Journal of Yeungnam Medical Science

Review article

Oncology and Cancer Research
Immunotherapy in triple-negative breast cancer: mechanisms of resistance and emerging approaches: a narrative review: Sung Ae Koh; J Yeungnam Med Sci. 2026;43:17. Published online February 6, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.17

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Abstract PDF: Triple-negative breast cancer (TNBC) is characterized by less treatment responsiveness and poorer prognosis than other breast cancer subtypes. The introduction of anti-programmed cell death 1 (PD-1)/programmed cell death ligand 1 (PD-L1) immunotherapy has expanded the therapeutic options beyond conventional chemotherapy, leading to the adoption of pembrolizumab-based regimens in both adjuvant and first-line palliative settings. However, in contrast to other tumor types that respond robustly to immune checkpoint inhibitors, the efficacy of PD-1/PD-L1 blockade in TNBC remains modest. Multiple factors contribute to this limited response, including the heterogeneity of PD-L1 expression, presence of an immunosuppressive tumor microenvironment regulated by complex immunomodulatory pathways, differences in mutational burden and neoantigen presentation, quantity and functional exhaustion of tumor-infiltrating lymphocytes, and variable synergy with combination partners. Numerous combination strategies have been actively investigated to enhance immunotherapeutic efficacy. Among these, antibody drug conjugates (ADCs) have shown the most promising results. The phase III ASCENT-04/KEYNOTE-D19 trial demonstrated that the combination of sacituzumab govitecan and pembrolizumab significantly improved progression-free survival in patients with PD-L1–positive metastatic TNBC, establishing this regimen as a potential new first-line standard, pending guideline adoption. Although the overall survival data are still immature, the trend appears to be favorable. Other ADCs are being explored in early phase studies, and targeted therapies such as poly(ADP-ribose) polymerase and protein kinase B inhibitors have also shown preliminary activity in smaller trials. Further refinement of these strategies through biomarker-driven, large-scale studies is warranted to identify the most effective combinations and to improve outcomes in patients with TNBC.

Original articles

Surgery
Health system disruption and oncologic consequences: a retrospective observational study of South Korea’s 2024 medical walkout: Seung Ho Song, Chang Hyun Kim, Soo Yeun Park; J Yeungnam Med Sci. 2026;43:4. Published online December 18, 2025; DOI: https://doi.org/10.12701/jyms.2026.43.4

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Abstract PDF Supplementary Material: Background
In February 2024, a sudden government policy to drastically increase medical school admissions triggered the mass resignations of medical trainees across South Korea, severely disrupting hospital operations. This study aimed to evaluate the impact of the resulting healthcare workforce disruptions on short-term clinical outcomes and the timing of colorectal cancer surgeries.
Methods
This retrospective comparative study analyzed patients with colorectal cancer treated at two national university hospitals in Daegu and Gwangju, South Korea. Patients who first visited the colorectal surgery department between March and August of 2023 and 2024 were included. Data from 2020 to 2022 were used for extended comparisons. The primary outcome was the interval from initial outpatient visit to surgery. Secondary outcomes included treatment modality distribution, tumor staging, and postoperative complications.
Results
A total of 895 patients in 2023 and 853 in 2024 were included. In 2024, only 39.5% of patients (337/853) underwent upfront surgery compared to 63.5% (569/895) in 2023. The median time to surgery increased from 30 days (interquartile range [IQR], 22–44 days) to 52 days (IQR, 30–72 days) (p=0.001). Clinical T3–4 tumors increased from 49.9% to 59.3% (p=0.018), lymph node-positive cases increased from 25.9% to 51.3% (p=0.001), and postoperative complication rates increased from 12.0% to 28.2% (p=0.001).
Conclusion
The abrupt healthcare workforce crisis in early 2024 significantly delayed colorectal cancer surgeries and was associated with worse short-term oncologic outcomes. These findings highlight the critical importance of maintaining a stable healthcare workforce to protect access to timely cancer care.

Oncology and Cancer Research
ETS-related gene as a key factor in curcumin inhibition of glucose metabolism in prostate cancer cells: an in vitro experimental study: Yunye Wang, Xingyu Zhao, Jierui Zhao, Xin Wang, Yumiao Guo, Shutong Chen, Ying Jin, Peng Peng, Wei Zhang; J Yeungnam Med Sci. 2025;42:78. Published online November 20, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.78

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Abstract PDF: Background
Curcumin, the main yellow pigment in turmeric, is a potent anticancer agent. However, its effect on the viability of human prostate cancer (PCa) cells and underlying mechanisms remain unclear. This study aimed to determine the effects of curcumin on the proliferation and glucose metabolism of PCa cells.
Methods
Cell viability was measured by MTS assay, and apoptosis was measured by flow cytometry. Glucose metabolism was assessed by measuring glucose intake, lactate production, and adenosine triphosphate content. Western blotting was performed to detect the expression of apoptosis-related proteins.
Results
Curcumin treatment significantly reduced the viability of two types of PCa cells. We also found that curcumin increased apoptosis and glycolysis by inhibiting the activities of phosphatidylinositol 3-kinase/protein kinase B and hypoxia-inducible factor-1α. Furthermore, curcumin reduced the expression of ETS-related gene (ERG). However, after the ERG was knocked out, the effects of curcumin treatment were attenuated.
Conclusion
This study investigated the effects of curcumin on the proliferation and apoptosis of PCa cells, which may be related to the inhibition of glycolysis, and further explored the pathway involved. The subsequent effect on ERG expression indicated that these effects may be related to this oncogene.

Case report

Dermatology
Ungual scabies mimicking periungual verruca in a patient with metastatic breast cancer treated with abemaciclib: a case report: Min Chong Kim, Joon-Goon Kim; J Yeungnam Med Sci. 2025;42:55. Published online September 13, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.55

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Abstract PDF: Ungual scabies is a rare manifestation of Sarcoptes scabiei infestation in nail units and may mimic other nail diseases, resulting in diagnostic delay. Herein, we report the case of a 58-year-old woman with metastatic breast cancer who received abemaciclib and presented with recalcitrant paronychia and verruca-like periungual hyperkeratosis, sparing the finger web area without pruritus. Skin biopsy confirmed multiple mites in the stratum corneum, resulting in the diagnosis of crusted scabies with nail involvement. Topical permethrin 5% cream and oral ivermectin were then administered. The prolonged unrecognized disease in our patient led to repeated visits to long-term care facilities and tertiary hospitals, thereby increasing the risk of nosocomial transmission. This case emphasizes that clinicians, including non-dermatologists, should consider scabies in patients with chronic periungual lesions, particularly in patients who are immunocompromised such as those using abemaciclib, to prevent hospital outbreaks and excessive healthcare costs.

Review article

Radiation Oncology
Radiation therapy in the treatment of pancreatoblastoma: a narrative review: Atsuto Katano; J Yeungnam Med Sci. 2025;42:37. Published online June 16, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.37

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Abstract PDF: Pancreatoblastoma is an extremely rare pediatric pancreatic tumor that primarily affects children <10 years of age, with a mean age of onset of 5 years. Risk factors such as vascular and lymph node involvement often lead to incomplete resection, necessitating a multidisciplinary approach. Despite these strategies, the role of radiotherapy in the management of pancreatoblastoma remains unclear. A quantitative literature search of the PubMed database was performed to identify relevant case reports and series that explicitly documented the use of radiotherapy for pancreatoblastoma. The search covered the period from January 1986 to November 2024. Of the 36 records retrieved, seven case reports comprising eight patients fulfilled the inclusion criteria. Six patients underwent radiotherapy at the primary tumor site with external beam therapy doses ranging from 36 to 46.2 Gy. Intraoperative radiotherapy was also administered in two cases, with doses of 15 and 20 Gy. Additionally, stereotactic radiotherapy was administered to two patients with intracranial metastases, demonstrating its effectiveness in managing brain metastases. Although the role of radiotherapy in pancreatoblastoma remains ambiguous, it demonstrates promise in cases of incomplete resection, recurrence, or non-resectable disease. However, pediatric patients require careful consideration because of potential long-term side effects. Further research is required to optimize radiotherapy protocols and integrate emerging therapies.

Case reports

Endocrinology, Diabetes, and Metabolism
Bilateral adrenal adenomas with autonomous cortisol secretion from both glands and autonomous aldosterone secretion from the left adrenal: a case report: Jung Eun Han, Soyeon Yoo, Sang Ah Lee, Gwanpyo Koh; J Yeungnam Med Sci. 2025;42:33. Published online April 28, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.33

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Abstract PDF: Primary aldosteronism (PA) is the most common cause of secondary hypertension and increases the morbidity and mortality associated with cardiovascular diseases. When PA coexists with autonomous cortisol secretion (ACS), the cardiovascular risk increases significantly, especially in cases of bilateral adrenal adenomas with asymmetric hormone secretion, which poses diagnostic and therapeutic challenges. A 50-year-old female presented with hypertension and hypokalemia. PA was diagnosed based on elevated aldosterone levels, suppressed plasma renin activity, and the results of various dynamic endocrine tests. Imaging revealed bilateral adrenal adenomas, and adrenal venous sampling (AVS) confirmed aldosterone hypersecretion from the left adrenal gland and cortisol hypersecretion from both adrenal glands. The patient subsequently underwent left adrenalectomy, which resolved the aldosterone hypersecretion and normalized blood pressure and potassium levels. However, the cortisol hypersecretion persisted. This case highlights the importance of AVS in identifying the sources of hormone secretion and enabling targeted surgical treatment while avoiding bilateral adrenalectomy, which can lead to lifelong adrenal insufficiency. Comprehensive endocrine evaluation, including ACS assessment, in patients with PA is essential to help reduce the cardiovascular risks associated with PA and ACS and thus improve treatment outcomes.

