Journal of Yeungnam Medical Science

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

Editorial

Appreciation to peer reviewers in 2024: So-Young Park; J Yeungnam Med Sci. 2025;42:1. Published online December 31, 2024; DOI: https://doi.org/10.12701/jyms.2025.42.1

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Imagery

Following the snow-covered path to home: J Yeungnam Med Sci. 2025;42:i. Published online November 13, 2024; DOI: https://doi.org/10.12701/jyms.2024.01382

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Original article

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 [Epub ahead of print]

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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.

Focused Review articles

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

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Abstract PDF

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

Citations

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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
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
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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

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

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

Resident fellow section: Clinical vignette

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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Citations

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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

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.

Case report

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

Citations to this article as recorded by

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 articles

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

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Abstract PDF

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

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

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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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

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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
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The Journal of nutrition, health and aging.2025; 29(4): 100480. CrossRef
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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
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Intermittent Fasting Improves Social Interaction and Decreases Inflammatory Markers in Cortex and Hippocampus
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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
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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
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Ketogenic Interventions in Autosomal Dominant Polycystic Kidney Disease: A Comprehensive Review of Current Evidence
Carla Pezzuoli, Giuseppe Biagini, Riccardo Magistroni
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Cureus.2023;[Epub] CrossRef

Original article

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

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Abstract PDF

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

Citations

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The inflammatory and metabolic status of patients with sudden-onset sensorineural hearing loss
Jônatas Bussador do Amaral, Kelly Abdo Peron, Tracy Lima Tavares Soeiro, Marina Cançado Passarelli Scott, Flávia Tatiana Pedrolo Hortense, Michelly Damasceno da Silva, Carolina Nunes França, Luiz Henrique da Silva Nali, André Luis Lacerda Bachi, Norma de
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Which Environmental Pollutants Are Toxic to Our Ears?—Evidence of the Ototoxicity of Common Substances
Gregory M. Zarus, Patricia Ruiz, Rae Benedict, Stephan Brenner, Krystin Carlson, Layna Jeong, Thais C. Morata
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Review articles

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.

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
Jace Brown, Gary Kearns, Emily Hedges, Samantha Samaniego, Sharon Wang‐Price
Journal of Ultrasound in Medicine.2025; 44(1): 127. CrossRef
Integrating Ultrasound-Guided Multifidus Injections with Repeated Peripheral Magnetic Stimulation for Low Back Pain: A Feasibility Study
Wei-Ting Wu, Ke-Vin Chang, Levent Özçakar
Journal of Pain Research.2024; Volume 17: 2873. CrossRef
Ultrasound-guided fascial plane blocks in chronic pain: a narrative review
Francesco Marrone, Carmine Pullano, Alessandro De Cassai, Pierfrancesco Fusco
Journal of Anesthesia, Analgesia and Critical Care.2024;[Epub] CrossRef

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.

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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

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.

Focused Review article

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.

Review article

Octacalcium phosphate, a promising bone substitute material: a narrative review: Jooseong Kim, Sukyoung Kim, Inhwan Song; J Yeungnam Med Sci. 2024;41(1):4-12. Published online May 9, 2023; DOI: https://doi.org/10.12701/jyms.2023.00010

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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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Improvement of bone regeneration by a synergistic combination of octacalcium phosphate and water glass
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
Development of Hydroxyapatite Coatings for Orthopaedic Implants from Colloidal Solutions: Part 1—Effect of Solution Concentration and Deposition Kinetics
Bríd Murphy, Mick A. Morris, Jhonattan Baez
Nanomaterials.2023; 13(18): 2577. CrossRef

Case report

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.

Review articles

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.

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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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.

Citations

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Seven-day rehabilitation services in hospital settings: benefits and drawbacks
Massimiliano Polastri, Luciana Scuotto
International Journal of Therapy and Rehabilitation.2024; 31(12): 1. CrossRef

Focused Review article

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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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.

Review article

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

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Abstract PDF

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

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Pattern Clustering of Symmetric Regional Cerebral Edema on Brain MRI in Patients with Hepatic Encephalopathy
Chun Geun Lim, Hui Joong Lee
Journal of the Korean Society of Radiology.2024; 85(2): 381. CrossRef
Response to “Brain Lesions in Liver Cirrhosis May Not Only Be Due to Hepatic Encephalopathy”
Hui Joong Lee
Journal of the Korean Society of Radiology.2024; 85(4): 827. CrossRef
Altered Mental Status in the Solid-Organ Transplant Recipient
Nicolas Weiss, Henning Pflugrad, Prem Kandiah
Seminars in Neurology.2024; 44(06): 670. CrossRef
Reversibility of structural and functional alterations of hepatic encephalopathy
Henning Pflugrad, Ann-Katrin Hennemann
Metabolic Brain Disease.2024;[Epub] CrossRef
Rule out all differential causes before attributing cerebral bleeding to 5-aminolevulinic acid
Josef Finsterer, Sounira Mehri
Child's Nervous System.2023; 39(4): 847. CrossRef
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
Nangarhar University International Journal of Biosciences.2023; : 34. CrossRef

Original article

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.

