Journal of Yeungnam Medical Science

Original article

Radiology, Radiotherapy & Diagnostic Imaging
Puncture needle with a hard plastic sheath and plastic wings minimizes repuncture attempts in ultrasound-guided paracentesis: a retrospective case-control study: Il Wan Son, Suk Kim, Seung Baek Hong, Nam Kyung Lee, Mi Ri Jeong, Sung Yong Han, Hyun Young Woo; J Yeungnam Med Sci. 2022;39(1):18-23. Published online July 12, 2021; DOI: https://doi.org/10.12701/yujm.2021.01109

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Abstract PDF: Background
This study was performed to evaluate periprocedural factors, complications, and repuncture rate of the newly developed puncture needle and compare it with the routinely used puncture needle for ultrasound (US)-guided paracentesis.
Methods
We retrospectively identified 137 patients who underwent US-guided paracentesis between July 2018 and March 2019. Among them, 82 patients underwent US-guided paracentesis with a newly developed puncture needle. The other 55 patients underwent US-guided paracentesis with a routinely used puncture needle. The periprocedural factors, complications, and repuncture rate were compared between the two groups using the Mann-Whitney U test and Fisher exact test. The repuncture-associated factors were assessed using logistic regression analysis.
Results
There were no major or minor complications in either group. The rate of repuncture was significantly lower in the group using the newly developed puncture needle compared with the group using the routinely used puncture needle (p=0.01). The duration of the procedure was significantly shorter with the newly developed puncture needle compared with the routinely used puncture needle (p=0.01). In univariate analysis, the thickness of the abdominal wall (p=0.04) and the use of the newly developed puncture needle (p=0.01) were significantly associated with the rate of repuncture. In multivariate analysis, only the use of the newly developed puncture needle was significantly associated with the rate of repuncture.
Conclusion
Using this novel puncture needle with a hard plastic sheath and plastic wings, the rate of repuncture and the duration of the procedure were decreased without complications of US-guided paracentesis.

Case report

Radiology, Radiotherapy & Diagnostic Imaging
Multilocular cystic hemangioma of the liver mimicking mucinous cystic neoplasm: a case report: Nam Kyung Lee, Suk Kim, Seung Baek Hong, So Jeong Lee, Hyung Il Seo; J Yeungnam Med Sci. 2022;39(1):53-57. Published online April 7, 2021; DOI: https://doi.org/10.12701/yujm.2021.00969

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Hepatic hemangiomas infrequently exhibit atypical imaging features, which may cause diagnostic confusion with hepatic malignancies and lead to unnecessary surgery. We report a rare case of multilocular cystic hemangioma of the liver mimicking a mucinous cystic neoplasm of the liver in a 48-year-old female, focusing on computed tomography and magnetic resonance imaging features and their differential diagnosis.

Citations

Citations to this article as recorded by

Non-infectious Hepatic Cystic Lesions: A Narrative Review
Adem Ceri, Andreas Busse-Coté, Delphine Weil, Eric Delabrousse, Vincent Di Martino, Paul Calame
Current Medical Imaging Formerly Current Medical Imaging Reviews.2025;[Epub] CrossRef
Case series multilocular cystic hemangioma of the liver: Three cases and literature review
Chunmiao Liang, RiSheng Yu, Liuhong Wang, Ying Chen
Medicine.2024; 103(33): e39287. CrossRef

Case Report

Hematology
Ceftizoxime-induced immune hemolytic anemia associated with multi-organ failure: Jin Young Huh, Ari Ahn, Hyungsuk Kim, Seog Woon Kwon, Sujong An, Jae Yong Lee, Byoung Soo Kwon, Eun Hye Oh, Do Hyun Park, Jin Won Huh; Yeungnam Univ J Med. 2017;34(1):123-127. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.123

