Journal of Yeungnam Medical Science

Volume 34(1); June 2017

Reviews

Can we rejuvenate? Implications of biological aging research: Youlim Son, Jae Ryong Kim; Yeungnam Univ J Med. 2017;34(1):1-10. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.1

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Abstract PDF: The life history of man is summarized as a birth-aging-disease-death. Man eventually ages and dies. How long can humans live? What is aging? Why do we age? Is aging inevitable? Can we rejuvenate? Recent researches on biological aging suggest that humans might overcome aging and rejuvenate. In this paper, we review the biologic characteristics of aging and the latest results of biological aging research, implicating that aging can be controlled, further treated, and that humans can ultimately be rejuvenated.

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

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

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

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

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

Original Articles

Clinical significance of saccade test, smooth pursuit test, and optokinetic nystagmus test in nystagmography: Yoon Seok Choi, Hyung Gyun Na, Si Youn Song, Yong Dae Kim, Chang Hoon Bae; Yeungnam Univ J Med. 2017;34(1):29-36. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.29

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Abstract PDF

BACKGROUND
Saccade test, smooth pursuit test, and optokinetic nystagmus test are clinically useful tests to accurately diagnose vertigo. However, there have only been a few studies regarding a correlation between the anatomical site of the lesion and the abnormality of eyeball movement in patients with vertigo. METHODS: The medical records of 97 patients with vertigo between January 2006 and June 2008 were reviewed retrospectively. We classified many kinds of abnormalities regarding the saccade test, smooth pursuit test and optokinetic nystagmus test into several categories and analyzed the localizing lesion of vertigo. RESULTS: According to the saccade test, both total saccade abnormality (S-total) and slow velocity of saccade (S-type 3) were shown to be significantly higher in the central lesion of vertigo. According to the smooth pursuit test, symmetrical unidirectional smooth pursuit abnormality (SP-type 2) was observed to be significantly higher in the peripheral lesion over vertigo. Moreover, according to the optokinetic nystagmus test, total optokinetic nystagmus abnormalities (OKN-total) were shown to be significantly useful findings in the diagnosis of the central lesion of vertigo. The coexisting abnormalities of all three tests (S+SP+OKN abnormalities) were shown to be significantly higher in the central lesion of vertigo. CONCLUSION: These results suggest that all these tests, saccade test, smooth pursuit test, and optokinetic nystagmus test, are very useful to distinguish between the central lesion and the peripheral lesion of vertigo. However, these tests are not beneficial in localizing the central lesion of vertigo.

Citations

Citations to this article as recorded by

Current diagnosis and treatment of vestibular neuritis: a narrative review
Chang Hoon Bae, Hyung Gyun Na, Yoon Seok Choi
Journal of Yeungnam Medical Science.2022; 39(2): 81. CrossRef
Dizziness in Patients With Obstructive Sleep Apnea
Jae Rim Kim, Soo Ryun Park, Hea Ree Park, Eun Yeon Joo
Journal of Sleep Medicine.2022; 19(2): 39. CrossRef

A comparison of 0.075% and 0.15% of ropivacaine with fentanyl for postoperative patient controlled epidural analgesia after laparoscopic gynecologic surgery: Hyun Chul Jung, Hyo Jung Seo, Deok Hee Lee, Sang Jin Park; Yeungnam Univ J Med. 2017;34(1):37-42. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.37

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Abstract PDF: BACKGROUND
A motor blockade of lower limbs interferes with early ambulation and limits the usefulness of patient-controlled epidural analgesia (PCEA). The concentration of local anesthetic solution is a major determinant for motor block with PCEA. We compared the effects of epidural infusion of 0.075% ropivacaine with 0.15% epidural ropivacaine on postoperative analgesia, motor block of lower limbs, and other side effects. METHODS: A total of 70 patients undergoing laparoscopic gynecologic surgery received epidural infusions (group R1, 0.15% ropivacaine with fentanyl; group R2, 0.075% ropivacaine with fentanyl). Pain score, motor block, and side effects (hypotension, nausea, vomiting, pruritus, urinary retention, dizziness, and numbness) were measured. RESULTS: There were no significant differences in the demographic profiles between the groups. Pain scores of the group R1 and the group R2 were not significantly different. Motor block was more frequent in the group R1 (0.15% ropivacaine with fentanyl) than in the group R2 (0.075% ropivacaine with fentanyl). CONCLUSION: Lower concentration of ropivacaine (0.075%), when compared with higher concentration of ropivacaine (0.15%), seemed to provide similar analgesia with less motor blockade of the lower limbs for the purpose of PCEA.

