Journal of Yeungnam Medical Science

Original article

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

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

Case report

Ophthalmology
Cytomegalovirus retinitis with panretinal occlusive vasculopathy concealed by hypertensive uveitis: a case report: Seongyong Jeong; J Yeungnam Med Sci. 2024;41(4):300-305. Published online August 30, 2024; DOI: https://doi.org/10.12701/jyms.2024.00584

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Abstract PDF: Cytomegalovirus (CMV) retinitis is a rare disease, and overlapping manifestations involving the anterior segment are extremely uncommon. We report a patient who initially presented with persistent corneal edema and was later diagnosed with CMV retinitis. A 72-year-old man with uncontrolled intraocular pressure (IOP) in his right eye visited a tertiary hospital. At initial presentation, the IOP was 36 mmHg and the fundus was not clear due to corneal edema. Spectral domain optical coherence tomography revealed paracentral acute middle maculopathy (PAMM). Panretinal obstructive vasculopathy was observed on ultra-widefield fluorescein angiography. Three weeks later, trabeculectomy was performed to resolve the persistently high IOP. Once corneal edema improved, a white patch-like peripheral lesion and silver wire-like retinal vasculature were observed. Polymerase chain reaction of the aqueous humor was positive for CMV. Oral valganciclovir and intravitreal ganciclovir were administered as antiviral therapies. Despite treatment for 4 months, the final visual acuity was no light perception, with persistent corneal edema and neovascularization of the iris. We describe a rare case of the simultaneous occurrence of hypertensive uveitis and CMV retinitis. The presence of PAMM could be an initial identifiable sign of CMV retinitis, even in the presence of media opacity.

Review article

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

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Abstract PDF

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

Citations

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Mitochondrial function in intestinal ischemia-reperfusion injury: mechanisms and therapeutic perspectives
Xuena Han, Zekun Lang, Xinghua Lv, Yang Xing, Min Hou, Zhiguo Tan, Yan Zhang, Yufang Leng
Molecular Biology Reports.2025;[Epub] CrossRef
Hyperoside mitigates amphotericin B-induced nephrotoxicity in HK-2 cells via bioenergetic and oxidative stress modulation
Ekramy M. Elmorsy, Huda A. Al Doghaither, Ayat B. Al-Ghafari, Badriah Abdullah Hifni, Najlaa M.M. Jawad, Noor A. Hakim, Manal S. Fawzy, Nagwa M. Aly
BMC Pharmacology and Toxicology.2025;[Epub] CrossRef
The lactic dehydrogenase-to-albumin ratio predicts acute kidney injury in patients with intracerebral hemorrhage: a multicenter cohort study
Taotao Dong, Yangchun Xiao, Xiang Yuan, Peng Wang, Chao You, Fang Fang, Yu Zhang
Frontiers in Neurology.2025;[Epub] CrossRef
ZNRF2 integrates ubiquitination-driven ferroptosis and mitochondrial quality control in renal ischemia–reperfusion injury
Kangyu Wang, Yun Deng, Changhong Xu, Rui Yan, Hao Wang, Yalong Zhang, Jiangwei Man, Li Yang
Biomedicine & Pharmacotherapy.2025; 192: 118584. CrossRef
The role of gut microbiota–mitochondrial crosstalk in kidney disease: a bibliometric analysis
Qin Hu, Hua Jin, Lan Hu, Xu Li
International Urology and Nephrology.2025;[Epub] CrossRef
Arfgef3 knockout ameliorates ischemia reperfusion-induced acute kidney injury via mitochondrial dysfunction alleviation in mice
Longyu Wang, Lu Yao, Danshu Xie, Wei Ding
Renal Failure.2025;[Epub] CrossRef

Original articles

Gastroenterology and Hepatology
Diagnostic value of serum procalcitonin and C-reactive protein in discriminating between bacterial and nonbacterial colitis: a retrospective study: Jae Yong Lee, So Yeon Lee, Yoo Jin Lee, Jin Wook Lee, Jeong Seok Kim, Ju Yup Lee, Byoung Kuk Jang, Woo Jin Chung, Kwang Bum Cho, Jae Seok Hwang; J Yeungnam Med Sci. 2023;40(4):388-393. Published online April 3, 2023; DOI: https://doi.org/10.12701/jyms.2023.00059

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Abstract PDF

Background
Differentiating between bacterial and nonbacterial colitis remains a challenge. We aimed to evaluate the value of serum procalcitonin (PCT) and C-reactive protein (CRP) in differentiating between bacterial and nonbacterial colitis.
Methods
Adult patients with three or more episodes of watery diarrhea and colitis symptoms within 14 days of a hospital visit were eligible for this study. The patients’ stool pathogen polymerase chain reaction (PCR) testing results, serum PCT levels, and serum CRP levels were analyzed retrospectively. Patients were divided into bacterial and nonbacterial colitis groups according to their PCR. The laboratory data were compared between the two groups. The area under the receiver operating characteristic curve (AUC) was used to evaluate diagnostic accuracy.
Results
In total, 636 patients were included; 186 in the bacterial colitis group and 450 in the nonbacterial colitis group. In the bacterial colitis group, Clostridium perfringens was the commonest pathogen (n=70), followed by Clostridium difficile toxin B (n=60). The AUC for PCT and CRP was 0.557 and 0.567, respectively, indicating poor discrimination. The sensitivity and specificity for diagnosing bacterial colitis were 54.8% and 52.6% for PCT, and 52.2% and 54.2% for CRP, respectively. Combining PCT and CRP measurements did not increase the discrimination performance (AUC, 0.522; 95% confidence interval, 0.474–0.571).
Conclusion
Neither PCT nor CRP helped discriminate bacterial colitis from nonbacterial colitis.

Citations

Citations to this article as recorded by

Procalcitonin and C-Reactive Protein as Diagnostic Biomarkers for Bacterial Gastroenteritis: A Retrospective Analysis
Hyunseok Cho, Jung Ho Lee, Sung Chul Park, Sung Joon Lee, Hee-Jeong Youk, Seung-Joo Nam, Jin Myung Park, Tae Suk Kim, Ji Hyun Kim, San Ha Kim, Sang Hoon Lee
Journal of Clinical Medicine.2025; 14(7): 2135. CrossRef

Thoracic and Cardiovascular Surgery
Intensive care unit management of uncomplicated type B aortic dissection in relation to treatment period: a retrospective observational study: Chul Ho Lee, Jae Seok Jang, Jun Woo Cho; J Yeungnam Med Sci. 2022;39(4):294-299. Published online February 10, 2022; DOI: https://doi.org/10.12701/jyms.2021.01690

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Abstract PDF: Background
Medical therapy is the standard treatment for uncomplicated acute type B aortic dissection (ATBAD), but there is little evidence of the need for intensive care unit (ICU) management. Therefore, we aimed to investigate the effects of ICU treatment on uncomplicated ATBAD.
Methods
We retrospectively studied patients with uncomplicated ATBAD who were medically treated between January 2010 and July 2020. Patients were divided into long-term ICU stay (LIS) and short-term ICU stay (SIS) groups, according to a 48-hour cutoff of ICU stay duration. The incidence of pneumonia and delirium, rate of aortic events, hospital mortality, and survival rate were compared.
Results
Fifty-five patients were treated for uncomplicated ATBAD (n=26 for LIS and n=29 for SIS). The incidence of pneumonia (7.7% vs. 3.6%) and delirium (34.6% vs. 14.3%) was higher in the LIS group than in the SIS group, but the differences were not statistically significant. The survival rates at 1, 3, and 5 years were not different between the two groups (LIS: 96.2%, 88.0%, and 54.2% vs. SIS: 96.4%, 92.2%, and 75.5%, respectively; p=0.102). Multivariate Cox regression analysis for aortic events showed that using a calcium channel blocker lowered the risk of aortic events.
Conclusion
Long-term ICU treatment is unlikely to be necessary for the treatment of uncomplicated ATBAD. Active use of antihypertensive agents, such as calcium channel blockers, may be needed during the follow-up period.