Musculoskeletal Disorders
Unilateral lower extremity lymphedema followed by COVID-19 vaccination in patients with cervical cancer history: two case reports: Jae Ik Jung, Hee Kyung Cho; J Yeungnam Med Sci. 2025;42:23. Published online January 21, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.23

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Abstract PDF: The coronavirus disease 2019 (COVID-19) pandemic prompted the development of messenger RNA vaccines. Following extensive vaccination campaigns worldwide, several adverse reactions to these vaccines have been reported. This is a case series of unilateral lower extremity lymphedema after COVID-19 vaccination in two patients with a history of cervical cancer. An 82-year-old woman and a 68-year-old woman visited the outpatient clinic with unilateral leg edema after receiving a COVID-19 booster vaccine (BNT162b2; Pfizer-BioNTech) in the deltoid muscle. Both patients had a common history of cervical cancer treated with surgery, chemotherapy, and radiotherapy and were in complete remission. Gynecological evaluations, including laboratory and imaging studies, revealed no specific findings. Lymphoscintigraphy revealed delayed lymphatic drainage with diffuse dermal backflow in a unilateral lower extremity. This case series explores adverse reactions to COVID-19 vaccination in patients who are at high risk of developing lymphedema, providing novel data for similar clinical presentations.

Endocrinology, Diabetes, and Metabolism
A 32-year-old man with plexiform schwannoma of the thyroid gland: a case report: Il Rae Park, Min Chong Kim, Seung Min Chung, Si Youn Song; J Yeungnam Med Sci. 2024;41(4):312-317. Published online September 10, 2024; DOI: https://doi.org/10.12701/jyms.2024.00556

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Abstract PDF

Plexiform schwannomas representing a rare subset, comprise 5% of all schwannomas. However, their occurrence in the thyroid gland is exceptionally rare. A 32-year-old male presented with an incidentally discovered, asymptomatic thyroid mass. Imaging revealed an approximately 5 cm heterogeneous solid mass on the right thyroid lobe extending to the upper mediastinum and directly invading the upper trachea. Under the suspicion of thyroid malignancy, the patient underwent right thyroidectomy. Histological examination confirmed a plexiform schwannoma with S100-positive spindle cells. Currently, the patient is undergoing outpatient follow-up, with no reported complications. To our knowledge, this is the first documented case of plexiform schwannoma of the thyroid gland within the English literature. This case highlights the diverse and unpredictable clinical manifestations of thyroid masses, emphasizing the importance of a multidisciplinary approach for diagnosing and managing rare entities, such as thyroid gland schwannomas.

Citations

Citations to this article as recorded by

Plexiform Schwannoma Over the Anterior Chest Wall: A Clinicopathological Review
Debojyoti Sasmal, Saswata Barenya, Hinglaj Saha, Pankaj Kumar Halder
Amrita Journal of Medicine.2025; 21(2): 95. CrossRef

Original article

Urology
Risk factors for prostate-specific antigen persistence in pT3aN0 prostate cancer after robot-assisted laparoscopic radical prostatectomy: a retrospective study: Jun Seop Kim, Jae Hoon Chung, Wan Song, Minyong Kang, Hyun Hwan Sung, Hwang Gyun Jeon, Byong Change Jeong, Seong Il Seo, Hyun Moo Lee, Seong Soo Jeon; J Yeungnam Med Sci. 2023;40(4):412-418. Published online June 28, 2023; DOI: https://doi.org/10.12701/jyms.2023.00234

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Abstract PDF

Background
The aim of this study was to evaluate the risk factors for prostate-specific antigen (PSA) persistence in pathological stage T3aN0 prostate cancer (PCa) after robot-assisted laparoscopic radical prostatectomy (RALP).
Methods
A retrospective study was performed on 326 patients with pT3aN0 PCa who underwent RALP between March 2020 and February 2022. PSA persistence was defined as nadir PSA of >0.1 ng/mL after RALP, and the risk factors for PSA persistence were evaluated using logistic regression analysis.
Results
Among 326 patients, 61 (18.71%) had PSA persistence and 265 (81.29%) had PSA of <0.1 ng/mL after RALP (successful radical prostatectomy [RP] group). In the PSA persistence group, 51 patients (83.61%) received adjuvant treatment. Biochemical recurrence occurred in 27 patients (10.19%) in the successful RP group during the mean follow-up period of 15.22 months. Multivariate analysis showed that the risk factors for PSA persistence were large prostate volume (hazard ratio [HR], 1.017; 95% confidence interval [CI], 1.002–1.036; p=0.046), lymphovascular invasion (LVI) (HR, 2.605; 95% CI, 1.022–6.643; p=0.045), and surgical margin involvement (HR, 2.220; 95% CI, 1.110–4.438; p=0.024).
Conclusion
Adjuvant treatment may be needed for improved prognosis in patients with pT3aN0 PCa after RALP with a large prostate size, LVI, or surgical margin involvement.

Citations

Citations to this article as recorded by

Exosomal non-coding RNAs: orchestrators of intercellular crosstalk in the prostate cancer tumor microenvironment
Huanglin Duan, Baisheng Xu, Peiyue Luo, Tao Chen, Jun Zou
Frontiers in Immunology.2025;[Epub] CrossRef

Case report

Endocrinology, Diabetes, and Metabolism
Thyroid storm caused by metastatic papillary thyroid carcinoma tissue after total thyroidectomy: a case report: So Hee Kwon, Min-Ji Kim, Sin Yeong Jung, Jae-Han Jeon; J Yeungnam Med Sci. 2023;40(Suppl):S93-S97. Published online May 17, 2023; DOI: https://doi.org/10.12701/jyms.2023.00199

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Abstract PDF

Thyroid storm is a life-threatening form of thyrotoxicosis and an endocrinological emergency. We present a case of thyroid storm in a patient with metastatic papillary thyroid cancer. A 67-year-old woman with a history of total thyroidectomy 4 years prior to presentation was admitted with deteriorating mental status, fever, and tachycardia. Laboratory tests revealed severe thyrotoxicosis. Although the patient had no residual thyroid tissue after total thyroidectomy, she had a previously diagnosed metastatic thyroid cancer lesion in the pelvic bone. Despite initial treatment with a standard thyroid storm regimen, the patient died 6 days after hospitalization. The patient had no history of Graves disease; however, a thyroxine receptor antibody was detected postmortem. The patient had a history of exposure to an iodine contrast agent, which is a rare cause of thyrotoxicosis. Thyroxine production from a differentiated thyroid carcinoma is rare but can be a source of clinically significant thyrotoxicosis in patients post-thyroidectomy. Overlapping Graves disease is a common stimulus; however, other causes, such as exogenous iodine, cannot be excluded. This case demonstrates that in the setting of metastatic thyroid carcinoma, thyrotoxicosis cannot be completely ruled out as a cause of suspicious symptoms, even in patients with a history of total thyroidectomy.

Citations

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Tormenta tiroidea: abordaje diagnóstico y terapéutico
José Correa-Guerrero, Hugo Corrales Santander, Jorge Yepes Caro, Jesús Bello Simanca, Luis Rodríguez Arrieta, Alejandro Castellanos Pinedo, Elguis Rodríguez Garizabalo, Carmelo Dueñas Castell
Acta Colombiana de Cuidado Intensivo.2025; 25(1): 159. CrossRef
Plasma exchange as a rescue therapy for treatment-resistant thyroid storm with concurrent heart failure: a literature review based on a case report
Pouya Ebrahimi, Moloud Payab, Maryam Taheri, Salma Sefidbakht, Neda Alipour, Taha Hasanpour, Pedram Ramezani, Mahbube Ebrahimpur, Hamid Reza Aghaei Meybodi
International Journal of Emergency Medicine.2024;[Epub] CrossRef
Data Analysis and Systematic Scoping Review on the Pathogenesis and Modalities of Treatment of Thyroid Storm Complicated with Myocardial Involvement and Shock
Eman Elmenyar, Sarah Aoun, Zain Al Saadi, Ahmed Barkumi, Basar Cander, Hassan Al-Thani, Ayman El-Menyar
Diagnostics.2023; 13(19): 3028. CrossRef

Original articles

Urology
Novel cystography parameter to predict early recovery from urinary continence after radical prostatectomy for prostate cancer: a retrospective study: Yeong Uk Kim; J Yeungnam Med Sci. 2023;40(3):252-258. Published online July 21, 2022; DOI: https://doi.org/10.12701/jyms.2022.00311

