Journal of Yeungnam Medical Science

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.

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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Focused Review article

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

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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

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.

Citations

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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 reports

Intra-abdominal hypertension during hip arthroscopy: a case report: Saeyoung Kim, Hyun-Su Ri, Ji Hyun Kim, Jiyong Yeom; J Yeungnam Med Sci. 2023;40(1):102-105. Published online September 23, 2022; DOI: https://doi.org/10.12701/jyms.2022.00430

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Abstract PDF: Symptomatic extravasation of irrigation fluid is a rare complication of hip arthroscopy. However, depending on the amount of fluid, intra-abdominal hypertension (IAH) may occur and even develop into abdominal compartment syndrome, which can seriously alter hemodynamic circulation. Therefore, it is important for anesthesiologists to promptly recognize the abnormal signs of IAH for early diagnosis and better clinical outcomes. Nevertheless, these signs are difficult to detect because they are usually obscured when the patient is under anesthesia and masked by surgical drapes. We report a case of IAH under general anesthesia during hip arthroscopy to highlight possible symptoms and signs.

Severe congenital neutropenia mimicking chronic idiopathic neutropenia: a case report: Juhyung Kim, Soyoon Hwang, Narae Hwang, Yeonji Lee, Hee Jeong Cho, Joon Ho Moon, Sang Kyun Sohn, Dong Won Baek; J Yeungnam Med Sci. 2023;40(3):283-288. Published online July 28, 2022; DOI: https://doi.org/10.12701/jyms.2022.00353

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Abstract PDF Supplementary Material

Severe chronic neutropenia is classified as severe congenital, cyclic, autoimmune, or idiopathic. However, there is a lot of uncertainty regarding the diagnosis of severe congenital neutropenia (SCN) and chronic idiopathic neutropenia, and this uncertainty affects further evaluations and treatments. A 20-year-old man presented with fever and knee abrasions after a bicycle accident. On admission, his initial absolute neutrophil count (ANC) was 30/µL. He had no medical history of persistent severe neutropenia with periodic oscillation of ANC. Although his fever resolved after appropriate antibiotic therapy, ANC remained at 80/µL. Bone marrow (BM) aspiration and biopsy were performed, and a BM smear showed myeloid maturation arrest. Moreover, genetic mutation test results showed a heterozygous missense variant in exon 4 of the neutrophil elastase ELANE: c597+1G>C (pV190-F199del). The patient was diagnosed with SCN. After discharge, we routinely checked his ANC level and monitored any signs of infection with minimum use of granulocyte colony-stimulating factor (G-CSF), considering its potential risk of leukemic transformation. Considering that SCN can be fatal, timely diagnosis and appropriate management with G-CSF are essential. We report the case of a patient with SCN caused by ELANE mutation who had atypical clinical manifestations. For a more accurate diagnosis and treatment of severe chronic neutropenia, further studies are needed to elucidate the various clinical features of ELANE.

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ПЕРВИННІ МІНОРНІ ІМУНОДЕФІЦИТИ ЯК ПРИЧИНА РОЗВИТКУ ІМУНОЗАЛЕЖНОЇ ПАТОЛОГІЇ У ЛЮДЕЙ: ЕТІОЛОГІЯ, ЕПІДЕМІОЛОГІЯ, КЛАСИФІКАЦІЯ, ДІАГНОСТИКА І ЛІКУВАННЯ (СИСТЕМАТИЧНИЙ ОГЛЯД)
Dmytro Maltsev
Immunology and Allergology: Science and Practice.2024; (3-4): 37. CrossRef

Original articles

Factors associated with the prescription of probiotics in patients with inflammatory bowel disease: a cross-sectional study: Joo Kyung Kim, Jae Hee Cheon; J Yeungnam Med Sci. 2023;40(1):37-48. Published online April 18, 2022; DOI: https://doi.org/10.12701/jyms.2022.00031

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Abstract PDF

Background
Commensal bacteria play an important role in the pathogenesis of inflammatory bowel disease (IBD) and probiotics have been used as treatment options. We aimed to explore the current use of probiotics and factors associated with their prescription in patients with IBD.
Methods
This cross-sectional study was conducted on a single hospital-based cohort. Patients were eligible if they were ≥18 years old, visited the IBD clinic as an outpatient more than twice during the study period, and had a confirmed diagnosis of IBD. Patients were divided into two groups based on the prescription of probiotics. Clinical assessments were compared between the two groups.
Results
In total, 217 patients were enrolled in this study. In patients with Crohn disease (CD), moderate or severe abdominal pain; prior use of methotrexate (MTX), iron, thiopurines, or biologics; history of IBD-related surgery; and stool frequency were independently associated with the prescription of probiotics. In patients with ulcerative colitis (UC), moderate or severe abdominal pain, hematochezia, stool frequency, and moderate or severe physician global assessment score were independently associated with the prescription of probiotics.
Conclusion
Increased disease activity may be associated with fewer prescriptions of probiotics in patients with IBD. However, physicians prescribed probiotics to control symptoms, such as abdominal pain and increased stool frequency in patients with UC and CD, and hematochezia in patients with UC. Additionally, the use of MTX and iron, and a history of IBD-related surgeries were associated with more frequent probiotic prescriptions in patients with CD.

Citations

Citations to this article as recorded by

The role of the fecal microbiota in inflammatory bowel disease
Rami Khalaf, Martina Sciberras, Pierre Ellul
European Journal of Gastroenterology & Hepatology.2024; 36(11): 1249. CrossRef
Probiotics for the treatment of ulcerative colitis: a review of experimental research from 2018 to 2022
Cuilan Huang, Wujuan Hao, Xuyang Wang, Renmin Zhou, Qiong Lin
Frontiers in Microbiology.2023;[Epub] CrossRef

Effects of propofol-remifentanil versus sevoflurane-remifentanil on acute postoperative pain after total shoulder arthroplasty: a randomized trial: Eun Kyung Choi, Saeyoung Kim, Do young Kim; J Yeungnam Med Sci. 2023;40(3):247-251. Published online March 30, 2022; DOI: https://doi.org/10.12701/jyms.2022.00129

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Abstract PDF

Background
While some evidence indicates that propofol-based anesthesia has less postoperative pain than sevoflurane-based anesthesia, these results are controversial. We compared acute postoperative pain intensity and opioid consumption after total shoulder arthroplasty between propofol-remifentanil (PR) and sevoflurane-remifentanil (SR) anesthesia.
Methods
Among 48 patients undergoing shoulder arthroscopic surgery anesthetized with PR or SR, postoperative pain intensity was assessed at 30 minutes and at 2, 6, 12, and 24 hours. The total patient-controlled analgesia volume and number of patients requiring rescue analgesics were assessed.
Results
No significant difference in postoperative pain intensity was observed between the two groups. Postoperative opioid consumption and analgesic requirements were also comparable in the first 24 hours after surgery.
Conclusion
PR and SR anesthesia for shoulder arthroscopic surgery provide comparable postoperative analgesia results.

Citations

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Comparison of sevoflurane and propofol in combination with remifentanil on the quality of postoperative recovery in patients undergoing laparoscopic bariatric surgery
Zhuolin Shu, Tiancheng Lin, Dingchen Xu, Shuyuan Zheng
Frontiers in Medicine.2024;[Epub] CrossRef

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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Neonatal pyocele originating from a urinary tract infection: a case report
Zahra Jamali, Mohammad Shafie’ei, Najmeh Soltani Nejad
Journal of Medical Case Reports.2024;[Epub] CrossRef

Original articles

Infection prevention measures and outcomes for surgical patients during a COVID-19 outbreak in a tertiary hospital in Daegu, South Korea: a retrospective observational study: Kyung-Hwa Kwak, Jay Kyoung Kim, Ki Tae Kwon, Jinseok Yeo; J Yeungnam Med Sci. 2022;39(3):223-229. Published online November 5, 2021; DOI: https://doi.org/10.12701/yujm.2021.01431

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Abstract PDF: Background
The first large coronavirus disease 2019 (COVID-19) outbreak outside China occurred in Daegu. In response, we developed infection prevention measures for surgical patients during the outbreak at our hospital and retrospectively reviewed the outcomes of COVID-19–related surgical patients.
Methods
We reviewed the medical records of 118 COVID-19–related surgical patients and monitored their clinical outcomes until March 31, 2021. We also interviewed healthcare workers who participated in their perioperative care at Kyungpook National University Chilgok Hospital. The perioperative management guidelines for COVID-19–related patients were prepared through multidisciplinary discussions, including the infection control department, surgical departments, and anesthesiology department before and during the COVID-19 outbreak.
Results
One standard operating room was temporarily converted to a negative-pressure room by increasing the exhaust air volume, creating a relative pressure of −11.3 Pa. The healthcare workers were equipped with personal protective equipment according to the patient's classification of the risk of COVID-19 transmission. The 118 COVID-19–related patients underwent emergent surgery in the negative-pressure room, including three COVID-19–confirmed patients and five COVID-19–exposed patients.
Conclusion
All surgeries of the COVID-19–related patients were performed without specific adverse events or perioperative COVID-19 transmission. Our experience setting up a negative-pressure operating room and conservative perioperative protocol to prevent COVID-19 transmission will help plan and execute infection control measures in the future.

Treatment decision for cancer patients with fever during the coronavirus disease 2019 (COVID-19) pandemic: In Hee Lee, Sung Ae Koh, Soo Jung Lee, Sun Ah Lee, Yoon Young Cho, Ji Yeon Lee, Jin Young Kim; Yeungnam Univ J Med. 2021;38(4):344-349. Published online August 23, 2021; DOI: https://doi.org/10.12701/yujm.2021.01144

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Abstract PDF: Background
Cancer patients have been disproportionally affected by the coronavirus disease 2019 (COVID-19) pandemic, with high rates of severe outcomes and mortality. Fever is the most common symptom in COVID-19 patients. During the COVID-19 pandemic, physicians may have difficulty in determining the cause of fever (COVID-19, another infection, or cancer fever) in cancer patients. Furthermore, there are no specific guidelines for managing cancer patients with fever during the COVID-19 pandemic. Thus, this study evaluated the clinical characteristics and outcomes of cancer patients with fever during the COVID-19 pandemic.
Methods
This study retrospectively reviewed the medical records of 328 cancer patients with COVID-19 symptoms (fever) admitted to five hospitals in Daegu, Korea from January to October 2020. We obtained data on demographics, clinical manifestations, laboratory test results, chest computed tomography images, cancer history, cancer treatment, and outcomes of all enrolled patients from electronic medical records.
Results
The most common COVID-19-like symptoms were fever (n=256, 78%). Among 256 patients with fever, only three (1.2%) were diagnosed with COVID-19. Most patients (253, 98.8%) with fever were not diagnosed with COVID-19. The most common solid malignancies were lung cancer (65, 19.8%) and hepatobiliary cancer (61, 18.6%). Twenty patients with fever experienced a delay in receiving cancer treatment. Eighteen patients discontinued active cancer treatment because of fever. Major events during the treatment delay period included death (2.7%), cancer progression (1.5%), and major organ dysfunction (2.7%).
Conclusion
Considering that only 0.9% of patients tested for COVID-19 were positive, screening for COVID-19 in cancer patients with fever should be based on the physician’s clinical decision, and patients might not be routinely tested.

