Journal of Yeungnam Medical Science

Review articles

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

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

Pulmonary and Respiratory Medicine
Effects of postoperative rehabilitation on functional exercise capacity, dyspnea, and quality of life after pulmonary endarterectomy: a systematic review: Massimiliano Polastri; J Yeungnam Med Sci. 2025;42:32. Published online April 10, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.32

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Abstract PDF: Chronic thromboembolic pulmonary hypertension (CTEPH) leads to increased vascular resistance and progressive right heart failure resulting from occlusion of proximal pulmonary arteries by fibrotic intravascular material. The elective surgical treatment for CTEPH is pulmonary endarterectomy (PEA), which involves removal of the chronic thromboembolic material from the entire pulmonary arterial tree. This study aimed to verify the effects of acute and subacute postoperative rehabilitation on the functional exercise capacity, dyspnea, and quality of life (QoL) of patients with CTEPH undergoing PEA. This was a systematic review of seven primary databases. At the end of the selection process, five documents were included in the final analysis. Three of these five studies were conducted in Italy, one in Korea, and one in Germany. Of 204 patients, 95 (47%) were male. This systematic review determined that in patients with CTEPH pre-PEA, the 6-minute walk distance (6MWD) ranged between 284.7 m and 371.95 m and that at 6 to 12 weeks post-PEA, after having attended postoperative rehabilitation, the 6MWD was 434.1 m to 483.6 m. The Short Form-36 Health Survey (SF-36) questionnaire was administered to evaluate QoL 3 and 22 weeks after PEA. At 22 weeks, the SF-36 physical component summary score improved from baseline (42.78±18.37 points) by 19.55±19.42 points (p=0.001), and the SF-36 mental component summary score improved from baseline (55.76±23.94 points) by 6.36±20.44 points (p=0.137).

Physical therapy, Sports Therapy, and Rehabilitation
Postoperative conditions of rehabilitative interest in lung transplantation: a systematic review: Massimiliano Polastri, Esra Pehlivan, Robert M. Reed, Allaina Eden; J Yeungnam Med Sci. 2024;41(4):235-251. Published online August 22, 2024; DOI: https://doi.org/10.12701/jyms.2024.00521

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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.

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The Role of Pulmonary Rehabilitation in Lung Transplantation for Cystic Fibrosis
Esra Pehlivan
OBM Transplantation.2025; 09(01): 1. CrossRef
Early mobilization after lung transplantation: A scoping review protocol
Matthieu Reffienna, Adéla Foudhaïli, Colin Sidre, Damien Vitiello, Jonathan Messika
MethodsX.2025; 14: 103404. CrossRef
Seven-day rehabilitation services in hospital settings: benefits and drawbacks
Massimiliano Polastri, Luciana Scuotto
International Journal of Therapy and Rehabilitation.2024; 31(12): 1. CrossRef

Focused Review article

Pediatrics, Perinatology, and Child Health
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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Abstract PDF

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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Pediatric Metabolic and Bariatric Surgery and Antiobesity Medications: Weighing Efficacy, Risks, and Future Directions
Justine O. Chinn, Jennifer Woo Baidal, Janey S.A. Pratt, W. Elizabeth Shepard, Gillian L. Fell
The Journal of Pediatrics.2025; 283: 114610. CrossRef
Exploring comprehensive insights into pediatric obesity
Yong Hee Hong
Journal of Yeungnam Medical Science.2024; 41(3): 139. CrossRef

Communication

Physical therapy, Sports Therapy, and Rehabilitation
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

Dentistry
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.”

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Integrated cell membrane encapsulated PQDs-TK quantum dot nanoclusters with ROS-responsive triggering for efficient and visualized DNA delivery
Tiange Wang, Yanlin Sun, Dong Zeng, Mengying Wang, Yajing Zhang, Gang Liu, Xin Chen, Liang Liu
Journal of Colloid and Interface Science.2025; 683: 393. CrossRef

Original articles

Thoracic and Cardiovascular Surgery
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.

Otorhinolaryngology
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.

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

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Abstract PDF

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

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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

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

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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

Endocrinology, Diabetes, and Metabolism
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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Intermittent Fasting Improves Social Interaction and Decreases Inflammatory Markers in Cortex and Hippocampus
Martín García-Juárez, Adamary García-Rodríguez, Gabriela Cruz-Carrillo, Orlando Flores-Maldonado, Miguel Becerril-Garcia, Lourdes Garza-Ocañas, Ivan Torre-Villalvazo, Alberto Camacho-Morales
Molecular Neurobiology.2025; 62(2): 1511. CrossRef
External factors affecting weight loss during intermittent fasting. Author's reply
M. Khalil, H. Abdallah, G. Garruti, A.Di Ciaula, P. Portincasa
European Journal of Internal Medicine.2025; 131: 141. CrossRef
Fasting the brain for mental health
Roberto Carlos Perez-Kast, Alberto Camacho-Morales
Journal of Psychiatric Research.2025; 181: 215. CrossRef
Is isocaloric intermittent fasting superior to calorie restriction? A systematic review and meta-analysis of RCTs
Mohammed Hamsho, Wijdan Shkorfu, Yazan Ranneh, Abdulmannan Fadel
Nutrition, Metabolism and Cardiovascular Diseases.2025; 35(3): 103805. CrossRef
Exploring the metabolic patterns and response mechanisms of bile acids during fasting: A study with poultry as an example
Jun Zhang, Yujie Gong, Yidan Zhu, Qingduo Zeng, Hao Zhang, Ruili Han, Yujie Guo, Donghua Li, Yadong Tian, Xiangtao Kang, Yawei Yang, Zhuanjian Li, Ruirui Jiang
Poultry Science.2025; 104(2): 104746. CrossRef
Intermittent fasting and neurocognitive disorders: What the evidence shows
Jordan Beveridge, Allison Montgomery, George Grossberg
The Journal of nutrition, health and aging.2025; 29(4): 100480. CrossRef
Intermittent fasting and longevity: From animal models to implication for humans
Olha Strilbytska, Svitlana Klishch, Kenneth B. Storey, Alexander Koliada, Oleh Lushchak
Ageing Research Reviews.2024; 96: 102274. CrossRef
Combined Aerobic Exercise with Intermittent Fasting Is Effective for Reducing mTOR and Bcl-2 Levels in Obese Females
Purwo Sri Rejeki, Adi Pranoto, Deandra Maharani Widiatmaja, Dita Mega Utami, Nabilah Izzatunnisa, Sugiharto, Ronny Lesmana, Shariff Halim
Sports.2024; 12(5): 116. CrossRef
Effect of Intermittent Fasting Interventions for Treatment of Overweight and Obesity in Adults – A Systematic Review
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Acta Medica International.2024; 11(1): 7. CrossRef
Intermittent fasting influences immunity and metabolism
Daniel M. Marko, Meghan O. Conn, Jonathan D. Schertzer
Trends in Endocrinology & Metabolism.2024; 35(9): 821. CrossRef
Impact of Intermittent Fasting and Dietary Restriction on Redox State, Energetic Metabolism, and Liver Injury in Common Bile Duct Ligation Model
Dmitry S. Semenovich, Ljubava D. Zorova, Polina A. Abramicheva, Nadezda V. Andrianova, Andrey V. Elchaninov, Aleksandra S. Petrukhina, Irina B. Pevzner, Vasily N. Manskikh, Dmitry B. Zorov, Egor Y. Plotnikov
Antioxidants.2024; 13(7): 835. CrossRef
DOSE: a lifestyle philosophy for dementia prevention informed by drug development and epidemiology
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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
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The Combined Effect of Diets with Different Time Restriction and Low-intensity Aerobic Exercise on Metabolic Factors and Anthropometry in Overweight Middle-aged Men
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Ketogenic Interventions in Autosomal Dominant Polycystic Kidney Disease: A Comprehensive Review of Current Evidence
Carla Pezzuoli, Giuseppe Biagini, Riccardo Magistroni
Nutrients.2024; 16(16): 2676. CrossRef
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
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The distinct mechanism regulating taurine homeostasis in mice: Nutrient availability affects taurine levels in the liver and energy restriction influences it in the intestine
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Relationship Between Dietary Nutrient Intake and Autophagy—Related Genes in Obese Humans: A Narrative Review
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Examining Associations Between Fasting Behavior, Orthorexia Nervosa, and Eating Disorders
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Age-related differences in the effect of intermittent fasting on the morphofunctional parameters of the rat's pancreas
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Maternal intermittent fasting deteriorates offspring metabolism via suppression of hepatic mTORC1 signaling
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Time-Restricted Feeding and Intermittent Fasting as Preventive Therapeutics: A Systematic Review of the Literature
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Original articles

Oncology and Cancer Research
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

Hematology
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.

