Journal of Yeungnam Medical Science

Articles in E-pub version are posted online ahead of regular printed publication.

Editorial

Exploring comprehensive insights into pediatric obesity: Yong Hee Hong; Received May 27, 2024 Accepted June 10, 2024 Published online July 9, 2024; DOI: https://doi.org/10.12701/jyms.2024.00500 [Epub ahead of print]

91 View
6 Download

PDF

Original article

How much does clinical prediagnosis correlate with electrophysiological findings?: a retrospective study: Selda Çiftci İnceoğlu, Aylin Ayyıldız, Figen Yılmaz, Banu Kuran; Received April 24, 2024 Accepted June 5, 2024 Published online July 5, 2024; DOI: https://doi.org/10.12701/jyms.2024.00381 [Epub ahead of print]

107 View
11 Download

Abstract PDF: Background
Electrodiagnostic testing (EDX) is important in the diagnosis and follow-up of neuropathic and myopathic diseases. This study aimed to demonstrate the compatibility between clinical prediagnosis and electrophysiological findings.
Methods
EDX results from 2004 to 2020 at the physical medicine and rehabilitation (PM&R) clinic were screened. Tests with missing data, reevaluation studies, and cases of peripheral facial paralysis were excluded. The clinical prediagnosis and EDX results were recorded, and their compatibility was evaluated.
Results
A total of 2,153 tests were included in this study. The mean age was 49.0±13.9 years and 1,533 of them (71.2%) were female. The most frequently referred clinic was the PM&R clinic (90.0%). Numbness (73.6%) was the most common complaint, followed by pain (15.3%) and weakness (13.9%). The most common prediagnosis was entrapment neuropathy (55.3%), radiculopathy (16.1%), and polyneuropathy (15.7%). Carpal tunnel syndrome was the most frequently identified type of entrapment neuropathy (78.3%). Six hundred and seventy EDX results (31.1%) were within normal limits. While the EDX results were consistent with the prediagnosis in 1,328 patients (61.7%), a pathology different from the prediagnosis was detected in 155 patients (7.2%). In the discrepancy group, the most common pathologies were entrapment neuropathy (51.7%), polyneuropathy (17.3%), and radiculopathy (15.1%). The most common neuropathy type was carpal tunnel syndrome (79.3%).
Conclusion
After adequate anamnesis and physical and neurological examinations, requesting further appropriate tests will increase the prediagnosis accuracy and prevent unnecessary expenditure of time and labor.

Focused Review articles

The prevalence and prevention strategies of pediatric obesity: a narrative review: Mi Seon Lee; Received April 4, 2024 Accepted May 28, 2024 Published online July 5, 2024; DOI: https://doi.org/10.12701/jyms.2024.00346 [Epub ahead of print]

167 View
13 Download

Abstract PDF: Pediatric obesity has rapidly increased globally over the past few decades, including in Korea. We aimed to discuss trends in the prevalence of pediatric obesity and effective prevention strategies. Its prevalence has markedly increased in most high-income nations. According to recent reports, this increase has slowed in developed countries, but the levels remain alarmingly high. In Korea, the rate of pediatric obesity has surged notably since the 1990s; however, since the 2000s, this increase has become more gradual. According to recently published 2017 growth charts, the prevalence of pediatric obesity in Korea varies slightly depending on the data source. The National School Health Examination data showed that pediatric obesity gradually increase from 11.5% in 2014 to 15.1% in 2019, and after the coronavirus disease 2019 pandemic, it sharply increased to 19% in 2021. Based on data from the Korea National Health and Nutrition Examination Survey, the prevalence of pediatric obesity gradually increased from 10.8% in 2017 to 13.6% in 2019. This trend, which accelerated sharply to 15.9% in 2020 and 19.3% in 2021, was especially severe in boys and older children. Pediatric obesity not only affects health during childhood but also increases the risk of developing obesity and associated health conditions in adulthood. Despite ongoing research on treatment options, obesity prevention and control remain challenging. Hence, prioritizing early intervention and prevention of pediatric obesity through healthy eating habits and lifestyles is crucial. This requires intervention at the individual, family, school, and community levels.

Effective and appropriate use of weight loss medication in pediatric obesity: a narrative review: Yoojin Lindsey Chung; Received April 4, 2024 Accepted May 27, 2024 Published online July 2, 2024; DOI: https://doi.org/10.12701/jyms.2024.00353 [Epub ahead of print]

470 View
29 Download

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

Correction

Correction to “Marginal fit of three different nanocomposite inlays fabricated with computer-aided design/computer-aided manufacturing (CAD/CAM) technology: a comparative study”: Hyunsuk Choi, Jae-Young Jo, Min-Ho Hong; Published online July 1, 2024; DOI: https://doi.org/10.12701/jyms.2023.00934.e1 [Epub ahead of print]; Corrects: J Yeungnam Med Sci 2024;41(2):80

144 View
4 Download

PDF

Focused Review article

What is the disease burden from childhood and adolescent obesity?: a narrative review: Eun Byoul Lee; Received April 8, 2024 Accepted June 3, 2024 Published online June 27, 2024; DOI: https://doi.org/10.12701/jyms.2024.00360 [Epub ahead of print]