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Abstract PDF

Drug-induced immune hemolytic anemia (DIIHA) is a rare side effect of drugs. DIIHA may cause a systemic inflammatory response that results in acute multi-organ failure and death. Ceftizoxime belongs to the class of third generation cephalosporins, which are the most common drugs associated with DIIHA. Herein, we present a case of a 66-year-old man who developed fatal DIIHA after receiving a second dose of ceftizoxime. He was admitted to receive photodynamic therapy. He had a history of a single parenteral dose of ceftizoxime 3 months prior to admission. On the day of the procedure — shortly after the infusion of ceftizoxime — the patient's mental status was altered. The blood test results revealed hemolysis. Oliguric acute kidney injury developed, and continuous renal replacement therapy had to be applied. On the suspicion of DIIHA, the patient underwent plasmapheresis. Diagnosis was confirmed by a detection of drug-dependent antibody with immune complex formation. Although his hemolysis improved, his liver failure did not improve. He was eventually discharged to palliative care, and subsequently died.

Citations

Citations to this article as recorded by

Case report: Decreased hemoglobin and multiple organ failure caused by ceftizoxime-induced immune hemolytic anemia in a Chinese patient with malignant rectal cancer
Can Lou, Meng Liu, Ting Ma, Liu Yang, Dan Long, Jiaming Li, Hang Lei, Dong Xiang, Xuefeng Wang, Lei Li, Xiaohong Cai
Frontiers in Immunology.2024;[Epub] CrossRef
Laboratory Workup of Drug-Induced Immune Hemolytic Anemia
Hyunjin Nah, Hyun Ok Kim
The Korean Journal of Blood Transfusion.2018; 29(1): 18. CrossRef

Original Article

Obstetrics, Gynecology, and Reproductive Medicine
A Clinical Usefulness of Office Hysteroscopy.: Min Whan Koh, Tae Hyung Lee, Jeong Suk Kim, Yoon Young Choi, Sang Hoon Jeong; Yeungnam Univ J Med. 2005;22(1):81-89. Published online June 30, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.1.81

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Abstract PDF: BACKGROUND
Hysteroscopy is considered to be the gold standard not only for visualizing the cervical canal and the uterine cavity, but also for treating many different types of benign pathologies localized to those regions. The advent and evolution of endoscopic imaging and surgery during the last two decades has added new dimensions to the armamentarium of a gynecologist to combat intrauterine lesions. Office hysteroscopy is increasingly being used as a first line investigation for abnormal uterine bleeding and other diseases involving the uterine cavity. The aim of our study is to assess the diagnostic and operative efficacy of office hysteroscopy. MATERIALS AND METHODS: In our department, 140 patients underwent a hysteroscopy examination and 18 of these underwent an office based hysteroscopy examination from September 1995 to March 2005. The cases who underwent an office based hysteroscopy examination were reviewed in order to assess the clinical usefulness and significance in the management of intrauterine lesions. RESULTS: Major indication was abnormal uterine bleeding (12 cases, 66.7%). The others were a missed IUD and infertility. The hysteroscopic findings were a normal uterine cavity (6 cases, 33.3%), IUD in situ, polyp, submucosal myoma, endometrial hyperplasia and a placenta remnant. CONCLUSION: Office hysteroscopy is a safe, quick and effective method for making an intrauterine evaluation. In addition, it provides immediate results, offers the capacity of direct targeted biopsies of suspicious focal lesions, and offers the direct treatment of some intrauterine conditions.

Case Report

Obstetrics, Gynecology, and Reproductive Medicine
A Case of Spontaneous Uterine Rupture of the Unscarred Uterus in 14 Weeks Gestation.: Jeong Suk Kim, Jin Hee Kim, Yeun Kyoung Bae, Yoon Ki Park; Yeungnam Univ J Med. 2004;21(2):251-255. Published online December 31, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.2.251

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Abstract PDF: Spontaneous uterine rupture of the unscarred uterus during the second trimester of pregnancy is rare, but it is a surgical emergency. Because it results in rapid deterioration of patient and high mortality despite of prompt operation and massive transfusion, early diagnosis and proper management are critical for optimizing patient care. We present a case of spontaneous uterine rupture with fetal death in 14 weeks gestation with a brief review of literatures.