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Abstract PDF

Background
The purpose of this study was to investigate whether postoperative cystography findings can predict early and long-term recovery from incontinence after radical prostatectomy (RP), compared with the other cystography parameters.
Methods
I retrospectively reviewed 118 patients who underwent robot-assisted RP (RARP) for localized prostate cancer at single institution between January 2016 and April 2021. One hundred and seven patients were included in the study. Postoperative cystography was routinely performed 7 days after surgery. The bladder neck to pubic symphysis ratio, vesicourethral angle, and bladder neck anteroposterior length (BNAP) ratio (the bladder neck-posterior margin distances divided by the anteroposterior lengths) were evaluated. Continence was defined as cessation of pad use. The association between these variables and urinary incontinence was also analyzed.
Results
The urinary incontinence recovery rates 1, 3, 6, and 12 months after RARP were 43.92%, 66.35%, 87.85%, and 97.19%, respectively. Multivariate logistic regression analysis demonstrated that a lower BNAP ratio and wider vesicourethral angle were significantly associated with continence restoration at 1, 3, and 6 months after surgery. In addition, in terms of days of pad usage, lower BNAP ratio, wider vesicourethral angle, and bladder neck preservation were significantly associated with recovery from urinary incontinence within 12 months as assessed by Cox proportional hazard analysis.
Conclusion
This study demonstrated that vesicourethral angle and BNAP ratio were independent predictors of early recovery from post-prostatectomy incontinence. I suggest that both the sagittal and coronal views of postoperative cystography help anticipate early continence restoration after RARP.

Citations

Citations to this article as recorded by

Prognostic factors for urinary incontinence after robot-assisted radical prostatectomy: a systematic review and meta-analysis
Haoxin Huang, Keke Cai
Journal of Robotic Surgery.2025;[Epub] CrossRef
A single‐center retrospective comparative analysis of urinary continence in robotic prostatectomy with a combination of umbilical ligament preservation and Hood technique
Hiroaki Shimmura, Taro Banno, Kazutaka Nakamura, Anju Murayama, Haruki Shigeta, Toyoaki Sawano, Yukiko Kouchi, Akihiko Ozaki, Fumito Yamabe, Junpei Iizuka, Toshio Takagi
International Journal of Urology.2023; 30(10): 889. CrossRef

Gastroenterology and Hepatology
The effect and therapeutic compliance of adjuvant therapy in patients with cholangiocarcinoma after R0 resection: a retrospective study: Han Taek Jeong, Joonkee Lee, Hyeong Ho Jo, Ho Gak Kim, Jimin Han; J Yeungnam Med Sci. 2023;40(1):65-77. Published online May 26, 2022; DOI: https://doi.org/10.12701/jyms.2022.00213

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Abstract PDF

Background
This study aimed to compare clinical outcomes between surveillance and adjuvant therapy (AT) groups after R0 resection for cholangiocarcinoma (CCA).
Methods
A total of 154 patients who underwent R0 resection for CCA at the Daegu Catholic University Medical Center between January 2010 and December 2019 were included. Overall survival (OS) and progression-free survival (PFS) were analyzed.
Results
The median follow-up duration was 899 days. There were 109 patients in the AT group and 45 patients in the surveillance group. The patients in the AT group were younger (67 years vs. 74 years, p<0.001) and included more males (64.2% vs. 46.7%, p=0.044). The proportion of patients with stage III CCA was larger in the AT group than in the surveillance group (13.8% vs. 2.2%, p=0.005). In addition, AT did not improve OS (5-year OS rate, 69.3% in the AT group vs. 64.2% in the surveillance group, p=0.806) or PFS (5-year PFS rate, 42.6% in the AT group vs. 48.9% in the surveillance group, p=0.113). In multivariate analysis using the Cox proportional hazards model, stage III CCA (hazard ratio [HR], 10.81; 95% confidence interval [CI], 2.92–40.00; p<0.001) was a significant predictor of OS. American Society of Anesthesiologists classification II (HR, 0.50; 95% CI, 0.31–0.81; p=0.005), and American Joint Committee on Cancer stages II (HR, 3.14; 95% CI, 1.25–7.89; p=0.015) and III (HR, 8.08; 95% CI, 2.80–23.32; p<0.001) were independent predictors of PFS.
Conclusion
AT after R0 resection for CCA did not improve OS or PFS.

Citations

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Robotic Complete ALPPS (rALPPS)—First German Experiences
Jörg Arend, Mareike Franz, Alexander Rose, Christine March, Mirhasan Rahimli, Aristotelis Perrakis, Eric Lorenz, Roland Croner
Cancers.2024; 16(5): 1070. CrossRef

Review articles

Ophthalmology
Ocular adnexal mucosa-associated lymphoid tissue lymphoma: a narrative review: Hyun Uk Chung, Jun Hyuk Son; J Yeungnam Med Sci. 2022;39(1):3-11. Published online September 15, 2021; DOI: https://doi.org/10.12701/yujm.2021.01263

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Abstract PDF

Lymphoma is the most common primary tumor of the orbit, accounting for 55% of all orbital malignancies. When divided into histopathological subtypes, extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) comprises the largest proportion. Clinical manifestations are unspecific, but in patients with slow-growing painless orbital mass, or red conjunctival lesion suggestive of ‘salmon patch’, ocular adnexa lymphoma (OAL) should be suspected. Although the pathogenetic mechanism of ocular adnexal MALT lymphoma (OAML) is not yet fully understood, the relationship between OAML and Chlamydia psittaci has been hypothesized recently, similar to that between gastric MALT lymphoma and Helicobacter pylori. This suggests a new treatment option for OAML; bacterial eradication therapy with systemic antibiotics. Several other treatment methods for OAML have been introduced, but no treatment guidelines have been established yet. In this article, we summarize the current knowledge on the clinical features, pathogenesis, diagnostic methods, therapeutic strategies, and prognosis of OAML.

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Wei Weng, Yaomeng Chen, Rouhui Jin, Jinchun Chen, Yuantong Gao, Yongchou Li, Haochen Shao, Shitian Bao, Weikuan Xue
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Single-cell RNA-sequencing reveals cellular heterogeneity and immune microenvironment characteristics between ocular adnexal mucosa-associated lymphoid lymphoma and IgG4−related ophthalmic disease
Yu Yang, Yujiao Wang, Xuelian Jin, Weimin He
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Krystel Tran, Dongryul Oh, Richard Tsang, Chang-Ok Suh, Hong In Yoon, Hwa Kyung Byun, Senzo Taguchi, Jillian R. Gunther, Bouthaina Dabaja, Chelsea C. Pinnix, John Plastaras, Christopher Wright, Brandon S. Imber, Joachim Yahalom, Khaled Elsayad, Hans T. Ei
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Huirun Zeng, Xiaolin Peng, Weimin He
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Association of Chlamydia species with ocular adnexal mucosa-associated lymphoid tissue lymphoma in Taiwan
Wan-Chen Tsai, Shih-Ming Jung, Hsiao-Wen Kao, Yin-Hsi Chang, Yi-Lin Liao, Yueh-Ju Tsai, Yen-Chang Chu, Ching-Hsi Hsiao
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Fatma Seher Pehlivan, Ömer Atmış, Hanife Seda Mavili
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Current status and challenges in the diagnosis and treatment of psittacosis
Long Xu, Chi Zhang, Wanwan Shi, Jiaxi Ma, Guiqiang Wang
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Carson W. Ercanbrack, Jamal O. Azhari, David B. Warner, Maher Abulfaraj, Abdelrahman M. Elhusseiny
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Yuchao Shao, Yuqing Chen, Sainan Chen, Ruili Wei
BMC Ophthalmology.2023;[Epub] CrossRef
Etiopathogenesis of primary acquired nasolacrimal duct obstruction (PANDO)
Mohammad Javed Ali
Progress in Retinal and Eye Research.2023; 96: 101193. CrossRef
The Biology of Ocular Adnexal Marginal Zone Lymphomas
Patricia Johansson, Anja Eckstein, Ralf Küppers
Cancers.2022; 14(5): 1264. CrossRef
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Hematology
An update on immunotherapy with PD-1 and PD-L1 blockade: Sung Ae Koh; Yeungnam Univ J Med. 2021;38(4):308-317. Published online September 9, 2021; DOI: https://doi.org/10.12701/yujm.2021.01312

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Abstract PDF

Cancer is the leading cause of death and is on the rise worldwide. Until 2010, the development of targeted treatment was mainly focused on the growth mechanisms of cancer. Since then, drugs with mechanisms related to tumor immunity, especially immune checkpoint inhibitors, have proven effective, and most pharmaceutical companies are striving to develop related drugs. Programmed cell death-1 and programmed cell death ligand-1 inhibitors have shown great success in various cancer types. They showed durable and sustainable responses and were approved by the U.S. Food and Drug Administration. However, the response to inhibitors showed low percentages of cancer patients; 15% to 20%. Therefore, combination strategies with immunotherapy and conventional treatments were used to overcome the low response rate. Studies on combination therapy have typically reported improvements in the response rate and efficacy in several cancers, including non-small cell lung cancer, small cell lung cancer, breast cancer, and urogenital cancers. The combination of chemotherapy or targeted agents with immunotherapy is one of the leading pathways for cancer treatment.