473 View
17 Download

Abstract PDF: The prevalence of childhood and adolescent obesity has increased and exacerbated during the coronavirus disease 2019 pandemic, both in Korea and globally. Childhood and adolescent obesity poses significant risks for premature morbidity and mortality. The development of serious comorbidities depends not only on the duration of obesity but also on the age of onset. Obesity in children and adolescents affects almost all organ systems, including the endocrine, cardiovascular, gastrointestinal, reproductive, nervous, and immune systems. Obesity in children and adolescents affects growth, cognitive function, and psychosocial interactions during development, in addition to aggravating known adult comorbidities such as type 2 diabetes mellitus, hypertension, dyslipidemia, nonalcoholic fatty liver disease, obstructive sleep apnea, and cancer. Childhood and adolescent obesity are highly associated with increased cardiometabolic risk factors and prevalence of metabolic syndrome. The risk of cardiovascular and metabolic diseases in later life can be considerably decreased by even a small weight loss before the onset of puberty. Childhood and adolescent obesity is a disease that requires treatment and is associated with many comorbidities and disease burdens. Therefore, early detection and therapeutic intervention are crucial.

Review article

Ultrasound imaging and guidance in the management of myofascial pain syndrome: a narrative review: Wei-Ting Wu, Ke-Vin Chang, Vincenzo Ricci, Levent Özçakar; Received May 1, 2024 Accepted May 22, 2024 Published online June 17, 2024; DOI: https://doi.org/10.12701/jyms.2024.00416 [Epub ahead of print]

645 View
158 Download

Abstract PDF: Myofascial pain syndrome (MPS) is a common musculoskeletal disorder characterized by muscle pain, tenderness, and trigger points. Ultrasonography has emerged as a key tool for diagnosing and treating MPS owing to its ability to provide precise, minimally invasive guidance. This review discusses the use of ultrasonography in various approaches to evaluate and manage MPS. Studies have shown that shear-wave sonoelastography can effectively assess muscle elasticity and offer insights into trapezius stiffness in patients with MPS. Ultrasound-guided interfascial hydrodissection, especially with visual feedback, has demonstrated effectiveness in treating trapezius MPS. Similarly, ultrasound-guided rhomboid interfascial plane blocks and perimysium dissection for posterior shoulder MPS have significantly reduced pain and improved quality of life. The combination of extracorporeal shockwave therapy with ultrasound-guided lidocaine injections has been particularly successful in reducing pain and stiffness in trapezius MPS. Research regarding various guided injections, including dry needling, interfascial plane blocks, and fascial hydrodissection, emphasizes the importance of ultrasonography for accuracy and safety. Additionally, ultrasound-guided delivery of local anesthetics and steroids to the quadratus lumborum muscle has shown lasting pain relief over a 6-month period. Overall, these findings highlight the pivotal role of ultrasonography in the assessment and treatment of MPS.

Original article

Aortic valve replacement through right anterior mini-thoracotomy in patients with chronic severe aortic regurgitation: a retrospective single-center study: Eun Yeung Jung, Ji Eun Im, Ho-Ki Min, Seok Soo Lee; Received March 20, 2024 Accepted May 25, 2024 Published online June 12, 2024; DOI: https://doi.org/10.12701/jyms.2024.00290 [Epub ahead of print]

326 View
9 Download

Abstract PDF: Background
Aortic valve replacement (AVR) has recently been performed at many centers using a minimally invasive approach to reduce postoperative mortality, morbidity, and pain. Most previous reports on minimally invasive AVR (MiAVR) have mainly focused on aortic stenosis, and those exclusively dealing with aortic regurgitation (AR) are few. The purpose of this study was to investigate early surgical results and review our experience with patients with chronic severe AR who underwent AVR via right anterior mini-thoracotomy (RAT).
Methods
Data were retrospectively collected in this single-center study. Eight patients who underwent RAT AVR between January 2020 and January 2024 were enrolled. Short-term outcomes, including the length of hospital stay, in-hospital mortality, postoperative complications, and echocardiographic data, were analyzed.
Results
No in-hospital mortalities were observed. Postoperative atrial fibrillation occurred temporarily in three patients (37.5%). However, none required permanent pacemaker implantation or renal replacement therapy. The median values of ventilator time, length of intensive care unit stay, and hospital stay were 17 hours, 34.5 hours, and 9 days, respectively. Preoperative and postoperative measurements of left ventricular ejection fraction were similar. However, the left ventricular end systolic and diastolic diameters significantly decreased postoperatively from 42 mm to 35.5 mm (p=0.018) and 63 mm to 51 mm (p=0.012), respectively.
Conclusion
MiAVR via RAT is a safe and reproducible procedure with acceptable morbidity and complication rates in patients with chronic severe AR. Despite some limitations such as a narrow surgical field and demanding learning curve, MiAVR is a competent method for AR.