Nephrology
Analysis of the risk factors of acute kidney injury after total hip or knee replacement surgery: Yoo Jin Lee, Bong Soo Park, Sihyung Park, Jin Han Park, Il Hwan Kim, Junghae Ko, Yang Wook Kim; Yeungnam Univ J Med. 2021;38(2):136-141. Published online October 27, 2020; DOI: https://doi.org/10.12701/yujm.2020.00542

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Abstract PDF

Background
Postoperative acute kidney injury (AKI), which increases the risk of postoperative morbidity and mortality, poses a major concern to surgeons. We conducted this study to analyze the risk factors associated with the occurrence of AKI after orthopedic surgery.
Methods
This was a retrospective study that included 351 patients who underwent total hip or knee replacement surgery at Inje University Haeundae Paik Hospital between January 2012 and December 2016.
Results
AKI occurred in 13 (3.7%) of the 351 patients. The patients’ preoperative estimated glomerular filtration rate (eGFR) was 66.66±34.02 mL/min/1.73 m2 in the AKI group and 78.07±21.23 mL/min/1.73 m2 in the non-AKI group. The hemoglobin levels were 11.21±1.65 g/dL in the AKI group and 12.39±1.52 g/dL in the non-AKI group. Hemoglobin level was related to increased risk of AKI (odds ratio [OR], 0.13; 95% confidence interval [CI], 0.02–0.68; p=0.016). Administration of crystalloid or colloid fluid alone and the perioperative amount of fluid did not show any significant relationship with AKI. Further analysis of the changes in eGFR was performed using a cutoff value of 7.54. The changes in eGFR were significantly related to decreased risk of AKI (OR, 0.74; 95% CI, 0.61–0.89; p=0.002).
Conclusion
Renal function should be monitored closely after orthopedic surgery if patients have chronic kidney disease and low hemoglobin level. Predicting the likelihood of AKI occurrence, early treatment of high-risk patients, and monitoring perioperative laboratory test results, including eGFR, will help improve patient prognosis.

Citations

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Osteoarthritis is a risk factor for renal function injury based on the National Health and Nutrition Examination Survey and Mendelian Randomized study
Liang Pang, Kai Wu, Yibo Zhu, Qianwei Wang, Zhihui Zheng, Cunxian Lv, Zhancheng Bao
Scientific Reports.2025;[Epub] CrossRef
The sustained benefits of gram-negative antimicrobial prophylaxis in total hip arthroplasty: a 10-year retrospective analysis
Itay Ashkenazi, Weston Buehring, Armin Arshi, Vinay K Aggarwal, Joseph A Bosco, Ran Schwarzkopf
HIP International.2025;[Epub] CrossRef
Supplemental oxygen is associated with increased complications and readmission following total shoulder arthroplasty
Nikhil Vallabhaneni, Alexander S. Guareschi, Josef K. Eichinger, Richard J. Friedman
Seminars in Arthroplasty: JSES.2023; 33(3): 512. CrossRef
Acute kidney injury after primary total hip replacement
M. L. Lebed, M. G. Kirpichenko, E. V. Novikova, T. G. Lebed, A. V. Mankov
Acta Biomedica Scientifica.2023; 8(5): 125. CrossRef

Focused Review article

Pulmonary and Respiratory Medicine
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

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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 Report

Nephrology
Autoimmune thyroiditis with minimal change disease presenting acute kidney injury.: Ji Su Kim, Chi Young Park, Suk Pyo Shin, Yeong Min Lim, Eun Jung Ko, Hyung Jong Kim; Yeungnam Univ J Med. 2014;31(2):127-130. Published online December 31, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.2.127

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Abstract PDF: Autoimmune thyroiditis is the most common cause of hypothyroidism in the world. It is characterized clinically by gradual thyroid failure, goiter formation, or both, because of the autoimmune-mediated destruction of the thyroid gland. Renal involvement presenting proteinuria in autoimmune thyroiditis is not uncommon, occurring in 10% to 30% of the cases. Glomerulonephropathy associated with autoimmune thyroiditis, however, is a rare disease. Most reports of autoimmune thyroiditis with glomerulonephropathy have demonstrated a mixed pathological morphology and have been predominantly associated with membranous glomerulopathy. The case of minimal-change disease associated with thyroiditis presenting acute kidney injury is a rare disease that has not been reported in South Korea. Reported herein is the case of a 16-year-old man diagnosed with Hashimoto's thyroiditis, with minimal-change disease presenting acute kidney injury. He revealed hypothyroidism, proteinuria, and impaired renal function. Renal biopsy showed minimal-change disease and minimal tubular atrophy. The patient was treated with thyroid hormone, and his renal function and proteinuria improved. Therefore, for patients with autoimmune thyroiditis presenting unexplained proteinuria, glomerulonephropathy should be ruled out. Conversely, for patients with glomerulonephropathy and persistent proteinuria despite proper treatment, thyroid function and antibody tests should be performed.

Review

Differential diagnosis of peripheral vertigo
Differential diagnosis of peripheral vertigo.: Chang Hoon Bae; Yeungnam Univ J Med. 2014;31(1):1-8. Published online June 30, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.1.1

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Abstract PDF

Dizziness can be classified mainly into 4 types: vertigo, disequilibrium, presyncope, and lightheadedness. Among these types, vertigo is a sensation of movement or motion due to various causes. The main causes of peripheral vertigo are benign paroxysmal positional vertigo (BPPV), acute vestibular neuritis (AVN), and Meniere's disease. BPPV is one of the most common causes of peripheral vertigo. It is characterized by brief episodes of mild to intense vertigo, which are triggered by specific changes in the position of the head. BPPV is diagnosed from the characteristic symptoms and by observing the nystagmus such as in the Dix-Hallpike test. BPPV is treated with several canalith repositioning procedures. AVN is the second most common cause of peripheral vertigo. Its key symptom is the acute onset of sustained rotatory vertigo without hearing loss. It is treated with symptomatic therapy with antihistamines, anticholinergic agents, antidopaminergic agents, and gamma-aminobutyric acid-enhancing agents that are used for symptoms of acute vertigo. Meniere's disease is characterized by episodic vertigo, fluctuating hearing loss, and tinnitus. It is traditionally relieved with life-style modification, a low-salt diet, and prescription of diuretics. However, diagnosis and treatment of the peripheral vertigo can be difficult without knowledge of BPPV, AVN, and Meniere's disease. This article provides information on the differential diagnosis of peripheral vertigo in BPPV, AVN, and Meniere's disease.

Citations

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The Effect of Banhabaekchulcheonma-tang on Benign Paroxysmal Positional Vertigo: A Systematic Review Using the CNKI Database
Gi-hyeon Gwon, Seo-hye Oh, Eun-soo Park, Mi-hyeon Kim, Seung-hyo Hong, Geum-ju Song, Eun-young Park
The Journal of Internal Korean Medicine.2021; 42(4): 572. CrossRef
Korean Medicine Interventions for Benign Paroxysmal Positional Vertigo: A Systematic Review of Clinical Studies Published in Korea
Jun-su Jung, Sung-heon Jung, Min-joo Kim, Jang-kyung Park, Kwang-ho Bae, Kyung-hwan Kong, Ho-yeon Ko
The Journal of Internal Korean Medicine.2017; 38(4): 479. CrossRef
Clinical significance of saccade test, smooth pursuit test, and optokinetic nystagmus test in nystagmography
Yoon Seok Choi, Hyung Gyun Na, Si Youn Song, Yong Dae Kim, Chang Hoon Bae
Yeungnam University Journal of Medicine.2017; 34(1): 29. CrossRef

Case Reports

Nephrology
A Case of Recurrent Exercise-Induced Acute Renal Failure and Renal Hypouricemia with R90H Mutation in a SCL22A12 Gene.: Ae Jin Kim, Soo Yong Park, Ji Yong Jung, Jae Hyun Chang, Hyun Hee Lee, Wook Yung Chung, Han Ro; Yeungnam Univ J Med. 2012;29(2):150-152. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.150

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Abstract PDF

Acute renal failure with severe loin pain and patch renal ischemia after anaerobic exercise (ALPE) is a rare cause of exercise-induced acute kidney injury. Some ALPE patients also have renal hypouricemia. Mutations in the SCL22A12 gene are among the major factors of hypouricemia. Education for the prevention of relapse and genetic counseling should be recommended to ALPE patients with renal hypouricemia. This paper reports a 25-year-old man who showed recurrent exercise-induced ARF and renal hypouricemia with R90H mutation in his SCL22A12 gene.