Focused Review article

Novel respiratory infectious diseases in Korea: Hyun Jung Kim; Yeungnam Univ J Med. 2020;37(4):286-295. Published online September 23, 2020; DOI: https://doi.org/10.12701/yujm.2020.00633

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Abstract PDF

Respiratory infections are very common and highly contagious. Respiratory infectious diseases affect not only the person infected but also the family members and the society. As medical sciences advance, several diseases have been conquered; however, the impact of novel infectious diseases on the society is enormous. As the clinical presentation of respiratory infections is similar regardless of the pathogen, the causative agent is not distinguishable by symptoms alone. Moreover, it is difficult to develop a cure because of the various viral mutations. Various respiratory infectious diseases ranging from influenza, which threaten the health of mankind globally, to the coronavirus disease 2019, which resulted in a pandemic, exist. Contrary to human expectations that development in health care and improvement in hygiene will conquer infectious diseases, humankind’s health and social systems are threatened by novel infectious diseases. Owing to the development of transport and trading activity, the rate of spread of new infectious diseases is increasing. As respiratory infections can threaten the members of the global community at any time, investigations on preventing the transmission of these diseases as well as development of effective antivirals and vaccines are of utmost importance and require a worldwide effort.

Citations

Citations to this article as recorded by

Evaluation and analysis of respiratory infectious disease prevention behaviors in older adults
Liliang Yu, Min Liu, Qing Tan, Dan Wang, Xiaoyun Chen, Mingming Zhao, Jiang Long, Mingyue Fan, Daikun Zheng
Frontiers in Public Health.2024;[Epub] CrossRef
Barriers to and facilitators of populational adherence to prevention and control measures of COVID-19 and other respiratory infectious diseases: a qualitative evidence synthesis
Tácito Zaildo, Thayla Amorim Santino, Gabriela Chaves, Baldomero Antonio Kato da Silva, João Carlos Alchieri, Cecilia M. Patino, Sarah Leite, Kleber Giovanni Luz, Ricardo Oliveira Guerra, Tito Hugo Soares da Penha, Gabriel Rodrigues da Silva, Ada Cristina
European Respiratory Review.2023; 32(168): 220238. CrossRef
Diarylpentanoids, the privileged scaffolds in antimalarial and anti‐infectives drug discovery: A review
Amirah H. Ramli, Siti M. Mohd Faudzi
Archiv der Pharmazie.2023;[Epub] CrossRef
Infectious Respiratory Diseases Decreased during the COVID-19 Pandemic in South Korea
Da Hae Kim, Thi Mai Nguyen, Jin Hee Kim
International Journal of Environmental Research and Public Health.2021; 18(11): 6008. CrossRef
Advances in the science and treatment of respiratory diseases
Jin Hong Chung
Yeungnam University Journal of Medicine.2020; 37(4): 251. CrossRef

Case reports

Early surgical intervention for unusually located cardiac fibroelastomas: Eui Suk Chung, Jae Hoon Lee, Jong Kwon Seo, Byung Gyu Kim, Gwang Sil Kim, Hye Young Lee, Young Sup Byun, Hyun Jung Kim; Yeungnam Univ J Med. 2020;37(4):345-348. Published online August 5, 2020; DOI: https://doi.org/10.12701/yujm.2020.00556

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Abstract PDF

Papillary fibroelastomas are the second most common primary cardiac tumor in adults. Over 80% of fibroelastomas occur on the cardiac valves, usually on the left side of the heart, while the remaining lesions are typically scattered throughout the atria and ventricles. Although the optimal timing for surgery is controversial and depends on tumor size and location, prompt surgical resection is warranted in patients at high risk of embolism. A tumor on the cardiac valve can be removed using the slicing excision technique without leaflet injury. Here we present two cases of papillary fibroelastomas occurring on the ventricular surface of the aortic valve and in the right ventricle.

Citations

Citations to this article as recorded by

A Importância da Multimodalidade de Imagem no Diagnóstico de um Raro Caso de Fibroelastoma Papilar no Ápice do Ventrículo Esquerdo
Marcio Mendes Pereira, Vinícius José da Silva Nina, José Xavier de Melo Filho, Rodrigo de Jesus Louzeiro Melo, Marco Túlio Hercos Juliano, Luma Sayonara Martins Pereira
ABC Imagem Cardiovascular.2023;[Epub] CrossRef
The Importance of Imaging Multimodality in the Diagnosis of a Rare Case of Papillary Fibroelastoma in the Left Ventricular Apex
Marcio Mendes Pereira, Vinícius José da Silva Nina, José Xavier de Melo, Rodrigo de Jesus Louzeiro Melo, Marco Túlio Hercos Juliano, Luma Sayonara Martins Pereira
ABC Imagem Cardiovascular.2023;[Epub] CrossRef

Co-existence of relapsing polychondritis and Crohn disease treated successfully with infliximab: Hye-In Jung, Hyun Jung Kim, Ji-Min Kim, Ju Yup Lee, Kyung Sik Park, Kwang Bum Cho, Yoo Jin Lee; Yeungnam Univ J Med. 2021;38(1):70-73. Published online June 19, 2020; DOI: https://doi.org/10.12701/yujm.2020.00304

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Abstract PDF

Relapsing polychondritis (RP) is a rare, progressive immune-mediated systemic inflammatory disease of unknown etiology, characterized by recurrent inflammation of cartilaginous structures. Approximately 30% of RP cases are associated with other autoimmune diseases. However, the co-occurrence of RP and Crohn disease (CD) has rarely been reported. Herein, we present a 35-year-old woman diagnosed with RP and CD, who was refractory to initial conventional medications, including azathioprine and glucocorticoid, but who subsequently responded to infliximab (IFX). For both diseases, remission was sustained with IFX. There has been no previous report regarding the successful treatment of co-existing RP and CD with IFX.

Citations

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Relapsing Polychondritis in a Patient With Auricular Chondritis and Inflammatory Bowel Disease: A Case Report With Literature Review
David D Bickford, Thomas Ritter, Pinky Jha, Hari R Paudel
Cureus.2022;[Epub] CrossRef

Cushing syndrome in pregnancy, diagnosed after delivery: Han Byul Kim, Mi Kyung Kim, El Kim, Keun Soo Ahn, Hye Soon Kim, Nam Kyung Kim; Yeungnam Univ J Med. 2021;38(1):60-64. Published online May 22, 2020; DOI: https://doi.org/10.12701/yujm.2020.00290

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Abstract PDF

Cushing syndrome (CS) is rare in pregnancy, and few cases have been reported to date. Women with untreated CS rarely become pregnant because of the ovulatory dysfunction induced by hypercortisolism. It is difficult to diagnose CS in pregnancy because of its very low incidence, the overlap between the clinical signs of hypercortisolism and the physiological changes that occur during pregnancy and the changes in hypothalamus-pituitary-adrenal axis activity that occur during pregnancy and limit the value of standard diagnostic testing. However, CS in pregnancy is associated with poor maternal and fetal outcomes; therefore, its early diagnosis and treatment are important. Here, we report two patients with CS that was not diagnosed during pregnancy, in whom maternal and fetal morbidity developed because of hypercortisolism.

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Cushing’s disease with twin pregnancy and diabetes mellitus: a case report and literature review
Hideyasu Asai, Ikuo Yamamori, Shigeru Hagimoto, Kyoichi Okumura, Koki Sakakibara
Endocrine Journal.2024; 71(10): 1003. CrossRef
Endogenous Cushing’s syndrome during pregnancy
Nada Younes, Matthieu St-Jean, Isabelle Bourdeau, André Lacroix
Reviews in Endocrine and Metabolic Disorders.2023; 24(1): 23. CrossRef
Cushing Syndrome in Pregnancy: A Case Presentation and Review of Literature
HamidReza Samimagham, Ava Ziaei, Mohammad Tamaddondar, Mitra Kazemi Jahromi
Journal of Kermanshah University of Medical Sciences.2023;[Epub] CrossRef

Original article

Usefulness of intraoperative determination of central lymph node metastasis by palpation in papillary thyroid cancer: Wan Wook Kim, Jeeyeon Lee, Jin Hyang Jung, Ho Yong Park, Won Hwa Kim, Hye Jung Kim, Ji-Young Park, Ralph P. Tufano; Yeungnam Univ J Med. 2020;37(4):302-307. Published online April 22, 2020; DOI: https://doi.org/10.12701/yujm.2020.00122

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Abstract PDF: Background
This study evaluated the usefulness of judgment of central lymph node (LN) metastasis by surgeon’s palpation in papillary thyroid cancer.
Methods
This study included 127 patients who underwent thyroidectomy and central compartment node dissection between October 2014 and February 2015. The criterion for suspicious LNs was hardness.
Results
Of the 20.5% (28/127) of suspicious for metastatic LNs according to surgeon determination, 92.8% (26/28) were confirmed to be metastatic in the final pathological examinations. Metastatic LNs were found in 38 (38.3%) of 99 patients without suspicious LNs, 29 of whom (76.3%) had micrometastases. The sensitivity, specificity, and positive and negative predictive values for the determination of LN metastasis by a surgeon were 40.6%, 96.8%, 92.9%, and 61.6%, respectively.
Conclusion
Determination of central LN metastasis by a surgeon’s palpation may be useful to evaluate LNs owing to the high specificity and positive predictive values, especially in macrometastasis or high-risk LN disease.

