Journal of Yeungnam Medical Science

Original articles

Endocrinology, Diabetes, and Metabolism
Association between thyroid function and 10-year cardiovascular disease risk of patients with diabetes: a cross-sectional study using KNHANES 2013–2014: Bogyeong Kim, Minjin Jeon, Yuseop Lee, Hyunji Reem, Seung Min Chung; J Yeungnam Med Sci. 2026;43:28. Published online April 8, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.28

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Abstract PDF Supplementary Material: Background
This study investigated the association between thyroid function and the 10-year cardiovascular disease (CVD) risk in patients with diabetes.
Methods
This retrospective cross-sectional study analyzed 246 patients with diabetes aged 30 to 79 years (weighted n=1,611,708) from the 2013 to 2014 Korea National Health and Nutrition Examination Survey. Individuals with a history of CVD, thyroid disease, or pregnancy were excluded. Thyroid function was categorized as euthyroid, hypothyroid, or hyperthyroid, based on serum thyroid-stimulating hormone (TSH) levels (reference in Koreans, 0.62–6.86 mIU/L). The 10-year CVD risk was estimated using the Predicting Risk of CVD EVENTs calculator.
Results
The mean participant age was 54.3±10.1 years, with a male-to-female ratio of 1.41:1. Although patients with hypothyroid (14.1%) and hyperthyroid (15.7%) statuses showed a higher CVD risk than those with euthyroid status (12.3%), the difference was not statistically significant (p=0.337). However, in the hypothyroid group (n=11), TSH levels showed a moderate correlation with 10-year CVD risk (r=0.603, p<0.05), although this finding should be interpreted with caution owing to the small sample size. After adjusting for diabetes- and thyroid-related variables, TSH level was independently associated with higher estimated 10-year CVD risk, particularly in patients with a glycated hemoglobin level of <7% (adjusted coefficient, 0.17; 95% confidence interval, 0.05–0.29; p<0.05).
Conclusion
Monitoring TSH levels in patients with well-controlled diabetes may provide additional information regarding the risk of CVD; however, prospective studies are needed to confirm the long-term prognostic value.

Pulmonary and Respiratory Medicine
Feasibility of app-based pulmonary telerehabilitation program for textile dyeing workers with respiratory symptoms: a quasi-experimental study: Myeong Geun Jeong, Gun Seo Jung, Kyoung Tae Kim; J Yeungnam Med Sci. 2026;43:20. Published online March 2, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.20

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Abstract PDF Supplementary Material: Background
Textile dyeing workers are at an increased risk of developing occupational respiratory diseases owing to frequent exposure to harmful chemicals, irritants, and high humidity in the workplace. Pulmonary rehabilitation is essential but associated with access and adherence challenges. This study aimed to evaluate the feasibility, effectiveness, accessibility, and safety of an app-based pulmonary telerehabilitation program for this population.
Methods
Forty-five textile dyeing workers with respiratory symptoms underwent a 4-week pulmonary telerehabilitation program consisting of daily gamified respiratory muscle training using a Bluetooth-enabled device and video-guided flexibility exercises. The program was delivered through a mobile application and adherence was monitored using an online platform. Pulmonary function tests, 6-minute walk test, hand grip strength, and St. George’s Respiratory Questionnaire (SGRQ) scores were assessed at baseline (T0) and post-intervention (T1). The adherence, adverse events, and system usability were evaluated.
Results
Improvements were observed in forced expiratory volume in 1 second (FEV1), FEV1/forced vital capacity, maximal inspiratory pressure, and maximal expiratory pressure at T1 compared to T0. The SGRQ activity scores improved after the intervention. The mean adherence rate was 95.69%; three participants had adherence rates <80% for ≥1 week each. The mean System Usability Scale score was high.
Conclusion
The program resulted in significant improvements in pulmonary function and quality of life with high adherence rates and good usability. This may be a promising approach for managing occupational respiratory diseases among textile dyeing workers. Further studies with larger sample sizes and longer follow-up periods are warranted to validate these results and assess the long-term outcomes.

Public Health, Environmental, and Occupational Health
Radiologic evaluation of subclinical cardiovascular structural changes in school cafeteria workers: a chest computed tomography study with age-matched controls: Jung Hee Hong, Jin Young Kim, Kiook Baek; J Yeungnam Med Sci. 2025;42:76. Published online November 16, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.76

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Abstract PDF: Background
Chronic exposure to cooking oil fumes (COFs) is associated with adverse health outcomes. Although previous studies have focused on respiratory effects, the impact on cardiovascular structures remains unclear. This study aimed to assess the subclinical cardiovascular changes in school cafeteria workers with long-term COF exposure.
Methods
We conducted a retrospective analysis of the low-dose chest computed tomography (CT) scans of 88 school cafeteria workers and an age- and sex-matched control group of 88 individuals. The cardiothoracic ratio; ascending aortic diameter; and presence of coronary artery, aortic valve, and ascending aortic calcifications were evaluated and compared between the groups.
Results
The cafeteria worker group demonstrated a significantly greater ascending aortic diameter (31.69±3.28 mm vs. 30.64±3.21 mm, p=0.032) and cardiothoracic ratio (0.47±0.04 vs. 0.45±0.04, p=0.026) compared to controls. No significant differences were observed in the prevalence of coronary artery, aortic valve, or ascending aortic calcification between the two groups.
Conclusion
Our findings suggest that long-term occupational exposure to COFs contributes to subtle cardiovascular alterations detectable on chest CT, even in the absence of overt calcification. These results highlight the need for occupational health surveillance and longitudinal studies to evaluate the clinical implications of these changes.

Review article

Infectious Disease
Vaccine trends: a narrative review: Jacob Sangwoon Bae; J Yeungnam Med Sci. 2025;42:71. Published online November 5, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.71

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Abstract PDF: Vaccination has played a central role in the historical and modern fight against infectious diseases. This review explores the evolution of infectious disease perception from ancient humoral theories to the modern “One Health” framework, reflecting the integration of environmental, animal, and human health. Vaccines have not only reduced morbidity and mortality but have also provided profound economic and developmental benefits across societies. Climate change, antimicrobial resistance, and the rapid emergence of new infectious threats have prompted innovations in vaccine technologies, including messenger RNA, DNA, viral vector, and nanoparticle-based platforms. These advances support personalized vaccine strategies, such as vaccinomics, and extend their application to noncommunicable diseases, including cancer and Alzheimer disease. Despite their success, vaccines face challenges including global access disparities, waning immunity, pathogen evolution, and vaccine hesitancy. Nonetheless, vaccination remains a cornerstone of global health security, with strong returns on investment and crucial roles in socioeconomic stabilization during pandemics. Future vaccine strategies must integrate technological innovation with equitable access and public trust, for instance, through global initiatives like the Coalition for Epidemic Preparedness Innovations and the World Health Organization COVID-19 Vaccines Global Access, and the establishment of regional manufacturing hubs to effectively respond to unpredictable threats like “Disease X.”

Communications

Physical therapy, Sports therapy, and Rehabilitation
The feasibility of conducting successful pulmonary rehabilitation in India: Manivel Arumugam, Senthilkumar Ramasamy, Pitchaimani Govindharaj, Mahendran Murugan; J Yeungnam Med Sci. 2025;42:40. Published online June 28, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.40

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Abstract PDF

Pulmonary rehabilitation (PR) is a highly effective evidence-based treatment with multidisciplinary and comprehensive individualized interventions that reduce morbidity by improving functional capacity and managing respiratory symptoms. It can contribute to overall wellness, reduce symptoms related to respiratory conditions, and facilitate routine work and social activities. Hence, it is a vital component of integrated care for patients with chronic respiratory diseases. In India, PR faces several challenges arising from patients, society, and hospitals. Recent evidence suggests that PR has significant benefits in chronic respiratory diseases, including reduced morbidity and mortality, improved quality of life, and cost savings. Nevertheless, it has been significantly underutilized and has not received the necessary attention in India. The lack of proper utilization of PR can be attributed to several factors, including a lack of awareness and understanding among healthcare professionals regarding its advantages, insufficient referrals to PR programs, scarcity of specialized professionals trained in PR, and a general lack of awareness among patients about its benefits. This article aims to outline the obstacles to PR, identify the factors that influence its successful implementation, and propose possible solutions to overcome these barriers.

Citations

Citations to this article as recorded by

Creating home-based pulmonary rehabilitation programs for patients with asthma: insights from practice
Cahidenur Koçak, Massimiliano Polastri, Esra Pehlivan
Journal of Yeungnam Medical Science.2025; 42: 57. CrossRef

Original articles

Dentistry
Galectin-3 as a possible link between periodontitis and chronic kidney disease: a cross-sectional study: Sri Vidhya Marimuthu, Devi Arul, Muthukumar Santhanakrishnan, Ramprasad Elumalai, Sandhya Suresh, Sathya Selvarajan, Ravindranath Dhulipalla, Ramanarayana Boyapati; J Yeungnam Med Sci. 2025;42:22. Published online January 20, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.22

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Abstract PDF: Background
Chronic periodontitis is associated with various systemic inflammatory diseases; however, research on its association with chronic kidney disease (CKD) is relatively limited. Because both conditions share common risk factors, systemic inflammation plays a key role in the progression of these diseases. Galectin-3 (Gal-3) is a proinflammatory cytokine that plays an important role in chronic inflammatory diseases and is a potential biomarker. This study aimed to measure salivary Gal-3 levels in patients with periodontitis and CKD to better understand their association and evaluate Gal-3 as a diagnostic biomarker for these conditions.
Methods
Seventy-five patients were categorized into three groups: Group I, patients with CKD and periodontitis (n=25); Group II, patients with chronic periodontitis who were systemically healthy (n=25); and Group III, patients with CKD without chronic periodontitis (n=25). Demographic characteristics and periodontal and renal parameters were recorded for each patient. Saliva samples were collected to evaluate Gal-3 levels using an enzyme-linked immunosorbent assay.
Results
Patients with chronic periodontitis and CKD and those with chronic periodontitis alone (Groups I and II, respectively) showed significantly higher salivary Gal-3 levels than patients with CKD alone (Group III) (p<0.001). Bivariate correlation analysis indicated a strong relationship between clinical parameters and Gal-3 levels across all three groups.
Conclusion
Salivary Gal-3 level is a valuable early diagnostic marker of chronic periodontitis and CKD.

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.

Review article

Medical Informatics
Digital therapeutics in Korea: current status, challenges, and future directions – a narrative review: Hee Jun Shin, Ik Tae Cho, Wan Suk Choi, Hong Rae Kim, Min Bong Kang, Won Jong Yang; J Yeungnam Med Sci. 2025;42:8. Published online November 18, 2024; DOI: https://doi.org/10.12701/jyms.2024.01004

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Abstract PDF

Digital therapeutics (DTx) are emerging as a transformative innovation in healthcare offering evidence-based digital interventions for the treatment, management, and prevention of various diseases and disorders. In Korea, DTx have gained significant attention as potential solutions to the increasing burden of chronic diseases and mental health conditions. However, the Korean DTx market faces several challenges that hinder its widespread adoption and integration into the national healthcare system. This study provides a comprehensive analysis of the current state of the DTx market in Korea, identifies the key challenges impeding its growth, and proposes strategies for overcoming these obstacles. This study utilized a literature review and market analysis approach to examine the latest research, industry reports, and regulatory documents related to DTx. The analysis focused on three primary areas: (1) the current regulatory landscape, (2) technological advancements and challenges, and (3) economic and commercial factors influencing DTx adoption in Korea. A comparative analysis of global regulatory practices was also conducted to identify best practices. The findings revealed that while Korea has made significant strides in supporting DTx development, the market remains in its early stages. The key challenges include underdeveloped regulatory frameworks, issues with data quality and security, and a lack of established reimbursement pathways. We recommend developing tailored regulatory frameworks for DTx, enhancing policy support for small and medium-sized enterprises involved in DTx development, and increasing investments in technological infrastructure. By addressing these challenges, Korea could position itself as a leader in the global DTx market, delivering innovative and effective treatments to enhance patient care and outcomes.

Citations

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Strategies to Increase Patients’ Adherence to Digital Therapeutics for Musculoskeletal Diseases: A Narrative Review
Myeonghwan Bang, Jung Hyun Park
Yonsei Medical Journal.2026; 67(3): 175. CrossRef
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Madhumitha Masilamani, Melvin George
Therapeutic Innovation & Regulatory Science.2026; 60(3): 725. CrossRef
Comparing mental health professionals’ willingness to use digital therapeutics: a cross-national survey in South Korea and Germany
Daa Un Moon, Shinjae Park, Min-Ji Kim, Stefan Gutwinski, Felix Bermpohl, Malek Bajbouj, Hong Jin Jeon, Alva Lütt
BMC Health Services Research.2026;[Epub] CrossRef
Applying a mobile intervention for chronic insomnia in routine care: Study protocol for a multicenter randomized controlled trial
Daa Un Moon, Jeonghun Kim, Jeyoung Hannah Sun, Yujin Lee
Internet Interventions.2025; 41: 100848. CrossRef
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Grace Yuange Zang, Keqin Rao, Jing Wu, Yunhan He, Yi Tang, Leiyu Shi
Journal of Medical Internet Research.2025; 27: e73689. CrossRef
Cluster-based quality analysis of mobile health applications based on health behavior theories
Kyong Hee Park, Jeongwon Heo, Hyewon Jang, Youngju Lee, Seoyeon Kim, Hye-Ryoung Kim
Korean Journal of Health Education and Promotion.2025; 42(3): 53. CrossRef
Perceptions and Acceptance of Digital Mental Health Therapeutics Among Psychiatrists
Dahye Jeon, Mose Hwang, Sungmin Son, Taehui Kim, Kyuho Jeong, Aeri Shim, YeonJoo Nam
Journal of Korean Neuropsychiatric Association.2025; 64(4): 306. CrossRef
Musculoskeletal Digital Therapeutics and Digital Health Rehabilitation: A Global Paradigm Shift in Orthopedic Care
Youn Kyu Lee, Eun-Ji Yoon, Tae Hyung Kim, Jong-Ick Kim, Jong-Ho Kim
Journal of Clinical Medicine.2025; 14(23): 8467. CrossRef
Developing and Evaluating Guidelines to Prevent Overdependence on Digital Therapeutics in Children and Adolescents: Randomized Controlled Trial
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Original articles

Public Health, Environmental, and Occupational Health
Factors associated with musculoskeletal pain in professional dancers, including lapse period of group practice due to the COVID-19 outbreak: repeated-measures analysis: Kiook Baek, Yu-Mi Choi, Joon Sakong; J Yeungnam Med Sci. 2024;41(3):196-206. Published online May 17, 2024; DOI: https://doi.org/10.12701/jyms.2024.00171

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Abstract PDF Supplementary Material: Background
This study investigated the prevalence and associated factors of musculoskeletal pain among professional dancers who experienced a lapse in group practice due to coronavirus disease 2019.
Methods
General characteristics, practice time, region of musculoskeletal pain due to injury using the visual numeric scale (VNS), and causative motion were surveyed among professional dancers. Pain of VNS 0 to 3 was categorized as “no or minor,” 4 to 6 was categorized as “moderate,” and 7 to 10 was categorized as “severe.” The causal motions of musculoskeletal pain were analyzed according to body region. Factors other than motion associated with pain were also analyzed.
Results
In total, 368 participants were included. In the univariate analysis, age and practice time were positively associated with “moderate” pain. Practice time, dance experience, and postural accuracy were positively associated with “severe” pain, as was performing Korean traditional dance. In the multivariable analysis, practice time, group practice, and age were positively associated with pain of VNS 4 to 10, and practice time, group practice, and Korean traditional dance were positively associated with pain of VNS 7 to 10.
Conclusion
Among the factors related to dancer training, practice time, group practice, and dance type affect the occurrence of pain.

Nephrology
Effect of pitavastatin on erythrocyte membrane fatty acid content in patients with chronic kidney disease: two-arm parallel randomized controlled trial: Minna Kim, Seong Eun Kim, Su Mi Lee, Won Suk An; J Yeungnam Med Sci. 2024;41(3):188-195. Published online May 8, 2024; DOI: https://doi.org/10.12701/jyms.2024.00094

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Abstract PDF Supplementary Material

Background
Statins reduce the risk of cardiovascular events in patients with chronic kidney disease (CKD). Although diabetes mellitus (DM) is a reported side effect of statin treatment, some studies have indicated that pitavastatin does not cause DM. The present study investigated the effect of pitavastatin on the fatty acid (FA) content of erythrocyte membranes, which affects the occurrence of DM and cardiovascular diseases. In addition, changes in adiponectin and glycated hemoglobin (HbA1c) levels were evaluated after pitavastatin treatment.
Methods
A total of 45 patients were enrolled, 28 of whom completed the study. Over 24 weeks, 16 patients received 2 mg pitavastatin and 12 patients received 10 mg atorvastatin. Dosages were adjusted after 12 weeks if additional lipid control was required. There were 10 and nine patients with DM in the pitavastatin and atorvastatin groups, respectively. Erythrocyte membrane FAs and adiponectin levels were measured using gas chromatography and enzyme-linked immunosorbent assay, respectively.
Results
In both groups, saturated FAs, palmitic acid, trans-oleic acid, total cholesterol, and low-density lipoprotein cholesterol levels were significantly lower than those at baseline. The arachidonic acid (AA) content in the erythrocyte membrane increased significantly in the pitavastatin group, but adiponectin levels were unaffected. HbA1c levels decreased in patients treated with pitavastatin. No adverse effects were associated with statin treatment.
Conclusion
Pitavastatin treatment in patients with CKD may improve glucose metabolism by altering erythrocyte membrane AA levels. In addition, pitavastatin did not adversely affect glucose control in patients with CKD and DM.

Citations

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The use of hypolipidemic agents in patients with hyperuricemia on the background of type 2 diabetes mellitus and atherosclerosis
A. A. Mosina, Yu. A. Sorokina, L. V. Lovtsova, A. L. Urakov
Meditsinskiy sovet = Medical Council.2025; (6): 265. CrossRef

Psychiatry and Mental Health
The characteristics of elderly suicidal attempters in the emergency department in Korea: a retrospective study: Ji-Seon Jang, Wan-Seok Seo, Bon-Hoon Koo, Hey-Geum Kim, Seok-Ho Yun, So-Hey Jo, Dae-Seok Bai, Young-Gyo Kim, Eun-Jin Cheon; J Yeungnam Med Sci. 2024;41(1):30-38. Published online December 29, 2023; DOI: https://doi.org/10.12701/jyms.2023.01004

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Abstract PDF Supplementary Material

Background
Although Korea ranks first in the suicide rate of elderly individuals, there is limited research on those who attempt suicide, with preventive measures largely based on population-based studies. We compared the demographic and clinical characteristics of elderly individuals who attempted suicide with those of younger adults who visited the emergency department after suicide attempts and identified the factors associated with lethality in the former group.
Methods
Individuals who visited the emergency department after a suicide attempt from April 1, 2017, to January 31, 2020, were included. Participants were classified into two groups according to age (elderly, ≥65 years; adult, 18–64 years). Among the 779 adult patients, 123 were elderly. We conducted a chi-square test to compare the demographic and clinical features between these groups and a logistic regression analysis to identify the risk factors for lethality in the elderly group.
Results
Most elderly participants were men, with no prior psychiatric history or suicide attempts, and had a higher prevalence of underlying medical conditions and attributed their attempts to physical illnesses. Being sober and planning suicide occurred more frequently in this group. In the elderly group, factors that increased the mortality rate were biological male sex (p<0.05), being accompanied by family members (p<0.05), and poisoning as a suicide method (p<0.01).
Conclusion
Suicide attempts in elderly individuals have different characteristics from those in younger adults and are associated with physical illness. Suicides in the former group are unpredictable, deliberate, and fatal. Therefore, tailored prevention and intervention strategies addressing the characteristics of those who are elderly and attempt suicide are required.