Sulfatase 1 mediates the inhibitory effect of angiotensin II type 2 receptor inhibitor on angiotensin II-induced hypertensive mediator expression and proliferation in vascular smooth muscle cells from spontaneously hypertensive rats: Hye Young Kim, Hye Ju Cha, Hee Sun Kim; Yeungnam Univ J Med. 2017;34(1):43-54. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.43

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Abstract PDF

BACKGROUND
Extracellular sulfatases (Sulfs), sulfatase 1 (Sulf1) and sulfatase 2 (Sulf2), play a pivotal role in cell signaling by remodeling the 6-O-sulfation of heparan sulfate proteoglycans on the cell surface. The present study examined the effects of Sulfs on angiotensin II (Ang II)-induced hypertensive mediator expression and vascular smooth muscle cells (VSMCs) proliferation in spontaneously hypertensive rats (SHR). METHODS: Ang II receptors, 12-lipoxygenase (12-LO), and endothelin-1 (ET-1) messenger RNA (mRNA) expressions in SHR VSMCs were analyzed by real-time polymerase chain reaction and Western blotting. VSMCs proliferation was determined by [³ H]-thymidine incorporation. RESULTS: Basal Sulfs mRNAs expression and enzyme activity were elevated in SHR VSMCs. However, Sulfs had no effect on the basal or Ang II-induced 12-LO and ET-1 mRNA expression in SHR VSMCs. The inhibition of Ang II-induced 12-LO and ET-1 expression by blockade of the Ang II type 2 receptor (AT₂ R) pathway was not observed in Sulf1 siRNA-transfected SHR VSMCs. However, Sulf2 did not affect the action of AT₂ R inhibitor on Ang II-induced 12-LO and ET-1 expression in SHR VSMCs. The down-regulation of Sulf1 induced a reduction of AT₂ R mRNA expression in SHR VSMCs. In addition, the inhibition of Ang II-induced VSMCs proliferation by blockade of the AT₂ R pathway was mediated by Sulf1 in SHR VSMCs. CONCLUSION: These findings suggest that extracellular sulfatase Sulf1 plays a modulatory role in the AT₂ R pathway that leads to an Ang II-induced hypertensive effects in SHR VSMCs.

Citations

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Sulfatase 1 mediates IL-10-induced dimethylarginine dimethylaminohydrolase-1 expression and antiproliferative effects in vascular smooth muscle cells of spontaneously hypertensive rats
Hye Young Kim, Hee Sun Kim
Cytokine.2021; 137: 155344. CrossRef
Sulfatase 2 mediates, partially, the expression of endothelin-1 and the additive effect of Ang II-induced endothelin-1 expression by CXCL8 in vascular smooth muscle cells from spontaneously hypertensive rats
Hye Young Kim, Dae Won Jeong, Hee Sun Kim
Cytokine.2019; 114: 98. CrossRef

Associations between smartphone addiction scale and sociopsychological aspects in medical school students: Hye In Kim, Seong Hi Cheon, Hwa Jeong Kang, Keunmi Lee, Seung Pil Jung; Yeungnam Univ J Med. 2017;34(1):55-61. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.55