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Wonyoung Jo, Taejoon Won, Abdel Daoud, Daniela Čiháková
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Therapeutic targeting of thioredoxin reductase 1 causes ferroptosis while potentiating anti-PD-1 efficacy in head and neck cancer
Ming-Shou Hsieh, Hang Huong Ling, Syahru Agung Setiawan, Mardiah Suci Hardianti, Iat-Hang Fong, Chi-Tai Yeh, Jia-Hong Chen
Chemico-Biological Interactions.2024; 395: 111004. CrossRef

Case reports

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

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Abstract PDF

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

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

Radiology, Radiotherapy & Diagnostic Imaging
Pancreatic metastasis from malignant phyllodes tumor of the breast: Seung Eun Lee, Young Kyung Bae, Joon Hyuk Choi; Yeungnam Univ J Med. 2021;38(1):78-82. Published online November 27, 2020; DOI: https://doi.org/10.12701/yujm.2020.00759

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Abstract PDF

Pancreatic metastasis from malignant phyllodes tumor (PT) of the breast is rare, and only a few cases have been reported in the literature. Here, we report a case of pancreatic metastasis from malignant PT of the breast in a 48-year-old woman. She had had three episodes of recurrence of malignant PT in her right breast. She presented with epigastric pain for 2 months. Computed tomography and magnetic resonance imaging revealed a 6 cm-sized, well-defined, heterogeneous mass with peripheral enhancement in the body of the pancreas. Endoscopic ultrasonography-guided fine-needle aspiration was performed, and the pathologic report suggested spindle cell mesenchymal neoplasm. Subsequently, surgical excision was performed, and the mass was confirmed as a metastatic malignant PT. The imaging findings are discussed and the literature is briefly reviewed in this report.

Citations

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A Case of Resectable Malignant Phyllodes Tumor of the Breast with Pancreatic Metastasis
Munefumi TOMOMATSU, Tatsuo UMEOKA, Shuta TAMURA, Masashi KIMURA, Shigeru YUNOKI
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association).2025; 86(3): 387. CrossRef
Integrating single‐cell and spatial transcriptomes reveals COL4A1/2 facilitates the spatial organisation of stromal cells differentiation in breast phyllodes tumours
Xia Li, Xuewen Yu, Jiaxin Bi, Xu Jiang, Lu Zhang, Zhixin Li, Mumin Shao
Clinical and Translational Medicine.2024;[Epub] CrossRef
Case report: Osteosarcomatous differentiation in the lung metastasis of a malignant phyllodes tumor
Ruijing Liu, Jingli Xue, Wen Liu, Beibei Jiang, Fuyun Shi, Zhenzheng Wang, Peifeng Li
Frontiers in Medicine.2023;[Epub] CrossRef
Diagnostic approach to fibroepithelial tumors of the breast
Frances Tresserra, María Angeles Martinez-Lanao, Melissa Fernandez-Acevedo, Cristina Castellet, Sonia Baulies
Revista de Senología y Patología Mamaria.2022; 35: S22. 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.

Citations

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Haemophagocytic lymphohistiocytosis and abdominal compartment syndrome in acute pancreatitis
Nishka Tapaswi, Hasib Ahmadzai, Alec J Hope, Oliver Fisher, Linda Y Zhang
Journal of Surgical Case Reports.2025;[Epub] CrossRef
Prevalence and mortality of haemophagocytic lymphohistiocytosis in dengue fever: a systematic review and meta-analysis
Leong Tung Ong, Roovam Balasubramaniam
Transactions of The Royal Society of Tropical Medicine and Hygiene.2024; 118(11): 711. CrossRef
Predicting relapsed/refractory disease in childhood hemophagocytic lymphohistiocytosis based on clinical features at diagnosis: A 13-year single-institute retrospective study in Thailand
Pattranan Kusontammarat, Chane Choed-Amphai, Lalita Sathitsamitphong, Watchareewan Sontichai, Rungrote Natesirinilkul, Pimlak Charoenkwan
Annals of Hematology.2024; 103(10): 3963. CrossRef
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
Frontiers in Immunology.2024;[Epub] CrossRef
Hemophagocytic Lymphohistiocytosis Triggered by Herpes Simplex Virus 1 and 2: A Narrative Review
Andria Papazachariou, Petros Ioannou
Hematology Reports.2024; 16(3): 487. CrossRef
Spontaneous Resolution of Hemophagocytic Lymphohistiocytosis in a Child Infected with Epstein–Barr Virus
Rita Alfattal, Hussain Sadeq, Abdullah Ali
Journal of Applied Hematology.2023; 14(1): 57. CrossRef
Pediatric inborn errors of immunity causing hemophagocytic lymphohistiocytosis: Case report and review of the literature
María Soledad Caldirola, Andrea Gómez Raccio, Daniela Di Giovanni, María Isabel Gaillard, María Victoria Preciado
Journal of Leukocyte Biology.2022; 112(4): 607. CrossRef
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
Lauren T. Maloney, Bronwyn Baz, Dia Hazra
Pediatrics.2021;[Epub] CrossRef

Case report

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

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Abstract PDF

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

Citations

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

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

47,319 View
633 Download
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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
Scientific Reports.2026;[Epub] CrossRef
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
Dong Jiang, Yi Qian, Yijun Gu, Ru Wang, Hua Yu, Zhenmeng Wang, Hui Dong, Dongyu Chen, Yan Chen, Haozheng Jiang, Yiran Li
European Journal of Medical Research.2025;[Epub] CrossRef
Incidental Gallbladder Polyps – A Case Report on Diagnostic Dilemmas and Management Uncertainty
Brice Bestenheider, Florian Simon Buehlmann, Christoph F. Dietrich
Zeitschrift für Gastroenterologie.2025; 63(10): 1046. CrossRef
Danning tablets for the treatment of multiple gallbladder polyps: Study protocol of multicentre, randomised, open-labelled, controlled trial
Tian Yang, Ming-Da Wang, Gui-Lin Xie, Xiong-Hua Wang, Liu Zheng, Li-Min Wang, Guang-Fa Xiao, Yong-Qing Yang, Chao Li, Alfred Wei Chieh Kow, Feng Shen
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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The gallbladder: what’s new in 2022?
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)
G. V. Shavkuta
South Russian Journal of Therapeutic Practice.2020; 1(2): 78. CrossRef

Original article

Obstetrics, Gynecology, and Reproductive Medicine
Clinical and histopathologic analysis of gynecological cancer: a single institute experience over 7 years: Soo-Young Lee, Eunbyeol Kim, Hyo-Shin Kim, Yu-Jin Koo, Dae-Hyung Lee; Yeungnam Univ J Med. 2020;37(3):179-185. Published online March 5, 2020; DOI: https://doi.org/10.12701/yujm.2019.00451

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Abstract PDF

Background
Approximately 100,000 women are diagnosed with cancer each year in Korea. According to a survey by the Korean central cancer registry in 2016, uterine cervical cancer, uterine corpus cancer, and ovarian cancer were the 5th, 7th, and 8th most prevalent cancers respectively among Korean women. The present study aims to review the clinico-pathologic characteristics of patients who were treated for major gynecological malignancies at Yeungnam University Medical Center.
Methods
Patients with invasive gynecological cancers from January 2012 to February 2019 were retrospectively identified. We analyzed the clinical features, demographic profiles, pathologic data, treatment modality used, adjuvant treatment used, complications, recurrence, and survival outcomes.
Results
A total of 287 patients (cervical cancer 115; corporal cancer 86; and ovarian, tubal, or primary peritoneal cancer 90) were included. Most cervical (82.7%) and corporal cancers (89.5%) were diagnosed in the early stages (stage I or II), while more than half (58.9%) the cases of ovarian, tubal or peritoneal cancers were diagnosed in the advanced stages (stage III or IV). Surgical complications were observed in 12.2% of cervical cancers, 16.3% of uterine corpus cancers, and 11.1% of ovarian, tubal, and peritoneal cancers, respectively. The 5-year overall survival rate was 94.1%, 91.0%, and 77.1% for cervical, corporal, and ovarian, tubal, or peritoneal cancers, respectively.
Conclusion
Surgical treatment was satisfactory in terms of the incidence of complications, and survival outcomes were generally good. Clinicians should be aware of the clinical and histopathological characteristics of patients with gynecological cancers to be able to provide optimal strategies and counseling.

