Journal of Yeungnam Medical Science

Volume 28(2); December 2011

Reviews

Health Effects of Mercury Exposure through Fish.: Joon Sakong; Yeungnam Univ J Med. 2011;28(2):105-115. Published online December 31, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.2.105

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Mercury is atoxic, persistent pollutant that bioaccumulates and biomagnifies through food webs. People are exposed to methylmercury mainly through their diet, especially through the consumption of freshwater and marine fish and of other animals that consumefish (e.g., marinemammals). All humans are exposed to low levels of mercury. Dietary patterns can increase exposure toafish-eating population wherethefish and seafood arecontaminated with mercury. The primary toxicity targets of mercury and mercury compounds are the nervous system, kidneys, and cardiovascular system. It is generally accepted that developing organ systems are most sensitive to the toxic effects of mercury. The fetal-brain mercury levels appear to be significantly higherthan the maternal-blood mercury levels,and the developingcentralnervoussystem of the fetus is currently regarded as the main system of concern as it demonstrates the greatest sensitivity. The subpopulation that may be at greater risk for mercury toxicity are those exposed to higher levels of methylmercury due to carnivorous fish, including sharks.

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어패류의 구매 및 소비 패턴에 따른 소비자 영양, 위생, 안전 인식 분석
용희 석, 민준 이, 성희 민, 선희 채, 선옥 함
Korean Journal of Food and Cookery Science.2023; 39(4): 288. CrossRef
Women, Environment, and Health
박은교, 하은희, 김규연
JOURNAL OF THE KOREAN SOCIETY OF MATERNAL AND CHILD HEALTH.2014; 18(1): 54. CrossRef
Reference levels of blood mercury and association with metabolic syndrome in Korean adults
Sang-Yong Eom, Sun-Hee Choi, Su-Ju Ahn, Dong-Kyeong Kim, Dong-Won Kim, Ji-Ae Lim, Byung-Sun Choi, Hye-Jung Shin, Sin-Weon Yun, Hae-Jung Yoon, Yu-Mi Kim, Young-Seoub Hong, Yong-Woon Yun, Seok-Joon Sohn, Heon Kim, Kyung-Su Park, Hee-Soo Pyo, Ho Kim, Se-Youn
International Archives of Occupational and Environmental Health.2014; 87(5): 501. CrossRef

Various Abdominal Flaps for Breast Reconstruction: Pedicled TRAM, Free TRAM, Muscle-sparing TRAM, DIEP, and SIEA Flaps.: Jun Ho Lee; Yeungnam Univ J Med. 2011;28(2):116-123. Published online December 31, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.2.116

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Abstract PDF: The incidence of breast cancer, the second most prevalent cancer type in South Korea, has increased by 6.8% annually in the lastsix years.The higher number of breast cancer patients has led to an increase in the cases of skin-sparing mastectomies, thereby increasing the need for reconstructive procedures. The reconstruction options include alloplastic techniques such as implant or autologous reconstruction with numerous flaps. The abdominal area is the preferred donorsite for the harvest of autologous tissue for breast reconstruction. Breast reconstruction using abdonimal tissue is commonly accomplished using the transverse rectus abdominis myocutaneous (TRAM) flap. The establishment of microvascular surgery led to the development of the free TRAM flap because of its increased vascularity and decreased rectus abdominis sacrifice. The muscle-sparing TRAM, DIEP, and SIEA flap techniques were later developed in an effort to decrease the abdominal-donor-site morbidity by decreasing the injury to the rectus abdominis muscle and fascia. This article summarizes the various abdominal flaps for breast reconstruction.

Original Articles

Effects of Combined Antiplatelets on Bleeding in Off-Pump Coronary-Artery Bypass Surgery.: Su Kyeong Lee, Tae Jin Kim, Song Yun Seok, Sun Ho Jung, Kyung Ho Yang, Kang Joo Choi, Young Bok Kim; Yeungnam Univ J Med. 2011;28(2):124-132. Published online December 31, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.2.124