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Abstract PDF

BACKGROUND
Smartphone addiction, academic stress and anxiety of university students are increasing gradually; however, few studies have investigated these factors in medical school students. Therefore, this study investigated associations between smartphone addiction scale and sociopsychological aspects in medical school students. METHODS: A total of 231 Yeungnam University College of Medicine students were enrolled in this study in March 2017. Gender, school grade, type of residence, and smartphone usage patterns of the students were surveyed. The Korean Smartphone Addiction Proneness Scale and each Korean version scale were used to assess sociopsychological aspects such as loneliness, stress and anxiety. RESULTS: There was a direct statistical correlation between loneliness, stress of negative perception, anxiety and smartphone addiction scales. There was also a negative statistical correlation between stress of positive perception and smartphone addiction scales. There was a higher level of anxiety among female students than male students. Additionally, there was a higher level of stress associated with negative perception and anxiety among medical students in the first grade than other students. Moreover there was a higher level of loneliness, stress of negative perception and anxiety among students who live with friends than students who live with their own family. CONCLUSION: Smartphone addiction scale and sociopsychological aspects significantly correlated. Moreover, the results suggest that female medical students in the first grade who have been separated from their family need more attention and management of loneliness, stress and anxiety to avoid smartphone addiction.

Citations

Citations to this article as recorded by

Effect of smartphone addiction on mental health and sleep quality among undergraduate pharmacy students in a Nigerian public university
Chibueze Anosike, Mario-Ephraim Afam Ogbu, Ezinwanne Jane Ugochukwu, Rita Chinenye Osefo, Jonathan Chimaobi Nwaji
The Journal of Mental Health Training, Education and Practice.2024; 19(4): 201. CrossRef
Exploring the role of cognitive fusion and experiential avoidance in predicting smartphone use among medical university students
Jimin Lee, Seunghee Won, Sung Man Chang, Byung-Soo Kim, Seung Jae Lee
Journal of Contextual Behavioral Science.2023; 28: 18. CrossRef
Prevalence of Addictive Behaviors in Medical Students and Their Association With Stress
Jimin Lee, Seunghee Won, Sung Man Chang, Byung-Soo Kim, Seung Jae Lee
Psychiatry Investigation.2022; 19(1): 44. CrossRef
How addicted are newly admitted undergraduate medical students to smartphones?: a cross-sectional study from Chitwan medical college, Nepal
Sirisa Karki, Jaya Prasad Singh, Gita Paudel, Sushma Khatiwada, Sameer Timilsina
BMC Psychiatry.2020;[Epub] CrossRef

Student selection factors of admission and academic performance in one medical school: Keunmi Lee, Taeyoon Hwang, So young Park, Hyoungchul Choi, Wanseok Seo, Philhyun Song; Yeungnam Univ J Med. 2017;34(1):62-68. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.62

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Abstract PDF: BACKGROUND
This study was conducted to examine the academic achievements of first year medical students in one medical school based on their characteristics and student selection factors of admission. METHODS: The admission scores of student selection factors (Medical Education Eligibility Test [MEET], grade point average [GPA], English test score and interview) and demographic information were obtained from 61 students who had interviewed (multiple mini interview [MMI]) for admission (38 graduate medical school students in 2014, 23 medical college-transfer students in 2015). T-tests and ANOVA were used to examine the differences in academic achievement according to the student characteristics. Correlations between admission criteria scores and academic achievements were examined. RESULTS: MEET score was higher among graduate medical students than medical college transfer students among student selection factors for admission. There were no significant differences in academic achievement of first grade medical school between age, gender, region of high school, years after graduation and school system. The lowest interview score group showed significantly lower achievement in problem-based learning (PBL) (p=0.034). Undergraduate GPA score was positively correlated with first grade total score (r=0.446, p=0.001) among admission scores of student selection factors. CONCLUSION: Students with higher GPA scores tend to do better academically in their first year of medical school. In case of interview, academic achievement did not lead to differences except for PBL.

