Journal of Yeungnam Medical Science

Original articles

Cardiology and Cardiovascular Medicine
The performance of ASpirin-FREE therapy after successful percutaneous coronary intervention for acute coronary syndrome: the ASFREE prospective pilot study: Donghyeon Joo, Sungho Jo, Jeong Tae Byoun, Jae Young Cho, Kyeong Ho Yun; J Yeungnam Med Sci. 2026;43:25. Published online March 19, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.25

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Abstract PDF: Background
Dual antiplatelet therapy with aspirin and a P2Y12 inhibitor is standard after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS); however, bleeding risk remains a major concern. Early discontinuation of aspirin due to potent P2Y12 inhibition may mitigate bleeding without increasing thrombotic events.
Methods
The ASpirin-FREE therapy after successful percutaneous coronary intervention for acute coronary syndrome (ASFREE) study was an investigator-initiated, single-center, prospective, open-label, single-arm pilot study enrolling patients with ACS who underwent PCI with drug-eluting stents. All patients received a single loading dose of aspirin on the day of the PCI, followed by ticagrelor or prasugrel monotherapy. The primary efficacy endpoint was target vessel failure (TVF) at 12 months. The primary safety endpoint was definite stent thrombosis. Event rates are reported with 95% confidence intervals (CIs).
Results
In total, 228 patients were enrolled. TVF occurred in 10 patients (4.4%; 95% CI, 2.1%–7.9%). Definite stent thrombosis was observed in one patient (0.4%; 95% CI, 0.01%–2.4%), with no acute or subacute events. Major bleeding (Bleeding Academic Research Consortium type 3 or 5) occurred in two patients (0.9%; 95% CI, 0.1%–3.1%).
Conclusion
An aspirin-free strategy following a single loading dose with continuation of potent P2Y12 inhibitor monotherapy was feasible in patients with ACS undergoing PCI and was associated with low rates of thrombotic and major bleeding events. These findings should be regarded as hypothesis-generating and supporting further evaluations in adequately powered randomized controlled trials (CRIS registration: KCT0008182).

Biomedical Engineering
Gene expression-based machine learning model for diagnosis, prognosis, and treatment response prediction in hepatocellular carcinoma: a retrospective study: Tan Thinh Nguyen, Thanh Dat Nguyen, Phu Qui Le Nguyen, Phuong Thi Bui, Minh Nam Nguyen; J Yeungnam Med Sci. 2026;43:21. Published online March 4, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.21

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Abstract PDF Supplementary Material: Background
Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related mortality worldwide, largely because of challenges in early diagnosis and the limited sensitivity of conventional biomarkers. Therefore, reliable molecular tools for early detection, prognostic stratification, and individualized treatment predictions are urgently required.
Methods
This retrospective study analyzed publicly available gene expression datasets. Candidate biomarkers were identified from the GSE14520 cohort using a multistep screening workflow that integrated differential expression analysis, diagnostic performance, and prognostic relevance. A 10-gene diagnostic model was constructed using least absolute shrinkage and selection operator logistic regression and subsequently validated across multiple independent cohorts. Survival outcomes were evaluated using the Kaplan-Meier analysis and treatment responses to sorafenib and transarterial chemoembolization (TACE) were assessed using receiver operating characteristic analysis.
Results
A 10-gene signature (TOP2A, CDK1, CYP3A4, MASP2, EPHX2, HAO1, RACGAP1, GLYAT, ADH1B, and CYP4A11) was established. The model demonstrated robust internal performance and consistent accuracy across external validation cohorts (area under the curve [AUC], >0.9). This signature effectively identified early-stage HCC and distinguished malignancy from cirrhosis. High-risk scores were significantly associated with poor overall survival and recurrence-free survival (p<0.05). Furthermore, the model could predict treatment sensitivity, with higher risk scores associated with better outcomes for sorafenib (AUC, 0.791), whereas lower risk scores correlated with an improved response to TACE (AUC, 0.768).
Conclusion
Our gene expression-based machine learning model provides a robust tool for HCC diagnosis, prognosis, and treatment response prediction, with potential as a supportive system for personalized clinical decision-making.

Ophthalmology
Efficacy of high-dose vs. low-dose intravitreal ganciclovir for cytomegalovirus retinitis: a systematic review and meta-analysis: Seongyong Jeong, Areum Jeong, Jae Rock Do, Yong Koo Kang, Min Sagong; J Yeungnam Med Sci. 2026;43:13. Published online January 14, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.13

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Abstract PDF: Background
Intravitreal ganciclovir is widely used to achieve effective local antiviral concentrations for cytomegalovirus (CMV) retinitis; however, to our knowledge, standardized dosing strategies have not been established, and the reported regimens vary considerably across studies. In this study, we evaluated dose-dependent treatment outcomes of intravitreal ganciclovir for CMV retinitis.
Methods
The PubMed, Embase, Cochrane Library, and Scopus databases were searched through November 2025. Eligible studies included intravitreal ganciclovir monotherapy, with or without systemic antiviral therapy. Cumulative first-week intravitreal dose was calculated and classified as low dose (<4,000 μg) or high dose (≥4,000 μg). The pooled proportions for resolution, visual outcomes, recurrence, and retinal detachment were estimated using a random-effects model.
Results
Eighteen studies comprising 1132 eyes were included across all outcomes. The pooled proportion of anatomical resolution was 89% (95% confidence interval, 0.77–0.95), and 74% of eyes maintained stable or improved vision. Recurrence and retinal detachment occurred in 12% and 9% of the eyes, respectively. High-dose regimens achieved a significantly higher resolution than low-dose regimens (94% vs. 73%, p=0.019). Visual outcomes did not differ according to dose (77% vs. 73%, p=0.646). Recurrence also showed no dose-dependent difference (14% vs. 8%, p=0.654) and was observed predominantly in patients before the introduction of highly active antiretroviral therapy. The retinal detachment rates were similar (9% vs. 10%, p=0.780).
Conclusion
Initial intravitreal dosing at ≥4,000 μg within the first week achieved better retinitis resolution, supporting the benefit of a higher local ganciclovir concentration in the treatment of CMV retinitis.