Focused Review article

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.

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Exploring comprehensive insights into pediatric obesity
Yong Hee Hong
Journal of Yeungnam Medical Science.2024; 41(3): 139. CrossRef
Title: A Qualitative Systematic Review of Parental Perceptions, Motivators, and Barriers to Management of Childhood Obesity
Sarah Musa, Ayman Al-Dahshan, Vahe Kehyayan
Diabetes, Metabolic Syndrome and Obesity.2024; Volume 17: 4749. CrossRef

Review articles

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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Anti-rheumatic arthritis efficacy of Pueraria montana extract against type-II collagen-induced rheumatoid arthritis rat model an in vitro and in vivo assessment
Fangming Wang, Minli Liu, Qian Tang, Haijian Sun, Guangxia Yang, Jian Sun
Journal of Ethnopharmacology.2025; 340: 119175. CrossRef
CRISPRa engineered Elite macrophages enable adoptive cell therapy for rheumatoid arthritis
Yuhong Huang, Zhuqian Wang, Chuanxin Zhong, Hongzhen Chen, Xinxin Chen, Chunhao Cao, Fang Qiu, Duoli Xie, Jin Li, Jie Li, Xu Yang, Aiping Lu, Xuekun Fu, Chao Liang
The Innovation Medicine.2024; 2(1): 100050. CrossRef
Microenvironmental Enzyme-Responsive Methotrexate Modified Quercetin Micelles for the Treatment of Rheumatoid Arthritis
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
JAK Inhibitors in Rheumatoid Arthritis: Immunomodulatory Properties and Clinical Efficacy
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
Future Health.2024; 2: 138. CrossRef
Impaired Development of Collagen Antibody-Induced Arthritis in Rab44-Deficient Mice
Yu Yamaguchi, Tomoko Kadowaki, Eiko Sakai, Mayuko Noguromi, Shun Oyakawa, Takayuki Tsukuba
Biomedicines.2024; 12(11): 2504. CrossRef
Levamisole Ameliorates Rheumatoid Arthritis by Downregulating the PI3K/Akt Pathway in SD Rats
Mu Guo, Xiangbin Yu, Zesheng Yang, Hanlu Zheng, Jiahui Zhang, Junxiang Wang, Yiqi Liao, Weirui Huang, Zhaolong Lin, Yingxue Yan, Nengfu Qiu, Jianmin Chen, Yue Yu
Pharmaceuticals.2024; 17(11): 1504. CrossRef

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.

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

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.

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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

Original article

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.

Focused Review article

Management and rehabilitation of moderate-to-severe diabetic foot infection: a narrative review: Chi Young An, Seung Lim Baek, Dong-Il Chun; J Yeungnam Med Sci. 2023;40(4):343-351. Published online September 19, 2023; DOI: https://doi.org/10.12701/jyms.2023.00717

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Abstract PDF

Diabetic foot is one of the most devastating consequences of diabetes, resulting in amputation and possibly death. Therefore, early detection and vigorous treatment of infections in patients with diabetic foot are critical. This review seeks to provide guidelines for the therapy and rehabilitation of patients with moderate-to-severe diabetic foot. If a diabetic foot infection is suspected, bacterial cultures should be initially obtained. Numerous imaging studies can be used to identify diabetic foot, and recent research has shown that white blood cell single-photon emission computed tomography/computed tomography has comparable diagnostic specificity and sensitivity to magnetic resonance imaging. Surgery is performed when a diabetic foot ulcer is deep and is accompanied by bone and soft tissue infections. Patients should be taught preoperative rehabilitation before undergoing stressful surgery. During surgical procedures, it is critical to remove all necrotic tissue and drain the inflammatory area. It is critical to treat wounds with suitable dressings after surgery. Wet dressings promote the formation of granulation tissues and new blood vessels. Walking should begin as soon as the patient’s general condition allows it, regardless of the wound status or prior walking capacity. Adequate treatment of comorbidities, including hypertension and dyslipidemia, and smoking cessation are necessary. Additionally, broad-spectrum antibiotics are required to treat diabetic foot infections.

