Journal of Yeungnam Medical Science

Review article

Postoperative conditions of rehabilitative interest in lung transplantation: a systematic review: Massimiliano Polastri, Esra Pehlivan, Robert M. Reed, Allaina Eden; Received June 3, 2024 Accepted July 12, 2024 Published online August 22, 2024; DOI: https://doi.org/10.12701/jyms.2024.00521 [Epub ahead of print]

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Abstract PDF: Lung transplantation is an elective treatment option for end-stage respiratory diseases in which all medical therapy options have been exhausted. The current study aimed to identify updated information on the postoperative conditions that may impair rehabilitation after lung transplantation and to provide specific considerations of their clinical relevance during the recovery process. The present study is a systematic review conducted by searching three primary databases: the United States National Library of Medicine PubMed system, Scopus, and the Cochrane Library. The databases were searched for articles published from database inception until May 2024; at the end of the selection process, 27 documents were included in the final analysis. The retrieved material identified 19 conditions of rehabilitative interest that potentially affect the postoperative course: graft dysfunction, dysphagia, postsurgical pain, cognitive impairment, chronic lung allograft dysfunction-bronchiolitis obliterans syndrome, phrenic nerve injury, delayed extracorporeal membrane oxygenation weaning, airway clearance, refractory hypoxemia, mediastinitis, reduced oxidative capacity, sternal dehiscence, coronavirus disease 2019 (COVID-19), gastroparesis, ossification of the elbow, Takotsubo cardiomyopathy, airway dehiscence, recurrent pleural effusion, and scapular prolapse. Although some patients are not amenable to rehabilitation techniques, others can significantly improve with rehabilitation.

Focused Review article

Effective and appropriate use of weight loss medication in pediatric obesity: a narrative review: Yoojin Lindsey Chung; J Yeungnam Med Sci. 2024;41(3):158-165. Published online July 2, 2024; DOI: https://doi.org/10.12701/jyms.2024.00353

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Over the past few decades, there has been a notable increase in the incidence of pediatric obesity, which is a significant public health concern. Children who are obese have a greater risk of type 2 diabetes, hypertension, dyslipidemia, polycystic ovary syndrome, obstructive sleep apnea, and adult obesity. Lifestyle modification therapy is typically the initial approach to treat pediatric obesity. For patients who do not achieve success with lifestyle modification therapy alone, pharmacotherapy is the next logical treatment option. When selecting an anti-obesity medication (AOM), it is essential to first ascertain the medical background of the patient, including current medications and obesity-associated comorbidities. Evaluation of obesity phenotypes in patients may also be beneficial. AOMs for pediatric obesity include metformin, orlistat, glucagon-like peptide 1 agonists, phentermine, and the phentermine/topiramate combination. Sufficient lifestyle modification therapy should be administered before considering pharmacotherapy and continued after the initiation of AOM. To ensure healthy development, monitoring growth and puberty development during anti-obesity treatments is essential.

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Exploring comprehensive insights into pediatric obesity
Yong Hee Hong
Journal of Yeungnam Medical Science.2024; 41(3): 139. CrossRef

Communication

Odynophagia in individuals with neck pain: the importance of differential diagnosis in physiotherapy practice: Massimiliano Polastri, Luca Di Marco, Ernesto Andreoli; J Yeungnam Med Sci. 2023;40(Suppl):S129-S133. Published online November 14, 2023; DOI: https://doi.org/10.12701/jyms.2023.00843

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Abstract PDF: Odynophagia refers to painful swallowing caused by various underlying factors that must be excluded to determine the best treatment approach. Neck pain is a debilitating condition requiring treatment in rehabilitative settings. There are several circumstances in which odynophagia and neck pain coexist, such as tendinitis of the longus colli muscle and paravertebral calcification, prevertebral and retropharyngeal abscess, esophageal perforation, aortic dissection, thyroid cartilage fracture, thyrohyoid ligament syndrome, pneumomediastinum and subcutaneous emphysema, and after physical exercise. Physiotherapists are professionals most likely to encounter individuals with neck pain and provide interventions such as massage, manual therapy, exercise, and electrotherapy. Therefore, it is important to recognize that neck pain can stem from different clinical conditions that require interventions other than physiotherapy. A differential diagnosis is crucial to ensure appropriate referrals for therapeutic interventions.