Original Articles

Thoracic and Cardiovascular Surgery
Two cases report of bronchial carcinoid tumors.: Kyo Won Choi, Jeong Ill Suh, Sung Suk Kim, Jin Hong Chung, Kwan Ho Lee, Hyun Woo Lee, Dong Hyup Lee, Jung Cheul Lee, Sung Sae Han; Yeungnam Univ J Med. 1993;10(2):525-536. Published online December 31, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.2.525

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Abstract PDF: Bronchial carcinoid tumor was a low grade malignant and it was regarded as predictable clinical course and good survivality after surgical resection. But despite of its low grade malignant potentiality, bronchial carcinoid tumor was clearly capable of metastasizing and causing death. We present 2 cases of bronchial carcinoid tumors. One of them was typical carcinoid tumor in 44 year-old female and another was atypical carcinoid tumor in 53 year-old male patient. Currative therapeutic procedure was performed by lobectomy and wedge resection.

Obstetrics, Gynecology, and Reproductive Medicine
C-reactive protein inpregnancy and labor.: Jong Ho Kim, Byung Suk Kim, Jae Yul Lee, Young Gi Lee, Tae Hyung Lee, Seung Ho Lee; Yeungnam Univ J Med. 1993;10(2):298-305. Published online December 31, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.2.298

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Abstract PDF: In order to evaluate the clinical usefulness of maternal serum C-reactive protein measurement in early detection of infectious morbidity at term laboring women, serum C-reactive protein levels were measured in 521 healthy pregnant women : 64 who were not in labor before term, 55 who were in labor before term, 71 who were not in labor at term and 331 who were in labor at term. The frequencies of elevated serum C-reactive protein level were compared in relation to the gestational weeks, the presence or absence of labor, the status of amniotic membranes and the degree of cervical dilation. The obtained results were as follows. 1. The frequencies of women with elevated serum C-reactive protein, 0.8 mg/dl or higher and 2.9 mg/dl or higher, in 521 health pregnant women were, 12 % and 4 %, respectively. 2. C-reactive pretein levels of 0.8 mg/dl or higher were more frequent in the group of women in labor than those not in labor(5. 93 %, vs, 13.73 %, p<0.05), but the frequencies of C-reactive protein level of 2.0 mg/dl or higher were not statistically different between both groups. The frequencies of C-reactive protein level of 0.8 mg/dl or higher and 2.0 mg/dl or higher were not statistically different between the groups before term and at term, intact and ruptured membranes, latent phase and active phase of labor, respectively. 3. Before term, C-reactive protein levels of 0.8 mg/dl or higher and 2.0 mg/dl or higher were more frequent in the group of women in labor than those not in labor(23.64 vs. 4.69, p<0.001 and 12.73% vs. 3.13%, p<0.05, respectively), but those statistical differences were not seen between both group at term. Above results and review of literature suggest that serum C-reactive protein level of 2.0 mg/dl or higher may be reliable in early detection of infectious morbidity at term laboring women as well as laboring women before term, and the presence of subclinical infection should be suspected in the laboring women before term with serum C-reactive protein level of 0.8 mg/dl or higher.

Pathology and Forensic Medicine
Histopathologic consideration of hepatocellular carcinoma.: Hae Joo Nam, Dong Suk Kim, Won Hee Choi, Tae Sook Lee; Yeungnam Univ J Med. 1992;9(2):351-358. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.351

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Abstract PDF: Hepatocellular carcinoma represents approximately 90% of the primary liver cancers. Recently, its incidence tends to be increased. Thirsty seven cases from 1986 to 1991 diagnosed as hepatocellular carcinoma by resection were analyzed to know their histopathologic feature and related clinical findings. The average age at the time of resection was 53.1 years, with frequent occurrence in third and fourth decades. Microscopically, the trabecular type was the most frequent growth pattern (35.1%) and classic hepatocyte-like cell type was the most frequent cell type (75.7%). The tumors are mainly moderately differentiated and frequently associated with liver cirrhosis. In comparison of cytological differentiation with liver cirrhosis, there was a tendency for well-differentiated tumors to arise in cirrhotic livers more often than poorly differentiated tumors, and the tendency was statistically significant. But differentiation and tumor size did not show significant correlation. Also statistically significant correlations were not observed between the level of alpha-fetoprotein and tumor size, and between the level of alpha-fetoprotein and differentiation.