Citations

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Effectiveness of the Loving Life TokTok 65+ Program for Suicide Prevention Education for the Elderly
Jae Sang Lee, Eun Seok Kim, Kkotdawoon Han, Su Kyong Song, Young-Eun Jung
Journal of Korean Neuropsychiatric Association.2026; 65(1): 44. CrossRef
Poisoning in the elderly is increasing rapidly and is more severe than younger patients
Geoffrey K. Isbister, Michael A. Downes, Kylie McArdle, Shane Jenkins, Caitlyn Lovett, Ingrid Berling
Clinical Toxicology.2026; : 1. CrossRef
Analysis of suicide cases in post-mortem examination files of the Department of Forensic Medicine at the Medical University of Białystok in the years 2016-2021 = Analiza samobójstw w materiale sekcyjnym Zakładu Medycyny Sądowej Uniwersytetu Medycznego w B
Anna Francuziak, Paulina Kulasza, Kinga Kozłowska, Julia Janica, Urszula Cwalina, Anna Niemcunowicz-Janica, Michał Szeremeta
Archives of Forensic Medicine and Criminology.2024; 74(2): 106. CrossRef

Physical therapy, Sports Therapy, and Rehabilitation
Incidence and risk factors of deep vein thrombosis and pulmonary thromboembolism after spinal cord disease at a rehabilitation unit: a retrospective study: Yoonhee Kim, Minjae Jeong, Myung Woo Park, Hyun Iee Shin, Byung Chan Lee, Du Hwan Kim; J Yeungnam Med Sci. 2023;40(Suppl):S56-S64. Published online September 20, 2023; DOI: https://doi.org/10.12701/jyms.2023.00689

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Abstract PDF

Background
Deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) are major complications of spinal cord disease. However, studies of their incidence in Korean patients are limited. Thus, this study investigated the incidence and risk factors of DVT and PTE in Korean patients with spinal cord disease.
Methods
We retrospectively analyzed the medical records of 271 patients with spinal cord disease who were admitted to a rehabilitation unit within 3 months of disease onset at a tertiary hospital. The presence of DVT and PTE was mainly determined using Doppler ultrasonography and chest embolism computed tomography. Risk factor analysis included variables such as sex, age, obesity, completeness of motor paralysis, neurological level of injury, cause of injury, lower extremity fracture, active cancer, and functional ambulation category (FAC) score.
Results
The incidences of DVT and PTE in the patients with spinal cord disease were both 6.3%. Risk factor analysis revealed that age of ≥65 years (p=0.031) and FAC score of ≤1 (p=0.023) were significantly associated with DVT development. Traumatic cause of injury (p=0.028) and DVT (p<0.001) were significant risk factors of PTE.
Conclusion
Patients with spinal cord disease developed DVT and PTE within 3 months of disease onset with incidence rates of 6.3% and 6.3%, respectively. Age of ≥65 years and an FAC of score ≤1 were risk factors for DVT. Traumatic cause of injury and DVT were risk factors for PTE. However, given the inconsistent results of previous studies, the risk factors for DVT and PTE remain inconclusive. Therefore, early screening for DVT and PTE should be performed in patients with acute-to-subacute spinal cord disease regardless of the presence or absence of these risk factors.

Citations

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Safety and efficacy of botulinum toxin in Human T-Lymphotropic Virus-1-Associated Myelopathy/Tropical Spastic Paraparesis: A randomized clinical trial
Matheus Sales, Giselle Barbara De Almeida Scaldafferri, Matheus Henrique Almeida, Vítor Melo, Tatiana Dias, Paulo Canas Rodrigues, Ailton Melo, Nildo Manoel Da Silva Ribeiro
The Journal of Spinal Cord Medicine.2026; : 1. CrossRef
Assessing the Incidence and Risk Factors of Deep Vein Thrombosis in Traumatic Spinal Cord Injury Patients at Tertiary Care Hospital in India
Sushil Chugh, Dhananjay B. Alagundagi, Shwetha Shetty Kalladka, Prakash Patil, Kurian Zachariah
Indian Journal of Physical Medicine and Rehabilitation.2025; 35(3): 191. CrossRef
Trends and Impact of Pharmacological VTE Prophylaxis Timing for Traumatic Cervical Spinal Cord Injury Across North American Trauma Centers
Ahmad Essa, Armaan K. Malhotra, Husain Shakil, James P. Byrne, Jetan Badhiwala, Avery B. Nathens, Tej D. Azad, Eva Y. Yuan, Yingshi He, Andrew S. Jack, Francois Mathieu, Jefferson R. Wilson, Christopher D. Witiw
Journal of Bone and Joint Surgery.2025;[Epub] CrossRef
Associations of RBC counts and incidence of DVT in patients with spinal cord injury: a five year observational retrospective study
Zhang Jinlong, Wang Cheng, He Chengqi
Journal of Orthopaedic Surgery and Research.2024;[Epub] CrossRef
Coagulation parameters correlate to venous thromboembolism occurrence during the perioperative period in patients with spinal fractures
Yong Jiao, Xiaohong Mu
Journal of Orthopaedic Surgery and Research.2023;[Epub] CrossRef

Gastroenterology and Hepatology
Association between total body muscle percentage and prevalence of non-alcoholic fatty liver disease in Korean adults findings from an 18-year follow-up: a prospective cohort study: Byoung Chan Ahn, Chul Yong Park, Jung Hee Hong, Ki Ook Baek; J Yeungnam Med Sci. 2023;40(Suppl):S47-S55. Published online August 29, 2023; DOI: https://doi.org/10.12701/jyms.2023.00605

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Abstract PDF Supplementary Material: Background
This study aimed to elucidate the association between total lean muscle mass and the incidence of non-alcoholic fatty liver disease (NAFLD) in the adult Korean population.
Methods
Utilizing data derived from the 18-year prospective cohort of the Korean Genome and Epidemiology Study, NAFLD was diagnosed via the hepatic steatosis index with an established cutoff value of 36. Lean muscle mass was assessed via bioelectrical impedance analysis and subsequently divided into tertiles. A generalized mixed model with a logit link was employed for repeated measures data analysis, accounting for potential confounders.
Results
Analysis encompassed 7,794 participants yielding 49,177 measurements. The findings revealed a markedly increased incidence of NAFLD in the lower tertiles of muscle mass, specifically, tertile 1 (odds ratio [OR], 20.65; 95% confidence interval [CI], 9.66–44.11) and tertile 2 (OR, 4.57; 95% CI, 2.11–9.91), in comparison to tertile 3. Age-dependent decreases in the OR were observed within the tertile 1 group, with ORs of 10.12 at age of 40 years and 4.96 at age of 80 years. Moreover, each 1%-point increment in total muscle mass corresponded with an estimated OR of 0.87 (95% CI, 0.82–0.93) for NAFLD resolution.
Conclusions
The study demonstrates a significant association between total muscle mass and NAFLD prevalence among Korean adults. Given the potential endocrine role of muscle mass in NAFLD pathogenesis, interventions aimed at enhancing muscle mass might serve as an effective public health strategy for mitigating NAFLD prevalence.

Case report

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

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

Original articles

Dentistry
Evaluation of periodontal status in women with polycystic ovary syndrome versus healthy women: a cross-sectional study: Sandhya Pavankumar, Pavan Kumar Yellarthi, Sandeep JN, Ramanarayana Boyapati, Trinath Kishore Damera, Naveen Vital Kumar G; J Yeungnam Med Sci. 2023;40(Suppl):S17-S22. Published online May 8, 2023; DOI: https://doi.org/10.12701/jyms.2023.00143

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Abstract PDF

Background
Polycystic ovary syndrome (PCOS) affects approximately 4% to 12% of females of reproductive age. Previous studies have shown an association between systemic and periodontal diseases. This study aimed to compare the prevalence of periodontal disease in women with PCOS and healthy women.
Methods
A total of 196 women aged 17 to 45 years were included in this study. Oral hygiene index-simplified (OHI-S), gingival index (GI), community periodontal index (CPI), and loss of attachment (LA) were assessed. Individuals who smoked, were pregnant, had any systemic disease (such as type 1 or type 2 diabetes mellitus, cardiovascular disease, malignancy, osteoporosis, and thyroid dysfunction), had a history of systemic antibiotic use in the past three months, or received any periodontal intervention in the past 6 months of screening were excluded. Student t-test was used to analyze the data. A p-value of <0.05 was considered statistically significant.
Results
Despite similar OHI-S scores (p=0.972) in the two groups, women with PCOS had significantly higher GI, CPI, and LA scores than healthy women (p<0.001).
Conclusion
Periodontal disease was more prevalent in women with PCOS than in healthy women. This finding may be due to the synergistic effects of PCOS and periodontitis on proinflammatory cytokines. PCOS may have an effect on periodontal disease, and vice versa. Hence, education on periodontal health and early detection and intervention for periodontal diseases is of paramount importance in patients with PCOS.

Citations

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A Potential Link Between Oral Microbiota and Female Reproductive Health
Justyna Marcickiewicz, Małgorzata Jamka, Jarosław Walkowiak
Microorganisms.2025; 13(3): 619. CrossRef
The Association Between Periodontal Disease and Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis
Vincenzo Bitonti, Tiziana Perri, Lorenzo Cigni, Domenico Familiari, Giuseppe Vazzana, Rocco Franco
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Nephrology
Cortical thickness of the rostral anterior cingulate gyrus is associated with frailty in patients with end-stage renal disease undergoing hemodialysis in Korea: a cross-sectional study: Sang Hyun Jung, Jong Soo Oh, So-Young Lee, Hye Yun Jeong; J Yeungnam Med Sci. 2023;40(4):381-387. Published online March 24, 2023; DOI: https://doi.org/10.12701/jyms.2022.00941

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Abstract PDF

Background
Frailty is defined as a condition of being weak and delicate, and it represents a state of high vulnerability to adverse health outcomes. Recent studies have suggested that the cingulate gyrus is associated with frailty in the elderly population. However, few imaging studies have explored the relationship between frailty and the cingulate gyrus in patients with end-stage renal disease (ESRD) undergoing hemodialysis.
Methods
Eighteen right-handed patients with ESRD undergoing hemodialysis were enrolled in the study. We used the FreeSurfer software package to estimate the cortical thickness of the regions of interest, including the rostral anterior, caudal anterior, isthmus, and posterior cingulate gyri. The Beck Depression Inventory, Beck Anxiety Inventory, and laboratory tests were also conducted.
Results
The cortical thickness of the right rostral anterior cingulate gyrus (ACG) was significantly correlated with the Fried frailty index, age, and creatinine level. Multiple regression analysis indicated that the cortical thickness of the right rostral ACG was associated with frailty after controlling for age and creatinine level.
Conclusion
Our results indicate that the cortical thickness of the rostral ACG may be associated with frailty in patients with ESRD on hemodialysis and that the rostral ACG may play a role in the frailty mechanism of this population.

Citations

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The impact of balance exercise on brain age and brain morphometry: insights from MRI analysis
Varima Narula, Denise Taylor, Ruth McLaren, Rachael L. Taylor, Susan Mahon, Paul F. Smith, Shikha Chaudhary, Roger W. Winton, Justin Fernandez, Vickie Shim, Alan Wang
Aging Clinical and Experimental Research.2026;[Epub] CrossRef

Case report

Neurology
Intravesical bacillus Calmette–Guérin-induced myopathy presenting as rhabdomyolysis: a case report: Chae Hun Lee, Byeong Joo Choi, Jung Hun Kim, Tae Woong Yang, Gi Jeong Kim, Ha Young Shin, Se Hoon Kim, Seung Woo Kim; J Yeungnam Med Sci. 2023;40(4):430-434. Published online February 13, 2023; DOI: https://doi.org/10.12701/jyms.2022.00850

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Abstract PDF: Intravesical bacillus Calmette–Guérin (BCG) instillation is an adjuvant treatment for non–muscle-invasive urinary bladder cancer. Although most complications associated with BCG immunotherapy are mild and self-limiting, rare albeit serious complications have been reported. Only a few cases of BCG-related rhabdomyolysis have been reported. In this study, we present the case of a 72-year-old woman who developed severe weakness and hyperCKemia following intravesical BCG instillation. A muscle biopsy was performed, and a diagnosis of drug-induced myopathy was made.

Original article

Cardiology and Cardiovascular Medicine
Outcomes after repair of complete atrioventricular canal with a modified single-patch technique: a retrospective study: George Samanidis, Konstantinos Kostopanagiotou, Meletios Kanakis, Georgios Kourelis, Kyriaki Kolovou, Georgios Vagenakis, Dimitrios Bobos, Nicholas Giannopoulos; J Yeungnam Med Sci. 2023;40(2):187-192. Published online February 1, 2023; DOI: https://doi.org/10.12701/jyms.2022.00759

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Abstract PDF: Background
This study aimed to present the short- and midterm outcomes after complete atrioventricular canal defect (CAVC) repair using a single-patch technique.
Methods
This study included 30 children who underwent surgical correction of the CAVC using a single-patch technique.
Results
The median age of the patients was 5.7 months (interquartile range [IQR], 5.0–7.5 months), and 23 patients (76.7%) had type A CAVC. Fourteen patients (46.7%) were female and 17 (56.7%) had been diagnosed with Down syndrome. The in-hospital mortality rate was 0%. No deaths were observed during a median follow-up of 4 years (IQR, 3.5–5.0 years). Patients without Down syndrome were associated with late moderate mitral regurgitation (MR) (p=0.02). Late MR less than moderate degree was observed in 96.6%, 78.5%, and 50% of patients after 2, 4, and 5 years of follow-up, respectively, while late tricuspid valve regurgitation less than moderate degree was observed in 96.7%, 85.9%, and 59.0% of patients after 2, 4, and 6 years of follow-up, respectively. After a median follow-up of 4 years, only one patient had required surgical repair of a left ventricular outflow tract obstruction, which occurred 26 months after the first operation. Multivariable logistic regression analysis adjusted for the type of CAVC, sex, Down syndrome, age, and weight revealed that the absence of Down syndrome was a risk factor for late moderate MR (MR-2) (odds ratio, 0.05; 95% confidence interval, 0.006–0.50; p=0.01).
Conclusion
A single-patch technique for CAVC surgical repair is a safe method with acceptable short- and midterm results.

Review articles

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

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Abstract PDF

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

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

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Abstract PDF

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

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Cureus.2023;[Epub] CrossRef

Focused Review article

Neurology
Pain in amyotrophic lateral sclerosis: a narrative review: Soyoung Kwak; J Yeungnam Med Sci. 2022;39(3):181-189. Published online June 8, 2022; DOI: https://doi.org/10.12701/jyms.2022.00332

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Abstract PDF

Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative condition characterized by loss of motor neurons, resulting in motor weakness of the limbs and/or bulbar muscles. Pain is a prevalent but neglected symptom of ALS, and it has a significant negative impact on the quality of life of patients and their caregivers. This review outlines the epidemiology, clinical characteristics, underlying mechanisms, and management strategies of pain in ALS to improve clinical practice and patient outcomes related to pain. Pain is a prevalent symptom among patients with ALS, with a variable reported prevalence. It may occur at any stage of the disease and can involve any part of the body without a specific pattern. Primary pain includes neuropathic pain and pain from spasticity or cramps, while secondary pain is mainly nociceptive, occurring with the progression of muscle weakness and atrophy, prolonged immobility causing degenerative changes in joints and connective tissue, and long-term home mechanical ventilation. Prior to treatment, the exact patterns and causes of pain must first be identified, and the treatment should be tailored to each patient. Treatment options can be classified into pharmacological treatments, including nonsteroidal anti-inflammatory drugs, antiepileptic drugs, drugs for cramps or spasticity, and opioid; and nonpharmacological treatments, including positioning, splints, joint injections, and physical therapy. The development of standardized and specific assessment tools for pain-specific to ALS is required, as are further studies on treatments to reduce pain, diminish suffering, and improve the quality of life of patients with ALS.

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Clinical parameters affecting the course of amyotrophic lateral sclerosis: a longitudinal analysis of the Greek registry for amyotrophic lateral sclerosis (ALS-GR)
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Sagar S. Bhovare, Akhataribano S. Sayyad
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Dilip Dhakal, Congzhou Chen, Bo Zhang, Guanqiao Li
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Qianping Jiang, Dan Yang, Rui Jiang, Shilei Wan, Miao Wu, Dandan Xu, Jing Zhou
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Katie Stenson, T. E. Fecteau, L. O’Callaghan, P. Bryden, J. Mellor, J. Wright, L. Earl, O. Thomas, H. Iqbal, S. Barlow, S. Parvanta
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Amyotrophic Lateral Sclerosis and Pain: A Narrative Review from Pain Assessment to Therapy
Vincenzo Pota, Pasquale Sansone, Sara De Sarno, Caterina Aurilio, Francesco Coppolino, Manlio Barbarisi, Francesco Barbato, Marco Fiore, Gianluigi Cosenza, Maria Beatrice Passavanti, Maria Caterina Pace, Enzo Emanuele
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Bogdan Bjelica, Maj-Britt Bartels, Jasper Hesebeck-Brinckmann, Susanne Petri
Journal of Neurology.2024; 271(7): 3953. CrossRef
Perceived Pain in People Living with Amyotrophic Lateral Sclerosis—A Scoping Review
Debora Rosa, Laura Ingrande, Ilaria Marcomini, Andrea Poliani, Giulia Villa, Martina Sodano, Duilio Fiorenzo Manara
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Palliative Care in Amyotrophic Lateral Sclerosis
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The blind spot and challenges in pain management
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Case reports

Emergency and Critical Care Medicine
Prolonged oral sildenafil use-induced Mondor disease: a case report: Han Sol Chung, You Ho Mun; J Yeungnam Med Sci. 2022;39(3):262-265. Published online May 24, 2022; DOI: https://doi.org/10.12701/jyms.2022.00220

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Abstract PDF

Penile Mondor disease (MD) is a palpable, painful, subcutaneous induration caused by superficial dorsal penile vein thrombosis. We report a case of penile MD that was suspected to be related to prolonged oral sildenafil use. A 46-year-old man visited our emergency department with sustained penile pain and swelling that began 7 hours after sexual intercourse. He had used oral sildenafil intermittently for 11 years and engaged in sexual intercourse the previous night after taking sildenafil. Examination revealed no evidence of intercourse-related trauma to the genital area or an increase in penile skin temperature. However, penile swelling and tenderness over the protruding dorsal penile vein were noted. A color Doppler ultrasound examination was performed immediately, which showed hyperechoic thrombosis in the right superficial dorsal penile vein that was dilated, with soft tissue swelling and no detectable flow signal in the thrombotic lesion. The patient was diagnosed as having penile MD. The patient was treated conservatively. Some reports have indicated the involvement of sildenafil in thrombogenesis. Physicians should be aware that prolonged oral sildenafil use may be associated with penile MD.

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Management of Penile Mondor’s disease: insights from a scoping review
Alessio Papaveri, Angelo Cafarelli, Federico Falsetti, Luca Spinozzi, Davide Ciavarella, Enrico Sicignano, Valentina Maurizi, Michele Marchioni, Luigi Schips, Daniele Castellani, Vineet Gauhar, Carlo Giulioni
Sexual Medicine Reviews.2026;[Epub] CrossRef
Penile superficial dorsal vein thrombophlebitis following prolonged sexual activity
Ahmed Adam Osman, Hanan HassanHirei, Abdulkadir Isse Mohamed, Shuayb Moallim Ali, Amal Naleye Ali, Abdikarim Hussein Mohamed
Radiology Case Reports.2024; 19(12): 6161. CrossRef
A case with Penile Mondor’s disease
Hülya Cenk, Gülbahar Saraç, İrem Mantar Yanatma
TURKDERM.2023; : 151. CrossRef

Obstetrics, Gynecology, and Reproductive Medicine
Laparoscopic excision and repair of a cesarean scar pregnancy in a woman with uterine didelphys: a case report: Seong-Eon Park, Ji-Eun Ryu, Tae-Kyu Jang; J Yeungnam Med Sci. 2023;40(2):202-206. Published online May 16, 2022; DOI: https://doi.org/10.12701/jyms.2022.00115

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1 Crossref

Abstract PDF

Cesarean scar pregnancy (CSP) is a rare complication that occurs in less than 1% of ectopic pregnancies, and uterine didelphys is one of the rarest uterine forms. We report a successful laparoscopic excision and repair of CSP in a woman with uterine didelphys and a double vagina. A 34-year-old gravida one, para one woman with a history of low transverse cesarean section presented to our hospital with a suspected CSP. She was confirmed to have uterine didelphys with a double vagina during an infertility examination 7 years earlier. Magnetic resonance imaging showed a 2.5-cm gestational sac-like cystic lesion in the lower segment of the right uterus at the cesarean scar. We decided to perform a laparoscopic approach after informing the patient of the surgical procedure. The lower segment of the previous cesarean site was excised with monopolar diathermy to minimize bleeding. We identified the gestational sac in the lower segment of the right uterus, which was evacuated using spoon forceps. The myometrium and serosa of the uterus were sutured layer-by-layer using synthetic absorbable sutures. No remnant gestational tissue was visible on follow-up ultrasonography one month after the surgery. This laparoscopic approach to CSP in a woman with uterine didelphys is an effective and safe method of treatment. In women with uterine anomalies, it is important to confirm the exact location of the gestational sac by preoperative imaging for successful surgery.

