Journal of Yeungnam Medical Science

Review article

Invasive strategies for rhythm control of atrial fibrillation: a narrative review: Hong-Ju Kim, Chan-Hee Lee; J Yeungnam Med Sci. 2024;41(4):279-287. Published online September 20, 2024; DOI: https://doi.org/10.12701/jyms.2024.00703

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Abstract PDF: Atrial fibrillation (AF) is the most common sustained tachyarrhythmia and its increasing prevalence has resulted in a growing healthcare burden. A recent landmark randomized trial, the EAST-AFNET 4 (Early Treatment of Atrial Fibrillation for Stroke Prevention Trial), highlighted the importance of early rhythm control in AF, which was previously underemphasized. Rhythm control therapy includes antiarrhythmic drugs, direct-current cardioversion, and catheter ablation. Currently, catheter ablation is indicated for patients with AF who are either refractory or intolerant to antiarrhythmic drugs or who exhibit decreased left ventricular systolic function. Catheter ablation can be categorized according to the energy source used, including radiofrequency ablation (RFA), cryoablation, laser ablation, and the recently emerging pulsed field ablation (PFA). Catheter ablation techniques can also be divided into the point-by-point ablation method, which ablates the pulmonary vein (PV) antrum one point at a time, and the single-shot technique, which uses a spherical catheter to ablate the PV antrum in a single application. PFA is known to be applicable to both point-by-point and single-shot techniques and is expected to be promising owing to its tissue specificity, resulting in less collateral damage than catheter ablation involving thermal energy, such as RFA and cryoablation. In this review, we aimed to outline catheter ablation for rhythm control in AF by reviewing previous studies.

Case report

Solar retinopathy related to antidepressant use in a patient with major depressive disorder: a case report: Eun-Jin Cheon; J Yeungnam Med Sci. 2024;41(3):228-232. Published online May 23, 2024; DOI: https://doi.org/10.12701/jyms.2024.00213

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Abstract PDF: This case report is a unique case of solar retinopathy following antidepressant-induced mydriasis and highlights the need for comprehensive ophthalmic evaluation in patients treated with medications having mydriatic effects. A 49-year-old female patient who had received long-term antidepressant therapy presented with bilateral visual impairment after prolonged sun exposure. Fundoscopy confirmed solar retinopathy, which was attributed to drug-induced mydriasis. Medication adjustments and sun protection strategies led to full visual recovery, underscoring the importance of interdisciplinary awareness. This case emphasizes the challenges associated with the simultaneous management of psychiatric and ophthalmic conditions and highlights the need for routine ophthalmic evaluation of patients prescribed antidepressants with reported ocular side effects.

Original article

Right anterior mini-thoracotomy aortic valve replacement versus transcatheter aortic valve implantation in octogenarians: a single-center retrospective study: Ji Eun Im, Eun Yeung Jung, Seok Soo Lee, Ho-Ki Min; J Yeungnam Med Sci. 2024;41(2):96-102. Published online February 26, 2024; DOI: https://doi.org/10.12701/jyms.2023.01228

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Abstract PDF

Background
The aim of this study was to compare the early outcomes of octogenarians undergoing minimally invasive right anterior mini-thoracotomy aortic valve replacement (RAT-AVR) with those undergoing transcatheter aortic valve implantation (TAVI) for aortic valve disease.
Methods
In this single-center retrospective study, data were collected from octogenarians before and after RAT-AVR and TAVI between January 2021 and July 2022. Short-term outcomes, including the length of hospital stay, in-hospital mortality, all-cause mortality, and other major postoperative complications, were compared and analyzed.
Results
There were no significant differences in in-hospital mortality, stroke, acute kidney dysfunction requiring renal replacement therapy, length of intensive care unit stay, or length of hospital stay. However, the TAVI group had a higher incidence of permanent pacemaker insertion (10% vs. 0%, p=0.54) and paravalvular leaks (75% vs. 0%, p<0.001).
Conclusion
In the present study on octogenarians, both TAVI and RAT-AVR showed comparable short-term results. Although both procedures were considered safe and effective in the selected group, RAT-AVR had a lower incidence of complete atrioventricular block and paravalvular regurgitation.

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Aortic valve replacement through right anterior mini-thoracotomy in patients with chronic severe aortic regurgitation: a retrospective single-center study
Eun Yeung Jung, Ji Eun Im, Ho-Ki Min, Seok Soo Lee
Journal of Yeungnam Medical Science.2024; 41(3): 213. CrossRef
Sutureless Aortic Prosthesis Valves versus Transcatheter Aortic Valve Implantation in Intermediate Risk Patients with Severe Aortic Stenosis: A Literature Review
Laura Asta, Adriana Sbrigata, Calogera Pisano
Journal of Clinical Medicine.2024; 13(18): 5592. CrossRef

Review article

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

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

Original article

Comparison of serum anti-Müllerian hormone between unilateral and bilateral ovarian endometriomas during follicular, luteal, and random menstrual phases: a retrospective study: Juhun Lee, Jong Mi Kim, Gun Oh Chong, Dae Gy Hong, Yoon Hee Lee; J Yeungnam Med Sci. 2023;40(Suppl):S65-S72. Published online September 22, 2023; DOI: https://doi.org/10.12701/jyms.2023.00661

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Abstract PDF

Background
Over the last two decades, serum levels of anti-Müllerian hormone (AMH) have been shown to be reliable markers of ovarian reserve. This study aimed to compare baseline serum AMH levels and well-controlled clinical factors between patients with unilateral and bilateral ovarian endometriomas during the menstrual phase.
Methods
We conducted a retrospective study. We enrolled 136 patients aged 18 to 36 years who were diagnosed with unilateral or bilateral ovarian endometriomas. Serum AMH levels of all patients and their latest two to three menstrual cycles were measured before surgery for ovarian endometriomas. The latest menstrual cycle length ranged from 26 to 30 days. Patients with irregular menstruation, a recent medication history of hormonal drugs other than oral contraceptive pills, a previous history of ovarian surgery, or any medical history influencing ovarian function were excluded.
Results
Of the 136 patients, 76 (55.9%) had unilateral ovarian endometriomas and 60 (44.1%) had bilateral ovarian endometriomas. Serum AMH levels were not significantly different between the two groups in the follicular phase, luteal phase, or at any random time point.
Conclusion
Serum AMH levels were not significantly different between unilateral and bilateral ovarian endometriomas in the follicular and luteal phases, or at any random time during the menstrual cycle when various confounding factors were excluded.

Citations

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Factors affected the ovarian reserve after laparoscopic cystectomy for ovarian endometriomas
Kit-Sum Mak, Yi-Ting Huang, Cindy Hsuan Weng, Kai-Yun Wu, Wei-Li Lin, Chin-Jung Wang
European Journal of Obstetrics & Gynecology and Reproductive Biology.2024; 303: 244. CrossRef
The Relationship Between Serum Anti-Müllerian Hormone and Basal Antral Follicle Count in Infertile Women Under 35 Years: An Assessment of Ovarian Reserve
Ummey Nazmin Islam, Anwara Begum, Fatema Rahman, Md. Ahsanul Haq, Santosh Kumar, Kona Chowdhury, Susmita Sinha, Mainul Haque, Rahnuma Ahmad
Cureus.2023;[Epub] CrossRef

Case report

A rare pathogenic variant identified in a heart transplant recipient with hereditary transthyretin amyloidosis: a case report: Myeong Seop Kim, Soo Youn Lee, Kyung-Hee Kim; J Yeungnam Med Sci. 2023;40(Suppl):S98-S104. Published online May 30, 2023; DOI: https://doi.org/10.12701/jyms.2023.00241

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Abstract PDF: Hereditary transthyretin (ATTRv) amyloidosis is a rare and complex genetic disorder that can lead to life-threatening cardiac amyloidosis and rapid disease progression. Early diagnosis and treatment with disease-modifying drugs can improve patient outcomes; however, heart transplantation may be necessary in some patients. We present the unique case of a 65-year-old Korean woman diagnosed with ATTRv amyloidosis after experiencing progressive neurological symptoms, followed by heart failure. Despite the absence of significant symptoms of heart failure, subsequent screening revealed cardiac amyloid infiltration, which caused left ventricular hypertrophy and rapid disease progression. The patient underwent successful heart transplantation, and subsequent genetic testing revealed a pathogenic variant, NM_000371.3:c.425T>C (p.Val142Ala), which affects both the nerves and heart and has not been previously reported in Korea. Our report underscores the potential benefits of heart transplantation in managing advanced ATTRv amyloidosis and emphasizes the need for continued research on the genetic heterogeneity of the disease. Clinicians should consider ATTRv amyloidosis in the differential diagnosis of patients presenting with neurological symptoms and heart failure, particularly in those with a family history of the disease.

Review article

Octacalcium phosphate, a promising bone substitute material: a narrative review: Jooseong Kim, Sukyoung Kim, Inhwan Song; J Yeungnam Med Sci. 2024;41(1):4-12. Published online May 9, 2023; DOI: https://doi.org/10.12701/jyms.2023.00010

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Abstract PDF

Biomaterials have been used to supplement and restore function and structure by replacing or restoring parts of damaged tissues and organs. In ancient times, the medical use of biomaterials was limited owing to infection during surgery and poor surgical techniques. However, in modern times, the medical applications of biomaterials are diversifying owing to great developments in material science and medical technology. In this paper, we introduce biomaterials, focusing on calcium phosphate ceramics, including octacalcium phosphate, which has recently attracted attention as a bone graft material.