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

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

Review articles

Anesthesiology and Pain Medicine
Acute postoperative pain control in pediatric patients: a scoping review: Eun Kyung Choi, Sang-Jin Park, Seong Wook Hong; J Yeungnam Med Sci. 2026;43:1. Published online December 10, 2025; DOI: https://doi.org/10.12701/jyms.2026.43.1

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Abstract PDF: Acute postoperative pain results from tissue injury during surgery and subsequent inflammatory responses. The incidence of chronic postsurgical pain ranges from 10% to 30%, and its development is influenced by various clinical factors, including psychological, biological, and social determinants. Optimal management of acute postoperative pain is crucial for enhancing patient satisfaction, preventing adverse outcomes in the immediate postoperative period, and minimizing progression to chronic postoperative pain. In particular, postoperative pain in pediatric patients is often underestimated and inadequately managed because of developmental differences in pain perception, expression, and challenges in assessment. Therefore, age-appropriate and validated assessment tools that consider cognitive development and situational factors are required. Given age-related variability in pharmacokinetics and pharmacodynamics, individualized multimodal analgesic strategies with careful dose adjustments should be utilized. These approaches have demonstrated improved analgesic efficacy and enhanced recovery outcomes in pediatric surgical patients. A comprehensive understanding of pediatric pain pathophysiology, combined with appropriate methods of pain assessment and management strategies, should be selected to promote postoperative recovery and reduce morbidity.

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.

Citations

Citations to this article as recorded by

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

Communications

Pulmonary and Respiratory Medicine
Rehabilitative goals for patients undergoing lung retransplantation: Massimiliano Polastri, Robert M. Reed; J Yeungnam Med Sci. 2024;41(2):134-138. Published online April 5, 2024; DOI: https://doi.org/10.12701/jyms.2024.00241

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Abstract PDF

Lung retransplantation (LRT) involves a second or subsequent lung transplant (LT) in a patient whose first transplanted graft has failed. LRT is the only treatment option for irreversible lung allograft failure caused by acute graft failure, chronic lung allograft dysfunction, or postoperative complications of bronchial anastomosis. Prehabilitation (rehabilitation before LT), while patients are on the waiting list, is recognized as an essential component of the therapeutic regimen and should be offered throughout the waiting period from the moment of listing until transplantation. LRT is particularly fraught with challenges, and prehabilitation to reduce frailty is one of the few opportunities to address modifiable risk factors (such as functional and motor impairments) in a patient population in which there is clearly room to improve outcomes. Although rehabilitative outcomes and quality of life in patients receiving or awaiting LT have gained increased interest, there is a paucity of data on rehabilitation in patients undergoing LRT. Frailty is one of the few modifiable risk factors of retransplantation that is potentially preventable. As such, it is imperative that professionals involved in the field of retransplantation conduct research specifically exploring rehabilitative techniques and outcomes of value for patients receiving LRT, because this area remains unexplored.

Citations

Citations to this article as recorded by

Experimental and Clinical Transplantation.2024;[Epub] CrossRef
Postoperative conditions of rehabilitative interest in lung transplantation: a systematic review
Massimiliano Polastri, Esra Pehlivan, Robert M. Reed, Allaina Eden
Journal of Yeungnam Medical Science.2024; 41(4): 235. 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

Case reports

Thoracic and Cardiovascular Surgery
Treatment of phlegmonous esophagitis in various patients: a case series: Han Sol Lee, Chul Ho Lee, Yun-Ho Jeon; J Yeungnam Med Sci. 2023;40(4):442-447. Published online April 26, 2023; DOI: https://doi.org/10.12701/jyms.2023.00136

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Abstract PDF

Acute phlegmonous esophagitis (APE) is a rare and fatal disease. Phlegmonous infection involves the submucosal layer and muscularis propria but not the mucosal layer. Because surgery is not the first treatment option for this disease, an accurate diagnosis is crucial. Herein, we report three cases of APE with various clinical features. All patients were successfully treated with antibiotics and appropriate medical procedures.

Citations

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Case Report: A rare case of oesophageal cellulitis caused by Klebsiella pneumoniae: diagnosis, management, and literature review
Jinfeng Yang, Tengyan Wang, Weiwen Yang, Jian Zhu, Chen Pan
Frontiers in Medicine.2026;[Epub] CrossRef
Acute Diffuse Phlegmonous Esophagitis Involving the Entire Esophagus with Septic Shock: A Case Report and Literature Review
Xiaoyan Xian, Binrong Cai, Yiqin Xia
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A Rare Case of Candida-Induced Acute Phlegmonous Esophagitis Complicated by Pericarditis and Myocarditis
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Dentistry
Oral chemical burns caused by topical application of policresulen: a case report: Hwa Suk Chae, Sohee Kang; J Yeungnam Med Sci. 2023;40(3):293-296. Published online October 20, 2022; DOI: https://doi.org/10.12701/jyms.2022.00472

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Abstract PDF: Oral mucosal burns can occur after contact with various chemical agents, and commonly manifest as areas of mucosal sloughing and ulceration. Policresulen (Albothyl, Celltrion Pharm Inc.) is an over-the-counter topical antiseptic that is frequently used to treat stomatitis. Policresulen solution is highly acidic, with an approximate pH of 0.6; it can thus cause mucosal injury when improperly applied in the oral cavity. Here, we present a rare case of an oral mucosal burn resulting from incorrect self-administration of policresulen and emphasize the importance of increasing understanding of this adverse drug event among consumers and health professionals.

Focused Review article

Anesthesiology and Pain Medicine
The mechanism of action of pulsed radiofrequency in reducing pain: a narrative review: Donghwi Park, Min Cheol Chang; J Yeungnam Med Sci. 2022;39(3):200-205. Published online April 7, 2022; DOI: https://doi.org/10.12701/jyms.2022.00101

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Abstract PDF

Pain from nervous or musculoskeletal disorders is one of the most common complaints in clinical practice. Corticosteroids have a high pain-reducing effect, and their injection is generally used to control various types of pain. However, they have various adverse effects including flushing, hyperglycemia, allergic reactions, menstrual changes, immunosuppression, and adrenal suppression. Pulsed radiofrequency (PRF) is known to have a pain-reducing effect similar to that of corticosteroid injection, with nearly no major side effects. Therefore, it has been widely used to treat various types of pain, such as neuropathic, joint, discogenic, and muscle pain. In the current review, we outlined the pain-reducing mechanisms of PRF by reviewing previous studies. When PRF was first introduced, it was supposed to reduce pain by long-term depression of pain signaling from the peripheral nerve to the central nervous system. In addition, deactivation of microglia at the level of the spinal dorsal horn, reduction of proinflammatory cytokines, increased endogenous opioid precursor messenger ribonucleic acid, enhancement of noradrenergic and serotonergic descending pain inhibitory pathways, suppression of excitation of C-afferent fibers, and microscopic damage of nociceptive C- and A-delta fibers have been found to contribute to pain reduction after PRF application. However, the pain-reducing mechanism of PRF has not been clearly and definitely elucidated. Further studies are warranted to clarify the pain-reducing mechanism of PRF.

