnesium plus nimodipine versus nimodipine alone in patients with SAH were included. Key outcomes included cerebral vasospasm (CV), delayed cerebral ischemia (DCI), functional outcomes, mortality, and adverse events.
Results
Twelve studies involving 2,338 patients were included. The combination of magnesium and nimodipine significantly reduced the incidence of CV (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.29–0.95; p=0.03) and DCI (OR, 0.52; 95% CI, 0.31–0.87; p=0.01) compared to nimodipine alone. However, no significant differences were found in functional outcomes (modified Rankin Scale: OR, 0.97; p=0.75; Glasgow Outcome Scale: OR, 0.81; p=0.24), mortality (OR, 0.97; p=0.83), or secondary cerebral infarction (OR, 0.38; p=0.12). The incidence of adverse events was higher in the combination group; however, this difference was not statistically significant (OR, 3.14; p=0.33).
Conclusion
Adding magnesium to nimodipine therapy in patients with SAH may help reduce CV and DCI incidence but does not significantly improve functional outcomes or mortality. Further large-scale studies are needed to optimize the dosing regimens and confirm these findings.

Gastroenterology and Hepatology
Increased risk of adenomatous colon polyps in patients with long-term use of proton pump inhibitors: a single-center retrospective study: Na Rae Lim, Woo Chul Chung; J Yeungnam Med Sci. 2025;42:24. Published online January 21, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.24

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Abstract PDF: Background
It is unclear whether long-term use of proton pump inhibitors (PPIs) has a potential carcinogenic effect on the colorectum.
Methods
We reviewed a consecutive series of neurosurgery outpatients who underwent two or more colonoscopies between January 2014 and April 2023. Patients in whom the timing of endoscopy was not in accordance with the guidelines and those without a history of previous endoscopy were excluded. In the second colonoscopy, the risk of adenomatous colon polyps was evaluated depending on whether the patient had taken a PPI.
Results
In total, 520 patients were enrolled. In the multivariate analysis related to the risk of adenomatous colon polyps, age and aspirin use for >5 years were identified as significant factors. After excluding patients who had taken aspirin for >5 years, the patients were divided into three groups: those who had taken PPIs for >12 months, those who had taken PPIs for >3 months but <12 months, and those who had not taken PPIs. The risk of adenomatous colon polyps in these groups was 35.2%, 32.8%, and 22.8%, respectively (p=0.10). In the post-hoc analysis, there was a significant difference between patients who took PPIs and those who did not (p=0.03). In the multivariate analysis, a history of PPI use for >12 months was a significant risk factor for the development of advanced colon polyps (p=0.03).
Conclusion
Prolonged PPI use appears to increase the risk of developing adenomatous and advanced colon polyps.

Focused Review article

Pathology and Forensic Medicine
Pathology and diagnostic approaches to well-differentiated hepatocellular lesions: a narrative review: Joon Hyuk Choi, Swan N. Thung; J Yeungnam Med Sci. 2025;42:5. Published online October 24, 2024; DOI: https://doi.org/10.12701/jyms.2024.00766

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Abstract PDF: Well-differentiated hepatocellular lesions (WDHLs) are liver tumors or nonneoplastic lesions in which the cells closely resemble normal hepatocytes. These lesions often include focal nodular hyperplasia, hepatocellular adenoma, macroregenerative nodule, dysplastic nodule, and well-differentiated hepatocellular carcinoma. The diagnosis of these lesions remains challenging because of their morphological similarities, particularly when examined using needle biopsy. The accurate diagnosis of WDHLs is crucial for patient management and prognosis. This review addresses the histopathological characteristics and diagnostic approaches of WDHLs.

Resident fellow section: Clinical vignette

Physical therapy, Sports Therapy, and Rehabilitation
A 30-year-old male patient who experienced recurring weakness in bilateral upper and lower extremities: a clinical vignette: Soo Hyun Ahn, Mathieu Boudier-Revéret, Seoyon Yang, Min Cheol Chang; J Yeungnam Med Sci. 2025;42:27. Published online February 17, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.27

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Original article

Obstetrics, Gynecology, and Reproductive Medicine
Patient-specific predictors of successful frozen embryo transfer using the freeze-all protocol: a retrospective observational study: Hyun Joo Lee, Eun Hee Yu, Jong Kil Joo; J Yeungnam Med Sci. 2025;42:28. Published online February 25, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.28

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Abstract PDF: Background
The aim of this study was to examine various patient factors affecting first programmed embryo transfer (ET) outcomes under the freeze-all policy at a single tertiary university infertility center.
Methods
This retrospective observational study reviewed the medical records of 243 couples who underwent their first ET using blastocysts collected under the freeze-all antagonist-controlled ovarian stimulation (COS) protocol from 2015 to 2023. Patients were grouped into pregnant and nonpregnant groups, and their data, including demographics, COS and ET outcomes, and embryo storage duration, were analyzed.
Results
Patient body mass index, cause of infertility, follicle-to-oocyte index, distribution of blastocyst grades, number of transferred embryos, and embryo storage duration were not significantly different between the groups. In a simple comparative analysis, patients with successful clinical pregnancy tended to have significantly lower female and male age (33.83±3.67 and 35.32±4.54 years vs. 37.07±4.15 and 39.33±5.60 years, respectively), higher anti-Müllerian hormone levels (6.27±5.32 ng/mL vs. 4.14±3.82 ng/mL) and antral follicle counts (14.20±8.26 vs. 10.04±5.75), and higher numbers of retrieved oocytes and metaphase II oocytes (13.74±6.92 and 9.64±6.19 vs. 11.21±6.04 and 7.53±5.56, respectively). Multivariate logistic regression analysis of these variables revealed that only male age was a significant factor for successful clinical pregnancy (odds ratio, 4.768; 95% confidence interval, 1.252–18.162; p=0.022).
Conclusion
During the first programmed ET using blastocysts collected under the freeze-all antagonist COS protocol, male age and correspondingly the quality of gametes for fertilization were crucial for successful pregnancy, having more importance than calculated female ovarian reserve and embryo storage duration.

Review articles

Anesthesiology and Pain Medicine
Failed back surgery syndrome—terminology, etiology, prevention, evaluation, and management: a narrative review: Jinseok Yeo; J Yeungnam Med Sci. 2024;41(3):166-178. Published online June 10, 2024; DOI: https://doi.org/10.12701/jyms.2024.00339

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Abstract PDF

Amid the worldwide increase in spinal surgery rates, a significant proportion of patients continue to experience refractory chronic pain, resulting in reduced quality of life and escalated healthcare demands. Failed back surgery syndrome (FBSS) is a clinical condition characterized by persistent or recurrent pain after one or more spinal surgeries. The diverse characteristics and stigmatizing descriptions of FBSS necessitate a reevaluation of its nomenclature to reflect its complexity more accurately. Accurate identification of the cause of FBSS is hampered by the complex nature of the syndrome and limitations of current diagnostic labels. Management requires a multidisciplinary approach that may include pharmacological treatment, physical therapy, psychological support, and interventional procedures, emphasizing realistic goal-setting and patient education. Further research is needed to increase our understanding, improve diagnostic accuracy, and develop more effective management strategies.

Citations

Citations to this article as recorded by

Short-term Effects of Combined Korean Medicine Treatment Including Acupotomy in a Patient with Failed Back Surgery Syndrome: A Case Report
Heejeon Hong, Soo Kwang An, Taewook Lee, Jihun Kim, Eunseok Kim
Journal of Acupuncture Research.2025;[Epub] CrossRef
Using Key Predictors in an SVM Model for Differentiating Spinal Fractures and Herniated Intervertebral Discs in Preoperative Anesthesia Evaluation
Shih-Ying Yang, Shih-Yen Hsu, Yi-Kai Su, Nan-Han Lu, Kuo-Ying Liu, Tai-Been Chen, Kon-Ning Chiu, Yung-Hui Huang, Li-Ren Yeh
Diagnostics.2024; 14(21): 2456. CrossRef

Endocrinology, Diabetes, and Metabolism
Beneficial effects of intermittent fasting: a narrative review: Dae-Kyu Song, Yong-Woon Kim; J Yeungnam Med Sci. 2023;40(1):4-11. Published online April 4, 2022; DOI: https://doi.org/10.12701/jyms.2022.00010

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23 Web of Science
27 Crossref

Abstract PDF

Caloric restriction is a popular approach to treat obesity and its associated chronic illnesses but is difficult to maintain for a long time. Intermittent fasting is an alternative and easily applicable dietary intervention for caloric restriction. Moreover, intermittent fasting has beneficial effects equivalent to those of caloric restriction in terms of body weight control, improvements in glucose homeostasis and lipid profiles, and anti-inflammatory effects. In this review, the beneficial effects of intermittent fasting are discussed.