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Improvement of bone regeneration by a synergistic combination of octacalcium phosphate and water glass
Won-Pyo Lee, Euisin Yang, Woong Kim, Riessa Nanda Mertamani, Hana Lee, Se Eun Kim, Kyung Mi Shim, Seong Soo Kang, Sukyoung Kim, Seok-Jun Kim, Jooseong Kim
Materials & Design.2024; 248: 113484. CrossRef
Development of Hydroxyapatite Coatings for Orthopaedic Implants from Colloidal Solutions: Part 1—Effect of Solution Concentration and Deposition Kinetics
Bríd Murphy, Mick A. Morris, Jhonattan Baez
Nanomaterials.2023; 13(18): 2577. CrossRef

Original article

Clinical investigation on acute pyelonephritis without pyuria: a retrospective observational study: Hyung Keun Song, Dong Hyuk Shin, Ji Ung Na, Sang Kuk Han, Pil Cho Choi, Jang Hee Lee; J Yeungnam Med Sci. 2022;39(1):39-45. Published online August 11, 2021; DOI: https://doi.org/10.12701/yujm.2021.01207

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Abstract PDF: Background
The current guidelines for the diagnosis of acute pyelonephritis (APN) recommend that APN be diagnosed based on the clinical features and the presence of pyuria. However, we observed that some of the patients who are diagnosed with APN do not have characteristic clinical features or pyuria at the initial examination. We performed this study to investigate the characteristics of APN without pyuria.
Methods
A retrospective, cross-sectional study was conducted on 391 patients diagnosed with APN based on clinical and radiologic findings, between 2015 and 2019. The clinical features, laboratory results, and computed tomography (CT) findings were compared between patients with normal white blood cell (WBC) counts and those with abnormal WBC counts (WBC of 0–5/high power field [HPF] vs. >5/HPF) in urine.
Results
More than 50% of patients with APN had no typical urinary tract symptoms and one-third of them had no costovertebral angle (CVA) tenderness. Eighty-eight patients (22.5%) had normal WBC counts (0–5/HPF) on urine microscopy. There was a negative correlation between pyuria (WBC of >5/HPF) and previous antibiotic use (odds ratio, 0.249; 95% confidence interval, 0.140–0.441; p<0.001), and the probability of pyuria was reduced by 75.1% in patients who took antibiotics before visiting the emergency room.
Conclusion
The diagnosis of APN should not be overlooked even if there are no typical clinical features, or urine microscopic examination is normal. If a patient has already taken antibiotics at the time of diagnosis, imaging studies such as CT should be performed more actively, regardless of the urinalysis results.

Case reports

Pedunculated mucinous cystic neoplasm of the liver: a case report: Sang-Woo Ha, Shin Hwang, Hyejin Han, Song Ie Han, Seung-Mo Hong; J Yeungnam Med Sci. 2022;39(3):250-255. Published online August 3, 2021; DOI: https://doi.org/10.12701/yujm.2021.01256

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Abstract PDF: In 2010, the World Health Organization classified mucin-producing bile duct tumors of the liver into two distinct entities; mucinous cystic neoplasm of the liver (MCN-L) and intraductal papillary mucinous neoplasm of the bile duct. We present the case of a patient with MCN-L having a uniquely pedunculated shape. A 32‐year‐old woman was referred to our institution with a diagnosis of biliary cystic neoplasm. She had undergone left salpingo-oophorectomy for ovarian cancer 15 years ago. Imaging studies showed an 8 cm-sized well defined, multiloculated cystic lesion suggesting a mucinous cystic neoplasm. The cystic mass was pedunculated at the liver capsule and pathologically diagnosed as MCN-L. The mass was resected with partial hepatectomy. The patient recovered uneventfully. She was discharged 7 days postoperatively. The patient has been doing well for 6 months after the operation. The patient will be followed up annually because of the favorable postresection prognosis of MCN-L.

Anti-N-methyl-D-aspartate receptor encephalitis associated with ovarian teratoma in Korea: three case reports: Jisun Lee, Seongwoo Kang, Hye Jin Chang, Yong Hee Lee, Joo-Hyuk Son, Tae Wook Kong, Suk-Joon Chang, Kyung Joo Hwang, Miran Kim; Yeungnam Univ J Med. 2021;38(4):350-355. Published online January 27, 2021; DOI: https://doi.org/10.12701/yujm.2020.00794

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Abstract PDF

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a severe autoimmune paraneoplastic syndrome associated with ovarian teratomas. Most patients develop neurologic symptoms, including psychosis, memory deficits, seizures, or abnormal movements, and experience abdominal pain related to ovarian neoplasm. We present a case report of three patients diagnosed with anti-NMDAR encephalitis accompanied by ovarian teratomas at Ajou University Hospital in Korea. The patients demonstrated a different clinical course of the disease. However, upon diagnosis, all patients underwent surgical removal of the ovarian teratoma followed by intensive immunotherapy. The symptoms progressively improved following treatment. This is a case report of a rare autoimmune anti-NMDAR encephalitis associated with ovarian neoplasms, including immature teratoma.

Citations

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Patterns of Neuropsychiatric Manifestations of Ovarian Teratomas: A Systematic Review of Case Reports
Gaelle Umutoni Mihigo, Luigjina Uljic, Jasrina Kaushal, Shannia Amoah, Kudrat Jha, Ayodeji Jolayemi
Cureus.2024;[Epub] CrossRef
Ovarian teratoma-associated Anti-NMDAR encephalitis in women with first-time neuropsychiatric symptoms: A meta-analysis and systematic review of reported cases
Weronika Banach, Paulina Banach, Hanna Szweda, Andrzej Wiśniewski, Mirosław Andrusiewicz, Igor Gurynowicz, Wioletta K. Szepieniec, Paweł Szymanowski
Heliyon.2024; 10(19): e36042. CrossRef
Association of ovarian teratoma with anti-N-methyl-D-aspartate receptor encephalitis: a case report and narrative review
Konrad Joseph, Sarah van der Hock, Ishith Seth, Nipuni Hapangama, Lara Gibson, Roberto Cuomo, Warren M. Rozen, Nita Dhupar
Archives of Gynecology and Obstetrics.2024;[Epub] CrossRef

Original articles

Perioperative outcomes of interrupted anticoagulation in patients with non-valvular atrial fibrillation undergoing non-cardiac surgery: Bo Eun Park, Myung Hwan Bae, Hyeon Jeong Kim, Yoon Jung Park, Hong Nyun Kim, Se Yong Jang, Jang Hoon Lee, Dong Heon Yang, Hun Sik Park, Yongkeun Cho, Shung Chull Chae; Yeungnam Univ J Med. 2020;37(4):321-328. Published online July 16, 2020; DOI: https://doi.org/10.12701/yujm.2020.00353

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Abstract PDF

Background
This study aimed to investigate the incidences of and risk factors for perioperative events following anticoagulant discontinuation in patients with non-valvular atrial fibrillation (NVAF) undergoing non-cardiac surgery.
Methods
A total of 216 consecutive patients who underwent cardiac consultation for suspending perioperative anticoagulants were enrolled. A perioperative event was defined as a composite of thromboembolism and major bleeding.
Results
The mean anticoagulant discontinuation duration was 5.7 (±4.2) days and was significantly longer in the warfarin group (p<0.001). Four perioperative thromboembolic (1.85%; three strokes and one systemic embolization) and three major bleeding events (1.39%) were observed. The high CHA2DS2-VASc and HAS-BLED scores and a prolonged preoperative anticoagulant discontinuation duration (4.4±2.1 vs. 2.9±1.8 days; p=0.028) were associated with perioperative events, whereas the anticoagulant type (non-vitamin K antagonist oral anticoagulants or warfarin) was not. The best cut-off levels of the HAS-BLED and CHA2DS2-VASc scores were 3.5 and 2.5, respectively, and the preoperative anticoagulant discontinuation duration for predicting perioperative events was 2.5 days. Significant differences in the perioperative event rates were observed among the four risk groups categorized according to the sum of these values: risk 0, 0%; risk 1, 0%; risk 2, 5.9%; and risk 3, 50.0% (p<0.001). Multivariate logistic regression analysis showed that the HAS-BLED score was an independent predictor for perioperative events.
Conclusion
Thromboembolic events and major bleeding are not uncommon during perioperative anticoagulant discontinuation in patients with NVAF, and interrupted anticoagulation strategies are needed to minimize these.