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Pain and Therapy.2024; 13(5): 1271. CrossRef
Efficacy and Safety of Pulsed Radiofrequency of Dorsal Root Ganglion in Elderly Patient Population With Acute and Subacute Zoster‐Related Pain
Gözde Dağıstan, Serdar Erdine, Massimiliano Valeriani
Pain Research and Management.2024;[Epub] CrossRef
Effectiveness of combining greater occipital nerve block and pulsed radiofrequency treatment in patients with chronic migraine: a double-blind, randomized controlled trial
Tuba Tanyel Saraçoğlu, Ayten Bılır, Mehmet Sacit Güleç
Head & Face Medicine.2024;[Epub] CrossRef
Two-Centre Retrospective Analysis on Selective Sensory Denervation of Shoulder Joint by Means of Cooled Radiofrequency in Chronic Shoulder Pain
Carola Santi, Thomas Haag, Christian Cooke, Michael Schatman, Andrea Tinnirello
Journal of Pain Research.2024; Volume 17: 3139. CrossRef
A central and peripheral dual neuromodulation strategy in pain management of zoster-associated pain
Xuelian Li, Huaxiang Zhang, Xu Zhang, Ke Ma, Yan Lv, Tao Song, Gangwen Guo, Dong Huang
Scientific Reports.2024;[Epub] CrossRef
Pulsed Radiofrequency on Sphenopalatine Ganglion as the Interventional Pain Management in Cluster Headache Secondary to Sphenoid Meningioma
Naomi Rahmasena, Mirza Koeshardiandi, Fajar Tri Mudianto
Indonesian Journal of Anesthesiology and Reanimation.2024; 6(1): 32. CrossRef
The efficacy of ultrasound-guided pulsed radiofrequency in the treatment of primary glossopharyngeal neuralgia
Fubo Li, Hongcheng Lu, Gege Gong, Cehua Ou, Yue Zhang
Frontiers in Neurology.2024;[Epub] CrossRef
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Hiroki Nakamura, Ikuo Uekita, Keiji Hashizume
Cureus.2024;[Epub] CrossRef
Comparison of two distinct needle tip positions in pulsed radiofrequency for herpes zoster‐related pain
Shao‐jun Li, Dan Feng
CNS Neuroscience & Therapeutics.2023; 29(7): 1881. CrossRef
Previous Lumbar Spine Surgery Decreases the Therapeutic Efficacy of Dorsal Root Ganglion Pulsed Radiofrequency in Patients with Chronic Lumbosacral Radicular Pain
Jiri Jandura, Milan Vajda, Roman Kostysyn, Jiri Vanasek, Eva Cermakova, Jan Zizka, Pavel Ryska
Journal of Personalized Medicine.2023; 13(7): 1054. CrossRef
Spinal Injections: A Narrative Review from a Surgeon’s Perspective
Dong Ah Shin, Yoo Jin Choo, Min Cheol Chang
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Original article

Thoracic and Cardiovascular Surgery
Intensive care unit management of uncomplicated type B aortic dissection in relation to treatment period: a retrospective observational study: Chul Ho Lee, Jae Seok Jang, Jun Woo Cho; J Yeungnam Med Sci. 2022;39(4):294-299. Published online February 10, 2022; DOI: https://doi.org/10.12701/jyms.2021.01690

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Abstract PDF: Background
Medical therapy is the standard treatment for uncomplicated acute type B aortic dissection (ATBAD), but there is little evidence of the need for intensive care unit (ICU) management. Therefore, we aimed to investigate the effects of ICU treatment on uncomplicated ATBAD.
Methods
We retrospectively studied patients with uncomplicated ATBAD who were medically treated between January 2010 and July 2020. Patients were divided into long-term ICU stay (LIS) and short-term ICU stay (SIS) groups, according to a 48-hour cutoff of ICU stay duration. The incidence of pneumonia and delirium, rate of aortic events, hospital mortality, and survival rate were compared.
Results
Fifty-five patients were treated for uncomplicated ATBAD (n=26 for LIS and n=29 for SIS). The incidence of pneumonia (7.7% vs. 3.6%) and delirium (34.6% vs. 14.3%) was higher in the LIS group than in the SIS group, but the differences were not statistically significant. The survival rates at 1, 3, and 5 years were not different between the two groups (LIS: 96.2%, 88.0%, and 54.2% vs. SIS: 96.4%, 92.2%, and 75.5%, respectively; p=0.102). Multivariate Cox regression analysis for aortic events showed that using a calcium channel blocker lowered the risk of aortic events.
Conclusion
Long-term ICU treatment is unlikely to be necessary for the treatment of uncomplicated ATBAD. Active use of antihypertensive agents, such as calcium channel blockers, may be needed during the follow-up period.

Focused Review article

Psychiatry and Mental Health
An update on the cause and treatment of sleep disturbance in children and adolescents with autism spectrum disorder: Wan Seok Seo; Yeungnam Univ J Med. 2021;38(4):275-281. Published online September 13, 2021; DOI: https://doi.org/10.12701/yujm.2021.01410

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223 Download
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Abstract PDF

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by abnormalities in social communication/interaction and restrictive, repetitive patterns of behavior. ASD is a relatively common psychiatric disorder, with a prevalence of approximately 1.7% in children. Although many children and adolescents with ASD visit the hospital for medical help for emotional and behavioral problems such as mood instability and self-harming behavior, there are also many visits for sleep disturbances such as insomnia and sleep resistance. Sleep disturbances are likely to increase fatigue and daytime sleepiness, impaired concentration, negatively impact on daytime functioning, and pose challenges in controlling anger and aggressive behavior. Sleep disturbance in children and adolescents with ASD negatively affects the quality of life, nothing to say the quality of life of their families and school members. In this review, sleep disturbances that are common in children and adolescents with ASD and adolescents are presented. The developmental and behavioral impacts of sleep disturbances in ASD were also considered. Finally, non-pharmacological and pharmacological treatments for sleep disturbances in children and adolescents with ASD and adolescents are reviewed.

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Review articles

Radiology, Radiotherapy & Diagnostic Imaging
Avulsion injuries: an update on radiologic findings: Changwon Choi, Sun Joo Lee, Hye Jung Choo, In Sook Lee, Sung Kwan Kim; Yeungnam Univ J Med. 2021;38(4):289-307. Published online August 13, 2021; DOI: https://doi.org/10.12701/yujm.2021.01102

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Abstract PDF

Avulsion injuries result from the application of a tensile force to a musculoskeletal unit or ligament. Although injuries tend to occur more commonly in skeletally immature populations due to the weakness of their apophysis, adults may also be subject to avulsion fractures, particularly those with osteoporotic bones. The most common sites of avulsion injuries in adolescents and children are apophyses of the pelvis and knee. In adults, avulsion injuries commonly occur within the tendon due to underlying degeneration or tendinosis. However, any location can be involved in avulsion injuries. Radiography is the first imaging modality to diagnose avulsion injury, although advanced imaging modalities are occasionally required to identify subtle lesions or to fully delineate the extent of the injury. Ultrasonography has a high spatial resolution with a dynamic assessment potential and allows the comparison of a bone avulsion with the opposite side. Computed tomography is more sensitive for depicting a tiny osseous fragment located adjacent to the expected attachment site of a ligament, tendon, or capsule. Moreover, magnetic resonance imaging is the best imaging modality for the evaluation of soft tissue abnormalities, especially the affected muscles, tendons, and ligaments. Acute avulsion injuries usually manifest as avulsed bone fragments. In contrast, chronic injuries can easily mimic other disease processes, such as infections or neoplasms. Therefore, recognizing the vulnerable sites and characteristic imaging features of avulsion fractures would be helpful in ensuring accurate diagnosis and appropriate patient management. To this end, familiarity with musculoskeletal anatomy and mechanism of injury is necessary.