Citations

Citations to this article as recorded by

Intermittent Fasting Improves Social Interaction and Decreases Inflammatory Markers in Cortex and Hippocampus
Martín García-Juárez, Adamary García-Rodríguez, Gabriela Cruz-Carrillo, Orlando Flores-Maldonado, Miguel Becerril-Garcia, Lourdes Garza-Ocañas, Ivan Torre-Villalvazo, Alberto Camacho-Morales
Molecular Neurobiology.2025; 62(2): 1511. CrossRef
External factors affecting weight loss during intermittent fasting. Author's reply
M. Khalil, H. Abdallah, G. Garruti, A.Di Ciaula, P. Portincasa
European Journal of Internal Medicine.2025; 131: 141. CrossRef
Fasting the brain for mental health
Roberto Carlos Perez-Kast, Alberto Camacho-Morales
Journal of Psychiatric Research.2025; 181: 215. CrossRef
Is isocaloric intermittent fasting superior to calorie restriction? A systematic review and meta-analysis of RCTs
Mohammed Hamsho, Wijdan Shkorfu, Yazan Ranneh, Abdulmannan Fadel
Nutrition, Metabolism and Cardiovascular Diseases.2025; 35(3): 103805. CrossRef
Exploring the metabolic patterns and response mechanisms of bile acids during fasting: A study with poultry as an example
Jun Zhang, Yujie Gong, Yidan Zhu, Qingduo Zeng, Hao Zhang, Ruili Han, Yujie Guo, Donghua Li, Yadong Tian, Xiangtao Kang, Yawei Yang, Zhuanjian Li, Ruirui Jiang
Poultry Science.2025; 104(2): 104746. CrossRef
Intermittent fasting and neurocognitive disorders: What the evidence shows
Jordan Beveridge, Allison Montgomery, George Grossberg
The Journal of nutrition, health and aging.2025; 29(4): 100480. CrossRef
Intermittent fasting and longevity: From animal models to implication for humans
Olha Strilbytska, Svitlana Klishch, Kenneth B. Storey, Alexander Koliada, Oleh Lushchak
Ageing Research Reviews.2024; 96: 102274. CrossRef
Combined Aerobic Exercise with Intermittent Fasting Is Effective for Reducing mTOR and Bcl-2 Levels in Obese Females
Purwo Sri Rejeki, Adi Pranoto, Deandra Maharani Widiatmaja, Dita Mega Utami, Nabilah Izzatunnisa, Sugiharto, Ronny Lesmana, Shariff Halim
Sports.2024; 12(5): 116. CrossRef
Effect of Intermittent Fasting Interventions for Treatment of Overweight and Obesity in Adults – A Systematic Review
Teena Lal, S. J. Ajeet Arulkumar, S. Roopa
Acta Medica International.2024; 11(1): 7. CrossRef
Intermittent fasting influences immunity and metabolism
Daniel M. Marko, Meghan O. Conn, Jonathan D. Schertzer
Trends in Endocrinology & Metabolism.2024; 35(9): 821. CrossRef
Impact of Intermittent Fasting and Dietary Restriction on Redox State, Energetic Metabolism, and Liver Injury in Common Bile Duct Ligation Model
Dmitry S. Semenovich, Ljubava D. Zorova, Polina A. Abramicheva, Nadezda V. Andrianova, Andrey V. Elchaninov, Aleksandra S. Petrukhina, Irina B. Pevzner, Vasily N. Manskikh, Dmitry B. Zorov, Egor Y. Plotnikov
Antioxidants.2024; 13(7): 835. CrossRef
DOSE: a lifestyle philosophy for dementia prevention informed by drug development and epidemiology
Timothy Daly
Dementia & Neuropsychologia.2024;[Epub] CrossRef
The effects of time‐restricted eating alone or in combination with probiotic supplementation in comparison with a calorie‐restricted diet on endocrine and metabolic profiles in women with polycystic ovary syndrome: A randomized clinical trial
Sepide Talebi, Sakineh Shab‐Bidar, Ashraf Moini, Hamed Mohammadi, Kurosh Djafarian
Diabetes, Obesity and Metabolism.2024; 26(10): 4468. CrossRef
The Combined Effect of Diets with Different Time Restriction and Low-intensity Aerobic Exercise on Metabolic Factors and Anthropometry in Overweight Middle-aged Men
Hamid Vasfi, Hamid Mohebbi, Marefat Siahkouhian, Lotfollah Rezagholizadeh, Abouzar jorbonian
Journal of Ardabil University of Medical Sciences.2024; 24(1): 58. CrossRef
Ketogenic Interventions in Autosomal Dominant Polycystic Kidney Disease: A Comprehensive Review of Current Evidence
Carla Pezzuoli, Giuseppe Biagini, Riccardo Magistroni
Nutrients.2024; 16(16): 2676. CrossRef
Impact of diet intervention on visceral adipose tissue and hepatic fat in patients with obesity or type 2 diabetes: a randomized trial
Rungroj Krittayaphong, Witcha Treesuwan, Pornpoj Pramyothin, Thammarak Songsangjinda, Yodying Kaolawanich, Weerachai Srivanichakorn, Preechaya Jangtawee, Ahthit Yindeengam, Prajak Tanapibunpon, Apichart Vanavichit
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Exploring the Impact of Fasting and Fasting-Mimicking Diets on Type 2 Diabetes Management in Adults: A Systematic Review
José Amilcar Rivera Regalado, Juan García, Isabella Ramirez, Plinio Hermosilla, Jose Rascon, Sergio José Fausto Girón
Cureus.2024;[Epub] CrossRef
As a phenomenon: Ramadan fasting improves olfactory performance
Doğan Çakan, Hüseyin Baki Yılmaz, Harun Cansız, Haluk Çevik, Michael C. F. Tong, Begüm Bahar Yılmaz, Zeliha Kübra Çakan
Laryngoscope Investigative Otolaryngology.2024;[Epub] CrossRef
Artificial intelligence driven definition of food preference endotypes in UK Biobank volunteers is associated with distinctive health outcomes and blood based metabolomic and proteomic profiles
Hana F. Navratilova, Anthony D. Whetton, Nophar Geifman
Journal of Translational Medicine.2024;[Epub] CrossRef
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Hiba Fathimathul Harshiba, Nabeel Muhammed Rafi
Cosmoderma.2024; 4: 124. CrossRef
The distinct mechanism regulating taurine homeostasis in mice: Nutrient availability affects taurine levels in the liver and energy restriction influences it in the intestine
András Gregor, Arturo Auñon-Lopez, Marc Pignitter, Kalina Duszka
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Socio-demographic determinants of dietary choices and their impact on health in Spanish adults
Elena Sandri, Eva Cantín Larumbe, Michela Capoferri, Germán Cerdá Olmedo, Lisa Ursula Werner, M. Jesús Vega-Bello
Frontiers in Public Health.2024;[Epub] CrossRef
Relationship Between Dietary Nutrient Intake and Autophagy—Related Genes in Obese Humans: A Narrative Review
Martyna Bednarczyk, Nicola Dąbrowska-Szeja, Dariusz Łętowski, Sylwia Dzięgielewska-Gęsiak, Dariusz Waniczek, Małgorzata Muc-Wierzgoń
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Examining Associations Between Fasting Behavior, Orthorexia Nervosa, and Eating Disorders
Przemysław Domaszewski, Aleksandra M. Rogowska, Kaja Żylak
Nutrients.2024; 16(24): 4275. CrossRef
Age-related differences in the effect of intermittent fasting on the morphofunctional parameters of the rat's pancreas
R.V. Yanko
The Journal of V. N. Karazin Kharkiv National University, Series "Biology".2024; (43): 138. CrossRef
Maternal intermittent fasting deteriorates offspring metabolism via suppression of hepatic mTORC1 signaling
Wenzhen Yin, Lijun Sun, Yuan Liang, Chao Luo, Tiange Feng, Yunhua Zhang, Weizhen Zhang, Yue Yin
The FASEB Journal.2023;[Epub] CrossRef
Time-Restricted Feeding and Intermittent Fasting as Preventive Therapeutics: A Systematic Review of the Literature
Arturo P Jaramillo, Javier Castells, Sabina Ibrahimli, Luisa Jaramillo, Rebeca R Briones Andriuoli, Denisse Moncada, Jhoanny C Revilla
Cureus.2023;[Epub] CrossRef

Case report

Musculoskeletal Disorders
Unilateral lower extremity lymphedema followed by COVID-19 vaccination in patients with cervical cancer history: two case reports: Jae Ik Jung, Hee Kyung Cho; J Yeungnam Med Sci. 2025;42:23. Published online January 21, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.23

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Abstract PDF: The coronavirus disease 2019 (COVID-19) pandemic prompted the development of messenger RNA vaccines. Following extensive vaccination campaigns worldwide, several adverse reactions to these vaccines have been reported. This is a case series of unilateral lower extremity lymphedema after COVID-19 vaccination in two patients with a history of cervical cancer. An 82-year-old woman and a 68-year-old woman visited the outpatient clinic with unilateral leg edema after receiving a COVID-19 booster vaccine (BNT162b2; Pfizer-BioNTech) in the deltoid muscle. Both patients had a common history of cervical cancer treated with surgery, chemotherapy, and radiotherapy and were in complete remission. Gynecological evaluations, including laboratory and imaging studies, revealed no specific findings. Lymphoscintigraphy revealed delayed lymphatic drainage with diffuse dermal backflow in a unilateral lower extremity. This case series explores adverse reactions to COVID-19 vaccination in patients who are at high risk of developing lymphedema, providing novel data for similar clinical presentations.