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Evaluation of clinical outcome and predictive factors for thromboembolism or hemorrhagic complications in patients treated for chronic subdural hematoma. A prospective observational study
Alba Scerrati, Giorgio Mantovani, Michele Alessandro Cavallo, Maria Elena Flacco, Pietro Zangrossi, Silvia Eichner, Luca Ricciardi, Antonella Mangraviti, Antonino Raco, Tamara Ius, Daniele Piccolo, Oriela Rustemi, Fabio Raneri, Carmelo Lucio Sturiale, Alb
Neurosurgical Review.2025;[Epub] CrossRef
Bleeding risk in female patients undergoing intravesical injection of onabotulinumtoxinA for overactive bladder: a Danish retrospective cohort study
Meryam El Issaoui, Sophia Elissaoui, Marlene Elmelund, Niels Klarskov
International Urogynecology Journal.2023; 34(10): 2581. CrossRef

Mineralization-inducing potentials of calcium silicate-based pulp capping materials in human dental pulp cells: Sohee Kang; Yeungnam Univ J Med. 2020;37(3):217-225. Published online May 22, 2020; DOI: https://doi.org/10.12701/yujm.2020.00248

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Abstract PDF

Background
To provide a long-term bacterial seal through the formation of reparative dentin bridge, calcium silicate-based pulp capping materials have been used at sites of pulpal exposure. The aim of this study was to evaluate the mineralization-inducing potentials of calcium silicate-based pulp capping materials (ProRoot MTA [PR], Biodentine [BD], and TheraCal LC [TC]) in human dental pulp cells (HDPCs).
Methods
Specimens of test materials were placed in deionized water for various incubation times to measure the pH variation and the concentration of calcium released. The morphology of HDPCs cultured on the specimens was examined using a confocal laser scanning microscope (CLSM). Alizarin red S staining and alkaline phosphatase assays were used to evaluate mineralization-inducing potentials of the capping materials.
Results
BD showed the highest calcium release in all test periods, followed by PR and TC. (p<0.05). All experimental groups showed high alkalinity after 1 day, except at 14 days. BD showed the highest cell viability compared with PR and TC after 1 and 3 days, while TC showed the lowest value (p<0.05). The CLSM analysis showed that cells were well adhered and expressed actin filaments for all pulp capping materials. Mineralization by PR and BD groups was higher than that by TC group based on alizarin red S staining. BD showed significantly higher alkaline phosphatase activity than PR and TC, while TC showed the lowest value (p<0.05).
Conclusion
Within the limitations of the in vitro study, BD had higher mineralization-inducing potential than PR and TC.

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Effect of pulp capping materials on odontogenic differentiation of human dental pulp stem cells: An in vitro study
Mahmoud M. Bakr, Mohamed Shamel, Shereen N. Raafat, Robert M. Love, Mahmoud M. Al‐Ankily
Clinical and Experimental Dental Research.2024;[Epub] CrossRef
Ex Vivo Osteogenesis Induced by Calcium Silicate-Based Cement Extracts
Gabriel Kato, Rita Araújo, Cláudia Rodrigues, Pedro Sousa Gomes, Liliana Grenho, Maria Helena Fernandes
Journal of Functional Biomaterials.2023; 14(6): 314. CrossRef
Evaluation of the chemical, physical, and biological properties of a newly developed bioceramic cement derived from cockle shells: an in vitro study
Monthip Wannakajeepiboon, Chankhrit Sathorn, Chatvadee Kornsuthisopon, Busayarat Santiwong, Thanakorn Wasanapiarnpong, Pairoj Linsuwanont
BMC Oral Health.2023;[Epub] CrossRef
Cytotoxicity of dental self-curing resin for a temporary crown: an in vitro study
Jae-wan Ko, Joon Sakong, Sohee Kang
Journal of Yeungnam Medical Science.2023; 40(Suppl): S1. CrossRef
Ion release, biocompatibility, and bioactivity of resin-modified calcium hydroxide cavity liners
Nastaran Taghvaei, Mehrsima Ghavami-Lahiji, Mehdi Evazalipour, Reza Tayefeh Davalloo, Ehsan Zamani
BMC Oral Health.2023;[Epub] CrossRef
Morphogenesis of Osteoid Structures during Cultivation of Mesenchymal Stromal Cells on Fibrillary Collagen in the Presence of Silicoaluminophosphate
A. A. Gaidash, M. I. Blinova, S. A. Aleksandrova, Yu. A. Nashchekina, V. K. Krutko, O. N. Musskaya, K. V. Skrotskaya, A. V. Nashchekin, N. A. Mikhailova, A. I. Kulak
Cell and Tissue Biology.2022; 16(1): 52. CrossRef
Present status and future directions: Hydraulic materials for endodontic use
Josette Camilleri, Amre Atmeh, Xin Li, Nastaran Meschi
International Endodontic Journal.2022; 55(S3): 710. CrossRef
The scientific management of deep carious lesions in vital teeth using contemporary materials—a narrative review
M. Al-Ali, J. Camilleri
Frontiers in Dental Medicine.2022;[Epub] CrossRef

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.

Citations

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Molecular landscape of recurrent cervical cancer
Divya Adiga, Sangavi Eswaran, Deeksha Pandey, Krishna Sharan, Shama Prasada Kabekkodu
Critical Reviews in Oncology/Hematology.2021; 157: 103178. CrossRef
Histopathological Study of Gynecological Cancers in Patients Admitted to Baqiyatallah Hospital in Tehran during 2011-2019
Seyedeh Razieh Hashemi, Mohammad Reza Akbari, Zahra Soleimani
Avicenna Journal of Clinical Medicine.2021; 28(1): 42. CrossRef

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

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Abstract PDF

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

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A predictive model for recurrence in patients with borderline ovarian tumor based on neural multi-task logistic regression
Qiulin Ye, Yue Qi, Juanjuan Liu, Yuexin Hu, Xiao Li, Qian Guo, Danye Zhang, Bei Lin
BMC Cancer.2025;[Epub] CrossRef
Comparison of conventional diffusion-weighted imaging, diffusion kurtosis imaging and intravoxel incoherent motion in characterization of sonographically indeterminate adnexal masses
Gurkawal Kaur, Smita Manchanda, Raju Sharma, Surabhi Vyas, Devasenathipathy Kandasamy, Smriti Hari, Neerja Bhatla, Sandeep R. Mathur
Abdominal Radiology.2024; 49(5): 1512. CrossRef
Advances in fertility preserving surgery for borderline ovarian tumors
Mingdan Wang, Kuiran Liu
European Journal of Obstetrics & Gynecology and Reproductive Biology.2022; 270: 206. CrossRef
Recurrence characteristics and clinicopathological results of borderline ovarian tumors
Lina Niu, Huihui Tian, Yongjun Xu, Jieqiong Cao, Xu Zhang, Junli Zhang, Jiajia Hou, Weiqin Lv, Junxia Wang, Li Xin, XuFeng Dong, Tao Xu, Yuan Nan, Hua Wei, Xinting Chai, Na Li, Yan Ni, Yun Shang, Lizhen Zhang, Ye Zhao
BMC Women's Health.2021;[Epub] CrossRef
Erratum to “Assessment of solid components of borderline ovarian tumor and stage I carcinoma: added value of combined diffusion- and perfusion-weighted magnetic resonance imaging”
See Hyung Kim
Yeungnam University Journal of Medicine.2020; 37(2): 147. CrossRef
Minimal apparent diffusion coefficient value of the solid component to differentiate borderline and malignant ovarian epithelial tumours: a preliminary report
Sahat B.R.E. Matondang, Avrilia Ekawati, Andrijono Andrijono, Hartono Tjahjadi, Joedo Prihartono
Polish Journal of Radiology.2020; 85: 250. CrossRef

Review article

Intraoperative consultation for ovarian tumors: Insun Kim; Yeungnam Univ J Med. 2019;36(3):163-182. Published online June 11, 2019; DOI: https://doi.org/10.12701/yujm.2019.00227

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Abstract PDF

The primary function of intraoperative frozen consultation is to provide an as accurate and prompt diagnosis as possible during surgery and to guide the surgeon in further management. However, the evaluation of frozen section (FS) is sometimes difficult because of suboptimal tissue quality and frozen artifacts compared with routinely processed tissue section. The pathologist responsible for the FS diagnosis requires experience and good judgment. Ovarian tumors are a heterogeneous group of tumors including primary surface epithelial tumors, germ cell tumors and sex cord-stromal tumors, secondary tumors, and other groups of tumors of uncertain histogenesis or nonspecific stroma. Intraoperative FS is a very important and reliable tool that guides the surgical management of ovarian tumors. In this review, the diagnostic key points for the pathologist and the implication of the FS diagnosis on the operator’s decisions are discussed.

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A Clinicopathological Study of Surface Epithelial Tumors of the Ovary: A Retrospective Analysis at a Tertiary Care Center in Jeddah, Saudi Arabia
Layla S Abdullah, Badraa Alahmadi, Reema Abonab, Salma Baeisa, Bodoor Alahmadi
Cureus.2025;[Epub] CrossRef
Gross mucinous multinodular appearance aids in the identification of ovarian metastases in low-grade appendiceal mucinous neoplasms during intraoperative consultation
Hiroshi Yoshida, Hiroki Tanaka, Takafumi Tsukada, Naoko Abeto, Mayumi Kobayashi-Kato, Yasuhito Tanase, Masaya Uno, Mitsuya Ishikawa, Tomoyasu Kato
Annals of Diagnostic Pathology.2021; 50: 151641. CrossRef
Diagnostic Accuracy and Discrepancies of Frozen Section Analysis in a Colombian Intermediate Care Center
Anggi Margarita Velez Bohorquez, Daniel Javier Vélez Bohórquez , Mabel Elena Bohórquez Lozano, Angela Cecilia Rios
Universitas Médica.2021;[Epub] CrossRef

Original Articles

Association of head circumference with cognitive decline and symptoms of depression in elderly: a 3-year prospective study: Oh Dae Kwon, So-Young Choi, Jisuk Bae; Yeungnam Univ J Med. 2018;35(2):205-212. Published online December 31, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.205

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Abstract PDF: Background
Brain volume is associated with dementia and depression in the elderly. An easy way to predict relative brain volume is to measure head circumference. In this study, we investigated the relationship between head circumference and cognition as well as depression in a non-demented elderly community.
Methods
Baseline and follow-up surveys were conducted in 2007 and 2010. At baseline, community residents aged 65 years or over (n=382) within a rural area of South Korea were screened for dementia and symptoms of depression and were followed using the same screening battery after 3 years (n=279). Data from anthropometric measurements (head circumference, height, and body weight), demographics, and blood tests were gathered. Neuropsychological tests, including the Korean version of mini-mental state examination (K-MMSE), clinical dementia rating (CDR) including the CDR-sum of boxes, the Korean version of instrumental activities of daily living, and geriatric depression scale (GDS), were performed. None of the 279 subjects followed were demented.
Results
Baseline performance on the K-MMSE and GDS was poorer for participants with smaller head circumferences. Follow-up performance on the MMSE was also poorer for participants with smaller head circumferences. Interestingly, participants with smaller head circumference showed worse GDS scores at baseline but on follow-up examination, participants with larger head circumference showed rapid worsening than those with smaller head circumference with marginal significance by ANOVA test. In regression coefficient analysis, GDS decline showed significant difference.
Conclusion
Head circumference was not associated with cognitive change but was associated with symptoms of depression in non-demented community residents.