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Exceptional responders to immunotherapy in pancreatic cancer: A multi-institutional case series of a rare occurrence
Kavin Sugumar, Andrew Alabd, Andre Alabd, Jonathan J. Hue, Josh Lyons, Sherri Fields, Zev Wainberg, Lei Zheng, Brianna Coogle, Anup Kasi, Nicholas Grewal, Hedy L. Kindler, Jason Starr, Ashwin R. Sama, Jordan M. Winter
Oncotarget.2025; 16(1): 427. CrossRef
Second-line therapy adjustment for advanced pancreatic cancer using circulating tumor cells: Preliminary results
Joachim Drevs, Mandeep Singh Malhotra, Huseyin Sahinbas, Aggelos Iliopoulos, George Beis, Panagiotis Apostolou, Ioannis Papasotiriou
Cancer Treatment and Research Communications.2025; 44: 100956. CrossRef
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;[Epub] 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

Hematology
An update on immunotherapy with PD-1 and PD-L1 blockade: Sung Ae Koh; Yeungnam Univ J Med. 2021;38(4):308-317. Published online September 9, 2021; DOI: https://doi.org/10.12701/yujm.2021.01312

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Abstract PDF

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

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Immune checkpoint inhibitors associated cardiovascular immune-related adverse events
Wonyoung Jo, Taejoon Won, Abdel Daoud, Daniela Čiháková
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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

Radiation Oncology
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.

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Impact of Multileaf Collimator Width and Normal Tissue Objective on Radiation Dose Distribution in Stereotactic Radiosurgery Using HyperArc for Single Brain Lesions
Se An Oh, Jae Won Park, Ji Woon Yea, Jaehyeon Park, Yoon Young Jo
Current Oncology.2025; 32(5): 272. CrossRef

Case report

Radiology, Radiotherapy & Diagnostic Imaging
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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Ronghua Wu, Cong Xu, Xing Liu, Weihua Fu, Yujia Chen, Jingzhen Zhu, Guangsheng Du
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Review articles

Radiation Oncology
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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Radiation therapy, radiosurgery, chemotherapy and targeted therapies for metastatic spine tumors: WFNS Spine committee recommendations
Vashisht Sekar, Jamie Walsh, Luke H. Pearson, Ori Barzilai, Salman Sharif, Mehmet Zileli
Neurosurgical Review.2024;[Epub] CrossRef
Dosimetric Comparison Study Between Free Breathing and Breath Hold Techniques in Patients Treated by Liver-Directed Stereotactic Body Radiation Therapy
Atsuto Katano, Tomoyuki Noyama, Kosuke Morishima, Yuki Nozawa, Hideomi Yamashita
Cureus.2023;[Epub] CrossRef
The role of stereotactic body radiotherapy (SBRT) in the treatment of recurrent / progressive lung lesions after primary treatment
H. Demir, S. Özdemir, N. Işık, G. Yaprak
International Journal of Radiation Research.2023; 21(4): 727. CrossRef
Gastric Fistula After MR-Guided Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma
Sarah Goodchild, Matthew N. Mills, Russell F. Palm, Sarah E. Hoffe, Jessica M. Frakes
Applied Radiation Oncology.2023; 12(4): 40. CrossRef
MRI features of treated hepatocellular carcinoma following locoregional therapy: a pictorial review
Mohanned Alnammi, Jeremy Wortman, Jaclyn Therrien, Jalil Afnan
Abdominal Radiology.2022; 47(7): 2299. CrossRef
Radiofrequency ablation versus laparoscopic hepatectomy for treatment of hepatocellular carcinoma: a systematic review and meta-analysis
Shan Jin, Shisheng Tan, Wen Peng, Ying Jiang, Chunshan Luo
World Journal of Surgical Oncology.2020;[Epub] CrossRef

Gastroenterology and Hepatology
Pharmacologic therapy for nonalcoholic steatohepatitis focusing on pathophysiology: In Cheol Yoon, Jong Ryeol Eun; Yeungnam Univ J Med. 2019;36(2):67-77. Published online April 11, 2019; DOI: https://doi.org/10.12701/yujm.2019.00171

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Abstract PDF

The paradigm of chronic liver diseases has been shifting. Although hepatitis B and C viral infections are still the main causes of liver cirrhosis and hepatocellular carcinoma (HCC), the introduction of effective antiviral drugs may control or cure them in the near future. In contrast, the burden of nonalcoholic fatty liver disease (NAFLD) has been increasing for decades, and 25 to 30% of the general population in Korea is estimated to have NAFLD. Over 10% of NAFLD patients may have nonalcoholic steatohepatitis (NASH), a severe form of NAFLD. NASH can progress to cirrhosis and HCC. NASH is currently the second leading cause to be placed on the liver transplantation list in the United States. NAFLD is associated with obesity, type 2 diabetes, dyslipidemia, and metabolic syndrome. The pathophysiology is complex and associated with lipotoxicity, inflammatory cytokines, apoptosis, and insulin resistance. The only proven effective treatment is weight reduction by diet and exercise. However, this may not be effective for advanced fibrosis or cirrhosis. Therefore, effective drugs are urgently needed for treating these conditions. Unfortunately, no drugs have been approved for the treatment of NASH. Many pharmaceutical companies are trying to develop new drugs for the treatment of NASH. Some of them are in phase 2 or 3 clinical trials. Here, pharmacologic therapies in clinical trials, as well as the basic principles of drug therapy, will be reviewed, focusing on pathophysiology.

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Tharani Senavirathna, Armaghan Shafaei, Ricky Lareu, Lois Balmer
Antioxidants.2024; 13(4): 485. CrossRef
Mechanism of PANoptosis in metabolic dysfunction-associated steatotic liver disease
Keying Ni, Lina Meng
Clinics and Research in Hepatology and Gastroenterology.2024; 48(7): 102381. CrossRef
Effect of Lactobacillus rhamnosus hsryfm 1301 Fermented Milk on Lipid Metabolism Disorders in High-Fat-Diet Rats
Hengxian Qu, Lina Zong, Jian Sang, Yunchao Wa, Dawei Chen, Yujun Huang, Xia Chen, Ruixia Gu
Nutrients.2022; 14(22): 4850. CrossRef
Oxidative Stress Is a Key Modulator in the Development of Nonalcoholic Fatty Liver Disease
Yuanqiang Ma, Gyurim Lee, Su-Young Heo, Yoon-Seok Roh
Antioxidants.2021; 11(1): 91. CrossRef
Elevated 1-h post-load plasma glucose levels in normal glucose tolerance children with obesity is associated with early carotid atherosclerosis
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Obesity Research & Clinical Practice.2020; 14(2): 136. CrossRef
Pathophysiology of NAFLD and NASH in Experimental Models: The Role of Food Intake Regulating Peptides
L. Kořínková, V. Pražienková, L. Černá, A. Karnošová, B. Železná, J. Kuneš, Lenka Maletínská
Frontiers in Endocrinology.2020;[Epub] CrossRef

Original articles

Pathology and Forensic Medicine
What are the most important prognostic factors in patients with residual rectal cancer after preoperative chemoradiotherapy?: Sol-Min Kim, Ghilsuk Yoon, An Na Seo; Yeungnam Univ J Med. 2019;36(2):124-135. Published online April 1, 2019; DOI: https://doi.org/10.12701/yujm.2019.00157