Review articles

Physical therapy, Sports Therapy, and Rehabilitation
Postoperative conditions of rehabilitative interest in lung transplantation: a systematic review: Massimiliano Polastri, Esra Pehlivan, Robert M. Reed, Allaina Eden; J Yeungnam Med Sci. 2024;41(4):235-251. Published online August 22, 2024; DOI: https://doi.org/10.12701/jyms.2024.00521

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220 Download
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Abstract PDF

Lung transplantation is an elective treatment option for end-stage respiratory diseases in which all medical therapy options have been exhausted. The current study aimed to identify updated information on the postoperative conditions that may impair rehabilitation after lung transplantation and to provide specific considerations of their clinical relevance during the recovery process. The present study is a systematic review conducted by searching three primary databases: the United States National Library of Medicine PubMed system, Scopus, and the Cochrane Library. The databases were searched for articles published from database inception until May 2024; at the end of the selection process, 27 documents were included in the final analysis. The retrieved material identified 19 conditions of rehabilitative interest that potentially affect the postoperative course: graft dysfunction, dysphagia, postsurgical pain, cognitive impairment, chronic lung allograft dysfunction-bronchiolitis obliterans syndrome, phrenic nerve injury, delayed extracorporeal membrane oxygenation weaning, airway clearance, refractory hypoxemia, mediastinitis, reduced oxidative capacity, sternal dehiscence, coronavirus disease 2019 (COVID-19), gastroparesis, ossification of the elbow, Takotsubo cardiomyopathy, airway dehiscence, recurrent pleural effusion, and scapular prolapse. Although some patients are not amenable to rehabilitation techniques, others can significantly improve with rehabilitation.

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Seven-day rehabilitation services in hospital settings: benefits and drawbacks
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Endocrinology, Diabetes, and Metabolism
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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A 30-year-old male patient who experienced recurring weakness in bilateral upper and lower extremities: a clinical vignette
Soo Hyun Ahn, Mathieu Boudier-Revéret, Seoyon Yang, Min Cheol Chang
Journal of Yeungnam Medical Science.2025; 42: 27. CrossRef
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
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Deborah J. W. Lee, Soon Kieng Phua, Yali Liang, Claire Chen, Tar-Choon Aw
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Original article

Cardiology and Cardiovascular Medicine
Complete or incomplete revascularization in patients with left main culprit lesion acute myocardial infarction with multivessel disease: a retrospective observational study: Sun Oh Kim, Hong-Ju Kim, Jong-Il Park, Kang-Un Choi, Jong-Ho Nam, Chan-Hee Lee, Jang-Won Son, Jong-Seon Park, Sung-Ho Her, Ki-Yuk Chang, Tae-Hoon Ahn, Myung-Ho Jeong, Seung-Woon Rha, Hyo-Soo Kim, Hyeon-Cheol Gwon, In-Whan Seong, Kyung-Kuk Hwang, Seung-Ho Hur, Kwang-Soo Cha, Seok-Kyu Oh, Jei-Keon Chae, Ung Kim; J Yeungnam Med Sci. 2025;42:18. Published online December 19, 2024; DOI: https://doi.org/10.12701/jyms.2025.42.18

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Abstract PDF: Background
Complete revascularization has demonstrated better outcomes in patients with acute myocardial infarction (AMI) and multivessel disease. However, in the case of left main (LM) culprit lesion AMI with multivessel disease, there is limited evidence to suggest that complete revascularization is better.
Methods
We reviewed 16,831 patients in the Korea Acute Myocardial Infarction Registry who were treated from July 2016 to June 2020, and 399 patients were enrolled with LM culprit lesion AMI treated with percutaneous coronary intervention. We categorized the patients as those treated with complete revascularization (n=295) or incomplete revascularization (n=104). The study endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause death, myocardial infarction, ischemia-driven revascularization, stent thrombosis, and stroke. We performed propensity score matching (PSM) and analyzed the incidence of MACCE at 1 year.
Results
After PSM, the two groups were well balanced. There was no significant difference between the two groups in MACCE at 1 year (12.1% vs. 15.2%; hazard ratio, 1.28; 95% confidence interval, 0.60–2.74; p=0.524) after PSM. The components of MACCE and major bleeding were also not significantly different.
Conclusion
There was no significant difference in clinical outcomes between the groups treated with complete or incomplete revascularization for LM culprit lesion AMI with multivessel disease.

Review articles

Gastroenterology and Hepatology
Recent updates on classification and unsolved issues of diverticular disease: a narrative review: Kyeong Ok Kim; J Yeungnam Med Sci. 2024;41(4):252-260. Published online August 30, 2024; DOI: https://doi.org/10.12701/jyms.2024.00542

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Abstract PDF: Recently, a paradigm shift has occurred in the classification of diverticular disease and the understanding of its pathogenesis. Diverticular disease is now defined as a variety of clinically significant conditions such as diverticulitis, diverticular bleeding, symptomatic uncomplicated diverticular disease, and segmental colitis associated with diverticulosis. Low-grade inflammation, visceral hypersensitivity, abnormal intestinal motility, and genetic factors have emerged as the key contributors to the pathogenesis of diverticular disease. Routine antibiotic use is no longer recommended for all cases of diverticulitis, and simple recurrence is not an indication for surgical treatment. Early colonoscopy with proper preparation is recommended for the treatment of diverticular bleeding, although recent studies have not shown significant efficacy in preventing recurrence. The roles of dietary fiber, nonabsorbable antibiotics, 5-aminosalicylates, and probiotics in the prevention of diverticular disease are controversial and require further investigation.

Physical therapy, Sports Therapy, and Rehabilitation
Ultrasound imaging and guidance in the management of myofascial pain syndrome: a narrative review: Wei-Ting Wu, Ke-Vin Chang, Vincenzo Ricci, Levent Özçakar; J Yeungnam Med Sci. 2024;41(3):179-187. Published online June 17, 2024; DOI: https://doi.org/10.12701/jyms.2024.00416

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Abstract PDF

Myofascial pain syndrome (MPS) is a common musculoskeletal disorder characterized by muscle pain, tenderness, and trigger points. Ultrasonography has emerged as a key tool for diagnosing and treating MPS owing to its ability to provide precise, minimally invasive guidance. This review discusses the use of ultrasonography in various approaches to evaluate and manage MPS. Studies have shown that shear-wave sonoelastography can effectively assess muscle elasticity and offer insights into trapezius stiffness in patients with MPS. Ultrasound-guided interfascial hydrodissection, especially with visual feedback, has demonstrated effectiveness in treating trapezius MPS. Similarly, ultrasound-guided rhomboid interfascial plane blocks and perimysium dissection for posterior shoulder MPS have significantly reduced pain and improved quality of life. The combination of extracorporeal shockwave therapy with ultrasound-guided lidocaine injections has been particularly successful in reducing pain and stiffness in trapezius MPS. Research regarding various guided injections, including dry needling, interfascial plane blocks, and fascial hydrodissection, emphasizes the importance of ultrasonography for accuracy and safety. Additionally, ultrasound-guided delivery of local anesthetics and steroids to the quadratus lumborum muscle has shown lasting pain relief over a 6-month period. Overall, these findings highlight the pivotal role of ultrasonography in the assessment and treatment of MPS.

Citations

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Blood Flow of the Infraspinatus Muscle in Individuals With and Without Shoulder Pain and Myofascial Trigger Points
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Kwangho Kim, Juhwan Song, Hongmin Chu, Robin Kwon, Seongjun Park, Junhui Kwon, Hyeon Joon Hong, Youngyun Lee, Sanghyuk Kwon, Kyungho Kang, Jungtae Leem, Cheol-Hyun Kim
Journal of Pain Research.2025; Volume 18: 1417. CrossRef
Integrating Ultrasound-Guided Injections and Peripheral Magnetic Stimulation in Chronic Myofascial/Lumbar Pain
Wei-Ting Wu, Ke-Vin Chang, Kamal Mezian, Vincenzo Ricci, Levent Özçakar
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Original articles

Medical Education
Current status and needs of community-based practice in public healthcare institutions among Korean medical schools: a cross-sectional study: Songrim Kim, Bongeun Cha, Sun Young Kyung, So Jung Yune, Kyung Hye Park, Kwi Hwa Park; J Yeungnam Med Sci. 2025;42:21. Published online January 6, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.21

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Abstract PDF: Background
This study analyzed the status of community-based practice in public healthcare institutions in Korean medical schools and identified related needs.
Methods
We conducted an online cross-sectional survey in which 32 of 40 medical schools (80.0%) participated between March and April 2023. We developed questionnaire items aimed at ascertaining the status and perceptions of community-based practice and analyzed the response data using frequency analysis, the Mann-Whitney U test, and content analysis with word clouds.
Results
Of the 32 medical schools analyzed, 23 (71.9%) offered practical courses, and of those, 12 (52.2%) implemented practice lessons within courses. Among 20 schools, 18 (90.0%) required students to complete practical courses and over 50% offered these courses in the third and fourth years of the clerkship phase. Perceptions of community practice showed no significant differences based on whether courses were offered. Many schools have proposed that practice should be a continuous curricular element from the premedical to medical years. The primary challenges facing community-based practice were identified as faculty development, collaboration, and compensation of practice institutions. The following words were extracted from the respondents’ comments: practice, community, institution, student, education, faculty, university, and public.
Conclusion
This study identified the limitations of community-based education provided by Korean medical schools and we report findings that highlight areas of improvement. Notable among these is the need to continuously incorporate community-based practice into medical education while engaging in discussions and conducting research toward developing a comprehensive and systematic curriculum.