Effects of small tidal volume and positive end-expiratory pressure on oxygenation in pressure-controlled ventilation-volume guaranteed mode during one-lung ventilation: Sung Hye Byun, So Young Lee, Jin Yong Jung; Yeungnam Univ J Med. 2018;35(2):165-170. Published online December 20, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.165

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Abstract PDF

Background
The purpose of this study was to investigate whether tidal volume (TV) of 8 mL/kg without positive end-expiratory pressure (PEEP) and TV of 6 mL/kg with or without PEEP in pressure-controlled ventilation-volume guaranteed (PCV-VG) mode can maintain arterial oxygenation and decrease inspiratory airway pressure effectively during one-lung ventilation (OLV).
Methods
The study enrolled 27 patients undergoing thoracic surgery. All patients were ventilated with PCVVG mode. During OLV, patients were initially ventilated with TV 8 mL/kg (group TV8) without PEEP. Ventilation was subsequently changed to TV 6 mL/kg with PEEP (5 cmH2O; group TV6+PEEP) or without (group TV6) in random sequence. Peak inspiratory pressure (Ppeak), mean airway pressure (Pmean), and arterial blood gas analysis were measured 30 min after changing ventilator settings. Ventilation was then changed once more to add or eliminate PEEP (5 cmH2O), while maintaining TV 6 mL/kg. Thirty min after changing ventilator settings, the same parameters were measured once more.
Results
The Ppeak was significantly lower in group TV6 (19.3±3.3 cmH2O) than in group TV8 (21.8±3.1 cmH2O) and group TV6+PEEP (20.1±3.4 cmH2O). PaO2 was significantly higher in group TV8 (242.5±111.4 mmHg) than in group TV6 (202.1±101.3 mmHg) (p=0.044). There was no significant difference in PaO2 between group TV8 and group TV6+PEEP (226.8±121.1 mmHg). However, three patients in group TV6 were dropped from the study because PaO2 was lower than 80 mmHg after ventilation.
Conclusion
It is postulated that TV 8 mL/kg without PEEP or TV 6 mL/kg with 5 cmH2O PEEP in PCV-VG mode during OLV can safely maintain adequate oxygenation.

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Pressure‐Controlled Ventilation‐Volume Guaranteed Mode Combined with an Open‐Lung Approach Improves Lung Mechanics, Oxygenation Parameters, and the Inflammatory Response during One‐Lung Ventilation: A Randomized Controlled Trial
Jianli Li, Baogui Cai, Dongdong Yu, Meinv Liu, Xiaoqian Wu, Junfang Rong, Jürgen Bünger
BioMed Research International.2020;[Epub] CrossRef

Review Article

IRB review points for studies utilizing paraffin blocks archived in the pathology laboratory: Yong-Jin Kim, Chang Rok Jeong, Jeong Sik Park; Yeungnam Univ J Med. 2018;35(1):36-39. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.36

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Abstract PDF: In the personalized medicine era, utilizing paraffin blocks in pathology archives for investigating human diseases has come into the limelight. This archived material with clinical data will reduce the research time and could prevent new patient recruitment to obtain tissue for research. However, the clause indicating the necessity of consent from human material providers in the Korean Bioethics and Safety Act has made the Institutional Review Board (IRB) deny permission to use paraffin blocks for research without consent, and alternatively to get the same before starting an experiment. Written consent may be waived off in studies using paraffin blocks with anonymous status or conditions not linked to personal information by applying the paragraph 3, article 16 of the current Bioethics and Safety Act. Also, the IRB should recommend researchers to preserve the blocks as medical records of patients in long-term archives.

Case Reports

Preoperative arterial embolization of heterotopic ossification around the hip joint: Jin Hyeok Kim, Chankue Park, Seung Min Son, Won Chul Shin, Joo Yeon Jang, Hee Seok Jeong, In Sook Lee, Tae Young Moon; Yeungnam Univ J Med. 2018;35(1):130-134. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.130

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Abstract PDF

Heterotopic ossification (HO) around the hip joint is not uncommon following neurological injury. Often, surgical treatment is performed in patients with restricted motion and/or refractory pain due to grade III or IV HO according to Brooker classification. The major complication that occurs as a result of surgical HO removal is perioperative bleeding due to hyper-vascularization of the lesion. Here, we report a case of preoperative embolization in a 51-year-old male patient presenting with restricted bilateral hip range of motion (ROM) due to HO following a spinal cord injury. In the right hip without preoperative arterial embolization, massive bleeding occurred during surgical removal of HO. Thus, the patient received a transfusion postoperatively due to decreased serum hemoglobin levels. For surgery of the left hip, preoperative embolization of the arteries supplying HO was performed. Surgical treatment was completed without bleeding complications, and the patient recovered without a postoperative transfusion. This case highlights that, while completing surgical removal for ROM improvements, orthopedic surgeons should consider preoperative arterial embolization in patients with hip HO.

Citations

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Embolization followed by resection of the heterotopic hip joint ossification with spinal cord injury
Takahiro Igei, Satoshi Nakasone, Masato Ishihara, Masamichi Onaga, Kotaro Nishida
Journal of Orthopaedic Science.2024; 29(1): 454. CrossRef
Preoperative Arterial Embolization for Heterotopic Ossification of the Hip
Nicolas Papalexis, Giuliano Peta, Costantino Errani, Marco Miceli, Giancarlo Facchini
Journal of Vascular and Interventional Radiology.2023; 34(4): 608. CrossRef
Neurogenic heterotopic ossification: A review. Part 2
Vladimir A. Novikov, Alina M. Khodorovskaya, Valery V. Umnov, Evgenii V. Melchenko, Dmitry V. Umnov
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery.2023; 11(4): 557. CrossRef
ENDOVASCULAR TREATMENT BEFORE OPERATIONS IN CLINIC OF TRAUMATOLOGY AND ORTHOPAEDICS
S. Prozorov, P. Ivanov, N. Zadneprovsky
Vrach.2023; : 21. CrossRef

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.

Reviews

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.

The relationship between muscle mitochondrial nutritional overloading and insulin resistance: Jae Han Jeon, Jun Sung Moon, Kyu Chang Won, In Kyu Lee; Yeungnam Univ J Med. 2017;34(1):19-28. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.19

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Abstract PDF: The incidence of type 2 diabetes mellitus and insulin resistance is growing rapidly. Multiple organs including the liver, skeletal muscle and adipose tissue control insulin sensitivity coordinately, but the mechanism of skeletal muscle insulin resistance has not yet been fully elucidated. However, there is a growing body of evidence that lipotoxicity induced by mitochondrial dysfunction in skeletal muscle is an important mediator of insulin resistance. However, some recent findings suggest that skeletal mitochondrial dysfunction generated by genetic manipulation is not always correlated with insulin resistance in animal models. A high fat diet can provoke insulin resistance despite a coordinate increase in skeletal muscle mitochondria, which implies that mitochondrial dysfunction is not mandatory in insulin resistance. Furthermore, incomplete fatty acid oxidation by excessive nutrition supply compared to mitochondrial demand can induce insulin resistance without preceding impairment of mitochondrial function. Taken together we suggested that skeletal muscle mitochondrial overloading, not mitochondrial dysfunction, plays a pivotal role in insulin resistance.

Case Report

Dermatomyositis sine dermatitis, a rare phenotype of idiopathic inflammatory myopathy: Jin Sung Park, Ji Young Park; Yeungnam Univ J Med. 2017;34(1):137-139. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.137

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Abstract PDF

Dermatomyositis (DM) is characterized by progressive proximal limb weakness and typical skin manifestations. The histological findings that show perifascicular atrophy and deposition of membrane attack complex are pathognomic features of DM. Dermatomyositis is categorized into classical DM and non-classical DM, which includes amyopathic DM and DM sine dermatitis. DM sine dermatitis is seldom described because of its rarity, making the diagnosis more challenging. We report a case of DM sine dermatitis, a rare phenotype of DM.