Review article

Role of gene therapy in treatment of cancer with craniofacial regeneration—current molecular strategies, future perspectives, and challenges: a narrative review: Himanshu Singh; J Yeungnam Med Sci. 2024;41(1):13-21. Published online May 23, 2023; DOI: https://doi.org/10.12701/jyms.2023.00073

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Abstract PDF: Gene therapy involves the introduction of foreign genetic material into host tissue to alter the expression of genetic products. Gene therapy represents an opportunity to alter the course of various diseases. Hence, genetic products utilizing safe and reliable vectors with improved biotechnology will play a critical role in the treatment of various diseases in the future. This review summarizes various important vectors for gene therapy along with modern techniques for potential craniofacial regeneration using gene therapy. This review also explains current molecular approaches for the management and treatment of cancer using gene therapy. The existing literature was searched to find studies related to gene therapy and its role in craniofacial regeneration and cancer treatment. Various databases such as PubMed, Science Direct, Scopus, Web of Science, and Google Scholar were searched for English language articles using the keywords “gene therapy,” “gene therapy in present scenario,” “gene therapy in cancer,” “gene therapy and vector,” “gene therapy in diseases,” and “gene therapy and molecular strategies.”

Original articles

Safety of low-dose anticoagulation in extracorporeal membrane oxygenation using the Permanent Life Support System: a retrospective observational study: Kyungsub Song, Jae Bum Kim; J Yeungnam Med Sci. 2023;40(3):276-282. Published online May 18, 2023; DOI: https://doi.org/10.12701/jyms.2023.00339

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Abstract PDF: Background
Bleeding and thrombosis are major complications associated with high mortality in extracorporeal membrane oxygenation (ECMO) management. Anticoagulant therapy should be adequate to reduce thrombosis. However, related studies are limited.
Methods
We retrospectively reviewed all patients supported with ECMO at a single institution between January 2014 and July 2022 and included those on all types of ECMO using the Permanent Life Support System. Patients were classified into two groups according to their measured mean activated partial thromboplastin time (aPTT) during ECMO management: a high-anticoagulation (AC) group (aPTT, ≥55 seconds; n=52) and a low-AC group (aPTT, <55 seconds; n=79). The primary outcome was thrombotic or bleeding events during ECMO.
Results
We identified 10 patients with bleeding; significantly more of these patients were in the high-AC group (n=8) than in the low-AC group (15.4% vs. 2.5%, p=0.01). However, thrombus events and oxygenator change-free times were not significantly different between the two groups. Four patients in the high-AC group died of bleeding complications (brain hemorrhage, two; hemopericardium, one; and gastrointestinal bleeding, one). One patient in the low-AC group developed a thrombus and died of ECMO dysfunction due to circuit thrombosis.
Conclusion
Heparin did not significantly improve thrombotic outcomes. However, maintaining an aPTT of ≥55 seconds was a significant risk factor for bleeding events, especially those associated with mortality.

Effect of prehydration solution on hearing threshold after chemotherapy in patients with head and neck cancers: a retrospective study: Dongbin Ahn, Kyu-Yup Lee, Eunjung Oh, Minji Oh, Boseung Jung, Da Jung Jung; J Yeungnam Med Sci. 2023;40(2):164-171. Published online August 24, 2022; DOI: https://doi.org/10.12701/jyms.2022.00276

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Abstract PDF: Background
The study aimed to evaluate the effect of prehydration solution on hearing thresholds after cisplatin chemotherapy.
Methods
In this retrospective cohort study, we reviewed the data of patients who underwent ≥3 courses of cisplatin-based chemotherapy for locally advanced head and neck cancers at a tertiary referral center (n=64). The dextrose solution (DW) group (n=26) received 2 L of normal saline and 1 L of 5% dextrose. The Hartmann solution (HS) group (n=38) received 2 L of normal saline and 1 L of HS. Hearing data were measured 1 day before starting the first course of chemotherapy, and again 20 days after the first, second, and third courses of chemotherapy. The severity of hearing loss was evaluated using the Common Terminology Criteria for Adverse Events (CTCAE).
Results
Thresholds at all frequencies after chemotherapy were greater in the DW group than in the HS group. The increase in thresholds in 1 to 4 kHz after the third course of chemotherapy was greater in the DW group than in the HS group. CTCAE grades after the second and third courses of chemotherapy were greater in the DW group than in the HS group. Logistic regression showed that the odds ratio for CTCAE grade 3 or 4 after the third course of chemotherapy in the DW group was 4.84 on univariate analysis.
Conclusion
Prehydration using a solution with salt was associated with a decrease in change in hearing thresholds after cisplatin chemotherapy in patients with head and neck cancers.