Follow-up of thyroid ultrasonography in patients with hemodialysis: Hyun Jung Kim, Bo Ra Kim, Yeong Mi Seo, Yoon Young Cho, Jong Ha Baek, Kyong Young Kim, Soo Kyung Kim, Seung Hoon Woo, Jung Hwa Jung, Jaehoon Jung, Jong Ryeal Hahm; Yeungnam Univ J Med. 2017;34(1):69-74. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.69

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Abstract PDF: BACKGROUND
Chronic kidney disease is considered a risk factor for thyroid nodules as well as thyroid dysfunction such as hypothyroidism. Among patients on hemodialysis, we assessed the size of thyroid nodule and goiter at baseline and 1 year later with ultrasonography. METHODS: We prospectively selected 47 patients with hemodialysis at January 2012 and reviewed their medical records. We checked goiter and thyroid nodules at January 2012 and December 2012. RESULTS: In the hemodialysis patients (n=47), 24 patients (51.1%) had thyroid nodules and 33 patients (70.2%) had goiter at baseline. Parathyroid hormone (PTH) was higher in patients with thyroid nodules (204.4±102.9 vs. 129.9±93.6 pg/mL, p=0.01). Thyroid ultrasonography was conducted in 29 patients after 1 year. The thickness of the thyroid isthmus increased (2.8±1.6 vs. 3.2±1.9 mm, p=0.003), but the number of nodules did not change (1.2±1.9 vs. 1.4±2.0, p=0.109). PTH was associated with the enlargement of thyroid nodules significantly through logistic regression analysis. CONCLUSION: Thyroid goiter and nodules in hemodialysis patients were more prevalent than in the general population. PTH influenced the production of thyroid nodules in hemodialysis patients. Regular examination with thyroid ultrasonography and thyroid function test should be considered in hemodialysis patients.

Case Reports

Conservative treatment of cytomegalovirus colitis with bowel perforation in an immunocompetent patient: case report and review of literature: Kyoung Sik Nam, Hee Ug Park, Min Gi Park, Su Ho Park, Ji Yeon Hwang, Dong Kyu Kim, Sung Jun Kim; Yeungnam Univ J Med. 2017;34(1):75-79. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.75

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Abstract PDF: Cytomegalovirus (CMV) colitis, which is rare in an immunocompetent patient, was encountered in a 67-year-old man who was admitted due to persistent diarrhea. The first diagnostic tool was colonoscopy, which showed multiple ulcers from cecum to rectum. The secondary tool was CMV polymerase chain reaction, and CMV colitis was diagnosed. Intravenous ganciclovir therapy was administered, which resulted in improvement of diarrhea and ulcers throughout the colon were healed. Asymptomatic colon perforation was detected during diagnostic testing, which improved over the conventional treatment. CMV colitis is rare in immunocompetent patients, but it is essential for the differential diagnosis.

Ankylosing spondylitis associated with balanced reciprocal X-1 translocation: Young Hoon Kim, Jung Ouk Lee; Yeungnam Univ J Med. 2017;34(1):80-83. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.80

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Abstract PDF: A number of research papers have reported more frequent occurrence of rheumatic/autoimmune disease among patients with hypogonadism or a chromosomal anomaly with potential X-chromosome defects. A 30-year-old female patient came to the hospital with a main cause of bilateral buttock pain, which began two years ago and worsened seven days ago. Ankylosing spondylitis with invasion of both sacral-iliac joints was observed. On magnetic resonance imaging, although the uterus was observed normally, an ovary was not observed. In a chromosome test, balanced reciprocal X-1 translocation of 46,X,t(X;1)(p10;q10) was diagnosed. Here, we report on the first case involving ankylosing spondylitis accompanied by balanced reciprocal X-1 translocation.

Multifocal nodular lymphoid hyperplasia of the lung: Gil Tae Lee, Eun Kyoung Kim, Eirie Cho, Seung Sook Lee, Seo Yun Kim, Cheol Hyeon Kim, Hye Ryoun Kim; Yeungnam Univ J Med. 2017;34(1):84-87. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.84

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Abstract PDF: Nodular lymphoid hyperplasia (NLH) is a benign lymphoproliferative disease that can affect the lung. Because of its rarity, little is known about the etiology and natural history of NLH. Most cases are usually asymptomatic and found incidentally on imaging studies. Imaging finding of NLH has shown most commonly as a solitary lesion, although multifocal pulmonary nodules may be seen. Surgical resection has proved curative in the cases previously described. We report a rare case of NLH in a 55 year-old man who presented with bilateral multiple pulmonary nodules on chest radiography. Open biopsy was performed from the upper and lower lobe of the left lung. The lesions were pathologically diagnosed as pulmonary NLH. Multifocal residual nodules in both lungs remain stable without spontaneous regression during the 3 years of follow-up.