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Otorhinolaryngology
Current diagnosis and treatment of vestibular neuritis: a narrative review: Chang Hoon Bae, Hyung Gyun Na, Yoon Seok Choi; J Yeungnam Med Sci. 2022;39(2):81-88. Published online August 9, 2021; DOI: https://doi.org/10.12701/yujm.2021.01228

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Abstract PDF

Vertigo is the sensation of self-motion of the head or body when no self-motion is occurring or the sensation of distorted self-motion during an otherwise normal head movement. Representative peripheral vertigo disorders include benign paroxysmal positional vertigo, Ménière disease, and vestibular neuritis. Vestibular neuritis, also known as vestibular neuronitis, is the third most common peripheral vestibular disorder after benign paroxysmal positional vertigo and Ménière disease. The cause of vestibular neuritis remains unclear. However, a viral infection of the vestibular nerve or ischemia of the anterior vestibular artery is known to cause vestibular neuritis. In addition, recent studies on immune-mediated mechanisms as the cause of vestibular neuritis have been reported. The characteristic clinical features of vestibular neuritis are abrupt true-whirling vertigo lasting for more than 24 hours, and no presence of cochlear symptoms and other neurological symptoms and signs. To accurately diagnose vestibular neuritis, various diagnostic tests such as the head impulse test, bithermal caloric test, and vestibular-evoked myogenic potential test are conducted. Various treatments for vestibular neuritis have been reported, which are largely divided into symptomatic therapy, specific drug therapy, and vestibular rehabilitation therapy. Symptomatic therapies include generalized supportive care and administration of vestibular suppressants and antiemetics. Specific drug therapies include steroid therapy, antiviral therapy, and vasodilator therapy. Vestibular rehabilitation therapies include generalized vestibular and customized vestibular exercises.

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Original articles

Neurosurgery
Personal experience with microvascular decompression and partial sensory rhizotomy for trigeminal neuralgia: Jung Hwan Lee, Jae Meen Lee, Chang Hwa Choi; Yeungnam Univ J Med. 2021;38(3):202-207. Published online November 23, 2020; DOI: https://doi.org/10.12701/yujm.2020.00745

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139 Download
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Abstract PDF

Background
Trigeminal neuralgia (TN) is a severe, paroxysmal pain in the distribution of the fifth cranial nerve. Microvascular decompression (MVD) is the most widely used surgical treatment for TN. We undertook this study to analyze the effects of and complications of MVD and to refine the surgical procedure for treating TN.
Methods
A total of 88 patients underwent for TN underwent surgery at our hospital. Among them, 77 patients underwent MVD alone, and 11 underwent partial sensory rhizotomy (PSR) with or without MVD. The medical records of these patients were retrospectively analyzed for patient characteristics, clinical results, offending vessels, and complications if any.
Results
The mean follow-up duration was 43.2 months (range, 3–216 months). The most common site of pain was V2+V3 territory (n=27), followed by V2 (n=25) and V3 (n=23). The most common offending vessels were the superior cerebellar artery and anterior inferior cerebellar artery in that order. The overall rate of postoperative complications was 46.1%; however, most complications were transient. There were two cases of permanent partial hearing disturbance. In the MVD alone group, the cure rate was 67.5%, and the improvement rate was 26.0%. Among 11 patients who underwent PSR with or without MVD, the cure rate was 50.0%, and the improvement rate was 30.0%.
Conclusion
The clinical results of MVD were satisfactory. Although the outcomes of PSR were not as favorable as those of pure MVD in this study, PSR can be considered in cases where there is no significant vascular compressive lesion or uncertainty of the causative vessel at the surgery.

Citations

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Partial sensory rhizotomy in therapy-refractory and recurrent trigeminal neuralgia – a single center experience
Ina Lange, Ehab El Refaee, Marc Matthes, Henry W. S. Schroeder, Jörg Baldauf
Acta Neurochirurgica.2026;[Epub] CrossRef
Revisiting the Efficacy of Redo Microvascular Decompression for Trigeminal Neuralgia
Zhongding Zhang, Hua Zhao, Yinda Tang, Baimiao Wang, Qing Yuan, Ying Zhang, Yihua Li, Jun Zhong, Shiting Li
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A systematic review on the efficacy of adjunctive surgical strategies during microvascular decompression for trigeminal neuralgia without intraoperative evidence of neurovascular conflict
Nicola Montano, Grazia Menna, Alessandra Musarra, Renata Martinelli, Alessandro Izzo, Quintino Giorgio D’Alessandris, Manuela D’Ercole, Alessandro Olivi
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滨何
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A. N. Zhurkin, A. V. Semenov, V. A. Sorokovikov, N. V. Bartul
Acta Biomedica Scientifica.2021; 6(4): 123. CrossRef
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Nephrology
The relationship between disability and clinical outcomes in maintenance dialysis patients: Seok Hui Kang, Jun Young Do, Jun Chul Kim; Yeungnam Univ J Med. 2021;38(2):127-135. Published online October 15, 2020; DOI: https://doi.org/10.12701/yujm.2020.00346

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Abstract PDF

Background
Dialysis patients are prone to having disabilities. We aimed to evaluate the association between disability and various clinical outcomes in Korean dialysis patients.
Methods
This study consisted of 1,615 dialysis patients from 27 centers. We evaluated disability by using four questions on the activities of daily living (ADLs) concerning whether help was needed for feeding, dressing/undressing, getting in/out of bed, or taking a bath/shower. We divided the patients into three groups: no disability (Non-D, none of the four ADL domains required help; n=1,312), mild disability (Mild-D, one ADL domain required some/full help; n=163), or moderate to severe disability (MS-D, two or more ADL domains required some/full help; n=140). We evaluated falls, frailty, health-related quality of life (HRQoL), mortality, and hospitalization.
Results
The numbers of participants with a fall during the last 1 year were 199 (15.2%), 42 (25.8%), and 44 (31.4%) in the Non-D, Mild-D, and MS-D groups, respectively (p<0.001). The numbers of participants with frailty in the Non-D, Mild-D, and MS-D groups were 381 (29.0%), 84 (51.5%), and 93 (66.4%), respectively (p<0.001). In both univariate and multivariate analyses, the physical component scale and mental component scale scores decreased as the grade of disability increased (p<0.001 for both scores). Hospitalization-free survival rate at 500 days was 64.2%, 56.7%, and 51.1% in the Non-D, Mild-D, and MS-D, respectively (p=0.001 for trend). Patient survival rate at 500 days was 95.3%, 89.5%, and 92.3% in the Non-D, Mild-D, and MS-D, respectively (p=0.005 for trend).
Conclusion
Disability was associated with falls, frailty, HRQoL scales, and survival trends in Korean dialysis patients.