Pathology and Forensic Medicine
Effect of phenobarbital pretreatment on the hepatotoxicity of carbon tetrachloride in rat.: Young Soo Byun, Hae Joo Nam, Mi Jin Kim, Dong Suk Kim, Won Hee Choi, Tae Sook Lee; Yeungnam Univ J Med. 1992;9(1):137-148. Published online June 30, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.1.137

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Abstract PDF: The purpose of this study was to evaluate the influence of phenobarbital (PB) on hepatotoxic effect of carbon tetrachloride (CCI4) which induces centrilobular necrosis in liver. Rats were injected intraperitoneally CCI4 dissolved in olive oil by a dose of 0.4 mg/kg. For change related to PB pretreatment, rats were injected CCI₄ 0.4mg/kg after PB pretreatment. The liver samples were taken in 6, 12, 24, 48, 72 and 120 hours after CCI₄ and/ or PB injection. Extracted liver tissue was examined with light and electron microscopes. The results were summarized as follows: 1. Light microscopic findings: In CCI₄ group, centrilobular necrosis developed from 6 hours after injection, was the most severe in 48 hours, and recovered after 72 hours. In addition to necrosis, fatty change and pale cell change were accompanied. In PB-CCI4 group, necrosis occurred from 6 hours after CCI₄ injection and continued to 72 hours, and the degree of necrosis was more severe than that of CCI₄ group and pale cell change was decreased. 2. Electron microscopic findings: In CCI4 group, the early principal change was clumping and vesicular dilatation of endoplasmic reticulum. In PB-CCI₄ group, the degenerative change of endoplasmic reticulum was aggravated and the mitochondria also revealed severe degenerative change. According to the results, it was revealed that CCI₄ hepatotoxicity primarily began with the damage of endoplasmic reticulum, then damage of other cell organelles and cell necrosis followed, and these cytotoxic effects were aggravated by PB pretreatment.

Pathology and Forensic Medicine
Effects of carbon tetrachloride on structures in hepatocytes following DMN induced hepatotoxicity.: Young Chun Kang, Hae Joo Nam, Dong Suk Kim, Won Hee Choi, Tae Sook Lee; Yeungnam Univ J Med. 1991;8(2):84-94. Published online December 31, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.2.84

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Abstract PDF: The purpose of this study was to evaluate the influence of high dose carbon tetrachloride (CCI4) on the hepatotoxic effect of dimethylnitrosamine (DMN) which induces acute hemorrhagic necrosis in liver. Rats were injected intraperitoneally DMN dissolved in physiologic saline by a dose of 40 mg/kg. For changes related to CCI⁴ pretreatment, rats were injected intraperitoneally CCI⁴ dissolved in olive oil by a dose of 0.4 mg/kg, and then injected DMN. The livers were extracted from the rats 3, 6, 12, 24, 48, 72, and 120 hours after CCI⁴ and/ or DMN injection. Liver tissues were examined with light and electron microscopes. The results were summarized as follows; Light microscopic findings: Severe centrilobular hemorrhagic necrosis developed from 12 hours after injection of DMN and continued to 120 hours. On injection of DMN after CCI4 pretreatment, Massive necrosis occurred early. But active regenerative changes were produced in 24 hours. In 120 hours, the liver recovered in almost normal appearance. The degree of necrosis in pretreated group was similar to that in DMN injection only, and the time of recovery was faster in pretreated group. Electron microscopic findings: The early change was mainly disorganization of RER in DMN injection, and clumping and vesicular dilatation of ER in injection of CCI4. In pretreatment group, the early change was similar in appearance with CCI4 group, but severer in degree. According to the results, it was revealed that acute toxic effect of DMN was recovered more rapidly in pretreatment group. Thus it was suggested that CCI4 had protective effect in DMN hepatotoxicity.

