Journal of Yeungnam Medical Science

Resident fellow section: Clinical vignette

Cephalosporin-induced encephalopathy in patients with hematologic malignancies: a significant concern: Young Seob Park, Min Kyoung Kim, Kyung Hee Lee, Sung Ae Koh, Ji Yoon Jung, Byeong Il Jang, Se-Jin Lee; J Yeungnam Med Sci. 2023;40(Suppl):S137-S141. Published online November 14, 2023; DOI: https://doi.org/10.12701/jyms.2023.00864

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Original article

Effects of early clinical and basic laboratory exposure program on premedical students: a questionnaire survey: Kyu Hyang Cho, Hyun Sook Ko, Kyung Hee Lee, Tae-Yoon Hwang, Keun-Mi Lee, Sae Yoon Kim, Min Cheol Chang; J Yeungnam Med Sci. 2022;39(4):309-313. Published online July 20, 2022; DOI: https://doi.org/10.12701/jyms.2022.00318

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Abstract PDF: Background
Because premed students do not take courses related to medicine during their first 2 years, they cannot establish their identity as students at medical schools, making it difficult for them to set goals as future doctors. We conducted an early clinical and basic laboratory exposure program for premed students and studied the effects of the program and student satisfaction levels.
Methods
We performed an early clinical and basic laboratory exposure program for premed students for 2 days and evaluated the effects of the program and student satisfaction with it. The program consisted of two types: type 1, where two to four students formed a group, which was assigned to a particular department to participate and make observations during ward rounds, outpatient clinics, examinations, procedures, and surgeries (in the case of basic laboratory work, the students partook in experimental observations); and type 2, where one student followed a medical school professor to observe the professor’s day. After the program ended, an online survey was conducted to investigate the effects on students, their thoughts, and satisfaction levels.
Results
In total, 114 students (91.2%) responded to the survey. Approximately 94% of them were satisfied with the program. They found that the program would be useful for deciding on future career paths, gaining knowledge about a department of interest, studying for a medical program after premedical studies, and befriending residents and professors in certain departments.
Conclusion
Early clinical and basic laboratory exposure programs are recommended for premedical students.

Review article

Function of hepatocyte growth factor in gastric cancer proliferation and invasion: Sung Ae Koh, Kyung Hee Lee; Yeungnam Univ J Med. 2020;37(2):73-78. Published online February 20, 2020; DOI: https://doi.org/10.12701/yujm.2019.00437

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Abstract PDF

Cancer incidence has been increasing steadily and is the leading cause of mortality worldwide. Gastric cancer is still most common malignancy in Korea. Cancer initiation and progression are multistep processes involving various growth factors and their ligands. Among these growth factors, we have studied hepatocyte growth factor (HGF), which is associated with cell proliferation and invasion, leading to cancer and metastasis, especially in gastric cancer. We explored the intercellular communication between HGF and other surface membrane receptors in gastric cancer cell lines. Using complimentary deoxyribonucleic acid microarray technology, we found new genes associated with HGF in the stomach cancer cell lines, NUGC-3 and MKN-28, and identified their function within the HGF pathway. The HGF/N-methyl-N’-nitroso-guanidine human osteosarcoma transforming gene (c-MET) axis interacts with several molecules including E-cadherin, urokinase plasminogen activator, KiSS-1, Jun B, and lipocalin-2. This pathway may affect cell invasion and metastasis or cell apoptosis and is therefore associated with tumorigenesis and metastasis in gastric cancer.