Citations

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Case reports

Pediatrics, Perinatology, and Child Health
Delayed treatment-free response after romiplostim discontinuation in pediatric chronic immune thrombocytopenia: Hyun Ji Lim, Young Tae Lim, Jeong Ok Hah, Jae Min Lee; Yeungnam Univ J Med. 2021;38(2):165-168. Published online August 7, 2020; DOI: https://doi.org/10.12701/yujm.2020.00493

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We report the case of a 16-month-old patient with chronic immune thrombocytopenia (ITP) patient who experienced delayed treatment-free response (TFR) after romiplostim treatment. He received intravenous immunoglobulin every month to maintain a platelet count above 20,000/μL for 2 years. Thereafter, he received rituximab and cyclosporine as second-line therapy, with no response, followed by romiplostim. After 4 weeks of treatment, the platelet count was maintained above 50,000/μL. Following 7 months of treatment, he discontinued romiplostim, and the platelet count decreased. His platelet counts remained above 50,000/μL, without any bleeding symptoms, 2 years after romiplostim discontinuation. This is the first report of TFR after romiplostim treatment in pediatric chronic ITP.

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Tapering and Sustained Remission of Thrombopoietin Receptor Agonists (TPO-RAs): Is it Time for Paediatric ITP?
Susana Marcos-Peña, Beatriz Fernández-Pernia, Drew Provan, Tomás José González-López
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A cost–utility analysis of thrombopoietin receptor agonists for treating pediatric immune thrombocytopenia purpura after failure of first‐line therapies
Huimin Du, Jiamin Wang, Joel Livingston, Ziyad Alrajhi, Melanie Kirby‐Allen, Brian Chan, Rebecca Hancock‐Howard, Peter C. Coyte
Pediatric Blood & Cancer.2023;[Epub] CrossRef
Generic romiplostim for children with persistent or chronic immune thrombocytopenia: Experience from a tertiary care centre in North India
Chandana Mareddy, Manas Kalra, Anupam Sachdeva
British Journal of Haematology.2022; 197(5): 618. CrossRef
Tapering of the thrombopoietin receptor agonist in paediatric patients with chronic immune thrombocytopenia: Is it possible?
María Solsona, Rubén Berrueco, Elena Sebastián, Áurea Cervera, Ana Sastre, Itziar Astigarraga, Bienvenida Argilés, María Ángeles Dasí, José Luís Dapena, Emilio Monteagudo
British Journal of Clinical Pharmacology.2022; 88(9): 4220. CrossRef

Urology
Ureterosciatic hernia causing obstructive uropathy successfully managed with minimally invasive procedures: Yeong Uk Kim, Jae Ho Cho, Phil Hyun Song; Yeungnam Univ J Med. 2020;37(4):337-340. Published online July 29, 2020; DOI: https://doi.org/10.12701/yujm.2020.00402

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Abstract PDF

Ureterosciatic hernia is extremely rare. In ureteral herniation, ureter prolapses occur through either the greater or lesser sciatic foramen. Atrophy of the piriformis muscle, hip joint diseases, and defects in the parietal pelvic fascia are predisposing factors for the development of ureterosciatic hernia. Most symptomatic patients have been treated surgically, with conservative treatment reserved only for asymptomatic patients. To the best of our knowledge, long-term follow-up outcomes after ureterosciatic hernia management are sparse. In this paper, we report the case of a 68-year-old woman who presented with colicky left abdominal pain. After computed tomography (CT) scan and anterograde pyelography, she was diagnosed ureterosciatic hernia with obstructive uropathy. We performed ureteral balloon dilatation and double-J ureteral stent placement. After this minimally invasive procedure, CT scan demonstrated that the left ureter had returned to its normal anatomical position without looping into the sciatic foramen. The patient remained asymptomatic with no adverse events 7 years after the minimally invasive procedures. This brief report describes ureterosciatic hernia successfully managed with minimally invasive procedures with long-term follow-up outcomes.

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Review articles

Physical therapy, Sports Therapy, and Rehabilitation
Effectiveness of orthoses for treatment in patients with spinal pain: Yoo Jin Choo, Min Cheol Chang; Yeungnam Univ J Med. 2020;37(2):84-89. Published online March 24, 2020; DOI: https://doi.org/10.12701/yujm.2020.00150

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Abstract PDF

Spinal pain is a common patient complaint in clinical practice. Conservative treatment methods include oral medication, physical therapy, injections, and spinal orthoses. The clinical application of orthoses is debated because of potential complications associated with long-term use, such as muscle weakness and joint contracture. We reviewed the orthoses most frequently used to manage spinal pain. We review the use of soft cervical and Philadelphia collars, lumbosacral corsets, and thoracolumbosacral orthosis to manage spinal pain. Spinal orthoses can help reduce pain by protecting the muscles and joints of the injured spinal region, preventing or correcting malformations, and limiting trunk flexion, extension, lateral flexion, and rotation. The short-term use of spinal orthoses is known to improve pain and disability during the treatment period without significant adverse effects. Spinal orthoses are expected to alleviate pain and improve patients’ lifestyle.

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Orthopedics and Sports Medicine
Forefoot disorders and conservative treatment: Chul Hyun Park, Min Cheol Chang; Yeungnam Univ J Med. 2019;36(2):92-98. Published online May 14, 2019; DOI: https://doi.org/10.12701/yujm.2019.00185

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Abstract PDF

Forefoot disorders are often seen in clinical practice. Forefoot deformity and pain can deteriorate gait function and decrease quality of life. This review presents common forefoot disorders and conservative treatment using an insole or orthosis. Metatarsalgia is a painful foot condition affecting the metatarsal (MT) region of the foot. A MT pad, MT bar, or forefoot cushion can be used to alleviate MT pain. Hallux valgus is a deformity characterized by medial deviation of the first MT and lateral deviation of the hallux. A toe spreader, valgus splint, and bunion shield are commonly applied to patients with hallux valgus. Hallux limitus and hallux rigidus refer to painful limitations of dorsiflexion of the first metatarsophalangeal joint. A kinetic wedge foot orthosis or rocker sole can help relieve symptoms from hallux limitus or rigidus. Hammer, claw, and mallet toes are sagittal plane deformities of the lesser toes. Toe sleeve or padding can be applied over high-pressure areas in the proximal or distal interphalangeal joints or under the MT heads. An MT off-loading insole can also be used to alleviate symptoms following lesser toe deformities. Morton’s neuroma is a benign neuroma of an intermetatarsal plantar nerve that leads to a painful condition affecting the MT area. The MT bar, the plantar pad, or a more cushioned insole would be useful. In addition, patients with any of the above various forefoot disorders should avoid tight-fitting or high-heeled shoes. Applying an insole or orthosis and wearing proper shoes can be beneficial for managing forefoot disorders.