Citations

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A Case Report of Familial Renal Hypouricemia Confirmed by Genotyping of SLC22A12, and a Literature Review
Hyung Oh Kim, Chun-Gyoo Ihm, Kyung Hwan Jeong, Hyun Joon Kang, Jae-Min Kim, Hyung Suk Lim, Jin Sug Kim, Tae Won Lee
Electrolytes & Blood Pressure.2015; 13(2): 52. CrossRef

Nephrology
A Case of Chronic Renal Failure Associated with Systemic Capillary Leak Syndrome.: Seon Ha Baek, Nara Shin, Hyo Jin Kim, Mi Yeun Han, Dong Ju Choi, Soo Mee Bang, Sejoong Kim, Jin Ho Paik; Yeungnam Univ J Med. 2012;29(2):145-149. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.145

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Abstract PDF

Systemic capillary leak syndrome (SCLS) is an unusual entity characterized by hypovolemic shock, hemoconcentration, and hypo-albuminemia associated with paraproteinemia as a result of marked capillary hyperpermeability. Complications of this syndrome can include compartment syndromes, pulmonary edema, thrombosis, and acute kidney injury. This paper reports a case of severe SCLS accompanied by acute tubular necrosis caused by hypoperfusion and myoglobinuria secondary to rhabdomyolysis, which resulted in chronic kidney disease that necessitated hemodialysis. However, there have been rare data of residual end-organ damage after acute attacks in Korea. Therefore, this paper reports a case of complicated SCLS enough to hemodialysis and that developed into chronic kidney disease.

Citations

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Fatal Systemic Capillary Leak Syndrome after SARS-CoV-2Vaccination in Patient with Multiple Myeloma
Gwang-Jun Choi, Seon Ha Baek, Junmo Kim, Jung Ho Kim, Geun-Yong Kwon, Dong Keun Kim, Yeon Haw Jung, Sejoong Kim
Emerging Infectious Diseases.2021; 27(11): 2973. CrossRef
Systemic capillary leak syndrome (Clarkson's disease) during elective pylorus-preserving pancreaticoduodenectomy: case report
Kun Moo Choi, Cheon Soo Park, Mi Hye Kim
Korean Journal of Hepato-Biliary-Pancreatic Surgery.2014; 18(1): 38. CrossRef

Infectious Disease
Simultaneous Actinomycosis with Mucormycosis in Maxillary Sinus.: Han Sol Lee, Min Jung Kim, Seung Il Bae, Jung Min Park, Myung Soo Hyun, Choong Ki Lee, Jian Hur; Yeungnam Univ J Med. 2012;29(2):106-109. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.106

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Abstract PDF: Actinomycosis is a rare subacute-to-chronic infection that causes sinus fistula, tract, or abscess due to the invasion surrounding the soft tissue. Actinomyces colonize the mouth, colon, and vagina. Mucosal disruption may lead to infection at virtually any site in the body. Cervicofacial infection accounts for 50-60% of all actinomycosis cases. The mandible and nasopharynx are the sites of predilection, but maxillary sinus infection is rare. Reported herein is a case involving a 57-year-old female with acute myeloid leukemia who had simultaneous actinomycosis with mucormycosis in the maxillary sinus.

Gastroenterology and Hepatology
Rhabdomyolysis and Mild Kidney Injury in a Patient with Acute Hepatitis A.: Gu Min Cho, Chang Wook Kim, Hyeonjin Seong, Joon Hur, Bu Seok Jeon, Jonghwan Lee, Eun Hui Sim, Seok Jong Lee, Chang Don Lee; Yeungnam Univ J Med. 2012;29(1):28-30. Published online June 30, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.1.28

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Abstract PDF: A 48-year-old male visited the emergency room of the authors' hospital due to nausea, vomiting, and myalgia for four days. Acute hepatitis A was identified from the serologic marker of the hepatitis A virus. Mild elevation of the serum creatinine and creatinine phosphokinase (CPK) suggested rhabomyolysis, which was confirmed with the serum aldolase, myoglobin, and urine myoglobin. With supportive care, both the liver and renal functions were recovered gradually and fully. This case shows that rhabdomyolysis can be one of the mechanisms of renal complication in cases of acute symptomatic hepatitis A.

Nephrology
Rhabdomyolysis Induced Acute Kidney Injury in a Patient with Leptospirosis.: Yoon Jung Choi, Jeung Min Park, Yo Han Jung, Jong Ho Nam, Hyun Hee Chung, Tae Woo Kim, Kyu Hyang Cho, Jun Young Do, Kyeung Woo Yun, Jong Won Park; Yeungnam Univ J Med. 2011;28(1):54-59. Published online June 30, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.1.54

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Abstract PDF

Leptospirosis is a spirochetal infectious disease caused by Leptospira interrogans, and may vary in degree from an asymptomatic infection to a severe and fatal illness. The kidney is one of the principal target organs of Leptospira. Renal disorders caused by Leptospira infection vary from an abnormality in urinalysis to acute kidney injury (AKI). Incidence of AKI in severe leptospirosis varies from 40% to 60%. AKI reflects the severity of leptospirosis and is generally accompanied by cholestatic jaundice. The pathophysiology of AKI in leptospirosis consists of hypovolemia, direct tubular toxicity, and rhabdomyolysis. Most patients with acute leptospirosis experience severe myalgias, and show laboratory evidence of mild rhabdomyolysis. However, occurrence of severe rhabdomyolysis is rare. We report here on a patient with leoptospirosis, who had severe rhabdomyolysis and acute kidney injury without jaundice.

Citations

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A case of severe leptospirosis complicated with massive rhabdomyolysis and acute kidney injury: a case report
Milad Badri, Negar Sheikhdavoodi, Farhad Nikkhahi, Aida Vafae Eslahi, Panagiotis Karanis
Journal of Medical Case Reports.2025;[Epub] CrossRef

Nephrology
A Case of Acute Renal Failure Associated with Non-fulminant Acute Hepatitis A.: Ji Hoon Na, Jong Won Park, Kyu Hwan Park, Myong Jin Oh, Yun Jung Choi, Jung Min Park, Woo Jin Chang; Yeungnam Univ J Med. 2010;27(2):127-132. Published online December 31, 2010; DOI: https://doi.org/10.12701/yujm.2010.27.2.127

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Abstract PDF: Acute hepatitis A is a generally self-limiting disease of the liver. Acute renal failure is rare in patients with acute non-fulminant hepatitis A. Acute tubular necrosis is the most common form of renal injury found in such patients. The 36 years old male patient visited our hospital with complaint of general weakness, fatigue, nausea, vomiting and myalgia. He was diagnosed with acute renal failure associated with acute non-fulminant hepatitis A. We report here on a case of acute renal failure associated with non-fulminant hepatitis A, and we include a review of the literature.

Original Article

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

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

Case Reports

Endocrinology, Diabetes, and Metabolism
A Case of Parathyroid Adenoma Presenting as Acute Pancreatitis Accompanied with Empty Sella.: Eon Ju Jun, Ji He O, Kyung Ryun Bae, Saet Byul Jang, Seung Woon Jun, Eui Dal Jung, Ho Sang Shon, Kyu Chang Won; Yeungnam Univ J Med. 2009;26(1):63-69. Published online June 30, 2009; DOI: https://doi.org/10.12701/yujm.2009.26.1.63

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Abstract PDF: The incidence of coexisting hyperparathyroidism and empty sella syndrome is rare and the etiology and incidence of their coexistence is not known. The association of hyperparathyroidism and the empty sella syndrome may be related to multiple endocrine neoplasia (MEN) syndrome due to a genetic disorder. We experienced a rare case of hyperparathyroidism presenting as acute pancreatitis combined with empty sella. We report here a 37-year old female who manifested epigastric pain because of acute pancreatitis. She had hypercalcemia due to parathyroid adenoma. A pituitary gland was not visible in the sella turcica on MRI scans. On genetic analysis, she did not show a mutation of the MENIN gene. Empty sella is thought to be a coincidental finding with hyperparathyroidism.