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Umesh Sharma, Birendra Kumar Yadav, Ujwal Rai, Akash Pradhan, Jyoti Bhaju Lama, Alok Thakur
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Divya Adiga, Sangavi Eswaran, Deeksha Pandey, Krishna Sharan, Shama Prasada Kabekkodu
Critical Reviews in Oncology/Hematology.2021; 157: 103178. CrossRef
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Case reports

Oncology and Cancer Research
Impressive effect of cisplatin monotherapy on a patient with heavily pretreated triple-negative breast cancer with poor performance: Dong Won Baek, Ji-Young Park, Soo Jung Lee, Yee Soo Chae; Yeungnam Univ J Med. 2020;37(3):230-235. Published online January 22, 2020; DOI: https://doi.org/10.12701/yujm.2019.00423

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Abstract PDF

Systemic therapy for metastatic triple-negative breast cancer (TNBC) still remains challenging because there are no targeted agents or endocrine therapies currently available. The present case report documents the successful use of cisplatin monotherapy to manage a heavily pretreated TNBC patient showing poor response to therapy. The patient was a 51-year-old woman who had already undergone several lines of systemic chemotherapy for widespread TNBC. Although the mutation analysis performed on DNA isolated from blood cells and progressed lesion samples confirmed the tumor to be germline BRCA wild-type, cisplatin monotherapy was administered based on the increasing evidence of safety and efficacy of platinum for breast cancer. After three cycles of cisplatin treatment, the patient’s metastatic lesions dramatically improved without any major toxicity, and she completed 17 cycles with good response. This case study indicates that patients with heavily pretreated TNBC can potentially achieve a good response to cisplatin monotherapy.

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Alfredo Cruz-Gregorio
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Łukasz Balewski, Iwona Inkielewicz-Stępniak, Maria Gdaniec, Katarzyna Turecka, Anna Hering, Anna Ordyszewska, Anita Kornicka
Pharmaceuticals.2025; 18(3): 375. CrossRef
Structure–activity insights and molecular modeling approaches of anti-TNBC agents: a comprehensive systematic review
Risqi Ayu Febriana, Dhania Novitasari, Nur Kusaira Khairul Ikram, Muchtaridi Muchtaridi
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Zeolitic Imidazole Framework/Silica Nanocomposite for Targeted Cancer Therapeutics: Comparative Study of Chemo-Drug Cisplatin (CPt) and Green Platinum (GPt) Efficacy
Hend Ghnaim Alotaibi, Eman Al-Abbad, Dana Almohazey, Vijaya Ravinayagam, Sultan Akhtar, Hatim Dafalla, B. Rabindran Jermy
International Journal of Molecular Sciences.2024; 25(6): 3157. CrossRef
Cisplatin Monotherapy as a Treatment Option for Patients with HER-2 Negative Breast Cancer Experiencing Hepatic Visceral Crisis or Impending Visceral Crisis
Mirosława Püsküllüoğlu, Małgorzata Pieniążek, Agnieszka Rudzińska, Agnieszka Pietruszka, Renata Pacholczak-Madej, Aleksandra Grela-Wojewoda, Marek Ziobro
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Hypoxia: syndicating triple negative breast cancer against various therapeutic regimens
Nityanand Srivastava, Salman Sadullah Usmani, Rajasekaran Subbarayan, Rashmi Saini, Pranav Kumar Pandey
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Lu-Yao Zhang, Zhi-Xin Shen, Lu Guo
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Curcumin as an Enhancer of Therapeutic Efficiency of Chemotherapy Drugs in Breast Cancer
Reyhaneh Farghadani, Rakesh Naidu
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Atorvastatin improves cisplatin sensitivity through modulation of cholesteryl ester homeostasis in breast cancer cells
Diandra Zipinotti dos Santos, Isabella dos Santos Guimaraes, Mariam F. Hakeem-Sanni, Blake J. Cochran, Kerry-Anne Rye, Thomas Grewal, Andrew J. Hoy, Leticia B. A. Rangel
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Andrew Sulaiman, Sarah McGarry, Jason Chambers, Emil Al-Kadi, Alexandra Phan, Li Li, Karan Mediratta, Jim Dimitroulakos, Christina Addison, Xuguang Li, Lisheng Wang
International Journal of Molecular Sciences.2020; 21(16): 5788. CrossRef
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International Journal of Molecular Sciences.2020; 21(20): 7753. CrossRef

Pathology and Forensic Medicine
Extramedullary tanycytic ependymoma of the lumbar spinal cord: Dong Ja Kim, Man-Hoon Han, SangHan Lee; Yeungnam Univ J Med. 2020;37(2):128-132. Published online November 11, 2019; DOI: https://doi.org/10.12701/yujm.2019.00367

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Abstract PDF

Tanycytic ependymoma is a rare variant of ependymoma that commonly affects the cervical and thoracic spinal cord. It usually arises as intramedullary lesions, and extramedullary cases are extremely rare. We report a case of a 44-year-old woman who was diagnosed with tanycytic ependymoma in her lumbar spine at level 2-3. The tumor mass developed in an intradural extramedullary location. Histopathologically, tanycytic ependymoma can be misdiagnosed as schwannoma or pilocytic astrocytoma. Immunohistochemical findings such as strong positivity for glial fibrillary acidic protein, perinuclear dot-like positive patterns for epithelial membrane antigen, and focal positivity for S-100 are helpful in diagnosing tanycytic ependymoma. It is important to be aware of this rare tumor to ensure appropriate patient management and accurate prognosis.

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Focal classic intradural extramedullary ependymoma near the conus medullaris: A case report and literature review
Xingui Kang, Tao Hu, Keqiang Shi, Quanze Hu, Bin Yu, Ziqi Zhu, Desheng Wu, Yufeng Huang
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Review article

Gastroenterology and Hepatology
Endoscopic features aiding the diagnosis of gastric mucosa-associated lymphoid tissue lymphoma: Byung Sam Park, Si Hyung Lee; Yeungnam Univ J Med. 2019;36(2):85-91. Published online February 26, 2019; DOI: https://doi.org/10.12701/yujm.2019.00136

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Abstract PDF

The incidence of gastric mucosa-associated lymphoid tissue (MALT) lymphoma is increasing worldwide, but the diagnosis is difficult. Most patients are asymptomatic or complain of nonspecific gastrointestinal symptoms. As the endoscopic features of gastric MALT lymphoma are variable and nonspecific, the possibility of this condition may be overlooked during esophagogastroduodenoscopy, and it remain undiagnosed. Therefore, this condition needs to be considered when an abnormal mucosa is observed during this procedure. Biopsy performed during endoscopy is the primary diagnostic test, but false negative results are possible; large numbers of samples should be collected from both normal and abnormal mucosae. Endoscopic ultrasonography is useful to assess the depth of invasion and to predict the treatment response. After treatment, follow-up tests are required every 3 months until complete remission is achieved, and annually thereafter. Early diagnosis of gastric MALT lymphoma is difficult, and its diagnosis and follow-up require wide experience and competent endoscopic technique.

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Vitor Lauar Pimenta de Figueiredo, Igor Braga Ribeiro, Diogo Turiani Hourneaux de Moura, Cristiano Claudino Oliveira, Eduardo Guimarães Hourneaux de Moura
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Gastrointestinal Tract Lymphoma
Ji Yong Ahn
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Multiple Synchronous Mucosa-Associated Lymphoid Lymphomas Involving in the Stomach, Duodenum, Ileum, and Sigmoid
Chun-Wei Chen, Yang-Yuan Chen, Yung-Fang Chen
Diagnostics.2022; 12(12): 3150. CrossRef
Gastric Mucosa-Associated Lymphoid Tissue Lymphomas Diagnosed by Jumbo Biopsy Using Endoscopic Submucosal Dissection: A Case Report
Jian Han, Jun Wang, Hua-ping Xie
Frontiers in Medicine.2021;[Epub] CrossRef
Pedunculated mucosa-associated lymphoid tissue (MALT) lymphoma causing gastric outlet obstruction
Elena Resina Sierra, Pablo Miranda García, Magdalena Adrados, Cecilio Santander Vaquero
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Primary mucosal-associated lymphoid tissue extranodal marginal zone lymphoma of the bladder from an imaging perspective: A case report
Zhen-Zhen Jiang, Yuan-Yuan Zheng, Chuan-Ling Hou, Xia-Tian Liu
World Journal of Clinical Cases.2021; 9(32): 10024. CrossRef

Original article

Obstetrics, Gynecology, and Reproductive Medicine
Clinical significance of lymph node size in locally advanced cervical cancer treated with concurrent chemoradiotherapy: Jinju Oh, Ki Ho Seol, Youn Seok Choi, Jeong Won Lee, Jin Young Bae; Yeungnam Univ J Med. 2019;36(2):115-123. Published online February 21, 2019; DOI: https://doi.org/10.12701/yujm.2019.00143

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Abstract PDF

Background
This study aimed to assess the in-field lymph node (LN) failure rate according to LN size and to investigate effect of LN size on the survival outcome of patients with locally advanced cervical carcinoma treated with concurrent chemoradiotherapy (CCRT).
Methods
A total of 310 patients with locally advanced cervical carcinoma treated with CCRT were enrolled in retrospective study. LN status was evaluated by magnetic resonance imaging. All patients received conventional external beam irradiation and high-dose rate brachytherapy, and concurrent cisplatin-based chemotherapy. In-field LN failure rate according to LN size was analyzed.
Results
The median follow-up period was 83 months (range, 3-201 months). In-field LN failure rate in patients with pelvic LN size more than 10 mm was significantly higher than that in patients with pelvic LN size less than 10 mm (p<0.001). A similar finding was observed in the in-field para-aortic LN failure rate (p=0.024). The pelvic and para-aortic LN size (≥10 mm) was a significant prognostic factor of overall-survival (OS) and disease-free survival rate in univariate and multivariate analyses. The OS rate was significantly different between groups according to LN size (<10 mm vs. ≥10 mm).
Conclusion
A LN of less than 10 mm in size in an imaging study is controlled by CCRT. On the other hand, in LN of more than 10 mm in size, the in-field LN failure rate increase and the prognosis deteriorate. Therefore, a more aggressive treatment strategy is needed.