Massive bleeding from a rectal Dieulafoy lesion in a patient with alcoholic cirrhosis: Young Hoon Choi, Jong Ryeol Eun, Jae Ho Han, Hyun Lim, Jung A Shin, Gun Hwa Lee, Seung Hee Lee; Yeungnam Univ J Med. 2017;34(1):88-90. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.88

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Abstract PDF: Although Dieulafoy lesion can occur in any part of the gastrointestinal tract, its occurrence in the rectum is rare. Rectal Dieulafoy lesions have been associated with advanced age, renal failure, burns, liver transplantation and cirrhosis. Here, we report on a case of massive bleeding from a rectal Dieulafoy lesion after lung decortication surgery in a 57-year-old male patient with alcoholic cirrhosis. Although rare, a rectal Dieulafoy lesion should be included in the differential diagnosis of massive lower gastrointestinal bleeding in a patient with cirrhosis.

Bronchogenic cyst masquerading as malignant pericardial effusion with tamponade: Kang Un Choi, Byung Jun Kim, Hong Ju Kim, Jang Won Son, Jong Seon Park, Dong Gu Shin, Young Jo Kim; Yeungnam Univ J Med. 2017;34(1):91-95. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.91

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Abstract PDF: We report on a rare case involving a 23-year-old female patient with mediastinal cystic mass complicated with acute pericarditis and cardiac tamponade. Pericardial fluid demonstrated lymphocyte-predominant exudate and the level of carcinoembryonic antigen (CEA) was unexpectedly elevated. Successive aspiration of mediastinal cystic mass revealed a very high level of CEA (>100,000 U/mL) and carbohydrate antigen 19-9 (>15,000 ng/mL). This patient was clinically diagnosed as an infected bronchogenic cyst complicated with pericarditis and cardiac tamponade. The treatment resulted in alleviation of her symptoms.

Amebic liver abscesses resulting in diagnosis of human immunodeficiency virus infection: Seok Weon Kim, Hyeok Choon Kwon, Seung Woo Nam, Jong Kyung Choi, Joo Won Chung, Dong Won Jang, Soo Yoen Park; Yeungnam Univ J Med. 2017;34(1):96-100. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.96

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Abstract PDF: Amebic liver abscess (ALA) is the most common extraintestinal manifestation of amebiasis. Amebiasis, a parasitic infection caused by Entamoeba histolytica, used to be a prevalent protozoan disease in Korea, however, with an improving sanitary system, it has been among very uncommon etiology of liver abscess. A recent report suggested that ALA is an emerging parasitic infection in human immunodeficiency virus (HIV)-infected patients even in areas where the disease is not endemic and recommended HIV screening in patients in areas where ALA is not endemic, particularly those without history of travel to a disease-endemic area. We report on two patients who were admitted for treatment of ALA and then diagnosed as HIV infection. We also reviewed the etiology and characteristics of ALA in our hospital during the last 5 years.

Rheumatoid arthritis accompanied by Gitelman syndrome: Min Gi Park, Ji Hyun Lee, Sung Jun Kim, Su Ho Park, Suk Ki Park, Joon Sul Choi, Ji Yeon Hwang; Yeungnam Univ J Med. 2017;34(1):101-105. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.101

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Abstract PDF: Gitelman syndrome is a condition caused by a mutation of the thiazide sensitive Na-Cl cotransporter gene on the distal convoluted tubule. It results in a variety of clinical features, including hypokalemia, hypomagnesemia, hypocalciuria, and metabolic alkalosis. It is often diagnosed in asymptomatic adults presented with unexplained hypokalemia; however, it is sometimes associated with muscular cramps, numbness, fatigue, weakness, or paralysis. We experienced a case of rheumatoid arthritis accompanied by Gitelman syndrome, presented with hand tremor. We diagnosed her using renal clearance study and genetic analysis. Here, we report our experiences regarding this case along with a literature review.