Gastroenterology and Hepatology
Ulcerative Colitis Mimicking Acute Hemorrhagic Colitis.: Hee Jung Moon, Byung Ik Jang, Sung Bum Kim, Ho Chan Lee, Jae Hyun Park, Jong Ryul Eun, Tae Nyeun Kim; Yeungnam Univ J Med. 2008;25(2):182-186. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.182

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Abstract PDF: Ulcerative colitis (UC) is a chronic inflammatory disorder of the gastrointestinal tract that affects the large bowel. Its etiology remains controversial. However, an infectious or immunologic origin is considered the primary cause. The onset of UC is typically slow and insidious, but some patients may present acutely with symptoms mimicking infectious colitis. We report a case of ulcerative colitis mimicking acute hemorrhagic colitis at initial presentation. A 60-year-old man was referred to Yeungnam University Hospital for bloody diarrhea and abdominal pain. Sigmoidoscopy revealed mildly edematous mucosa in the rectum and hyperemic mucosa with petechiae in the sigmoid colon. The patient was treated with antibiotics for several days, and his symptoms improved. However, after one month, his bloody diarrhea relapsed. Follow-up sigmoidoscopy revealed mucosal friability in the rectum and sigmoid colon. He was diagnosed with ulcerative colitis, and his symptoms were improved with mesalazine and a steroid enema.

Nephrology
A Case of Adult onset Henoch-Sch?nlein Purpura with Acute Renal Failure.: Seok Min Kim, Kyung Ae Chang, Sun Young Jung, Chan Soh Park, Jong Won Park, Jun Young Do, Yong Jin Kim, Kyung Woo Yoon; Yeungnam Univ J Med. 2008;25(1):58-63. Published online June 30, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.1.58

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Abstract PDF: Henoch-Schonlein purpura (HSP) is a leukocytoclastic vasculitis of small vessels with deposition of IgA, commonly resulting in skin, joint, gastrointestinal, and kidney involvement. HSP is an uncommon disorder in adults and accounts for 0.6% to 2% of adult nephropathy. We report a case of HSP with acute renal failure successfully treated with corticosteroid. In this case, the patient presented with vasculitic purpuric rash on lower extremity, arthralgia in the wrist, abdominal pain, hematochezia, oliguria and azotemia. Abdominal CT showed wall thickening of the small and large bowels. Skin biopsy revealed leukocytoclastic vasculitis. Percutaneous renal biopsy showed no crescent formation, but mesangial IgA and C3 deposits were observed by immunofluorescence. The patient was treated with corticosteroid (1mg/kg per day) and hemodialysis. After treatment, renal function improved and purpuric lesion, arthralgia and abdominal pain disappeared. Thus, when adults present with purpuric rash and rapidly progressive glomerulonephritis (RPGN), HSP should be a diagnostic consideration.

Original Articles

Anesthesiology and Pain Medicine
Risk Factors of Acute Renal Failure after Colorectal Surgery.: Hae Mi Lee, Chang Jae Hwang, Jaehwang Kim, Heung Dae Kim, Dae Pal Park, Il Suk Seo, Sun Ok Song, Sae Yeon Kim, Deuk Hee Lee, Daelim Jee; Yeungnam Univ J Med. 2007;24(2):275-286. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.275

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Abstract PDF: BACKGROUND
Acute renal failure is one of the leading causes of postoperative morbidity and mortality. The purpose of this study was to determine the risk factors that are associated with acute renal failure after colorectal surgery. MATERIALS AND METHODS: Five hundred seventy patients who operated colorectal surgery at the Yeungnam University Medical Center over three years from 2004 to 2006 were enrolled in this study. The effects of gender, age, ASA classification, concomitant disease, surgery type and duration, reoperation, urogenital manipulation, medication, hypotension, hypovolemia, transfusion, and postoperative ventilatory care on the occurrence of acute renal failure after colorectal surgery were studied. RESULTS: The major risk factors of acute renal failure after colorectal surgery were age of patients (P=0.003), ASA classification (P<0.001), concomitant disease (P<0.001), duration of the time surgery (P=0.034), reoperation (P=0.001), use of intraoperative diuretics (P=0.005), use of postoperative diuretics (P<0.001), intraoperative hypotension (P=0.018), intraoperative transfusion (P<0.001), postoperative transfusion (P<0.001), and postoperative ventilatory care (P=0.001). CONCLUSION: Multiple factors cause synergistic effects on the development of acute renal failure after colorectal surgery. Therefore, efforts to reduce the risk factors associated with acute renal failure are needed. In addition, intensive postoperative care should be provided to all patients.

Pediatrics, Perinatology, and Child Health
Power Doppler Sonography for the Upper Urinary Tract Infection in Children.: Jung Youn Choi, Jae Ho Cho, Yong Hoon Park; Yeungnam Univ J Med. 2007;24(2):179-185. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.179

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Abstract PDF

BACKGROUND
Urinary tract infection (UTI) is common in children. The available gold standard methods for diagnosis, Tc-99m dimercaptosuccinic acid (DMSA) scan and computed tomography (CT) are invasive and expensive. This study was performed to assess the role of power Doppler ultrasound (PDU) for diagnosis of acute pyelonephritis (APN). MATERIALS AND METHODS: A prospective study was conducted in 25 children with aged 2 weeks to 5 years who were hospitalized with the first episode of febrile UTI suggesting acute pyelonephritis. All children were examined in the first 3-5 days of admission by PDU and Tc-99m DMSA scan. The comparison between PDU and DMSA scan was performed on the basis of patients. RESULTS: The sensitivity and specificity of PDU for the detection of affected kidneys were 38.1% and 50.0%, and the positive predictive value and negative predictive value were 61.9% and 50.0%, respectively. Vesicoureteral refluxes (VUR) were identified in 11 patients (44.4%) and 18 kidneys (36%). The PDU and DMSA scan showed a matching perfusion defect in 23.8% and 50.0% respectively. CONCLUSION: These data indicate the PDU has a relatively low sensitivity and specificity for differentiating APN from lower UTI but may be a complement tool to DMSA scan for the prediction of VUR in infants and children.

Citations

Citations to this article as recorded by

Comparison of 99mTc-DMSA Renal Scan and Power Doppler Ultrasonography for the Detection of Acute Pyelonephritis and Vesicoureteral Reflux
Hee Jung Bae, Yong-Hoon Park, Jae Ho Cho, Kyung Mi Jang
Childhood Kidney Diseases.2018; 22(2): 47. CrossRef
Urinary tract infections in pediatric oncology patients with febrile neutropenia
Kyoo Hyun Suh, Sun Young Park, Sae Yoon Kim, Jae Min Lee
Yeungnam University Journal of Medicine.2016; 33(2): 105. CrossRef

Gastroenterology and Hepatology
Clinical Characteristics of Adult Patients with Acute Hepatitis A.: Jong Ryul Eun, Heon Ju Lee, Tae Nyeun Kim, Byung Ik Jang, Hee Jung Moon; Yeungnam Univ J Med. 2007;24(2):170-178. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.170

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Abstract PDF

BACKGROUND
The incidence of acute hepatitis A in adults has recently been increasing. This study was conducted to investigate the epidemiology and clinical characteristics of acute hepatitis A in Daegu province over the past 10 years. MATERIALS AND METHODS: We reviewed the medical records of 55 patients (male/female: 34/21), who were diagnosed with acute hepatitis A by confirmation of the IgM anti-HAV between January 1998 and June 2007. RESULTS: The mean age was 29.7+/-10.3 years (range; 17-65 years). The incidence was most common between March and June (56.1%), in the third and fourth decades of life (78.2%) and 90.9% (50/55) of the patients were diagnosed from 2003 to present. The common symptoms included anorexia, nausea or vomiting (69.1%), fever and chills (49.1%), myalgia (47.3%), weight loss (47.3%), fatigue (40.0%), abdominal pain (36.4%), diarrhea (9.1%) and pruritus (5.5%). The mean duration of hospital stay was 8.6+/-3.4 days (range; 3-20 days). The route of transmission was identified in only 11 patients (20.0%); 7 patients (12.7%) traveled (abroad or domestic), 2 patients (3.6%) ingested raw food and 2 patients (3.6%) had friends with acute hepatitis A. Fifty four patients recovered without complication; one patient developed fulminant hepatitis and recovered after a liver transplantation. CONCLUSION: The incidence of acute hepatitis A in adults is increasing. Because of the cost of treatment and potential for serious disease, persons, under 40 are recommened to have hepatitis A vaccination and confirmation of IgG anti-HAV.