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Original Article

Orthopedics and Sports Medicine
Could immediate treatment change the management method of digital tendon musculotendinous junction avulsion?: a systematic review: Sam Guk Park; Yeungnam Univ J Med. 2017;34(2):200-207. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.200

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Abstract PDF: BACKGROUND
We conducted a systematic review of the literature to investigate the correlation between the interval to treatment and management of tendon avulsion ruptures in the musculotendinous junction (MTJ) of the forearm. METHODS: A thorough literatures search for studies of tendon avulsion injuries at the forearm was conducted using PubMed, MEDLINE, CINAHL, and Cochrane databases in accordance with the PRISMA guidelines. In total, five case series and 15 case reports accounting for 87 injured tendons involving 60 patients were selected for the analysis. RESULTS: Twenty-six patients had 44 tendon injuries associated with avulsion amputations, 31 patients had 38 tendon ruptures associated with closed avulsion injuries and three patients had five tendon ruptures associated with open avulsion injuries. Eighteen of the 49 (37%) patients were immediately treated for tendon ruptures and one of the 32 (3%) tendon ruptures treated via elective surgery was directly repaired. Additionally, 18 of the 30 (60%) tendons were directly repaired and 12 of the 30 (40%) tendons were transferred or side-to-side repaired in the immediately treated series. In contrast, one of the 28 (4%) tendon ruptures were directly repaired and 27 of the 28 (96%) tendons were transferred or side-to-side repaired in the electively treated series. CONCLUSION: In managing digital tendon avulsions at the MTJ, an immediate treatment could provide an opportunity to repair the ruptured tendon directly to the muscle.

Case Reports

Cardiology and Cardiovascular Medicine
Successful emergency transcatheter aortic valve implantation.: Jung Hee Lee, Ah Young Ji, Young Ju Kim, Changho Song, Moo Nyun Jin, Sun Wook Kim, Myeong Ki Hong, Geu Ru Hong; Yeungnam Univ J Med. 2014;31(2):144-147. Published online December 31, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.2.144

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Abstract PDF: Despite the necessity of surgical aortic valve replacement, many patients with symptomatic severe aortic stenosis (AS) cannot undergo surgery because of their severe comorbidities. In these high-risk patients, percutaneous transcatheter aortic valve implantation (TAVI) can be safely accomplished. However, no study has shown that TAVI can be performed for patients with severe AS accompanied by acute decompensated heart failure. In this case report, 1 patient presented a case of severe pulmonary hypertension with decompensated heart failure after diagnosis with severe AS, and was successfully treated via emergency TAVI. Without any invasive treatment, acute decompensated heart failure with severe pulmonary hypertension is common in patients with severe AS, and it can increase mortality rates. In conclusion, TAVI can be considered one of the treatment options for severe as presented as acute decompensated heart failure patients with pulmonary hypertension.

Rheumatology
A Case of Successful Treatment of Refractory Synovitis Acne Pustulosis Hyperostosis Osteitis (SAPHO) Syndrome with Adalimumab.: Jin Taek Yoo, Young Hwan Kim, Soon Myung Jung, Sang Chang Kwon, Seung Min Ryu, Jun Ouk Ha, Joung Wook Lee; Yeungnam Univ J Med. 2013;30(1):55-57. Published online June 30, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.1.55

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Abstract PDF: Synovitis acne pustulosis hyperostosis osteitis (SAPHO) syndrome is a rare disease that involves the skin, bones and joints. It is thought to be caused by infection with low-toxicity bacteria and to be the result of reactive infectious osteitis. However, this hypothesis has not yet been clearly established. New SAPHO syndrome treatment methods are needed because the disease does not respond to treatment in many cases. In this paper, a case is reported of SAPHO syndrome with pain in the acromioclavicular joint and with squamous and pustular macules on the palms and soles. First, the patient was treated with aceclofenac, prednisolon and sulfasalazine for two weeks. However, the symptoms were not relieved, so methotrexate and pamidronate were added to the treatment. Since no improvement was seen after four weeks of treatment, adalimumab was prescribed. The skin lesions were relieved two weeks later, and the bone pain and arthralgia, four weeks later. No recurrence or adverse effects were observed at the 22-week follow-up.

Reviews

Urology
Current Trend of the Primary Treatment in Lower Urinary Tract Symptom/Benign Prostatic Hyperplasia.: Hee Chang Jung; Yeungnam Univ J Med. 2009;26(2):85-92. Published online December 31, 2009; DOI: https://doi.org/10.12701/yujm.2009.26.2.85

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Abstract PDF

Clinical benign prostatic hyperplasia (BPH) is a multifaceted phenomenon that is due to prostatic and bladder influences as well as nonurological causes. It is also important to differentiate between the more common voiding or obstructive symptoms as well as the more bothersome storage or irritative symptoms. Lower urinary tract symptoms (LUTS) and BPH may be two separate conditions with different underlying pathologies. However, they are often treated incorrectly as one entity. Both conditions are very common and they represent chronic conditions of the aging male. They are often associated with a significant reduction in the patients' quality of life. Although these are not new conditions, there have been enormous changes in the methods of assessing and managing the patients with these conditions. This review describes some of the influential studies in this area and the current trends of the primary treatment for LUTS/BPH.

Citations

Citations to this article as recorded by

Image Analysis of Computer Aided Diagnosis using Gray Level Co-occurrence Matrix in the Ultrasonography for Benign Prostate Hyperplasia
Jin-Young Cho, Chang-Soo Kim, Se-Sik Kang, Seong-Jin Ko, Soo-Young Ye
The Journal of the Korea Contents Association.2015; 15(3): 184. 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.

Case Report

Radiology, Radiotherapy & Diagnostic Imaging
Endovascular Treatment of Ruptured Dissecting Basilar Artery Aneurysm: One Case Report: Woo Mok Byun, Bok Hwan Park; Yeungnam Univ J Med. 2007;24(2 Suppl):S636-641. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S636

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Abstract PDF: Optimal treatment for ruptured dissecting basilar artery aneurysms in patients presenting with SAH is endovascular method using stent placement and coil embolization. We report a case (52-year-old woman) of ruptured dissecting aneurysm of the basilar artery which was treated with stent placement and coil embolization.