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Unveiling the challenges of diabetic foot infections: diagnosis, pathogenesis, treatment, and rehabilitation
Chul Hyun Park
Journal of Yeungnam Medical Science.2023; 40(4): 319. CrossRef

Original article

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

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Abstract PDF

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

Citations

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M Bonfanti-Gris, E Ruales, MP Salido, F Martinez-Rus, M Özcan, G Pradies
Journal of Dentistry.2025; 153: 105533. CrossRef
Accuracy of Artificial Intelligence Models in Dental Implant Fixture Identification and Classification from Radiographs: A Systematic Review
Wael I. Ibraheem
Diagnostics.2024; 14(8): 806. CrossRef
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Mohammed A. H. Lubbad, Ikbal Leblebicioglu Kurtulus, Dervis Karaboga, Kerem Kilic, Alper Basturk, Bahriye Akay, Ozkan Ufuk Nalbantoglu, Ozden Melis Durmaz Yilmaz, Mustafa Ayata, Serkan Yilmaz, Ishak Pacal
Journal of Imaging Informatics in Medicine.2024; 37(5): 2559. CrossRef
Applications of Machine Learning in Periodontology and Implantology: A Comprehensive Review
Cristiana Adina Șalgău, Anca Morar, Andrei Daniel Zgarta, Diana-Larisa Ancuța, Alexandros Rădulescu, Ioan Liviu Mitrea, Andrei Ovidiu Tănase
Annals of Biomedical Engineering.2024; 52(9): 2348. CrossRef
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Journal of Dentistry.2024; 151: 105385. CrossRef
Fracture strength of poly ether ether ketone abutment over short implant after fatigue
Mohamed A.E. Elsayed, Radwa A. El-dessouky, Mahmoud A.-A. Shakal
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Dentistry Journal.2024; 13(1): 13. CrossRef
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The Journal of Prosthetic Dentistry.2023;[Epub] CrossRef

Editorial

Journal of Yeungnam Medical Science is now indexed in Scopus, a great step closer to a journal’s goal: So-Young Park; J Yeungnam Med Sci. 2023;40(2):113-114. Published online March 31, 2023; DOI: https://doi.org/10.12701/jyms.2023.00269

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Appreciation to peer reviewers in 2023
So-Young Park
Journal of Yeungnam Medical Science.2024; 41(1): 1. CrossRef
Appreciation to peer reviewers in 2024
So-Young Park
Journal of Yeungnam Medical Science.2024; 42: 1. CrossRef
Journal of Yeungnam Medical Science is indexed in Emerging Sources Citation Index (ESCI)
So-Young Park
Journal of Yeungnam Medical Science.2023; 40(4): 317. CrossRef

Focused Review article

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

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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

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

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Abstract PDF

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

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Case report

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.

Focused Review article

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

Resident fellow section: Teaching images

Ultrasound assessment of a supraclavicular lipoma entrapping the brachial plexus: a diagnostic insight: Wei-Ting Wu, Ke-Vin Chang, Kamal Mezian, Vincenzo Ricci, Levent Özçakar; J Yeungnam Med Sci. 2024;41(1):58-60. Published online December 29, 2023; DOI: https://doi.org/10.12701/jyms.2023.01284

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Case report

Development of an automated foot contact area measurement program for podoscopes using ChatGPT-4: a case report: Min Cheol Chang; J Yeungnam Med Sci. 2025;42:13. Published online December 3, 2024; DOI: https://doi.org/10.12701/jyms.2024.01326

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Abstract PDF: Accurate measurement of the foot contact area is crucial for diagnosing pes planus (flatfoot) and pes cavus (high arch), which significantly affect pressure distribution across the plantar surface. This study aimed to develop a program using ChatGPT-4 to automate foot contact area measurements using a podoscope, thereby enhancing diagnostic precision. A 53-year-old female volunteer stood on a podoscope to capture images of her feet, which were processed to isolate the foot contours and measure the contact areas. A program developed utilizing ChatCPT-4 was designed to outline the feet, detect contact areas, and calculate their sizes and ratios. The results demonstrated clear visualization of foot contours with automated calculation of the contact area and its ratio to the total foot area. The entire foot area measured 1,091,381.00 pixels, with a contact area of 604,252.50 pixels. The ratio of the ground contact area to the entire foot area was calculated as 55.37%. This method, which employs advanced image-processing techniques powered by ChatGPT-4, demonstrates the potential for integrating artificial intelligence into clinical applications. This approach could improve diagnostic precision and patient outcomes through personalized treatment strategies.