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Pattern of Hepatitis A Incidence According to Area Characteristics Using National Health Insurance Data
Joo Youn Seo, Jae Hee Seo, Myoung Hee Kim, Moran Ki, Hee Suk Park, Bo Youl Choi
Journal of Preventive Medicine & Public Health.2012; 45(3): 164. CrossRef

Case Reports

Pediatrics, Perinatology, and Child Health
Intrathecal Methotrexate Induced Neurotoxicity in Children with Acute Lymphoblastic Leukemia: Jae Min Lee, Han Ku Moon, Jeong Ok Hah; Yeungnam Univ J Med. 2007;24(2 Suppl):S761-769. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S761

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Abstract PDF: Central nervous system (CNS) prophylaxis is an essential component of the treatment in childhood acute lymphoblastic leukemia (ALL). Methotrexate (MTX) is an dispensable antimetabolite for treatment of ALL. High-dose (HD) MTX and intrathecal (IT) MTX have improved the prognosis and reduced the rate of CNS relapse. However, the drug also has a significant toxic effect on the CNS and can potentially lead to severe neurologic morbidity. The overall incidence of acute MTX induced neurotoxicity has been estimated to be 0.8∼10% of treated children, depending on the amounts of MTX and leucovorin in the treatment protocol. Acute neurotoxicity generally develops within 5∼14 days after IT MTX or HD MTX and may include headache, nausea, emesis, lethargy, altered mental status, blurred vision, aphasia, hemiparesis, and seizure. Diffusion weighted MRI shows restricted diffusion of water in brains of patients with ALL who experienced stroke-like event after IT MTX. We report the cinical and imaging findings of acute neurotoxicity in two patients after intrathecal administration of MTX for CNS prophylaxes of ALL.

Thoracic and Cardiovascular Surgery
Surgical Treatment of Renal Cell Carcinoma with Acute Pulmonary Embolism Using Deep Hypothermic Circulatory Arrest －A Case Report－: Dong Hyup Lee, Dong Chun Park; Yeungnam Univ J Med. 2007;24(2 Suppl):S731-736. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S731

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Abstract PDF: Renal cell carcinoma occasionally invades the inferior vena cava and rarely extends to the right atrium and occurred massive pulmonary embolism. A healthy 54-year-old man presented to the emergency room with anterior chest pain, dyspnea and hypotension from which he had been suffering for several hours. We diagnosed him as left renal cell carcinoma with acute both pulmonary arteries embolism. The patient underwent a complex surgical procedure in which left radical nephrectomy, inferior vena cava thrombectomy and both pulmonary arteries thromboembolectomy under deep hypothermic circulatory arrest. Total circulatory arrest time was 44 minutes. We should use many inotropic agents for weaning of cardiopulmonary bypass. The patient had many postoperative complications including of acute renal failure, respiratory distress and sepsis. He died from septic shock and multi organ failure at 36th postoperative day.

Cardiology and Cardiovascular Medicine
Enoxaparin Induced Fatal Retroperitoneal Hematoma in Elderly Patient with Acute Coronary Syndrome －Case Report－: Sang-Hee Lee, Jong-Seon Park, Woong Kim, Geu-Ru Hong, Dong-Gu Shin, Young-Jo Kim, Bong-Sub Shim; Yeungnam Univ J Med. 2007;24(2 Suppl):S642-646. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S642

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Abstract PDF

Anticoagulation and antiplatelet therapy became a cornerstone of the primary treatment strategy in the case of acute coronary syndrome patients which planned to receive medical treatment or percutaneous coronary intervention. The anticoagulation regimen is unfractionated heparins and low molecular weight heparins enoxaparin. Despite of some debates, enoxaparin has replaced unfractionated heparins recently due to its demonstrated advantages. When we encountered acute coronary syndrome patients without contraindication for enoxaparin, it tends to be administered with no hesitation. However, a few patients treated with enoxaparin could be suffered from bleeding complication. Also, in case of bleeding into the retroperitoneal space, the result can be fatal. We report a patient who developed a fatal retroperitoneal hematoma during enoxaparin treatment for acute coronary syndrome.

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Enoxaparin-induced spontaneous massive retroperitoneal hematoma with fatal outcome
Nikolaos S. Salemis, Ioannis Oikonomakis, Emanuel Lagoudianakis, Georgios Boubousis, Christos Tsakalakis, Sotirios Sourlas, Stavros Gourgiotis
The American Journal of Emergency Medicine.2014; 32(12): 1559.e1. CrossRef

Pediatrics, Perinatology, and Child Health
Normal Amylase and Lipase Serum Level in Acute Pancreatitis : A Case Report: Kwang Hae Choi; Yeungnam Univ J Med. 2007;24(2 Suppl):S627-631. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S627

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Abstract PDF: Acute pancreatitis is an inflammatory disease of pancreas which comes from various etiologies. The pathologic spectrum of acute pancreatitis varies from mild edematous pancreatitis to severe necrotizing pancreatitis. Diagnosis of acute pancreatitis relies on clinical symptoms and increase of serum lipase and amylase within 48 hours. We report the case of a patient admitted in the pediatric department with about 24 hour history of acute abdominal pain. A computed tomography scan revealed an acute pancreatitis in spite of the serum amylase and lipase level being normal.

Original Article

Pulmonary and Respiratory Medicine
Effect of on Aerosolized Vitamin E Pretreatment on Interleukin-1 Induced Acute Lung Injury in Rats: Jin Hong Chung, Kyeong-Cheol Shin; Yeungnam Univ J Med. 2007;24(2 Suppl):S365-372. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S365

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Abstract PDF: Background
：Interleukin-1 (IL-1) and neutrophil appear to contribute to the pathogenesis of acute respiratory distress syndrome (ARDS). Reactive oxygen species, as well as elastase released from activated neutrophil, are thought to play pivotal roles in the experimental models of acute lung leak. This study investigated whether aerosolized vitamin E can attenuate acute lung injury induced by IL-1 in rats. Materials and Methods：We intratracheally instilled either saline or IL-1 with and without pretreatment with aerosolized vitamin E in rats. After 5 hours of intratracheal instillation, lung lavage neutrophils, lung lavage protein concentration, lung myeloperoxidase(MPO) activity and lung wet weight to dry weight ratio(WW/DW) were measured in rat.
Results
：In rats given IL-1 intratracheally, lung lavage neutrophils, lung lavage protein concentration, lung MPO activity and WW/DW were higher. Pretreatment with aerosolized vitamin E decreased lung lavage neutrophils, lung MPO activity and WW/DW in rats given IL-1 intratracheally.
Conclusion
：These results suggest that direct pulmonary supplement of vitamin E decreases lung inflammation and leak in rats given IL-1 intratracheally.

Case Report

Hematology
Acute Myeloid Leukemia with t(8;21)(q22;q22) (AML1/ETO) in a Patient with Marked Hypocellularity and Low Blasts Count.: Sung Ho Chun, Hee Soon Cho, Chae Hoon Lee, Kyung Dong Kim, Min Kyoung Kim, Myung Soo Hyun, Soon Il Jung; Yeungnam Univ J Med. 2007;24(1):85-90. Published online June 30, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.1.85

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Abstract PDF: According to the World Health Organization (WHO) classification system, cases with t(8;21)(q22;q22) should be diagnosed as acute myeloid leukemia (AML) even with a blast count of less than 20 percent in blood or bone marrow. It is an uncommon manifestation, moreover hypocellularity is rarely observed in this subtype of leukemia. Here, we report a case of t(8;21) in a patient with marked hypocellularity of less than 5 percent and a blast count of less than 20 percent. This patient responded relatively well to chemotherapy. An allogeneic bone marrow transplantation was performed with good engraftment . This case suggests that hypocellular AML with a t(8;21) has as good a prognosis as hypercellular AML with t(8;21).