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Clinical study of two reversible arterial blockade methods in the treatment of scar pregnancy under combined hysterolaparoscopy
Wei Wei
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Original articles

Dentistry
Effect of nonsurgical periodontal therapy and smoking status on hematological variables related to anemia of chronic disease in chronic periodontitis patient: a case-control study: Sangita Show, Somen Bagchi, Arka Kanti Dey, Ramanarayana Boyapati, Pritish Chandra Pal, Kanikanti Siva Tejaswi; J Yeungnam Med Sci. 2022;39(3):244-249. Published online May 16, 2022; DOI: https://doi.org/10.12701/jyms.2022.00045

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105 Download
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Abstract PDF: Background
Chronic infectious, inflammatory, or neoplastic disorders are associated with anemia of chronic disease. Chronic inflammatory diseases such as periodontitis may contribute to masked anemia, especially in smokers. This study was aimed at verifying and comparing the efficacy of nonsurgical periodontal therapy (NSPT) for improving anemia among chronic periodontitis patients with and without the habit of smoking.
Methods
Thirty systemically healthy individuals with chronic periodontitis were divided into two groups of 15 each, smokers (group A) and nonsmokers (group B). The groups were compared based on hematological parameters such as serum erythropoietin (SE) and serum ferritin (SF) levels at baseline and 3 months after NSPT for anemia evaluation.
Results
The baseline SE levels in groups A and B were 11.84 and 15.19 mIU/mL (p=0.031), respectively; the corresponding levels at 3 months after NSPT were 13.00 and 17.74 mIU/mL (p=0.022). The baseline SF levels in groups A and B were 95.49 and 44.86 ng/mL (p=0.018), respectively; the corresponding levels at 3 months after NSPT were 77.06 and 39.05 ng/mL (p=0.009). Group B showed a significant increase and decrease in the SE and SF levels, respectively, at 3 months after NSPT (p=0.035 and p=0.039, respectively), whereas group A showed insignificant changes (p=0.253 and p=0.618, respectively).
Conclusion
NSPT led to an improvement in anemia among chronic periodontitis patients. However, the improvement is less in smokers compared to that in nonsmokers. Furthermore, SF and SE levels might serve as effective biomarkers for assessing anemia in smokers and nonsmokers with chronic periodontitis.

Gastroenterology and Hepatology
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

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Oral administration of nanozyme-armed probiotic Escherichia coli Nissle 1917 with ROS scavenging for inflammatory bowel disease therapy
Tiantian Cui, Bing Li, Zhaoyang Lou, Kai Yang, Kaijin Yan, Danhong Ding, Hong Ge
Chemical Engineering Journal.2025; 519: 164949. CrossRef
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

Review article

Anatomy
Optogenetic neuromodulation with gamma oscillation as a new strategy for Alzheimer disease: a narrative review: Haneol Ko, Sang-Pil Yoon; J Yeungnam Med Sci. 2022;39(4):269-277. Published online February 14, 2022; DOI: https://doi.org/10.12701/jyms.2021.01683

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Abstract PDF

The amyloid hypothesis has been considered a major explanation of the pathogenesis of Alzheimer disease. However, failure of phase III clinical trials with anti-amyloid-beta monoclonal antibodies reveals the need for other therapeutic approaches to treat Alzheimer disease. Compared to its relatively short history, optogenetics has developed considerably. The expression of microbial opsins in cells using genetic engineering allows specific control of cell signals or molecules. The application of optogenetics to Alzheimer disease research or clinical approaches is increasing. When applied with gamma entrainment, optogenetic neuromodulation can improve Alzheimer disease symptoms. Although safety problems exist with optogenetics such as the use of viral vectors, this technique has great potential for use in Alzheimer disease. In this paper, we review the historical applications of optogenetic neuromodulation with gamma entrainment to investigate the mechanisms involved in Alzheimer disease and potential therapeutic strategies.

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Acta Optica Sinica.2025; 45(9): 0900001. CrossRef
γ neuromodulations: unraveling biomarkers for neurological and psychiatric disorders
Zhong-Peng Dai, Qiang Wen, Ping Wu, Yan-Ni Zhang, Cai-Lian Fang, Meng-Yuan Dai, Hong-Liang Zhou, Huan Wang, Hao Tang, Si-Qi Zhang, Xiao-Kun Li, Jian-Song Ji, Liu-Xi Chu, Zhou-Guang Wang
Military Medical Research.2025;[Epub] CrossRef
Modulating Proteasome Function with Polyphenol Metabolites: A Promising Therapeutic Avenue for Alzheimer's Disease
Nyerovwo Charity Okei
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A comprehensive review of optical fiber technologies in optogenetics and their prospective developments in future clinical therapies
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Optics & Laser Technology.2024; 179: 111332. CrossRef
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Original articles

Pediatrics, Perinatology, and Child Health
Increase in blood glucose level and incidence of diabetic ketoacidosis in children with type 1 diabetes mellitus in the Daegu-Gyeongbuk area during the coronavirus disease 2019 (COVID-19) pandemic: a retrospective cross-sectional study: Mi Seon Lee, Rosie Lee, Cheol Woo Ko, Jung Eun Moon; J Yeungnam Med Sci. 2022;39(1):46-52. Published online August 26, 2021; DOI: https://doi.org/10.12701/yujm.2021.01221

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Abstract PDF

Background
The coronavirus disease 2019 (COVID-19) outbreak in the Daegu-Gyeongbuk area in 2020 has caused difficulties in the daily life and hospital care of children with type 1 diabetes mellitus (T1DM). We detected an increase in blood sugar levels in these children and the number of patients hospitalized with more severe diabetic ketoacidosis (DKA) compared to those before COVID-19.
Methods
This single-center study was conducted at Kyungpook National University Children’s Hospital. The following patient groups were included; 45 returning patients diagnosed with T1DM and undergoing insulin treatment for more than 2 years and 20 patients newly diagnosed with T1DM before and after COVID-19 were selected by age matching. Returning patients before and after the outbreak were selected, and changes in hemoglobin A1c (HbA1c) levels were retrospectively reviewed. The HbA1c levels and severity of symptoms in newly diagnosed patients during hospitalization were examined.
Results
HbA1c levels in returning patients with T1DM were significantly increased after COVID-19 (before, 7.70%±1.38% vs. after, 8.30%±2.05%; p=0.012). There were 10 and 10 newly diagnosed patients before and after COVID-19, respectively. The proportion of patients with drowsiness and dyspnea at the time of admission was higher after COVID-19 than before (before, 2 of 10 vs. after, 4 of 10). The HbA1c levels were higher in newly diagnosed patients hospitalized after COVID-19 than before (before, 11.15% vs. after, 13.60%; p=0.036).
Conclusion
Due to COVID-19 in the Daegu-Gyeongbuk area, there was an increase in blood glucose levels in children with T1DM and in the incidence of severe DKA in newly diagnosed diabetes mellitus patients.

Citations

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Commentary on "Incidence rate and characteristics of newly diagnosed type 1 diabetes in a Vietnamese tertiary pediatric center: challenges in early detection"
Young Suk Shim
Annals of Pediatric Endocrinology & Metabolism.2025; 30(5): 227. CrossRef
Incidences of newly diagnosed childhood diabetes and onset severity: a multicenter regional study in Thailand over two decades and during the COVID-19 pandemic
Pattharaporn Sinthuprasith, Karn Wejaphikul, Dolrutai Puttawong, Hataitip Tang-Ngam, Naphatsorn Sanrattana, Kevalee Unachak, Prapai Dejkhamron
Journal of Pediatric Endocrinology and Metabolism.2024; 37(6): 487. CrossRef
COVID-19 infection and inactivated vaccination: Impacts on clinical and immunological profiles in Chinese children with type 1 diabetes
Zhen-Ran Xu, Li Xi, Jing Wu, Jin-Wen Ni, Fei-Hong Luo, Miao-Ying Zhang
World Journal of Diabetes.2024; 15(12): 2276. CrossRef
Incidence of diabetic ketoacidosis during COVID-19 pandemic: a meta-analysis of 124,597 children with diabetes
Anas Elgenidy, Ahmed K. Awad, Khaled Saad, Mostafa Atef, Hatem Helmy El-Leithy, Ahmed A. Obiedallah, Emad M. Hammad, Faisal-Alkhateeb Ahmad, Ahmad M. Ali, Hamad Ghaleb Dailah, Amira Elhoufey, Samaher Fathy Taha
Pediatric Research.2023; 93(5): 1149. CrossRef
Comments on Rahmati et al., The global impact of COVID‐19 pandemic on the incidence of pediatric new‐onset type 1 diabetes and ketoacidosis: A systematic review and meta‐analysis. J Med Virol. 2022; 1‐16 (doi: 10.1002/jmv.27996)
Joachim Rosenbauer, Anna Stahl‐Pehe, Sabrina Schlesinger, Oliver Kuß
Journal of Medical Virology.2023;[Epub] CrossRef
Impact of the COVID-19 Pandemic on Children and Adolescents with New-Onset Type 1 Diabetes
Clemens Kamrath, Alexander J. Eckert, Reinhard W. Holl, Joachim Rosenbauer, Andrea Scaramuzza
Pediatric Diabetes.2023; 2023: 1. CrossRef
Difficulties in differential diagnosis of carbohydrate metabolism disorders in patients with coronavirus infection in real clinical practice. Case report
Tatyana N. Markova, Mukhamed S. Stas, Valentina V. Chibisova, Anastasia A. Anchutina
Consilium Medicum.2023; 25(4): 241. CrossRef
Endocrinological Involvement in Children and Adolescents Affected by COVID-19: A Narrative Review
Valeria Calcaterra, Veronica Maria Tagi, Raffaella De Santis, Andrea Biuso, Silvia Taranto, Enza D’Auria, Gianvincenzo Zuccotti
Journal of Clinical Medicine.2023; 12(16): 5248. CrossRef
Glycemic control and complications of type 2 diabetes mellitus in children and adolescents during the COVID-19 outbreak
Kyeong Eun Oh, Yu Jin Kim, Ye Rim Oh, Eungu Kang, Hyo-Kyoung Nam, Young-Jun Rhie, Kee-Hyoung Lee
Annals of Pediatric Endocrinology & Metabolism.2023; 28(4): 275. CrossRef
Incidence of Diabetic Ketoacidosis Among Pediatrics With Type 1 Diabetes Prior to and During COVID-19 Pandemic: A Meta-Analysis of Observational Studies
Osamah M. Alfayez, Kholood S. Aldmasi, Nada H. Alruwais, Nouf M. Bin Awad, Majed S. Al Yami, Omar A. Almohammed, Abdulaali R. Almutairi
Frontiers in Endocrinology.2022;[Epub] CrossRef
Comparison of Initial Presentation of Pediatric Diabetes Before and During the Coronavirus Disease 2019 Pandemic Era
Yoonha Lee, Minseung Kim, Kyeongeun Oh, Eungu Kang, Young-Jun Rhie, Jieun Lee, Yong Hee Hong, Young-Lim Shin, Jae Hyun Kim
Journal of Korean Medical Science.2022;[Epub] CrossRef
The global impact of COVID‐19 pandemic on the incidence of pediatric new‐onset type 1 diabetes and ketoacidosis: A systematic review and meta‐analysis
Masoud Rahmati, Maryam Keshvari, Shahrzad Mirnasuri, Dong K. Yon, Seung W. Lee, Jae Il Shin, Lee Smith
Journal of Medical Virology.2022; 94(11): 5112. CrossRef
COVID-19 and diabetes: What do we know so far?
Prakash Gangadaran, Himabindu Padinjarathil, Shri Hari Subhashri Rajendran, Manasi P Jogalekar, Chae Moon Hong, Baladhandapani Aruchamy, Uma Maheswari Rajendran, Sridharan Gurunagarajan, Anand Krishnan, Prasanna Ramani, Kavimani Subramanian
Experimental Biology and Medicine.2022; 247(15): 1330. CrossRef
Stress hyperglycemia, Diabetes mellitus and COVID-19 infection: The impact on newly diagnosed type 1 diabetes
Ioanna Farakla, Theano Lagousi, Michael Miligkos, Nicolas C. Nicolaides, Ioannis-Anargyros Vasilakis, Maria Mpinou, Maria Dolianiti, Elina Katechaki, Anilia Taliou, Vasiliki Spoulou, Christina Kanaka-Gantenbein
Frontiers in Clinical Diabetes and Healthcare.2022;[Epub] CrossRef

Oncology and Cancer Research
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.

Case reports

Immunology and Allergy
Idiopathic multicentric Castleman disease presenting progressive reticular honeycomb infiltration of lung and immunoglobulin G and immunoglobulin G4 dominant hypergammaglobulinemia: a case report: Hyun-Je Kim, Young-Hoon Hong; J Yeungnam Med Sci. 2022;39(2):153-160. Published online July 5, 2021; DOI: https://doi.org/10.12701/yujm.2021.01039

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Abstract PDF

Multicentric Castleman disease (MCD) is an uncommon systemic lymphoproliferative disorder that may cause multiple organ damage. Castleman disease-associated diffuse parenchymal lung disease (DPLD) has not been well studied. A 32-year-old man was referred to our hospital for progressive generalized weakness, light-headedness, and dyspnea on exertion for more than one year. Laboratory evaluations showed profound anemia, an elevated erythrocyte sedimentation rate, and an increased C-reactive protein level with polyclonal hypergammaglobulinemia. Chest radiography, computed tomography (CT), and positron emission tomography-CT scan demonstrated diffuse lung infiltration with multiple cystic lesions and multiple lymphadenopathy. In addition to these clinical laboratory findings, bone marrow, lung, and lymph node biopsies confirmed the diagnosis of idiopathic MCD (iMCD). Siltuximab, an interleukin-6 inhibitor, and glucocorticoid therapy were initiated. The patient has been tolerating the treatment well and had no disease progression or any complications in 4 years. Herein, we report this case of human herpesvirus-8-negative iMCD-associated DPLD accompanied by multiple cystic lesions, multiple lymphadenopathy, and polyclonal hypergammaglobulinemia with elevated immunoglobulin G (IgG) and IgG4 levels. We recommend a close evaluation of MCD in cases of DPLD with hypergammaglobulinemia.

Citations

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Striking effectiveness of siltuximab-based treatment in refractory idiopathic multicentric Castleman disease resembling IgG4-related disease
Xing Gong, Weiwei Yan, Feng Zhang, Dongdong Zhang
Journal of Chemotherapy.2025; : 1. CrossRef

Pediatrics, Perinatology, and Child Health
Successful treatment with vedolizumab in an adolescent with Crohn disease who had developed active pulmonary tuberculosis while receiving infliximab: Sujin Choi, Bong Seok Choi, Byung-Ho Choe, Ben Kang; Yeungnam Univ J Med. 2021;38(3):251-257. Published online February 19, 2021; DOI: https://doi.org/10.12701/yujm.2020.00878

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Abstract PDF

Vedolizumab (VDZ) has been approved for the treatment of inflammatory bowel diseases (IBDs) in patients aged ≥18 years. We report a case of a pediatric patient with Crohn disease (CD) who was successfully treated with VDZ. A 16-year-old female developed severe active pulmonary tuberculosis (TB) during treatment with infliximab (IFX). IFX was stopped, and TB treatment was started. After a 6-month regimen of standard TB medication, her pulmonary TB was cured; however, gastrointestinal symptoms developed. Due to the concern of the patient and parents regarding TB reactivation on restarting treatment with IFX, VDZ was started off-label. After the second dose of VDZ, the patient was in clinical remission and her remission was continuously sustained. Ileocolonoscopy at 1-year after VDZ initiation revealed endoscopic healing. Therapeutic drug monitoring conducted during VDZ treatment showed negative antibodies to VDZ. No serious adverse events occurred during the VDZ treatment. This is the first case report in Korea demonstrating the safe and effective use of VDZ treatment in a pediatric CD patient. In cases that require recommencement of treatment with biologics after recovery of active pulmonary TB caused by anti-tumor necrosis factor agents, VDZ may be a good option even in pediatric IBD.

Citations

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The safety of vedolizumab in a patient with Crohn’s disease who developed anti-TNF-alpha agent associated latent tuberculosis infection reactivation: A case report
Yuya Sugiyama, Nobuhiro Ueno, Shion Tachibana, Yu Kobayashi, Yuki Murakami, Takahiro Sasaki, Aki Sakatani, Keitaro Takahashi, Katsuyoshi Ando, Shin Kashima, Kentaro Moriichi, Hiroki Tanabe, Toshikatsu Okumura, Mikihiro Fujiya
Medicine.2023; 102(28): e34331. CrossRef
Vedolizumab Is Safe and Efficacious for the Treatment of Pediatric-Onset Inflammatory Bowel Disease Patients Who Fail a Primary Biologic Agent
Sujin Choi, Eun Sil Kim, Yiyoung Kwon, Mi Jin Kim, Yon Ho Choe, Byung-Ho Choe, Ben Kang
Journal of Korean Medical Science.2022;[Epub] CrossRef

Original article

Hematology
A retrospective analysis of etiology and outcomes of hemophagocytic lymphohistiocytosis in children and adults: Abraham Kwak, Nani Jung, Ye Jee Shim, Heung Sik Kim, Hyun Ji Lim, Jae Min Lee, Mi Hwa Heo, Young Rok Do; Yeungnam Univ J Med. 2021;38(3):208-218. Published online November 27, 2020; DOI: https://doi.org/10.12701/yujm.2020.00591

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Abstract PDF

Background
Hemophagocytic lymphohistiocytosis (HLH) is a rare but severe, life-threatening inflammatory condition if untreated. We aimed to investigate the etiologies, outcomes, and risk factors for death in children and adults with HLH.
Methods
The medical records of patients who met the HLH criteria of two regional university hospitals in Korea between January 2001 and December 2019 were retrospectively investigated.
Results
Sixty patients with HLH (35 children and 25 adults) were included. The median age at diagnosis was 7.0 years (range, 0.1–83 years), and the median follow-up duration was 8.5 months (range, 0–204 months). Four patients had primary HLH, 48 patients had secondary HLH (20 infection-associated, 18 neoplasm-associated, and 10 autoimmune-associated HLH), and eight patients had HLH of unknown cause. Infection was the most common cause in children (14/35, 40.0%), whereas neoplasia was the most common cause in adults (13/25, 52.0%). Twenty-eight patients were treated with HLH-2004/94 immunochemotherapy. The 5-year overall survival (OS) rate for all HLH patients was 59.9%. The 5-year OS rates for patients with primary, infection-associated, neoplasm-associated, autoimmune-associated, and unknown cause HLH were 25.0%, 85.0%, 26.7%, 87.5%, and 62.5%, respectively. Using multivariate analysis, neoplasm-induced HLH (p=0.001) and a platelet count <50×109/L (p=0.008) were identified as independent risk factors for poor prognosis in patients with HLH.
Conclusion
Infection was the most common cause of HLH in children, while it was neoplasia in adults. The 5-year OS rate for all HLH patients was 59.9%. HLH caused by an underlying neoplasm or a low platelet count at the time of diagnosis were risk factors for poor prognosis.

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Lorenzo Gaini, Anna Cozzi, Gioia Piatti, Michele Gaffuri, Samantha Bosis, Paola Marchisio, Giovanna Ghidini, Giorgio Croci, Antonio Carpino, Sara Torretta
Journal of Clinical Medicine.2026; 15(7): 2516. CrossRef
Novel perspectives on the rare hemophagocytic lymphohistiocytosis: insights from a multi-center retrospective cohort
Changkun Chen, Yanquan Liu, Xiaojun Chen, Hehui Zhang, Jianzhen Shen, Zuotao Li, Yue Yin, He Huang
Frontiers in Medicine.2026;[Epub] CrossRef
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Nishka Tapaswi, Hasib Ahmadzai, Alec J Hope, Oliver Fisher, Linda Y Zhang
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Pattranan Kusontammarat, Chane Choed-Amphai, Lalita Sathitsamitphong, Watchareewan Sontichai, Rungrote Natesirinilkul, Pimlak Charoenkwan
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Autoimmune encephalitis followed by hemophagocytic lymph histiocytosis: a case report
Li Huang, Jie Tan, Peihao Lin, Zixuan Chen, Qihua Huang, Haiyan Yao, Lihong Jiang, Baoyi Long, Youming Long
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Andria Papazachariou, Petros Ioannou
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Rita Alfattal, Hussain Sadeq, Abdullah Ali
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María Soledad Caldirola, Andrea Gómez Raccio, Daniela Di Giovanni, María Isabel Gaillard, María Victoria Preciado
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Secondary Hemophagocytic Lymphohistiocytosis and Autoimmune Cytopenias: Case Description and Review of the Literature
Bruno Fattizzo, Marta Ferraresi, Juri Giannotta, Wilma Barcellini
Journal of Clinical Medicine.2021; 10(4): 870. CrossRef
HLH-Like Syndrome and Rhabdomyolysis in an Adolescent Patient
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Case report

Hematology
Hemophagocytic lymphohistiocytosis with recurrent Kikuchi-Fujimoto disease: Sang Min Lee, Young Tae Lim, Kyung Mi Jang, Mi Jin Gu, Jong Ho Lee, Jae Min Lee; Yeungnam Univ J Med. 2021;38(3):245-250. Published online November 11, 2020; DOI: https://doi.org/10.12701/yujm.2020.00654

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Abstract PDF

Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a self-limiting lymphadenitis. It is a benign disease mainly characterized by high fever, lymph node swelling, and leukopenia. Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease with clinical symptoms similar to those of KFD, but it requires a significantly more aggressive treatment. A 19-year-old Korean male patient was hospitalized for fever and cervical lymphadenopathy. Variable-sized lymph node enlargements with slightly necrotic lesions were detected on computed tomography. Biopsy specimen from a cervical lymph node showed necrotizing lymphadenitis with HLH. Bone marrow aspiration showed hemophagocytic histiocytosis. The clinical symptoms and the results of the laboratory test and bone marrow aspiration met the diagnostic criteria for HLH. The patient was diagnosed with macrophage activation syndrome—HLH, a secondary HLH associated with KFD. He was treated with dexamethasone (10 mg/m2/day) without immunosuppressive therapy or etoposide-based chemotherapy. The fever disappeared within a day, and other symptoms such as lymphadenopathy, ascites, and pleural effusion improved. Dexamethasone was reduced from day 2 of hospitalization and was tapered over 8 weeks. The patient was discharged on day 6 with continuation of dexamethasone. The patient had no recurrence at the 18-month follow-up.