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Abstract PDF

Background
We aimed to establish robust histoprognostic predictors on residual rectal cancer after preoperative chemoradiotherapy (CRT).
Methods
Analyzing known histoprognostic factors in 146 patients with residual disease allows associations with patient outcome to be evaluated.
Results
The median follow-up time was 77.8 months, during which 59 patients (40.4%) experienced recurrence and 41 (28.1%) died of rectal cancer. On univariate analysis, residual tumor size, ypT category, ypN category, ypTNM stage, downstage, tumor regression grade, lymphatic invasion, perineural invasion, venous invasion, and circumferential resection margin (CRM) were significantly associated with recurrence free survival (RFS) or/and cancer-specific survival (CSS) (all p<0.005). On multivariate analysis, higher ypTNM stage and CRM positivity were identified as independent prognostic factors for RFS (ypTNM stage, p=0.024; CRM positivity, p<0.001) and CSS (p=0.022, p=0.017, respectively). Furthermore, CRM positivity was an independent predictor of reduced RFS, irrespective of subgrouping according to downstage (non-downstage, p=0.001; downstage, p=0.010) or lymph node metastasis (non-metastasis, p=0.004; metastasis, p=0.007).
Conclusion
CRM status may be as powerful as ypTNM stage as a prognostic indicator for patient outcome in patients with residual rectal cancer after preoperative CRT.

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Risk score model for predicting local control and survival in patients with rectal cancer treated with neoadjuvant chemoradiotherapy
Tuba Kurt Catal, Günay Can, İsmai̇l Demi̇rel, Sefi̇ka Ergen, Di̇dem Öksüz
Oncology Letters.2025; 29(5): 1. CrossRef
Potential Prognostic Factors in Low Rectal Cancer Patients Treated With Neoadjuvant Chemoradiation and Abdominoperineal Resection
Mohamed I Fahim, Fady Shafeik, Rasha M Allam, Marina Asaad, Mohammad Taher
Cureus.2025;[Epub] CrossRef
Poor nutrition and sarcopenia are related to systemic inflammatory response in patients with rectal cancer undergoing preoperative chemoradiotherapy
Shinya Abe, Hiroaki Nozawa, Kazushige Kawai, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Junko Kishikawa, Tsuyoshi Ozawa, Yuichiro Yokoyama, Yuzo Nagai, Hiroyuki Anzai, Hirofumi Sonoda, Soichiro Ishihara
International Journal of Colorectal Disease.2022; 37(1): 189. CrossRef
Preoperative sarcopenia is a poor prognostic factor in lower rectal cancer patients undergoing neoadjuvant chemoradiotherapy: a retrospective study
Shinya Abe, Kazushige Kawai, Hiroaki Nozawa, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Junko Kishikawa, Hiroaki Ishii, Yuichiro Yokoyama, Yuzo Nagai, Hiroyuki Anzai, Hirofumi Sonoda, Koji Oba, Soichiro Ishihara
International Journal of Clinical Oncology.2022; 27(1): 141. CrossRef
A Four-Methylated lncRNAs-Based Prognostic Signature for Hepatocellular Carcinoma
Le-En Liao, Dan-Dan Hu, Yun Zheng
Genes.2020; 11(8): 908. CrossRef

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

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Abstract PDF

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

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Therapeutic effects of surgical debulking of metastatic lymph nodes in cervical cancer IIICr: a trial protocol for a phase III, multicenter, randomized controlled study (KGOG1047/DEBULK trial)
Bo Seong Yun, Kwang-Beom Lee, Keun Ho Lee, Ha Kyun Chang, Joo-Young Kim, Myong Cheol Lim, Chel Hun Choi, Hanbyoul Cho, Dae-Yeon Kim, Yun Hwan Kim, Joong Sub Choi, Chae Hyeong Lee, Jae-Weon Kim, Sang Wun Kim, Yong Bae Kim, Chi-Heum Cho, Dae Gy Hong, Yong J
Journal of Gynecologic Oncology.2024;[Epub] CrossRef
Can we triumph over locally advanced cervical cancer with colossal para-aortic lymph nodes? A case report
Abdulla Alzibdeh, Issa Mohamad, Lina Wahbeh, Ramiz Abuhijlih, Fawzi Abuhijla
World Journal of Clinical Cases.2024; 12(10): 1851. CrossRef
RECIST 1.1 versus clinico-radiological response assessment for locally advanced cervical cancer: implications on interpreting survival outcomes of future trials
Mayuri Charnalia, Supriya Chopra, Jaahid Mulani, Palak Popat, Sushmita Rath, Maarten Thomeer, Prachi Mittal, Ankita Gupta, Ingrid Boere, Sudeep Gupta, Remi A Nout
International Journal of Gynecological Cancer.2024; 34(6): 817. CrossRef
Efficacy of lymph node dissection on stage IIICr of cervical cancer before CCRT: study protocol for a phase III, randomized controlled clinical trial (CQGOG0103)
Misi He, Mingfang Guo, Qi Zhou, Ying Tang, Lin Zhong, Qing Liu, Xiaomei Fan, Xiwa Zhao, Xiang Zhang, Gang Chen, Yuanming Shen, Qin Xu, Xiaojun Chen, Yuancheng Li, Dongling Zou
Journal of Gynecologic Oncology.2023;[Epub] CrossRef
Stadializarea clinică şi chirurgicală a pacientelor cu cancer de col uterin – studiu retrospectiv privind corelaţiile dintre diagnosticul iniţial, opţiunile de tratament şi rezultatele histopatologice
Mihai-Cristian Dumitraşcu, Adina-Elena Nenciu, Cătălin George Nenciu, Carmen Ursu, Andreea Ilieşiu, Alexandru Baroş, Diana Secară, Monica Mihaela Cîrstoiu
Ginecologia.ro.2023; 1(39): 30. CrossRef
Treatment of bulky lymph nodes in locally advanced cervical cancer: boosting versus debulking
Ester Paulien Olthof, Hans Wenzel, Jacobus van der Velden, Anje M Spijkerboer, Ruud Bekkers, Jogchum J Beltman, Hans W Nijman, Brigitte Slangen, Ramon Smolders, Nienke van Trommel, Petra L M Zusterzeel, Ronald Zweemer, Lukas J A Stalpers, Maaike van der A
International Journal of Gynecological Cancer.2022; 32(7): 861. CrossRef
Targetability of cervical cancer by magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU)-mediated hyperthermia (HT) for patients receiving radiation therapy
Lifei Zhu, Yi Huang, Dao Lam, H. Michael Gach, Imran Zoberi, Dennis E. Hallahan, Perry W. Grigsby, Hong Chen, Michael B. Altman
International Journal of Hyperthermia.2021; 38(1): 498. CrossRef
Surgical versus clinical staging prior to primary chemoradiation in patients with cervical cancer FIGO stages IIB–IVA: oncologic results of a prospective randomized international multicenter (Uterus-11) intergroup study
Simone Marnitz, Audrey Tieko Tsunoda, Peter Martus, Marcelo Vieira, Renato Jose Affonso Junior, João Nunes, Volker Budach, Hermann Hertel, Alexander Mustea, Jalid Sehouli, Jens-Peter Scharf, Uwe Ulrich, Andreas Ebert, Iris Piwonski, Christhardt Kohler
International Journal of Gynecological Cancer.2020; 30(12): 1855. CrossRef

Radiation Oncology
Non–coplanar whole brain radiotherapy is an effective modality for parotid sparing: Jaehyeon Park, Jae Won Park, Ji Woon Yea; Yeungnam Univ J Med. 2019;36(1):36-42. Published online January 3, 2019; DOI: https://doi.org/10.12701/yujm.2019.00087

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Abstract PDF

Background
The purpose of this study was to evaluate the efficacy and feasibility of non–coplanar whole brain radiotherapy (NC–WBRT) for parotid sparing.
Methods
Fifteen cases, previously treated with WBRT were selected. NC–WBRT plans were generated. The beam arrangement for the non–coplanar plans consisted of superior anterior, right, and left beams. After generation of the non–coplanar plans a field–in–field technique was applied to the bilateral parallel opposed beams in order to reduce maximum dose and increase dose homogeneity. The NC–WBRT plans were subsequently compared with the previously generated bilateral WBRT (B–WBRT) plans. A field–in–field technique was also used with the B–WBRT plans according to our departmental protocol. As per our institutional practice a total dose of 30 Gy in 10 fractions of WBRT was administered 5 days a week.
Results
The mean dose to the parotid gland for the two different plans were 16.2 Gy with B–WBRT and 13.7 Gy with NC–WBRT (p<0.05). In the NC–WBRT plan, the V5Gy, V10Gy, V15Gy, V20Gy, and V25Gy of the parotid were significantly lower (p<0.05) than those of the B–WBRT plan. The Dmax of the lens was also lower by 10% with NC–WBRT.
Conclusion
The use of NC–WBRT plans could be a simple and effective method to reduce irradiated volumes and improve the dose–volume parameters of the parotid gland.