Correction

Erratum to “Assessment of solid components of borderline ovarian tumor and stage I carcinoma: added value of combined diffusion- and perfusion-weighted magnetic resonance imaging”: See Hyung Kim; Yeungnam Univ J Med. 2020;37(2):147-147. Published online March 31, 2020; DOI: https://doi.org/10.12701/yujm.2019.00234.e1; Corrects: J Yeungnam Med Sci 2019;36(3):231

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Original articles

Does oral doxycycline treatment affect eradication of urine vancomycin-resistant Enterococcus? A tertiary hospital study: Yoonjung Kim, Sohyun Bae, Soyoon Hwang, Ki Tae Kwon, Hyun-Ha Chang, Su-Jeong Kim, Han-Ki Park, Jong-Myung Lee, Shin-Woo Kim; Yeungnam Univ J Med. 2020;37(2):112-121. Published online February 18, 2020; DOI: https://doi.org/10.12701/yujm.2019.00430

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Abstract PDF Supplementary Material

Background
Vancomycin-resistant Enterococcus (VRE) has become more common in nosocomial infections, especially in urine samples. However, until now, no treatment regimen has been proven to effectively eradicate urine VRE colonization. Therefore, to evaluate the efficacy of doxycycline in eradicating urine VRE and shortening VRE isolation period, we compared VRE colony detection period between doxycycline-treated and untreated patients.
Methods
A retrospective cohort study of 83 patients with VRE colonization in urine cultures was conducted at a tertiary academic hospital from January 2011 to February 2018. Kaplan-Meier survival analysis was used to evaluate eradication rates in the treatment and non-treatment groups. Factors affecting urine VRE colonization persistence were analyzed by multiple logistic regression analysis.
Results
The overall rate of VRE eradication during the entire hospital stay was higher in the doxycycline treatment group (90.5%) than in the non-treatment group (58.1%, p=0.014). Survival analysis showed that the 5-, 10-, and 20-day cumulative eradication rates were 78.3%, 100%, and 100% in the doxycycline treatment group, and 18.5%, 45.7%, and 67.8% in the non-treatment group, respectively, thereby indicating that eradication rates were higher in the doxycycline treatment group than in the non-treatment group (p<0.001). Only doxycycline treatment was shown to affect urine VRE colonization persistence in multivariate logistic regression analysis
Conclusion
Doxycycline treatment enhanced the eradication rate of urine VRE colonization and appeared to be useful in shortening VRE isolation period.

Citations

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Therapeutics for Vancomycin-Resistant Enterococcal Bloodstream Infections
Kelly A. Cairns, Andrew A. Udy, Trisha N. Peel, Iain J. Abbott, Michael J. Dooley, Anton Y. Peleg
Clinical Microbiology Reviews.2023;[Epub] CrossRef
Aminopenicillins for treatment of ampicillin-resistant enterococcal urinary tract infections
Kristen Bunnell, Amy Duong, Thomas Ringsred, Asia Mian, Sanaya Bhathena
American Journal of Health-System Pharmacy.2022; 79(13): 1056. CrossRef
Doxycycline for ESBL-E Cystitis
Tomasz Jodlowski, Charles R Ashby, Sarath G Nath
Clinical Infectious Diseases.2021; 73(1): e274. CrossRef

Nasal tip plasty using three-dimensional printed polycaprolactone (Smart Ball^®): Joo Hyoung Kim, Geon Woo Kim, Won Kyung Kang; Yeungnam Univ J Med. 2020;37(1):32-39. Published online September 5, 2019; DOI: https://doi.org/10.12701/yujm.2019.00290

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Abstract PDF

Background
Rhinoplasty is one of the most commonly performed cosmetic surgery procedures. Most Asians desire elevation of their relatively flat nasal dorsum and tip to make them appear more prominent. This study introduces a simple method of nasal tip plasty using three-dimensional (3D)-printed polycaprolactone (PCL) (Smart Ball^®), which provides the required length and volume for this purpose and enables the creation of a nasal tip of the desired shape in a safe and simple manner.
Methods
Between September 2014 and May 2017, 22 patients participated in a survey to assess postoperative satisfaction levels. Additionally, three plastic surgeons compared patients’ pre- and 1-year postoperative photographs to evaluate the results. All patients underwent 2- to 4-year postoperative follow-up.
Results
Levels of subjective satisfaction among patients were 3.59, 3.50, 3.82, 3.73, 3.55, and 3.82 for each of the 6 categories evaluated, with a mean of 3.67/4 points, indicating high satisfaction levels. The mean plastic surgeon-reported score for the 22 patients was 4.47/5 points, which also indicates highly successful outcomes. Postoperative nasal tip rotation and tip projection were ideal in most patients.
Conclusion
Our novel method using 3D-printed PCL (Smart Ball®) provides the optimal length and volume required for nasal tip plasty and enables the creation of a nasal tip of the desired shape, in a safe and simple manner. An advantage of our method is that it retains the original nasal structure in contrast to structural changes observed with the use of conventional methods.

Citations

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From Novel Facial Measurements to Facial Implantology: A Systematic Review
Helena Baecher, Alexandra Scheiflinger, Katya Remy, Niklas Straub, Bhagvat Maheta, Khalil Sherwani, Can Deniz, Samuel Knoedler, Ali-Farid Safi, Martin Kauke-Navarro, Max Heiland, Leonard Knoedler
JPRAS Open.2025; 43: 1. CrossRef
Unveiling the Impact of Three-Dimensional Technology on Rhinoplasty: A Systematic Review and Meta-analysis
Methini Werathammo, Kachorn Seresirikachorn, Prapitphan Charoenlux
Facial Plastic Surgery.2024;[Epub] CrossRef
Implanted cartilaginous grafts following rhinoplasty: A retrospective histopathological study
Susumu Matsukuma, Ayano Matsunaga, Sho Ogata
Experimental and Therapeutic Medicine.2024;[Epub] CrossRef
Nasal Tip and Alar Groove Plasty Through External Nasal Cutting in Asians: A Clinical Study
Meng-Qiong Xu, Yu-Xi Tang, Bao-Fu Yu, Qi Zeng, Jiao Wei, Chuan-Chang Dai
Journal of Craniofacial Surgery.2023; 34(3): 870. CrossRef
Cosmetic Open Rhinoplasty in Acute Nasal Bone Fracture With Pre-Existing Deformity
Yong-Ha Kim, Won Seob Lee, Jae-Won Kim, Kyu-Jin Chung
Journal of Craniofacial Surgery.2023; 34(4): e358. CrossRef
The latest trends in Asian rhinoplasty
Haibo Xiang, Wanwen Dang, Yang An, Yonghuan Zhen, Dong Li
Chinese Journal of Plastic and Reconstructive Surgery.2022; 4(2): 82. CrossRef
Ex Vivo Maturation of 3D-Printed, Chondrocyte-Laden, Polycaprolactone-Based Scaffolds Prior to Transplantation Improves Engineered Cartilage Substitute Properties and Integration
Carlos M. Chiesa-Estomba, Raquel Hernáez-Moya, Claudia Rodiño, Alba Delgado, Gonzalo Fernández-Blanco, Javier Aldazabal, Jacobo Paredes, Ander Izeta, Ana Aiastui
CARTILAGE.2022; 13(4): 105. CrossRef
The Nasal Tip Rotation After Primary Rhinoplasty Using Columellar Strut Graft
Yazeed Alghonaim , Fahad Alobaid, Jury Alnwaiser
Cureus.2021;[Epub] CrossRef
Aesthetic Nasal Lobule Correction Using a Three-Dimensional Printed Polycaprolactone Implant
Syeo Young Wee, Tae Hyung Kim, Hee Yong Kang, Eun Soo Park
Journal of Craniofacial Surgery.2021; 32(8): e808. CrossRef
A Review of Current Developments in Three-Dimensional Scaffolds for Medical Applications
Ufkay Karabay, Resit Bugra Husemoglu, Mehtap Yuksel Egrilmez, Hasan Havitcioglu
Turkish Journal of Plastic Surgery.2021; 29(Suppl 1): S38. CrossRef

Assessment of solid components of borderline ovarian tumor and stage I carcinoma: added value of combined diffusion- and perfusion-weighted magnetic resonance imaging: See Hyung Kim; Yeungnam Univ J Med. 2019;36(3):231-240. Published online June 13, 2019; DOI: https://doi.org/10.12701/yujm.2019.00234; Correction in: J Yeungnam Med Sci 2020;37(2):147

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Abstract PDF

Background
We sought to determine the value of combining diffusion-weighted (DW) and perfusion-weighted (PW) sequences with a conventional magnetic resonance (MR) sequence to assess solid components of borderline ovarian tumors (BOTs) and stage I carcinomas.
Methods
Conventional, DW, and PW sequences in the tumor imaging studies of 70 patients (BOTs, n=38; stage I carcinomas, n=32) who underwent surgery with pathologic correlation were assessed. Two independent radiologists calculated the parameters apparent diffusion coefficient (ADC), Ktrans (vessel permeability), and Ve (cell density) for the solid components. The distribution on conventional MR sequence and mean, standard deviation, and 95% confidence interval of each DW and PW parameter were calculated. The inter-observer agreement among the two radiologists was assessed. Area under the receiver operating characteristic curve (AUC) and multivariate logistic regression were performed to compare the effectiveness of DW and PW sequences for average values and to characterize the diagnostic performance of combined DW and PW sequences.
Results
There were excellent agreements for DW and PW parameters between radiologists. The distributions of ADC, Ktrans and Ve values were significantly different between BOTs and stage I carcinomas, yielding AUCs of 0.58 and 0.68, 0.78 and 0.82, and 0.70 and 0.72, respectively, with ADC yielding the lowest diagnostic performance. The AUCs of the DW, PW, and combined PW and DW sequences were 0.71±0.05, 0.80±0.05, and 0.85±0.05, respectively.
Conclusion
Combining PW and DW sequences to a conventional sequence potentially improves the diagnostic accuracy in the differentiation of BOTs and stage I carcinomas.