Original Articles

Pediatrics, Perinatology, and Child Health
Etiology of Treatment Related Mortality after Hematopoietic Stem Cell Transplantation: Yong Jik Lee, Jeong Ok Hah; Yeungnam Univ J Med. 2007;24(2 Suppl):S569-579. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S569

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Abstract PDF: Bactground：The etiologies of treatment related mortality (TRM) after hematopoietic stem cell transplantation (HSCT) have been variable according to the disease status or the centers. We evlauated the etiologies of TRM for the pediatric patients at Yeungnam University Hospital (YNUH). Materials and Methods：The records of 66 patients, 19 years of age or younger, who had HSCT at YNUH from September 1995 to August 2007 were reviewed.
Results
：Among 66 patients, allogeneic bone marrow transplantation (Allo-BMT) was done in 21 (19 related, 2 unrelated), allogeneic peripheral blood stem cell transplantation (Allo- PBSCT) in 1, cord blood transplantation (CBT) in 12 (1 related, 11 unrelated), autologous peripheral blood stem cell transplantation (Auto-PBSCT) in 32 patients. The TRM rates of Allo-BMT, CBT, and Auto-PBSCT were 19%, 33.3%, and 12.5%, respectively. Among four patients who had TRM after Allo-BMT, two were related transplantation and the others were unrelated. All four patients developed severe acute GVHD of at least grade Ⅲ. Sepsis developed in three patients, acute renal failure (ARF) in two, veno-occlusive disease (VOD) and thrombotic microangiopathy (TMA) in one patient each. All four patients who had TRM after CBT had two mismatches in HLA-A, B, DR, and engraftment syndrome developed in three. Sepsis developed in all four patients, VOD in two, encephalopathy in two, TMA and ARF in one patient each. All four patients who had TRM after Auto-PBSCT developed sepsis and ARF in two, VOD and TMA in one patient each.
Conclusion
：Although the number of cases were not large enough for firm conclusion, sepsis was the most common TRM after HSCT. Therefore, prevention and control of sepsis are very important in reducing TRM after HSCT. Outcomes of severe acute GVHD after Allo-BMT and engraftment syndrome after CBT are very poor and contribute for TRM. Continuous effort to reduce the incidence of GVHD and engraftment syndrome are needed.

Surgery
Surgical Treatment of BCG Lymphadenitis: Nam Hyuk Lee; Yeungnam Univ J Med. 2007;24(2 Suppl):S562-568. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S562

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Abstract PDF: Background
：Regional lymphadenitis is a common complication after BCG vaccination and has various clinical course. Various treatment, including medical, surgical, and combined are used to treat BCG lymphadenitis, but results are controversial. This study was performed to provide guidelines for surgical approach to BCG lymphadenitis. Materials and Methods：37 patients with BCG lymphadenitis at Yeungnam University Hospital between March 2004 and August 2007 were retrospectively reviewed. Suppurative BCG lymphadenitis were treated by surgical excision or incision and curettage. Non-suppurative BCG lymphadenitis were observed without any treatment and surgical treatment was applied when it became suppurative.
Results
：The mean age was 7.5 months(range 2-47 months) and most prevalent site of lesion was the ipsilateral axilla. Among 37 cases, 20 cases were already suppurative when diagnosed and 2 cases of 17 non-suppurative BCG lymphadenitis showed spontaneous resolution without any treatment. Surgery was performed successfully on 35 suppurative BCG lymphadenitis and postoperative complication was trivial.
Conclusion
：Suppurative BCG lymphadenitis were successfully treated with excision or incision and curettage without any serious complication. So non-suppurative BCG lymphadenitis can be observed expecting spontaneous resolution.

Review Articles

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

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Abstract PDF

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

Citations

Citations to this article as recorded by

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

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

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

Surgery
Treatment Options for Early Gastric Cancer: Sang Woon Kim; Yeungnam Univ J Med. 2007;24(2 Suppl):S152-158. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S152

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Abstract PDF: Patients with early gastric cancer (EGC) have had a good prognosis with conventional gastrectomy and radical lymph node dissection. The conventional surgery revealed some kinds of early and late complications which may hurt patients seriously. Therefore, treatment options for EGC which preserve patients’ quality of life with maintaining a high level of curability have been developed. In surgeon’s field, these include limited gastrectomy with or without modified lymph node resection, gastrectomy with vagal nerve preservation, pylorus preserving gastrectomy, and laparoscopic gastrectomy. Laparoscopic gastrectomy has introduced a new concept of procedure in the treatment of EGC. Endoscopic mucosal resection (EMR) by endoscopist has also become a standard treatment option for EGC with limited indications. The development of endoscopic submucosal dissection (ESD) expanded the clinical relevance of EMR. Certain treatment options for EGC, such as laparoscopic surgery or EMR, are known to be good options for EGC treatment, but the long-term results should be confirmed by randomized prospective study before becoming standard treatments. At present. these less invasive treatment should be applied under the strict indications.

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

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

Review

Orthopedics and Sports Medicine
Current Concepts in Arthroscopic Treatment of Anterior Shoulder Instability.: Jae Sung Seo; Yeungnam Univ J Med. 2003;20(1):13-27. Published online June 30, 2003; DOI: https://doi.org/10.12701/yujm.2003.20.1.13

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Abstract PDF: In the past, the report of shoulder instability undergoing open shoulder stabilization had satisfactory outcomes of greater than 90%. However, the functional loss of open procedure is severe in abduction and external rotation especially. Current arthroscopic techniques for shoulder instability result in success rate equal to open surgical procedure when the labrum is properly fixed to the glenoid rim using suture anchors, the capsule is tightened, and associated bony and soft tissue pathology is addressed. The arthroscopic surgery facilitates the view within shoulder joint for more accurate diagnosis, reduces operating time, minimises postoperative pain, reduces operative morbidity, improves shoulder function, and provides the possibility to perform other procedure simultaneously. However, to accomplish a successful arthroscopic stabilization procedure and to prevent complications, numerous advanced arthroscopic skill must be mastered. Although the arthroscope provides means to visualize new lesions, the pathomechanism and biomechanical explanation is not clear yet. Further studies are necessary to develop for shoulder reconstruction.