Original Article

Radiology, Radiotherapy & Diagnostic Imaging
Acute Pulmonary Embolism by Silicone Injection: Radiologic Findings.: Jae Kyo Lee; Yeungnam Univ J Med. 2004;21(2):215-223. Published online December 31, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.2.215

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Abstract PDF: Silicone is widely used for medical purposes in breast augmentation and other cosmetic procedures. Illegal injections of silicone in human beings might have adverse effects and one of the serious problems is a silicone embolism. We experienced five cases of unusual respiratory difficulties after an injection of liquid silicone in the breast, vagina, uterus, and hip. They were all young adult females, who were previously healthy. One of them died after the injection. The three remaining patients were admitted because of dyspnea, coughing, chest discomfort and bilateral pulmonary infiltration after the silicone injection. A transbronchial lung biopsy and autopsy disclosed many oil like materials filling the alveolar septal capillaries. Three patients underwent a computed tomogram (CT), which revealed multifocal airspace consolidations at the peripheral and non-dependent portions of both lungs, which is a different finding from other thromboembolisms. Lung scans of the disclosed abnormalities were compatible with silicone induced pulmonary embolism.

Case Report

Anesthesiology and Pain Medicine
Acute Postoperative Pulmonary Edema without Reasonable Causes: A Case Report.: Ji Hoon Jeong, Hyung Jun Lim, Sung Min Lee, Dae Lim Jee; Yeungnam Univ J Med. 2004;21(1):114-119. Published online June 30, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.1.114

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Abstract PDF: This report concerns an unusual case of acute postoperative pulmonary edema without any apparent causes in a 45-year-old man. The patient was subjected to the removal of a previously placed device on the left tibia, and the excision of a benign mass on the right forearm. Unexpected acute bilateral pulmonary edema occurred immediately after the completion of the procedures. The etiologies were reviewed in relation to the patient's condition and clinical manifestations. Fluid overloading was excluded as a cause in view of the patient's perioperative state and postoperative chest X-ray results. We could not find any symptoms of upper airway obstruction during emergence from general anesthesia. We had doubts about tourniquet or fentanyl-induced pulmonary edema, but these factors were not sufficient to bring about pulmonary edema in this case. To our knowledge, the cause of acute pulmonary edema in this case is indeterminate.

Original Articles

Pulmonary and Respiratory Medicine
Effect of Neutrophil Elastase inhibitor, ICI 200,355, on Interleukin-1 Induced acute lung injury in rats.: Jin Hong Chung, Yeung Chul Mun, Hye Jung Park, Kyeong Cheol Shin, Kwan Ho Lee; Yeungnam Univ J Med. 2002;19(1):55-62. Published online June 30, 2002; DOI: https://doi.org/10.12701/yujm.2002.19.1.55

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Abstract PDF: BACKGROUND
Interleukin-1 (IL-1) and neutrophil appear to contribute to the pathogenesis of acute respiratory distress syndrome (ARDS). Elastase, as well as reactive oxygen species released from activated neutrophil, are thought to play pivotal roles in the experimental models of acute lung leak. This study investigated whether ICI 200,355, a synthetic elastase inhibitor, can attenuate acute lung injury induced by IL-1 in rats. MATERIALS AND METHODS: We intratracheally instilled either saline or IL-1 with and without treatment of ICI 200,355 in rats. Lung lavage neutrophils, lung lavage cytokine-induced neutrophil chemoattractant(CINC) concentration, lung lavage protein concentration, lung myeloperoxidase(MPO) activity and lung leak index were measured at 5 hours of intratracheal treatment. RESULTS: In rats given IL-1 intratracheally, lung lavage neutrophils, lung lavage CINC concentration, lung lavage protein concentration, lung MPO activity and lung leak index were higher. Intratracheal ICI 200,355 administration decreased lung lavage neutrophils, lung MPO activity and lung leak index, respectively, but did not decreased lung lavage CINC concentration. CONCLUSION: These results suggest that ICI 200,355 decreases lung inflammation and leak without decreasing lung lavage CINC concentration in rats given IL-1 intratracheally.

Pediatrics, Perinatology, and Child Health
Indication of Bone Marrow Aspiration in Acute Idiopathic Thrombocytopenic Purpura in Children.: Won Duck Kim, Jeong Ok Hah; Yeungnam Univ J Med. 2001;18(2):239-245. Published online December 31, 2001; DOI: https://doi.org/10.12701/yujm.2001.18.2.239

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Abstract PDF: BACKGROUND
Acute idiopathic thrombocytopenic purpura(ITP) is one of the common hematologic disorders in children. Bone marrow aspiration(BMA) is often performed in children with acute ITP to rule out leukemia, aplastic anemia or other hematologic diseases. However, whether BMA is needed in children with typical clinical and hematological features of acute ITP have been questioned. This study was performed to examine the proper indication of BMA in acute childhood ITP. MATERIALS AND METHODS: The medical records and BMA reports of children with the provisional diagnosis of acute ITP were reviewed from January 1984 to December 2000. Patients were divided into two groups, one with typical and another with atypical clinical and hematological features of acute ITP. Typical acute ITP group was characterized by the history of previous viral infection, well being appearance, no hepatosplenomegaly, no lymphadenopathy, normal Hb, WBC, neutrophil count and peripheral blood smear except thrombocytopenia. A platelet count of 50x109/L or lower was the cutoff level. RESULTS: Total 120 children with the provisional diagnosis of acute ITP were included. One hundred eighteen of them were confirmed to have acute ITP by BMAs. Of these, 66 had typical and 54 had atypical features. All of typical features and 52 of 54 with atypical features of acute ITP were confirmed to have acute ITP by BMAs. Two patients with atypical features of acute ITP were diagnosed as aplastic anemia and myelodyspalstic syndrome, respectively, by BMAs. CONCLUSION: This study concludes that BMA is not needed for the children with typical features of acute ITP but it is needed for the children with atypical features of acute ITP to rule out other hematologic disorders.

Review

Pathology and Forensic Medicine
Tests for Acute Coronary Syndrome.: Kyung Dong Kim; Yeungnam Univ J Med. 2001;18(1):13-29. Published online June 30, 2001; DOI: https://doi.org/10.12701/yujm.2001.18.1.13

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Abstract PDF

The enzyme activities of creatine kinase(CK), its isoenzyme MB(CK-MB) and of lactate dehydrogenase isoenzyme 1(LD-1) have been used for years in diagnosing patients with chest pain in order to differentiate patients with acute myocardial infarction(AMI) from non-AMI patients. These methods are easy to perform as automated analyses, but they are not specific for cardiac muscle damage. During the early 90's the situation changed. First, creatine kinase MB mass(CK-MB mass) replaced the measurement of CK-MB activity. Subsequently cardiac-specific proteins, troponin T(cTnT) and troponin I(cTnI) appeared and displacing LS-1 analysis. However troponin concentration in blood increase only from four to six hours after onset of chest pain. Therefore a rapid marker such as myoglobin, fatty acid binding protein or glycogen phosphorylase BB could be used in early diagnosis of AMI. On the other hand, CK-MB isoforms alone may also be useful in rapid diagnosis of cardiac muscle damage. Myoglobin, CK-MB mass, cTnT and cTnI are nowadays wisely used in diagnosing patients with acute chest pain. Myoglobin is not cardiac-specific and therefore requires supplementation with some other analysis such as troponins to support the myoglobin value. Troponins are very highly cardiac-specific. Only the sera of some patients with severe renal failure, which requires hemodialysis, have elevated cTnT and/or cTnI without there being any evidence of cardiac damage. The latest studies have shown that elevated troponin levels in sera of hemodialysis patients point to an increased risk of future cardiac events in a similar manner to the elevated troponin values in sera of patiets with unstable angina pectoris. In addition, the bedside tests for cTnT and cTnI alone or together with myoglobin and CK-MB mass can be used instead of quantitative analyses in the diagnosis of patients with chest pain. These rapid tests are easy to perform and they do not require expensive instrumentation. For the diagnosis patients with chest pain, routinely myoglobin and CK-MB mass measurements should be performed whenever they are requested (24 h/day) and cTnT and cTnI on admission to the hospital and then 4-6 and 12 hours later and maintained less than 10% imprecision.