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Clinical outcomes of external radiotherapy boost versus no boost to radiologically positive lymph nodes in FIGO stage IIIC cervical cancer
Karthik S. Rishi, K. Harshita, Pilli Spandana, Pradeep Kumar Reddy Donapati, P.S. Hari, G.V. Giri
International Journal of Gynecological Cancer.2025; 35(10): 102030. CrossRef
Therapeutic effects of surgical debulking of metastatic lymph nodes in cervical cancer IIICr: a trial protocol for a phase III, multicenter, randomized controlled study (KGOG1047/DEBULK trial)
Bo Seong Yun, Kwang-Beom Lee, Keun Ho Lee, Ha Kyun Chang, Joo-Young Kim, Myong Cheol Lim, Chel Hun Choi, Hanbyoul Cho, Dae-Yeon Kim, Yun Hwan Kim, Joong Sub Choi, Chae Hyeong Lee, Jae-Weon Kim, Sang Wun Kim, Yong Bae Kim, Chi-Heum Cho, Dae Gy Hong, Yong J
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Abdulla Alzibdeh, Issa Mohamad, Lina Wahbeh, Ramiz Abuhijlih, Fawzi Abuhijla
World Journal of Clinical Cases.2024; 12(10): 1851. CrossRef
RECIST 1.1 versus clinico-radiological response assessment for locally advanced cervical cancer: implications on interpreting survival outcomes of future trials
Mayuri Charnalia, Supriya Chopra, Jaahid Mulani, Palak Popat, Sushmita Rath, Maarten Thomeer, Prachi Mittal, Ankita Gupta, Ingrid Boere, Sudeep Gupta, Remi A Nout
International Journal of Gynecological Cancer.2024; 34(6): 817. CrossRef
Efficacy of lymph node dissection on stage IIICr of cervical cancer before CCRT: study protocol for a phase III, randomized controlled clinical trial (CQGOG0103)
Misi He, Mingfang Guo, Qi Zhou, Ying Tang, Lin Zhong, Qing Liu, Xiaomei Fan, Xiwa Zhao, Xiang Zhang, Gang Chen, Yuanming Shen, Qin Xu, Xiaojun Chen, Yuancheng Li, Dongling Zou
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Mihai-Cristian Dumitraşcu, Adina-Elena Nenciu, Cătălin George Nenciu, Carmen Ursu, Andreea Ilieşiu, Alexandru Baroş, Diana Secară, Monica Mihaela Cîrstoiu
Ginecologia.ro.2023; 1(39): 30. CrossRef
Treatment of bulky lymph nodes in locally advanced cervical cancer: boosting versus debulking
Ester Paulien Olthof, Hans Wenzel, Jacobus van der Velden, Anje M Spijkerboer, Ruud Bekkers, Jogchum J Beltman, Hans W Nijman, Brigitte Slangen, Ramon Smolders, Nienke van Trommel, Petra L M Zusterzeel, Ronald Zweemer, Lukas J A Stalpers, Maaike van der A
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Targetability of cervical cancer by magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU)-mediated hyperthermia (HT) for patients receiving radiation therapy
Lifei Zhu, Yi Huang, Dao Lam, H. Michael Gach, Imran Zoberi, Dennis E. Hallahan, Perry W. Grigsby, Hong Chen, Michael B. Altman
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Surgical versus clinical staging prior to primary chemoradiation in patients with cervical cancer FIGO stages IIB–IVA: oncologic results of a prospective randomized international multicenter (Uterus-11) intergroup study
Simone Marnitz, Audrey Tieko Tsunoda, Peter Martus, Marcelo Vieira, Renato Jose Affonso Junior, João Nunes, Volker Budach, Hermann Hertel, Alexander Mustea, Jalid Sehouli, Jens-Peter Scharf, Uwe Ulrich, Andreas Ebert, Iris Piwonski, Christhardt Kohler
International Journal of Gynecological Cancer.2020; 30(12): 1855. CrossRef

Case report

Nuclear Medicine
Rapid progression from trochlear nerve palsy to orbital apex syndrome as an initial presentation of advanced gastric cancer: Eunjung Kong, Sung Ae Koh, Won Jae Kim; Yeungnam Univ J Med. 2019;36(2):159-162. Published online February 15, 2019; DOI: https://doi.org/10.12701/yujm.2019.00129

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Abstract PDF

The most cases with orbital metastases have been reported in patients with a prior established diagnosis of cancer and widespread systemic involvement. However, ocular symptoms can be developed as an initial presentation of cancer in patients without cancer history. We report a case of rapid progression from trochlear nerve palsy to orbital apex syndrome as an initial presentation of advanced gastric cancer.

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Neoplastic nerve lesions
Deep K. Patel, Kelly G. Gwathmey
Neurological Sciences.2022; 43(5): 3019. CrossRef

Case Reports

Pulmonary and Respiratory Medicine
Tracheal pleomorphic adenoma with coexisting pulmonary tuberculoma: Jehun Kim, Chul-Ho Oak, Tae-Won Jang, Mann-Hong Jung; Yeungnam Univ J Med. 2018;35(1):114-120. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.114

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Abstract PDF

Tracheal tumors are rare and difficult to diagnose. Moreover, delays in diagnosis are very common because the symptoms are nonspecific. As a result, tracheal tumors are commonly mistreated as chronic obstructive pulmonary disease or bronchial asthma. We report a case of a 49-year-old male who presented with a 3-month history of dyspnea and cough. Chest computed tomography scan showed a 1.5×1.3 cm homogenous tumor originating from the right lateral wall of the tracheobronchial angle into the tracheal lumen as well as a 0.5×0.4 cm round nodular lesion at the right upper lobe with multiple mediastinal lymph nodes enlargement. Bronchoscopic findings revealed a broad-based, polypoid lesion nearly obstructing the airway of the right main bronchus. The patient was diagnosed with pleomorphic adenoma which is the most common benign tumor of the salivary glands, but rarely appears in the trachea. Upon surgery, tracheal pleomorphic adenoma and co-existing active pulmonary tuberculoma that had been mistreated as bronchial asthma over 3 months was revealed. Following surgery, the patient underwent anti-tuberculosis treatment. No recurrence has been detected in the 3 years since treatment and the patient is now asymptomatic.

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Mayu Inomata, Shoei Kuroki, Nobuyuki Oguri, Yuichiro Sato, Fumiya Kawano, Ryo Maeda
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Pleomorphic adenoma of the trachea: A case report and review of the literature
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World Journal of Clinical Cases.2020; 8(23): 6021. CrossRef
Pleomorphic adenoma of the trachea: A case report and review of the literature
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World Journal of Clinical Cases.2020; 8(23): 6026. CrossRef
Obstructive tracheal neoplasm
Badreeddine Alami, Saïd Boujraf, Mohamed Smahi, Mounia Serraj, Moulay Youssef Alaoui Lamrani, Meryem Boubbou, Mustapha Maaroufi
Formosan Journal of Surgery.2019; 52(3): 92. CrossRef

Oncology and Cancer Research
Huge pheochromocytoma presented with paraaortic lymph node and spine metastases: Yeon Won Park, Han Ju Moon, Jung Suk Han, Ji Min Han, Jong Wook Park, Yun Hyi Ku; Yeungnam Univ J Med. 2017;34(2):247-253. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.247

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Abstract PDF: Approximately 10–15% of pheochromocytomas are malignant. There are insufficient histologic criteria for the diagnosis of malignant pheochromocytoma. Thus, the term malignant pheochromocytoma is restricted to tumors with local invasion or distant metastases. We experienced a case of malignant pheochromocytoma recurred with spinal metastasis 4 years after the surgery for huge benign pheochromocytoma. A 68-year-old female was admitted for trunk and back pain. The patient had a history of surgery 4 years ago for a 10.0×9.5×7.5 cm sized benign pheochromocytoma at the left adrenal gland. A thoracolumbar magnetic resonance imaging showed a tumor in the 7th thoracic vertebral body and a 24-hour urinary norepinephrine increased, suggesting metastatic recurrence of malignant pheochromocytoma. After metastasectomy in the 7th thoracic vertebral body, urine catecholamine was normalized and pain also disappeared. However, a metastatic lesion was found in the paraaortic area on a follow-up abdominal computed tomography scan and an additional metastasectomy was performed. The pathology confirmed the diagnosis of metastatic pheochromocytoma in the paraaortic lymph nodes. She is supposed to be treated with adjuvant iodine 131-meta-iodobenzylguanidine therapy. In our experience, a close follow-up should be considered in patients who had a huge benign pheochromocytoma due to the possibility of malignant metastases.