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Review

Approach to pupillary abnormalities via anatomical pathways: Sung Hee Kim; Yeungnam Univ J Med. 2017;34(1):11-18. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.11

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Abstract PDF

The pupillary size and movement are controlled dynamically by the autonomic nervous system; the parasympathetic system constricts the iris, while the sympathetic system dilates the iris. Under normal conditions, these constrictions and dilations occur identically in both eyes. Asymmetry in the pupillomotor neural input or output leads to impaired pupillary movement on one side and an unequal pupil size between both eyes. Anisocoria is one of the most common signs in neuro-ophthalmology, and the neurological disorders that frequently cause anisocoria include serious diseases, such as vascular dissection, fistula, and aneurysm. A careful history and examination can identify and localize pupillary disorders and provide a guide for appropriate evaluations.

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Multimodal Metaphor Research on China’s Recruiting Commercials in the New Era—Case Studies of the 2015~2020 Recruiting Commercials
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Modern Linguistics.2021; 09(04): 998. CrossRef

Original Articles

Urinary tract infections in pediatric oncology patients with febrile neutropenia.: Kyoo Hyun Suh, Sun Young Park, Sae Yoon Kim, Jae Min Lee; Yeungnam Univ J Med. 2016;33(2):105-111. Published online December 31, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.2.105

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Abstract PDF: BACKGROUND
Neutropenic fever is one of the most common and potentially severe complications of chemotherapy in pediatric oncology patients, while urinary tract infection (UTI) is one of the most prevalent bacterial infections in these patients. Therefore, this study was conducted to investigate features of UTI with neutropenic fever in pediatric oncology patients. METHODS: We retrospectively reviewed and analyzed the medical records, laboratory results and image findings of cases of neutropenic fever in the Department of Pediatrics of Yeungnam University Medical Center, South Korea between November 2013 and May 2015. Episodes were divided into two groups, UTI vs. non-UTI group according to the results of urine culture. The results were then compared between groups. The analysis was performed using IBM SPSS 23.0. A p-value <0.05 was considered to indicate a significant difference between groups. RESULTS: Overall, 112 episodes of neutropenic fever were analyzed, among which 22 episodes (19.6%) showed organisms on urine culture and were classified as UTI. The remaining 90 episodes were classified as non-UTI. Only four episodes (18.2%) of the UTI group showed pyuria on urine analysis. In the UTI group, 76.5% were sensitive to the first line antibiotics and showed higher clinical response than the non-UTI group. Among hematologic malignancy patients, the UTI group revealed higher serum β 2-microglobulin levels than the non-UTI group (1.56±0.43 mg/L vs. 1.2±0.43 mg/L, p<0.028). CONCLUSION: UTI in pediatric neutropenic fever responds well to antibiotics. Hematologic malignancy cases with UTI reveal increased serum β2-microglobulin level. These results will be helpful to early phase diagnosis of UTI.

The usefulness of newly developed R2CHA2DS2-VASc score and comparison with CHADS2 and CHA2DS2-VASc scores in atrial fibrillation patients.: Jae Hoon Kwak, Se Hwan Yeo, Yeo Un Kim, Jin Suk Lee, Byong Kyu Kim, Jin Wook Chung, Jun Ho Bae, Deuk Young Nah, Kwan Lee; Yeungnam Univ J Med. 2016;33(1):8-12. Published online June 30, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.1.8

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Abstract PDF: BACKGROUND
The decision to administer oral anticoagulation therapy depends on accurate assessment of stroke risk in patients with atrial fibrillation (AF). Various stroke risk stratification schemes have been developed to help inform clinical decision making. The CHADS2 and CHA2DS2-VASc scores have been used in estimating the risk of stroke in patients with AF. Recently R2CHA2DS2-VASc score was developed. The objective of the current study is to validate the usefulness of the R2CHA2DS2-VASc score and to compare the accuracy of the CHADS2, CHA2DS2-VASc, and R2CHA2DS2-VASc scores in predicting a patient's risk of stroke. METHODS: Based on medical records, we conducted a retrospective study of patients hospitalized with AF from March 2011 to July 2013. A total of 448 AF patients were included in this study. The receiver operating characteristic (ROC) curve analysis in MedCalc was used for comparison with respective diagnostic values. RESULTS: The patient characteristics showed male predominance (60.9%). Among the 448 AF patients, 131 (29.2%) patients had strokes during the study. A R2CHA2DS2-VASc score of more than 5 is the optimal cut-off value for prediction of stroke. A risk score of three, the area under the ROC curve (AUC) of R2CHA2DS2-VASc score (AUC 0.631; 95% confidence interval, 0.585-0.679) was the highest. A significant difference was observed between AUC for R2CHA2DS2-VASc, CHADS2, and CHA2DS2-VASc scores, but no meaningful difference between CHADS2 and CHA2DS2-VASc scores. CONCLUSION: We determined the usefulness of the R2CHA2DS2-VASc score, which showed better association with stroke than the CHADS2 and CHA2DS2-VASc scores.

Microbiologic distribution and clinical features of nontuberculous mycobacteria in the tertiary hospital in Daegu.: Kyung Soo Hong, June Hong Ahn, Eun Young Choi, Hyun Jung Jin, Kyeong Cheol Shin, Jin Hong Chung, Kwan Ho Lee; Yeungnam Univ J Med. 2015;32(2):71-79. Published online December 31, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.2.71

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Abstract PDF

BACKGROUND
Recent studies have shown that the nontuberculosis mycobacterium (NTM) recovery rate in clinical cultures has increased within Korea. However, another study conducted by a secondary hospital within Daegu reported different results. Therefore, the purpose of this study is to understand and evaluate the microbiological distribution and clinical features of NTM in Daegu. METHODS: A retrospective study was conducted on 11,672 respiratory specimens undergoing acid fast bacilli (AFB) culture from 6,685 subjects who visited Yeungnam University Respiratory Center from January 2012 to December 2013. RESULTS: Of the 11,672 specimens undergoing AFB culture, 1,310 specimens (11.2%) showed positive results. Of these specimens, NTM was recovered from 587 specimens, showing a recovery rate of 44.8%. Identification test for NTM was performed on 191 subjects; the results were as follows: M. avium-intracellulare complex (MAC) 123 (64.4%), M. abscessus 20 (10.5%), M. kansasii 12 (6.3%), and 33 other NTM germ strains. Of the 382 subjects with NTM, 167 were diagnosed with pulmonary NTM disease (43.7%), however virulence differed depending on NTM strain. Multivariate analysis showed that nodular bronchiectasis, the nodules, and finding consistent with cavity under imaging study were statistically significant for triggering pulmonary NTM disease. AFB culture showing MAC and M. abscessus was statistically significant as well. Positive predictive value for NTM polymerase chain reaction (NTM-PCR) was 88.6%. CONCLUSION: Results for NTM recovery rate within the Daegu area were similar to those for the Seoul metropolitan area. We can assume that NTM infection is increasing in our community, therefore AFB-positive subjects (1) should undergo NTM-PCR, (2) should have their culture results checked for differentiation of mycobacterium tuberculosis complex (MTB) from NTM, and (3) undergo NTM identification test to confirm its type. Administration of treatment with the above results should be helpful in improving the patients' prognosis.

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Geunin Lee, Sol Kim, Shihwan Chang, Hojoon Sohn, Young Ae Kang, Youngmok Park
Tuberculosis and Respiratory Diseases.2024; 87(3): 386. CrossRef
Distribution and Antimicrobial Resistance of Non-Tuberculous Mycobacteria during 2015∼2020: A Single-Center Study in Incheon, South Korea
Jiwoo Kim, Hyo-Jin Ju, Jehyun Koo, Hyeyoung Lee, Hyeonhwan Park, Kyungcheol Song, Jayoung Kim
The Korean Journal of Clinical Laboratory Science.2021; 53(3): 225. CrossRef
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The Korean Journal of Clinical Laboratory Science.2020; 52(4): 349. CrossRef
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Journal of Korean Medical Science.2017; 32(8): 1263. CrossRef

Case Reports

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.

A Case of Immunoglobulin A Nephropathy in a Patient with Kimura's Disease.: Hye Jung Park, Jae Kyung Kim, Hyun Ju Kim, Kwan Kyu Park, Yoon Sung Bae, Yong Kyu Lee, Beom Seok Kim; Yeungnam Univ J Med. 2013;30(2):149-151. Published online December 31, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.2.149

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Abstract PDF: Kimura's disease is an angiolymphoid-proliferative disorder that manifests with benign subcutaneous swelling predominantly in the head and the neck. Kidney involvement, including proteinuria, occurs in 12-16% of patients with the disease, and 60-78% of such cases is nephrotic syndrome. Reported etiologies of nephrotic syndrome in Kimura's disease include membranous glomerulonephritis, mesangial proliferative glomerulonephritis, minimal-change disease, focal segmental glomerulosclerosis, diffuse proliferative glomerulonephritis and immunoglobulin A (IgA) nephropathy. There have been only two case reports of IgA nephropathy in Kimura's disease, in 1998. In this report, we present a third case of IgA nephropathy associated with Kimura's disease.