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

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

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

Review article

Beneficial effects of intermittent fasting: a narrative review: Dae-Kyu Song, Yong-Woon Kim; J Yeungnam Med Sci. 2023;40(1):4-11. Published online April 4, 2022; DOI: https://doi.org/10.12701/jyms.2022.00010

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Abstract PDF

Caloric restriction is a popular approach to treat obesity and its associated chronic illnesses but is difficult to maintain for a long time. Intermittent fasting is an alternative and easily applicable dietary intervention for caloric restriction. Moreover, intermittent fasting has beneficial effects equivalent to those of caloric restriction in terms of body weight control, improvements in glucose homeostasis and lipid profiles, and anti-inflammatory effects. In this review, the beneficial effects of intermittent fasting are discussed.

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DOSE: a lifestyle philosophy for dementia prevention informed by drug development and epidemiology
Timothy Daly
Dementia & Neuropsychologia.2024;[Epub] CrossRef
The effects of time‐restricted eating alone or in combination with probiotic supplementation in comparison with a calorie‐restricted diet on endocrine and metabolic profiles in women with polycystic ovary syndrome: A randomized clinical trial
Sepide Talebi, Sakineh Shab‐Bidar, Ashraf Moini, Hamed Mohammadi, Kurosh Djafarian
Diabetes, Obesity and Metabolism.2024; 26(10): 4468. CrossRef
The Combined Effect of Diets with Different Time Restriction and Low-intensity Aerobic Exercise on Metabolic Factors and Anthropometry in Overweight Middle-aged Men
Hamid Vasfi, Hamid Mohebbi, Marefat Siahkouhian, Lotfollah Rezagholizadeh, Abouzar jorbonian
Journal of Ardabil University of Medical Sciences.2024; 24(1): 58. CrossRef
Ketogenic Interventions in Autosomal Dominant Polycystic Kidney Disease: A Comprehensive Review of Current Evidence
Carla Pezzuoli, Giuseppe Biagini, Riccardo Magistroni
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Impact of diet intervention on visceral adipose tissue and hepatic fat in patients with obesity or type 2 diabetes: a randomized trial
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Exploring the Impact of Fasting and Fasting-Mimicking Diets on Type 2 Diabetes Management in Adults: A Systematic Review
José Amilcar Rivera Regalado, Juan García, Isabella Ramirez, Plinio Hermosilla, Jose Rascon, Sergio José Fausto Girón
Cureus.2024;[Epub] CrossRef
As a phenomenon: Ramadan fasting improves olfactory performance
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Maternal intermittent fasting deteriorates offspring metabolism via suppression of hepatic mTORC1 signaling
Wenzhen Yin, Lijun Sun, Yuan Liang, Chao Luo, Tiange Feng, Yunhua Zhang, Weizhen Zhang, Yue Yin
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Cureus.2023;[Epub] CrossRef

Original articles

Clinical implication of adjuvant chemotherapy according to mismatch repair status in patients with intermediate-risk stage II colon cancer: a retrospective study: Byung Woog Kang, Dong Won Baek, Eunhye Chang, Hye Jin Kim, Su Yeon Park, Jun Seok Park, Gyu Seog Choi, Jin Ho Baek, Jong Gwang Kim; J Yeungnam Med Sci. 2022;39(2):141-149. Published online December 22, 2021; DOI: https://doi.org/10.12701/yujm.2021.01571

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Abstract PDF

Background
The present study evaluated the clinical implications of adjuvant chemotherapy according to the mismatch repair (MMR) status and clinicopathologic features of patients with intermediate- and high-risk stage II colon cancer (CC).
Methods
This study retrospectively reviewed 5,774 patients who were diagnosed with CC and underwent curative surgical resection at Kyungpook National University Chilgok Hospital. The patients were enrolled according to the following criteria: (1) pathologically diagnosed with primary CC; (2) stage II CC classified based on the 7th edition of the American Joint Committee on Cancer staging system; (3) intermediate- and high-risk features; and (4) available test results for MMR status. A total of 286 patients met these criteria and were included in the study.
Results
Among the 286 patients, 54 (18.9%) were identified as microsatellite instability-high (MSI-H) or deficient MMR (dMMR). Although all the patients identified as MSI-H/dMMR showed better survival outcomes, T4 tumors and adjuvant chemotherapy were identified as independent prognostic factors for survival. For the intermediate-risk patients identified as MSI-low (MSI-L)/microsatellite stable (MSS) or proficient MMR (pMMR), adjuvant chemotherapy exhibited a significantly better disease-free survival (DFS) but had no impact on overall survival (OS). Oxaliplatin-containing regimens showed no association with DFS or OS. Adjuvant chemotherapy was not associated with DFS in intermediate-risk patients identified as MSI-H/dMMR.
Conclusion
The current study found that the use of adjuvant chemotherapy was correlated with better DFS in MSI-L/MSS or pMMR intermediate-risk stage II CC patients.