Original Article

Surgery
Prognostic role of preoperative carcinoembryonic antigen levels in colorectal cancer: propensity score matching: Cho Shin Kim, Sohyun Kim; Yeungnam Univ J Med. 2017;34(2):216-221. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.216

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Abstract PDF: BACKGROUND
This study was conducted to investigate preoperative carcinoembryonic antigen (CEA) as a prognostic factor in colorectal cancer. METHODS: Between January 2000 and July 2011, 1298 patients with primary adenocarcinoma colorectal cancer without metastasis, who underwent curative resection were retrospectively identified. The patients were divided into two groups according to serum CEA level at primary diagnosis: a high CEA (HCEA) group (serum CEA ≥6 ng/mL) and a normal CEA (NCEA) group (serum CEA <6 ng/mL). A 1:1 propensity score matching analysis was applied to reduce bias. Finally, 364 patients were enrolled in this study. Matched variables were age, gender, preoperative chemoradiotherapy, tumor site, cell differentiation and pathologic stage. RESULTS: The clinicopathological characteristics of the two groups did not differ significantly difference. The systemic metastasis rate was 16.5% (30/182) and 25.3% (46/182) in the NCEA and HCEA groups, respectively (p=0.039). There were no significant differences in local recurrence or metastatic sites between groups. The 5-year disease-free survival (DFS) rate of the HCEA group was worse than that of the NCEA group; however, there was no significant difference in overall survival between the two groups. CONCLUSION: Elevated preoperative CEA was related to frequent systemic recurrence and low DFS. Therefore, elevated preoperative CEA could be considered a prognostic factor for worse clinical outcomes in patients with colorectal cancer.

Case Report

Endocrinology, Diabetes, and Metabolism
Metastatic papillary thyroid cancers with malignant pleural effusion aggravated during thyroid hormone withdrawal for radioiodine therapy.: Ji Hye Seo, Ji Hye Je, Hyun Jung Lee, Young Ju Na, Il Woo Jeong, Jee Hyun An, Sin Gon Kim, Dong Seop Choi, Nam Hoon Kim; Yeungnam Univ J Med. 2015;32(2):138-142. Published online December 31, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.2.138

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Abstract PDF: L-thyroxine (LT4) withdrawal prior to radioactive iodine (RAI) ablation therapy is a commonly used method for successful treatment of patients with papillary thyroid cancer (PTC). However, a prolonged period of hypothyroidism induced by LT4 withdrawal is sometimes associated with impaired quality of life and cardiopulmonary dysfunction in PTC patients. Furthermore, LT4 withdrawal may have a trophic effect on residual cancer by means of increased thyrotropin. We report on 2 cases of metastatic PTC patients with malignant pleural effusion (MPE) whose disease showed rapid worsening after LT4 withdrawal and RAI therapy. The first case is a 65-year-old woman who had PTC with multiple distant metastases and MPE. During LT4 withdrawal for RAI therapy, MPE showed rapid worsening, and the patient required repetitive therapeutic thoracentesis. The second case is a 49-year-old woman with PTC who underwent 3 additional operations for cancer recurrence in the neck lymph nodes and 6 times of RAI treatments. While preparing for the 7th RAI treatment by withdrawing LT4, she developed MPE which became progressively aggravated after RAI therapy. Both patients experienced increased pleural effusion during the LT4 withdrawal period and a rise in the thyroglobulin level was observed after RAI therapy. MPE was not controlled with therapeutic thoracentesis and pleurodesis. Eventually, both patients died of rapid disease progression after RAI therapy. In summary, LT4 withdrawal may have an adverse effect on metastatic PTC patients, particularly those with MPE.

Original Articles

Surgery
The Relationship Between the Expression of Estrogen Receptor beta and Recurrence in Breast Cancer.: Su Hwan Kang, Jung Eun Choi, Soo Jung Lee; Yeungnam Univ J Med. 2011;28(2):153-164. Published online December 31, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.2.153

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Abstract PDF: BACKGROUND
It has been reported that estrogen receptor beta (ERbeta) mRNA expression was down-regulated during carcinogenesis and was inversely related to estrogen receptor alpha (ERalpha) expression in breast cancer. The association of ERbeta mRNA expression to tamoxifen resistance has also been reported. In this study, the expression of ERalpha and ERbeta via immunohistochemistry (IHC) and reverse transcription-polymerase chain reaction (RT-PCR) was prompted, and an attempt was made to find out the relationship between ERbeta expression and recurrence in the hormonal therapy group, and between ERbeta expression and known prognostic factors. METHODS: Tumor specimens were obtained at surgery from 67 female breast cancer patients during the period of September 1995 to December 2000. All the specimens were frozen in liquid nitrogen and kept at -70degrees C until they were used. The medical records were analyzed retrospectively. The expressions of ER were analyzed using IHC and RT-PCR methods. RESULTS: The median follow-up was at 93.0 months (range: 14-157 months). The percentage of ERalpha+/ERbeta+, ERalpha+/ERbeta-, ERalpha-/ERbeta+, and ERalpha-/ERbeta group were 35.9% 9.4%, 47.2%, and 7.5%, respectively, in 53 patients with hormonal therapy. ERbeta was positive in 42 (82.3%) of 51 ER-positive patients. In the hormonal therapy group, the recurrence rates of each group was 15.8%, 0%, 40.0%, and 0%, respectively. In this group, the ERbeta expression tended to recur, but there was no clinical significance (p=0.084). CONCLUSION: The ERbeta expression may be a predictive marker of a poor response to endocrine therapy in breast cancer patients, although this needs to be confirmed in additional studies.

Radiology, Radiotherapy & Diagnostic Imaging
Radiologic Findings of Renal Oncocytomas.: Jae Ho Cho; Yeungnam Univ J Med. 2009;26(1):30-37. Published online June 30, 2009; DOI: https://doi.org/10.12701/yujm.2009.26.1.30

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Abstract PDF: PURPOSE: To radiologically differentiate renal oncocytoma from other renal solid tumors, we analyzed and characterized, retrogradely, radiologic findings of renal oncocytomas. MATERIALS AND METHODS: Radiologic findings of pathologically proven renal oncocytoma were analyzed in 9 patients. CT was performed in all patients, ultrasonography in 4 patients and MRI in 3 patients. (51) RESULTS: On ultrasonography, the echogenicity of the mass was slightly more hyperechoic than normal renal parenchyma in all 4 cases. Two cases were homogeneous and the remaining two cases were relatively homogeneous. On CT, all 8 cases showed iso-density to slightly low density compared to normal renal parenchyma and 5 cases were homogeneous but the central portion of the mass was of a slightly lower density than the peripheral portion in 3 cases. All six cases had an arterial phase scan and were heterogeneously enhanced. An irregular, lower-enhancing portion was found in the central portion of the mass. Segmental inversion of contrast enhancement was found in 5 of 6 cases that had a dynamic enhancement study. On MR T1-weighted imaging, the mass was of iso-signal intensity to normal renal parenchyma and the central portion of the mass had a slightly hypo-signal intensity than the peripheral portion. On T2-weighted imaging, 2 cases were heterogeneous; the peripheral portion was of low signal intensity and the central portion was of higher signal intensity than normal renal parenchyma. One case was relatively homogeneous and showed a slightly lower signal intensity than that of normal renal parenchyma, except for a central small portion showing high signal intensity. For 2 cases that had a dynamic study, a segmental inversion of contrast enhancement was noted. CONCLUSION: Renal oncocytoma is seen as a well-marginated solid mass lesion. On enhanced scans it is heterogeneously enhanced and segmental inversion of contrast enhancement may be seen. The possibility of oncocytoma can be suggested in cases showing these radiologic findings.

Case Report

Radiology, Radiotherapy & Diagnostic Imaging
Supratentorial Leptomeningeal Hemangioblstoma －Case Report－: Han Won Jang, Woo Mok Byun, Jae Kyo Lee, Jae Ho Cho, Kil Ho Cho, Mi Soo Hwang, Bok Hwan Park, Joon Hyuk Choi; Yeungnam Univ J Med. 2007;24(2 Suppl):S770-774. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S770

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Abstract PDF

Hemangioblastoma is a benign tumor that most commonly occurs in the cerebellum and associated with von Hippel-Lindau (VHL) disease. Supratentorial hemanigoblastomas are exceptionally rare. We describe the magnetic resonance imaging (MRI) and histopathologic findings of a supratentorial leptomeningeal hemangioblastoma.

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Sporadic supratentorial hemangioblastoma with meningeal affection: A case report and literature review
Juan Francisco Sánchez-Ortega, Marta Claramonte, Mónica Martín, Juan Calatayud-Pérez
Surgical Neurology International.2021; 12: 394. CrossRef
Supratentorial hemangioblastomas in von Hippel–Lindau wild-type patients – case series and literature review
Luís Rocha, Carolina Noronha, Ricardo Taipa, Joaquim Reis, Mário Gomes, Ernesto Carvalho
International Journal of Neuroscience.2018; 128(3): 295. CrossRef
Meningeal Supratentorial Hemangioblastoma in a Patient with Von Hippel-Lindau Disease Mimicking Angioblastic Menigioma
Hoon Kim, Ik-Seong Park, Kwang Wook Jo
Journal of Korean Neurosurgical Society.2013; 54(5): 415. CrossRef
Supratentorial hemangioblastoma: clinical features, prognosis, and predictive value of location for von Hippel-Lindau disease
S. A. Mills, M. C. Oh, M. J. Rutkowski, M. E. Sughrue, I. J. Barani, A. T. Parsa
Neuro-Oncology.2012; 14(8): 1097. CrossRef

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.