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Arian Akhondi, Valerie Anne-Sophie Faber, Adam Hawkins, David Ray Chen
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Histiocytic necrotizing lymphadenitis with hemophagocytic lymphohistiocytosis in adults: A single‐center analysis of 5 cases
Qingqing Chen, Jing Zhang, Huijun Huang, Tonglu Qiu, Ze Jin, Yu Shi, Huayuan Zhu, Lei Fan, Jianyong Li, Wenyu Shi, Yi Miao
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A young Saudi female with combined hemophagocytic lympho-histiocytosis and Kikuchi’s disease: A case report
Kamal Al-Zahrani, Batol Gasmelseed, Hesham Waaer Shadi, Rehab Y AL-Ansari
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Revista Española de Casos Clínicos en Medicina Interna.2023; 8(2): 105. CrossRef
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V. G. Potapenko, V. V. Baykov, А. Yu. Markova, N. B. Mikhailova, A. S. Ter‑Grigoryan, Yu. А. Krivolapov
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Focused Review article

Pulmonary and Respiratory Medicine
An update on the role of bronchoscopy in the diagnosis of pulmonary disease: June Hong Ahn; Yeungnam Univ J Med. 2020;37(4):253-261. Published online August 28, 2020; DOI: https://doi.org/10.12701/yujm.2020.00584

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Abstract PDF

Bronchoscopy has evolved over the past few decades and has been used by respiratory physicians to diagnose various airway and lung diseases. With the popularization of medical check-ups and growing interest in health, early diagnosis of lung diseases is essential. With the development of endobronchial ultrasound, ultrathin bronchoscopy, and electromagnetic navigational bronchoscopy, bronchoscopy has been able to widen its scope in diagnosing pulmonary diseases. In this review, we have described the brief history, role, and complications of bronchoscopy used in diagnosing pulmonary lesions, from simple flexible bronchoscopy to bronchoscopy combined with several up-to-date technologies.

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Case reports

Gastroenterology and Hepatology
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.

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Coexistence of Relapsing Polychondritis and Crohn’s Disease: Clinical Insights from a Rare Case
Sang Wan Chung
Journal of Clinical Medicine.2026; 15(4): 1609. CrossRef
Coexistence of Relapsing Polychondritis, Crohn's Disease, and Pyoderma Gangrenosum Treated Successfully with Adalimumab: A Case Report and Literature Review
Shun Yamazaki, Kentaro Tominaga, Kotaro Watanabe, Makoto Watanabe, Shuhei Kondo, Norihiro Sakai, Tomoaki Yoshida, Yuichi Kojima, Yusuke Watanabe, Yuzo Kawata, Naruhiro Kimura, Kazuya Takahashi, Hiroki Sato, Satoshi Ikarashi, Hiroteru Kamimura, Kazunao Hay
Internal Medicine.2025; 64(20): 2971. CrossRef
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

Nephrology
Development of donepezil-induced hypokalemia following treatment of cognitive impairment: Dongryul Kim, Hye Eun Yoon, Hoon Suk Park, Seok Joon Shin, Bum Soon Choi, Byung Soo Kim, Tae Hyun Ban; Yeungnam Univ J Med. 2021;38(1):65-69. Published online June 1, 2020; DOI: https://doi.org/10.12701/yujm.2020.00269

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Abstract PDF

Donepezil is a cholinesterase inhibitor used extensively to treat Alzheimer disease. The increased cholinergic activity is associated with adverse effects, therefore gastrointestinal symptoms, including nausea, vomiting, and diarrhea, are common. Hypokalemia is a rare adverse event that occurs in less than 1% of donepezil-treated patients. Although hypokalemia of mild and moderate grade does not present serious signs and symptoms, severe hypokalemia often results in prolonged hospitalization and mortality. Herein, we report a case of hypokalemia developed after the initiation of donepezil therapy for cognitive impairment.

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Thymus vulgaris Essential Oil Protects Zebrafish against Cognitive Dysfunction by Regulating Cholinergic and Antioxidants Systems
Luminita Capatina, Elena Todirascu-Ciornea, Edoardo Marco Napoli, Giuseppe Ruberto, Lucian Hritcu, Gabriela Dumitru
Antioxidants.2020; 9(11): 1083. CrossRef

Pediatrics, Perinatology, and Child Health
Prevention of thiopurine-induced early leukopenia in a Korean pediatric patient with Crohn’s disease who turned out to possess homozygous mutations in NUDT15 R139C: Jaewoan Bae, Byung-Ho Choe, Ben Kang; Yeungnam Univ J Med. 2020;37(4):332-336. Published online May 22, 2020; DOI: https://doi.org/10.12701/yujm.2020.00178

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Abstract PDF

Homozygous mutations in NUDT15 R139C are known as the major factor associated with thiopurine-induced early leukopenia, particularly in Asian patients. Therefore, NUDT15 genotyping is currently recommended before thiopurine treatment to identify patients who are NUDT15 poor metabolizers and consider the use of an alternative immunomodulatory therapy. We report a case of a 12-year-old Korean girl with Crohn’s disease (CD), in whom thiopurine-induced leukopenia was prevented by initiation of azathioprine (AZA) therapy at a low dose (0.5 mg/kg/day) and early detection of significant hair loss and white blood cell (WBC) count decrease at 17 days from the start of AZA treatment. The WBC count dropped from 8,970/μL to 3,370/μL in 2 weeks, and AZA treatment was stopped because of concerns of potential leukopenia in the near future. Her WBC count recovered to 5,120/μL after 3 weeks. Gene analysis later revealed that she had a homozygous mutation in NUDT15 R139C, resulting in a poor metabolizing activity of NUDT15. In situations when NUDT15 genotyping is unavailable, initiation of AZA therapy at 0.5 mg/kg/day with close observation of hair loss and WBC counts within 2 weeks may be an alternative way to prevent thiopurine-induced early leukopenia in Asian children with CD.

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NUDT15 Pharmacogenetics in Acute Lymphoblastic Leukemia: Synthesizing Progress for Personalized Thiopurine Therapy
Isfahan Shah Lubis, Kusnandar Anggadiredja, Aluicia Anita Artarini, Nur Melani Sari, Nur Suryawan, Zulfan Zazuli
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Veterinary Sciences.2023; 10(5): 307. CrossRef
Case report: NUDT15 polymorphism and severe azathioprine-induced myelosuppression in a young Chinese female with systematic lupus erythematosus: a case analysis and literature review
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Review article

Gastroenterology and Hepatology
Gallbladder polyps: evolving approach to the diagnosis and management: Kook Hyun Kim; Yeungnam Univ J Med. 2021;38(1):1-9. Published online May 15, 2020; DOI: https://doi.org/10.12701/yujm.2020.00213

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Abstract PDF

Gallbladder (GB) polyp is a mucosal projection into the GB lumen. With increasing health awareness, GB polyps are frequently found using ultrasonography during health screening. The prevalence of GB polyps ranges between 1.3% and 9.5%. Most patients are asymptomatic and have benign characteristics. Of the nonneoplastic polyps, cholesterol polyps are most common, accounting for 60%–70% of lesions. However, a few polyps have malignant potential. Currently, the guidelines recommend laparoscopic cholecystectomy for polyps larger than 1 cm in diameter due to their malignan potential. The treatment algorithm can be influenced by the size, shape, and numbers of polyps, old age (>50 years), the presence of primary sclerosing cholangitis, and gallstones. This review summarizes the commonly recognized concepts on GB polyps from diagnosis to an algorithm of treatment.

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Efficacy and safety of ultrasound-guided radiofrequency ablation versus laparoscopic cholecystectomy in gallbladder polyps: a bicentric study
Huajiao Zhao, Gang Dong, Zheng Zhang, Yanwei Chen, Shuangshuang Zhao, Mengyuan Shang, Yun Cai, Xincai Wu, Baoding Chen
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Predicting Neoplastic Gallbladder Polyps: The Role of Current Surgical Indications and Preoperative Images
Ik Hyun Jo, Chang Nyol Paik, Hong Geun Ahn, Dong Do You, Jae Hyun Han, Hyun A Kim
The Korean Journal of Gastroenterology.2025; 85(1): 52. CrossRef
Establishing a radiomics model using contrast-enhanced ultrasound for preoperative prediction of neoplastic gallbladder polyps exceeding 10 mm
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iLIVER.2024; 3(4): 100127. CrossRef
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Huifang Pang, Quan Man, Li Min, Zheng Zhang, Shengtao Zhu, Shuyue Yang, Yao Xu, Haijun Hou, Shutian Zhang, Peng Li
Minimally Invasive Therapy & Allied Technologies.2023; 32(1): 24. CrossRef
The link between Helicobacter pylori infection and gallbladder and biliary tract diseases: A review
Klay Puay Khim Lim, Aaron Jia Loong Lee, Xiuting Jiang, Thomas Zheng Jie Teng, Vishal G. Shelat
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Rachel Runde, Edward D. Auyang, Raye Ng, Kaysey Llorente, Hina Arif Tiwari, Shana Elman, William M. Thompson
Abdominal Radiology.2022; 48(1): 2. CrossRef
Gallbladder polyps: diagnosis and treatment tactics (literature review)
S. N. Perekhodov, D. V. Nikolaev, S. S. Saidov
Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH).2021; 11(4): 88. CrossRef
Is there a role for growth status in distinguishing gallbladder adenomas from cholesterol polyps? – A retrospective study based on 520 cholecystectomy patients
Wenqing Bao, Anan Xu, Shubin Ni, Bo Wang, Humaira Urmi, Bin Zhao, Yongmei You, Hai Hu
Scandinavian Journal of Gastroenterology.2021; 56(12): 1450. CrossRef
Imagerie des tumeurs bénignes des voies biliaires et de la vésicule
J.-P. Tasu, B. Bergougnoux, E. Frouin, S. Velasco, C. Aubé, N. Beydoun
EMC - Radiologie et imagerie médicale - Abdominale - Digestive.2021; 39(4): 1. CrossRef
Polyps and cancer of the biliary system (lecture for medical practitioners)
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Original articles

Obstetrics, Gynecology, and Reproductive Medicine
Clinical outcomes of hysterectomy for benign diseases in the female genital tract: 6 years’ experience in a single institute: Hyo-Shin Kim, Yu-Jin Koo, Dae-Hyung Lee; Yeungnam Univ J Med. 2020;37(4):308-313. Published online April 24, 2020; DOI: https://doi.org/10.12701/yujm.2020.00185

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Abstract PDF

Background
Hysterectomy is one of the major gynecologic surgeries. Historically, several surgical procedures have been used for hysterectomy. The present study aims to evaluate the surgical trends and clinical outcomes of hysterectomy performed for benign diseases at the Yeungnam University Hospital.
Methods
We retrospectively reviewed patients who underwent a hysterectomy for benign diseases from 2013 to 2018. Data included the patients’ demographic characteristics, surgical indications, hysterectomy procedures, postoperative pathologies, and perioperative outcomes.
Results
A total of 809 patients were included. The three major indications for hysterectomy were uterine leiomyoma, pelvic organ prolapse, and adenomyosis. The most common procedure was total laparoscopic hysterectomy (TLH, 45.2%), followed by open hysterectomy (32.6%). During the study period, the rate of open hysterectomy was nearly constant (29.4%–38.1%). The mean operative time was the shortest in the single-port laparoscopic assisted vaginal hysterectomy (LAVH, 89.5 minutes), followed by vaginal hysterectomy (VH, 96.8 minutes) and TLH (105 minutes). The mean decrease in postoperative hemoglobin level was minimum in single-port LAVH (1.8 g/dL) and VH (1.8 g/dL). Conversion to open surgery or multi-port surgery occurred in five cases (0.6%). Surgical complications including wound dehiscence, organ injuries, and conditions requiring reoperation were observed in 52 cases (6.4%).
Conclusion
Minimally invasive approach was used for most hysterectomies for benign diseases, but the rate of open hysterectomy has mostly remained constant. Single-port LAVH and VH showed the most tolerable outcomes in terms of operative time and postoperative drop in hemoglobin level in selected cases.

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Depression and qulity of life in women of reproductive age in the context of surgical menopause
Olga Cernetchi, Elena Vataman
Bulletin of the Academy of Sciences of Moldova. Medical Sciences.2025; (2(82)): 18. CrossRef
Analysis of Different Routes of Hysterectomy Based on a Prospective Algorithm and Their Complications in a Tertiary Care Institute
Subrat Panda, Ananya Das, Rituparna Das, Nalini Sharma, Wansalan Shullai, Vinayak Jante, Anusuya Sharma, Kaushiki Singh, Prateeti Baruah, Ruksana Makakmayum, Imtiaz Wani
Minimally Invasive Surgery.2022; 2022: 1. CrossRef

Pulmonary and Respiratory Medicine
Polyunsaturated fatty acids, lung function, and health-related quality of life in patients with chronic obstructive pulmonary disease: Hyunji Choi, Taeyun Kim; Yeungnam Univ J Med. 2020;37(3):194-201. Published online April 7, 2020; DOI: https://doi.org/10.12701/yujm.2020.00052

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Abstract PDF

Background
Dietary polyunsaturated fatty acids (PUFA) are thought to modify systemic inflammation. The present study aimed to evaluate the relationship between PUFA intake, lung function, and health-related quality of life (HRQoL) in patients with chronic obstructive pulmonary disease (COPD).
Methods
In this study, we used the dataset of 6th Korea National Health and Nutrition Examination Survey, in which, a total of 22,948 individuals including 573 participants with a high probability of developing COPD were enrolled. Participants with missing data for the investigated variables were excluded. Linear regression analyses were used to evaluate the association between PUFA intake (omega-3 [N3], omega-6 [N6], and total) with lung function, and HRQoL. HRQoL was determined according to the European Quality of Life-5 Dimensions (EQ-5D). Subgroup analysis of older patients was performed. Age, sex, body mass index, smoking, alcohol, education, residence, total calorie intake, and predicted FEV1% were adjusted in all analyses.
Results
Although lung function was not associated with PUFA intake, EQ-5D index was remarkably associated with N3, N6, and total PUFA intake in a dose-dependent manner. This association was more pronounced in elderly COPD patients. Mean levels of N3, N6, and total PUFA intake were significantly higher in patients having better HRQoL with respect to mobility, self-care, and usual activities.
Conclusion
Our results suggest that N3, N6, and total PUFA intake are associated with HRQoL in COPD patients. This association may be attributed to mobility, self-care, and usual activities. Further longitudinal study is required to clarify this relationship.

Citations

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The Inflammatory Roles of n-3 and n-6 Polyunsaturated Fatty Acids in COPD: Clinical Implications and Underlying Mechanisms
Yingqi Wang, Yidie Bao, Boya Liu, Hui Li, Hongxia Duan, Yide Wang, Jiachi Zhang, Weibing Wu, Peijun Li, Xiaodan Liu
Journal of Inflammation Research.2026; Volume 19: 1. CrossRef
Association between polyunsaturated fatty acids dietary intake and pulmonary function among American children: NHANES 2007–2012
Mengmeng Ding, Shuyan Qie, Hanming Wang
Frontiers in Nutrition.2025;[Epub] CrossRef
Association between dietary fatty acid intake and preserved ratio impaired spirometry in U.S. adults: a population-based cross-sectional study
Xiang Liu, Wei Zeng, Wangyan Zhou, Dayang Zheng, Xu Yang, Weijun Liao
Frontiers in Nutrition.2025;[Epub] CrossRef
From metabolic alterations to chronic inflammation: mechanisms and immunoregulation of metabolic reprogramming in COPD
Siyu Zeng, Yanqiu Zhang, Shiran Li, Zhimin Li, Pengfei Li, Jingxian Xie, Jiao Zhang, Liling Xie, Yong Yang
Frontiers in Immunology.2025;[Epub] CrossRef
Dietary modulation of lung lipids influences inflammatory responses to inhaled ozone
Russell Hunter, Brenna Baird, Milad Mazloumi-Bakhshayesh, Siem Goitom, Selita Lucas, Guy Herbert, David Scieszka, Edward Davis, Haiwei Gu, Yan Jin, Barry E. Bleske, Matthew J. Campen
Journal of Lipid Research.2024; 65(9): 100630. CrossRef
Nutrition as a modifiable factor in the onset and progression of pulmonary function impairment in COPD: a systematic review
Lieke E J van Iersel, Rosanne J H C G Beijers, Harry R Gosker, Annemie M W J Schols
Nutrition Reviews.2022; 80(6): 1434. CrossRef
Medium and long chain free fatty acid receptors in the pathophysiology of respiratory diseases
O. Yu. Kytikova, T. P. Novgorodtseva, Yu. K. Denisenko, M. V. Antonyuk, T. A. Gvozdenko
Bulletin Physiology and Pathology of Respiration.2021; (80): 115. CrossRef

Case report

Gastroenterology and Hepatology
Anti-nuclear antibody-negative immunoglobulin G4-associated autoimmune hepatitis mimicking lymphoproliferative disorders: Min Kyu Kang, Jung Gil Park, Joon Hyuk Choi; Yeungnam Univ J Med. 2020;37(2):136-140. Published online March 24, 2020; DOI: https://doi.org/10.12701/yujm.2020.00066

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Abstract PDF

Immunoglobulin G4 (IgG4)-associated autoimmune hepatitis (AIH) is a very rare subtype of autoimmune hepatitis and characterized by marked elevated serum IgG and hepatic infiltration of IgG4-expressing plasma cells. Pathologic confirmation of hepatic IgG4-expressing plasma cells is usually required for the final diagnosis of IgG4-associated AIH. Herein, we report the case of a 47-year-old female diagnosed with autoantibody-negative IgG4-associated AIH mimicking lymphoproliferative disorders.

Citations

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IgG4‐Associated Autoimmune Hepatitis: a Systematic Review
Chun‐Hsun Liao, Hsu‐Hua Tseng, Ting‐An Shen, Tzu‐Chan Hong, Shih‐Jer Hsu, Jia‐Horng Kao, Chun‐Jen Liu
Journal of Gastroenterology and Hepatology.2026; 41(2): 443. CrossRef
Immunoglobulin G4-related Autoimmune Hepatitis Following Type 1 Autoimmune Pancreatitis: A Case Report and Literature Review
Chiharu Toh, Shinichi Morita, Nobutaka Takeda, Fusako Yamazaki, Kunihiko Yokoyama, Masatoshi Sato, Daisuke Kumaki, Takeshi Sakai, Kazuhiro Funakoshi, Koichi Tsuneyama
Internal Medicine.2025; 64(11): 1659. CrossRef
A clinicopathological study of IgG4-related autoimmune hepatitis and IgG4-hepatopathy
Atsushi Tanaka, Kenji Notohara, Maki Tobari, Masanori Abe, Takeji Umemura, Atsushi Takahashi, Akemi Tsutsui, Takanori Ito, Kohichi Tsuneyama, Atsushi Masamune, Ken-ichi Harada, Hiromasa Ohira, Mitsuhiro Kawano
Journal of Gastroenterology.2025; 60(5): 632. CrossRef
Hepatic Involvement of Diffuse Large B-Cell Lymphoma Mimicking Antinuclear Antibody-Negative Autoimmune Hepatitis Diagnosed by Liver Biopsy
Euna Lee, Min-Kyu Kang, Gabin Moon, Mi-Jin Gu
Medicina.2022; 59(1): 77. CrossRef
Immunoglobulin G4 (IgG4)‐related autoimmune hepatitis and IgG4‐hepatopathy: A histopathological and clinical perspective
Atsushi Tanaka, Kenji Notohara
Hepatology Research.2021; 51(8): 850. CrossRef

Review article

Public Health, Environmental, and Occupational Health
Reproductive toxic agents in work environments and related cases in Korea: Chulyong Park; Yeungnam Univ J Med. 2020;37(1):22-31. Published online January 9, 2020; DOI: https://doi.org/10.12701/yujm.2019.00416

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Abstract PDF

There has been a growing concern and subsequent interest surrounding numerous reproductive toxic agents found in various working and non-working environments. Meanwhile, there have been many efforts in medical fields such as toxicology and epidemiology applying experimental studies to elucidate reproductive toxic agents’ characterization and health effects. However, there remains insufficient research data and inadequate evidence in humans. Adverse reproductive outcomes vary from transient, moderate health effects to severely detrimental consequences, such as permanent infertility or childhood cancer of one’s offspring. Furthermore, upon exposure to toxic agents, the latent period before reproductive health effects are observed is relatively short compared to other occupational diseases (e.g., occupational cancer); instant action is required once exposure to reproductive toxic agents is detected. Therefore, it is very important for workers and healthcare professionals to know about the reproductive toxic agents they are likely to be exposed to. In this review, we discuss the general epidemiology of reproductive health in Korea, and the information regarding these reproductive toxic agents.