Review article

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

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

Case Report

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 article

Hepatic ischemia-reperfusion injury with respect to oxidative stress and inflammatory response: a narrative review: Eun Kyung Choi, Dong Gun Lim; J Yeungnam Med Sci. 2023;40(2):115-122. Published online March 21, 2022; DOI: https://doi.org/10.12701/jyms.2022.00017

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Abstract PDF

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

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Communications

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.

Focused Review article

State-of-the-art update for diagnosing diabetic foot osteomyelitis: a narrative review: Inha Woo, Seung Jae Cho, Chul Hyun Park; J Yeungnam Med Sci. 2023;40(4):321-327. Published online October 12, 2023; DOI: https://doi.org/10.12701/jyms.2023.00976

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Abstract PDF

Recently, the International Working Group on the Diabetic Foot and the Infectious Diseases Society of America divided diabetic foot disease into diabetic foot infection (DFI) and diabetic foot osteomyelitis (DFO). DFI is usually diagnosed clinically, while numerous methods exist to diagnose DFO. In this narrative review, the authors aim to summarize the updated data on the diagnosis of DFO. An extensive literature search using “diabetic foot [MeSH]” and “osteomyelitis [MeSH]” or “diagnosis” was performed using PubMed and Google Scholar in July 2023. The possibility of DFO is based on inflammatory clinical signs, including the probe-to-bone (PTB) test. Elevated inflammatory biochemical markers, especially erythrocyte sedimentation rate, are beneficial. Distinguishing abnormal findings of plain radiographs is also a first-line approach. Moreover, sophisticated modalities, including magnetic resonance imaging and nuclear medicine imaging, are helpful if doubt remains after a first-line diagnosis. Transcutaneous bone biopsy, which does not pass through the wound, is necessary to avoid contaminating the sample. This review focuses on the current diagnostic techniques for DFOs with an emphasis on the updates. To obtain the correct therapeutic results, selecting a proper option is necessary. Based on these numerous diagnosis modalities and indications, the proper choice of diagnostic tool can have favorable treatment outcomes.

Citations

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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

Invasive strategies for rhythm control of atrial fibrillation: a narrative review: Hong-Ju Kim, Chan-Hee Lee; J Yeungnam Med Sci. 2024;41(4):279-287. Published online September 20, 2024; DOI: https://doi.org/10.12701/jyms.2024.00703

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Abstract PDF: Atrial fibrillation (AF) is the most common sustained tachyarrhythmia and its increasing prevalence has resulted in a growing healthcare burden. A recent landmark randomized trial, the EAST-AFNET 4 (Early Treatment of Atrial Fibrillation for Stroke Prevention Trial), highlighted the importance of early rhythm control in AF, which was previously underemphasized. Rhythm control therapy includes antiarrhythmic drugs, direct-current cardioversion, and catheter ablation. Currently, catheter ablation is indicated for patients with AF who are either refractory or intolerant to antiarrhythmic drugs or who exhibit decreased left ventricular systolic function. Catheter ablation can be categorized according to the energy source used, including radiofrequency ablation (RFA), cryoablation, laser ablation, and the recently emerging pulsed field ablation (PFA). Catheter ablation techniques can also be divided into the point-by-point ablation method, which ablates the pulmonary vein (PV) antrum one point at a time, and the single-shot technique, which uses a spherical catheter to ablate the PV antrum in a single application. PFA is known to be applicable to both point-by-point and single-shot techniques and is expected to be promising owing to its tissue specificity, resulting in less collateral damage than catheter ablation involving thermal energy, such as RFA and cryoablation. In this review, we aimed to outline catheter ablation for rhythm control in AF by reviewing previous studies.

Case report

Scrotal pyocele secondary to gastrointestinal perforation in infants: a case series: Soo-Hong Kim, Yong-Hoon Cho, Hae-Young Kim, Narae Lee, Young Mi Han, Shin Yun Byun; J Yeungnam Med Sci. 2023;40(1):86-90. Published online December 15, 2021; DOI: https://doi.org/10.12701/yujm.2021.01508

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Abstract PDF

Pyocele in infants is rarely described in the literature, but it is an emergent condition that requires rapid recognition and treatment to prevent testicular loss. If peritonitis due to gastrointestinal perforation occurs, abdominal contamination may spread through a patent processus vaginalis in an infant, which may lead to pyocele. We report the cases of three infants with scrotal pyocele due to the spread of infection or inflammatory material from the intraperitoneal cavity through a patent processus vaginalis. Two infants were surgically treated, while the other was treated with percutaneous aspiration and intravenous antibiotic administration. Although rare, pyocele should be considered in the differential diagnosis of acute scrotum in infants, especially in infants who previously had peritonitis due to gastrointestinal perforation.