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Comparison of conventional diffusion-weighted imaging, diffusion kurtosis imaging and intravoxel incoherent motion in characterization of sonographically indeterminate adnexal masses
Gurkawal Kaur, Smita Manchanda, Raju Sharma, Surabhi Vyas, Devasenathipathy Kandasamy, Smriti Hari, Neerja Bhatla, Sandeep R. Mathur
Abdominal Radiology.2024; 49(5): 1512. CrossRef
Advances in fertility preserving surgery for borderline ovarian tumors
Mingdan Wang, Kuiran Liu
European Journal of Obstetrics & Gynecology and Reproductive Biology.2022; 270: 206. CrossRef
Recurrence characteristics and clinicopathological results of borderline ovarian tumors
Lina Niu, Huihui Tian, Yongjun Xu, Jieqiong Cao, Xu Zhang, Junli Zhang, Jiajia Hou, Weiqin Lv, Junxia Wang, Li Xin, XuFeng Dong, Tao Xu, Yuan Nan, Hua Wei, Xinting Chai, Na Li, Yan Ni, Yun Shang, Lizhen Zhang, Ye Zhao
BMC Women's Health.2021;[Epub] CrossRef
Erratum to “Assessment of solid components of borderline ovarian tumor and stage I carcinoma: added value of combined diffusion- and perfusion-weighted magnetic resonance imaging”
See Hyung Kim
Yeungnam University Journal of Medicine.2020; 37(2): 147. CrossRef
Minimal apparent diffusion coefficient value of the solid component to differentiate borderline and malignant ovarian epithelial tumours: a preliminary report
Sahat B.R.E. Matondang, Avrilia Ekawati, Andrijono Andrijono, Hartono Tjahjadi, Joedo Prihartono
Polish Journal of Radiology.2020; 85: 250. CrossRef

Digital subtraction angiography vs. real-time fluoroscopy for detection of intravascular injection during transforaminal epidural block: Kibeom Park, Saeyoung Kim; Yeungnam Univ J Med. 2019;36(2):109-114. Published online January 24, 2019; DOI: https://doi.org/10.12701/yujm.2019.00122

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Abstract PDF

Background
Transforaminal epidural block (TFEB) is an effective treatment option for radicular pain. To reduce complications from intravascular injection during TFEB, use of imaging modalities such as real-time fluoroscopy (RTF) or digital subtraction angiography (DSA) has been recommended. In this study, we investigated whether DSA improved the detection of intravascular injection during TFEB at the whole spine level compared to RTF.
Methods
We prospectively examined 316 patients who underwent TFEB. After confirmation of final needle position using biplanar fluoroscopy, 2 mL of nonionic contrast medium was injected at a rate of 0.5 mL/s under RTF; 30 s later, 2 mL of nonionic contrast medium was injected at a rate of 0.5 mL/s under DSA.
Results
Thirty-six intravascular injections were detected for an overall rate of 11.4% using RTF, with 45 detected for a rate of 14.2% using DSA. The detection rate using DSA was statistically different from that using RTF (p=0.004). DSA detected a significantly higher proportion of intravascular injections at the cervical level than at the thoracic (p=0.009) and lumbar (p=0.011) levels.
Conclusion
During TFEB at the whole spine level, DSA was better than RTF for the detection of intravascular injection. Special attention is advised for cervical TFEB, because of a significantly higher intravascular injection rate at this level than at other levels.

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1. Lumbosacral radicular pain
Laurens Peene, Steven P. Cohen, Jan Willem Kallewaard, Andre Wolff, Frank Huygen, Antal van de Gaag, Steegers Monique, Kris Vissers, Chris Gilligan, Jan Van Zundert, Koen Van Boxem
Pain Practice.2024; 24(3): 525. CrossRef
Safety of local anesthetics in cervical nerve root injections: a narrative review
Zachary E. Stewart
Skeletal Radiology.2023; 52(10): 1893. CrossRef
An update on technical and safety practice patterns in transforaminal epidural steroid injections
Ashley E. Gureck, Berkenesh Gebrekristos, Razvan Turcu, Dana Kotler, Alec L. Meleger
Interventional Pain Medicine.2023; 2(4): 100286. CrossRef
Thoracic transforaminal epidural steroid injection for management of thoracic spine pain: A multicenter cross-sectional study of short-term outcomes
Josh Levin, John Chan, Lisa Huynh, Matt Smuck, Jayme Koltsov, Bilge Kesikburun, Graham E. Wagner, Marc Caragea, Keith Kuo, Zachary L. McCormick, Byron Schneider, Evan Berlin, D.J. Kennedy, Serdar Kesikburun
Interventional Pain Medicine.2022; 1(1): 100004. CrossRef
The American Society of Pain and Neuroscience (ASPN) Best Practices and Guidelines for the Interventional Management of Cancer-Associated Pain
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Journal of Pain Research.2021; Volume 14: 2139. CrossRef

Case Report

Acute left main coronary artery thrombosis as an initial presentation of systemic lupus erythematosus: Kang Un Choi, Ung Kim; Yeungnam Univ J Med. 2018;35(2):227-231. Published online December 31, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.227

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Abstract PDF: Left main coronary artery (LMCA) thrombosis is rare and the cause should be determined. A previously healthy young man presented with severe chest pain and dyspnea. The electrocardiogram showed typical ST-segment elevation myocardial infarction with clinical instability. Emergency coronary angiography revealed complete LMCA occlusion by thrombosis. After reperfusion, the patient was admitted to the cardiac care unit. He was diagnosed with hemolytic anemia and tested positive for antinuclear antibodies. Systemic lupus erythematosus (SLE) and LMCA disease due to systemic thrombosis were diagnosed. Steroids were started and the patient was discharged without complications. We report this rare case of LMCA thrombosis as an initial presentation of SLE.

Original Article

Antiepileptic and anti-neuroinflammatory effects of red ginseng in an intrahippocampal kainic acid model of temporal lobe epilepsy demonstrated by electroencephalography: Ju Young Kim, Jin Hyeon Kim, Hee Jin Lee, Sang Hoon Kim, Young Jin Jung, Hee-Young Lee, Hee Jaung Kim, Sae Yoon Kim; Yeungnam Univ J Med. 2018;35(2):192-198. Published online December 31, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.192

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Abstract PDF

Background
Chronic inflammation can lower the seizure threshold and have influence on epileptogenesis. The components of red ginseng (RG) have anti-inflammatory effects. The abundance of peripherally derived immune cells in resected epileptic tissue suggests that the immune system is a potential target for anti-epileptogenic therapies. The present study used continuous electroencephalography (EEG) to evaluate the therapeutic efficacy of RG in intrahippocampal kainic acid (IHKA) animal model of temporal lobe epilepsy.
Methods
Prolonged status epilepticus (SE) was induced in 7-week-old C57BL/6J mice via stereotaxic injection of kainic acid (KA, 150 nL; 1 mg/mL) into the right CA3/dorsal hippocampus. The animals were implanted electrodes and monitored for spontaneous seizures. Following the IHKA injections, one group received treatments of RG (250 mg/kg/day) for 4 weeks (RG group, n=7) while another group received valproic acid (VPA, 30 mg/kg/day) (VPA group, n=7). Laboratory findings and pathological results were assessed at D29 and continuous (24 h/week) EEG monitoring was used to evaluate high-voltage sharp waves on D7, D14, D21, and D28.
Results
At D29, there were no differences between the groups in liver function test but RG group had higher blood urea nitrogen levels. Immunohistochemistry analyses revealed that RG reduced the infiltration of immune cells into the brain and EEG analyses showed that it had anticonvulsant effects.
Conclusion
Repeated treatments with RG after IHKA-induced SE decreased immune cell infiltration into the brain and resulted in a marked decrease in electrographic seizures. RG had anticonvulsant effects that were similar to those of VPA without serious side effects.

Citations

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Comparative analysis of physicochemical properties, ginsenosides content and α-amylase inhibitory effects in white ginseng and red ginseng
Huairui Wang, Yao Cheng, Xue Zhang, Yingping Wang, Hui Zhao
Food Science and Human Wellness.2023; 12(1): 14. CrossRef
Robust chronic convulsive seizures, high frequency oscillations, and human seizure onset patterns in an intrahippocampal kainic acid model in mice
Christos Panagiotis Lisgaras, Helen E. Scharfman
Neurobiology of Disease.2022; 166: 105637. CrossRef
The interplay of epilepsy with impaired mitophagy and autophagy linked dementia (MAD): A review of therapeutic approaches
Siva Prasad Panda, Yogita Dhurandhar, Mehak Agrawal
Mitochondrion.2022; 66: 27. CrossRef

Case report

Awareness during general anesthesia despite simultaneous bispectral index and end-tidal anesthetic gas concentration monitoring: Jungwon Lee, Chorong Park, Saeyoung Kim; Yeungnam Univ J Med. 2019;36(1):50-53. Published online December 14, 2018; DOI: https://doi.org/10.12701/yujm.2019.00010

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Abstract PDF

Awareness during general anesthesia occurs in approximately 0.1–0.2% of cases; nevertheless, particular attention is required because it can lead to critical complications including insomnia, depression, anxiety, and post-traumatic stress disorder. To prevent these complications, bispectral index (BIS) and end-tidal anesthetic gas (ETAG) concentration monitoring are commonly used to examine patient consciousness during surgery. In the present case, an 80-year-old man was scheduled for total gastrectomy. Anesthesia was maintained using desflurane 4.0–5.0% vol, oxygen, and nitrous oxide. The authors simultaneously monitored BIS, which was maintained between 37 and 43, and ETAG, which was maintained between 0.9 and 1.2 minimum alveolar concentration (MAC). After the operation, however, the authors were surprised to learn that the patient complained of awareness during anesthesia. Although BIS and ETAG concentration monitoring are useful in preventing awareness during anesthesia, they cannot be completely trusted. Even though BIS was maintained at approximately 40 and ETAG at 0.7–1.3 MAC, awareness during anesthesia occurred.

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Depth of anaesthesia monitoring: updated evidence. Comment on Br J Anaesth 2023; 131: 196–9
Paul S. Myles
British Journal of Anaesthesia.2023; 131(5): e145. CrossRef
Impact of bispectral index monitoring on critical incidents rate in high-risk patients: a randomised controlled trial
N. V. Trembach
Kuban Scientific Medical Bulletin.2022; 29(1): 48. CrossRef
A Crossover Comparison of the Sensitivity and the Specificity between BIS and AEP in Predicting Unconsciousness in General Anesthesia
Haitao Yang, Guan Wang, Jinxia Gao, Jie Liu, Liang Zhao
Scientific Programming.2020; 2020: 1. CrossRef

Original Articles

Risk factors for persistent otitis media with effusion in children: a case-control study: Ju Yeon Lee, Se-Hyung Kim, Chan Il Song, Young Ree Kim, Yoon-Joo Kim, Jae Hong Choi; Yeungnam Univ J Med. 2018;35(1):70-75. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.70

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Abstract PDF

Background
Otitis media with effusion (OME) is defined as middle ear effusion without acute signs of infection. OME usually resolves spontaneously; however, persistent OME may require the insertion of a ventilation tube. This study investigated risk factors for persistent OME in children who undergo ventilation tube insertion.
Methods
Children who were admitted to undergo ventilation tube insertion at Jeju National University Hospital between August 2015 and July 2016 were enrolled as the case group. Healthy children without persistent OME from August 2016 to July 2017 were enrolled as the control group. Baseline characteristics and predisposing factor data were collected using an interview questionnaire. Middle ear fluids were collected from the case group.
Results
A total of 31 patients underwent ventilation tube insertion. The mean age of the case group was 4.53 years, with a male-to-female ratio of 21:10. Twenty-nine (93.5%) children attended a daycare center, and 21 (67.7%) had experience with bottle feeding. Fifteen (48.4%) children in the case group and 3 (9.7%) in the control group first attended a daycare center at <1 year of age (odds ratio=9.96; 95% confidence interval=2.44-39.70; p=0.001). No bacteria were found in middle ear fluid collected from the 31 operated children. Nasopharyngeal bacterial colonization was found in 13 (41.9%) and 17 (54.8%) children in the case and control groups, respectively.
Conclusion
Earlier attendance at a daycare center was the only predisposing factor for ventilation tube insertion in our study. The aseptic nature of middle ear fluids found in children with OME highlights the efficacy of antimicrobial use.