A Case of Membranoproliferative Glomerulonephritis in a Patient with Type 2 Diabetes Mellitus.: Dong Hyun Kim, Jang Won Lee, Min Suk Jung, Seung Hyun Lee, Byung Cheol Min, Hyun Ju Kim; Yeungnam Univ J Med. 2013;30(2):136-140. Published online December 31, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.2.136

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Abstract PDF: Diabetic nephropathy (DN) is a common complication and the leading cause of end-stage renal disease (ESRD) in diabetic patients. The occurrence of non-diabetic renal disease (NDRD) in diabetic patients has been increasingly recognized in recent years. Generally, renal injuries in DN are deemed difficult to reverse, whereas some NDRDs are often treatable and even remittable. Thus, the diagnosis of NDRD in patients with diabetes mellitus (DM) via a kidney biopsy would be significant for its prognosis and therapeutic strategy. According to recent studies, the most common NDRD is IgA nephropathy in type 2 diabetic patients, and some cases of minimal change disease and membranous glomerulonephritis have been reported in Korea. However, membranoproliferative glomerulonephritis (MPGN) is an uncommon condition in diabetic patients. To our knowledge, there has been no case yet of MPGN, except in a child with type 1 DM. We present an unusual case of a 27-year-old woman who had type 2 DM with MPGN, as confirmed via a kidney biopsy.

Review

Obesity and Insulin Resistance in Childhood.: Kwang Hae Choi; Yeungnam Univ J Med. 2012;29(2):73-76. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.73

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Abstract PDF: More and more children are becoming obese and overweight due to several factors that include a high energy density in the diet (a high fat intake) and low energy expenditure. Consequently childhood obesity is becoming a significant health problem. Fat tissue releases many cytokines such as resistin, tumor necrosis factor-alpha, leptin, interleukin-6. These adipocytokines induce obesity-related insulin resistance. Insulin resistance is a key component of obesity-related metabolic problems such as hypertension, type 2 diabetes mellitus, dyslipidemia, non-alcoholic steatohepatitis, acanthosis nigricans and polycystic ovarian syndrome. This review article focused on insulin resistance and its related metabolic diseases.

Original Articles

Parasympathetic Modulation Plays a Key Role in Initiation of Paroxysmal Atrial Fibrillation.: Won Jae Lee, Dong Gu Shin, Geu Ru Hong, Jong Sun Park, Young Jo Kim; Yeungnam Univ J Med. 2007;24(2):216-231. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.216

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Abstract PDF: BACKGROUND
An acceleration or deceleration of the heart rate (HR), which reflects autonomic effects, is observed before the onset of paroxysmal atrial fibrillation (PAF). The purpose of this study was to assess the discrepancy in the autonomic interactions before the onset of PAF for different patterns of change in the HR. MATERIALS AND METHODS: From 105 Holter tapes with the PAF recorded, 55 episodes (42 patients, 34 men, 58+/-12 years) of PAF (>5 min), preceded by a sinus rhythm for more than 1 hour, were selected and submitted to time-domain and frequency-domain HR variability analyses. Fifty-five episodes were divided into 2 groups: group A PAF (n=30) with acceleration of the HR during the last 2 minutes before the PAF and group B (n=25) with deceleration of the HR. RESULTS: A significant linear decrease in the mean R-R interval was observed in group A (924+/-30 to 835+/-28 ms, P=0.001) and an increase from 831+/-32 to 866+/-31 ms in group B PAF episodes (P=0.046). In the frequency-domain analyses, the LF/HF ratio exhibited a progressive linear increase before the PAF in group A (P=0.005). The HF normalized units (HFnu) and natural logarithm-transformed HF (lnHF) values decreased from 30.8+/-4.0 to 16.1+/-1.8 (P=0.003) and 4.49+/-0.25 to 4.07+/-0.22 (P=0.001), respectively. Contrary to the results in group A, a significant increase in the HF components (HFnu and lnHF) (from 22.6+/-3.2 to 30.2+/-4.0, P=0.005, and 4.27+/-0.27 to 4.75 0.33, P=0.001, respectively) and a resultant decrease in the LF/HF ratio were observed in group B PAF episodes. No significant changes were observed in the LF components in either PAF group. CONCLUSION: Autonomic stimuli leading to an acceleration or deceleration of the HR before the onset of AF are due to parasympathetic modulation. Parasympathetic modulation plays a key role in the initiation of PAF

The Difference of Left Atrial Volume Index: Can It Predict the Occurrence of Atrial Fibrillation after Radiofrequency Ablation of Atrial Flutter?.: Ung Kim, Young Jo Kim, Sang Wook Kang, In Wook Song, Jung Hwan Jo, Sang Hee Lee, Geu Ru Hong, Jong Seon Park, Dong Gu Shin; Yeungnam Univ J Med. 2007;24(2):197-205. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.197

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Abstract PDF: BACKGROUND
The occurrence of atrial fibrillation after ablation of atrial flutter is clinically important. We investigated variables predicting this evolution in ablated patients without a previous atrial fibrillation history. MATERIALS AND METHODS: Thirty-six patients (Male=28) who were diagnosed as atrial flutter without previous atrial fibrillation history were enrolled in this study. Group 1 (n=11) was defined as those who developed atrial fibrillation after atrial flutter ablation during 1 year follow-up. Group 2 (n=25) was defined as those who has not occurred atrial fibrillation during same follow-up term. Echocardiogram was performed to all patients. We measured left atrial size, left ventricle end diastolic and systolic dimension, ejection fraction and left atrial volume index before and after ablation of atrial flutter. The differences of each variables were compared and analyzed between two groups. RESULTS: The preablation left ventricular ejection fraction (preLVEF) and postablation left ventricular ejection fraction (postLVEF) are 54+/-14%, 56+/-13% in group 1 and 47+/-16%, 52+/-13% in group 2. The differences between each two groups are statistically insignificant (2.2+/-1.5 in group 1 vs 5.4+/-9.8 in group 2, p=0.53). The preablation left atrial size (preLA) and postablation left atrial size (postLA) are 40+/-4 mm, 41+/-4 mm in group1 and 44+/-8 mm, 41+/-4 mm in group 2. The atrial sizes of both groups were increased but, the differences of left atrial size between two groups before and after flutter ablation were statistically insignificant (0.6+/-0.9mm in group 1 vs -3.8+/-7.4 mm in group 2, p=0.149). The left atrial volume index before flutter ablation was significantly reduced in group 1 than group 2 (32+/-10 mm3/m2, 35+/-10 mm3/m2 in group 1 and 32+/-10 mm3/m2, 29+/-8 mm3/m2 in group 2, p<0.05). CONCLUSION: The difference between left atrial volume index before and after atrial flutter ablation is the robust predictor of occurrence of atrial fibrillation after atrial flutter ablation without previous atrial fibrillation.

Case Reports

A Case of Facial Lichen Striatus: Mi Hye Kim, Chan Woo Kim, Seok Ki Moon, Dong Hoon Shin, Jong Soo Choi, Ki Hong Kim; Yeungnam Univ J Med. 2007;24(2 Suppl):S746-748. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S746

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Abstract PDF: Lichen striatus is a inflammatory disorder characterized by distinctive linear distribution of papules. The lesion presents commonly on the extremities and facial involvement has been reported as being less frequent. Only four cases have been reported in the Korean literatures. A 3-year-old patient presented with linear erythematous papules on the nose. Histopathologically, the lesion showed spongiosis in the epidermis and lymphocytic infiltration around the hair follicles and eccrine glands in the dermis. We report a case of lichen striatus with facial involvement.

A Case of Uterine Didelphys with Obstructed Hemivagina and Ipsilateral Renal Agenesis: Sung Chul Park, Doo Jin Lee, Sung Ho Lee, Yoon Ki Park; Yeungnam Univ J Med. 2007;24(2 Suppl):S737-741. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S737

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Abstract PDF

Frequency of female genital congenital abnormality is about 0.2%. We suspect female as uterine abnormality with hematocolpos, who after menarche with progressive abdominal pain during menses, in associated with the finding of growing pelvic mass and not visible unilateral kidney at urography. Commonly it was fined with acute lower abdominal pain at puberty. Early diagnosis is very important to treatment and to fertility of patient. The simple and adequate treatment of the condition is incision of the obstructed vaginal septum providing adequate drainage of the retained blood. If diagnosis of this disease is late, it may occur complications of hematocolpos, hematosalphinx, endometriosis and pelvic adhesions by flowing backward of mensturational blood. Also it may cause decreasing fertility and secondary infection. We report a case of uterine didelphys with obstructed hemivagina and ipsilateral renal agenesis with a brief review of the literature.