Social and Family Medicine
Effects of psychological conditions and changes on smoking cessation success after a residential smoking cessation therapy program: a retrospective observational study: Gyu Lee Kim, Yu Hyeon Yi, Jeong Gyu Lee, Young Jin Tak, Seung Hun Lee, Young Jin Ra, Sang Yeoup Lee, Young Hye Cho, Eun Ju Park, Youngin Lee, Jung In Choi; J Yeungnam Med Sci. 2025;42:20. Published online January 2, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.20

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Abstract PDF: Background
Residential smoking cessation therapy programs offer intensive treatment for heavy smokers who struggle to quit independently, particularly those with high nicotine dependence and health conditions that necessitate urgent cessation. While previous studies have established the effectiveness of such programs and identified various factors influencing smoking cessation success, it remains unclear how changes in smokers’ thoughts and attitudes following residential therapy correlate with their ability to quit smoking. We investigated the relationship between smoking cessation-related characteristics, smoking-related psychological status, and participants’ smoking cessation success after a residential smoking cessation therapy program.
Methods
From January 2017 to December 2018, 291 participants completed the program. All participants completed questionnaires on smoking cessation-related characteristics and smoking-related psychological status before the program and on the 5th day. Six months later, smoking cessation success was assessed using a urine cotinine test.
Results
After 6 months, 222 participants successfully quit smoking, while 69 failed. The success and failure groups exhibited statistically significant differences in age, marital status, total smoking duration, stress, and emotion regulation strategies. Participants who used ineffective emotion regulation strategies more frequently had a lower rate of smoking cessation success (odds ratio [OR], 0.969; 95% confidence interval [CI], 0.948–0.991). Moreover, an increase in the perception of the negative effects of smoking cessation (OR, 0.982; 95% CI, 0.967–0.997) and smoking temptation (OR, 0.960; 95% CI, 0.929–0.993) was associated with higher cessation success.
Conclusion
Emotion regulation strategies, perceptions of the effects of smoking cessation, and smoking temptation were associated with successful smoking cessation.

Dentistry
Galectin-3 as a possible link between periodontitis and chronic kidney disease: a cross-sectional study: Sri Vidhya Marimuthu, Devi Arul, Muthukumar Santhanakrishnan, Ramprasad Elumalai, Sandhya Suresh, Sathya Selvarajan, Ravindranath Dhulipalla, Ramanarayana Boyapati; J Yeungnam Med Sci. 2025;42:22. Published online January 20, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.22

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Abstract PDF: Background
Chronic periodontitis is associated with various systemic inflammatory diseases; however, research on its association with chronic kidney disease (CKD) is relatively limited. Because both conditions share common risk factors, systemic inflammation plays a key role in the progression of these diseases. Galectin-3 (Gal-3) is a proinflammatory cytokine that plays an important role in chronic inflammatory diseases and is a potential biomarker. This study aimed to measure salivary Gal-3 levels in patients with periodontitis and CKD to better understand their association and evaluate Gal-3 as a diagnostic biomarker for these conditions.
Methods
Seventy-five patients were categorized into three groups: Group I, patients with CKD and periodontitis (n=25); Group II, patients with chronic periodontitis who were systemically healthy (n=25); and Group III, patients with CKD without chronic periodontitis (n=25). Demographic characteristics and periodontal and renal parameters were recorded for each patient. Saliva samples were collected to evaluate Gal-3 levels using an enzyme-linked immunosorbent assay.
Results
Patients with chronic periodontitis and CKD and those with chronic periodontitis alone (Groups I and II, respectively) showed significantly higher salivary Gal-3 levels than patients with CKD alone (Group III) (p<0.001). Bivariate correlation analysis indicated a strong relationship between clinical parameters and Gal-3 levels across all three groups.
Conclusion
Salivary Gal-3 level is a valuable early diagnostic marker of chronic periodontitis and CKD.

Review article

Radiology, Radiotherapy & Diagnostic Imaging
Digital auscultation in clear and present threat of novel respiratory infectious disease: a narrative review: Heeeon Lee, Gun Kim, Jacob Sangwoon Bae; J Yeungnam Med Sci. 2025;42:19. Published online December 30, 2024; DOI: https://doi.org/10.12701/jyms.2025.42.19

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Abstract PDF: The coronavirus disease 2019 pandemic has underscored the limitations of traditional diagnostic methods, particularly in ensuring the safety of healthcare workers and patients during infectious outbreaks. Smartphone-based digital stethoscopes enhanced with artificial intelligence (AI) have emerged as potential tools for addressing these challenges by enabling remote, efficient, and accessible auscultation. Despite advancements, most existing systems depend on additional hardware and external processing, increasing costs and complicating deployment. This review examines the feasibility and limitations of smartphone-based digital stethoscopes powered by AI, focusing on their ability to perform real-time analyses of audible and inaudible sound frequencies. We also explore the regulatory barriers, data storage challenges, and diagnostic accuracy issues that must be addressed to facilitate broader adoption. The implementation of these devices in veterinary medicine is discussed as a practical step toward refining their applications. With targeted improvements and careful consideration of existing limitations, smartphone-based AI stethoscopes could enhance diagnostic capabilities in human and animal healthcare settings.

Review Article

Pulmonary and Respiratory Medicine
Effects of postoperative rehabilitation on functional exercise capacity, dyspnea, and quality of life after pulmonary endarterectomy: a systematic review: Massimiliano Polastri; J Yeungnam Med Sci. 2025;42:32. Published online April 10, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.32 [Epub ahead of print]

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Abstract PDF: Chronic thromboembolic pulmonary hypertension (CTEPH) leads to increased vascular resistance and progressive right heart failure resulting from occlusion of proximal pulmonary arteries by fibrotic intravascular material. The elective surgical treatment for CTEPH is pulmonary endarterectomy (PEA), which involves removal of the chronic thromboembolic material from the entire pulmonary arterial tree. This study aimed to verify the effects of acute and subacute postoperative rehabilitation on the functional exercise capacity, dyspnea, and quality of life (QoL) of patients with CTEPH undergoing PEA. This was a systematic review of seven primary databases. At the end of the selection process, five documents were included in the final analysis. Three of these five studies were conducted in Italy, one in Korea, and one in Germany. Of 204 patients, 95 (47%) were male. This systematic review determined that in patients with CTEPH pre-PEA, the 6-minute walk distance (6MWD) ranged between 284.7 m and 371.95 m and that at 6 to 12 weeks post-PEA, after having attended postoperative rehabilitation, the 6MWD was 434.1 m to 483.6 m. The Short Form-36 Health Survey (SF-36) questionnaire was administered to evaluate QoL 3 and 22 weeks after PEA. At 22 weeks, the SF-36 physical component summary score improved from baseline (42.78±18.37 points) by 19.55±19.42 points (p=0.001), and the SF-36 mental component summary score improved from baseline (55.76±23.94 points) by 6.36±20.44 points (p=0.137).

Review article

Medical Informatics
Digital therapeutics in Korea: current status, challenges, and future directions – a narrative review: Hee Jun Shin, Ik Tae Cho, Wan Suk Choi, Hong Rae Kim, Min Bong Kang, Won Jong Yang; J Yeungnam Med Sci. 2025;42:8. Published online November 18, 2024; DOI: https://doi.org/10.12701/jyms.2024.01004

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Abstract PDF: Digital therapeutics (DTx) are emerging as a transformative innovation in healthcare offering evidence-based digital interventions for the treatment, management, and prevention of various diseases and disorders. In Korea, DTx have gained significant attention as potential solutions to the increasing burden of chronic diseases and mental health conditions. However, the Korean DTx market faces several challenges that hinder its widespread adoption and integration into the national healthcare system. This study provides a comprehensive analysis of the current state of the DTx market in Korea, identifies the key challenges impeding its growth, and proposes strategies for overcoming these obstacles. This study utilized a literature review and market analysis approach to examine the latest research, industry reports, and regulatory documents related to DTx. The analysis focused on three primary areas: (1) the current regulatory landscape, (2) technological advancements and challenges, and (3) economic and commercial factors influencing DTx adoption in Korea. A comparative analysis of global regulatory practices was also conducted to identify best practices. The findings revealed that while Korea has made significant strides in supporting DTx development, the market remains in its early stages. The key challenges include underdeveloped regulatory frameworks, issues with data quality and security, and a lack of established reimbursement pathways. We recommend developing tailored regulatory frameworks for DTx, enhancing policy support for small and medium-sized enterprises involved in DTx development, and increasing investments in technological infrastructure. By addressing these challenges, Korea could position itself as a leader in the global DTx market, delivering innovative and effective treatments to enhance patient care and outcomes.