Citations

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Otitis Media With Effusion After the COVID‐19 Pandemic: Return to the Past and New Lessons
Mirko Aldè, Paola Marchisio, Francesco Folino, Umberto Ambrosetti, Federica Di Berardino, Stefania Barozzi, Diego Zanetti, Lorenzo Pignataro, Giovanna Cantarella
Otolaryngology–Head and Neck Surgery.2024; 171(3): 724. CrossRef
Impact of COVID-19 on nationwide pediatric otolaryngology: Otitis media and myringotomy tube trends
David Z. Allen, Sai Challapalli, Sean McKee, Kyung Hyun Lee, Cynthia S. Bell, Soham Roy, Sarah Bowe, Karthik Balakrishnan, C.W. David Chang, Zhen Huang
American Journal of Otolaryngology.2022; 43(2): 103369. CrossRef
Special Considerations for Tympanoplasty Type I in the Oncological Pediatric Population: A Case-Control Study
Celine Richard, Emily Baker, Joshua Wood
Frontiers in Surgery.2022;[Epub] CrossRef

Ultrasound-guided superficial cervical plexus block under dexmedetomidine sedation versus general anesthesia for carotid endarterectomy: a retrospective pilot study: Wangseok Do, Ah-Reum Cho, Eun-Jung Kim, Hyae-Jin Kim, Eunsoo Kim, Heon-Jeong Lee; Yeungnam Univ J Med. 2018;35(1):45-53. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.45

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Abstract PDF

Background
Carotid endarterectomy (CEA) has been performed under regional and general anesthesia (GA). The general anesthesia versus local anesthesia for carotid surgery study compared the two techniques and concluded that there was no difference in perioperative outcomes. However, since this trial, new sedative agents have been introduced and devices that improve the delivery of regional anesthesia (RA) have been developed. The primary purpose of this pilot study was to compare intraoperative hemodynamic stability and postoperative outcomes between GA and ultrasound-guided superficial cervical plexus block (UGSCPB) under dexmedetomidine sedation for CEA.
Methods
Medical records from 43 adult patients who underwent CEA were retrospectively reviewed, including 16 in the GA group and 27 in the RA group. GA was induced with propofol and maintained with sevoflurane. The UGSCPB was performed with ropivacaine under dexmedetomidine sedation. We compared the intraoperative requirement for vasoactive drugs, postoperative complications, pain scores using the numerical rating scale, and the duration of hospital stay.
Results
There was no difference between groups in the use of intraoperative antihypertensive drugs. However, intraoperative inotropic and vasopressor agents were more frequently required in the GA group (p<0.0001). In the GA group, pain scores were significantly higher during the first 24 h after surgery (p<0.0001 between 0-6 h, p<0.004 between 6-12 h, and p<0.001 between 12-24 h). The duration of hospital stay was significantly more in the GA group (13.3±4.6 days in the GA group vs. 8.5±2.4 days in the RA group, p<0.001).
Conclusion
In this pilot study, intraoperative hemodynamic stability and postoperative outcomes were better in the RA compared to the GA group.

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Evaluating Anesthesia Guidance for Rescue Analgesia in Awake Patients Undergoing Carotid Endarterectomy with Cervical Plexus Blocks: Preliminary Findings from a Randomized Controlled Trial
Michał Jan Stasiowski, Nikola Zmarzły, Beniamin Oskar Grabarek
Journal of Clinical Medicine.2024; 14(1): 120. CrossRef
Outcomes of Dexmedetomidine with Local Regional Anesthesia in Carotid Endarterectomy
Samik H. Patel, Vikram L. Sundararaghavan, Amber M. Pawlikowski, Jeremy Albright, Jason M. Adams, Michael J. Heidenreich, Robert J. Beaulieu, Abdulhameed Aziz
Annals of Vascular Surgery.2023; 89: 174. CrossRef
Anesthetic Management of a Patient Undergoing Cochlear Implantation With Superficial Cervical Plexus Block and Sedation: A Case Report
Natsuki Takemura, Tetsuya Miyashita, Yasuko Baba
A&A Practice.2022; 16(1): e01555. CrossRef
Ultrasound-guided intermediate cervical plexus block for postoperative analgesia in patients undergoing carotid endarterectomy under general anesthesia: a case-control study
Onat BERMEDE, Volkan BAYTAŞ
Journal of Contemporary Medicine.2022; 12(2): 261. CrossRef
Relationship between annular calcification of plaques in the carotid sinus and perioperative hemodynamic disorder in carotid angioplasty and stenting
Qingjie Chi, Zhuo Chen, Li Zhu, Ruifan Yuan, Kaixuan Ren, Tianle Wang, Wenbin Ding
Journal of Stroke and Cerebrovascular Diseases.2022; 31(10): 106634. CrossRef
Cardiac output and cerebral blood flow during carotid surgery in regional versus general anesthesia: A prospective randomized controlled study
Helmuth Tauber, Werner Streif, Jennifer Gebetsberger, Lukas Gasteiger, Eve Pierer, Michael Knoflach, Gustav Fraedrich, Maria Gummerer, Josef Fritz, Corinna Velik-Salchner
Journal of Vascular Surgery.2021; 74(3): 930. CrossRef
Cerebral and Systemic Stress Parameters in Correlation with Jugulo-Arterial CO2 Gap as a Marker of Cerebral Perfusion during Carotid Endarterectomy
Zoltán Kovács-Ábrahám, Timea Aczél, Gábor Jancsó, Zoltán Horváth-Szalai, Lajos Nagy, Ildikó Tóth, Bálint Nagy, Tihamér Molnár, Péter Szabó
Journal of Clinical Medicine.2021; 10(23): 5479. CrossRef
Plexus anesthesia versus general anesthesia in patients for carotid endarterectomy with patch angioplasty: Protocol for a systematic review with meta-analyses and Trial Sequential Analysis of randomized clinical trials
M. S. Marsman, J. Wetterslev, F. Keus, D. van Aalst, F. G. van Rooij, J. M.M. Heyligers, F. L. Moll, A. Kh. Jahrome, P. W.H.E Vriens, G. G. Koning
International Journal of Surgery Protocols.2020; 19: 1. CrossRef

Review Article

Recent updates in transcatheter aortic valve implantation: Jeonghwan Cho, Ung Kim; Yeungnam Univ J Med. 2018;35(1):17-26. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.17

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Abstract PDF

Transcatheter aortic valve implantation (TAVI) has evolved from a challenging intervention to a standardized, simple, and streamlined procedure with over 350,000 procedures performed in over 70 countries. It is now a novel alternative to surgical aortic valve replacement in patients with intermediate surgical risk and its indications have been expanded to cohorts with bicuspid aortic valves, low surgical risk, and younger age and fewer comorbidities. Attention should be paid to further reducing remaining complications, such as paravalvular aortic regurgitation, conduction abnormalities, cardiac tamponade, and stroke. The aim of this review is to provide an overview on the rapidly changing field of TAVI treatment and to explore past achievements, current issues, and future perspectives of this treatment modality.

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Surgical Repair of Ventricular Septal Defect Following Transcatheter Aortic Valve Implantation: A Case Report
Satoru Fujii, Mohammed Tarabzoni, Pantelis Diamantouros, Rodrigo Bagur, Michael W. A. Chu
A&A Practice.2024; 18(6): e01790. CrossRef
Might simplification of transcatheter aortic valve implantation reduce the burden on hospital resources?
Lenka Kratochvílová, Petr Mašek, Marek Neuberg, Markéta Nováčková, Petr Toušek, Jakub Sulženko, Tomáš Buděšínský, , and Viktor Kočka
European Heart Journal Supplements.2022; 24(Supplement): B28. CrossRef

Case Reports

Use of stellate ganglion block for treatment of recurrent syncope followed by chest pain: Young-ung Kim, Yong-joon Shin, Young Woo Cho; Yeungnam Univ J Med. 2018;35(1):104-108. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.104

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Abstract PDF: Syncope is defined as a transient loss of consciousness and postural tone, characterized by rapid onset, short duration, and spontaneous recovery. Stellate ganglion block (SGB) is a nerve block method that is used for treatment of neuropathic pain in the head, neck and upper extremities, especially trigeminal neuralgia, postherpetic neuralgia and complex regional pain syndrome. SGB can modulate and stabilize the sympathetic nervous system, which prevents it from overexcitation and improves symptoms of syncope. The authors report a patient who was treated for pain and edema of both upper extremities with SGB, then showed improvement in recurrent syncope followed by chest pain and overall quality of life.

Partial spontaneous remission of small cell lung carcinoma with neurologic symptom: Kyung Hyun Yun, Sung Heon Song, Chung Hyoun Kim, Chan Hee Hwang, Jun Ho Lee, Je Hyoung Choi, Sun Young Kim; Yeungnam Univ J Med. 2017;34(2):275-278. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.275

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Abstract PDF: Small cell lung carcinoma (SCLC) is a cancer that shows aggressive behavior, early spread to distant sites, and frequent association with distinct paraneoplastic syndromes. Spontaneous remission of cancer, particularly of SCLC, is a rare biological event. Cases involving spontaneous regression of SCLC were reported, and were associated with paraneoplastic syndromes of the nervous system. This article reports on a 78-year-old man with SCLC in remission, with neurological symptoms. The patient visited the hospital because of generalized weakness, and imaging studies revealed a mass in the lower lobe of the left lung, pathological evaluation showed SCLC. The patient refused oncologic treatment and was treated only with conservative care. In follow-up study the diameter of the mass had decreased from initial 32 mm, 9 months after admission to 20 mm, 17 months after admission to 13 mm. The patient kept complaining of generalized weakness, dizziness, and paresthesia of limbs. We assumed that, in this case, the spontaneous remission of lung cancer was related to the immunologic response directed against the tumor, which is believed to be an important factor in the pathogenesis of paraneoplastic neurologic syndromes.