Original Articles

Thoracic and Cardiovascular Surgery
Clinical Analysis of Patch Repair of Ventricular Septal Defect in Infant.: Tae Eun Jung, Jang Hoon Lee, Dong Hyup Lee, Jung Cheul Lee, Sung Sae Han, Sae Yeun Kim, Dae Lim Ji; Yeungnam Univ J Med. 2002;19(2):99-106. Published online December 31, 2002; DOI: https://doi.org/10.12701/yujm.2002.19.2.99

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Abstract PDF: BACKGROUND
Simple ventricular septal defect(VSD) is the most common congenital heart disease. Although closure of VSD is currently associated with a relatively low risk, experience with younger and smaller infants has been variably less satisfactory. We assessed the results of surgical closure of VSD in infant. MATERIALS AND METHODS: Between 1996 and 2000, 45 non-restrictive VSD patients underwent patch repair and retrospective analysis was done. Patients were divided into two groups based on weight: group I infants weighed 5kg or less(n=16), and group II infants weighed more than 5kg(n=29). Both groups had similar variation in sex, VSD location, aortic cross clamp time and total bypass time. But combined diseases (ASD, PDA, MR) were more in group I. We closed VSD with patch and used simple continuous suture method in all patients. RESULTS: There were no operative mortality, no reoperation for hemodynamically significant residual shunt and no surgically induced complete heart block. As a complication, pneumonia(group I: 2 cases, group II: 2 cases), transient seizure(group II: 2), wound infection(group I: 1, group II: 1), urinary tract infection(group I: 1) and chylopericardium(group I: 1) developed, and there was no significant difference between two groups(p>0.05). CONCLUSION: Early primary closure with simple continuous suture method was applicable in all patients with non-restrictive VSD without any serious complications.

Orthopedics and Sports Medicine
Operative Treatment of Tibial Plateau Fractures.: Duck Seop Shin, Byeong Yeon Seong, Dong Won Kim; Yeungnam Univ J Med. 2001;18(2):187-198. Published online December 31, 2001; DOI: https://doi.org/10.12701/yujm.2001.18.2.187

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Abstract PDF: BACKGROUND
The purpose of this study was to evaluate the relationship between variable factors and clinical results following the operative treatment of the tibial plateau fractures. MATERIALS AND METHODS: The clinical and radiological analysis was performed on 29 cases of the tibial plateau fractures who had been treated with operative treatment and followed up for more than 1 year from January 1991 to December 1997. The analysis of clinical results was performed dividing into age, cause of injury, fracture type of Schatzker classification, associated soft tissue injury and method of operative treatment. RESULTS: According to Schatzker classification, 2 cases(6.9%) were type I, 11 cases(37.9%) were type II, 1 case(3.5%) was type III, 5 cases(17.2%) were type IV, 4 cases(13.8%) were type V, and 6 cases(20.7%) were type VI. In all cases, bony unions were obtained. According to Blokker evaluation, 23 cases(79.3%) of 29 cases were acceptable. CONCLUSION: We could expect good clinical results if early knee joint mobilization following minimal invasive open reduction and internal fixation could be obtained. Bad clinical results were related with young age group under 30, more than Schatzker classification type IV of high energy trauma and associated injury of anterior cruciated ligment or meniscus.

Radiation Oncology
Evaluation of Treatment Response Using Diffusion-Weighted MRI in Metastatic Spines.: Jang Jin Lee, Sei One Shin; Yeungnam Univ J Med. 2001;18(1):30-38. Published online June 30, 2001; DOI: https://doi.org/10.12701/yujm.2001.18.1.30

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Abstract PDF: BACKGROUND
The purpose of this study was to evaluated the usefulness of diffusion-weighted magnatic resonance imaging for monitoring the response to radiation therapy in metastatic bone marrow of the spines. MATERIALS AND METHOD: Twenty-one patients with metastatic bone marrow of the spine were examined with MRI. Diffusion-weighted and spin-echo MRI were performed in 10 patients before and after radiation therapy with or without systematic chemotherapy, and performed in 11 patiemts after radiation therapy alone. Follow up spin-echo and diffusion-weighted MRI were obtained at 1 to 6 months after radiation therapy according to patients' condition. The diffusion-weighted imaging sequence was based on reversed fast imaging with steady-state precession(PSIF). Signal intensity changes of the metastatic bone marrows before and after radiation therapy on conventional spin-echo sequence MRI and diffusion-weighted MRI were evaluated. Bone marrow contrast ratios and signal-to-noise ratio before and after radiation therapy of diffusion-weighted MRI were analyzed. RESULTS: All metastatic bone marrow of the spinal bodies were hyperintense to normal bone marrow of the spinal bodies on pretreatment diffusion-weighted MRI and positive bone marrow contrast ratio(p<0.001). and hypointense to normal spinal bodies on posttreatment diffusion-weighted MRI and negative bone marrow contrast ratio(p<0.001). The signal to noise ratio after treatment decreased comparing with those of pretreatment. Decreased signal intensity of the metastatic bone marrows on diffusion-weighted MRI began to be observed at average more than one month after the initiation of the radiation therapy. CONCLUSION: tThese results suggest that diffusion-weighted MRI would be an excellent method for monitoring the response to therapy of metastatic bone marrow of the spinal bodies. However, must be investigated in a larger series of patients with longer follow up period.

Case Report

Neurosurgery
The Treatment of Giant Middle Artery Aneurysm with MDS Coil: Case Report.: Gwang Shik Choi, Sung Ho Kim, Jung Ho Bae, O Lyong Kim, Byung Youn Choi, Soo Ho Cho, Woo Mok Byun; Yeungnam Univ J Med. 1997;14(1):237-244. Published online June 30, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.1.237

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Abstract PDF: A 14-year old boy was admitted with stuporous mentality. CT scan, MRI and cerebral angiogram revealed SAH and a giant aneurysm of right middle cerebral artery(4x5x5.3cm). To minimize surgical risk, endovascular treatment was done with MDS(mechanical detachable system)-spiral coil. Follow up MRI showed intraluminal thrombus formation of the aneurysm.

Original Article

Radiation Oncology
Radiation therapy of nasopharyngeal cancers.: Sei One Shin, Sung Kyu Kim, Myung Se Kim; Yeungnam Univ J Med. 1992;9(2):312-320. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.312

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Abstract PDF: Radiotherapeutically, nasopharyngeal caner is an important disease in Korea. Because of its blind anatomic location, early detection is relatively uncommon. Clinically, most of cases are locally advanced and nodal involvements are common. Recently better understanding of nature of the disease and improvement of radio – therapy technique permit better treatment result, including locoregional control and survival rate, and minimal normal tissue damages comparing with previously published date. We analyzed 31 patients of pathologically proven and previously untreated naso – pharyngeal carcinoma with different treatment techniques, retrospectively. Minimal and maximal follow up period of the survivor is 6 months and 68 months, respectively. Thirteen patients with squamous cell carcinoma are included in this analysis. The median age is 49 years (range from 20 to 64 years). Twenty two patients are stage III. Eleven patients are treated with radiotherapy alone and 20 are treated with combined modalities treatment. The degree of response after radiotherapy are categorized by 3-classes, i,e. complete response, partial response. In spite of similarities of complete response rate and 1-year survival rate between two different treatment techniques, those patients with undifferentiated carcinoma appear to benefit from the adjuvant chemotherapy. In addition, systemic failure is more suggest that adjuvant therapy in the radiotherapeutic management of nasopharyngeal cancer needs additional research according to histologic types and future extensive clinical trials.

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