Communications

Medical Informatics
Emerging technologies in the field of medicine presented at the Consumer Electronics Show 2025: Jong-Ryul Yang, Min Cheol Chang; J Yeungnam Med Sci. 2025;42:31. Published online April 1, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.31 [Epub ahead of print]

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Abstract PDF: The Consumer Electronics Show 2025 highlighted innovative technologies with considerable potential for healthcare, particularly artificial intelligence (AI) and sensor technologies. Notable advances that were showcased included products that leverage AI to personalize health management, such as devices capable of recommending binaural beat stimulation, analyzing speech patterns to detect language impairment, and predicting blood pressure through sleep data analysis. AI applications to enhance sleep quality, reduce snoring, and assess the caloric content of children’s meals were presented. However, the accuracy of these products remains inadequate for clinical use, which limits their applications in community settings. This showcase also featured advances in both contact and noncontact sensor technologies. Contact-type sensors, such as wearable rings and sensors designed to measure vital signs, including pulse rate, blood glucose, and blood pressure, have been developed to mitigate discomfort while maintaining high accuracy. Noncontact sensors employing radar and remote photoplethysmography technologies have further demonstrated promise for vital sign monitoring without physical contact, although maintaining accuracy during movement remains a challenge. AI integration with sensors was further demonstrated by the development of an electronic stethoscope utilizing microelectromechanical systems and deep learning algorithms to facilitate the perception of heart and breath sounds, emulating the functionality of conventional stethoscopes. Furthermore, advances in laser-based blood glucose monitoring and wearable robotic belts designed to assist gait have underscored the progress in devices aimed at enhancing patient care and daily living. These technologies hold considerable potential to profoundly transform healthcare systems, particularly in home and community settings.

Review article

Emergency and Critical Care Medicine
Advances and utility of digital twins in critical care and acute care medicine: a narrative review: Gabriele A. Halpern, Marko Nemet, Diksha M. Gowda, Oguz Kilickaya, Amos Lal; J Yeungnam Med Sci. 2025;42:9. Published online November 25, 2024; DOI: https://doi.org/10.12701/jyms.2024.01053

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Abstract PDF: Artificial intelligence (AI) has shown promise for revolutionizing healthcare. This narrative review focuses on the evolving discussion of the utility of AI and clinical informatics in critical care and acute care medicine, specifically focusing on digital twin (DT) technology. The improved computational power and iterative validation of these intelligent tools have enhanced medical education, in silico research, and clinical decision support in critical care settings. Integrating DTs into critical care opens vast opportunities, but simultaneously poses complex challenges, from data safety and privacy concerns to potentially increasing healthcare disparities. In medicine, DTs can significantly improve the efficiency of critical care systems. Stakeholder investment is essential for successful implementation and integration of these technologies.

Original article

Medical Informatics
Large language model usage guidelines in Korean medical journals: a survey using human-artificial intelligence collaboration: Sangzin Ahn; J Yeungnam Med Sci. 2025;42:14. Published online December 11, 2024; DOI: https://doi.org/10.12701/jyms.2024.00794

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Abstract PDF Supplementary Material: Background
Large language models (LLMs), the most recent advancements in artificial intelligence (AI), have profoundly affected academic publishing and raised important ethical and practical concerns. This study examined the prevalence and content of AI guidelines in Korean medical journals to assess the current landscape and inform future policy implementation.
Methods
The top 100 Korean medical journals determined by Hirsh index were surveyed. Author guidelines were collected and screened by a human researcher and AI chatbot to identify AI-related content. The key components of LLM policies were extracted and compared across journals. The journal characteristics associated with the adoption of AI guidelines were also analyzed.
Results
Only 18% of the surveyed journals had LLM guidelines, which is much lower than previously reported in international journals. However, the adoption rates increased over time, reaching 57.1% in the first quarter of 2024. High-impact journals were more likely to have AI guidelines. All journals with LLM guidelines required authors to declare LLM tool use and 94.4% prohibited AI authorship. The key policy components included emphasizing human responsibility (72.2%), discouraging AI-generated content (44.4%), and exempting basic AI tools (38.9%).
Conclusion
While the adoption of LLM guidelines among Korean medical journals is lower than the global trend, there has been a clear increase in implementation over time. The key components of these guidelines align with international standards, but greater standardization and collaboration are needed to ensure the responsible and ethical use of LLMs in medical research and writing.

Case Report

Hematology
Isolated central nervous system relapse in blast crisis of chronic myeloid leukemia: a case report: Hari Priya Raghvan, Caroline Ho Siew Ling, Wee Shiang Yui, Boo Yang Liang, Ehram Jamian, Indhira Subbiah; J Yeungnam Med Sci. 2025;42:17. Published online December 19, 2024; DOI: https://doi.org/10.12701/jyms.2025.42.17

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Abstract PDF: Chronic myeloid leukemia (CML) typically progresses from a chronic phase to an accelerated phase, and eventually to a blast crisis, often involving the bone marrow and peripheral blood, if left untreated. Central nervous system (CNS) involvement is an uncommon manifestation of CML, particularly as an isolated CNS relapse. Here, we present a rare case of CML in lymphoid blast crisis with an isolated CNS relapse. A 46-year-old female with underlying CML in lymphoid blast crisis, previously treated with chemotherapy and tyrosine kinase inhibitors, presented with visual disturbances. Imaging and cerebrospinal fluid analysis confirmed leukemic infiltration of the CNS without evidence of a systemic disease. Isolated CNS involvement is an atypical complication of CML and presents significant therapeutic challenges owing to the blood-brain barrier, which limits the efficacy of systemic therapies. Subsequently, the patient was treated with intrathecal chemotherapy targeting the CNS. Despite aggressive treatment, CNS relapse remains a major concern due to the limited penetration of standard therapies into the CNS. This case underscores the importance of early recognition of CNS symptoms in CML patients, particularly in those with blast crisis, and highlights the need for tailored therapeutic strategies to manage this rare and challenging manifestation.

Review articles

Endocrinology, Diabetes, and Metabolism
Screening and treatment of endocrine hypertension focusing on adrenal gland disorders: a narrative review: Seung Min Chung; J Yeungnam Med Sci. 2024;41(4):269-278. Published online September 19, 2024; DOI: https://doi.org/10.12701/jyms.2024.00752

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Abstract PDF: Most cases of high blood pressure have no identifiable cause, termed essential hypertension; however, in approximately 15% of cases, hypertension occurs due to secondary causes. Primary aldosteronism (PA) and pheochromocytoma and paraganglioma (PPGL) are representative endocrine hypertensive diseases. The differentiation of endocrine hypertension provides an opportunity to cure and prevent target organ damage. PA is the most common cause of secondary hypertension, which significantly increases the risk of cardiovascular disease compared to essential hypertension; thus, patients with clinical manifestations suggestive of secondary hypertension should be screened for PA. PPGL are rare but can be fatal when misdiagnosed. PPGL are the most common hereditary endocrine tumors; therefore, genetic testing using next-generation sequencing panels is recommended. Herein, we aimed to summarize the characteristic clinical symptoms of PA and PPGL and when and how diagnostic tests and treatment strategies should be performed.

Anesthesiology and Pain Medicine
Breakthrough pain and rapid-onset opioids in patients with cancer pain: a narrative review: Jinseok Yeo; J Yeungnam Med Sci. 2024;41(1):22-29. Published online June 30, 2023; DOI: https://doi.org/10.12701/jyms.2023.00367

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Abstract PDF: Breakthrough pain is transitory pain that occurs despite the use of opioids for background pain control. Breakthrough pain occurs in 40% to 80% of patients with cancer pain. Despite effective analgesic therapy, patients and their caregivers often feel that their pain is not sufficiently controlled. Therefore, an improved understanding of breakthrough pain and its management is essential for all physicians caring for patients with cancer. This article reviews the definition, clinical manifestations, accurate diagnostic strategies, and optimal treatment options for breakthrough pain in patients with cancer. This review focuses on the efficacy and safety of rapid-onset opioids, which are the primary rescue drugs for breakthrough pain.

Image vignette

Pediatrics, Perinatology, and Child Health
Bilateral spontaneous pneumothorax in systemic lupus erythematosus and the role of low-dose intravenous immunoglobulin: Felix Liauw, Tiara Nien Paramita, Endah Citraresmi, Abdurrahman Hadi; J Yeungnam Med Sci. 2025;42:29. Published online March 27, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.29

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PDF

Review article

Psychiatry and Mental Health
Advances, challenges, and prospects of electroencephalography-based biomarkers for psychiatric disorders: a narrative review: Seokho Yun; J Yeungnam Med Sci. 2024;41(4):261-268. Published online September 9, 2024; DOI: https://doi.org/10.12701/jyms.2024.00668

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Abstract PDF

Owing to a lack of appropriate biomarkers for accurate diagnosis and treatment, psychiatric disorders cause significant distress and functional impairment, leading to social and economic losses. Biomarkers are essential for diagnosing, predicting, treating, and monitoring various diseases. However, their absence in psychiatry is linked to the complex structure of the brain and the lack of direct monitoring modalities. This review examines the potential of electroencephalography (EEG) as a neurophysiological tool for identifying psychiatric biomarkers. EEG noninvasively measures brain electrophysiological activity and is used to diagnose neurological disorders, such as depression, bipolar disorder (BD), and schizophrenia, and identify psychiatric biomarkers. Despite extensive research, EEG-based biomarkers have not been clinically utilized owing to measurement and analysis constraints. EEG studies have revealed spectral and complexity measures for depression, brainwave abnormalities in BD, and power spectral abnormalities in schizophrenia. However, no EEG-based biomarkers are currently used clinically for the treatment of psychiatric disorders. The advantages of EEG include real-time data acquisition, noninvasiveness, cost-effectiveness, and high temporal resolution. Challenges such as low spatial resolution, susceptibility to interference, and complexity of data interpretation limit its clinical application. Integrating EEG with other neuroimaging techniques, advanced signal processing, and standardized protocols is essential to overcome these limitations. Artificial intelligence may enhance EEG analysis and biomarker discovery, potentially transforming psychiatric care by providing early diagnosis, personalized treatment, and improved disease progression monitoring.