Acute myocardial infarction with a giant left main aneurysm in atypical Kawasaki disease: Min Wook Kim, Hyun Soo Kim, Myung Dong Lee, Hyun Sook Jung, Seong Bo Yoon, Young Woo Kim; Yeungnam Univ J Med. 2017;34(1):106-110. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.106

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Abstract PDF: Kawasaki disease (KD) is an acute vasculitis of small and medium sized arteries. Even many years after onset, aneurysms and stenosis in coronary arteries may lead to an acute myocardial infarction, which is described as atypical or missed KD in childhood. KD is an underlying disease of young adults with acute myocardial infarction. We report on a rare case involving a total occlusion in the proximal left anterior descending coronary artery combined with a giant left main aneurysm in a young adult patient with acute myocardial infarction ascribed to antecedent KD that is undefined but almost certain.

Central serous chorioretinopathy associated with low dose systemic corticosteroid treatment of Behcet's disease: Sungwook Cha, Kyung Jin Kim, Seongmin Kweon, Sinae Lee, Byungchul Min, Eunsung Kim, Jungwook Lee; Yeungnam Univ J Med. 2017;34(1):111-114. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.111

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Abstract PDF: Central serous chorioretinopathy may induce poor eyesight and serous retinal detachment. However, its exact cause has not been well established thus far. It can be associated with systemic high-dose corticosteroid treatment mainly for young and middle-aged men and may spontaneously regress or recur after withdrawal from corticosteroid. After corticosteroid administration for Behcet's disease, it is necessary to identify any ocular symptoms. Behcet's disease can lead to the development of ocular complications, such as uveitis, hypopyon, retinal vasculitis, optic neuritis, angiogenesis, secondary cataract, and glaucoma. It is possible to diagnose any of these complications via optical coherence tomography and digital indocyanine green angiography. It is easy to neglect an ocular symptom that may appear after a low-dose corticosteroid treatment as an ocular complication in patients with Behcet's disease. Thus, we report on a case concerning high-dose corticosteroid treatment with a literature review.

Insulin autoimmune syndrome associated with alpha-lipoic acid in a young woman with no concomitant disease: Sang Bae Lee, Min Young Lee, Ji Hong You, Seong Han Kim, Ji Sun Nam; Yeungnam Univ J Med. 2017;34(1):115-118. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.115

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Abstract PDF: Insulin autoimmune syndrome (IAS) is characterized by spontaneous hypoglycemia, extremely high serum insulin levels, and high titers of autoantibodies against endogenous insulin, in the absence of exogenous insulin injection. IAS often occurs following exposure to sulfhydryl-containing drugs, including alpha-lipoic acid (ALA). A 30-year-old woman without diabetes visited our outpatient clinic with recurrent hypoglycemia. She had been taken ALA for weight reduction since 3 weeks ago. Further hypoglycemia work up revealed very high insulin levels, C-Peptide levels and positive insulin antibodies. And conventional imaging examinations were negative for insulinoma or other pancreatic tumors. Finally, the diagnosis of Insulin autoimmune syndrome (IAS) was made. Following the cessation of ALA, hypoglycemia improved, with no medication, and the patient experienced no further hypoglycemic attacks over the next month. The use of ALA as a nutritional supplement is increasing. We report a case of IAS associated with ALA in a non-diabetic patient.