Citations

Citations to this article as recorded by

Reciprocal Regulation of Cancer-Associated Fibroblasts and Tumor Microenvironment in Gastrointestinal Cancer: Implications for Cancer Dormancy
Shih-Hsuan Cheng, Hsin-Ying Clair Chiou, Jiunn-Wei Wang, Ming-Hong Lin
Cancers.2023; 15(9): 2513. CrossRef
Expression of E-cadherin and N-cadherin in Epithelial-to-Mesenchymal Transition of Osteosarcoma: A Systematic Review
Leo Issagholian, Ethan Tabaie, Akshay J Reddy, Muhammad S Ghauri, Rakesh Patel
Cureus.2023;[Epub] CrossRef
Remodelling of the tumour microenvironment by the kallikrein-related peptidases
Srilakshmi Srinivasan, Thomas Kryza, Jyotsna Batra, Judith Clements
Nature Reviews Cancer.2022; 22(4): 223. CrossRef
Identification of hub pathways and drug candidates in gastric cancer through systems biology
Seyed Reza Salarikia, Mohammad Kashkooli, Mohammad Javad Taghipour, Mahdi Malekpour, Manica Negahdaripour
Scientific Reports.2022;[Epub] CrossRef
Signaling pathways and therapeutic interventions in gastric cancer
Zi-Ning Lei, Qiu-Xu Teng, Qin Tian, Wei Chen, Yuhao Xie, Kaiming Wu, Qianlin Zeng, Leli Zeng, Yihang Pan, Zhe-Sheng Chen, Yulong He
Signal Transduction and Targeted Therapy.2022;[Epub] CrossRef
Proteomic Signatures of Diffuse and Intestinal Subtypes of Gastric Cancer
Smrita Singh, Mohd Younis Bhat, Gajanan Sathe, Champaka Gopal, Jyoti Sharma, Anil K. Madugundu, Neha S. Joshi, Akhilesh Pandey
Cancers.2021; 13(23): 5930. CrossRef

Case Reports

Metastatic eyelid cancer from gastric adenocarcinoma.: Ji Yoon Jung, Eun Joo Goo, Jae Chang Lee, Jay Song, Sung Ae Koh, Kyung Hee Lee, Young Kyung Bae; Yeungnam Univ J Med. 2016;33(2):142-145. Published online December 31, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.2.142

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Abstract PDF: Gastric cancer is the most common cancer in Korean males and can easily spread to distant organs such as the liver, lungs, brain, or bones. However, skin metastasis, particularly of the eye, is rare. Metastatic eyelid cancer is extremely rare; metastases from internal organs have not been reported so far. We recently experienced a patient with metastatic eyelid cancer from adenocarcinoma of the stomach. A 62-year-old female was admitted with a right upper eyelid mass and foreign body sensation. She had a history of stomach cancer of 3 years. She was treated by chemotherapy and radiotherapy for pathologic fracture. After receiving supportive care for 2 years, the mass appeared on her right pupil. Punch-biopsy of the mass was performed and histological examination revealed adenocarcinoma, the same as the initial histological result. We report this case with a review of related literature.

Paratesticular Alveolar Rhabdomyosarcoma with Multiple Lymph Nodes Metastasis Successfully Treated with Chemotherapy.: Ha young Lee, Myung Soo Hyun, Kyung Hee Lee, Min Kyoung Kim, Sung Ae Koh, Se Hoon Sohn, Sung Woo Park, Dong Geun Kim, Myung Jin Kim, Hyo Jin Jang, Mi Jin Kim; Yeungnam Univ J Med. 2011;28(1):70-76. Published online June 30, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.1.70

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Abstract PDF: Rhabdomyosarcomas are soft tissue sarcomas; while extremely rare in adults, they are one of the most common neoplasms in children and adolescents. Histologically, they can be classified into embryonal(ERMS), alveolar(ARMS), pleomorphic, and undifferentiated types. The ARMS type is very rare, and is associated with a poor prognosis. Common primary sites of ARMS are the trunk and extremities. We report on a case of paraaortic, supraclavicular, and axillary lymph node metastasis from paratesticular ARMS treated with VAC(vincristine, dactinomycin, cyclophosphamide)/ IE(ifosfamide, etoposide) chemotherapy in a young adult. Administration of six cycles of chemotherapy with VAC/ IE resulted in complete remission. The patient has maintained complete remission over the past 27 months.

Original Articles

Early or Late Gefitinib, Which is Better for Survival?: Retrospective Analysis of 228 Korean Patients with Advanced or Metastatic NSCLC.: Dong Gun Kim, Min Kyoung Kim, Sung Hwa Bae, Sung Ae Koh, Sung Woo Park, Hyun Je Kim, Myung Jin Kim, Hyo Jin Jang, Kyung Hee Lee, Kwan Ho Lee, Jin Hong Chung, Kyung Chul Shin, Hun Mo Ryoo, Myung Soo Hyun; Yeungnam Univ J Med. 2011;28(1):31-44. Published online June 30, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.1.31