Original Article

Clinical characteristics of acute lower respiratory tract infections according to respiratory viruses in hospitalized children without underlying disease during the last 3 years: Min Hae Seo, Hyung Young Kim, Tae Min Um, Hye Young Kim, Hee Ju Park; Yeungnam Univ J Med. 2017;34(2):182-190. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.182

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Abstract PDF: BACKGROUND
Respiratory viruses play a significant role in the etiology of acute respiratory infections and exacerbation of chronic respiratory illnesses. This study was conducted to identify the epidemiological and clinical characteristics of children with acute viral lower respiratory infections. METHODS: This study investigated 1,168 children diagnosed with acute viral lower respiratory tract infections (RTIs) between January 2012 and December 2014. Specimens of respiratory viruses were collected using a nasopharyngeal swab and analyzed by reverse transcriptase polymerase chain reaction. We retrospectively reviewed the medical records and analyzed the clinical features of children hospitalized for acute lower respiratory infections. RESULTS: Respiratory syncytial virus (RSV), the main cause of infection in children aged <5 years, was the most commonly detected pathogen in children with bronchiolitis and pneumonia, and resulted in high proportions of children requiring oxygen treatment and intensive care unit admission. Rhinovirus was preceded by RSV as the second most common cause of bronchiolitis and pneumonia, and was detected most frequently in the children aged ≥6 years. In addition, asthma was predominantly caused by rhinovirus in children aged ≥6 years, whereas croup was mostly caused by parainfluenza virus in those aged <5 years. Rhinovirus infection (p < 0.001) and history of asthma (p=0.049) were identified as significant risk factors for readmission within a month. CONCLUSION: We identified the epidemiological and clinical characteristics of respiratory viruses in children with acute lower respiratory infections during the last 3 years. Our findings may provide useful clinical insight to comprehend the acute viral lower RTIs in children.

Case Report

Multifocal nodular lymphoid hyperplasia of the lung: Gil Tae Lee, Eun Kyoung Kim, Eirie Cho, Seung Sook Lee, Seo Yun Kim, Cheol Hyeon Kim, Hye Ryoun Kim; Yeungnam Univ J Med. 2017;34(1):84-87. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.84

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Abstract PDF: Nodular lymphoid hyperplasia (NLH) is a benign lymphoproliferative disease that can affect the lung. Because of its rarity, little is known about the etiology and natural history of NLH. Most cases are usually asymptomatic and found incidentally on imaging studies. Imaging finding of NLH has shown most commonly as a solitary lesion, although multifocal pulmonary nodules may be seen. Surgical resection has proved curative in the cases previously described. We report a rare case of NLH in a 55 year-old man who presented with bilateral multiple pulmonary nodules on chest radiography. Open biopsy was performed from the upper and lower lobe of the left lung. The lesions were pathologically diagnosed as pulmonary NLH. Multifocal residual nodules in both lungs remain stable without spontaneous regression during the 3 years of follow-up.

Original Articles

Follow-up of thyroid ultrasonography in patients with hemodialysis: Hyun Jung Kim, Bo Ra Kim, Yeong Mi Seo, Yoon Young Cho, Jong Ha Baek, Kyong Young Kim, Soo Kyung Kim, Seung Hoon Woo, Jung Hwa Jung, Jaehoon Jung, Jong Ryeal Hahm; Yeungnam Univ J Med. 2017;34(1):69-74. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.69

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Abstract PDF: BACKGROUND
Chronic kidney disease is considered a risk factor for thyroid nodules as well as thyroid dysfunction such as hypothyroidism. Among patients on hemodialysis, we assessed the size of thyroid nodule and goiter at baseline and 1 year later with ultrasonography. METHODS: We prospectively selected 47 patients with hemodialysis at January 2012 and reviewed their medical records. We checked goiter and thyroid nodules at January 2012 and December 2012. RESULTS: In the hemodialysis patients (n=47), 24 patients (51.1%) had thyroid nodules and 33 patients (70.2%) had goiter at baseline. Parathyroid hormone (PTH) was higher in patients with thyroid nodules (204.4±102.9 vs. 129.9±93.6 pg/mL, p=0.01). Thyroid ultrasonography was conducted in 29 patients after 1 year. The thickness of the thyroid isthmus increased (2.8±1.6 vs. 3.2±1.9 mm, p=0.003), but the number of nodules did not change (1.2±1.9 vs. 1.4±2.0, p=0.109). PTH was associated with the enlargement of thyroid nodules significantly through logistic regression analysis. CONCLUSION: Thyroid goiter and nodules in hemodialysis patients were more prevalent than in the general population. PTH influenced the production of thyroid nodules in hemodialysis patients. Regular examination with thyroid ultrasonography and thyroid function test should be considered in hemodialysis patients.

Sulfatase 1 mediates the inhibitory effect of angiotensin II type 2 receptor inhibitor on angiotensin II-induced hypertensive mediator expression and proliferation in vascular smooth muscle cells from spontaneously hypertensive rats: Hye Young Kim, Hye Ju Cha, Hee Sun Kim; Yeungnam Univ J Med. 2017;34(1):43-54. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.43

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Abstract PDF

BACKGROUND
Extracellular sulfatases (Sulfs), sulfatase 1 (Sulf1) and sulfatase 2 (Sulf2), play a pivotal role in cell signaling by remodeling the 6-O-sulfation of heparan sulfate proteoglycans on the cell surface. The present study examined the effects of Sulfs on angiotensin II (Ang II)-induced hypertensive mediator expression and vascular smooth muscle cells (VSMCs) proliferation in spontaneously hypertensive rats (SHR). METHODS: Ang II receptors, 12-lipoxygenase (12-LO), and endothelin-1 (ET-1) messenger RNA (mRNA) expressions in SHR VSMCs were analyzed by real-time polymerase chain reaction and Western blotting. VSMCs proliferation was determined by [³ H]-thymidine incorporation. RESULTS: Basal Sulfs mRNAs expression and enzyme activity were elevated in SHR VSMCs. However, Sulfs had no effect on the basal or Ang II-induced 12-LO and ET-1 mRNA expression in SHR VSMCs. The inhibition of Ang II-induced 12-LO and ET-1 expression by blockade of the Ang II type 2 receptor (AT₂ R) pathway was not observed in Sulf1 siRNA-transfected SHR VSMCs. However, Sulf2 did not affect the action of AT₂ R inhibitor on Ang II-induced 12-LO and ET-1 expression in SHR VSMCs. The down-regulation of Sulf1 induced a reduction of AT₂ R mRNA expression in SHR VSMCs. In addition, the inhibition of Ang II-induced VSMCs proliferation by blockade of the AT₂ R pathway was mediated by Sulf1 in SHR VSMCs. CONCLUSION: These findings suggest that extracellular sulfatase Sulf1 plays a modulatory role in the AT₂ R pathway that leads to an Ang II-induced hypertensive effects in SHR VSMCs.

Citations

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Sulfatase 1 mediates IL-10-induced dimethylarginine dimethylaminohydrolase-1 expression and antiproliferative effects in vascular smooth muscle cells of spontaneously hypertensive rats
Hye Young Kim, Hee Sun Kim
Cytokine.2021; 137: 155344. CrossRef
Sulfatase 2 mediates, partially, the expression of endothelin-1 and the additive effect of Ang II-induced endothelin-1 expression by CXCL8 in vascular smooth muscle cells from spontaneously hypertensive rats
Hye Young Kim, Dae Won Jeong, Hee Sun Kim
Cytokine.2019; 114: 98. CrossRef

Case Reports

C-ANCA-positive glomerulonephritis associated with subacute infective endocarditis caused by Bartonella infection: Min Jeong Kim, Ha Nee Jang, Tae Won Lee, Hyun Seop Cho, Se Ho Chang, Hyun Jung Kim; Yeungnam Univ J Med. 2017;34(1):140-145. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.140

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Abstract PDF

Glomerulonephritis (GN) is sometimes associated with infective endocarditis (IE). Bartonella endocarditis is difficult to diagnose because it is rare and cannot be detected by blood culture. This is the first report of cytoplasmic anti-neutrophil cytoplasmic antibody-positive subacute endocarditis-associated GN caused by Bartonella infection in South Korea. A 67-year-old man was hospitalized due to azotemia. He complained of weight loss and anorexia for 6 months. A diagnosis of IE was made based upon echocardiographic detection of vegetations on the mitral and aortic valves and a Bartonella antibody titer of 1:2,048. Renal histology identified focal crescentic GN. Azotemia and proteinuria improved after doxycycline and rifampin treatment combining with steroid therapy.

Citations

Citations to this article as recorded by

Clinicopathological differences between Bartonella and other bacterial endocarditis-related glomerulonephritis – our experience and a pooled analysis
Mineaki Kitamura, Alana Dasgupta, Jonathan Henricks, Samir V. Parikh, Tibor Nadasdy, Edward Clark, Jose A. Bazan, Anjali A. Satoskar
Frontiers in Nephrology.2024;[Epub] CrossRef

Ileal epithelioid leiomyosarcoma with omental and peritoneal seeding: Chung Hyoun Kim, Sun Young Kim, Chang Kil Jung, Jung Pil Choi, Keum Soo Seo, Jun Ho Lee, Jae Hyung Choi; Yeungnam Univ J Med. 2017;34(1):132-136. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.132

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Abstract PDF: Leiomyosarcoma (LMS) of the small intestine is a rare tumor, accounting for about 1% of all malignant mesenchymal lesions in the gastrointestinal tract. Since small bowel tumors are initially asymptomatic and nonspecific, delayed diagnosis and treatment are common. We found that a 44-year-old male patient who came in for lower abdominal pain had partial obstruction in the small bowel. Multiple ascites and ileal tumors involving peritoneal seeding were observed from his abdominal computed tomography. He was diagnosed as epithelioid LMS involving peritoneal transition after surgical resection, and the outpatient department has planned for a conservative therapy with observation. To the best of our knowledge, ileal epithelioid LMS accompanying a huge omental mass, with a size of 18 cm in dimension, and peritoneal seeding has not yet been reported in Korea. We report this rare case with literature review.