Severe ileus after colonoscopy in a patient on peritoneal dialysis: Sang Un Kim, Su Hee Kim, So Yoon Hwang, Ryang Hi Kim, Ji Young Choi, Jang Hee Cho, Chan Duck Kim, Yong Lim Kim, Sun Hee Park; Yeungnam Univ J Med. 2017;34(1):119-122. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.119

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Abstract PDF: Peritoneal dialysis (PD) is associated with the development of various complications, such as exit site infection or peritonitis, and rarely, intestinal obstruction in prolonged PD patients with recurrent peritonitis. However, post-colonoscopy acute intestinal obstruction has not been reported in PD patients to date. Herein, we report a case of severe ileus after a colonoscopy without previous episodes of peritonitis in a PD patient. A 51-year-old man undergoing PD for 7 years visited our emergency department due to severe abdominal pain and vomiting after colonoscopic polypectomy. A simple abdominal radiography and abdominal computed tomography showed ileus with collapsed distal ileal loop. A peritoneal dialysate study revealed no evidence of peritonitis. The patient was treated with decompression therapy, and ileus was successfully treated without complications. This case suggests that it is not only necessary to prevent peritonitis, but also important to monitor the development of ileus after colonoscopy in PD patients.

Ceftizoxime-induced immune hemolytic anemia associated with multi-organ failure: Jin Young Huh, Ari Ahn, Hyungsuk Kim, Seog Woon Kwon, Sujong An, Jae Yong Lee, Byoung Soo Kwon, Eun Hye Oh, Do Hyun Park, Jin Won Huh; Yeungnam Univ J Med. 2017;34(1):123-127. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.123

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Abstract PDF

Drug-induced immune hemolytic anemia (DIIHA) is a rare side effect of drugs. DIIHA may cause a systemic inflammatory response that results in acute multi-organ failure and death. Ceftizoxime belongs to the class of third generation cephalosporins, which are the most common drugs associated with DIIHA. Herein, we present a case of a 66-year-old man who developed fatal DIIHA after receiving a second dose of ceftizoxime. He was admitted to receive photodynamic therapy. He had a history of a single parenteral dose of ceftizoxime 3 months prior to admission. On the day of the procedure — shortly after the infusion of ceftizoxime — the patient's mental status was altered. The blood test results revealed hemolysis. Oliguric acute kidney injury developed, and continuous renal replacement therapy had to be applied. On the suspicion of DIIHA, the patient underwent plasmapheresis. Diagnosis was confirmed by a detection of drug-dependent antibody with immune complex formation. Although his hemolysis improved, his liver failure did not improve. He was eventually discharged to palliative care, and subsequently died.

Citations

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Case report: Decreased hemoglobin and multiple organ failure caused by ceftizoxime-induced immune hemolytic anemia in a Chinese patient with malignant rectal cancer
Can Lou, Meng Liu, Ting Ma, Liu Yang, Dan Long, Jiaming Li, Hang Lei, Dong Xiang, Xuefeng Wang, Lei Li, Xiaohong Cai
Frontiers in Immunology.2024;[Epub] CrossRef
Laboratory Workup of Drug-Induced Immune Hemolytic Anemia
Hyunjin Nah, Hyun Ok Kim
The Korean Journal of Blood Transfusion.2018; 29(1): 18. CrossRef

Severe chest pain with mid-ventricular obstruction in a patient with hyperthyroidism: Jong Ho Nam, Jang Won Son, Geu Ru Hong; Yeungnam Univ J Med. 2017;34(1):128-131. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.128

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Abstract PDF: Mid-ventricular obstruction (MVO) rarely occurs in patients without hypertrophic cardiomyopathy. Increased cardiac contractility may play an important role in causing MVO. We experienced a case of severe chest pain and MVO in a 50-year-old female patient. She had hypertension, diabetes, stroke and peripheral artery disease. Her blood pressure was very high (222/122 mmHg) with severe fluctuation. The transthoracic echocardiography revealed MVO accompanied by hyper-dynamic left ventricular systolic function. We regarded her chest pain and MVO as secondary findings related to other diseases. Coronary angiography and several tests for uncontrolled hypertension were performed, and those evaluations revealed that she had coronary artery disease and hyperthyroidism. We considered that the increase in the myocardial oxygen demand in response to the increase in cardiac contractility and workload associated with hyperthyroidism aggravated her symptoms and MVO. She was treated with methimazole and beta blockers and her symptoms dramatically improved.