Citations

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Zipper Pattern: An Investigation into Psychotic Criminal Detection Using EEG Signals
Gulay Tasci, Prabal Datta Barua, Dahiru Tanko, Tugce Keles, Suat Tas, Ilknur Sercek, Suheda Kaya, Kubra Yildirim, Yunus Talu, Burak Tasci, Filiz Ozsoy, Nida Gonen, Irem Tasci, Sengul Dogan, Turker Tuncer
Diagnostics.2025; 15(2): 154. CrossRef

Communications

Physical therapy, Sports Therapy, and Rehabilitation
Differences in pain treatment between the healthcare systems in South Korea and Quebec and proposals for improvements: Min Cheol Chang, Mathieu Boudier-Revéret; J Yeungnam Med Sci. 2025;42:16. Published online December 18, 2024; DOI: https://doi.org/10.12701/jyms.2024.01410

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Abstract PDF: After a year of exchange in Montreal, a South Korean academic physiatrist and his Canadian colleague have reflected on the strengths and weaknesses of their respective healthcare systems. They have focused more specifically on physiatrist-delivered pain medicine treatments. This article is written based on personal perspectives. It aims to present the differences between the systems in South Korea and Quebec, highlighting the issues arising from each system and providing perspectives on potential solutions.

Case report

Physical therapy, Sports Therapy, and Rehabilitation
GMNN and DLL1 mutation-related spondylocarpotarsal synostosis: a case report: Joonhwan Lee, Byungju Ryu, Yunhee Kim, Eunyoung Lee; J Yeungnam Med Sci. 2025;42:15. Published online December 11, 2024; DOI: https://doi.org/10.12701/jyms.2024.01137

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Abstract PDF: Spondylocarpotarsal synostosis syndrome (SCTS) is a rare genetic disorder characterized by vertebral fusion, short stature, and skeletal anomalies. SCTS is primarily associated with mutations in filamin B. However, in this report, we present a unique case of SCTS in a 28-year-old male who complained of neck and shoulder pain persisting for 1 year. His clinical presentation included radioulnar synostosis, cervical spine anomalies (scoliosis and agenesis of the posterior arch of C1), and a history of polydactyly. Genetic analysis revealed mutations in GMNN and DLL1. To the best of our knowledge, this is the first report on the association of SCTS with these genes.

Review article

Rheumatology
The use of animal models in rheumatoid arthritis research: Jin-Sun Kong, Gi Heon Jeong, Seung-Ah Yoo; J Yeungnam Med Sci. 2023;40(1):23-29. Published online November 22, 2022; DOI: https://doi.org/10.12701/jyms.2022.00773

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Abstract PDF

The pathological hallmark of rheumatoid arthritis (RA) is a synovial pannus that comprises proliferating and invasive fibroblast-like synoviocytes, infiltrating inflammatory cells, and an associated neoangiogenic response. Animal models have been established to study these pathological features of human RA. Spontaneous and induced animal models of RA primarily reflect inflammatory aspects of the disease. Among various induced animal models, collagen-induced arthritis (CIA) and collagen antibody-induced arthritis (CAIA) models are widely used to study the pathogenesis of RA. Improved transplantation techniques for severe combined immunodeficiency (SCID) mouse models of RA can be used to evaluate the effectiveness of potential therapeutics in human tissues and cells. This review provides basic information on various animal models of RA, including CIA and CAIA. In addition, we describe a SCID mouse coimplantation model that can measure the long-distance migration of human RA synoviocytes and cartilage destruction induced by these cells.

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Xiuying Li, Xin Wang, Xiuwu Qu, Ningning Shi, Qinqing Li, Zhifang Yan, Yandong Li, Yingli Wang
International Journal of Nanomedicine.2024; Volume 19: 3259. CrossRef
Clinical Phenotypes, Serological Biomarkers, and Synovial Features Defining Seropositive and Seronegative Rheumatoid Arthritis: A Literature Review
James Perera, Chiara Aurora Delrosso, Alessandra Nerviani, Costantino Pitzalis
Cells.2024; 13(9): 743. CrossRef
Emerging Landscape of In Vitro Models for Assessing Rheumatoid Arthritis Management
Abhay Prakash Mishra, Rajesh Kumar, Seetha Harilal, Manisha Nigam, Deepanjan Datta, Sudarshan Singh
ACS Pharmacology & Translational Science.2024; 7(8): 2280. CrossRef
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Kajetan Kiełbowski, Paulina Plewa, Aleksandra Wiktoria Bratborska, Estera Bakinowska, Andrzej Pawlik
International Journal of Molecular Sciences.2024; 25(15): 8327. CrossRef
Astaxanthin, Compared to Other Carotenoids, Increases the Efficacy of Methotrexate in Rat Adjuvant Arthritis
Katarína Pružinská, Martin Chrastina, Sasan Khademnematolahi, Veronika Vyletelová, Lívia Gajdošová, Lucia Pastvová, František Dráfi, Silvester Poništ, Ľudmila Pašková, Jarmila Kucharská, Zuzana Sumbalová, Jana Muchová, Silvia Martiniaková, Katarína Bauero
International Journal of Molecular Sciences.2024; 25(16): 8710. CrossRef
In vivo murine models for evaluating anti-arthritic agents: An updated review
Santenna Chenchula, Ahmad Najmi, Shubham Atal, Balakrishnan Sadasivam
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Impaired Development of Collagen Antibody-Induced Arthritis in Rab44-Deficient Mice
Yu Yamaguchi, Tomoko Kadowaki, Eiko Sakai, Mayuko Noguromi, Shun Oyakawa, Takayuki Tsukuba
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Pharmaceuticals.2024; 17(11): 1504. CrossRef

Image vignette

Physical therapy, Sports Therapy, and Rehabilitation
Spondyloenchondrodysplasia with immune dysregulation: an under-the-radar cause of spasticity: Berkay Yalçınkaya, Ahmet Furkan Çolak, Hilmi Berkan Abacıoğlu, Alp Çetin; J Yeungnam Med Sci. 2025;42:30. Published online March 27, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.30

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Case report

Internal Medicine
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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Abstract PDF

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.

Citations

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Thallium reabsorption via NKCC2 causes severe acute kidney injury with outer medulla-specific calcium crystal casts in rats
Kana Unuma, Shuheng Wen, Sho Sugahara, Shutaro Nagano, Toshihiko Aki, Tadayuki Ogawa, Shino Takeda-Homma, Masakazu Oikawa, Akihiro Tojo
Archives of Toxicology.2024; 98(12): 3973. CrossRef
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

Review article

Radiology, Radiotherapy & Diagnostic Imaging
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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Cell–cell communications in the brain of hepatic encephalopathy: The neurovascular unit
Kyuwan Choi, Yena Cho, Yerin Chae, So Yeong Cheon
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Hiromu Yurimoto, Taiki Matsubayashi, Isamu Shibata, Misako Furuki, Masato Obayashi
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Pattern Clustering of Symmetric Regional Cerebral Edema on Brain MRI in Patients with Hepatic Encephalopathy
Chun Geun Lim, Hui Joong Lee
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Rule out all differential causes before attributing cerebral bleeding to 5-aminolevulinic acid
Josef Finsterer, Sounira Mehri
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Minimal hepatic encephalopathy: clinical, neurophysiological, neuroimaging markers
P. I. Kuznetsova, A. A. Raskurazhev, S. N. Morozova, I. M. Lovchev, M. S. Novruzbekov, M. M. Tanashyan
Russian neurological journal.2023; 28(5): 21. CrossRef
Prevalence of Precipitating Factors of Hepatic Encephalopathy at Nangarhar Regional Hospital
Ameerullah Razai, Ismail Khan Safi, Said Abdul Jamil Saidi, Said Inam Saidi
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Case reports

Dentistry
Oral chemical burns caused by topical application of policresulen: a case report: Hwa Suk Chae, Sohee Kang; J Yeungnam Med Sci. 2023;40(3):293-296. Published online October 20, 2022; DOI: https://doi.org/10.12701/jyms.2022.00472

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Abstract PDF: Oral mucosal burns can occur after contact with various chemical agents, and commonly manifest as areas of mucosal sloughing and ulceration. Policresulen (Albothyl, Celltrion Pharm Inc.) is an over-the-counter topical antiseptic that is frequently used to treat stomatitis. Policresulen solution is highly acidic, with an approximate pH of 0.6; it can thus cause mucosal injury when improperly applied in the oral cavity. Here, we present a rare case of an oral mucosal burn resulting from incorrect self-administration of policresulen and emphasize the importance of increasing understanding of this adverse drug event among consumers and health professionals.