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.

Pathology and Forensic Medicine
Pathologic Features of Small Cell Lymphoid Neoplasms: Won hee Choi; Yeungnam Univ J Med. 2007;24(2 Suppl):S118-124. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S118

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Abstract PDF: The category of small sized cell lymphoid neoplasms include chronic lymphocytic leukemia (CLL) / small lymphocytic lymphoma (SLL), mantle cell lymphoma (MCL), follicular lymphoma, marginal zone lymphoma (MZL) and lymphoplasmacytic lymphoma (LDL) / Waldenstrom macroglobulinemia (WM). The unifying feature for this group of neoplasms is their derivation from mature B cell and are indolent lymphomas mostly. But, their morphological and immunophenotypical findings, cytogenetics and molecular genetics exhibit considerable heterogenic expression. The recent identification about pathologic features of the small cell lymphoid neoplasms might contribute to their better understandings.

Original Articles

Radiology, Radiotherapy & Diagnostic Imaging
Effectiveness of the Transrectal Ultrasonography in the Detection of Prostate Cancer: in Patients with Prostate Specific Antigen of 10 ng/ml or Less.: Han Won Chang, Jae Ho Cho; Yeungnam Univ J Med. 2004;21(2):191-197. Published online December 31, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.2.191

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Abstract PDF: BACKGROUND
This study was performed to reconsider the efficacy of transrectal ultrasonography (TRUS) in diagnosing prostate cancer by analyzing the results of a digital rectal examination (DRE), serum prostate-specific antigen (PSA) and a transrectal ultrasono- graphy in patients with prostate specific antigen levels of 10 ng/ml or less. MATERIALS AND METHODS: One-hundred and eighty one men with PSA levels of 10 ng/ml or less, who had a TRUS-guided tissue biopsy performed, were included in this study. The detection rate of prostate cancer was compared according to the TRUS result and the presence or absence of nodularity and the consistency of the prostate on DRE. RESULTS: In a total 181 patients, there were 73 patients with PSA levels of 4 ng/ml or less and 4 of them had prostate cancer. Thre were 108 patients with PSA levels of 4-10 ng/ml and 18 of them were prostate cancer. TRUS was performed in 152 patients and 16 out of 58 patients diagnosed with prostate cancer, 3 out of 39 diagnosed with suspicious prostate cancer, and 2 out of 55 patients diagnosed as having no prostate cancer were found to have prostate cancer. In 40 patients, a nodule was palpated on DRE and 8 of them were found to have prostate cancer. Five out of 19 patients with a stony hard consistency, 3 of 12 with a firm to hard consisency, 12 of 129 with a firm consistency, 0 of 13 with a soft to firm consistency, and 2 of 8 with a soft consistency were prostate cancer. In the prostate cancer patients, there were 4 patients with PSA levels of 4 ng/ml or less and all these patients were diagnosed with prostate cancer or suspicious prostate cancer on TRUS but the nodule was not palpated in all patients. Two were soft and 2 were firm consistency on DRE. CONCLUSION: In patients with serum PSA levels of 10 ng/ml or less, TRUS is a more useful supporting method than DRE and a more active application of TRUS may lead to an early diagnosis and pertinent treatment of prostate cancer.

Radiation Oncology
Imaging Feature of Radiation Induced Lung Disease.: Jae Gyo Lee, Byeung Hak Rho, Jae Chun Chang, Mung Se Kim; Yeungnam Univ J Med. 2000;17(2):146-154. Published online December 31, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.2.146

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Abstract PDF: BACKGROUND
AND PURPOSE: Radioopaque lesions are commonly seen in patients who received thoracic radiotherapy for various kinds of thoracic neoplasm, But therir exact diagnos are sometimes uncertain. PATIENTS AND METHODS: We examined simple chest radiograph and computed tomogram(CT) of 69 patients who received thoracic radiotherapy for lung cancer and were follow up at least 6 months in Yeungnam University Medical Center. RESULTS: Of the 69 patients. thirty-eight patients showed radioopaque lesions in their chest radiographs except radiation fibrosis; radiation pneumonitis was witnessed in 24 patients. infectious pneumonia in 8 patients, and recurrence in 6 patients. In radiateionpneumonitis patients, the pneumonitis occurred usually between 50 to 130 days after receiving radiation therapy, and interval between pneumonitis and fibrosis is 21 to 104 days. Simple chest radiographs of radiation pneumonitis(24 patients) represented ground glass opacities or consolidation in 4 cases(type I, 17%), reticular of reticulonodular opacities in 10 cases(type II, 42%), irregular patichy consolidations in 2 cases( type III, 8%), and consolidation with fibrosis in 8 cases(type IV, 33%), CT represent ground glass opacities or consolidation in 5 cases(type I, 29%), irregular nodular opacities in 3 cases(type II, 19%), irregular opacity beyond radiation fields in 3 cases(type III, 18%), and consolidation with fibrosis in 6 cased(typeIV, 35%). The CT of four patients who represented type II on simple chest radiographs reveal type I and III, and CT of two patients with clinical symptoms who had no abnormal finding on simple radiograph revealed type I. CONCLUSIONS: In conclusion, computed tomogram is superior to the simple radiograph when trying to understand the pathologic process of radiation pneumonitis and provide confidence in the diagnosis of radiation induced lung disease.

Oncology and Cancer Research
Radiologic Findings of Uncommon Breast Cancer.: Jae Woon Kim, Jae Hong An, Mi Soo Hwang, Jae Kyo Lee, Woo Mok Byun; Yeungnam Univ J Med. 1998;15(1):114-124. Published online June 30, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.1.114

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Abstract PDF: We analyzed the mammographic (n=21) findings (location, margin, shape, cluster microcalcifications, size, multiplicity) and ultrasonographic (n=12) findings (shape, border, internal echo, boundary echo, posterior echo, lateral echo, width/depth ratio) to evaluate specific radiologic findings of histopathologically proved uncommon breast cancer. The mammographic findings (n=21) are as follow; 1) single; 16, multiple; 5 2) margin (smooth; 13, irregular; 4, spiculated; 4) 3) shape (round and ovoid; 9, lobulated; 8, irregular; 4) 4) cluster microcalcifications (abscent; 20, present; 1) 5) size (1-3cm; 18, 3-5cm; 2, 5cm> ; 1) 6) location (UOQ; 13, UIQ; 4, LIQ; 3, LOQ; 1). The ultrasonographic findings (n=12) are as follow; 1) shape (round to oval; 5, lobulated; 5, irregular; 2) 2) border (smooth even; 9, rough uneven; 3) 3) internal echo (fine homogeneous; 5, coarse heterogeneous; 7) 4) boundary echo (regular fine; 4, irregular thick; 8) 5) posterior echo (enhanced; 11, no change; 1) 6) lateral echo (marked; 7, nonexistent; 5) 7) width/depth ratio (1.5> 1, 1.0-1.5; 7, 1.0< ; 4). Uncommon breast cancer show benign nature on mammogram, but malignant nature on ultrasonogram (especially boundary echo, internal echo, width/depth ratio)

Urology
Assessment of Perirenal Fat Infiltration in Renal Cell Carcinoma by CT.: Dae Hyoun Cho, Jae Ho Cho, Jay Chun Chang, Bok Hwan Park; Yeungnam Univ J Med. 1997;14(1):175-182. Published online June 30, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.1.175

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Abstract PDF: Forty-two preoperative CT scans with renal cell carcinoma were reviewed and compared with pathologic findings to evaluate the differential points between stage I and II. Regardless of whole body staging, perirenal fat infiltrations were seen in 9 cases and the other 33 cases showed no infiltration onto perirenal fat tissue. We retrospectively reviewed them by comparing tumor size and CT findings, following three view points, lobulating contour of tumor margin, thickening of Gerota's fascia and strands in perirenal fat tissue. The size of them was 2-15 cm, size of the stage I tumors was 2-15 cm and that of stage II was 6-15 cm. In stage I(n=33), 25 cases(76%) showed smooth margin, and the others(n=8) showed lobulating contours. Thickening of Gerota's fascia was observed in 7 cases(21%) and strands in perirenal fat tissue in 14(42%). Of these, only one positive finding was seen in 7 cases(21%), 2 findings in 6(18%), 3 findings in 3(9%) and nothing in 17cases(51%). In stage II(n=9), 3 cases(34%) showed smooth margin, and the others(n=6) showed lobulating contours. Thickening of Gerota's fascia were observed in 5 cases(55%) and strands in perirenal fat tissue in 9(100%). Of these, one finding was seen in 2 cases(22%), 2 findings in 3(33%), 3 findings in 4(44%). In conclusion, it is insufficient to evaluate the perirenal fat infiltration in renal cell carcinoma with only one positive finding of 3 view points; lobulation of tumor margin, thickening of Gerota's fascia, strands in perirenal fat tissue. But if all these findings are shown, it is helpful to determinate perirenal fat infiltration of renal cell carcinoma.

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