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Case Reports

Cardiology and Cardiovascular Medicine
Lower limb ischemia after bee sting.: Hee Yun Ryu, Min Seok Yoo, Ji Young Park, Jae Woong Choi, Sung Kee Ryu, Seunghwan Kim, Se Jin Lee, Young Bin Kim; Yeungnam Univ J Med. 2016;33(2):134-137. Published online December 31, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.2.134

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Abstract PDF

Bee sting causes mild symptoms such as urticaria and localized pain, and severe symptoms including anaphylaxis, cardiovascular collapse, and death. We reported on a patient with arterial thrombotic occlusion and severe ischemia in the lower limb after multiple bee stings. The patient was stung 5 times and complained of pallor, pain, and coldness in the left toe, and did not have dorsalis pedis pulsation. Computed tomography angiography showed multiple thrombotic occlusion of the anterior and posterial tibial artery below the knee. Local thrombolytic therapy using urokinase was administered and the occluded arteries were successfully recanalized.

Citations

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A Rare Case of Acute Lower Limb Ischemia following Bee Sting
Jayesh Patel, Arya Patel, Shivangi Jha, Ketul S Barot, Pratiksha Patel, Dwisha Poptani
Indian Journal of Vascular and Endovascular Surgery.2023; 10(3): 231. CrossRef

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

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

Rheumatology
Use of post-operative negative-pressure wound therapy for gouty ulcer.: Chang Yul Oh, Jung Ran Choi, Min Su Son, Sun Young Jo, Jun Ho Hur, Jung Gyu Park, Dong Ho Oh, Young Hyun Yi; Yeungnam Univ J Med. 2015;32(1):42-46. Published online June 30, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.1.42

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Abstract PDF: Gouty ulcer can be caused by the accumulation of clumps of uric acid in body tissues that lead to acute or chronic inflammation at sites of accumulation. Furthermore, tophi-inhibiting granulation tissue may form a canal that channels microbial infection from the underlying involved joint space, and thus, presents the risk of osteomyelitis development. Accordingly, gouty ulcer must be treated appropriately. In this case, refractory wounds on gouty ulcers at the left shin and left radial ankle were treated by surgical debridement. Negative-pressure wound therapy was used successfully to prevent post-operative delayed wound healing.

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

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

Gastroenterology and Hepatology
A Case of Metastatic Hepatocellular Carcinoma of the Orbit.: Young Joo Yang, Seung Hyeon Bae, Il Young Jang, Mi Jung Jun, Ji Won Jung, Ji Hyun An, Ju Hyun Shim; Yeungnam Univ J Med. 2013;30(2):152-155. Published online December 31, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.2.152

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Abstract PDF: Orbital metastasis from hepatocellular carcinoma is very rare, with only 14 biopsy-proven cases from hepa tocellular carcinoma cases reported in English literature and three cases reported in Korea. Common symptoms of orbital metastasis are proptosis, visual loss, ocular pain and oculomotor dysfunction. For its precise diagnosis, we can perform fine needle aspiration biopsy, orbit CT or MRI, and ultrasonography. Radiotherapy is the mainstay in the treatment of orbital metastasis. In addition, chemotherapy, hormonal therapy and surgical intervention can play a role in the treatment of orbital metastasis according to the primary cancer and symptoms. However, the prognosis of orbital metastasis is poor. We report herein a rare case of a patient with orbital metastasis from hepatocellular carcinoma, which was treated with various modalities that included resection, and who had good clinical and radiological responses to radiation therapy and sorafenib (Nexavar, Bayer HealthCare).

Cardiology and Cardiovascular Medicine
Deep Vein Thrombosis Due to Hematoma as a Rare Complication after Femoral Arterial Catheterization.: Minsoo Kim, Jong Young Lee, Cheol Whan Lee, Seung Whan Lee, Soo Jin Kang, Yong Hoon Yoon, Sang Yong Om, Young Hak Kim; Yeungnam Univ J Med. 2013;30(1):31-35. Published online June 30, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.1.31

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Abstract PDF

Hematoma is quite a common complication of femoral arterial catheterization. However, to the best of our knowledge, there have been no previous studies regarding deep vein thrombosis (DVT) caused by compression of a vein due to a hematoma. We report a case of a hematoma developing after femoral arterial catheterization and causing extensive symptomatic DVT. A 59-year-old male was seen in our Emergency Department with right lower leg swelling 15 days after coronary stent implantation performed using right femoral artery access. Computed tomographic (CT) scanning revealed a large hematoma (45 mm in its longest diameter) compressing the common femoral vein and with DVT from the right external iliac vein to the popliteal vein. Due to the extensive DVT involvement, we decided to release the compressed common femoral vein by surgical evacuation of the large hematoma. However, even following evacuation of the hematoma, as the DVT did not resolve soon, further mechanical thrombectomy and catheter-directed thrombolysis were performed. Angiography then showed nearly resolved DVT, and the leg swelling was improved. The patient was discharged with the anticoagulation medication, warfarin.

Citations

Citations to this article as recorded by

Femoral Vein Thrombosis Following Femoral Access Cardiac Catheterisation – A Rare Complication
Laurence Disler, Mathew Disler, Dayle Disler Biddle, Camilla Friedman, Janet Couper-Smith
Cardiovascular Revascularization Medicine.2023; 53: S224. CrossRef
A Case of Puncture-Site Giant Pseudoaneurysm Following Recanalization Therapy for Acute Ischemic Stroke: Marked Growth and Rupture of a Femoral Artery Pseudoaneurysm
Noriaki Matsubara, Yusuke Fukuo, Kohei Yoshimura, Hideki Kashiwagi, Gen Futamura, Yangtae Park, Toshihiko Kuroiwa, Masahiko Wanibuchi
Journal of Neuroendovascular Therapy.2021; 15(6): 366. CrossRef
Deep Vein Thrombosis after Femoral Arterial Access: Pathophysiologic and Therapeutic Challenges
Evan Harmon, Yoo Jin Lee, Sula Mazimba, Kanwar Singh, Aditya Sharma, Younghoon Kwon
Case Reports in Cardiology.2019; 2019: 1. CrossRef
Treatment of pulmonary thromboembolism using Arrow-Trerotola percutaneous thrombolytic device
Tae Kyun Kim, Ji Young Park, Jun Ho Bae, Jae Woong Choi, Sung Kee Ryu, Min-Jung Kim, Jun Bong Kim, Jang Won Sohn
Yeungnam University Journal of Medicine.2014; 31(1): 28. CrossRef

Original Article

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

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

Reviews

Anatomy
Adult Mesenchymal Stem Cells for Cell Therapy in Clinical Application.: In Hwan Song; Yeungnam Univ J Med. 2009;26(1):1-14. Published online June 30, 2009; DOI: https://doi.org/10.12701/yujm.2009.26.1.1

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Abstract PDF

Human bone marrow-derived mesenchymal stem cells (MSCs) are a rare population of undifferentiated cells that have the capacity of self renewal and the ability to differentiate into mesodermal phenotypes, including osteocytes, chondrocytes, and adipocytes in vitro. Recently, MSCs have been shown to reside within the connective tissue of most organs, and their surface phenotype has been well analyzed. Many reports showed that transplanted MSCs enhanced regeneration as well as functional improvement of damaged organs and tissues. The wide differentiation plasticity of MSCs was expected to contribute to their demonstrated efficacy in a wide variety of experimental animal models and in human clinical trials. However, new findings suggest that the ability of MSCs to alter the tissue microenvironment via secretion of soluble factors may contribute more significantly than their capacity for differentiation in tissue repair. This review describes what is known about the cellular characteristics and differentiation potential of MSCs, which represent a promising stem cell population for further applications in regenerative medicine.