Citations

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Association between Occupational Chemical Exposure and Sperm Parameters; A Narrative Review
Soheila Pourmasumi, Reza Vazirinejad, Zahra Ahmadi, Ali Mehdipour, Alireza Nazari
Journal of Occupational Health and Epidemiology.2023; 12(1): 50. CrossRef

Original article

Gastroenterology and Hepatology
Comparison of small bowel findings using capsule endoscopy between Crohn’s disease and intestinal tuberculosis in Korea: Yong Gil Kim, Kyung-Jo Kim, Young-Ki Min; Yeungnam Univ J Med. 2020;37(2):98-105. Published online November 22, 2019; DOI: https://doi.org/10.12701/yujm.2019.00374

10,782 View
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Abstract PDF

Background
Little is known about capsule endoscopy (CE) findings in patients with intestinal tuberculosis who exhibit small bowel lesions. The aim of the present study was to distinguish between Crohn’s disease (CD) and intestinal tuberculosis based on CE findings.
Methods
Findings from 55 patients, who underwent CE using PillCam SB CE (Given Imaging, Yoqneam, Israel) between February 2003 and June 2015, were retrospectively analyzed.
Results
CE revealed small bowel lesions in 35 of the 55 patients: 19 with CD and 16 with intestinal tuberculosis. The median age at diagnosis for patients with CD was 26 years and 36 years for those with intestinal tuberculosis. On CE, three parameters, ≥10 ulcers, >3 involved segments and aphthous ulcers, were more common in patients with CD than in those intestinal tuberculosis. Cobblestoning was observed in five patients with CD and in none with intestinal tuberculosis. The authors hypothesized that a diagnosis of small bowel CD could be made when the number of parameters in CD patients was higher than that for intestinal tuberculosis. The authors calculated that the diagnosis of either CD or intestinal tuberculosis would have been made in 34 of the 35 patients (97%).
Conclusion
The number of ulcers and involved segments, and the presence of aphthous ulcers, were significantly higher and more common, respectively, in patients with CD than in those with intestinal tuberculosis. Cobblestoning in the small bowel may highly favor a diagnosis of CD on CE.

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Sergiu Marian Cazacu, Costin Teodor Streba, Cristian Constantin, Claudiu Marinel Ionele, Ion Rogoveanu, Alexandru Valentin Popescu, Mirela-Marinela Florescu
Medicina.2026; 62(4): 794. CrossRef
An Updated Review on Differential Diagnosis of Crohn's Disease and Intestinal Tuberculosis
Ravi K Sharma, Alpa Singh, Saurabh Dawra
Journal of Postgraduate Medicine, Education and Research.2025; 60(1): 18. CrossRef
Deep Learning Radiomics Analysis of CT Imaging for Differentiating Between Crohn’s Disease and Intestinal Tuberculosis
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Case report

Radiology, Radiotherapy & Diagnostic Imaging
Massive cerebral venous sinus thrombosis secondary to Graves' disease: Hye-Min Son; Yeungnam Univ J Med. 2019;36(3):273-280. Published online September 18, 2019; DOI: https://doi.org/10.12701/yujm.2019.00339

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Abstract PDF

Cerebral venous sinus thrombosis (CVT) is a rare cerebrovascular condition accounting for 0.5–1% of all types of strokes in the general population. Hyperthyroidism is associated with procoagulant and antifibrinolytic activity, thereby precipitating a hypercoagulable state that predisposes to CVT. We report the case of a 31-year-old Korean man with massive CVT and diagnosis of concomitant Graves’ disease at admission. Early diagnosis and prompt treatment of CVT are important to improve prognosis; therefore, CVT should be considered in the differential diagnosis in all patients with hyperthyroidism presenting with neurological symptoms.

Citations

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Associations between deep venous thrombosis and thyroid diseases: a two-sample bidirectional Mendelian randomization study
Lifeng Zhang, Kaibei Li, Qifan Yang, Yao Lin, Caijuan Geng, Wei Huang, Wei Zeng
European Journal of Medical Research.2024;[Epub] CrossRef
Association Between Thyrotoxicosis and Cerebral Venous Thrombosis
Margherita Paccagnella, Anna Pizzo, Veronica Calabrò, Valerio Velardi, Bruno Fabris, Stella Bernardi
Journal of Clinical Medicine.2024; 13(21): 6547. CrossRef
Hyperthyroidism-induced Cerebral Venous Thrombosis Presenting as Chronic Isolated Intracranial Hypertension
Takumi Tashiro, Yuichi Kira, Norihisa Maeda
Internal Medicine.2023; 62(20): 3021. CrossRef
Cerebral Sinus Vein Thrombosis and Gender: A Not Entirely Casual Relationship
Tiziana Ciarambino, Pietro Crispino, Giovanni Minervini, Mauro Giordano
Biomedicines.2023; 11(5): 1280. CrossRef
Insights Into a Hypercoagulable Case of Thyrocardiac Disease and Literature Overview
Pin-Yi Wu, Ruchika Meel
Annals of Internal Medicine: Clinical Cases.2023;[Epub] CrossRef
Cerebral Venous Thrombosis during Thyrotoxicosis: Case Report and Literature Update
Emanuela Maria Raho, Annibale Antonioni, Niccolò Cotta Ramusino, Dina Jubea, Daniela Gragnaniello, Paola Franceschetti, Francesco Penitenti, Andrea Daniele, Maria Chiara Zatelli, Maurizio Naccarato, Ilaria Traluci, Maura Pugliatti, Marina Padroni
Journal of Personalized Medicine.2023; 13(11): 1557. CrossRef
Unprovoked Isolated Pulmonary Embolism and Graves’ Disease in a Patient With Dyspnea: A Case Report
Roshan Bisural, Deepak Acharya, Samaj Adhikari, Baikuntha Chaulagai, Arjun Mainali, Tutul Chowdhury, Nicole Gousy
Cureus.2022;[Epub] CrossRef
Cerebral venous sinus thrombosis caused by traumatic brain injury complicating thyroid storm: a case report and discussion
Shurong Gong, Wenyao Hong, Jiafang Wu, Jinqing Xu, Jianxiang Zhao, Xiaoguang Zhang, Yuqing Liu, Rong-Guo Yu
BMC Neurology.2022;[Epub] CrossRef
Severe headache as a monosymptom of cerebral venous sinus thrombosis: a case report with effective utilization of the SNNOOP10 approach
Garik Yeganyan, Hasmik Sargsyan, Mariam Manukyan, Henrik Schytz, Samson Khachatryan
Armenian Journal of Health & Medical Sciences.2022; : 52. CrossRef
Hyperthyroidism as a Precipitant Factor for Cerebral Venous Thrombosis: A Case Report
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Journal of Investigative Medicine High Impact Case Reports.2020;[Epub] CrossRef

Review articles

Psychiatry and Mental Health
Cognitive dysfunctions in individuals with diabetes mellitus: Hye-Geum Kim; Yeungnam Univ J Med. 2019;36(3):183-191. Published online July 24, 2019; DOI: https://doi.org/10.12701/yujm.2019.00255

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Abstract PDF

Some patients with type 1 and type 2 diabetes mellitus (DM) present with cognitive dysfunctions. The pathophysiology underlying this complication is not well understood. Type 1 DM has been associated with a decrease in the speed of information processing, psychomotor efficiency, attention, mental flexibility, and visual perception. Longitudinal epidemiological studies of type 1 DM have indicated that chronic hyperglycemia and microvascular disease, rather than repeated severe hypoglycemia, are associated with the pathogenesis of DM-related cognitive dysfunction. However, severe hypoglycemic episodes may contribute to cognitive dysfunction in high-risk patients with DM. Type 2 DM has been associated with memory deficits, decreased psychomotor speed, and reduced frontal lobe/executive function. In type 2 DM, chronic hyperglycemia, long duration of DM, presence of vascular risk factors (e.g., hypertension and obesity), and microvascular and macrovascular complications are associated with the increased risk of developing cognitive dysfunction. The pathophysiology of cognitive dysfunction in individuals with DM include the following: (1) role of hyperglycemia, (2) role of vascular disease, (3) role of hypoglycemia, and (4) role of insulin resistance and amyloid. Recently, some investigators have proposed that type 3 DM is correlated to sporadic Alzheimer’s disease. The molecular and biochemical consequences of insulin and insulin-like growth factor resistance in the brain compromise neuronal survival, energy production, gene expression, plasticity, and white matter integrity. If patients claim that their performance is worsening or if they ask about the effects of DM on functioning, screening and assessment are recommended.

Citations

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Pathology and Forensic Medicine
Pathological interpretation of connective tissue disease-associated lung diseases: Kun Young Kwon; Yeungnam Univ J Med. 2019;36(1):8-15. Published online January 15, 2019; DOI: https://doi.org/10.12701/yujm.2019.00101

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Abstract PDF

Connective tissue diseases (CTDs) can affect all compartments of the lungs, including airways, alveoli, interstitium, vessels, and pleura. CTD-associated lung diseases (CTD-LDs) may present as diffuse lung disease or as focal lesions, and there is significant heterogeneity between the individual CTDs in their clinical and pathological manifestations. CTD-LDs may presage the clinical diagnosis a primary CTD, or it may develop in the context of an established CTD diagnosis. CTD-LDs reveal acute, chronic or mixed pattern of lung and pleural manifestations. Histopathological findings of diverse morphological changes can be present in CTD-LDs airway lesions (chronic bronchitis/bronchiolitis, follicular bronchiolitis, etc.), interstitial lung diseases (nonspecific interstitial pneumonia/fibrosis, usual interstitial pneumonia, lymphocytic interstitial pneumonia, diffuse alveolar damage, and organizing pneumonia), pleural changes (acute fibrinous or chronic fibrous pleuritis), and vascular changes (vasculitis, capillaritis, pulmonary hemorrhage, etc.). CTD patients can be exposed to various infectious diseases when taking immunosuppressive drugs. Histopathological patterns of CTD-LDs are generally nonspecific, and other diseases that can cause similar lesions in the lungs must be considered before the diagnosis of CTD-LDs. A multidisciplinary team involving pathologists, clinicians, and radiologists can adequately make a proper diagnosis of CTD-LDs.

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Multidisciplinary Approach to the Diagnosis of Idiopathic Interstitial Pneumonias: Focus on the Pathologist’s Key Role
Stefano Lucà, Francesca Pagliuca, Fabio Perrotta, Andrea Ronchi, Domenica Francesca Mariniello, Giovanni Natale, Andrea Bianco, Alfonso Fiorelli, Marina Accardo, Renato Franco
International Journal of Molecular Sciences.2024; 25(7): 3618. CrossRef
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Case Report

Ophthalmology
Ocular manifestations in a patient with de novo Fabry disease: You Hyun Lee, Kyu Young Shim, Sung Bae Park, Yu Cheol Kim; Yeungnam Univ J Med. 2018;35(2):232-235. Published online December 31, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.232

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Abstract PDF

Fabry disease (FD) is an X-linked, recessively inherited, rare, progressive, disorder of glycosphingolipid metabolism affecting multiple organs resulting in organ dysfunction. It is rare to find only one FD affected subject with a de novo mutation. Here we report a case of a 41-year-old Asian male diagnosed with de novo FD. Comprehensive ophthalmological evaluation was performed using slit lamp, color fundus photography, optical coherence tomography, fluorescein angiography, and indocyanine green angiography. On slit lamp examination, cornea verticillata and slightly tortuous, and aneurysmal dilatation of inferior bulbar conjunctival vessels were observed. Other imaging modalities showed unremarkable findings. Cornea verticillata and inferior bulbar conjunctival vascular abnormalities may be detected earlier than other ocular abnormalities in de novo FDs like hereditary FDs.

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Review article

Public Health, Environmental, and Occupational Health
Implementation of a care coordination system for chronic diseases: Jung Jeung Lee, Sang Geun Bae; Yeungnam Univ J Med. 2019;36(1):1-7. Published online December 20, 2018; DOI: https://doi.org/10.12701/yujm.2019.00073

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Abstract PDF

The number of people with chronic diseases has been increasing steadily but the indicators for the management of chronic diseases have not improved significantly. To improve the existing chronic disease management system, a new policy will be introduced, which includes the establishment of care plans for hypertension and diabetes patients by primary care physicians and the provision of care coordination services based on these plans. Care coordination refers to a series of activities to assist patients and their families and it has been known to be effective in reducing medical costs and avoiding the unnecessary use of the hospital system by individuals. To offer well-coordinated and high-quality care services, it is necessary to develop a service quality assurance plan, track and manage patients, provide patient support, agree on patient referral and transition, and develop an effective information system. Local governance should be established for chronic disease management, and long-term plans and continuous quality improvement are necessary.

Citations

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Coordination of care in health systems for users with diabetes and hypertension: a scoping review
Virgílio Luiz Marques de Macedo, Naira Pereira de Sousa, Ana Cristina dos Santos, Walterlânia Santos, Marina Morato Stival, Tânia Cristina Morais Santa Barbara Rehem
Revista Latino-Americana de Enfermagem.2025;[Epub] CrossRef
Coordenação do cuidado nos sistemas de saúde a usuários com diabetes e hipertensão: uma revisão de escopo
Virgílio Luiz Marques de Macedo, Naira Pereira de Sousa, Ana Cristina dos Santos, Walterlânia Santos, Marina Morato Stival, Tânia Cristina Morais Santa Barbara Rehem
Revista Latino-Americana de Enfermagem.2025;[Epub] CrossRef
Coordinación del cuidado en los sistemas de salud para usuarios con diabetes e hipertensión: una revisión de alcance
Virgílio Luiz Marques de Macedo, Naira Pereira de Sousa, Ana Cristina dos Santos, Walterlânia Santos, Marina Morato Stival, Tânia Cristina Morais Santa Barbara Rehem
Revista Latino-Americana de Enfermagem.2025;[Epub] CrossRef
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Nataša Stojnić, Monika Martens, Edwin Wouters, Savina Chham, Josefien van Olmen, Katrien Danhieux, Nina Ružić Gorenjec, Ir Por, Antonija Poplas-Susič, Zalika Klemenc-Ketiš
International Journal of Integrated Care.2024;[Epub] CrossRef
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Yeong Geun Gwon, Seung Jin Han, Kyoung Hoon Kim
Journal of Preventive Medicine and Public Health.2023; 56(3): 248. CrossRef

Case Reports

Pathology and Forensic Medicine
Mammary Paget’s disease without underlying malignancy of the breast: Nuri Jang, Suhwan Kang, Young Kyung Bae; Yeungnam Univ J Med. 2018;35(1):99-103. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.99

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Abstract PDF

Mammary Paget’s disease (MPD) is usually accompanied by underlying breast malignancy; however, a few cases have been reported as only skin lesions without any evidence of malignancy of the breast on imaging tests and microscopic examination of surgical specimen. Here, we describe a 47-year-old woman who visited our hospital who had an eczematous lesion on right nipple and areola for over 10 years. The lesion was diagnosed as Paget’s disease by punch biopsy; however, imaging studies demonstrated no breast malignancy or lymph node metastasis. The patient underwent surgery of on the nipple and areola including underlying breast tissue. No underlying malignancy was found upon microscopic examination, except for Paget’s disease. Immunohistochemical stains revealed that the tumor cells were positive for cytokeratin 7, and negativity for p63, cytokeratin 5/6, estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2. We report a case of MPD without underlying malignancy. To the best of our knowledge, this is the third case reported in Korea.

Citations

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Isolated Extensive Paget’s Disease Without Underlying Breast Carcinoma
Shivani Moudgil, Cherry Bansal, Gurupriya Anand, Gomty Mahajan
Indian Journal of Surgery.2025;[Epub] CrossRef
‘Eczematous’ dermatitis of the nipple: clinical and histopathological differential diagnosis of Paget disease
Hatice B. Zengin, Puay Hoon Tan, Regina Liu, Bruce R. Smoller
Pathology.2024; 56(3): 300. CrossRef
An unusual case of longstanding mammary Paget disease presenting with reticulated skin changes
S. K. Dhariwal, E. Rytina, J. C. Sterling
Clinical and Experimental Dermatology.2021; 46(4): 748. CrossRef
Histopathological patterns of skin adnexal tumours in Ibadan, South-West Nigeria
OmoladeO Adegoke, MustaphaAkanji Ajani
Hamdan Medical Journal.2021; 14(4): 168. CrossRef
Clinicopathological characteristics of mammary Paget’s disease: A single‐center 25‐year experience in Korea
Young J. Kim, Keon H. Lee, Woo J. Lee, Chong H. Won, Sung E. Chang, Jee H. Choi, Mi W. Lee
The Breast Journal.2020; 26(4): 806. CrossRef

Emergency and Critical Care Medicine
Ultrasonographic findings in Fitz-Hugh-Curtis syndrome: a thickened or three-layer hepatic capsule: You Ho Moon, Jung ho Kim, Won joon Jeong, Sin-Youl Park; Yeungnam Univ J Med. 2018;35(1):127-129. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.127

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Abstract PDF

Fitz-Hugh-Curtis syndrome (FHCS) is characterized by inflammation of the perihepatic capsules associated with the pelvic inflammatory disease (PID). FHCS is not a serious disease, but if not treated properly, it can result in increased medical costs, prolonged treatment, and dissatisfaction with treatment. However, early recognition of FHCS in the emergency department can be difficult because its symptoms or physical findings may mimic many other diseases. Although contrast-enhanced computed tomography (CECT) is the useful imaging modality for recognition of FHCS, it is available only when a high suspicion is established. We performed point-of-care ultrasonography in an 18-year-old woman who had a sharp right upper quadrant (RUQ) abdominal pain without PID symptoms and found a thickened or three-layer hepatic capsule. These findings coincided with areas showing increased hepatic capsular enhancement in the arterial phase of CECT. These results show that if the thickened or three-layer hepatic capsule without evidence of a common cause of RUQ pain is observed on ultrasonography in women of childbearing age with RUQ abdominal pain, the physician can consider the possibility of FHCS.

Citations

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Analysis of Misdiagnosis of FHCS Syndrome as Cholecystitis and Literature Review
旭旗申
Advances in Clinical Medicine.2022; 12(06): 5608. CrossRef

Review Article

Nuclear Medicine
Beta-amyloid imaging in dementia: Kyung Ah Chun; Yeungnam Univ J Med. 2018;35(1):1-6. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.1

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Abstract PDF

Alzheimer's disease (AD) is a neurodegenerative disorder associated with extracellular plaques, composed of amyloid-beta (Aβ), in the brain. Although the precise mechanism underlying the neurotoxicity of Aβ has not been established, Aβ accumulation is the primary event in a cascade of events that lead to neurofibrillary degeneration and dementia. In particular, the Aβ burden, as assessed by neuroimaging, has proved to be an excellent predictive biomarker. Positron emission tomography, using ligands such as 11C-labeled Pittsburgh Compound B or 18F-labeled tracers, such as 18F-florbetaben, 18F-florbetapir, and 18F-flutemetamol, which bind to Aβ deposits in the brain, has been a valuable technique for visualizing and quantifying the deposition of Aβ throughout the brain in living subjects. Aβ imaging has very high sensitivity for detecting AD pathology. In addition, it can predict the progression from mild cognitive impairment to AD, and contribute to the development of disease-specific therapies.