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Citations to this article as recorded by

The Usefulness of Rapid Triple Test for Cardiac Marker in Forensic Paragnosis of Sudden Cardiac Death
Chae-Won Lim, Jin-Gak Kim
The Korean Journal of Clinical Laboratory Science.2017; 49(2): 108. CrossRef

Original Articles

Orthopedics and Sports Medicine
The Results of Primary Repair in Acute Injuries of the Posterior Cruciate Ligament.: Dong Chul Lee, Seung Hee Baek; Yeungnam Univ J Med. 2001;18(1):101-111. Published online June 30, 2001; DOI: https://doi.org/10.12701/yujm.2001.18.1.101

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Abstract PDF: BACKGROUND
We analyze the functional evaluation, posterior stability after surgery of acute injuries in the femoral detachment and tibial avulsion fracture of posterior cruciate ligament. MATERIALS AND METHODS: Twenty two patient who underwent primary repair were followed more than one year after operation (mean follow-up 33.7 months). The patients were evaluated with KT 2000 arthrometer and posterior stress test for posterior stability. Lysholm knee score was used for knee function. RESULTS: Lysholm score revealed 85.3 in femoral detachment group and 91.1 in tibial avulsion fracture group (p<0.05). Posterior displacement of the posterior stress test showed 17.2 mm at initial injury and 8.6 mm at last follow up in femoral detachment group. 16.8 mm at initial injury and 7.1 mm at last follow up in tibial avulsion fracture group There revealed the tendency of the improved posterior stability of the tibial avulsion group compared with femoral detachment group, but there showed no statistical significance in KT 2000 arthrometer and posterior stress x-ray. CONCLUSION: Functional results of tibial avulsion fracture group revealed the better outcome compared with femoral detachment group, but the degree of posterior stability in tibial avulsion fracture group showed no statistical significance in posterior stability.

Infectious Disease
The Clinical Effects of Cefpirome for the Treatment of Acute Lower Respiratory Infection.: Kyeong Cheol Shin, Young Hoon Hong, Eun Young Lee, Ki Do Park, Sung Dong Kim, Jin Hong Chung, Choong Ki Lee, Kwan Ho Lee, Cha Kyung Sung, Hyun Woo Lee; Yeungnam Univ J Med. 1999;16(2):219-227. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.219

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Abstract PDF: BACKGROUND
In contrast to a healthy person, patients who have acute lower pespiratory tract infection with underlying pulmonary diseases have various pathogens, a rapidly progressie downhill course, and a poor response to prior antimicrobial therapy. Broad spectrum antivacterial therapy is needed for full evaluation. MATERIALS AND METHODS: To evaluate the efficacy and safety of cefpirome, we administered 1gm cefpirome, twice a day to 30 patients who had signs and symptoms of acute lower repiratory infection regardless of their underlying disease, except to those who had an allergic history to antibiotics or severe systemic diseases. RESULTS: The results were as follows : 1) Among 30 cases, 21 cases(70.0%) showed excellent improvement, and 7 cases(23.3%) showed good improvement in their symptoms and signs of acute lower respiratory infection. 2) In 14 cases with isolated pathogens, we observed bacteriologic eradication in 11 cases(78.6%). 3) Significant side effects were not found CONCLUSION: Above results suggest that cefpirome was effective as a monotherapy in patients with acute lower respriatory infection, especially on those with as underlying chronic obstructive pulmonary disease(COPD).

Pulmonary and Respiratory Medicine
The Clinical Effect of Sparfloxacin for the Treatment of Acute Respiratory Infection.: Hak Jun Lee, Hye Jung Park, Chang Jin Shin, Kyeong Cheol Shin, Jin Hong Chung, Kwan Ho Lee, Hyun Woo Lee; Yeungnam Univ J Med. 1998;15(2):246-253. Published online December 31, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.2.246

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Abstract PDF: Sparfloxacin is a new synthetic quinolone antimicrobial developed at the Research Laboratories of Dainippon Pharmaceutical Co, Ltd. To evaluate the efficacy and safty of sparfloxacin in acute pulmonary infection, we administered sparfloxacina(100mg) twice in a day to 30 patients who had sign and symptoms of acute pulmonary infectious diseases regardless of their underlying lung disease for 7 days. The results were : 1) A total 30 patients were enrolled in the trial. Among them 24 cases(80%) had underlying lung problems such as chronic obstructive pulmonary disease(36.4%), bronchiectasis(36.4%), bronchial asthma(3.3%), lung cancer(3.3%). 2) In 26 cases(86.6%), we observed effective improvement, and 4 cases(13.4%) show mildly effective improvement of symptoms and signs of respiratory infection. 3) In 23 cases(73.4%), we observed bacteriological eradication in culture or decreased the number of bacteria in Gram stain which found dominantly in previous Gram stain. 4) The significant side effect was not noted. The above results suggest that sparfloxacin was effective as a first line therapy in patients with acute respiratory infection.

Case Report

Nephrology
A case of Rifampin-induced Acute Renal Failure.: Dong Hwa Lee, Te Gue Park, Je Sung Lee, Heui Sik Kim, Kyoung Hyun Kim, Young Jun Ha, Sung Bok Jung, Jun Young Do, Kyung Woo Yoon; Yeungnam Univ J Med. 1998;15(1):173-181. Published online June 30, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.1.173

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Abstract PDF: Rifampin is common drug to treat tuberculosis. Rifampin induced acute renal failure, hemolytic anemia and thrombocytopenia is rare and severe complication. We have experienced a case of rifampin induced acute renal failure, hemolytic anemia and thrombocytopenia. Forty-six years old male was suffered from reactivation of pulmonary tuberculosis, and had to medicate antituberculosis drugs including rifampin(600mg/day). Seven years ago, antituberdulosis medication were successfully administered to treat pulmonary tuberculosis without any side effects of drugs. But eight days after readministration of rifampin, fever, abdominal pain, vomiting, oliguria, elevated BUN and creatinine were developed. And thrombocytopenia was also identified after administration of rifampin. The patient was recovered slowly after discontinuation of rifampin & intensive medical care. The renal function was normalized at 55 days after cessation of rifampin. The renal pathologic findings were interstitial nephritis and acute tubular necrosis. And, the rifampin dependent antibodies were identified by indirect antiglobulin test in the presence of rifampin. So we report this case with a brief review of literature.

Original Articles

Hematology
Surface Marker Analysis in Acute Leukemias.: Jin Young Moon, Chae Hoon Lee, Kyung Dong Kim, Chung Sook Kim; Yeungnam Univ J Med. 1997;14(2):359-369. Published online December 31, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.2.359

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Abstract PDF: We studied the expression of the cell surface antigen associated with myeloid and lymphoid leukemias on bone marrow or peripheral blood blast cells from 153 leukemic patients including 61 cases of acute myelogenous leukemias(AML), 46 of acute lymphocytic leukemias(ALL) and 12 of acute leukemias. They were analyzed by direct or indirect immunofluorescence method for reactivity with the monoclonal antibodies to B cells(CD10, CD19, SmIg), T cells(CD2, CD5, CD7, CD3, CD4, CD8), myeloid antigen(CD13, CD14, CD33, CD61) and a nonspecific antigen, HLA-DR. Lymphoid associated markers detected on AML is CD7 32.8%, CD10 14.8%, CD5 13.1%, CD2 6.6% and CD19 1.6%. TdT was positive in 4.9% of AMLs. Hybrid leukemias were 8 cases out 61 AML cases and were mainly composed of monocytic lineage, M4 and M5a. Myeloid markers detected in ALL were CD13 2.2% and CD33 2.2%. In this study, immunologically classified ALLs were composed of 65.2% of CALLA (+) B precursor type, 10.9% of CALLA (-) B precursor pattern, 8.7% of T cell type, 2.2% of B cell type, 4.5% of mixed lymphoid lineage(B&T), 2.2% of undifferentiated leukemia, and 6.5% of hybrid leukemia. Twelve cases of acute leukemias ware finally diagnosed to be 5 cases of hybrid leukemia, 3 cases of B lineage, 3 case of T lineage and 1 case of mixed lymphoid(B&T) leukemia. In summary, we think the best method for typing acute leukemias is by using a combination of FAB classification and immunophenotying.