Citations

Citations to this article as recorded by

Application of Bio-Active Elastin-like Polypeptide on Regulation of Human Mesenchymal Stem Cell Behavior
Vijaya Sarangthem, Harshita Sharma, Mohini Mendiratta, Ranjit Kumar Sahoo, Rang-Woon Park, Lalit Kumar, Thoudam Debraj Singh, Sujata Mohanty
Biomedicines.2022; 10(5): 1151. CrossRef
Mesenchymal Stem Cells Decrease Oxidative Stress in the Bowels of Interleukin-10 Knockout Mice
Kyong Jin Jung, Gun Woo Lee, Chul Hyun Park, Tae Jin Lee, Joo Young Kim, Eon Gi Sung, Seong Yong Kim, Byung Ik Jang, In Hwan Song
Gut and Liver.2020; 14(1): 100. CrossRef
Human adipose-derived stem cells attenuate inflammatory bowel disease in IL-10 knockout mice
Woo Yeun Jung, Joo Hwan Kang, Kyung Gon Kim, Hee Snn Kim, Byung Ik Jang, Yong Hoon Park, In-Hwan Song
Tissue and Cell.2015; 47(1): 86. CrossRef

Radiation Oncology
Quality Assurance in Intensity Modulated Radiation Theray.: Sung Kyu Kim; Yeungnam Univ J Med. 2008;25(2):85-91. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.85

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Abstract PDF: Intensity-modulated radiation therapy (IMRT) is believed to be one of the best radiation treatment techniques. IMRT is able to deliver fatal doses of radiation to the tumor region with minimal exposure of critical organs. It is essential to have a comprehensive quality assurance program to assure precision and accuracy in treatment, due to the character of IMRT. We applied quality assurance technique to the Eclipse treatment planning system and sought to determine its effectiveness in patient treatment planning. An acrylic phantom, film, and an ionization chamber were used in this study.

Gastroenterology and Hepatology
Long Term Effects of Lamivudine and Adefovir dipivoxil in Chronic Hepatitis B Patients on the Development of Hepatocellular Carcinoma.: Heon Ju Lee; Yeungnam Univ J Med. 2008;25(1):1-18. Published online June 30, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.1.1

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Abstract PDF: Although Lamivudine and adefovir dipivoxil are efficacious drugs for preventing hepatocellular carcinoma (HCC) in chronic hepatitis B patients, their efficacy is far from completely satisfactory. The risk of liver cirrhosis and HCC begins to increase at an HBV DNA level of 10(4) copies/ml. Even with latent or past HBV infection, episomal covalently closed circular DNA(cccDNA) plays a key rolein the persistence, relapse and resistance of HBV in its natural course or during therapy. The annual incidence of HCC in YUMC is 1.8% and 4.7% patients/year in the antiviral treatment and control groups, respectively. The ability to achieve a high rate of sustained HBV suppression with low risk of drug resistance is the ultimate goal in the treatment of chronic HBV infection. The efficacy of universal immunization with striking reductions in the prevalence of HBV in localized countries needs to be spread worldwide. With hepatitis B immunization and effective antiviral therapy, global control of HBV infection and HBV-related complications, including HCC, are possible by the end of the first half of the 21st century.

Original Article

Orthopedics and Sports Medicine
Spinal Fusion Based on Ex Vivo Gene Therapy Using Recombinant Human BMP Adenoviruses.: Gi Beom Kim, Jae Ryong Kim, Myun Hwan Ahn, Jae Sung Seo; Yeungnam Univ J Med. 2007;24(2):262-274. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.262

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Abstract PDF: PURPOSE: Bone morphogenetic proteins (BMPs) play an important role in the formation of cartilage and bone, as well as regulating the growth of chondroblasts and osteoblasts. In this study, we investigated whether recombinant human BMP adenoviruses are available for ex vivo gene therapy, using human fibroblasts and human bone marrow stromal cells in an animal spinal fusion model. MATERIALS AND METHODS: Human fibroblasts and human bone marrow stromal cells were transduced with recombinant BMP-2 adenovirus (AdBMP-2) or recombinant BMP-7 adenovirus (AdBMP-7), referred to as AdBMP-7/BMSC, AdBMP-2/BMSC, AdBMP-7/HuFb, and AdBMP-2/HuFb. We showed that each cell secreted active BMPs by alkaline phosphatase staining. Since AdBMP-2 or AdBMP-7 tranducing cells were injected into the paravertebral muscle of athymic nude mice, at 4 weeks and 7 weeks, we confirmed that new bone formation occurred by induction of spinal fusion on radiographs and histochemical staining. RESULTS: In the region where the AdBMP-7/BMSC was injected, new bone formation was observed in all cases and spinal fusion was induced in two of these. AdBMP-2/BMSC induced bone formation and spinal fusion occurred among one of five. However, in the region where AdBMP/HuFb was injected, neither bone formation nor spinal fusion was observed. CONCLUSION: The osteoinductivity of AdBMP-7 was superior to that of AdBMP-2. In addition, the human bone marrow stromal cells were more efficient than the human fibroblasts for bone formation and spinal fusion. Therefore, the results of this study suggest that AdBMP-7/ BMSC would be the most useful approach to ex vivo gene therapy for an animal spinal fusion model.

Case Report

Anesthesiology and Pain Medicine
Treatment of Atelectasis Dectected in the Recovery Room after General Anesthesia: Chang jae Hwang, Heung dae Kim, Dae pal Park, Il suk Seo, Sun ok Song, Sae yeon Kim, Dae lim Jee, Deok hee Lee; Yeungnam Univ J Med. 2007;24(2 Suppl):S696-701. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S696

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Abstract PDF: Atelectasis is a relatively common complication following surgery in anesthetized patient with respiratory symptoms, but rarely occur in normal healthy patient. Anesthesiologists must be wary to prevent atelectasis, because it may lead to hypoxia during and after the operation. This case reports a healthy patient without previous respiratory symptoms who developed left lower lobar atelectasis after general anesthesia. Vigorous chest physiotherapy including intended coughing, deep breathing, chest percussion and vibration under postural change was effective. Therefore, vigorous chest physiotherapy is essential part of early treatment modalities for atelectasis in postoperative recovery room.

Original Articles

Radiation Oncology
Comparision of Parotid Gland Dose Distribution between 3DCRT and IMRT in Head and Neck Radiation Therapy: Sang Mo Yun, Sung Kyu Kim; Yeungnam Univ J Med. 2007;24(2 Suppl):S443-448. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S443

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Abstract PDF: Purpose：This study compared 3 dimensional conformal radiation therapy (3DCRT) to intensity modulated radiation therapy (IMRT) in parotid glands sparing in head and neck cancers. Materials and Methods：Planning target volume (PTV) was outlined on each CT slice. The dose of 50.4 Gy was prescribed to the PTV with the conventional fraction, 5 fractions per week. We also outlined spinal cord and both parotid glands. With Eclipse 3 dimensional planning system, 3DCRT and IMRT planning were done.
Results
：After plan optimization, PTV dose distribution was evaluated with dose volume histogram. The 90% isodose curve covered almost all of PTV for both techniques. Maximum and median dose for spinal cord were 36.8 Gy and 34.2 Gy in 3DCRT, 39.9 GY and 37.5 Gy in IMRT. For parotid glands, mean and median dose were 33.6 Gy and 37.6 Gy in 3DCRT, 24.9 Gy and 24.5 Gy in IMRT.
Conclusion
：For the non-pharyngeal head and neck cancers, 3DCRT was cost effective radiation modality in prevention radiation therapy induced xerostomia.