Nephrology
Ischemic monomelic neuropathy following arteriovenous fistula surgery: a case report: Da Woon Kim, You Hyun Jeon, Miju Bae, Sang Heon Song; J Yeungnam Med Sci. 2025;42:7. Published online November 11, 2024; DOI: https://doi.org/10.12701/jyms.2024.00948

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Abstract PDF: Ischemic monomelic neuropathy (IMN) is an uncommon complication of arteriovenous fistula (AVF) surgery that presents with pain, motor weakness, and sensory changes without critical ischemia. This report describes a rare case of successful IMN treatment after AVF surgery. A 61-year-old man with diabetic end-stage kidney disease was admitted for left brachiocephalic AVF surgery. Postoperatively, the patient complained of pain, motor weakness, and numbness in the left hand. However, the radial pulse remained palpable, and the overlying skin remained intact. A nerve conduction study above the wrist revealed reduced compound muscle action potential (CMAP) of the left ulnar nerve and no CMAP of the left median nerve. This study also showed the absence of sensory amplitude in both the left median and left ulnar nerves. Therefore, the patient was diagnosed with IMN. Proximalization of the arterial inflow surgery was performed to redistribute blood flow while maintaining the AVF. The patient’s neurological symptoms resolved postoperatively. Various conditions can cause hand pain after AVF surgery; however, IMN has rarely been reported. A multidisciplinary approach is needed to avoid this rare complication in patients presenting with hand pain after AVF surgery.

Resident fellow section: Clinical vignette

Cardiology and Cardiovascular Medicine
Differential diagnosis for unusually dilated coronary sinus and right coronary artery incidentally found on echocardiography: Byeng-Ju Son, Hojeong Kim, Jong-Ho Nam; J Yeungnam Med Sci. 2023;40(4):461-465. Published online October 6, 2023; DOI: https://doi.org/10.12701/jyms.2023.00906

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178 Download
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PDF

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Persistent left cranial vena cava in a dog
Z. Yilmaz, M. Kocaturk, J. Koch
Journal of Small Animal Practice.2024; 65(11): 830. CrossRef

Review article

Musculoskeletal Disorders
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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224 Download
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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.

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Won-Pyo Lee, Euisin Yang, Woong Kim, Riessa Nanda Mertamani, Hana Lee, Se Eun Kim, Kyung Mi Shim, Seong Soo Kang, Sukyoung Kim, Seok-Jun Kim, Jooseong Kim
Materials & Design.2024; 248: 113484. CrossRef
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Bríd Murphy, Mick A. Morris, Jhonattan Baez
Nanomaterials.2023; 13(18): 2577. CrossRef

Focused Review articles

Gastroenterology and Hepatology
Overview of hepatocarcinogenesis focusing on cellular origins of liver cancer stem cells: a narrative review: Jong Ryeol Eun; J Yeungnam Med Sci. 2025;42:3. Published online November 11, 2024; DOI: https://doi.org/10.12701/jyms.2024.01088

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1 Web of Science

Abstract PDF: Hepatocellular carcinoma (HCC) accounts for 85% to 90% of primary liver cancers and generally has a poor prognosis. The hierarchical model, which posits that HCC originates from liver cancer stem cells (CSCs), is now widely accepted, as it is for other cancer types. As CSCs typically reside in the G0 phase of the cell cycle, they are resistant to conventional chemotherapy. Therefore, to effectively treat HCC, developing therapeutic strategies that target liver CSCs is essential. Clinically, HCCs exhibit a broad spectrum of pathological and clinical characteristics, ranging from well-differentiated to poorly differentiated forms, and from slow-growing tumors to aggressive ones with significant metastatic potential. Some patients with HCC also show features of cholangiocarcinoma. This HCC heterogeneity may arise from the diverse cellular origins of liver CSCs. This review explores the normal physiology of liver regeneration and provides a comprehensive overview of hepatocarcinogenesis, including cancer initiation, isolation of liver CSCs, molecular signaling pathways, and microRNAs. Additionally, the cellular origins of liver CSCs are reviewed, emphasizing hematopoietic and mesenchymal stem cells, along with the well-known hepatocytes and hepatic progenitor cells.

Endocrinology, Diabetes, and Metabolism
What is the disease burden from childhood and adolescent obesity?: a narrative review: Eun Byoul Lee; J Yeungnam Med Sci. 2024;41(3):150-157. Published online June 27, 2024; DOI: https://doi.org/10.12701/jyms.2024.00360

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Abstract PDF

The prevalence of childhood and adolescent obesity has increased and exacerbated during the coronavirus disease 2019 pandemic, both in Korea and globally. Childhood and adolescent obesity poses significant risks for premature morbidity and mortality. The development of serious comorbidities depends not only on the duration of obesity but also on the age of onset. Obesity in children and adolescents affects almost all organ systems, including the endocrine, cardiovascular, gastrointestinal, reproductive, nervous, and immune systems. Obesity in children and adolescents affects growth, cognitive function, and psychosocial interactions during development, in addition to aggravating known adult comorbidities such as type 2 diabetes mellitus, hypertension, dyslipidemia, nonalcoholic fatty liver disease, obstructive sleep apnea, and cancer. Childhood and adolescent obesity are highly associated with increased cardiometabolic risk factors and prevalence of metabolic syndrome. The risk of cardiovascular and metabolic diseases in later life can be considerably decreased by even a small weight loss before the onset of puberty. Childhood and adolescent obesity is a disease that requires treatment and is associated with many comorbidities and disease burdens. Therefore, early detection and therapeutic intervention are crucial.

Citations

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Exploring comprehensive insights into pediatric obesity
Yong Hee Hong
Journal of Yeungnam Medical Science.2024; 41(3): 139. CrossRef

Review article

Geriatrics and Gerontology
Multidisciplinary approach to sarcopenia: a narrative review: Wook Tae Park, Oog-Jin Shon, Gi Beom Kim; J Yeungnam Med Sci. 2023;40(4):352-363. Published online September 7, 2023; DOI: https://doi.org/10.12701/jyms.2023.00724

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Abstract PDF

Sarcopenia is a condition in which muscle mass and strength are decreased and muscle function is impaired. It is an indicator of frailty and loss of independence in older adults. It is also associated with increased physical disability, which increases the risk of falls. As a multifactorial disease, sarcopenia is caused by a combination of factors including aging, hormonal changes, nutritional deficiencies, and physical inactivity. Understanding the underlying pathophysiology of sarcopenia and identifying its different causes is critical to developing effective prevention and treatment strategies. This review summarizes the pathophysiology, consequences, diagnostic methods, and multidisciplinary approaches to sarcopenia.

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Prevalence of, and factors associated with, sarcopenia in Iran: a systematic review and meta-analysis
Mobin Marzban Abbas Abadi, Danial Hosseinzade, Majid Khalilizad
Frontiers in Nutrition.2025;[Epub] CrossRef
Head and Neck Cancer and Sarcopenia: An Integrative Clinical and Functional Review
Kazuhira Endo, Mariko Ichinose, Eiji Kobayashi, Takayoshi Ueno, Nobuyuki Hirai, Yosuke Nakanishi, Satoru Kondo, Tomokazu Yoshizaki
Cancers.2024; 16(20): 3460. CrossRef
Economic burden of sarcopenia-related disability in the elderly population: a study in Iran
Ali Darvishi, Adeleh Nikkhah, Gita Shafiee, Rajabali Daroudi, Ramin Heshmat
BMC Research Notes.2024;[Epub] CrossRef

Original articles

Musculoskeletal Disorders
Impact of artificial intelligence in managing musculoskeletal pathologies in physiatry: a qualitative observational study evaluating the potential use of ChatGPT versus Copilot for patient information and clinical advice on low back pain: Christophe Ah-Yan, Ève Boissonnault, Mathieu Boudier-Revéret, Christopher Mares; J Yeungnam Med Sci. 2025;42:11. Published online November 29, 2024; DOI: https://doi.org/10.12701/jyms.2024.01151

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Abstract PDF Supplementary Material: Background
The self-management of low back pain (LBP) through patient information interventions offers significant benefits in terms of cost, reduced work absenteeism, and overall healthcare utilization. Using a large language model (LLM), such as ChatGPT (OpenAI) or Copilot (Microsoft), could potentially enhance these outcomes further. Thus, it is important to evaluate the LLMs ChatGPT and Copilot in providing medical advice for LBP and assessing the impact of clinical context on the quality of responses.
Methods
This was a qualitative comparative observational study. It was conducted within the Department of Physical Medicine and Rehabilitation, University of Montreal in Montreal, QC, Canada. ChatGPT and Copilot were used to answer 27 common questions related to LBP, with and without a specific clinical context. The responses were evaluated by physiatrists for validity, safety, and usefulness using a 4-point Likert scale (4, most favorable).
Results
Both ChatGPT and Copilot demonstrated good performance across all measures. Validity scores were 3.33 for ChatGPT and 3.18 for Copilot, safety scores were 3.19 for ChatGPT and 3.13 for Copilot, and usefulness scores were 3.60 for ChatGPT and 3.57 for Copilot. The inclusion of clinical context did not significantly change the results.
Conclusion
LLMs, such as ChatGPT and Copilot, can provide reliable medical advice on LBP, irrespective of the detailed clinical context, supporting their potential to aid in patient self-management.