Central serous chorioretinopathy associated with low dose systemic corticosteroid treatment of Behcet's disease: Sungwook Cha, Kyung Jin Kim, Seongmin Kweon, Sinae Lee, Byungchul Min, Eunsung Kim, Jungwook Lee; Yeungnam Univ J Med. 2017;34(1):111-114. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.111

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Abstract PDF: Central serous chorioretinopathy may induce poor eyesight and serous retinal detachment. However, its exact cause has not been well established thus far. It can be associated with systemic high-dose corticosteroid treatment mainly for young and middle-aged men and may spontaneously regress or recur after withdrawal from corticosteroid. After corticosteroid administration for Behcet's disease, it is necessary to identify any ocular symptoms. Behcet's disease can lead to the development of ocular complications, such as uveitis, hypopyon, retinal vasculitis, optic neuritis, angiogenesis, secondary cataract, and glaucoma. It is possible to diagnose any of these complications via optical coherence tomography and digital indocyanine green angiography. It is easy to neglect an ocular symptom that may appear after a low-dose corticosteroid treatment as an ocular complication in patients with Behcet's disease. Thus, we report on a case concerning high-dose corticosteroid treatment with a literature review.

Secondary adrenal insufficiency caused by sorafenib administration in a patient with hepatocellular carcinoma.: Soo Yeon Jo, Soo Hyung Ryu, Mi Young Kim, Jeong Seop Moon, Won Jae Yoon, Jin Nam Kim; Yeungnam Univ J Med. 2016;33(2):155-158. Published online December 31, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.2.155

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Abstract PDF: Sorafenib (Nexavar) has been regarded as a treatment for unresectable hepatocellular carcinoma (HCC), with side effects that include hand-foot skin reaction, diarrhea, rash, fatigue, hypertension, nausea, anorexia, weight loss, and alopecia. Thyroid disorder, such as endocrine side effect, has also been reported. However no case involving adrenal insufficiency has been reported. Here, we report a case of adrenal insufficiency which occurred after taking sorafenib in a patient with HCC. A 56-year-old man visited our hospital due to right upper quadrant abdominal pain and he was diagnosed as multiple disseminated and unresectable HCCs with portal vein invasion; therefore transarterial chemoembolization was performed and sorafenib administration was started. Two months later, he was admitted to the hospital complaining of severe fatigue. The laboratory results showed cortisol of <0.2µ g/dL and adrenocorticotropic hormone of <1.00 pg/mL. The patient had no history of taking steroids or herbal medications. Secondary adrenal insufficiency was diagnosed and prednisolone 10 mg per day was started immediately; as a result, fatigue remarkably improved. This may be the first report indicating a possible association between sorafenib and adrenal insufficiency and it implies that the possibility of adrenal insufficiency should be considered in patients taking sorafenib who complain of severe fatigue.

Chronic hepatitis C healed by peginterferon-α and rivabirin treatment after kidney transplantation.: Min Gue Seok, Tae Hee Lee, Sung Ro Yun, Won Min Hwang, Se Hee Yoon, In Soo Choe, Seong Joo Kang, Ju Young Hong, Dae Sung Kim; Yeungnam Univ J Med. 2016;33(2):150-154. Published online December 31, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.2.150

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Abstract PDF: Hepatitis C virus (HCV) infection is present in a high proportion of patients with kidney transplantation. Compared with uninfected kidney transplant recipients, HCV infected kidney recipient have higher prevalence of liver disease and worse allograft survival after transplantation. Interferon monotherapy before transplantation is standard therapy for HCV-infected kidney transplant candidates. If HCV infection is discovered after transplantation, interferon monotherapy is considered due to the limited critical situation. However, in this patient, who was a kidney recipient, HCV infection was treated after kidney transplantation with peginterferon-α and rivabirin. As a result, the patient achieved sustained virologic response.

Heterotopic bone formation in normal gastric cardiac mucosa.: Seok Hyeon Eom, Chang Hwan Park, Duk Won Chung, Sang Hyeok Lee, Ji Young Seo, Yeong Sung Kim, Dong Hyup Kwak, Jung Hee Kim; Yeungnam Univ J Med. 2016;33(2):146-149. Published online December 31, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.2.146

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Abstract PDF: Heterotopic bone formation in the gastrointestinal tract is a rare phenomenon. Most reported cases were associated with benign and malignant neoplasms, except for a case in which heterotopic bone formation was found in a patient with Barrett's esophagus. The exact pathogenesis of the disease has not yet been established. However, most heterotopic bones found in the gastrointestinal tract were associated with mucinproducing tumors of the appendix, colon, and rectum. Inflammation may also play a role in osseous metaplasia in a case with bone formation at the base of an ulcer in Barrett's esophagus. Here, we report on a patient with heterotopic bone formation in normal gastric cardiac mucosa. A 50-year-old female visited our hospital for a routine health examination. She had no gastrointestinal symptoms, and her physical examination, blood test, X-ray, urine, and stool examination results were normal. A 0.3 cm sized polypoid lesion located just below the squamocolumnar junction was observed on upper gastrointestinal endoscopy. A piece of biopsy was taken. Histologically, a lamella bone trabecula and chronic inflammatory cells were observed in the gastric cardiac mucosa. The follow-up endoscopy performed one month later showed no residual lesion.

Lymphocytic interstitial pneumonia in a patient with Sjögren's syndrome.: Eun Hye Lee, Ji Eun Park, Eun Kyong Goag, Young Joo Kim, In Young Jung, Chi Young Kim, Young Mok Park, Jung Mo Lee, Moo Suk Park; Yeungnam Univ J Med. 2016;33(2):112-115. Published online December 31, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.2.112

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Abstract PDF: Lymphocytic interstitial pneumonia (LIP) is a rare benign lymphoproliferative disorder characterized by diffuse infiltration of the pulmonary parenchymal interstitium by polyclonal lymphocytes and plasma cells. LIP has been associated with a variety of clinical conditions; such as connective tissue disorders and other immune system abnormalities. Treatment usually involves administration of corticosteroids and other immunosuppressants. We report on a 38-year-old female patient who complained of shortness of breath, dry mouth, and dry eyes for more than 1 month, and was positive for Raynaud's phenomenon. Based on surgical biopsy, she was diagnosed as having LIP accompanied by Sjögren's syndrome. The patient was treated with high-dose steroids followed by maintenance therapy for approximately 2 years, and her condition improved.

Efficacy of epidermal growth factor receptor-tyrosine kinase inhibitors for patient with leptomeningeal metastasis of epidermal growth factor receptor mutant non-small cell lung cancer.: Jong Sik Lee, Kyung Ann Lee, Kang Hoon Lee, Sun Young Moon, In Ae Kim, Sung Jin Jeon, Jae Ki Min, Hee Joung Kim, Kye Young Lee; Yeungnam Univ J Med. 2016;33(1):64-67. Published online June 30, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.1.64

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Abstract PDF: We report on a 64-year-old man with leptomeningeal metastasis (LM) from an epidermal growth factor receptor (EGFR)-mutated adenocarcinoma of the lung. He was treated with paclitaxel, cisplatin. After completion of chemotherapy, he complained of headache, nausea, and vomiting. EGFR-mutated tumor cells were identified from the cerebrospinal fluid (CSF). Second-line therapy with gefitinib, methotrexate was started. After receiving gefitinib for 4 weeks, he had no more headaches or vomiting. Eleven months after initiation of gefitinib, he developed headache and nausea. Chest computed tomography showed aggravation of bone metastasis. Third-line therapy was started with gemcitabine and carboplatin. Two weeks later, he experienced disorientation. After a fourth relapse within the central nervous system, the therapy was switched to erlotinib and significant improvement of LM was achieved. This case shows that LM can be diagnosed by detecting EGFR mutation in CSF and EGFR tyrosine kinase inhibitors are effective for LM from EGFR mutant non-small cell lung cancer.

DRESS syndrome with acute interstitial nephritis caused by quinolone and non-steroidal anti-inflammatory drugs.: Soo Jin Kim, Young Hee Nam, Ji Young Juong, Eun Young Kim, Su Mi Lee, Young Ki Son, Hee Joo Nam, Ki Ho Kim, Soo Keol Lee; Yeungnam Univ J Med. 2016;33(1):59-63. Published online June 30, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.1.59

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Abstract PDF: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and severe drug-induced hypersensitivity syndrome characterized by hematological abnormalities and multiorgan involvement. Liver involvement is the most common visceral manifestation. However, renal failure has been rarely described. The common culprit drugs are anticonvulsants and allopurinol. We experienced a patient with DRESS syndrome with acute interstitial nephritis caused by concomitant administration of quinolone and non-steroidal anti-inflammatory drugs (NSAIDs). A 41-year-old man presented with a diffuse erythematous rash and fever which developed after administration of quinolone and NSAIDs for a month due to prostatitis. He was diagnosed with DRESS syndrome. Skin rash, fever, eosinophilia, and elevations of liver enzymes improved with conservative treatment and discontinuation of the causative drugs. However, deterioration of his renal function occurred on day 8 of admission. The levels of blood urea nitrogen and serum creatinine increased and oliguria, proteinuria and urinary eosinophils were observed. Ultrasonography showed diffuse renal enlargement. The clinical features were compatible with acute interstitial nephritis. Despite intravenous rehydration and diuretics, renal function did not improve. After hemodialysis, his renal function recovered completely within 2 weeks without administration of systemic corticosteroid.

A late onset solitary mediastinal cystic lymphangioma in a 66-year-old woman who underwent kidney transplantation.: Jung Mo Lee, Sang Hoon Lee, Youngmok Park, Chi Young Kim, Eun Kyoung Goag, Eun Hye Lee, Ji Eun Park, Chang Young Lee, Se Kyu Kim; Yeungnam Univ J Med. 2015;32(2):155-158. Published online December 31, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.2.155

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Abstract PDF: Lymphangioma is a congenital abnormality of the lymphatic system detected primarily in early childhood. There are rare reports of mediastinal lymphangioma in older adults. We hereby report on a 66-year-old female patient who underwent kidney transplantation 20 years previously and who developed pathologically confirmed solitary mediastinal lymphangioma 1 year ago. Chest radiography showed a mediastinal nodule, which was not observed 2 year previously, therefore she was referred to the pulmonary division. She had no symptoms, and chest computed tomography demonstrated a 25-mm, well-defined, low-density nodule located at the anterior mediastinum. The size of the nodule had increased from 25 mm to 34 mm 1 year later, and it was completely resected via video-assisted thoracic surgery. The histological diagnosis was cystic lymphangioma. Therefore, we recommend that clinicians consider cystic lymphangioma as a possible diagnosis even in older patients with a mediastinal cystic mass that shows progressive enlargement.