Surgery
Efficacy and Side Effect of Docetaxel Based Chemotherapy as Second-Line Treatment in Recurrent Gastric Cancer: Se Won Kim, Sang Woon Kim, Sun Kyo Song; Yeungnam Univ J Med. 2007;24(2 Suppl):S399-406. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S399

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Abstract PDF: Purpose：To investigate the efficacy and safety of docetaxel based chemotherapy as a secondline treatment in patients with metastatic or recurrent gastric cancer. Materials and Methods：Between January 2001 and March 2007, 28 patients with recurrent or metastatic gastric cancer were enrolled. The administered doses of decetaxel was 75 mg/m² on day 1 and 5, cisplatin 60 mg/m² on day 3, 5-FU 600 mg/m² over 24 hrs on day 1 to day 5, every 4 weeks. The response was assessed every 2 cycles. The toxicities were evaluated for every course of chemotherapy according to National Cancer Institute-common toxicity criteria (NCI-CTC).
Results
：For response rates, 3 (10.7%) partial response, 13 (46.4%) stable disease, and 12 (42.9%) progressive disease, respectively. The overall disease control rate was 57.1%. The median time to progression was 3.0 months (2-8 months). Median overall survival was 8 months (5-11 months). NCI-CTC grade 3 leukocytopenia occurred in 1 cases, grade 3 anemia in 1case and grade 3 nausea/vomiting in 2 cases.
Conclusion
：Docetaxel based chemotherapy has a tolerable efficacy with acceptable toxicities in patients with recurrent gastric cancer as a second-line treatment.

Surgery
Efficacy of Unresectable or Recurred Gastric Cancer Treated with TS-1 Chemotherapy or TS-1/CDDP Combination Chemotherapy: Se Won Kim, Sang Woon Kim, Sun Kyo Song; Yeungnam Univ J Med. 2007;24(2 Suppl):S391-398. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S391

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Abstract PDF: Purpose：Although several chemotherapy regimens used against advanced and recurred gastric cancer have been studied extensively in an attempt to further improve the prognosis of patients, no standard chemotherapeutic regimens have been established. The aim of this study was to determine the anti-tumor efficacy and safety of TS-1 or TS-1 plus cisplatin (CDDP). Materials and Methods：From December 2004 to June 2007, we treated 43 patients with unresectable or recurred gastric cancer either with 80 mg/m2 of TS-1 for 28 days, which was followed by a 2-week rest, or with 80 mg/m² of TS-1 for 28 days and 60 mg/m² of CDDP on day 3 every 6 weeks.
Results
：Tumor response rates in the primary chemotherapy group and in the recurrent group were 46.7% and 21.4%, respectively. The median survival rates in the primary and the recurrent group were 14 months and 8 months, and it was not significantly different. But the one-year survival rates according to the kinds of regimens (TS-1 or TS-1/CDDP group) were significantly different (P=0.0014). The incidences of grade 3 or 4 adverse effects were 18%, respectively.
Conclusion
：The anti-tumor efficacy and safety of TS-1 and TS-1 plus CDDP in unresectable or recurred gastric cancer patients seemed to be high with modest adverse effects, thus suggesting the possible use of this regimen for unresectable or recurred gastric cancer patients.

Review Articles

Radiation Oncology
Role of Radiation Therapy in Treatment of Stomach Cancers: Sang Mo Yun, Myung Se Kim; Yeungnam Univ J Med. 2007;24(2 Suppl):S245-251. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S245

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Abstract PDF: Although occasionally used as a therapeutic modality, radiotherapy was not a routine part of the treatment of stomach cancer. As a single modality, preoperative radiotherapy showed some benefit, but this was not confirmed in radomized trial. In recent neoadjuvant trials, radiotherapy is usually given concurrently with chemotherapy, and pathologic complete response rates was about 30%. There were small studies of radiotherapy as an adjuvant, either alone or with chemotherapy, but the randomized studies using postoperative radiotherapy alone did not show a survival benefit. The results of intergroup gastric adjuvant trial(INT 0116) were presented in May 2000 at American Society of Clinical Oncology. In that report, postoperative concurrent chemoradiotherapy showed survival benefit. INT 0116 has established postoperative chemoradiotherapy as the standard care for high risk patients with resected stomach cancer. But, INT 0116 had several weak points including lack of standardized nodal dissection and delivery rates of treatments. So, Asian and European investigators did not agree. Korean study showed benefit of postoperative chemoradiotherapy after D2 dissection, but this study was not randomized. Recently, Korean investigators started randomized trial of chemoradiotherapy in D2 dissected patients. This trial may give answer to us about the benefit of postoperative chemoradiotherapy in resected stomach cancer.

Surgery
Treatment of Advanced Gastric Cancer: Sun-Kyo Song; Yeungnam Univ J Med. 2007;24(2 Suppl):S125-131. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S125

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Abstract PDF: Curative surgery is the most common and desirable treatment for advanced gastric cancer(AGC), but macroscopically curative resection of AGC dose not always mean a curative outcome. For the tailored management of AGC, accurate preoperative stage are made by using abdominal CT, FDG PET and laparoscopy is necessary. In case of T₃/T₄ lesion, neoadjuvant chemotherapy(NAC) and neoadjuvant chemoradiotherapy(NACR) are effective therapeutic approaches with acceptable toxicity without increasing surgical morbidity and mortality. I recommend the use of a multidisciplinary therapeutic strategy for treatment of AGC. Future applications of newer cytotoxic drugs such as oxaliplatin, capecitabine, irinotecan, and docetaxel or targeted therapies may help to improve the management of AGC.

Original Article

Otorhinolaryngology
Docetaxel and Cisplatin Combination Chemotherapy in Patients with Advanced Head and Neck Cancer.: Sung Won Choi, Young Ho Choi, Chang Hoon Bai, Yong Dae Kim, Si Youn Song; Yeungnam Univ J Med. 2006;23(2):162-170. Published online December 31, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.2.162

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Abstract PDF: BACKGROUND
Head and neck cancer is curable at early stages with local-regional therapy. However, most patients are diagnosed with advanced stage disease that requires combination therapy. The aim of this study was to determine the efficacy of docetaxel and cisplatin combination chemotherapy, in patients with advanced head and neck cancer by evaluating the response, survival and organ preservation rates. MATERIALS AND METHODS: We reviewed retrospectively the medical records of 39 patients with advanced head and neck cancer who received docetaxel and cisplatin combination chemotherapy from March 2000 to July 2004. RESULTS: The average age of the 39 patients was 53.4 (range 30 to 73 years) years and the most common primary site was the hypopharynx (23.0%). There were 36 patients who had stage IV disease and three patients with stage III disease. The overall response rate was 76.9% (30/39), including 12 complete responses (30.8%) and 18 partial responses (46.1%). The response rate based on the primary cancer and neck metastasis was 74.4% and 69.3%; the differences were not significant. Among 16 patients with laryngeal and hypopharyngeal cancer, 13 (81.2%) had their larynx preserved after chemotherapy followed by radiotherapy and a survival rate of 61.5%; three patients (18.8%) received a total laryngectomy and had a survival rate of 66.7%. The overall survival rate from the start of chemotherapy was 56.4% with a median survival of 30 months. The common toxicities observed were alopecia, vomiting, diarrhea, hepatotoxicity and anemia but they were all generally manageable. CONCLUSION: Docetaxel and cisplatin combination chemotherapy is an effective regimen with a relatively high response rate and acceptable toxicity