Citations

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A Case Report on Secondary Dysmenorrhea with Herlyn-Werner-Wunderlich Syndrome
Pyung-Wha Kim, Ji-Yeong Im, Yong-Tae Jeon, Eun-Hee Lee
The Journal of Oriental Obstetrics and Gynecology.2016; 29(4): 69. CrossRef

Original Article

Comparisons of Gas Analysis in Arterial, Venous and Warmed Venous Blood During Inhalation General Anesthesia: Heung Dae Kim; Yeungnam Univ J Med. 2007;24(2 Suppl):S519-526. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S519

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Abstract PDF: Background
：We determine whether venous blood, when sampled under carefully controlled conditions, was an acceptable alternative to arterial blood for the measurement of arterial blood gas analysis during inhalation general anesthesia. Materials and Methods：The arterial blood values of the carbon dioxide tension (PCO₂), pH, base excess (BE), oxygen tension (PO₂) and oxygen saturation (SO₂) were compared with the values of venous blood drawn from the cephalic vein as non controlled routine method and as localized warmed method during inhalation general anesthesia with sevoflurane and N₂O (50%) in 20 cases.
Results
：The blood gas analysis values of non controlled cephalic venous blood were close to those of arterial blood. They was similar between the PCO₂ (42.5 ± 0.97 vs. 38.7 ± 0.92 mmHg), pH (7.35 ± 0.01 vs. 7.39 ± 0.01) and BE (-3.13 ± 0.62 vs. -0.18 ± 0.13 mEq/l) of non controlled cephalic venous and of arterial blood. Although the PO₂ in non controlled cephalic venous blood was significantly less than that in arterial blood(130.8 ± 8.1 vs. 245.3 ± 6.8 mmHg), the difference in SO₂ was small(98.9 ± 2.1 vs. 99.7 ± 0.4%). The blood gas values of warmed cephalic venous blood were more similar to those of arterial blood (PCO₂, 41.2 ± 0.91 vs. 38.7 ± 0.92 mmHg; pH, 7.37 ± 0.01 vs. 7.39 ± 0.01; BE, -2.30 ± 0.62 vs. -0.18 ± 0.13 mEq/l; PO₂, 157.3 ± 11.4 vs. 245.3 ± 6.8 mmHg; SO₂, 99.2 ± 1.3 vs. 99.7 ± 0.4%) than to those of non controlled cephalic venous blood.
Conclusion
：We found that warmed cephalic venous blood during inhalation general anesthesia can be arterialized and PCO₂, pH, BE and SO₂ of warmed cephalic venous blood were not significantly different to those of arterial blood. Therefore we conclude that it is reliable to use localized warmed cephalic venous blood for the measurement of arterial blood gas analysis during inhalation general anesthesia.

Review Article

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.

Review

Recent Advances in Surgery for Atrial Fibrillation.: Dong Hyup Lee, Tae Eun Jung; Yeungnam Univ J Med. 2005;22(1):13-26. Published online June 30, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.1.13

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Abstract PDF: Atrial fibrillation (AF) is the most common cardiac rhythm disturbance, which carries significant cardiovascular morbidity and mortality. The medical treatment for AF is cumbersome and unsatisfactory, which has highlighted the need to develop alternative treatments for AF. The recent discovery that AF is often initiated by atrial ectopic beats has resulted in treatments designed to target the ectopic sources, particularly those within the pulmonary veins. Building on the pioneering work of Cox et al., a recent reported series demonstrated the feasibility of treating patients undergoing cardiac surgery for other structural heart diseases with limited, left-atrial ablation lesion sets using alternative energy sources. As less complex modifications of the Maze procedure have been developed, a number of energy sources have been introduced to create of electrically isolating lesions within the atria. These sources have been used both endocardially in arrest heart procedures as well as epicardially in a beating heart setting. This review summarizes the recent advances in surgery for AF that will aid in the development of an effective, minimally invasive surgical procedure to cure patients with AF.

Case Report

Laparoscopic Extirpation of the Term Sized Huge Ovarian Cyst.: Min Whan Koh, Hyun Cheol Choo, Oh Jin Kwon, Jeong Sook Kim; Yeungnam Univ J Med. 2004;21(1):108-113. Published online June 30, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.1.108

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Abstract PDF: A 23 years old single nulligravida woman underwent laparoscopic removal of a huge cystic adnexal mass that occupied her entire abdomen, giving the appearance of a full term pregnancy. After anesthesia, a vertical infra-umbilical incision, 1 cm long, was made and a telescope was introduced through the port to determine the status of the intra-abdomen and the surface contour of the mass. A needle tipped with a laparoscopic suction apparatus was inserted into the cyst through the infra-umbilical port, directly under the mass. Subsequently, 3, 200 ml of cystic fluid was aspirated without spillage. A huge cyst, reaching to the level of the xyphoid process was effectively excised through the operative laparoscopy after prelaparoscopic drainage. Operation time was 140 minutes and hospital stay was 2 days. There were no complications during hospital stay and after discharge. It seems the size of the cyst is not a criteria for the contraindication of laparoscopic surgery.

Original Articles

Preoperative Staging of Endometrial Carcinoma by MRI.: See Hyung Kim, Jae Ho Cho, Bok Hwan Park; Yeungnam Univ J Med. 2002;19(2):116-125. Published online December 31, 2002; DOI: https://doi.org/10.12701/yujm.2002.19.2.116

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Abstract PDF: BACKGROUND
In patients with endometrial carcinoma, preoperative evaluation of exact staging has important prognostic and therapeutic implications. The incidence of pelvic and aortic lymph node involvement in endometrial carcinoma depends on grade of tumor differentiation and depth of myometrial invasion. MATERIAL AND METHOD: To evaluate whether MRI provides a preoperative assessment for staging of endometrial carcinoma, MRI was undertaken in 28 patients, a few weeks before operation. Myometrial invasion was devided in three categories, and involvement of cervix, adnexa, and pelvic cavity were classified. RESULTS: The results of MR imaging were compared with these of pathology. The preoperative MRI staging of endometrial carcinoma was correct in 22 out of 28 patients. In the evaluation of myometrial invasion, the MR imaging underestimated in 4 cases and overestimated in 1 case. CONCLUSION: In patients with endometrial carcinoma, MR imaging is very useful in the assessment of the depth of myometrial invasion, stromal invasion of cevix, lymphatic & pelvic metastases and extent of the lesion.

P wave dispersion as a predictor of idiopathic paroxysmal atrial fibrillation.: Gue Ru Hong, Woong Kim, Jong Seon Park, Dong Gu Shin, Young Jo Kim, Bong Sup Shim; Yeungnam Univ J Med. 2001;18(2):267-276. Published online December 31, 2001; DOI: https://doi.org/10.12701/yujm.2001.18.2.267

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Abstract PDF: BACKGROUND
P wave dispersion(PWD) is defined as the difference between the maximum and minimal P wave duration in any of the 12 leads of the surface ECG. The prolongation of atrial conduction time and the inhomogeneous propagation of sinus impulse are known electrophysiologic features in patients with paroxysmal atrial fibrillation(PAF). The purpose of this study was to determine the role of P wave dispersion for the prediction of PAF and to evaluate the effectiveness of prophylactic antiarrhythmic therapy. MATERIALS AND METHODS: The study population included 20 patients with a history of idiopathic PAF and 20 age and sex matched healthy control subjects. We measured the maximum P wave duration(P maximum) and P wave dispersion from 12 lead ECG. RESULTS: P maximum and P dispersion in idiopathic PAF were significantly higher than normal control group(97.2+/-12, 48.5+/-9msec vs, 76.5+/-11, 21+/-8msec, respectively p<0.001, <0.001). After 12-month follow up period P maximum and P dispersion were significantly reduced than those of initial state(77.2+/-13, 26.4+/-9msec vs. 97.2+/-12, 48.5+/-9msec, respectively p<0.001,<0.001). CONCLUSION: P dispersion and P maximum were significantly different between patients with idiopathic PAF and healthy control group. Those are easily accessible, non-invasive simple electrocadiographic markers that could be used for the prediction and prognostic factors of idiopathic PAF.

The effect of Transarterial Chemoembolization(TAE) on Lung metastasis of Hepatocellular Carcinoma.: Heon Ju Lee, Jong Ryul Eun, Young Doo Song, Chan Won Park; Yeungnam Univ J Med. 2000;17(1):66-74. Published online June 30, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.1.66

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Abstract PDF: BACKGROUND
During follow up period after transarterial embolization(TAE), cases of pulmonary metastasis were more prevalent in TAE-treated patients than in TAE-untreated patients. Therefore, a study was conducted to evaluate whether TAE increases the incidence of pulmonary metastasis of hepatocellular carcinoma and to clarify the risk factors for pulmonary metastasis. METHODS: From march 1991 to march 1995, 156 patients who had been diagnosed with hepatocellular carcinoma by serology, and radiographic and histologic method at Yeungnam university hospital were involved in this study. We excluded 12 patients with lung metastasis on initial diagnosis and the others. The remaining 144 patients had been followed up for at least 5 months, and divided into four groups according to lung metastasis and trans-arterial embolization treatment, and evaluated the age, sex, child-pugh score, liver cirrhosis, and the level of AFP. RESULTS: Pulmonary metastasis was found in 18.0% (26/144), of witch 92.3%(24/26) and 7.7%(2/26) of the patients with and without transarterial chemoembolization, respectively. Of thepatients, 23.5% (24/102) with TAE had lung metastais during follow-up periods and 4.7% (2/42) without TAE had lung metastasis. there was more likelihood for lung metastasis after TAE, but there was no difference between two groups in age, sex, child-pugh class, the presence of liver cirrhosis, and AFP. CONCLUSIONS: The incidence of pulmonary metastasis of hepatocellular carcinoma after TAE was higher. child-pugh class was the only related clinical precipitating factors for pulmonary metastasis in TAE in our study. Our results suggest that regular chest X-ray check-up may be more frequently needed by patients who had TAE treatment for hepatocellular carcinoma.