Cardiology and Cardiovascular Medicine
Diagnostic Efficiency of Lactate Dehydrogenase, Crreatine Kinase and Troponin T in Acute Myocardial Infarction.: Chae Hoon Lee, Kyung Dong Kim, Chung Sook Kim; Yeungnam Univ J Med. 1995;12(1):48-55. Published online June 30, 1995; DOI: https://doi.org/10.12701/yujm.1995.12.1.48

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Abstract PDF: The present study was designed to evaluate the efficiency of total lactate dehydrogenase, total creatine kinase, LD1/LD2 ratio, CK-MB and newly developed troponin T in acute myocardial infarction. The level of troponin T was 0.010.02 pg/L in 34 healthy person, but the peak vaule of acute myocardial infarction ranged in 4.7-24.2 pg/L. Total lactate dehydrogenase was peaked in 1 to 3 days after chest pain and then progressively decreased, but LD1/LD2 ratio was persistently higher than 1.0 for 10 days in most patients. Total creatine kinase and CK-MB were peaked in 1-2 days, and normalized in 3-4 days, so they, were useful in early diagnosis of acute myocardial infarction, but not for the late stages of acute myocardiz l infarction. Troponin T is early elevated and persistently high level for more than 10 days. Comparing with total lactate dehydrogenase, total creatine kinase, LD1/LD2 ratio and CK-MB, troponin-T test improves the efficiency of serodiagnostic method for the detection of ischemic myocardial damage.

Case Report

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

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

Original Articles

Pulmonary and Respiratory Medicine
Clinical observation of acute drug intoxications.: Jun Ha Chun, Kyung Chul Shin, Jin Hong Chung, Chong Ki Lee, Bong Sup Shim, Hyun Woo Lee; Yeungnam Univ J Med. 1991;8(2):164-173. Published online December 31, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.2.164

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Abstract PDF: Clinical observations were made on 349 cases of acute drug intoxication who were visited to emergency room of Yeungnam University Hospital during recent 7 years from January 1984 to December 1990. The following results were obtained. 1) Total number of cases of acute drug intoxication was 349 which was 0.39% of the total patients of the emergency room during the same period. 2) The ratio of male to female was 1.1:1. The age incidence was highest in the third decade (26.7%). The monthly incidence was highest in May. Higher frequency was observed in summer season. 3) The most common drug of the intoxication was pesticides and herbicides (71.9%), the remainders were miscellaneous drugs (11.2%), sedatives (7.7%), rodenticides (6.3%) and unknown drug (3.2%) in orders. 4) The most common cause of drug intoxication was suicide (69.1%) and the others were accident, unknown cause, intention in orders. 5) Main clinical manifestations were the impairment of consciousness, nausea, vomiting and convulsion. Physical examination revealed increased pulses, increased blood pressure, miosis of the pupil and sweating. Above symptoms and signs were more prominent in pesticide intoxication. Leukocytosis, glycosuria and abnormal LFT were common findings in acute intoxications. 6) The complications were developed in 18.3% among 349 cases and the most common complication was respiratory failure, pneumonia, cardiovascular collapse and pulmonary edema in orders. 7) Overall mortality rate was 8.3% of total cases and mortality rate was highest in herbicide intoxication (22.2%).

Neurology
A clinical study of acute carbon monoxide intoxication.: Kyong Chan Choi, Mee Yeung Park, Jung Sang Hah, Yeung Ju Byun, Choong Suh Park; Yeungnam Univ J Med. 1991;8(1):86-97. Published online June 30, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.1.86

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Abstract PDF: To obtain the basic data of prognosis of acute carbon monoxide (CO) intoxication, one hundred and sixteen cases of CO intoxication defined by carboxyhemoglobin (COHb) and admitted via emergency room of Yeungnam University Hospital from Oct. '85 to April' 89 have been clinically analyzed and evaluated, including delayed postanoxic encephalopathy (DPE) and the following results were obtained. 1. The ratio of male to female was 1:1.5 and mental state was drowsy mostly (26.2% of 116 cases) 2. The more disturbed the mental state, the more decreased was the arterial pH and PaCO₂, which may be the result of metabolic acidosis. 3. The early laboratory findings in patients of CO intoxication were as follows: leukocytosis-65.5%, increase of hematocrit-23.3%, hyperglycemia-19.8%, increase of GPT-19.8% increase of creatinine-0.9% and glucosuria-12.1%. 4. The early findings of EKG were abnormal in 35.3%: change of rhythm-25.0%, abnormal ST segment 15.5% (change of rhythm and abnormal ST segment-5.2%) but the conduction disorder was not present. 5. The abnormal EEG above mild degree was 93.1%, of which moderate was most frequent (80.2%). 6. The incidence of DPE was 7.8% among all admitted CO patients. DPE cases had long duration of exposure time (8 hours), severe leukocytosis (20,000) and an abnormal EEG (MA).

Case Reports

Nephrology
Acute decompensated heart failure and acute kidney injury due to bilateral renal artery stenosis.: Ho Jin Jung, Won Suk Choi, Hyun Jae Kang, Byung Chun Jung, Bong Ryeol Lee, Jong Joo Lee, Jun Young Lee; Yeungnam Univ J Med. 2015;32(2):146-151.; DOI: https://doi.org/10.12701/yujm.2015.32.2.146

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Abstract PDF: Atherosclerotic renal artery stenosis (RAS) may result in hypertension, azotemia, and acute pulmonary edema. We report on a renal angioplasty with stent placement for bilateral RAS in a patient with acute decompensated heart failure and acute kidney injury. A 67-year-old female patient was admitted to our hospital with acute shortness of breath and generalized edema. Echocardiography showed left ventricular wall motion abnormality and the follow up electrocardiography showed T wave inversion in the precordial leads. We performed a coronary angiography to differentiate ischemic heart disease from non-cardiac origin for the cause of the heart failure. The coronary angiography showed no significant luminal narrowing, but bilateral RAS was confirmed on the renal artery angiography, therefore, we performed renal artery revascularization. After the procedure, the pulmonary edema was improved and the serum creatinine was decreased. Two weeks later, an echocardiography showed improvement of the left ventricular systolic function.

Nephrology
Amlodipine intoxication complicated by acute kidney injury and rhabdomyolysis.: In Hee Lee, Gun Woo Kang; Yeungnam Univ J Med. 2015;32(1):17-21.; DOI: https://doi.org/10.12701/yujm.2015.32.1.17

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Abstract PDF: Amlodipine, a calcium channel blocker of the dihydropyridine group, is commonly used in management of hypertension, angina, and myocardial infarction. Amlodipine overdose, characterized by severe hypotension, arrythmias, and pulmonary edema, has seldom been reported in Korean literature. We report on a fatal case of amlodipine intoxication with complications including rhabdomyolysis and oliguric acute kidney injury. A 70-year-old woman with a medical history of hypertension was presented at the author's hospital 6 hours after ingestion of 50 amlodipine (norvasc) tablets (total dosage 250 mg) in an attempted suicide. Her laboratory tests showed a serum creatinine level of 2.5 mg/dL, with elevated serum creatine phosphokinase and myoglobin. The patient was initially treated with fluids, alkali, calcium gluconate, glucagon, and vasopressors without a hemodynamic effect. High-dose insulin therapy was also started with a bolus injection of regular insulin (RI), followed by continuous infusion of RI and 50% dextrose with water. Despite intensive treatment including insulin therapy, inotropics, mechanical ventilation, and continuous venovenous hemodiafiltration, the patient died of refractory shock and cardiac arrest with no signs of renal recovery 116 hours after her hospital admission.

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