Review

Oncology and Cancer Research
Target Therapy for Colorectal Cancer.: Kyung Hee Lee; Yeungnam Univ J Med. 2006;23(2):143-151. Published online December 31, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.2.143

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Abstract PDF: In the past decade, the median duration of survival among patients with advanced colorectal cancer has increased from 12 months to about 18 months, primarily as a results of the introduction of irinotecan and oxaliplatin. Advances in the understanding of the molecular mechanisms underlying the development and progression of cancer have resulted in the discovery of new therapeutic interventions that target specific molecular abnormalities. Their specificity, and therefore their potential to bind preferentially and modify tumor-specific targets, sparing normal tissues and causing fewer side-effects compared to conventional cytotoxic agents, makes them an attractive therapeutic option. The future of this approach for the treatment of solid tumors is promising

Original Article

Surgery
The Comparison of Survival Rates of Postoperative Adjuvant Chemotherapies in The Stage III Gastric Cancer Patients.: Eun Mi Kim, Se Won Kim, Sang Woon Kim, Sun Kyo Song; Yeungnam Univ J Med. 2006;23(2):193-204. Published online December 31, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.2.193

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Abstract PDF: PURPOSE: Various postoperative adjuvant chemotherapy regimens have been proposed for the patients with advanced gastric cancer. The majority of clinical trials have shown no significant difference in the survival benefit. The aim of this study was to compare the survival rates of postoperative adjuvant chemotherapies used in stage III gastric cancer patients who received curative gastrectomy. MATERIALS AND METHODS: Between 1990 and 1999, a survival analysis was performed in 260 patients who received curative gastric resection and postoperative adjuvant chemotherapy. The patients were divided into four groups according to the chemotherapeutic regimens received. The groups were: the F group: furtulon alone, FM group: furtulon and mitomycin, FAM group: 5-FU, adriamycin and mitomycin, FLEP group: 5-FU, leucovorin, etoposide and cisplatin. The survival rates were analyzed using the Kaplan-Meier method and the Cox proportional hazards model. RESULTS: There were no differences among the groups of patients with regard to tumor characteristics except for lymph node metastasis and the ratio of metastasis to lymph nodes. In the FLEP group, the ratio of metastasis to lymph nodes was higher than in the other groups. The five and ten year survival rates of F, FM, FAM and FLEP were 51.9%, 28.9%, 59.5%, 49.8%, 66.1%, 57.4% and 30.0%, 27.5%, respectively. The univariate analysis showed that age, Borrmann type, lymph node metastasis, ratio of metastasis to lymph nodes, postoperative adjuvant chemotherapy and recurrence were significant factors for survival. For the multivariate analysis, recurrence, age, Borrmann type, ratio of lymph node metastasis and lymph node dissection were independent prognostic factors; however, the postoperative adjuvant chemotherapy was not an independent prognostic factor. CONCLUSION: The FAM regimen was the most beneficial postoperative adjuvant chemotherapy for improved survival rates; the FM regimen was the second and the FLEP regimen was the last. In order to determine the effectiveness of postoperative adjuvant chemotherapy in stage III gastric cancer, well designed prospective studies including a surgery only group will be needed.

Review

Cardiology and Cardiovascular Medicine
Cardiac Resynchronization Therapy.: Hyong Jun Kim, Dong Gu Shin; Yeungnam Univ J Med. 2005;22(2):131-140. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.131

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Abstract PDF: Heart failure is a clinical syndrome comprised of a number of symptoms and signs associated with congestion and/or hypoperfusion. Specific pharmacologic therapies have been developed to slow disease progression from early to more advanced stages. Once symptoms have developed, aggressive multimodality interventions are instituted to alleviate symptoms and improve clinical status and quality of life; especially in those patients that present symptoms. Recently, an evolving adjunctive therapeutic modality, that involves using implanted electrical devices: cardiac resynchronization with or without implantable cardioverter defibrillators (ICD). has been used for management. Cardiac resynchronization therapy (CRT) is a proven treatment for selected patients with heart failure-induced conduction disturbances and ventricular dyssynchrony. When used in combination with stable, optimal medical therapy, CRT is designed to reduce symptoms and improve cardiac function by restoring the mechanical sequence of ventricular activation and contraction. This review summarizes the rationale, procedure, clinical trials, and clinical indications for CRT.

Original Article

Oncology and Cancer Research
Phase II Study of Paclitaxel and Cisplatin as Second-line Chemotherapy in Advanced Non-small Cell Lung Cancer.: Yeoung Tae Seo, Bong Seog Kim, Ji Young Go, Dong Suk Choi, Seong Ho Choi, Hye Jin Kim, Young Mi Ahn, Yong Ho Roh, Kyung Hee Lee; Yeungnam Univ J Med. 2004;21(2):198-206. Published online December 31, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.2.198

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Abstract PDF: BACKGROUND
To evaluate the efficacy and safety of paclitaxel and cisplatin against advanced non-small cell lung cancer (NSCLC) as a second-line chemotherapy. SUBJECTS AND METHODS: Twenty-five patients were enrolled. The patients received 200 mg/m2 paclitaxel as a 3-hour intravenous infusion and 60 mg/m2 cisplatin as 30-minute intravenous infusion with vigorous hydration on day 1 every 28 days. The response was assessed every 2 cycles. RESULTS: All 25 patients were assessed for their response and toxicity. Partial responses were observed in 5 patients. The overall response rate was 20% (95% confidence interval, 4%~36%) and the median response duration was 4.5 (range, 2-11) months. The median time to progression was 3.3 (range, 0-14) months. The median overall survival of all patients was 7.4 (range, 1.3-39) months. The hematologic toxicities were minor and easily controlled. CONCLUSION: The combination chemotherapy of paclitaxel and cisplatin as a second-line treatment has a moderate efficacy with an acceptable toxicity in patients with advanced NSCLC.

Review

Orthopedics and Sports Medicine
The Role of Thallium-201 Scintigraphy in Bone and Soft Tissue Tumor.: Duk Seop Shin; Yeungnam Univ J Med. 2003;20(2):117-128. Published online December 31, 2003; DOI: https://doi.org/10.12701/yujm.2003.20.2.117

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Abstract PDF: Thallium-201 scintigraphy is used to discriminate the malignant bone tumor from the benign by qualitatively and quantitatively, and to predict the response of preoperative chemotherapy in osteosarcoma, by comparing the changes of thallium uptake ratio after chemotherapy to the tumor necrosis ratio. Thallium-201 scintigraphy scan should be done prior to surgical biopsy. PICKER Prism 2000 gamma camera with high resolution parallel hole collimator is usually used for scanning. The patient is injected with 2-3mCi of Tl-201 and the early phase is checked in 30 minutes and delayed phase in 3 hours. The scan images are visually evaluated by a blinded nuclear medicine physician. We could evaluate true positive, true negative, false positive and false negative by the comparison of results with those of biopsy, and calculate positive and negative predictive value(%), sensitivity(%), specificity(%) and diagnostic accuracy(%). For the quantitative analysis of thallium uptake, we drew the region of interest on the tumor side and contralateral normal side as mirror image, and calculated the uptake ratio with dividing the amount of gamma count in tumor side by normal side. We could calculate the percent changes of thallium uptake ratio in early and delayed phase, and compare them to the ratio of tumor necrosis. Thallium-201 scintigraphy proved as useful imaging study to discriminate malignant bone tumor from benign, but had exception in giant cell tumor and low grade malignant bone tumors. We can use T1-201 scan to differentiate the benign from the malignant tumor, and to evaluate the response of preoperative chemotherapy or radiotherapy, and to determine the residual tumor or local recurrence. For the better result, we need to have a more detail information about false positive cases and a more objective and quantitative reading technique.