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Zahra Jamali, Mohammad Shafie’ei, Najmeh Soltani Nejad
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Resident fellow section: Teaching images

Ultrasound-guided diagnosis/intervention for ischiofemoral impingement syndrome: Wei-Ting Wu, Ke-Vin Chang, Levent Özçakar; J Yeungnam Med Sci. 2023;40(Suppl):S134-S136. Published online July 12, 2023; DOI: https://doi.org/10.12701/jyms.2023.00500

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Case reports

Classical Hodgkin lymphoma following follicular lymphoma: a case report: Bomi Kim; J Yeungnam Med Sci. 2023;40(Suppl):S113-S122. Published online August 17, 2023; DOI: https://doi.org/10.12701/jyms.2023.00584

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Abstract PDF: The simultaneous, composite, or sequential occurrence of follicular lymphoma (FL) and classical Hodgkin lymphoma (HL), both of which originate from germinal center B-cell, is rare. Questions have been raised with regard to the type of tests that pathologists should perform when observing the presence of a “large-cell lymphoma” following an FL and what are the most critical pathological points for diagnosis. Here, we present a case of a classical HL following an FL after administering rituximab-bendamustine (R-Benda) chemotherapy. Furthermore, we also summarized the literature and compared this case with other HLs that followed FLs. A 55-year-old woman was diagnosed with a grade 3A FL of the breast and axillary lymph node masses. She completed six R-Benda chemotherapy cycles for stage IV FL. Twenty-three months after the diagnosis, follow-up image studies showed an increase in the size and number of the lesions. Biopsies of the neck lymph node and liver were performed, and the diagnosis was classical HL. Sequential or composite FL and HL may sometimes develop from the same clone because they share the same genetic alterations, such as B-cell lymphoma (Bcl)-2 or Bcl-6 translocation. When a large-cell lymphoma is found after the treatment of FL, classical HL should be considered a pathological differential diagnosis, and histological, immunohistochemical, or molecular investigations must be considered during the diagnostic process.

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

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Abstract PDF

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

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Les porokératoses
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Review articles

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 [Epub ahead of print]

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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.

Hypertension and cognitive dysfunction: a narrative review: Eun-Jin Cheon; J Yeungnam Med Sci. 2023;40(3):225-232. Published online November 29, 2022; DOI: https://doi.org/10.12701/jyms.2022.00605

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Abstract PDF

Cognitive dysfunction is relatively less considered a complication of hypertension. However, there is sufficient evidence to show that high blood pressure in middle age increases the risk of cognitive decline and dementia in old age. The greatest impact on cognitive function in those with hypertension is on executive or frontal lobe function, similar to the area most damaged in vascular dementia. Possible cognitive disorders associated with hypertension are vascular dementia, Alzheimer disease, and Lewy body dementia, listed in decreasing strength of association. The pathophysiology of cognitive dysfunction in individuals with hypertension includes brain atrophy, microinfarcts, microbleeds, neuronal loss, white matter lesions, network disruption, neurovascular unit damage, reduced cerebral blood flow, blood-brain barrier damage, enlarged perivascular damage, and proteinopathy. Antihypertensive drugs may reduce the risk of cognitive decline and dementia. Given the high prevalence of dementia and its impact on quality of life, treatment of hypertension to reduce cognitive decline may be a clinically relevant intervention.

Citations

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A study of cognitive functions in elderly men from the Arctic region of the Russian Federation with arterial hypertension using the auditory event-related potentials P300
Olga V. Krivonogova, Elena V. Krivonogova, Lilia V. Poskotinova
Ekologiya cheloveka (Human Ecology).2024; 31(2): 162. CrossRef
Chronic Neuroinflammation and Cognitive Decline in Patients with Cardiac Disease: Evidence, Relevance, and Therapeutic Implications
Jan Traub, Anna Frey, Stefan Störk
Life.2023; 13(2): 329. CrossRef
The A-to-Z factors associated with cognitive impairment. Results of the DeCo study
María Gil-Peinado, Mónica Alacreu, Hernán Ramos, José Sendra-Lillo, Cristina García, Gemma García-Lluch, Teresa Lopez de Coca, Marta Sala, Lucrecia Moreno
Frontiers in Psychology.2023;[Epub] CrossRef

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