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Yuanyuan Wang, Baichen Xiong, Hongzhi Lin, Qi Li, Hongyu Yang, Yuting Qiao, Qihang Li, Ziwei Xu, Weiping Lyu, Wei Qu, Wenyuan Liu, Yao Chen, Feng Feng, Haopeng Sun
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Case Report

Cardiology and Cardiovascular Medicine
Acute upper limb ischemia in a patient with newly diagnosed paroxysmal atrial fibrillation: Dong Shin Kim, Seunghwan Kim, Hyang Ki Min, Chiwoo Song, Young Bin Kim, Sae Jong Kim, Ji Young Park, Sung Kee Ryu, Jae Woong Choi; Yeungnam Univ J Med. 2017;34(2):242-246. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.242

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Abstract PDF: Acute limb ischemia (ALI) due to an embolism is associated with high mortality rate and poor prognosis, and early diagnosis with prompt revascularization is required to reduce the risk of limb amputation or even death. The etiologies of ALI are diverse, and it includes an embolism from the heart and thrombotic occlusion of the atherosclerotic native vessels, stents, or grafts. An uncommon cause of ALI is acute arterial thromboembolism, and atrial fibrillation (AF) is the single most important risk factors for systemic thromboembolism. It is important to correctly identify the source of ALI for secondary prevention, as it depends on the underlying cause. Percutaneous transluminal angioplasty (PTA) has been proven to be a safe and effective treatment for focal atherosclerotic and thrombotic occlusive diseases of the aorta and its major extremity branches. Herein, we report on a 77-year-old female patient with acute upper limb ischemia, treated by PTA using a catheter-guided thrombectomy. He was newly diagnosed with paroxysmal AF (PAF) while evaluation the cause of his acute arterial thromboembolism. We recommend that cardiologists always consider PAF as a possible diagnosis even in patients without any history of AF under ALI because it is possible to develop thromboembolism in clinical practice.

Original Article

Anatomy
Developing a new index to assess varicella outbreak: Kiwook Yang, Incheol Seo; Yeungnam Univ J Med. 2017;34(2):222-230. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.222

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Abstract PDF: BACKGROUND
Varicella is the most common infectious disease reported despite the high vaccination rate. Interventions that target humans are particularly effective for varicella because humans are its only natural host. On the other hand, the existing national varicella surveillance systems lack the information to identify an outbreak. Therefore, a new index to assess varicella outbreaks was developed. METHODS: The residential addresses of 2,718 varicella cases reported in Daegu in 2016 were converted to geographic coordinates and the distances between new varicella case and previous cases within 21 days were calculated from the date analyzed. Two cases were considered to be adjacent if the distance between them was less than 1 km. Finally, a proximity index was introduced by dividing the number of adjacent cases by the number of new cases on the date analyzed. RESULTS: First, time-series charts and scatter plots were used to verify that the proximity index reflected the spatial closeness of the different varicella cases. The proximity index is helpful in identifying outbreaks from a list of single varicella cases. In addition, in this study, a new epidemic characteristic of varicella based on the proximity index was shown. CONCLUSION: The proximity index introduced in this study can be used to determine the likelihood of an outbreak from a single case of varicella, and it can be embedded in a web-based national varicella surveillance system that is currently in operation.

Review

Surgery
Surgical treatment of perianal fistula in Crohn's disease: Sohyun Kim; Yeungnam Univ J Med. 2017;34(2):169-173. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.169

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Abstract PDF: Perianal Crohn's disease is a major problem that impair quality of life. This article reviews the current surgical treatment of Crohn's perianal fistula. Fistulotomy and loose seton are commonly used surgical methods for treatment of perianal Crohn's disease. Mucosal advancement flap and fibrin glue are used in this treatment, despite a lake of controlled trials. Fecal diversion is disturbingly high in complicated complex perianal fistula in Crohn's disease. Ligation of intersphincteric fistula and autologous or allogenic stem cells are new surgical procedures for treatment of Crohn's disease that need further studies. Treatment success might be improved by multimodal treatment and new surgical and medical treatment options.

Case Reports

Cardiology and Cardiovascular Medicine
Severe chest pain with mid-ventricular obstruction in a patient with hyperthyroidism: Jong Ho Nam, Jang Won Son, Geu Ru Hong; Yeungnam Univ J Med. 2017;34(1):128-131. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.128

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Abstract PDF: Mid-ventricular obstruction (MVO) rarely occurs in patients without hypertrophic cardiomyopathy. Increased cardiac contractility may play an important role in causing MVO. We experienced a case of severe chest pain and MVO in a 50-year-old female patient. She had hypertension, diabetes, stroke and peripheral artery disease. Her blood pressure was very high (222/122 mmHg) with severe fluctuation. The transthoracic echocardiography revealed MVO accompanied by hyper-dynamic left ventricular systolic function. We regarded her chest pain and MVO as secondary findings related to other diseases. Coronary angiography and several tests for uncontrolled hypertension were performed, and those evaluations revealed that she had coronary artery disease and hyperthyroidism. We considered that the increase in the myocardial oxygen demand in response to the increase in cardiac contractility and workload associated with hyperthyroidism aggravated her symptoms and MVO. She was treated with methimazole and beta blockers and her symptoms dramatically improved.

Cardiology and Cardiovascular Medicine
Acute myocardial infarction with a giant left main aneurysm in atypical Kawasaki disease: Min Wook Kim, Hyun Soo Kim, Myung Dong Lee, Hyun Sook Jung, Seong Bo Yoon, Young Woo Kim; Yeungnam Univ J Med. 2017;34(1):106-110. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.106

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Abstract PDF: Kawasaki disease (KD) is an acute vasculitis of small and medium sized arteries. Even many years after onset, aneurysms and stenosis in coronary arteries may lead to an acute myocardial infarction, which is described as atypical or missed KD in childhood. KD is an underlying disease of young adults with acute myocardial infarction. We report on a rare case involving a total occlusion in the proximal left anterior descending coronary artery combined with a giant left main aneurysm in a young adult patient with acute myocardial infarction ascribed to antecedent KD that is undefined but almost certain.

Nephrology
Rapidly resolved IgG4-related retroperitoneal fibrosis after steroid pulse therapy.: Soomin Jeung, Hyosang Kim, Yuri Seo, Hee Young Yoon, Nah Kyum Lee, Shinhee Park, Bomi Seo, Su Yeon Park, Su Kil Park; Yeungnam Univ J Med. 2016;33(1):40-43. Published online June 30, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.1.40

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Abstract PDF: Retroperitoneal fibrosis (RF) is a disorder characterized by the presence of a retroperitoneal mass and concurrent systemic inflammation. Some cases of RF are recognized as belonging to the spectrum of immunoglobulin G4-related disease (IgG4-RD). Glucocorticoids are highly effective for treatment of retroperitoneal fibrosis, although the optimal dose and duration of therapy have not been established. An initial dose of prednisone (40-60 mg) daily is usually administered with a tapering scheme. We report on a 55-year-old man diagnosed with IgG4-related RF and successfully treated with a 3-day course of daily 250 mg (4 mg/kg) intravenous methylprednisolone, which resulted in the prompt resolution of urinary obstruction and systemic symptoms.

Oncology and Cancer Research
Pumpless extracorporeal interventional lung assist for bronchiolitis obliterans after allogenic peripheral blood stem cell transplantation for acute lymphocytic leukemia.: Yeon Hee Park, Chae Uk Chung, Jae Woo Choi, Sang Ok Jung, Sung Soo Jung, Jeong Eun Lee, Ju Ock Kim, Jae Young Moon; Yeungnam Univ J Med. 2015;32(2):98-101. Published online December 31, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.2.98

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Abstract PDF: Bronchiolitis obliterans (BO), which is associated with graft-versus-host disease after allogenic hematopoietic stem cell transplantation, is a major obstacle to survival after bone marrow transplantation due to its gradual progress, eventually leading to respiratory failure. Pumpless extracorporeal interventional lung assist (iLA) is effective in treatment of reversible hypercapnic respiratory failure. In this paper, we present a 23-year-old female patient who underwent allogeneic peripheral blood stem cell transplantation (PBSCT) for acute lymphocytic leukemia. After 6 months, she complained of shortness of breath and was diagnosed with BO. Five months later, she developed an upper respiratory tract infection that worsened her BO and caused life-threatening hypercapnia. Since mechanical ventilation failed to eliminate CO2 effectively, iLA was applied as rescue therapy. Her hypercapnia and respiratory acidosis showed significant improvement within a few hours, and she was successfully weaned off iLA after 12 days. This is the first case report of iLA application for temporarily aggravated hypercapnia of PBSCT-associated BO followed by successful weaning. This rescue therapy should be considered in ventilator-refractory reversible hypercapnia in BO patients.

Original Article

Pediatrics, Perinatology, and Child Health
QT dispersion in children with Kawasaki disease.: Bo Kyung Song, Kyoung Sung, Min Jung Cho, Hyoung Doo Lee; Yeungnam Univ J Med. 2014;31(2):94-98. Published online December 31, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.2.94

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Abstract PDF: BACKGROUND
We analyzed the changes in QT dispersion (QTd) in children with Kawasaki disease (KD), and determined the presence of repolarization abnormality in these children even in the absence of coronary artery abnormalities. METHODS: Ninety-one children with KD and 20 healthy controls were enrolled in this retrospective study. Serial echocardiographic and electrocardiographic (ECG) measurements in the beginning of treatment, 2nd month and 6th month after the diagnosis were compared. Fifty-one of 91 children had at least 2 serial ECG data. The number of patients who had 3 consecutive ECG data was 23. RESULTS: Among the 67 KD patients with no coronary artery changes, the consecutive mean QTd values were 41.86 ms, 37.84 ms, and 25.47 ms, respectively (26 ms for controls). In the analysis of changes among KD patients without coronary artery abnormalities, QTd showed a significant decrease with time (p=0.01). Especially, the 1st month and the 6th month QTd values were significantly different (p=0.028). The mean QTd values in KD patients with coronary artery changes were significantly higher than those in KD patients with no coronary artery changes at each time (1st, 2nd, and 6th month exam). CONCLUSION: QTd is significantly increased in children during the early stage of KD. Repolarization abnormality may exist during the acute stage of KD, regardless of the echocardiographic changes.

Case Reports

Endocrinology, Diabetes, and Metabolism
Delayed presentation of aggravation of thyrotoxicosis after radioactive iodine therapy at Graves disease.: Ji Hyun Lee, Hyun Jin Na, Jin Woo Park, Cheol Ho Lee, Hyun Jeong Han, Tae Ho Kim, Se Hwa Kim; Yeungnam Univ J Med. 2014;31(2):148-151. Published online December 31, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.2.148

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Abstract PDF: Radioactive iodine (RAI) therapy is widely used for the treatment of Graves disease. After RAI therapy, 44% become hypothyroid and up to 28% remain hyperthyroid. The development of thyrotoxicosis after RAI therapy is believed to be mediated by 2 different mechanisms: a transient increased release of thyroid hormone due to radiation thyroiditis and the rare development of Graves disease due to the formation of antibodies to the thyroid-associated antigens released from the damaged follicular cells. A 55-year-old woman was hospitalized with severe headache, weight loss, and palpitation. She received a dose of 7 mCi of RAI (I-131) about 6 weeks earlier. Thyroid function test showed 7.98 ng/dL free T4, >8 ng/mL T3, <0.08 microIU/L thyroid stimulating hormone, and high titer thyroid stimulating immunoglobulin (TSI) (85.8 IU/L). She improved with propylthiouracil, propranolol, and steroid treatment. The TSI, however, was persistently elevated for 11 months.

Nephrology
Spontaneous abdominal intramuscular hematoma in a non-dialysis chronic kidney disease patient under cilostazol therapy.: Seonghui Kang, Hyung Min Yu, Ha Young Na, Young Kyung Ko, Se Woong Kwon, Chae Ho Lim, Sun Woong Kim, Young Il Jo; Yeungnam Univ J Med. 2014;31(2):139-143. Published online December 31, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.2.139

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Abstract PDF: Spontaneous intramuscular hematoma of the abdominal wall is a rare condition characterized by acute abdominal pain. It is often misdiagnosed as a surgical condition. It used to be associated with risk factors such as coughing, pregnancy, and anticoagulant therapy. Most cases of abdominal wall hematomas were rectus sheath hematomas caused by the rupture of either the superior or inferior epigastric artery, but spontaneous internal oblique hematoma was extremely rare. In this report, we present a case of spontaneous internal oblique hematoma in a 69-year-old man with non-dialysis chronic kidney disease who was taking cilostazol. The patient complained of abrupt abdominal pain with a painful palpable lateral abdominal mass while sleeping. The abdominal computed tomography showed an 8 cm-sized mass in the patient's left internal oblique muscle. The administration of cilostazol was immediately stopped, and the intramuscular hematoma of the lateral oblique muscle disappeared with conservative management.

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.

Cardiology and Cardiovascular Medicine
Coronary artery vasospasm after atrial septal defect surgery.: Jin Won Yoon, Young Soo Lee, Dong Keun Kim, Young Hoon Choi, Dong Ju Kim, Jae Jin Lee, Hyo Seung Ahn, Wook Hyun Cho; Yeungnam Univ J Med. 2014;31(2):122-126. Published online December 31, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.2.122

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Abstract PDF: Coronary vasospasm is one of the fatal complications that may occur in patients undergoing open heart surgery. To date, however, there are not many cases in this series and no definite pathophysiology has been documented. We experienced a case of coronary artery vasospasm after atrial septal defect (ASD) surgery and then successfully treated it with both transbrachial intra-aortic balloon pump and percutaneous cardiopulmonary support. Only several hours after ASD surgery, the patient exhibited the cardiovascular collapse, the ST-segment elevation, followed by ventricular fibrillation and normal coronary angiography findings. It is important to make a differential diagnosis of coronary artery vasospasm in patients presenting with ST-segment elevation who had no notable coronary artery diseases. This case indicates that clinicians should be aware of the possibility that the coronary artery vasospasm may also occur in patients undergoing ASD surgery.

Endocrinology, Diabetes, and Metabolism
Columnar variant of papillary carcinoma in the thyroglossal duct cyst with progression to lung metastasis.: Yujung Yun, Hye Jung Park, Young Ki Lee, Yongin Cho, Beoduel Kang, Hyun Ju Kim, Jung Hee Lee, Moo Nyun Jin, Dong Yeob Shin; Yeungnam Univ J Med. 2014;31(2):103-108. Published online December 31, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.2.103

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Abstract PDF: Thyroglossal duct cyst (TGDC) carcinoma generally shows a favorable prognosis. If metastasis is present latently, it may not threaten the patient's life immediately. It has been shown, however, that larger than 1 cm papillary carcinoma (PC), level VI metastasis to the lymph node (LN), which is the nearest to the thyroid, independently predicts a worse prognosis. In the case presented herein, a 61-year-old female patient was diagnosed with an about 3 cm PC in the TGDC, particularly the columnar variant subtype, one of the aggressive variants. She had occult papillary thyroid microcarcinoma, but no LN metastasis. Even though she underwent the Sistrunk procedure and total thyroidectomy with central compartment neck dissection followed by high-dose radioactive iodine remnant ablation, however, the cancer cells spread to level IV neck LN, and finally to the lung. Therefore, when a patient is diagnosed with an aggressive histologic variant of PC in the TGDC, even without LN metastasis, the invasive surgical approach and close postoperative surveillance are necessary, with consideration of the risk of disease progression. Therefore, if it is possible to stratify the risk for patients, higher-risk patients can be offered a more invasive therapeutic approach.

Dermatology
Fast-growing multiple symmetric lipomatosis.: Jin Hwa Choi, Byung Su Kim, Seung Hyun Sohng, Hyo Jin Lee, Dong Hoon Shin, Jong Soo Choi, Young Kyung Bae; Yeungnam Univ J Med. 2014;31(1):48-51. Published online June 30, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.1.48

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Abstract PDF: Multiple symmetric lipomatosis (MSL) is a rare disease characterized by symmetrical massive fatty deposits on the face, neck, shoulders, and upper trunk. We report a 74-year-old man who complained of painless subcutaneous nodules on his posterior neck that developed 3 weeks earlier. In a week, variably-sized similar lesions developed on both his shoulders and upper extremities. At the time of his hospital visit, several firm nodules as big as a walnut to a child's fist and with the normal-skin-hue were observed on his posterior neck, both shoulders, upper extremities, and trunk. The histological examination of his upper left arm revealed more mature adipocytes without encapsulation in the subcutaneous tissue. MSL was generally known to occur slowly over months or years. However, this is an unusual case that showed a fast-growing nature.

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

Citations to this article as recorded by

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

Rheumatology
A Case of Pseudolymphomatous IgG4-Related Disease Involving the Maxilla.: Min Jung Kim, Seung Il Bae, Hoon Tae Kim, Young Hoon Hong, Hyun Je Kim, Choong Ki Lee, Mi Jin Gu; Yeungnam Univ J Med. 2013;30(2):128-131. Published online December 31, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.2.128

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Abstract PDF: Immunoglobulin G4 (IgG4)-related disease is an inflammatory condition characterized by IgG4 positive plasma cell infiltration. It can affect any organ in the body and mainly involves the pancreas, liver, biliary tracts, orbits, salivary glands and lymph nodes. It can manifest as an inflammatory pseudotumor. Pseudolymphoma as an inflammatory pseudotumor is a group of benign tumors that exhibit histological and clinical features suggestive of malignant lymphoma. Studies on IgG4-related disease are rarely reported, and no case of the disease that involved the maxillary bone and adjacent soft tissue, except for the skin, has been reported. Therefore, we report herein a case of pseudolymphomatous IgG4-related disease that involved the maxilla, with a literature review.

Cardiology and Cardiovascular Medicine
A Case of von Hippel-Lindau Disease with Aortic Valve Insufficiency.: Sang Hyeon Kang, In Chul Park, Duk Song Cho, Hye Jung Lee, Ho Jin Lee, Dong Hyun Lee; Yeungnam Univ J Med. 2013;30(2):101-104. Published online December 31, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.2.101

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Abstract PDF: Von Hippel-Lindau (VHL) disease is an autosomal dominant hereditary disorder caused by a germline mutation of the VHL gene. It is a multi-systemic disorder that is predisposed to benign or malignant tumors of visceral organs such as hemangioblastoma of the central nervous system, renal cell carcinoma, retinal angioma and pheochromocytoma. We report herein a case of VHL disease that initially manifested with aortic valve insufficiency.

Endocrinology, Diabetes, and Metabolism
A Case of Pancytopenia with Hyperthyroidism.: Tae Hoon Kim, Ji Sung Yoon, Byung Sam Park, Dong Won Lee, Jae Ho Cho, Jun Sung Moon, Eui Hyun Kim, Kyu Chang Won, Hyoung Woo Lee; Yeungnam Univ J Med. 2013;30(1):47-50. Published online June 30, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.1.47

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Abstract PDF

There has been an increase in the number of reports of atypical manifestations of Graves' disease (GD), such as jaundice, anemia, thrombocytopenia and leukopenia. Pancytopenia also rarely occurs in GD. In this paper, a case of pancytopenia with GD that was successfully treated with an anti-thyroid drug is reported. In this case, a 69-year-old woman showed pancytopenia with a normal peripheral blood smear, bone marrow aspiration smear and bone marrow biopsy. Her thyroid function test and thyroid scintigraphy confirmed her hyperthyroid status. Her laboratory abnormality and clinical condition improved after she was treated with an anti-thyroid drug. This is a rare case of pancytopenia associated with GD.

Citations

Citations to this article as recorded by

Rare Autoimmune Pancytopenia Due to Graves Disease
Ally W Wang, Geeti Mahajan, Aaron Etra, Shira R Saul
JCEM Case Reports.2025;[Epub] CrossRef
Therapeutic plasma exchange for Graves’ disease in pregnancy
Matthew Lumchee, Mimi Yue, Josephine Laurie, Adam Morton
Obstetric Medicine.2023; 16(2): 126. CrossRef
Non-myeloproliferative Pancytopenia: A Rare Presentation of Thyrotoxicosis
Izzathunnisa Rahmathullah, Maheswaran Umakanth, Suranga Singhapathirane
Cureus.2023;[Epub] CrossRef
Atypical Complications of Graves’ Disease: A Case Report and Literature Review
Khaled Ahmed Baagar, Mashhood Ahmed Siddique, Shaimaa Ahmed Arroub, Ahmed Hamdi Ebrahim, Amin Ahmed Jayyousi
Case Reports in Endocrinology.2017; 2017: 1. CrossRef

Pediatrics, Perinatology, and Child Health
A Case of Hemolytic Disease of a Newborn by an Anti-Di(a) Antibody Treated with Intravenous Immunoglobulin.: Chang Eon Lee, Su Jin Park, Won Duck Kim; Yeungnam Univ J Med. 2013;30(1):21-24. Published online June 30, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.1.21

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Abstract PDF: Hemolytic disease in a newborn that causes early jaundice is common. It is often due to the Rh (D) and ABO incompatibility, but rarely due to unexpected antibodies. Among these unexpected antibodies, the anti-Di(a) antibody rarely occurs. The anti-Di(a) antibody was observed in the serum and red-cell eluate of an infant, and in the serum of his mother. The frequency of the appearance of the Di(a) antigen in the Korean population is estimated to be 6.4-14.5%. This paper reports a case of hemolytic disease in a newborn associated with the anti-Di(a) antibody. A full-term male infant was transferred to the authors' hospital due to hyperbilirubinemia the day after his birth. The laboratory data indicated a hemoglobin value of 11.6 g/dL, a reticulocyte count of 10.6%, a total bilirubin count of 14.4 mg/dL, a direct bilirubin count of 0.6 mg/dL, and a positive result in the direct Coombs' test. Due to the identification of an irregular antibody from the maternal serum, an anti-Di(a) antibody was detected, which was also found in the eluate made from the infant's blood. The infant had been treated with phototherapy and intravenous immunoglobulin since the second day after his birth and was discharged due to an improved condition without exchange transfusion. Therefore, in cases of iso-immune hemolytic disease in a newborn within 24 hours from birth who had a negative result in an antibody screening test, the conduct of an anti-Di(a) antibody identification test is recommended due to the suspicion of an anti-Di(a) antigen, followed by early administration of intravenous immunoglobulin.