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Abstract PDF: BACKGROUND
The optimal timing of treatment with EGFR-tyrosine kinase inhibitors (EGFR-TKI) in NSCLC patients has not yet been determined. METHODS: We separated 228 patients with advanced/metastatic NSCLC treated with gefitinib into an early gefitinib group (patients who received gefitinib as first- or second-line treatment) and a delayed gefitinib group (patients who received gefitinib as third or fourth-line treatment) and attempted to determine whether the timing of gefitinib treatment affected clinical outcomes. RESULTS: Median overall survival (OS), progression free survival (PFS), and median OS from first-line treatment of advanced/metastatic disease (OSt) for 111 patients in the early gefitinib group were 6.2 months, 3.3 months, and 11.6 months. However, median OS, PFS, and OSt for 84 patients in the delayed gefitinib group were 7.8 months, 2.3 months, and 22.7 months. No differences in OS and PFS were observed between the 2 groups. However, OSt was significantly longer in the delayed gefitnib group. Timing of gefitinib therapy was one of the independent predictors of OSt. Hb > or = 10 g/dl, and having never smoked, and ECOG performance status < or =1 were independent predictors of better PFS. CONCLUSION: Deferral of gefitinib therapy in patients with advanced or metastatic NSCLC may be preferable if they are able to tolerate chemotherapy.

Comparative Study on the Infection Rates of Protected Environment versus Non-Protected Environment in Acute Myeloid Leukemia during Remission Induction Chemotherapy.: Se Hoon Sohn, Ha young Lee, Dong Geun Kim, Sung Woo Park, Myung Jin Kim, Myung Jin Oh, Hye Deok Woo, Hun Mo Ryoo, Sung Hwa Bae, Kyung Hee Lee, Min Kyoung Kim, Myung Soo Hyun; Yeungnam Univ J Med. 2010;27(2):113-121. Published online December 31, 2010; DOI: https://doi.org/10.12701/yujm.2010.27.2.113

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Abstract PDF: BACKGROUND
AND PURPOSE: Patients with acute leukemia experience prolonged periods of neutropenia due to their disease or its treatment. For this reason, they often develop serious infectious complications. Although antibiotic therapy has improved in recent years, the fatality rate from infection remains high. For the control of infection, protected environment was developed. But because of economic issue, most of chemotherapy with acute myeloid leukemia have conducted in non-protected environment. So this study compared the rate of complete remission, days with neutropenia, rate of fever, rate of positive culture, rate of overt infection and use of antibacterial and antifungal agents with patients within non-protected environment and protected environment, retrospectively. Patients with acute myeloid leukemia during first remission induction chemotherapy were eligible for this study. METHODS: Retrospective analysis was conducted between patients in non-protected (25 patients) and protected environment (14 patients) with acute myeloid leukemia during remission induction chemotherapy. RESULTS: Rate of overt infection, rate of fever, rate of positive culture and rate of use of antibiotics were significantly high in patients within non-protected environment compared with patients within protected environment. There were no differences in rate of complete remission and days of neutropenia. CONCLUSIONS: This study suggests protected environment for patients with acute myeloid leukemia during remission induction chemotherapy could reduce rate of overt infection, and rate of use of antibiotics.

Case Reports

A Case of Intravesical Cidofovir Treatment of BK Virus-Associated Hemorrhagic Cystitis after Allogeneic Peripheral Blood Stem Cell Transplantation.: Seong Hun Kang, Hwa Jeong Lee, Ye Su Jang, Jun Ho Ji, Sun Ah Lee, Won Sik Lee, Jung Lim Lee, Kyung Hee Lee; Yeungnam Univ J Med. 2009;26(2):143-147. Published online December 31, 2009; DOI: https://doi.org/10.12701/yujm.2009.26.2.143

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Abstract PDF: Hemorrhagic cystitis (HC) is a common complication after allogeneic transplantation. Early posttransplant HC occurs in association with cyclophosphamide, while later on HC results from viral infections such as polyomavirus BK (BKV) and adenovirus. We report here the case of a 57-year-old woman who received an instillation of cidofovir into the bladder for the treatment of hemorrhagic cystitis after allogeneic peripheral stem cell transplantation for her acute myeloid leukemia. Cyclophosphamide and busulfan were used as conditioning treatments. Cyclosporin was administered daily. On the 71st day after transplantation, the patient developed acute severe hemorrhagic cystitis, and BK virus was demonstrated in the urine samples using polymerase chain reaction. Her urinary symptoms did not improve in spite of palliative treatment, but a response was evident after intravesical cidofovir treatment.