Citations

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Behavioral and Neuroanatomical Consequences of Cell-Type Specific Loss of Dopamine D2 Receptors in the Mouse Cerebral Cortex
Gloria S. Lee, Devon L. Graham, Brenda L. Noble, Taylor S. Trammell, Deirdre M. McCarthy, Lisa R. Anderson, Marcelo Rubinstein, Pradeep G. Bhide, Gregg D. Stanwood
Frontiers in Behavioral Neuroscience.2022;[Epub] CrossRef
A pilot retrospective study of comprehensive nursing care on psychological disorder in colorectal cancer undergoing chemotherapy
Zhou-Yi Zhang, Rui Wang, Li Zhang, Ming-Li Gu, Xiu-E Guan
Medicine.2022; 101(28): e29707. CrossRef

The clinical outcomes of second-line chemotherapy in patients with advanced pancreatic cancer: a retrospective study: Hyun yeb Jung, Eun Mi Lee; J Yeungnam Med Sci. 2022;39(2):124-132. Published online October 19, 2021; DOI: https://doi.org/10.12701/yujm.2021.01347

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Abstract PDF

Background
Despite recent advances in first-line chemotherapy for advanced pancreatic cancer, standard treatment after the failure of initial chemotherapy has not been established. Hence, we aimed to retrospectively analyze the clinical characteristics and outcomes of second-line chemotherapy in patients with advanced pancreatic cancer.
Methods
We reviewed the clinical data of patients with advanced pancreatic cancer who underwent palliative chemotherapy at Kosin University Gospel Hospital between January 2013 and October 2020.
Results
Among 366 patients with advanced pancreatic cancer who had received palliative chemotherapy, 104 (28.4%) underwent at least one cycle of second-line chemotherapy. The median age of the patients at the time of initiating second-line treatment was 62 years (interquartile range, 57–62 years), and 58.7% (61 patients) of them were male. The common second-line chemotherapy regimens were 5-fluorouracil (FU) plus leucovorin, irinotecan, and oxaliplatin (33 patients, 31.7%); gemcitabine/nab-paclitaxel (29, 27.9%), gemcitabine±erlotinib (13, 12.5%); and oxaliplatin and 5-FU/leucovorin (12, 11.5%). The median overall survival (OS) and progression-free survival were 6.4 months (95% confidence interval [CI], 4.5–8.6 months) and 4.5 months (95% CI, 2.7–6.3 months), respectively. In a multivariate analysis, poor performance status (PS) (hazard ratio [HR], 2.247; p=0.021), metastatic disease (HR, 2.745; p=0.011), and elevated carcinoembryonic antigen (CEA) levels (HR, 1.939; p=0.030) at the beginning of second-line chemotherapy were associated with poor OS.
Conclusion
The survival outcome of second-line chemotherapy for advanced pancreatic cancer remains poor. However, PS, disease extent (locally advanced or metastatic), and CEA level may help determine patients who could benefit from second-line treatment.

Citations

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Efficacy and tolerance of LV5FU2-carboplatin chemotherapy in patients with advanced pancreatic ductal adenocarcinoma after failure of standard regimens
Thomas Chaigneau, Lina Aguilera Munoz, Caroline Oger, Clémence Gourdeau, Olivia Hentic, Lucie Laurent, Nelly Muller, Marco Dioguardi Burgio, Marie-Pauline Gagaille, Philippe Lévy, Vinciane Rebours, Pascal Hammel, Louis de Mestier
Therapeutic Advances in Medical Oncology.2023; 15: 175883592311637. CrossRef
Real-Life Results of Palliative Chemotherapy in Metastatic Pancreatic Ductal Adenocarcinoma
Bianca Varzaru, Razvan A. Iacob, Adina E. Croitoru, Speranta M. Iacob, Cristina E. Radu, Stefania M. Dumitrescu, Cristian Gheorghe
Cancers.2023; 15(13): 3500. CrossRef

Review article

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.