Pathology and Forensic Medicine
Nucleolar organizer regions in glioma.: Hae Joo Nam, Dong Suk Kim, Won Hee Choi, Tae Sook Lee; Yeungnam Univ J Med. 1991;8(2):63-69. Published online December 31, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.2.63

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Abstract PDF: Nucleolar organizer regions (NOR) are loops of ribosomal DNA (rDNA) which are transcribed by RNA polymerase I. They produce ultimately ribosome and protein. Thus they are believed to reflect nuclear activity. We applied silver colloid staining technique to human glioma to examine relationship between the mean number of Ag-NOR and histopathological grading. The mean number of Ag-NOR (±S. E of the mean) were 1.17±0.07 in normal brain, 1.53±0.25 in astrocytoma, 2.37±0.71 in malignant astrocytoma. And 2.88±0.41 in glioblastoma multiforme. And there was a statistically significant difference among these. The results show that Ag-NOR technique is a rather simple and rapid method and will become a helpful tool for estimation of the proliferative potential of glioma.

Case Report

Hematology
Acute megakaryoblastic leukemia.: Young Jin Kim, Tae Nyun Kim, Myung Soo Hyun, Bong Sup Shim, Hyun Woo Lee, Jung Suk Kim; Yeungnam Univ J Med. 1991;8(2):209-216. Published online December 31, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.2.209

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Abstract PDF: Acute megakaryoblastic leukemia is a rare and rapidly fatal disease characterized by proliferation of megakaryocyte series and atypical megakaryocytes in the bone marrow. Acute megakaryoblastic leukemia is suspicious when 1) megakaryocyte in peripheral blood, mixture of large and small mononuclear megakaryoblast in the bone marrow 2) cytoplasmic budding in blast 3) myelofibrosis (dense medullary overgrowth of reticulin fibers) 4) PAS (+), ANAE (+), SBB (−), peroxidase (−) and which is confirmed by platelet peroxidase oxidation on electron microscope or monoclonal antibody. A case of acute megakaryoblastic leukemia was studied morphologically and monoclonal antibody.

Original Article

Microbiology
A Numerical Coding System(MCRCODE-N) for Identification of Glucose Nonfermenting Gram-Negative Bacilli.: Seok il Hong, Chung Suk Kim; Yeungnam Univ J Med. 1985;2(1):183-190. Published online December 31, 1985; DOI: https://doi.org/10.12701/yujm.1985.2.1.183

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Abstract PDF: The glucose nonfermenting gram-negative bacilli encountered about 10% of all gram-negative bacilli isolated from clinical material. Therefore, a rapid and correct identification of glucose nonfermenting gram-negative bacilli is impotent for a better management of infectious disease. There are many conventional systems for the identification of glucose nonfermenting gram-negative bacilli but most of them have problems and difficulties. Commercial Kit Systems exist and they are too expensive for daily use in Korea because of high cost. Based on 12 selected tests we propose a new code system, MCRCODE-N for rapid and inexpensive identification of glucose nonfermenting gram-negative bacilli. The selective 12 tests are oxidase, glucose oxidation motihty, urease, DNase arginine dehydrolase, nitrate reduction, gelatin Liquefaction, esculin hydrolysis, mannitol oxidation, maltose oxidation, Lactose oxidation. The 12 tests are divided 4 group and then each group has 3 tests. The result of each group is expressed by the number as below. The positive test is given by specific number (1st test=1, 2nd test=2, 3rd test=4), while any negative result is 0. Each 3 numbers of one group are added and make number of 1 digit. Four digit number is referred to the code book of MCRCODE-N system or MCRCODE system using computer (Apple-II model) created by authors. This MCRCODE-N system is suitable ones for out use in Korea. We propose the MCRCODE-N system for clinical use.

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