Page kidney after botulinum toxin injection during chiropractic care.: Han Min Park, Chung Jo Choi, Jin Hee Kim, Ja Kyung Kim, Bum Jun Kim, Jae Yong Seo, Yong Seol Jeong, Jwa Kyung Kim, Sung Gyun Kim; Yeungnam Univ J Med. 2015;32(2):143-145. Published online December 31, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.2.143

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Abstract PDF: Page kidney refers to the phenomenon of hypertension secondary to long-standing compression of renal parenchyma caused by renal subcapsular collection. The most common cause of renal subcapsular collection is a hematoma which usually occurs after a history of blunt trauma. A 42-year-old female patient who received botulinum toxin injection in her back during chiropractic care was admitted to the emergency room with sudden bilateral flank pain and hypertension. The computed tomography (CT) images demonstrated the presence of bilateral subcapsular renal hematoma. The patient was treated conservatively and recovered well. The follow up CT images showed markedly resolved bilateral hematoma.

An overlap syndrome of Churg-Strauss syndrome and rheumatoid arthritis.: Seung Il Bae, Jong Geol Jang, Hun Tae Kim, Hee Yun Ahn, Min Jung Kim, Hyun Je Kim, Choong Ki Lee, Young Hoon Hong; Yeungnam Univ J Med. 2015;32(2):127-131. Published online December 31, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.2.127

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Abstract PDF: Churg-Strauss syndrome (CSS) is a necrotizing vasculitis with extra-, peri-vascular eosinophilic infiltration. Chronic symmetric polyarthritis with the presence of rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody are the mainstay of rheumatoid arthritis (RA) diagnosis. Mononeuritis multiplex is a peripheral neuropathy involving more than 2 separate nerve areas. A 62-year-old male patient was referred for left foot drop and polyarthritis of both hands and feet for 4 months. During evaluation, mononeuritis multiplex was detected on nerve conduction study and electromyography tests: vasculitis with neutrophil, eosinophil, and lymphocyte infiltration on peroneal nerve biopsy. A positive response to methacholin and bronchodilator was observed on the pulmonary function test. Radiologic tests showed peri-articular soft tissue swelling and osteopenia on both hand and foot. Marked peripheral eosinophilia, high RF, and positive perinuclear anti-neutrophil cytoplasmic antibody were detected on blood tests. Here, we report on a patient with overlap syndrome of CSS and RA with review of the relevant literature, from which a few references to overlap syndrome of CSS and RA were available.

POEMS syndrome misdiagnosed as bone metastasis in a patient with thyroid cancer.: Sang Ah Baek, Hun Mo Ryoo, Sung Hwa Bae, Yoon Young Cho, Seong gyu Kim, Ga Young Kim, Min Keun Kim; Yeungnam Univ J Med. 2015;32(2):122-126. Published online December 31, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.2.122

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Abstract PDF: Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome is a monoclonal plasma cell disorder. Patients with POEMS syndrome also have various clinical manifestations including generalized edema, pleural effusion, ascites, papilledema, and sclerotic bone lesions. These manifestations can lead to a misdiagnosis or delayed diagnosis. We recently experienced a 51-year-old male patient with POEMS syndrome whose sclerotic bone lesion was misdiagnosed as malignant bone metastasis of papillary thyroid carcinoma. We reassessed the patient and found polyneuropathy, hepatosplenomegaly, hypothyroidism, partial hypopituitarism, immunoglobulin G lambda-type monoclonal gammopathy, hypertrichosis, ascites, and multiple sclerotic bone lesions, all of which led us to a diagnosis of POEMS syndrome. Treatment with thalidomide and dexamethasone resulted in clinical and radiological improvement. The patient has remained in remission after peripheral blood stem cell transplantation.

Choledochocele containing a stone mistaken as a distal common bile duct stone.: Tae Young Kwak, Chang Hwan Park, Seok Hyeon Eom, Hong Suk Hwang, Duk Won Chung, Ji Young Seo, Yeong Sung Kim, Dong Hyup Kwak; Yeungnam Univ J Med. 2015;32(1):60-64. Published online June 30, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.1.60

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Abstract PDF: A choledochocele is an expanded sac of the duodenal side of the distal common bile duct (CBD), and is categorized as a type III choledochal cyst. Unlike other choledochal cysts, it can be easily overlooked because of its very low prevalence, non-specific clinical symptoms, and lack of distinctive radiological findings. However, a patient having a repeated pancreaticobiliary disorder with an unknown origin, frequent abdominal pain after cholecystectomy, or repeated non-specific gastrointestinal symptoms can be suspected as having a choledochocele, and a more accurate diagnosis can be achieved via endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound. Because it rarely becomes malignant, a choledochocele can be treated via endoscopic sphincterotomy (EST) and surgical treatment. The authors were able to diagnose choledochocele accompanied by a stone in a patient admitted to the authors' hospital due to cholangitis and pancreatitis. The patient's condition was suspected to have been caused by a distal CBD stone detected via multiple detector computed tomography and ERCP, and was successfully treated via EST.

Tumor lysis syndrome following sorafenib treatment in hepatocellular carcinoma.: Shin Young Kim, Hee Yeon Kim, Yu Seung Kim, Sang Min Lee, Chang Wook Kim; Yeungnam Univ J Med. 2015;32(1):47-49. Published online June 30, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.1.47

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Abstract PDF

Sorafenib is indicated for the treatment of advanced hepatocellular carcinoma (HCC), but although rare, tumor lysis syndrome (TLS) can be fatal in HCC patients with a large tumor burden. The authors describe the case of a 55-year-old hepatitis B carrier who visited our clinic with progressive dyspnea for 3 weeks. Chest and abdominal computed tomography revealed a huge HCC in the left lobe of the liver with invasion of the inferior vena cava, right atrium, and pulmonary arteries. After 8 days of sorafenib administration, TLS was diagnosed based on the characteristic findings of hyperuricemia, hyperkalemia, and acute kidney injury with massive tumor necrosis by follow-up imaging. Despite discontinuation of sorafenib and supportive care, the patient's clinical course rapidly deteriorated. The authors describe a rare but fatal complication that occurred soon after sorafenib initiation for HCC. Careful follow-up is required after commencing sorafenib therapy for the early diagnosis and management of TLS.

Citations

Citations to this article as recorded by

A case of hepatocellular carcinoma caused severe tumor lysis by ramucirumab
Yuhi Sakamoto, Keizo Kato, Hiroshi Abe, Takeshi Yonezawa, Sadahiro Ito, Makiko Ika, Kiichiro Yoza, Mamika Ohara, Shogo Sakasai, Shohei Shimizu, Shinji Endo
Kanzo.2021; 62(3): 129. CrossRef
Sorafenib-induced tumor lysis syndrome in a patient with metastatic hepatocellular carcinoma ☆
Sardar Zakariya Imam, Mohammad Faizan Zahid, Muhammad Asad Maqbool
Hematology/Oncology and Stem Cell Therapy.2020; 13(3): 168. CrossRef

Immune thrombocytopenia associated with sarcoidosis.: Da Eun Jeong, Min Kyoung Kim, Sung Ae Koh, Kyoung Hee Lee, Joon Hyuk Choi, Young Hoon Hong, Jae Ho Cho, Eun Ju Goo, Myung Soo Hyun; Yeungnam Univ J Med. 2015;32(1):26-30. Published online June 30, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.1.26

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Abstract PDF: Sarcoidosis is a systemic disease of unknown cause involving multiple organs and is characterized by noncaseating granuloma. Immune thrombocytopenia (ITP) is an autoimmune disease characterized by increased peripheral platelet destruction due to the presence of an antibody to the platelet and abnormal platelet production. There is no known pathogenesis that occurs concurrently with ITP and sarcoidosis. However, considering together of 2 known pathogenesis, abnormal immune response triggers either ITP or sarcoidosis. The disease that develops first stimulates secondary disease. After development of secondary disease, they stimulate each other. A few cases of ITP associated with sarcoidosis are well documented in English; however, the disease has rarely been reported in Korea. Here, we report on a case of ITP with sarcoidosis in a 29-year-old man. He suffered from easy bruising. The chest X-ray and the contrast-enhanced computed tomography scan showed bihilar lymphadenopathy and reticulonodular infiltrates. Bone marrow study and fluoroscopy-guided percutaneous needle biopsy were performed and the patient was diagnosed with sarcoidosis and ITP. He was put on 400 mg/kg of intravenous immunoglobulin for 5 days and administered oral steroids and further follow-up will be carried out. He has shown a good response without significant bleeding event. However, administration of more oral steroid and additional follow-up is required than for single disease, whether sarcoidosis or ITP.

Recurrent thymic carcinoid tumor in familial isolated primary hyperparathyroidism.: Jeong Eun Song, Mu Hyun Shon, Ga Young Kim, Da Young Lee, Jung Hun Lee, Jong Ho Kim, Ho Sang Shon, Ji Hyun Lee, Eon Ju Jeon, Eui Dal Jung; Yeungnam Univ J Med. 2014;31(2):131-134. Published online December 31, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.2.131

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Abstract PDF: Familial isolated primary hyperparathyroidism(FIPH) is associated with multiple endocrine neoplasia type 1 (MEN1) syndrome, primary hyperparathyroidism accompanied by jaw-tumor syndrome, and familial hypocalciuric hypercalcemia. FIPH may be an early stage of MEN1 or an allelic variant of MEN1. Thymic carcinoid tumor is a rare tumor in MEN1 syndrome. Here, the authors report the case of a 40-year-old man diagnosed with recurrent thymic carcinoid tumor and FIPH. Both the patient and his elder sister had been previously diagnosed to have FIPH with a novel frameshift mutation in the MEN1 gene. Initially, the patient underwent thymectomy because of an incidental finding of a mediastinal mass in his chest X-ray, and had remained asymptomatic over the following 4 years. Pancreas computed tomography conducted to evaluate MEN1 syndrome revealed anterior and middle mediastinal masses, and resultantly, massive mass excision was performed. Histological findings disclosed atypical carcinoids with infiltrative margins. In view of the thymic carcinoid tumor relapse that occurred in this patient, the authors recommend that regular pancreas and pituitary imaging studies be conducted for FIPH associated with a MEN1 gene mutation.

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