Citations

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Immune checkpoint inhibitors associated cardiovascular immune-related adverse events
Wonyoung Jo, Taejoon Won, Abdel Daoud, Daniela Čiháková
Frontiers in Immunology.2024;[Epub] CrossRef
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

Original article

Clinical performance of FractionLab in patient-specific quality assurance for intensity-modulated radiotherapy: a retrospective study: Se An Oh, Sung Yeop Kim, Jaehyeon Park, Jae Won Park, Ji Woon Yea; J Yeungnam Med Sci. 2022;39(2):108-115. Published online September 9, 2021; DOI: https://doi.org/10.12701/yujm.2021.01123

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Abstract PDF: Background
This study was aimed at comparing and analyzing the results of FractionLab (Varian/Mobius Medical System) with those of portal dosimetry that uses an electronic portal imaging device. Portal dosimetry is extensively used for patient-specific quality assurance (QA) in intensity-modulated radiotherapy (IMRT).
Methods
The study includes 29 patients who underwent IMRT on a Novalis-Tx linear accelerator (Varian Medical System and BrainLAB) between June 2019 and March 2021. We analyzed the multileaf collimator (MLC) DynaLog files generated after portal dosimetry to evaluate the same condition using FractionLab. The results of the recently launched FractionLab at various gamma indices (0.1%/0.1 mm–1%/1 mm) are analyzed and compared with those of portal dosimetry (3%/3 mm).
Results
The average gamma passing rates of portal dosimetry (3%/3 mm) and FractionLab are 98.1 (95.5%–100%) and 97.5% (92.3%–99.7%) at 0.6%/0.6 mm, respectively. The results of portal dosimetry (3%/3 mm) are statistically comparable with the QA results of FractionLab (0.6%/0.6 mm–0.9%/0.9 mm).
Conclusion
This paper presents the clinical performance of FractionLab by the comparison of the QA results of FractionLab using portal dosimetry with various gamma indexes when performing patient-specific QA in IMRT treatment. Further, the appropriate gamma index when performing patient-specific QA with FractionLab is provided.

Case report

Stent graft treatment of an ilioenteric fistula secondary to radiotherapy: a case report: Joo Yeon Jang, Ung Bae Jeon, Jin Hyeok Kim, Tae Un Kim, Jae Yeon Hwang, Hwa Seong Ryu; J Yeungnam Med Sci. 2022;39(1):77-80. Published online July 7, 2021; DOI: https://doi.org/10.12701/yujm.2021.01053

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Abstract PDF

Fistulas between the arteries and the gastrointestinal tract are rare but can be fatal. We present a case of an ilioenteric fistula between the left external iliac artery and sigmoid colon caused by radiotherapy for cervical cancer, which was treated with endovascular management using a stent graft. A 38-year-old woman underwent concurrent chemoradiotherapy for cervical cancer recurrence. Approximately 9 months later, the patient suddenly developed hematochezia. On her first visit to the emergency room of our hospital, computed tomography (CT) images did not reveal extravasation of contrast media. However, 8 hours later, she revisited the emergency room because of massive hematochezia with a blood pressure of 40/20 mmHg and a heart rate of 150 beats per minute. At that time, CT images showed the presence of contrast media in almost the entire colon. The patient was referred to the angiography room at our hospital for emergency angiography. Inferior mesenteric arteriography did not reveal any source of bleeding. Pelvic arteriography showed contrast media extravasation from the left external iliac artery to the sigmoid colon; this was diagnosed as an ilioenteric fistula and treated with a stent graft. When the bleeding focus is not detected on visceral angiography despite massive arterial bleeding, pelvic arteriography is recommended, especially in patients with a history of pelvic surgery or radiotherapy.

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Resection of sigmoid cancer with bladder invasion using laparoscopic combined with a cystoscopic holmium laser: an innovative surgical procedure
Ronghua Wu, Cong Xu, Xing Liu, Weihua Fu, Yujia Chen, Jingzhen Zhu, Guangsheng Du
Lasers in Medical Science.2023;[Epub] CrossRef

Review article

Current status of stereotactic body radiotherapy for the treatment of hepatocellular carcinoma: Jongmoo Park, Jae Won Park, Min Kyu Kang; Yeungnam Univ J Med. 2019;36(3):192-200. Published online August 12, 2019; DOI: https://doi.org/10.12701/yujm.2019.00269

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Abstract PDF

Stereotactic body radiotherapy (SBRT) is an advanced form of radiotherapy (RT) with a growing interest on its application in the treatment of hepatocellular carcinoma (HCC). It can deliver ablative radiation doses to tumors in a few fractions without excessive doses to normal tissues, with the help of advanced modern RT and imaging technologies. Currently, SBRT is recommended as an alternative to curative treatments, such as surgery and radiofrequency ablation. This review discusses the current status of SBRT to aid in the decision making on how it is incorporated into the HCC management.

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