Case Report

Pediatrics, Perinatology, and Child Health
A Case of Superior Mesenteric Venous Thrombosis after Endoscopic Sclerotherapy.: Won Duck Kim, Kwang Hae Choi, Jeong Ok Hah; Yeungnam Univ J Med. 2001;18(2):297-301. Published online December 31, 2001; DOI: https://doi.org/10.12701/yujm.2001.18.2.297

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Abstract PDF: The efficacy of injection sclerotherapy for treatment of acute esophageal variceal bleeding is well established. But several complications of endoscopic sclerotherapy have been reported. One of the complications is mesenteric venous thrombosis which develops when vasopressin is user for the sclerotherapy. We report a case of superior mesenteric venous thrombosis with developed after endoscopic sclerotherapy for control of esophageal variceal bleeding.

Original Articles

Gastroenterology and Hepatology
The Role of Radiotherapy in Treatment of Hepatocellular Carcinoma.: Jong Ryul Eun, Kyo Won Choi, Heon Ju Lee, Mung Se Kim; Yeungnam Univ J Med. 2000;17(2):137-145. Published online December 31, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.2.137

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Abstract PDF: BACKGROUND
Hepatocellular carcinomal(HCC) has been considered to be relatively radioresistant. The role of radiotherapy(RT) in the treatment of HCC is controversial. But RT has a role in the treatment of hepatocellular carcinoma as a single or combination modalities. The effect of radiotherapy on HCC was evaluated. Patients and METHODS: From January 1984 through January 2000, a total of 18 patients with unresectable HCC underwent radiotherapy alone or in conjunction with transarterial embolization(TAE). We reviewed the medical ecords of patients treated with RT and measured the tumor size using measured the tumor size using planimetry method. The Kaplan-Meier method was used to calculate the survival rate. RESULTS: The RT patients were 15 men and 3 women. The mean age was 51 years. four(22.2%) of them were accompanied with ascites. Eleven(61.1%) of them were accompanied with liver cirrhosis and their functions were 6, 3, 2 in each Child-Pugh A, B, C, respectively. A partial response(PR) was observed in 2 patients(11.1%), minimal response(MR) in 4 patients (22.2%) and no change(NC), in 11 patients(61.1%), whereas progressive disease(PD) was seen in 1 patients(6%), respectively. CONCLUSIONS: Although the radiotherapy in HCC did not improve the survival rate. it decreased the tmor size. Radiotherapy strengthens the therapeutic efficacy when combined with TAE, but more studies are needed.

Radiation Oncology
Design of a New Applicator for High-Dose Rate Vaginal Brachytherapy.: Sei One Shin; Yeungnam Univ J Med. 2000;17(2):123-128. Published online December 31, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.2.123

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Abstract PDF: PURPOSE: This study was aimed to develop a new vaginal applicator(Shin's Applicator) for 2-channel high-dose rate vaginal brachytherapy to evaluate uniformity of surface dose, and to present 3-dimensional dose distribution of the applicator. METHODS: Shin's Applicator was inexpensively constructed using human soft tissue equivalent acrylic bar. We evaluated dose uniformity along the applicator surface using film densitometer and performed vaginal intracavitary brachytherapy after insertion of the applicator using HDR brachytherapy planning software and brachytherapy unit(Ralstron-20B). RESULTS: Shin's Applicator allows improved dose distribution than the existing 1-channel cylinder and achieves diminished urinary bladder and rectal dose by 20%. CONCLUSIONS: From the above results, it can be concluded that Shin's Applicator may be an improved form of a vaginal applicator. Furthermore, it can be suggested that this applicator has an advantage, for it prevents vaginal stenosis after radiation therapy and can be used as a disposable vaginal dilator. Further follow up examination with radiological study may be helpful to evaluate the therapeutic efficacy of this applicator.

Cardiology and Cardiovascular Medicine
The Effect of Early IABP and Reperfusion therapy in Patient of Post MI Cardiogenic shock.: Jong Suk Lee, Min Kyeung Kim, Woong Kim, Hyung Jun Kim, Jun Ho Bae, Jong Seon Park, Dong Gu Sin, Young Jo Kim, Bong Sup Shim; Yeungnam Univ J Med. 2000;17(1):31-38. Published online June 30, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.1.31

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Abstract PDF: BACKGROUND
We sought to examine the use and outcomes with early intraaortic balloon couterpulsation(IABP) combined early reperfusion therapy in patients presenting with cardiogenic shock complicating acute myocardial infarction. The use of IABP in patients with cardiogenic shock is widely accepted. however, there is a paucity of information on the use of this technique in patients with cardiogenic shock who are treated with reperfusion therapy in Korea. MATERIALS AND METHODS: Twenty-eight Patients presented with cardiogenic shock were classified into two groups: the early IABP group (insertion within 12 hours after AMI onset time) and late IABP group (insertion after 12 hours). We compared In-hospital mortality in two group (early IABP group vs late IABP group). RESULTS: Two groups show no significant difference at clinical feature and coronary angiographic results. Among total 28 patients, 7 patients were treated with thrombolytic therapy and 21 patients with PTCA. Insertion site bleeding, fever, thrombocytopenia were reported as some of the complications of IABP insertion. In-hospital mortality of early IABP group and late IABP group were 4 patients(25%) and 8 patients(66%), respectively(p<0.05). Early IABP insertion and early PTCA showed lower hospital mortality rates. There was significant difference in the time to PTCA after AMI onset between the to groups(p<0.05). CONCLUSION: IABP appears to be useful in patients presenting with cardiogenic shock unresponsive medical therapy. Early IABP insertion and early Reperfusion therapy may reduce In-hospital mortality rates in PostMI Cardiogenic shock patients.

Radiation Oncology
Treatment Planning Correction Using MRI in the Radiotherapy of Cervical Cancer.: Se One Shin, Kil Ho Cho, Chan Won Park; Yeungnam Univ J Med. 1995;12(2):203-209. Published online December 31, 1995; DOI: https://doi.org/10.12701/yujm.1995.12.2.203

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Abstract PDF: PURPOSE: To evaluate the role of MRI in the management of cervical cancer treated by conventional four-field whole pelvic irradiation. METHOD AND MATERIAL: Between 1993-march and 1994-february, 20 patients(4 Stage I B, 3 Stage U A, 13 Stage U B) with invasive cervical cancer were eligible for evaluation of accuracy of conventionally designed lateral treatment field without MRI determination. RESULTS: 5 out of 20 Patients had inadequate margin without MRI. The position of uterine fundus was more important than cervix in correction of field size and the center of treatment field. CONCLUSION: This Preliminary date show MRI determination of uterine position prior to radiotherapy planning is essential in the case of four-field whole pelvic irradiation technique.

Nephrology
An Analysis of 94 Percutaneous Renal Biopsies.: Ho Jung Kang, Sang Woo Lim, Joo Yeung Do, Kyung Woo Yoon; Yeungnam Univ J Med. 1995;12(1):84-95. Published online June 30, 1995; DOI: https://doi.org/10.12701/yujm.1995.12.1.84

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Abstract PDF: A clinical and histopathological study was performed on ninety-four patients with nephrotic syndrome (91 idiopathic and 3 secondary) who were admitted to Department of Internal Medicine, Yeungnam University Hospital during the period of nine years, from January 1985 to May 1994. The results were as following. 1. the ratio of male to female was 1.76:1. In young age group, minimal change was the most predominant type. In old age group, membranous glomerulonephritis and focal glomerulosclerosis were predominant types. 2.- The primary nephrotic syndromes were 96.8% and secondary nephrotic syndromes were 3.2%. Histopathologic findings of 94 renal biopsy tissue were classified into minimal change (43.6%) mesangial proliferative glomerulonephritis (29.8%), membranous glomerulonephritis (12.8%), Typel membranous proliferative glomerulonephritis (4.3%), focal glomerulosclerosis (3.2%) .and others (6.4%). 3. The response of eighty-six patients treated with steroid showed complete remission in 51.2%, partial remission in 20.9%, steroid dependent in 2.3%, and no effect in 25.6% of cases respectively. The response to steroid therapy was most effective in the patients with minimal change lesion. 4. In the patient with membranous proliferative glomerulonephlitis, long-term angiotensin converting enzyme inhibitor treatment showed less deterioration of renal function.

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