A Case of Tarsal Bone Tuberculosis in a Patient with Polycythemia Vera.: Sung Ae Koh, Se Hun Shon, Dong Gun Kim, Sung Woo Park, Choong Ki Lee, Kyung Hee Lee, Min Kyoung Kim, Myung Soo Hyun; Yeungnam Univ J Med. 2009;26(1):44-48. Published online June 30, 2009; DOI: https://doi.org/10.12701/yujm.2009.26.1.44

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Abstract PDF: Talus tuberculosis is a rare disease, even in an endemic tuberculosis area. In reviews of the worldwide literature, only 18 cases of talus tuberculosis have been reported. Recently, we experienced a case of a 70-year-old polycythemia vera patient with right metatarsopharyngeal joint pain for 2 months duration who was diagnosed with talus tuberculosis with prostate involvement. Tuberculosis should be considered as one of the causes of monoarticulitis, especially in countries, where the disease is endemic. Additionally, we highly recommend taking a biopsy of the site of suspected infection because an early diagnosis is the key to successful treatment.

A Case of Primary Mucinous Cystadenocarcinoma.: Jun Ho Ji, Hwa Jung Lee, Seung Chan Park, Jung Chul Park, Eun Jung Choi, Hye Jin Seo, Won Sik Lee, Jung Lim Lee, Byung Jo Bae, Kyung Rak Shon, Kyung Hee Lee; Yeungnam Univ J Med. 2008;25(2):134-138. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.134

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Abstract PDF

Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy, and little is known concerning its pathogenesis, optimal treatment, and prognosis. A 29-year-old pregnant woman (21 weeks) presented with abdominal discomfort. CA 19-9, CA 125, and CEA were normal. Abdominal CT scanning revealed a 19x15x13 cm retroperitoneal tumor. Exploratory laparotomy and tumor excision were performed. Mucinous retroperitoneal implants were removed as completely as possible. Histologically, the tumor showed focal areas of capsular invasion, but free resection margins. The uterus and both ovaries were normal in appearance. No adjuvant therapy was pursued. Six months later, peritoneal and bilateral ovarian metastases were discovered.Hence, we report the details of this case of primary retroperitoneal mucinous cystadeno-carcinoma and present a review of the literature.

Citations

Citations to this article as recorded by

MR Imaging of Primary Retroperitoneal Mucinous Cystadenocarcinoma in Pregnant Woman
Jisun Lee, Bum Sang Cho, Yook Kim, Kyung Sik Yi, Min Ho Kang, Seung Young Lee, Sung Jin Kim, Kil Sun Park
Journal of the Korean Society of Magnetic Resonance in Medicine.2013; 17(3): 243. CrossRef

A Case of Pancreatic Acinar Cell Carcinoma.: Hwa Jung Lee, Jun Ho Ji, Seung Chan Park, Jung Chul Park, Eun Jung Choi, Hye Jin Seo, Won Sik Lee, Jung Lim Lee, Byung Jo Bae, Kyung Rak Shon, Kyung Hee Lee; Yeungnam Univ J Med. 2008;25(2):128-133. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.128

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Abstract PDF: Acinar cell carcinoma is a rare tumor that represents 1~2% of all pancreatic cancers. Clinical and radiologic findings are inconclusive in this disease. Acinar cell carcinoma is characterized by rapid progression and early metastasis, which lead to its poor prognosis. A 41-year-old man was admitted to our hospital for abdominal pain. Abdominal computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) showed a splenic mass, which was being invaded by a pancreatic tail mass and which had increased 18F-fluorodeoxyglucose (FDG) uptake. Primary radical distal pancreatectomy and splenectomy were performed. Pathologic findings revealed an acinar cell carcinoma of the pancreas. The patient underwent a total gastrectomy three months later because of gastric recurrence. Four months later, multiple hepatic metastases were discovered, and the patient underwent a left hepatectomy. During treatment with capecitabine, there was no evidence of tumor progression for 14 months. We report a case of metastatic pancreatic acinar cell carcinoma, which did not progress for an extended period while the patient was being treated with capecitabine.

A Case of Multiple Myeloma with AL Amyloidosis Successfully Treated with Autologous Stem Cell Transplantation: Ha-young Lee, Kyung Hee Lee, Min Kyoung Kim, Hee Soon Cho, Myung Soo Hyun; Yeungnam Univ J Med. 2007;24(2 Suppl):S676-682. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S676

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Abstract PDF: Myeloma is a disease of neoplastic B lymphocytes that synthesize abnormal amounts of immunoglobulin (Ig) or Ig fragments. Ten to twenty percent of myeloma patients are known to develop clinical evidence of amyloid-light chain(AL) amyloidosis. A high index of suspicion, however, is needed to make a diagnosis of amyloidosis. We report a case of multiple myeloma with AL amyloidosis successfully treated with autologous stem cell transplantation. In our case, the patient presented with longstanding abdominal discomfort and anterior chest pain. Chest X-ray showed several osteolytic changes on ribs. Endoscopic biopsy revealed massive amyloid deposits in the wall of stomach and rectum. Serum/urine protein electroporesis and bone marrow biopsy confirmed the diagnosis of multiple myeloma. At 18 months after high dose chemotherapy and autologous stem cell transplantation(ASCT), the patient maintained a complete response. In patients with multiple myeloma with AL amyloidosis, high dose chemotherapy and ASCT can be effective treatment strategy.