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Abstract PDF: BACKGROUND
Antiplatelet agent administration is critical in managing coronary-artery disease, but there is a concern regarding operation-related bleeding and an increase in blood transfusion in such, especially when delivering combined antiplatelet agents. This study was conducted to evaluate the effect of the administration of antiplatelet agents on off-pump coronary-artery bypass surgery (OPCAB). METHODS: From March 2003 to December 2009, 49 patients who had undergone OPCAB were collected retrospectively. The patients were divided into three groups according to the administration of antiplatelet agents before the OPCAB operation: 21 patients were given an aspirin agent (group 1), 19 patients were given combined agents (aspirin+clopidogrel) (group 2), and nine patients were not given any antiplatelet agent (group 3). The three groups' perioperative hematologic and coagulation profiles, including their platelet counts, hemoglobin levels, hematocrit, prothrombin times, and aPTTs (activated partial thromboplastin times), and their postoperative bleeding, related complications, transfusion requirements, and operation times, were compared. RESULTS: The operation time in group 2 was 4.3 hours, longer than those in the two other groups, and urgent operation was significantly most frequent in group 2 (63%). The amount of blood loss and the number of patients who received blood transfusion were not different in the three groups. The perioperative hemoglobin level, hematocrit, platelet count, prothrombin time, and aPTT were also not significantly different among the three groups. CONCLUSION: The continuous administration of antiplatelet agents to the patients in this study did not increase their postoperative bleeding or operation-related complications. Therefore, OPCAB may well be considered even if combined antiplatelet agents are being administered.

Tigecycline Treatment for Infections Caused by Multidrug-Resistant Pathogens.: Mi Jung Lee, A Young Seo, Sang Soo Bae, Dong Hyong Jeong, Kyung Hwa Yoon, Byung Sik Hwang, Sung Hoon Kang, Dae Myung Oh, Ki Tae Kwon, Shin Won Lee, Do Young Song; Yeungnam Univ J Med. 2011;28(2):133-144. Published online December 31, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.2.133

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Abstract PDF

BACKGROUND
Tigecycline (TIG), a new broad-spectrum glycylcycline with anti-multidrug-resistant-(MDR)-pathogen activity, was launched in March 2009 in South Korea, but there are insufficient clinical studies on its use in the country. As such, this study was performed to analyze cases of severe MDR-pathogen-caused infections treated with TIG. METHODS: Patients treated with TIG within the period from May 2009 to June 2010 were enrolled in this study. Their clinical and microbiologic data were reviewed retrospectively. RESULTS: Twenty-one patients were treated with TIG for complicated skin and soft-tissue infections (cSSTIs) (42.9%), complicated intra-abdominal infections (cIAIs) (38.1%), or pneumonia (19.1%) caused by MDR pathogens like carbapenem-resistant Acinetobacter baumannii (76.2%), methicillin-resistant Staphylococcus aureus (61.9%), extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae (38.1%), and penicillin-resistant Enterococcus species (33.3%). Thirteen patients (61.9%) had successful clinical outcomes while five (23.8%) died within 30 days. The rate of clinical success was highest in cSSTI (77.8%), followed by cIAI (50%) and pneumonia (50%), and the mortality rate was highest in pneumonia (50%), followed by cIAI (25%) and cSSTI (11.1%). CONCLUSION: Tigecycline therapy can be an option for the treatment of severe MDR-pathogen-caused infections in South Korea. Due to its high risk of failure and mortality, however, prudence is required in its clinical use for the treatment of severe infections like nosocomial pneumonia.

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Evaluation of Clinical outcomes after Tigecycline and Colistin Treatment against Multidrug-resistant Acinetobacter baumannii
Sunhee Park, 최인, 김혜미, 최은주
Journal of Korean Society of Health-System Pharmacists.2016; 33(3): 228. CrossRef

The Effects of Nanoparticles for Irradiation.: Ji Woon Yea, Hyun Jin Shin; Yeungnam Univ J Med. 2011;28(2):145-152. Published online December 31, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.2.145

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Abstract PDF: BACKGROUND
To evaluate the changes in the radiation dose and temperature distribution on irradiated egg albumin and nanoparticle (Fe3O4) powder mixed egg albumin. METHODS: A new type of phantom was designed by fabricating a 30x30x30cm acryl square inside a 3x3x3cm small square and dividing it into two parts. In the control group, only egg albumin was irradiated, and in the test group, 25nm 20mg/cc, 25nm 40mg/cc, and 1 um 40 mg/cc nanoparticles with egg albumin were irradiated. The radiation isodose distributions and temperature changes were then observed. RESULTS: No significant changes were observed in the radiation dose and temperature distribution. CONCLUSION: The nanoparticles were considered not to have had any effect on the radiation dose and temperature distribution under the experimental conditions. Further studies can be conducted based on the changes in the mixture material.

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.