Cardiology and Cardiovascular Medicine
Superior Vena Cava Syndrome Without Thrombosis Found in Behcet's Disease.: Hyun Soo Kim, Hyung Jun Kim, Ki Hwan Hur, Kyung Rok Kim, Jae Won Choi, Dong Woo Kang; Yeungnam Univ J Med. 2012;29(1):38-41. Published online June 30, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.1.38

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Abstract PDF

Behcet's disease is a rare multisystemic disorder whose main pathological defectis vasculitis, and superior vena cava (SVC) syndrome without thrombosis is a very rare manifestation of the disease. These authors encountered a case of SVC syndrome without thrombosis caused by Behcet's disease. A 33-year-old man visited the hospital for aggravated dyspnea without any related medical and familial history. He had a three-day history of abrupt swelling of the face, neck, and right arm. He suffered from recurrent oral ulcer, and there were acneiform nodules on his face as well as redness and swelling at the site of the intravenous injection. On the multi-detected computed tomography (CT) chest angiograms (chest angio MDCT), the SVC narrowed without thrombosis. Venogram was carried out, and percutaneous transluminal balloon angioplasty of the SVC stenotic site was performed. The following day, the swelling was found to have subsided. The details of the case are reported herein.

Citations

Citations to this article as recorded by

Recurrent onycholysis in a patient with Behcet's disease
Hyeon Seok Kim, Dong Seok Lee, Seung Hwan Lee, Woo Hyuk Kwon, Yun Jeong Kim
Yeungnam University Journal of Medicine.2016; 33(1): 56. CrossRef

Endocrinology, Diabetes, and Metabolism
A Case of Rifampin-Induced Recurrent Adrenal Insufficiency During the Treatment of Pulmonary Tuberculosis in a Patient with Addison's Disease.: Jong Sik Kang, Gwang Beom Ko, Jae June Lee, Minsoo Kim, Sung Jin Jeon, Gwang Hyeon Choi, Sun Mok Kim, Woo Je Lee; Yeungnam Univ J Med. 2012;29(1):19-23. Published online June 30, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.1.19

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Abstract PDF: Adrenal insufficiency during the treatment of pulmonary tuberculosis is a troublesome condition and can at times be lifethreatening if untreated. Rifampin is one of the most widely prescribed anti-tuberculosis agents. Furthermore, rifampin has been known to be capable of affecting the metabolism of various medications, including glucocorticoids. In this paper, a case of recurrent adrenal insufficiency induced by rifampin during the treatment of pulmonary tuberculosis is reported. The patient was a 63-year-old man who was diagnosed with Addison's disease 17 years earlier and had been undergoing glucocorticoid replacement therapy. Five months before, the patient manifested pulmonary tuberculosis and was immediately given anti-tuberculosis medication that included rifampin. After one week of medication, general weakness and hyponatremia occurred. Despite the increased dose of the glucocorticoid medication, the adrenal insufficiency recurred many times. Since the substitution of levofloxacin for rifampin, the episodes of adrenal insufficiency have not recurred so far.

Nephrology
Two Cases of Severe Pancytopenia Associated with Low-Dose Methotrexate Therapy in Patients with Chronic Kidney Disease and Rheumatoid Arthritis.: Hong Ik Kim, Woo Hyun Lee, Jang Seok Oh, Hyo Rim Hong, In Hee Lee; Yeungnam Univ J Med. 2011;28(1):60-69. Published online June 30, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.1.60

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Abstract PDF: Due to its efficacy and tolerability, low dose oral methotrexate(MTX) therapy has been widely used for treatment of rheumatoid arthritis(RA). However, it can rarely cause serious, life-threatening hematologic toxicities, such as pancytopenia. We report here on two patients with chronic kidney disease(CKD), who developed severe pancytopenia after 5 years (cumulative dose 1,240mg) and 4 years(cumulative dose 1,320mg) of low dose MTX therapy for treatment of RA, respectively. Both patients presented with renal insufficiency, hypoalbuminemia, concurrent use of nonsteroidal anti-inflammatory drugs, and elevated mean corpuscular volume of red blood cells(RBCs), all of which are known as risk factors of MTX-induced pancytopenia. Despite receiving treatment, which included RBC and platelet transfusions, antibiotic therapy, granulocyte colony stimulating factor, and leucovorin rescue, one patient died of sepsis. Based on our case study, prompt investigation of risk factors associated with MTX toxicity is required for all patients receiving MTX therapy. MTX treatment, even at a low dose, should be discontinued in patients with advanced CKD.

Reumatology
A Case of Systemic Lupus Erythematosus Misdiagnosed as Adult-onset Still's Disease.: Myung Jin Oh, Hyun Je Kim, Han Sol Lee, Ji An Hur, Young Hoon Hong, Choong Ki Lee; Yeungnam Univ J Med. 2010;27(1):78-84. Published online June 30, 2010; DOI: https://doi.org/10.12701/yujm.2010.27.1.78

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Abstract PDF: Adult-onset Still's disease (AOSD) is an inflammatory disorder that's characterized by daily, spiking high fever, arthritis and an evanescent, salmon-pink rash. AOSD is diagnosed purely on the basis of the typical clinical features of the illness. The symptoms commonly include swelling of the lymph nodes, enlargement of the spleen and liver, and a sore throat. AOSD is difficult to differentiate from systemic lupus erythematosus (SLE) due to the similar clinical manifestations. We report here on a case of a 16-year-old female patient with autism and epilepsy and who complained of daily spiking fever for 20 days. The patient had maculopapular skin rashes on the face and whole body and lymphadenopathy. The liver function tests were elevated mildly. The initial rheumatoid factor (RF) and antinuclear antibody (ANA) tests were negative. We diagnosed her as having adult-onset Still's disease according to the criteria of Yamaguchi. We successfully treated her with oral prednisolone. But her antinuclear antibody test was changed to positive after discharge. So we finally diagnosed her as having SLE.

Anesthesiology and Pain Medicine
Anesthetic Management of a Patient with Alexander's Disease: Case Report.: Bum Soo Kim, Dae Lim Jee, Sun Ok Song; Yeungnam Univ J Med. 2010;27(1):47-51. Published online June 30, 2010; DOI: https://doi.org/10.12701/yujm.2010.27.1.47

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Abstract PDF: We present here the case of a 13-year-old male patient with Alexander's disease who underwent surgical correction of a femur fracture. Alexander's disease is a rare and fatal disorder that affects the white matter in the brain and it causes developmental delay, psychomotor regression, spasticity, megaloencephaly and seizure. The patient had the possibility of a seizure attack during the perioperative period. We discuss the anesthetic management of a patient with Alexander's disease and we review the relevant literature.

Anesthesiology and Pain Medicine
Anesthetic Management of a Patient with Kimura's Disease.: Eun Ji Choi, Sang Jin Park; Yeungnam Univ J Med. 2009;26(1):38-43. Published online June 30, 2009; DOI: https://doi.org/10.12701/yujm.2009.26.1.38

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Abstract PDF: Kimura's disease is an idiopathic chronic condition, associated with a high-titer of IgE and peripheral eosinophilia. It frequently presents as a solitary or multiple lesions in the head and neck area. During the perioperative period, anesthesiologists should understand the anatomical structures of the patient who has Kimura's disease involvement of the head and neck, especially the airway. It is important to pay attention to the occurrence of signs and symptoms of acute allergic reactions related to a high-titer of IgE and eosinophilia. We report our experience with anesthetic management in an 18-year-old patient with multiple neck masses due to Kimura's disease.

Review

Nuclear Medicine
Clinical Application of Cardiac Hybrid Imaging in Coronary Artery Disease.: Ihn Ho Cho, Eun Jung Kong; Yeungnam Univ J Med. 2009;26(1):15-23. Published online June 30, 2009; DOI: https://doi.org/10.12701/yujm.2009.26.1.15

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Abstract PDF: Constant technological developments in coronary artery disease have contributed to the assessment of both the presence of coronary stenosis and its hemodynamic consequences. Hence, noninvasive imaging helps guide therapeutic decisions by providing complementary information on coronary morphology and on myocardial perfusion and metabolism. This can be done using single photon emission computed tomography(SPECT) or positron emission tomography(PET) and multidetector CT(MDCT). Advances in image-processing software and the advent of SPECT/CT and PET/CT have paved the way for the combination of image datasets from different modalities, giving rise to hybrid imaging. Three dimensional cardiac hybrid imaging helped to confirm hemodynamic significance in many lesions, add new lesions such as left main coronay artery disease, exclude equivocal defects, correct the corresponding arteries to their allocated defects and identify culprit segment. Cardiac hybrid imaging avoids the mental integration of functional and morphologic images and facilitates a comprehensive interpretation of coronary lesions and their pathophysiologic adequacy by three dimensional display of fused images, and allows the best evaluation of myocardial territories and the coronary-artery branches that serve each territory. This integration of functional and morphological information were feasible to intuitively convincing and might facilitate developmnt of a comprehensive non-invasive assessment of coronary artery disease.

Case Report

Pediatrics, Perinatology, and Child Health
Pediatric Crohn's Disease presenting as Severe Constipation and Abdominal Distension.: Myong Soon Sung, Seok Jeong Kang, Kwang Hae Choi; Yeungnam Univ J Med. 2008;25(2):139-144. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.139

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Abstract PDF

Crohn's disease is a chronic inflammatory bowel disease that mainly affects children and young adults. Its cause remains unknown. The incidence of pediatric Crohn's disease is increasing, so it is important for clinicians to be aware of the presentation of this disease in the pediatric population. The majority of patients complain of abdominal pain (72%), with only 25% presenting with the 'classical triad' of abdominal pain, weight loss, and diarrhea. Many children with Crohn's disease present in a 'non-classical' manner, with vague complaints such as lethargy or anorexia, which may be associated with only mild abdominal discomfort. Other symptoms include fever, nausea, vomiting, growth retardation, malnutrition, delayed puberty, psychiatric symptoms, arthropathy, and erythema nodosum. Severe constipation and abdominal distension are uncommon symptoms at diagnosis. We report a case of pediatric Crohn's disease, which was diagnosed after the patient presented with severe constipation and abdominal distension.

Citations

Citations to this article as recorded by

Type 1 Dolichocolon as a Potential Anatomic Co-morbidity in Children with Perianal Crohn’s Disease
Richard Kellermayer, Réka G. Szigeti, Marla Sammer, Adam M. Vogel, Harland S. Winter
Digestive Diseases and Sciences.2026;[Epub] CrossRef

Original Articles

Dentistry
Oral Condition in Cardiovascular Disease Patients: Sung-Pyo Hong, Eun-Young Park, Hee-Kyung Lee; Yeungnam Univ J Med. 2007;24(2 Suppl):S598-605. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S598

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Abstract PDF

The main purpose of this study was to provide primary informations for developing dental health program which must be necessary for cardiovascular disease patients. To conduct this study we analyses the oral health condition of cardiovascular disease patients through oral examination (DMFT index, periodontal index, oral hygiene status) and evaluate oral health behavior through questionnaires survey April 2006 to June 2006. For patients group, we select 50 cardiovascular disease patients who have hypertension, hyperlipidemia, atherosclerosis or myocardial infarction by taking the health examination for the local insured which National Health Insurance Corporation carried out at Sungju area in Gyeongsangbuk-do. And for the controls, we select 50 persons who have normal healthy condition and match the age and sex to patients group. This study showed that DMFT mean values in cardiovascular disease patients were significantly higher than that in controls (p<0.05). Decay teeth index and Filling teeth index did not differ statistically between two groups but the mean Missing teeth index was significantly higher in cardiovascular disease patients than that in controls (p<0.05). PI (Periodontal Index) mean values were significantly higher in cardiovascular disease patients than in the controls(p<0.01). In the cardiovascular disease patients, the M component of the DMFT index was found to be higher as compared to the controls. Cardiovascular disease patients lose their teeth mainly due to periodontal disease, which is supported by the increased PI mean values.

Citations

Citations to this article as recorded by

A study on the general health status related hypertension and oral health status of rural elder
Hyun-Ja Jeong, Ae-Hwa Jaung, Hye-Jin Kim
Journal of the Korea Academia-Industrial cooperation Society.2011; 12(11): 4852. CrossRef

Gastroenterology and Hepatology
Does Ulcerative Proctitis Progress to Extensive Colitis Depending on Treatment?: Youn Sun Park, Byung Ik Jang, Tae Nyeun Kim; Yeungnam Univ J Med. 2007;24(2 Suppl):S384-390. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S384

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Abstract PDF: Background
：The incidence of Ulcerative colitis (UC) in Korea are low compared with those of Western countries, but have been increasing rapidly during the past decades. Clinical characteristics of UC in Asian population are not well recognized. Therefore we investigated the clinical course of UC in Korea. Material and Methods：We retrospectively analyzed 211 UC patients first diagnosed and long term follow up colonoscopic examined at Yeungnam University Medical Center between 1989 and 2006. We reviewed extension of lesion by follow up endoscopic finding and symptom depend on treatment.
Results
：The male to female ratio was 1 : 1.1 and the median age at diagnosis was 46.0 years (range, 17-83 years). At diagnosis, proctitis was noted in 70 patients (33.2%), proctosigmoiditis in 40 (19%), left-sided colitis in 22 (10.4%), extensive colitis in 79 (37.4%). Further extension in the colon was most frequently observed in patients with proctitis (22.8%). In the patients initially diagnosed with proctitis, 28.6% of the patients were not taking any kind of medication for UC and 54 patients (77%, treatment group 34 patients, untreatment group 20) had not progressed during the observation period (56 months, range 2-193 months). The maximal extent of the disease was not affected by treatment (P = 0.99).
Conclusion
：The initial extent of the disease in Korean UC patients was similar to that found in other Western studies. In the present study, most of limited UC(proctitis, proctosigmoiditis, 77-82%) did not progress to extensive colitis regardless of treatments, but large scale multicenter analysis was needed.

Thoracic and Cardiovascular Surgery
Comparison of Postoperative Results after Pneumonectomy between Lung Cancer and Infectious Lung Disease Groups: Jang Hoon Lee, Jung Cheul Lee; Yeungnam Univ J Med. 2007;24(2 Suppl):S304-309. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S304

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Abstract PDF: Background
：Pneumonectomy has been known with higher rate of morbidity and mortality. Thereby, we evaluated patients who received pneumonectomy for lung cancer and infectious lung disease related to postoperative morbidity and mortality. Materials and methods：The retrospective study was undertaken in 55 patients who had undergone pneumonectomy at Yeungnam University Hospital from January 1996 to December 2004. We devided into two groups, lung cancer group (group A, n=40) and infectious lung disease group (group B, n=15) and then compared and analyzed.
Results
：The mean age was higher in group A and there was statistical significance (60.8 9.4 vs 45.7 12.1, p<0.001). With preoperative pulmonary function test, FEV1, FVC were higher in group A and there were statistical significane (p<0.001, p=0.006). With preoperative lung perfusion scan, the perfusion ratio of affected lung and postoperative predicted FEV1 were higher in group A and there were statistical significance (p<0.001, p=0.007). According to MRC dyspnea scale, change of respiratory difficulty of group A had statistical significance (p<0.001). There were a total 20 postoperative complications (36.4%) of which arrhythmia 7, postoperative bleeding 5, empyema and/or bronchopleural fistula 3, pneumonia 2, adult respiratory distress syndrome 1, vocal cord palsy 1. The postoperative complication rate was no difference between two groups (37.5% vs 33.3%) but arrhythmia developed in group A only. There were 3 postoperative mortalities, all in group A.
Conclusion
：Preoperative pulmonary function test and postoperative predicted FEV1 were lower in group B, however, postoperative complication rate was no difference between two groups and mortality developed in group A only. Because of lesser resected lung volume and well adopted in long term diseased period, there was lesser hemodynamic change in infectious lung disease. So postoperative mortality not developed in infectious lung disease group due to arrhythmia and respiratory failure.

Review Articles

Radiology, Radiotherapy & Diagnostic Imaging
Ultrasonography of the Scrotum: Bok Hwan Park, Jae Ho Cho; Yeungnam Univ J Med. 2007;24(2 Suppl):S24-35. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S24

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Abstract PDF: Ultrasonography is an important imaging tool in the evaluation of the scrotal structures and various scrotal disorders because of excellent anatomic resolution, easy and speedy applicability, and safety with no inonizing radiation. Furthermore, a blood flow information can be obtained by the use of color Doppler ultrasonography and spectral waveform analysis. It plays a primary role in the detection, characterization, and localization of scrotal masses and fluid collections. Knowledge of characteristic imaging findings enables appropriate, expeditious evaluation of various scrotal disorders. The objective of this article is to familiarize the reader with the ultrasonographic features of various scrotal disorders.

Gastroenterology and Hepatology
Clinical Update: Inflammatory Bowel Disease: Byung Ik Jang; Yeungnam Univ J Med. 2007;24(2 Suppl):S221-233. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S221

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Abstract PDF

Inflammatory bowel disease(IBD) which is well known as Crohn’s disease and ulcerative colitis is a chronic disorder that repeats improvement and exacerbation. The possible causes of the disease are environmental factors, genetic factors and immune deficiency resulted from bacterial infection. Recently, IL-23 is proved to be a main cytokine which has a central role in Crohn’s disease. The diagnosis of IBD is made by clinical manifestation, serologic test, endoscopic finding and histologic finding. The mainstay of remission and maintenance therapy of ulcerative colitis is 5-aminosalicylate(5-ASA). Steroid can be used in severe or refractory case and nowadays, budesonide shows a good effect with minimal side effects. In cases of steroid dependent, we can use the immunomodulators such as azathioprine, cyclosporin and 6-thioguanine. The cytokine associated with inflammation of IBD has been emphasized and the treatment which targets the cytokine such as tumor necrosis factor is tried. Infliximab and adalimumab block tumor necrosis factors-a and they are proved the efficacy by many clinical trial. Leukocytapheresis(LCAP) is tried in ulcerative colitis since 1980 in Japan. When we treat IBD patients, we need to consider all the things such as safety, side effects and economy of the patients. We expect that the development of new biologic agent which is more cost effective and more effect with more convinience.

Citations

Citations to this article as recorded by

Inflammatory Bowel Disease and Cytokine
Eun Young Choi, Kwang Keun Cho, In Soon Choi
Journal of Life Science.2013; 23(3): 448. CrossRef

Radiology, Radiotherapy & Diagnostic Imaging
Radiological Diagnosis of Adrenal Diseases: Jae Ho Cho; Yeungnam Univ J Med. 2007;24(2 Suppl):S170-185. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S170

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Abstract PDF: Adrenal glands are relatively small than other upper abdominal solid organs but they are affected by complex physiologic and neoplastic processes. In the past, normal adrenal gland and small adrenal masses are difficult to examine because adrenal gland is small and located deeply in the abdominal cavity. However, by the recent remarkable advance of the MR and CT machines and imaging techniques detection of normal adrenal gland and detection and differential diagnosis of various adrenal lesions are possible. And so radiology is playing a critical role in not only the detection of adrenal abnormalities but in characterizing them as benign or malignant. In the diagnosis of adrenal lesions, various imaging modalities are used including, ultrasonography, CT, MR imaging and nuclear medicine imaging. Ultrasonography plays a role as a screening imaging modality. CT is the imaging modality of choice for both detection and characterization of adrenal masses. MR imaging is a problem solving modality in cases of inconclusive or insufficient on CT. The purpose of this article is to give an overview of adrenal diseases and their imaging appearances and describe the current concepts of differentiating a benign from a malignant adrenal mass.

Neurology
Diagnosis and Treatment of Parkinson's Disease Dementia : An Update: Mee Young Park; Yeungnam Univ J Med. 2007;24(2 Suppl):S159-169. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S159

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Abstract PDF: Dementia in the Parkinson’s disease has been increasingly recognized especially in old age. And akinetic-rigid symptoms or cognitive impairment at onset of Parkinson’s disease (PD) are also high risk factors for dementia. However, there have been no gold standard guideline in order to identify the Parkinson’s disease dementia (PDD). Recently, the Movement Disorder Society developed a new diagnostic criteria for PDD in December 2007. I introduce a new PDD diagnostic criteria proposal with a review of treatment strategy of PDD. After the sensitivity and specificity of these criteria ascertained, a revision may be need. But they promising clinical and prospective research baselines in the future.