Review

Target Therapy for Colorectal Cancer.: Kyung Hee Lee; Yeungnam Univ J Med. 2006;23(2):143-151. Published online December 31, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.2.143

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Abstract PDF: In the past decade, the median duration of survival among patients with advanced colorectal cancer has increased from 12 months to about 18 months, primarily as a results of the introduction of irinotecan and oxaliplatin. Advances in the understanding of the molecular mechanisms underlying the development and progression of cancer have resulted in the discovery of new therapeutic interventions that target specific molecular abnormalities. Their specificity, and therefore their potential to bind preferentially and modify tumor-specific targets, sparing normal tissues and causing fewer side-effects compared to conventional cytotoxic agents, makes them an attractive therapeutic option. The future of this approach for the treatment of solid tumors is promising

Case Reports

A Case of Mercury Intoxication Associated with Pernicious Anemia.: Kyoung Ae Chang, Hyun Do Kim, Sun Jung Mun, Dong Hee Kim, Sung Ho Chun, Ha Young Lee, Dong Woon Bae, Hee Soon Cho, Kyung Hee Lee, Myung Soo Hyun; Yeungnam Univ J Med. 2006;23(1):103-107. Published online June 30, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.1.103

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Abstract PDF: Pernicious anemia is the frequent cause of megaloblastic anemia, and it is the result of a vitamin B12 deficiency due to the decrease or absence of intrinsic factor (IF) because of gastric mucosa atrophy or autoimmune destruction of IF-producing parietal cells. With the existence of a severe gastric atrophy, there is a decreased in acid and IF production and a further change in vitamin B12 absorption. Mercury is ubiquitous in nature and exists in 3 forms, elemental mercury, inorganic salts and organic compounds. Organic forms, specifically methyl mercury, are the most toxic of the 3 classes of mercurials. Methyl mercury exerts its most devastating effect on the central nervous system by causing psychiatric disturbances, ataxia, visual loss, hearing loss, and neuropathy. We report a case of mercury intoxication associated with pernicious anemia. The 77 years old patient was referred to Yeungnam University Hospital for tongue pain, somatitis, headache and aggressive behavior. He had taken an unevaluated medicine for a long time. After clinical evaluation, this case was diagnosed as a pernicious anemia and the unevaluated medicine was made up of mercury. After the administration of D-penicillamine and intramuscular injection of BAL and cobalamine, clinical symptoms and aggressive behavior were improved as well as laboratory findings.

Langerhans Cell Histiocytosis with Central Diabetes Insipidus: A Case Report.: Jin Ho Kim, Jun Sung Moon, Sun Jung Mun, Ji Eun Lee, Jae Won Choi, Mi Jung Eun, Kyung A Chun, Ihn Ho Cho, Ji Sung Yoon, Kyu Chang Won, Kyung Hee Lee, Duk Seop Shin, Hyoung Woo Lee; Yeungnam Univ J Med. 2005;22(2):259-265. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.259

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Abstract PDF: Central diabetes insipidus (DI) is a syndrome characterized by thirst, polydipsia and polyuria. Langerhans cell histiocytosis is one of the etiologies of DI. Recently we experienced a central DI associated with Langerhans cell histiocytosis. The 44 years old female patient complained right hip pain, polydipsia and polyuria. We carried out water deprivation test. After vasopressin injection, urine osmotic pressure was increased from 109 mOsmol/kg to 327 mOsmol/kg (300%). Brain MRI showed a thickened pituitary stalk and air bubble like lesions sized with 5cm, 7cm was shown on fifth L-spine and right hip bone at hip bone CT. CT guided biopsy revealed abnormal histiocytes proliferation and abundant lymphocytes. The final diagnosis was central DI associated with systemic Langerhans cell histiocytosis invading hip bone, L-spine and pituitary stalk. Desmopressin and etoposide chemotherapy were performed to the patient.

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