Case Reports

A Case of Gastric Glomus Tumor.: Jin Sung Lee, Sun Taek Choi, Hyun Uk Lee, Byung Jin Kwon, Ji Eun Lee, Si Hyung Lee; Yeungnam Univ J Med. 2011;28(2):165-172. Published online December 31, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.2.165

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Abstract PDF: Gastric glomus tumor is a rare mesenchymal tumor that originates from modified smooth muscle cells of the glomus body. Glomus tumors are commonly observed in peripheral soft tissue, such as dermis or subungal region, but rarely in the gastrointestinal tract. A 39-year-old woman was admitted due to epigastric soreness. Upper gastrointestinal endoscopy revealed a subepithelial mass measuring 3.5cm with central ulceration at the lesser curvature-posterior wall of the antrum. Characteristically, contrast enhanced abdominal computed tomography scan demonstrated high enhancement of the submucosal mass up to the same level of the abdominal aorta in the arterial phase; this enhancement persisted to delayed phase. Due to the risk of bleeding and malignancy, wedge resection of the submucosal tumor was performed. Histologic findings were compatible with a glomus tumor.

Development of Steroid Myopathy during Polymyositis Treatment.: Ji Hoon Lee, Shin Young Hyun, Choong Ki Kim, Su Hwan Lee, A Ra Choi, Seong Woo Kim, Sung Hye Park, Chan Hee Lee; Yeungnam Univ J Med. 2011;28(2):173-179. Published online December 31, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.2.173

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Abstract PDF: Polymyositis is diffuse, inflammatory myopathy with proximal-muscle weakness due to lymphocyte infiltration to the muscle layer. The exact cause of the muscle weakness is unclear but may be related with an immunologic mechanism. Using high-dose steroid is the treatment of choice for polymyositis. It is difficult to distinguish steroid-resistant polymyositis from steroid myopathy, however, in the course of high-dose steroid therapy. These authors encountered a steroid myopathy patient during polymyositis treatment with high-dose steroid. A 57-year-old woman was diagnosed with polymyositis and was treated with high-dose steroid. Her condition was initially improved, but in the course of the treatment, her symptom was aggravated without increasing the muscle enzymes. Her muscle weakness was improved by reducing the steroid dosage.

Hepatocellular Carcinoma with Bile Duct Tumor Thrombi.: Hye Sun Shin, Ji Young Hong, Jung Woo Han, Fa Mee Doh, Gi Jeong Kim, Do Young Kim, Sang Hoon Ahn, Gi Hong Choi; Yeungnam Univ J Med. 2011;28(2):180-186. Published online December 31, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.2.180

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Abstract PDF

Obstruction of the bile duct owing to the direct extension of a tumor is occasionally found in patients with a hepatic neoplasm, but bile duct tumor thrombus caused by the intrabiliary transplantation of a free-floating tumor is a rare complication of hepatocellular carcinoma. A 50-year-old woman was diagnosed with HCC with bile duct tumor thrombi. She received transarterial chemoembolization (TACE) because her liver function was not suitable for surgery at the time of diagnosis. After TACE, infected biloma occurred recurrently. Thus, resection of the HCC, including the bile duct tumor thrombi, was performed. Six months after the surgery, recurred HCC in the distal common bile duct as drop metastasis was noted. The patient was treated with tomotherapy and has been alive for three years as of this writing, without recurrence. The prognosis of HCC with bile duct tumor thrombi is considered dismal, but if appropriate procedures are selected and are actively carried out, long-term survival can occasionally be achieved.

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Lipiodol-induced pneumonitis following transarterial chemoembolization for ruptured hepatocellular carcinoma
Haewon Kim, Yong Hoon Kim, Hong Jin Yoon, Kwang Hoon Lee, Seung Moon Joo, Min Kwang Byun, Jung Il Lee, Kwan Sik Lee, Ja Kyung Kim
Yeungnam University Journal of Medicine.2014; 31(2): 117. CrossRef

A Case of Cytomegalovirus Colitis in Chronic Adult T-Cell Leukemia/Lymphoma.: Han Seung Park, Dae Young Kim, Ji Beom Kim, Yun Ku Kim, Min Soo Cho, Tae Jin Ok, Sun Joo Jang, Kyoo Hyung Lee; Yeungnam Univ J Med. 2011;28(2):187-191. Published online December 31, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.2.187

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Abstract PDF: Adult T-cell leukemia/lymphoma (ATLL) is a malignancy of mature T-cells caused by the human T-cell lymphotrophic virus type I (HTLV-I). HTLV-I is endemic in some areas in Japan, the Caribbean basin, and Africa but has low prevalence in South Korea. Patients with ATLL are susceptible to opportunistic infections such as cytomegalovirus (CMV) infection, but CMV infection in chronic ATLL is uncommon. Reported herein is a case involving a 44-year-old woman with chronic ATLL who presented the symptoms of fever and diarrhea. She was suspected to have acute-type ATLL but was later diagnosed with CMV colitis.