Microbiology
Platelet Activating Factor-Acetylhydrolase: Tae-Yoon Lee; Yeungnam Univ J Med. 2007;24(2 Suppl):S142-151. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S142

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Abstract PDF: Platelet activating factor (PAF) is a phospholipid with a strong inflammatory mediator. PAF is synthesized in a variety of cells in response to inflammatory stimuli. PAF is degraded by intracellular and extracellular PAF-acetylhydrolases (PAF-AHs) thus providing proper level of PAF. Plasma PAF-AH deficiency is associated with several diseases such as asthma, systemic lupus erythematosus, juvenile rheumatoid arthritis, acute myocardial infarction, diabetes, and membranous nephropathy. Cloning of plasma PAF-AH gene enabled the use of recombinant PAF-AH as a therapeutic tool for these PAF-mediated diseases.

Review

Surgery
Hirschsprung's Disease.: Nam Hyuk Lee; Yeungnam Univ J Med. 2007;24(1):11-23. Published online June 30, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.1.11

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Abstract PDF: Hirschsprung's disease is one of the most common causes of intestinal obstruction in neonates and infants. The underlying pathology of this disease is the absence of the ganglion cells in both the myenteric (Auerbach's) plexus and the submucosal (Meissner's) plexus. Since Hirschsprung's report in 1886, there have been thousands of papers on Hirschsprung's disease but the cause of the absence of the ganglion cells has not been identified. Hirschsprung's disease can be successfully treated with the Swenson, the Duhamel, and the Soave operations even though the pathogenesis is unknown. With the recent progress of molecular biology and genetics, a more detailed approach to the pathogenesis of Hirschsprung's disease can be undertaken. In addition, there have been recent developments in the surgical approach. In this review, recent advances in surgery for Hirschsprung's disease are presented.

Case Report

Cardiology and Cardiovascular Medicine
A Case of Glycogen Storage Disease with Hypertrophic Cardiomyopathy.: Dong Hee Kim, Sang Wook Kang, Won Jong Park, Kyoung Ae Jang, Joon Hyuk Choi, Woong Kim, Sang Hee LEE, Geu Ru Hong; Yeungnam Univ J Med. 2006;23(2):252-257. Published online December 31, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.2.252

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Abstract PDF: Glycogen storage diseases are a heterogeneous group of metabolic disorder affecting multiple organ system: liver, skeletal muscle, heart and brain. Clinical features include: short status, hepatomegaly, hypoglycemia, dyslipidemia and rare involvement of the myocardium except in the case of type III, glycogen storage diseases with hypertrophic cardiomyopathy in adult, which is extremely rare. We treated a case of hypertrophic cardiomyopathy with hepatomegaly that was unknown etiology. The patient was diagnosed as having glycogen storage disease. This 46-year old women was transferred with dyspnea on exertion and abnormal LFTs. She was diagnosed with hypertrophic cardiomyopathy by echocardiography but there was no specific cause for hypertrophic cardiomyopathy. A liver biopsy was performed. The result showed glycogen storage disease possible type III, IV or IX. In conclusion, patients with hypertrophic cardiomyopathy of unknown etiology and abnormal LFTs should be evaluated for glycogen storage disease.

Original Article

Gastroenterology and Hepatology
The Usefulness of Capsule Endoscopy in Diagnosis of Small Bowel Diseases.: Jong Ryul Eun, Byung Ik Jang; Yeungnam Univ J Med. 2006;23(1):45-51. Published online June 30, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.1.45

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Abstract PDF: BACKGROUND
This study was conducted to evaluate the usefulness of capsule endoscopy (CE) for the diagnosis of small bowel diseases. MATERILAS AND METHODS: We reviewed the medical records of 66 patients (mean age: 52.1 years, male/female: 39/27), who underwent CE at Yeungnam University Hospital from August 2003 to March 2006. RESULTS: Suspicious gastrointestinal (GI) bleeding presenting as anemia or history of gross bleeding was the most common reason to perform CE (71.2%). Other indications included GI symptoms (21.2%) such as abdominal pain/discomfort, nausea, diarrhea, and others (7.6%). In studies performed for GI bleeding (n=47), ulcer/erosion was the most common finding (n=22, 46.8%) followed by tumor (n=5, 10.6%), angiodysplasia (n=3, 6.4%), polyp (n=3, 6.4%), active bleeding (n=1, 2.1 %), ulcer with stenosis (n=1, 2.1%), and normal findings (n=12, 25.5%). Of these, a bleeding focus was detected in 32 cases (68.1%) undergoing CE studies. Among 14 patients with GI symptoms, only two patients had typical findings related with symptoms. Surgical resection was performed in five cases with tumor. Of these, four were diagnosed as gastrointestinal stromal tumor and the other one was a lymphangioma. There were no complications associated with the CE procedure. CONCLUSION: Capsule endoscopy is a safe, noninvasive diagnostic tool for small bowel diseases and may be useful for the diagnosis of small bowel hemorrhage including obscure bleeding. However, further studies are needed to confirm its utility for abdominal symptoms other than hemorrhage because of the low diagnostic yield.

Case Reports

Gastroenterology and Hepatology
Colon Cancer in Behcet's Disease.: Ji Eun Lee, Jang Won Sohn, Kyu Hyung Lee, Youn Sun Park, Kook Hyun Kim, Jae Won Choi, Jong Ryul Eun, Byung Ik Jang, Tae Nyeun Kim; Yeungnam Univ J Med. 2006;23(1):124-130. Published online June 30, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.1.124

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Abstract PDF

Behcet's disease has rarely been reported in association with malignant diseases. In most cases the autoimmune nature of the disease itself or immunosuppressive drug use has been blamed for malignant transformation. Solid tumors in addition to lymphoid and hematological malignancies are also seen during the course of Behcet's disease. We present here a case of colon cancer in a 40-year-old man with Behcet's disease. A near total colectomy was performed and postoperative chemotherapy and radiotherapy was administered to treat visceral peritoneal invasion. Recurrent evidence was not found. We present the clinical details of this rare case of colon cancer with Behcet's disease.

Citations

Citations to this article as recorded by

Cancer colique au cours de la maladie de Behçet
S. Bouomrani, H. Baïli, K. Souid, I. Kilani, M. Beji
Journal Africain d'Hépato-Gastroentérologie.2016; 10(1): 1. CrossRef
Morbidity of Solid Cancer in Behçet's Disease: Analysis of 11 Cases in a Series of 506 Patients
So Young Na, Jaeyoung Shin, Eun-So Lee
Yonsei Medical Journal.2013; 54(4): 895. CrossRef

Neurology
A Family of Dentatorubropallidoluysian Atrophy.: Ji Yoon Chung, Mee Young Park, Jun Lee, Jun Pil Yoon, Hyun Jung Park; Yeungnam Univ J Med. 2006;23(1):118-123. Published online June 30, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.1.118

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Abstract PDF: Dentatorubropallidoluysian atrophy (DRPLA) is a rare neurodegenerative disorder usually inherited in an autosomal dominant pattern. DRPLA has been shown to be associated with expansion of an unstable cytosine-adenine-guanine (CAG) trinucleotide repeat in a gene on chromosome 12p. We evaluated a family with DRPLA that affected three members; A 35-year-old female presented with seven year history of gait ataxia, dysarthria and mild cognitive impairment. The MRI of the brain revealed diffuse cerebellar atrophy with an incidental lipoma in the midbrain. Her 30-year-old brother presented with progressive cerebellar ataxia that developed at the age of 20. Her grandmother and mother were reported to have developed ataxia during the late period of their life, and died at the age of 60 and 55, respectively. The demonstration of an expanded CAG repeat in the gene for DRPLA was used to confirm the diagnosis.

Review

Pulmonary and Respiratory Medicine
Nutritional Management in Patients with Chronic Obstructive Pulmonary Disease.: Kwan Ho Lee; Yeungnam Univ J Med. 2004;21(2):133-142. Published online December 31, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.2.133

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Abstract PDF

Chronic obstructive pulmonary disease (COPD) is characterized by a not entirely reversible limitation in the airflow. An airflow limitation is progressive and associated with an abnormal inflammatory response of the lung to gases and harmful particles. In COPD, the weight loss is commonly observed and there is a negative impact on the respiratory as well as skeletal muscle function. The pathophysiological mechanisms that result in weight loss in COPD are not fully understood. However, the mechanisms of weight loss in COPD may be the result of an increased energy expenditure unbalanced by an adequate dietary intake. The commonly occurring weight loss and muscle wasting in COPD patients adversely affect the respiratory and peripheral muscle function, the exercise capacity, the health status, and even the survival rates. Therefore, it is very valuable to include management strategies that the increase energy balance in order to increase the weight and fat free mass. A Better understanding of the molecular and cellular pathological mechanisms of COPD can improve the many new directions for both the basic and clinical investigations. The Nutritional supply is an important components of a multidisciplinary pulmonary rehabilitation program. Future studies combining an exercise program, the role of anabolic steroids, nutritional individualization, a more targeted nutritional therapy, and the development of new drugs including anti-cytokines is needed for the effective management of COPD.

Citations

Citations to this article as recorded by

Nutrient intake and dietary quality of Korean adults according to chronic obstructive pulmonary disease (COPD): Based on the 2012~2014 Korea National Health and Nutrition Examination Survey
Bo Mi Kang, Hae Ryun Park, Young Mi Lee, Kyung Hee Song
Journal of Nutrition and Health.2017; 50(6): 585. CrossRef

Case Report

Neurology
Neuro-Behcet's Disease Presented with Cerebral Venous Sinus Thrombosis: A Case Report.: Yun Kyung Lee, Mee Young Park, Seung Hyun Lee, Sung Gyun Joo, Yong Kook Cho; Yeungnam Univ J Med. 2004;21(1):96-100. Published online June 30, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.1.96

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Abstract PDF: Behcet's disease is a chronic, relapsing multisystem disorder, that may develop into variable neurological manifestations. They include vascular and parenchymal involvement. Vascular involvement is dominated by cerebral venous sinus thrombosis marked by benign intracranial hypertension. Cerebral venous sinus thrombosis can present with all the classical criteria for idiopathic intracranial hypertension, including normal brain CT findings with normal CSF content. But brain MRI is a useful diagnostic method in this situation to confirm the presence of cerebral venous sinus thrombosis. We experienced a case of raised intracranial pressure in a 21-year-old man, caused by cerebral venous sinus thrombosis. We disclosed his symptoms and signs thus fulfilling the diagnostic criteria for Behcet's disease.

Original Articles

Social and Family Medicine
The Relationship Between Adiposity and Risk factors for Cadiovascular Disease at Normal Body Weight Male.: Woo Sung Kwon, Jun Su Kim, Jin Wook Chae, Keun Mi Lee, Seung Pil Jung, Yong Moon; Yeungnam Univ J Med. 2003;20(1):62-70. Published online June 30, 2003; DOI: https://doi.org/10.12701/yujm.2003.20.1.62

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Abstract PDF: BACKGROUND
Most of all studies about the relation between the health risk and obesity are based on the European and American data. The purpose of this study is to examine the relation between adiposity and risk factors for cardio vacular disease (CVD) in normal weight individuals. MATERIALS AND METHODS: Normal weight subjects with a body mass index (BMI) between 18.5 and 23 kg/m2 (76 subjects) and overweight subjects with a BMI between 23 and 25 kg/m2 (53 subjects) were retained for this study. Normal weight subjects were divided into three group of each adiposity variable, then three group and the overweight group were evaluated for the presence of CVD risk factors and analyze the correlation coefficients between adiposity variables and risk factors controlled for age in normal weight, overweight groups. Using logistic regression analysis, the odds ratio (OR) for the prevalence of risk factors for each group of adiposity variables and the overweight group was estimated relative to the first group in normal weight subjects. RESULTS: Systolic BP, diastolic BP, LDL cholestrol, HDL cholesterol, triglycerides in normal weight subjects were significantly correlated with all adiposity variables (P<0.01). Third group (3.7 for %fat and 4.7 for fat mass)of adiposity variables in the normal weight group and the overweight group (6.6 for %fat and 11.5 for fat mass) tended to have higher ORs compared to first group for risk factor variables. CONCLUSION: Normal weight subjects with elevated adiposity had higher prevalence of risk factors than normal weights subjects with less adiposity. Measuring of adiposity added additional information of cardiovascular disease risk factors in normal weight subjects.

Dentistry
Clinical Evaluation about the Immediate Implant Replacement after Tooth Extraction.: Eun Young Yang, Sang Deuk Chun, Jae Hwan Rho, Seung Eun Lee, Jae Chul Song, Byung Rho Chin; Yeungnam Univ J Med. 2003;20(1):45-52. Published online June 30, 2003; DOI: https://doi.org/10.12701/yujm.2003.20.1.45

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Abstract PDF: BACKGROUND
Immediate implant placement has become an acceptable treatment for the edentulous area. The advantages of the immediate implant placement include considerable decrease in time from tooth extraction to placement of the finial prosthesis, fewer surgical procedures, and better acceptance of the overall treatment plans. But the success is dependent on the quantity and quality of the extraction socket. The purpose of this study is to evaluate the success of the immediate implant placement. MATERIALS AND METHODS: Twenty-one sites in 16 patients were selected for the evaluation of the immediate implant placement. All of the cases were followed using clinical and radiographic examinations. Criteria of success were the absence of peri-implant radiolucency, mobility, and persistent pain or sign of infection. RESULTS: Of the 21 implants, 13 implants have been succeeded. Of the 13 implants, 10 implants were replaced for the periodontal disease and 3 implants were replaced for the trauma. CONCLUSION: The criteria of the success in immediate implant placement are as follows. 1) Implants placed into fresh extraction sockets have a high rate of survival. 2) Implant should be placed as close as possible to the alveolar crest. 3) Implant placed into available bone beyond the apex have a high success rate.

Review

Pediatrics, Perinatology, and Child Health
Kawasaki Disease.: Young Hwan Lee; Yeungnam Univ J Med. 2000;17(2):99-107. Published online December 31, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.2.99

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Abstract PDF

Kawasaki disease, an acute febrile illness which primarily affects in children under the age of six, was first described by Tomisaku Kawasaki in 1967. It has been reported that Kawasaki disease is probable driven by abnormalities of the immune system after an infectious insult, but this has not been confirmed. It mainly affects small and medium-sized arteries, particularly the coronary arteries. Deaths may occur at any time with cardiovascular complications. The early recognition and treatment with follow-up evaluation for the coronary arterial lesion is very important in a case of Kawasaki disease.

Citations

Citations to this article as recorded by

Risk factors for the occurrence and persistence of coronary aneurysms in Kawasaki disease
Soo-kyeong Jeon, Geena Kim, Hoon Ko, Joung-Hee Byun, Hyoung Doo Lee
Korean Journal of Pediatrics.2019; 62(4): 138. CrossRef

Original Article

Pediatrics, Perinatology, and Child Health
Statistical analysis of patients referred to pediatric cardiologic clinic for diagosis of heart disease.: Kwang Hae Choi, Young Hwan Lee; Yeungnam Univ J Med. 2000;17(1):49-54. Published online June 30, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.1.49

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Abstract PDF

BACKGROUND
Echocardiography is rapidly established itself as the primary diagnostic technique for investigation of children with heart disease, and referrals are increasing to the pediatric cardiology clinic for investigation. However, because there is a lack of analysis data on the patients referred to pediatric cardiology clinics, we have proceeded to compare and analyze their characteristics to provide basic data base. METHODS: From Oct. 1, 1998 to Jul. 10, 1999, total 443 cases referred to the pediatric cardiology clinic of Yeungnam University Hospital were studied retrospectively by medical records, chest X-ray, EKG and echocardiography, etc. RESULTS: The results were as follows. 1. The proportion of male was 61.0%(261 cases) and that of female was 39.0%(167 cases). The ratio of male to female was 1.6:1. The proportion infants less than 1 year-old was 62.6%(268 cases) of all patients. 2. Cardiac murmur was present in 248 cases(57.9%), which was the most common case of referral to the pediatric cardiology clinic. The impression at referral was more congenital heart disease(70.6%) than acquired heart disease(17.8%) and arrhythmia(11.6%). 3. The final diagnosis was as follows : congenital heart disease was present in 212 cases(49.5%), acquired heart disease, 59 cases(13.9%); arrhythmia, 13 cases(3.0%); normal heart, 144 cases(33.6%). CONCLUSION: Among the patients referred to pediatric cardiology clinic, 33.6%(144 cases) had normal hearts and why these patient were referred may be possibly due to more dependence on echocardiography than on auscultation instruction. Threfore, clinical and auscultatory skill should be emphasized to minimize dependence on expensive echocardiography for evaluation of pediatric heart disease.

Citations

Citations to this article as recorded by

Evaluation and diagnostic approach for heart murmurs in children
Hee Joung Choi
Journal of the Korean Medical Association.2020; 63(7): 398. CrossRef

Case Report

Rheumatology
Two Cases of Systemic Lupus Erythematosus with Cerebrovascular Involvement.: Bong Jun Kim, Eun Young Lee, Young Hoon Hong, Ki Do Park, Young Doo Song, Choong Ki Lee, Young Ran Shim; Yeungnam Univ J Med. 1998;15(2):371-380. Published online December 31, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.2.371

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Abstract PDF: Systemic lupus erythematosus(SLE) is an autoimmune disease which may affect many different organs and disclose various clinical manifestations. Recently central nervous system(CNS) involvement has been recognized as an increasingly significant contributor to morbidity and mortality of SLE. The clinical manifestations of CNS-lupus are highly variable and range from mild cognitive dysfunction, movement disorder, headache, psychosis to life-threatening stroke and coma. Among the neuropsychiatric disorders encountered in patients with SLE, cerebrovascular disease has been a relatively rare complication. The diagnosis and management of CNS-lupus is difficult because of the lack of useful diagnostic methods. If, cerebrovascular involvement is suspected, then aggressive treatment such as high dose steroid, immunosuppressive therapy, plasma exchange, may be required to reduce high mortality rate. We experienced 2 cases cerebrovascular disease occurring in SLE patients which presented with various neuropsychiatric manifestations. They were diagnosed as CNS-lupus by neuropsychiatric symptoms, brain MRI, and EEG, and showed good response to high dose steroid pulse therapy.

Original Articles

Neurology
MRI Findings of Neuro-Behcet' Disease.: Han Won Jang, Woo Mok Byun, Kil Ho Cho, Mi Soo Hwang; Yeungnam Univ J Med. 1998;15(2):306-315. Published online December 31, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.2.306

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Abstract PDF: MR findings in nine patients(three female, six male) with neuroBehcet's disease were retrospectively analyzed. NeuroBehcet's disease was diagnosed on the basis of typical clinical symptoms. Involved site, pattern, signal intensity, and contrast enhancement pattern on MRI were evaluated. In addition, follow up MR imaging was performed in four patients. The midbrain(7/9), internal capsule(7/9), pons(6/9), thalamus(6/9), basal ganglia(5/9), middle cerebella peduncle(4/9), medulla oblongata(2/9), and subcortical white matter(2/9) are involved on MRI. The size of lesions were 1cm to 3cm and their margin was ill-defined and patchy. Inhomogeneous high signal intensity on the T2-weighted images and low signal intensity on T1-weighted images was seen respectvely. In four of nine cases, there was focal enhancement. On follow up MR imaging, improvement or recurrance of the lesions was found. Also in two cases of follow up cases there was artophy in brainstem and/or middle cerebellar peduncles. In conclusion, MR imaging with systemic clinical symptoms is useful for diagnosing neuro-Behcet's disease.

Gastroenterology and Hepatology
Effect of alpha-Interferon 2b on Chronic Hepatitis B Patients with High Serum ALT.: Heon Ju Lee, Young Doo Song; Yeungnam Univ J Med. 1998;15(2):237-245. Published online December 31, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.2.237

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Abstract PDF: No abstract available.

Pulmonary and Respiratory Medicine
The Clinical Study of Clarithromycin for the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease.: Ki Beom Kim, Chang Jin Shin, Hak Jun Lee, Jin Hong Chung, Kwan Ho Lee, Hyun Woo Lee; Yeungnam Univ J Med. 1997;14(1):94-100. Published online June 30, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.1.94

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Abstract PDF: To evaluate the efficacy and safety of clarithromycin in acute exacerbation of chronic obstructive pulmonary disease, we administered clarithromycin(250mg) twice in a day in 30 patients with acute exacerbation of chronic obstructive pulmonary disease from September to November in 1996. Twenty eight eases of 30 patients were cured(93.4%) and 2 cases(6.7%) show clinical improvement. Three cases were improved within 3 days of treatment and 24 cases were improved between 5 days and 12 days of treatment. There were no significant side effects. These results suggest that clarithromycin will be effective as a first line therapy in patients with acute exacerbation of chronic obstructive pulmonary disease.

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