MR Imaging of Uterine Malignant Mixed Mullerian Tumor: Comparison with Endometrial Carcinoma.: Jae Ho Cho, Jeen Woo Kim, Jay Chun Chang, Bok Hwan Park, Jung Sik Kim; Yeungnam Univ J Med. 1999;16(2):296-301. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.296

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Abstract PDF: BACKGROUND
Generally, it is difficult to differentiate uterine malignant mixed Mullerian Tumor(MMMT) from endometrial carcinom in radiological and clinical aspects. Our purpose is to investigate MR findings that distinguishes MMMT from endometrial carcinoma. MATERIALS AND METHODS: We retrogradely evaluated the magnetic resonance imaging findings of pathologically proven 5 cases of malignant mixed Mullerian Tumor(MMMT) and 13 endometrial carcinomas to know the differential points of these two tumors originating in the endometrial cavity. The size of the mass, presence or absence of myometrial or uterine cervical invasion, growth pattern of the mass, signal intensity and degree and pattern of contrast enhancement were analyzed and compared. RESULTS: The length of the long axis of the MMMT was 1.5-9.0cm(average, 5.7cm) but that of the endometrial carcinoma was 0.5-6.0cm(average, 2.5cm). Invasion of uterine cervix which was found in 3 MMMT cases, dilated the endometrial cavity and the lumen of the uterin cervix and showed the pattern of growing into the external os. Invasion of uterine cervix was found in only one case of endometrial carcinoma. The presence or absence of myometrial invasion, the signal intensity and homogeneity on T1-and T2-weighted images, and the degree and patterns of contrase enhancement showed no significant difference. CONCLUSION: Any specific finding to differentiate MMMT from endometrial carcinoma was not ascertained. However, MMMT can be suspected if the size of the endometrial mass is greater than 5cm and if the mass dilates the enocervical canal and invades the uterine cervix.

Case Reports

A Case of Right Atrial Mass Associated With Hepatocellular Carcinoma.: Chan Won Park, Jin Soo Choi, Soon UK Kwon, Young Doo Song, Jun Hwan Kim, Heun Joo Lee; Yeungnam Univ J Med. 1999;16(1):119-124. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.119

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Abstract PDF: Right atrial metastasis occurs in 1 to 4% of patients with hepatoma. and the extention to intracavitary or metastasis of tumor as a large mass rare. However, the high risk of progressive heart failure and sudden death from the tricuspid valve obstruction necessitates prompt diagnosis of intracavitary extension, and adequate intervention is needed to prolong a patient's life. A 49 year-old female was referred to our hospital for further evaluation of a liver mass, which was identified at a local clinic. The liver mass was confirmed as hepatocellular carcinoma with CT and celiac angiographic finding. She was treated with transarterial chemoembolization. Thirty-four months after discharge, a low density right atrial mass was noted incidentally with chest computed tomography while investigating massive right pleural effusion for possible pulmonary metastasis. Echocardiography showed a huge inhomogenous echogenic mass at the right atrium. The present report describes a case of primary hepatocellular carcinoma with a intracavitary cardiac mass detected with two dimensional echocardiography.

8 cases of delayed onset P. vivax malaria.: Young Do Song, Jae Chun Lee, Young Hoon Hong, Eun Young Lee, Bong Jun Kim, Choong Ki Lee, Jin Young Moon; Yeungnam Univ J Med. 1997;14(2):467-473. Published online December 31, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.2.467

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Abstract PDF: South Korea has been free from endemic malaria by P. vivax since the mid-1980s, but malaria infections, including military outbreak in 1995, have been increasing steadily in the soldiers serving near the western part of Demilitarized Zone(DMZ) since its first resurgence in 1993. We experinced 8 cases of delayed onset P. vivax malaria in young men who had never been abroad and had no history of blood transfusion or parenteral use of drug. All the patients had served near the western part of DMZ during their military life. They were admitted to Yeungnam University hospital due to cyclic fever with chills and the clinical symptoms were developed 2 months to 11months after discharge from military service. Peripheral blood smears showed typical ring forms and trophozoites of P. vivax in red blood cell. Patients were treated with hydroxychloroquine and primaquine showing rapid clinical and hematologic responses in all cases, but 2 cases were relapsed later. We presumed that theses cases were delayed onset of P. vivax infection resulted from the recent outbreak in the western part of DMZ, in 1995. Therefore, we reported theses cases to emphasize the need of active surveillance and prevention.

Original Article

Effect of NG-nitro-L-arginine methyl ester and Methylene Blue on the Endotoxin-induced Vascular Hyporesponsiveness.: Hyoung Chul Choi, Jeoung Hee Ha, Kwang Youn Lee, Won Joon Kim, Uy Dong Sohn; Yeungnam Univ J Med. 1997;14(2):337-349. Published online December 31, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.2.337

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Abstract PDF: The study was undertaken to examine the intensity of involvement of inducible nitric oxide synthase(iNOS) and cyclic GMP signal transduction pathway as one of the mechanisms of vaso-relaxative action of bacterial lipopolysaccharide (LPS) on the canine femoral artery strips. Canine femoral arteries were isolated and spiral strips of 10 mm long and 2 mm wide were made in the Tyroad solution of 0-4degrees C. The strips were prepared for isometric myography in Biancani's isolated muscle chamber contaning 1 ml of Tyrode solution, which was maintained with pH 7.4 by areation with 95% O2/5% CO2 at 37degrees C and nitric oxide (NO) production was measured simulltaneously with isolated nitric oxide mrter. LPS induced NO production, suppressed the phenylephrine (PE) induced contraction and enhanced the acetylcholine (ACh) induced relaxation. NG-nitro-L-arginine methyl ester (L-NAME), an NOS inhibitor, methylene blue, a guanylyl cyclase inhibitor, potentiated PE induced contraction and suppressed ACh induced relaxation on the LPS treated strips. The inhibitory potency of methylene blue for LPS induced vascular hyporeponsiveness was stronger than that of L-NAME. These result suggest that in canine femoral artery, both iNOS and cyclic GMP signal transduction pathway are related with LPS indused vascular hyporeponsiveness, but in minor with iNOS and in major with cyclic GMP signal transduction pathway.

Case Reports

Three cases of ovarian pregnancy.: Mi Na Lee, Jae Yeoul Lee, Yoon Kee Park, Sung Ho Lee; Yeungnam Univ J Med. 1993;10(1):245-252. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.245

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Abstract PDF: Primary ovarian pregnancy is one of the rerest types of extrauterine pregnancy. But an increase in the reported prevalence of ovarian pregnancies was published in recent years. Three cases of ovarian pregnancy which have Spiegelberg criteria are presented with a brief review of literatures.

A case of free-floating left atrial ball thrombus in mitral stenosis.: Young Jin Kim, Tea Il Lee, Kyo Won Choi, Seung Ho Kang, Dong Gu Sin, Young Jo Kim, Bong Sup Shim, Hyun Woo Lee, Eun Pyo Hong; Yeungnam Univ J Med. 1993;10(1):237-244. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.237

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Abstract PDF: A free-floating ball thrombus in the left atrium is a rare complication of the mitral valvular disease. A 53-year-old man was admitted for pain and paresthesia on both legs. On admission he had auscultatory sign of mitral stenosis and mitral regurgitation, and the roentgenogram of his chest revealed a slight pulmonary ve..ous congestion, enlargement of the pulmonary conus and cardiomegaly. Laboratory findings including complete blood counts, coagulation studies and blood chemistry were normal. An echocardiographic examination revealed a mitral stenosis and a free-floating ball thrombus in the left atrium. We performed the emergent open heart surgery for removal of the ball thrombus and mitral replacement successfuly with Duromedics 29 mm valve. The size of thrombus was 39 X 32 X 30 mm.

Original Article

Analysis of genes involved in the pathogenesis of intracellularly survival bacteria.: Tae Il Jeon, Tae Yoon Lee, Sung Kwang Kim; Yeungnam Univ J Med. 1992;9(2):248-255. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.248

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Abstract PDF: Eight bacterial strains were examined whether they have phoP/phoQ genes which were known to be involved in the intracellular survival of Salmonella typhimurium. The phoP/phoQ operon were known to sense the stimuli of the genes involved in the adaptation of the environment. Using 514-basepairs EcoRV DNA fragment of phoP region of Salmonella typhimurium as a probe, dot blot hybridization were performed. Chromosomal DNAs of Klebsiella pneumonia, Pseudomonas aeruginosa, Serratia marscescens, Enterobacter cloacae, Salmonella typhimurium, Escherichia coli, Shigella dysenteriae, and Listeria monocytogenes were examined by DNA hybridization assay. Against our expectation, intracellular pathogen, L. monocytogenes, did not have similar DNA sequences to phoP/phoQ of S. typhimurium, while E, coli, S. dysenteriae, and E. cloacae showed the positive signal even though they were not intracellular pathogens. This result suggested that the phoP/phoQ operon was absent in intracellular pathogenic bacterias other than S. typhimurium. Rather it was found in phylogenetically closer bacterias to S. typhimurium, which were not able to survive in intracellular environment. Some different mechanism, which is not dependent on phoP/phoQ operon, could be involved in the intracellular survival of L. monocytogenes.

Case Report

A case of meigs' syndrome occured in pregnancy.: Dae Hyun Cho, Sang Heon Kim, Min Whan Koh, Tae Hyung Lee, Sung Ho Lee; Yeungnam Univ J Med. 1992;9(1):197-202. Published online June 30, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.1.197

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Abstract PDF: Meigs' syndrome consists of an ovarian fibroma, or fibroma-like benign tumor, associated with fluid in both abdomen and chest. Characteristically, the ascites and hydrothorax disappeared and do not recurred following removal of the ovarian tumor. The authors presented a case of Meigs' syndrome that was cured by surgical removal of ovarian tumor and resulted in normal pregnancy outcome in 27-year-old pregnant woman with a brief review of literatures.

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