A Case of Eosinophilic Bronchitis Associated with Tracheal Diverticulum.: Seung Hoon Yoo, Jae Ho Chung, Byung Soo Kang, Won Sik Kang, Won Jun Koh, Min Kyung Lee, Chan Sub Park; Yeungnam Univ J Med. 2011;28(2):192-195. Published online December 31, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.2.192

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Abstract PDF: Tracheal diverticulum is relatively rare. It results from congenital or acquired weakness of the tracheal wall. Most cases are asymptomatic, but when symptoms are present, they are usually nonspecific. A 54-year-old man complained of sputum lasting for several months. Chest computed tomography showed an air-containing cystic structure in the trachea. Fiberoptic bronchoscopy demonstrated ostium arising from the right posterolateral wall at the trachea. Reported herein is a case of eosinophilic bronchitis associated with tracheal diverticulum.

A Case of Sacral Tuberculosis Mimicking Metastatic Bone Tumor with Elevated CA 19-9.: Kyung Yoon Chang, Kyung Sun Ha, Kyung Seon Park, Eun Hui Sim, Jae Ho Byun; Yeungnam Univ J Med. 2011;28(2):196-201. Published online December 31, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.2.196

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Abstract PDF

A 73-year-old male presented a six-month history of buttock pain radiating into his thigh. The MRI revealed a large enhancing mass lesion involving the sacrum, with extension into the sacral canal. The tumor markers were measured to distinguish skeletal metastasis of carcinoma from primary bone tumor. The CA 19-9 was elevated. Despite the investigation, the primary site of cancer could not be found. Sacral bone biopsy was done. The pathologic examination revealed necrosis, chronic granulomatous inflammation, and multinucleated giant cells, consistent with tuberculosis. Sacral tuberculosis is rare in patients with no history of tuberculosis. Such solitary osteolytic lesions involving the subarticular region of large joints may mimic bone neoplasms and may be called "tuberculous pseudotumors." This case report intends to emphasize that bone tuberculosis should be a differential diagnosis in the presence of atypical clinical and radiological features. As tuberculous lesions may be mistaken for neoplasms, a small amount of fresh tissue should be sent for culture even if clinical diagnosis of a tumor seems likely. Described herein is a case of sacral tuberculosis mimicking metastatic bone tumor with elevated CA 19-9.

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Isolated Sacral Tuberculosis: A Case Report and Review of Literature of this Rare Sacral Pathology
Harshit Arora, Vasudha Sharma, Waryaam Singh, Lavanya Arora, Sumer Singh Nanda, Rajesh Pasricha
EMJ Neurology.2023;[Epub] CrossRef

A Case of Hypomyopathic Dermatomyositis.: Hyun Tae Kim, Hyun Wook Lee, Byung Jin Kwon, Ji Eun Lee, Dong Ho Oh, Min Su Sohn, Jung Ran Choi; Yeungnam Univ J Med. 2011;28(2):202-205. Published online December 31, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.2.202

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Abstract PDF: Dermatomyositis is a rare and idiopathic inflammatory myopathy with a characteristic cutaneous manifestation. A 62-year-old female complained of polyarthralgia that lasted for many years. She was diagnosed with hypomyopathic dermatomyositis by the typical skin rash associated with dermatomyositis but without muscle involvement such as muscle weakness, elevated level of creatinine phosphokinase and aldolase. Her symptoms improved with treatment of hydroxychloroquine and prednisolone. We experienced a case of hypomyopathic dermatomyositis on 62-year-old female patient and report with review of literatures.

A Case of Mixed Papillary Thyroid Tumor and Squamous-Cell Carcinoma.: Ho Su Kim, Jong Ryeal Hahm, Tae Sik Jung, Jung Hwa Jung, Soo Kyoung Kim, Sang Min Lee, Soon Il Chung; Yeungnam Univ J Med. 2011;28(2):206-210. Published online December 31, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.2.206

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Abstract PDF

The occurrence of a mixed tumor containing papillary thyroid carcinoma (PTC) and primary squamous-cell carcinoma (SCC) is rare because there is no squamous epithelium in the thyroid gland. Reported herein is a 30-year-old female with mixed PTC and primary SCC of the thyroid presented as thyroid incidentaloma. Fine-needle aspiration biopsy of the thyroid nodule revealed the presence of malignant thyroid cells. The histopathological examination following total thyroidectomy yielded two mixed, morphologically distinct histotypes that included PTC and SCC. After total thyroidectomy, the patient underwent radioactive iodine therapy. No recurrence or metastasis occurred during the 20-month follow-up period after the operation.

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Meta-Analysis of Squamous Cell Carcinoma of Thyroid
Hyun Seok Shim, Oh Jin Kwon, Joon Seok Ko, Jung Je Park, Jin Pyeong Kim, Chan Ryeul Jeong, Seung Hoon Woo
Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2013; 56(7): 425. CrossRef

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