Geriatrics and Gerontology
Long-term supplementation with a combination of beta-hydroxy-beta-methylbutyrate, arginine, and glutamine for pressure ulcer in sedentary older adults: a retrospective matched case-control study: Igor Kisil, Yuri Gimelfarb; J Yeungnam Med Sci. 2023;40(4):364-372. Published online February 16, 2023; DOI: https://doi.org/10.12701/jyms.2022.00899

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Abstract PDF

Background
Growing evidence suggests that beta-hydroxy-beta-methylbutyrate (HMB), arginine (Arg), and glutamine (Gln) positively affect wound recovery. This study investigated the effects of long-term administration of HMB/Arg/Gln on pressure ulcer (PU) healing in sedentary older adults admitted to geriatric and rehabilitation care facilities.
Methods
This was a pilot retrospective case (standard of care and HMB/Arg/Gln)-control (standard of care alone) clinical study. Outcome measures were relative healing rates and Pressure Ulcer Scale for Healing (PUSH) scores (calculated after 4, 8, 12, 16, and 20 weeks) and time to healing.
Results
The study subpopulation was comprised of 14 participants (four males, 28.6%) with the median age of 85.5 years (interquartile range [IQR], 82.0–90.2 years). The control subpopulation was comprised of 31 participants (18 males, 58.1%) with the median age of 84.0 years (IQR, 78.0–90.0 years). At the beginning of follow-up, there were no statistically significant demographic (sex and age) and clinical (main diagnosis, baseline area, and PU perimeter) differences between the groups. During the study period, there were no significant differences in the relative healing rates and PUSH scores between the subpopulations. The median time to complete healing in the study and control populations was 170.0 days (95% confidence interval [CI], 85.7–254.3) and 218.0 days (95% CI, 149.2–286.7) (log-rank, chi-square=3.99; p<0.046), respectively.
Conclusion
More than 20 weeks of HMB/Arg/Gln supplementation had a positive effect on difficult PU healing in older adults with multiple comorbidities.

Citations

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Impact of oral nutritional supplement composition on healing of different chronic wounds: A systematic review
Allan Carlos Soares do Espírito Santo, Clara Sandra de Araújo Sugizaki, Alcides Corrêa de Morais Junior, Nara Aline Costa, Maria Marcia Bachion, João Felipe Mota
Nutrition.2024; 124: 112449. CrossRef

Case report

Cardiology and Cardiovascular Medicine
Uncorrectable hypoxemia due to large pulmonary arteriovenous malformation in a patient with myocardial infarction: a case report: Kang-Un Choi, Jang-Won Son; J Yeungnam Med Sci. 2025;42:12. Published online December 2, 2024; DOI: https://doi.org/10.12701/jyms.2024.01193

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Abstract PDF: Persistent hypoxemia following myocardial infarction can be challenging to manage and often requires considering uncommon etiologies such as extracardiac shunts. This case report describes a 78-year-old man with persistent hypoxemia post-myocardial infarction, which was ultimately attributed to a large pulmonary arteriovenous malformation (AVM). The patient presented with cardiogenic shock and underwent successful revascularization. Despite clinical improvement, the hypoxemia persisted, prompting further evaluation. Bedside saline contrast echocardiography and computed tomography confirmed the presence of a large pulmonary AVM, explaining the uncorrectable hypoxemia. This case underscores the importance of considering extracardiac shunts in patients with refractory hypoxemia and illustrates the utility of bedside imaging in such situations.

Focused Review article

Pediatrics, Perinatology, and Child Health
Effective and appropriate use of weight loss medication in pediatric obesity: a narrative review: Yoojin Lindsey Chung; J Yeungnam Med Sci. 2024;41(3):158-165. Published online July 2, 2024; DOI: https://doi.org/10.12701/jyms.2024.00353

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Abstract PDF

Over the past few decades, there has been a notable increase in the incidence of pediatric obesity, which is a significant public health concern. Children who are obese have a greater risk of type 2 diabetes, hypertension, dyslipidemia, polycystic ovary syndrome, obstructive sleep apnea, and adult obesity. Lifestyle modification therapy is typically the initial approach to treat pediatric obesity. For patients who do not achieve success with lifestyle modification therapy alone, pharmacotherapy is the next logical treatment option. When selecting an anti-obesity medication (AOM), it is essential to first ascertain the medical background of the patient, including current medications and obesity-associated comorbidities. Evaluation of obesity phenotypes in patients may also be beneficial. AOMs for pediatric obesity include metformin, orlistat, glucagon-like peptide 1 agonists, phentermine, and the phentermine/topiramate combination. Sufficient lifestyle modification therapy should be administered before considering pharmacotherapy and continued after the initiation of AOM. To ensure healthy development, monitoring growth and puberty development during anti-obesity treatments is essential.

Citations

Citations to this article as recorded by

Exploring comprehensive insights into pediatric obesity
Yong Hee Hong
Journal of Yeungnam Medical Science.2024; 41(3): 139. CrossRef

Resident fellow section: Teaching images

Musculoskeletal Disorders
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

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PDF

Focused Review article

Pediatrics, Perinatology, and Child Health
The prevalence and prevention strategies of pediatric obesity: a narrative review: Mi Seon Lee; J Yeungnam Med Sci. 2024;41(3):141-149. Published online July 5, 2024; DOI: https://doi.org/10.12701/jyms.2024.00346

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Abstract PDF

Pediatric obesity has rapidly increased globally over the past few decades, including in Korea. We aimed to discuss trends in the prevalence of pediatric obesity and effective prevention strategies. Its prevalence has markedly increased in most high-income nations. According to recent reports, this increase has slowed in developed countries, but the levels remain alarmingly high. In Korea, the rate of pediatric obesity has surged notably since the 1990s; however, since the 2000s, this increase has become more gradual. According to recently published 2017 growth charts, the prevalence of pediatric obesity in Korea varies slightly depending on the data source. The National School Health Examination data showed that pediatric obesity gradually increase from 11.5% in 2014 to 15.1% in 2019, and after the coronavirus disease 2019 pandemic, it sharply increased to 19% in 2021. Based on data from the Korea National Health and Nutrition Examination Survey, the prevalence of pediatric obesity gradually increased from 10.8% in 2017 to 13.6% in 2019. This trend, which accelerated sharply to 15.9% in 2020 and 19.3% in 2021, was especially severe in boys and older children. Pediatric obesity not only affects health during childhood but also increases the risk of developing obesity and associated health conditions in adulthood. Despite ongoing research on treatment options, obesity prevention and control remain challenging. Hence, prioritizing early intervention and prevention of pediatric obesity through healthy eating habits and lifestyles is crucial. This requires intervention at the individual, family, school, and community levels.

Citations

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Exploring comprehensive insights into pediatric obesity
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Original article

Endocrinology, Diabetes, and Metabolism
Adult height in girls with central precocious puberty without gonadotropin-releasing hormone agonist treatment: a retrospective case-control study: Hyun Ji Jang, Min Jung Kwak, Young Mi Kim, Soo-Han Choi, Kyung Hee Park, Hye Won Yoo, Su Jeong Park, Yoon Hee Jo, Ha Young Jo; J Yeungnam Med Sci. 2023;40(Suppl):S81-S86. Published online November 7, 2023; DOI: https://doi.org/10.12701/jyms.2023.00801

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Abstract PDF

Background
The primary aim of this study was to investigate the final adult height (FAH) of girls diagnosed with central precocious puberty (CPP) who were untreated.
Methods
We retrospectively analyzed the medical records of 36 girls diagnosed with CPP between 8 and 9 years of age who did not receive treatment, and 206 girls diagnosed with CPP within the same age range who received gonadotropin-releasing hormone (GnRH) agonist treatment. Midparental height (MPH), predicted adult height (PAH) obtained using height and bone age (BA) at the time of diagnosis (PAH for BA), and PAH obtained using the Bayley-Pinneau method (PAH by BP) were calculated. Additionally, height at the time of growth completion was compared with the predicted height.
Results
The FAHs were 160.71±4.56 cm in the untreated group and 159.31±4.26 cm in the treated group. In the untreated group, the FAH was 0.99±4.50 cm shorter than the MPH but 4.29±3.33 cm and 3.46±3.93 cm greater than the PAH for BA and PAH by BP, respectively.
Conclusion
In children diagnosed with CPP between 8 and 9 years of age who were untreated, FAH was greater than PAH for BA and PAH by BP at the time of diagnosis, indicating that the prognosis of FAH was not poor. Therefore, for girls diagnosed with CPP, it is recommended to consider various conditions, such as pubertal onset, height at diagnosis, BA, peak luteinizing hormone level, predicted height, and speed of puberty, when deciding whether to administer GnRH agonists.

Citations

Citations to this article as recorded by

LONG TERM CONSEQUENCES OF PRECOCIOUS PUBERTY - EXPLORING HEALTH, METABOLIC, AND PSYCHIATRIC CHALLENGES
Justyna Popczyńska, Agnieszka Raczyńska, Natalia Pacocha, Oliwia Krzemień, Kinga Kosiec, Jakub Jędrychowski, Natalia Karpowicz, Julia Kaszucka, Małgorzata Krzyżanowska, Marta Zgierska
International Journal of Innovative Technologies in Social Science.2024;[Epub] CrossRef

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