Ileal epithelioid leiomyosarcoma with omental and peritoneal seeding: Chung Hyoun Kim, Sun Young Kim, Chang Kil Jung, Jung Pil Choi, Keum Soo Seo, Jun Ho Lee, Jae Hyung Choi; Yeungnam Univ J Med. 2017;34(1):132-136. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.132

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Abstract PDF: Leiomyosarcoma (LMS) of the small intestine is a rare tumor, accounting for about 1% of all malignant mesenchymal lesions in the gastrointestinal tract. Since small bowel tumors are initially asymptomatic and nonspecific, delayed diagnosis and treatment are common. We found that a 44-year-old male patient who came in for lower abdominal pain had partial obstruction in the small bowel. Multiple ascites and ileal tumors involving peritoneal seeding were observed from his abdominal computed tomography. He was diagnosed as epithelioid LMS involving peritoneal transition after surgical resection, and the outpatient department has planned for a conservative therapy with observation. To the best of our knowledge, ileal epithelioid LMS accompanying a huge omental mass, with a size of 18 cm in dimension, and peritoneal seeding has not yet been reported in Korea. We report this rare case with literature review.

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

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

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Effect of Health Status and Heat-Induced Inactivation on the Proteomic Profile of Plasma Rich in Growth Factors Obtained from Donors with Chronic Inflammatory Skin Conditions
Eduardo Anitua, Roberto Tierno, Mikel Azkargorta, Félix Elortza, Mohammad H. Alkhraisat
Biomolecules.2024; 14(7): 763. CrossRef
Dermatomiyozit Tanılı Olgunun King’in Amaca Ulaşma Kuramına Dayalı Hemşirelik Bakımının Planlanması
Eda Çiftçi Aksoy, Lale Ayşegül Büyükgönenç
Sağlık Bilimleri Üniversitesi Hemşirelik Dergisi.2024; 6(2): 181. CrossRef
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Case Reports in Dermatology.2021; 13(1): 222. CrossRef

C-ANCA-positive glomerulonephritis associated with subacute infective endocarditis caused by Bartonella infection: Min Jeong Kim, Ha Nee Jang, Tae Won Lee, Hyun Seop Cho, Se Ho Chang, Hyun Jung Kim; Yeungnam Univ J Med. 2017;34(1):140-145. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.140

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Glomerulonephritis (GN) is sometimes associated with infective endocarditis (IE). Bartonella endocarditis is difficult to diagnose because it is rare and cannot be detected by blood culture. This is the first report of cytoplasmic anti-neutrophil cytoplasmic antibody-positive subacute endocarditis-associated GN caused by Bartonella infection in South Korea. A 67-year-old man was hospitalized due to azotemia. He complained of weight loss and anorexia for 6 months. A diagnosis of IE was made based upon echocardiographic detection of vegetations on the mitral and aortic valves and a Bartonella antibody titer of 1:2,048. Renal histology identified focal crescentic GN. Azotemia and proteinuria improved after doxycycline and rifampin treatment combining with steroid therapy.

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Clinicopathological differences between Bartonella and other bacterial endocarditis-related glomerulonephritis – our experience and a pooled analysis
Mineaki Kitamura, Alana Dasgupta, Jonathan Henricks, Samir V. Parikh, Tibor Nadasdy, Edward Clark, Jose A. Bazan, Anjali A. Satoskar
Frontiers in Nephrology.2024;[Epub] CrossRef

Medial malleolar fracture associated with deltoid ligament rupture following ankle pronation injury: Chan Ho Park, Jae Woo Park, Chul Hyun Park, Sang Jin Park; Yeungnam Univ J Med. 2017;34(1):146-148. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.146

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Abstract PDF: Concurrent injury of medial malleolus and deltoid ligament is difficult to occur considering the injury mechanism. When the concurrent injury comes about, the deltoid ligament injury could be missed and it may lead to medial ankle instability. There are few reported cases of the concurrent injury and domestic case of concurrent failure of both structures over the medial side has been reported just once; however, the injury mechanism is different from this case. The authors report a case of medial malleolus fracture with deltoid ligament rupture following pronation injury with a review of necessity of repairing deltoid ligament for ankle stability.

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