Review article

Failed back surgery syndrome—terminology, etiology, prevention, evaluation, and management: a narrative review: Jinseok Yeo; Received April 3, 2024 Accepted May 16, 2024 Published online June 10, 2024; DOI: https://doi.org/10.12701/jyms.2024.00339 [Epub ahead of print]

746 View
30 Download

Abstract PDF: Amid the worldwide increase in spinal surgery rates, a significant proportion of patients continue to experience refractory chronic pain, resulting in reduced quality of life and escalated healthcare demands. Failed back surgery syndrome (FBSS) is a clinical condition characterized by persistent or recurrent pain after one or more spinal surgeries. The diverse characteristics and stigmatizing descriptions of FBSS necessitate a reevaluation of its nomenclature to reflect its complexity more accurately. Accurate identification of the cause of FBSS is hampered by the complex nature of the syndrome and limitations of current diagnostic labels. Management requires a multidisciplinary approach that may include pharmacological treatment, physical therapy, psychological support, and interventional procedures, emphasizing realistic goal-setting and patient education. Further research is needed to increase our understanding, improve diagnostic accuracy, and develop more effective management strategies.

Original article

Enhancing ketamine anesthesia with midazolam and fentanyl for children's ear surgery: a prospective randomized study: Seong Min Han, So Young Kwon, Jang Hyeok In, Jin Deok Joo; Received March 9, 2024 Accepted April 11, 2024 Published online May 23, 2024; DOI: https://doi.org/10.12701/jyms.2024.00276 [Epub ahead of print]

709 View
25 Download

Abstract PDF: Background
Myringotomy with tympanostomy tube insertion (MTI) is a superficial surgical procedure used to prevent hearing loss in children with serous otitis media. Intravenous anesthesia, often ketamine, is preferred for this procedure because of its ability to induce sedation without compromising airway reflexes. However, ketamine alone may be insufficient and potentially lead to spontaneous movement during surgery. This study evaluated the effectiveness of midazolam and fentanyl as adjuvants to ketamine in reducing spontaneous movement during MTI and enhancing the quality of recovery.
Methods
This study involved two groups of 30 patients each: one group received intravenous ketamine (1.5 mg/kg) with an equal volume of normal saline (K group), while the other received a combination of midazolam, fentanyl, and ketamine (0.05 mg/kg, 1 μg/kg, and 1.5 mg/kg, respectively; MFK group). We assessed side effects, intraoperative patient movement, surgeon satisfaction, and emergence agitation scores.
Results
The MFK group exhibited significantly lower scores for patient movement (p<0.01) and emergence agitation (p<0.01) and markedly higher surgeon satisfaction scores (p<0.01) than the K group.
Conclusion
Administering a midazolam-fentanyl-ketamine combination effectively reduced spontaneous movement during surgery and emergence agitation during recovery without prolonging discharge times in children undergoing MTI.

Case report

Solar retinopathy related to antidepressant use in a patient with major depressive disorder: a case report: Eun-Jin Cheon; Received February 23, 2024 Accepted April 11, 2024 Published online May 23, 2024; DOI: https://doi.org/10.12701/jyms.2024.00213 [Epub ahead of print]

689 View
10 Download

Abstract PDF: This case report is a unique case of solar retinopathy following antidepressant-induced mydriasis and highlights the need for comprehensive ophthalmic evaluation in patients treated with medications having mydriatic effects. A 49-year-old female patient who had received long-term antidepressant therapy presented with bilateral visual impairment after prolonged sun exposure. Fundoscopy confirmed solar retinopathy, which was attributed to drug-induced mydriasis. Medication adjustments and sun protection strategies led to full visual recovery, underscoring the importance of interdisciplinary awareness. This case emphasizes the challenges associated with the simultaneous management of psychiatric and ophthalmic conditions and highlights the need for routine ophthalmic evaluation of patients prescribed antidepressants with reported ocular side effects.

Original articles

Factors associated with musculoskeletal pain in professional dancers, including lapse period of group practice due to the COVID-19 outbreak: repeated-measures analysis: Kiook Baek, Yu-Mi Choi, Joon Sakong; Received February 21, 2024 Accepted April 3, 2024 Published online May 17, 2024; DOI: https://doi.org/10.12701/jyms.2024.00171 [Epub ahead of print]

824 View
9 Download

Abstract PDF Supplementary Material: Background
This study investigated the prevalence and associated factors of musculoskeletal pain among professional dancers who experienced a lapse in group practice due to coronavirus disease 2019.
Methods
General characteristics, practice time, region of musculoskeletal pain due to injury using the visual numeric scale (VNS), and causative motion were surveyed among professional dancers. Pain of VNS 0 to 3 was categorized as “no or minor,” 4 to 6 was categorized as “moderate,” and 7 to 10 was categorized as “severe.” The causal motions of musculoskeletal pain were analyzed according to body region. Factors other than motion associated with pain were also analyzed.
Results
In total, 368 participants were included. In the univariate analysis, age and practice time were positively associated with “moderate” pain. Practice time, dance experience, and postural accuracy were positively associated with “severe” pain, as was performing Korean traditional dance. In the multivariable analysis, practice time, group practice, and age were positively associated with pain of VNS 4 to 10, and practice time, group practice, and Korean traditional dance were positively associated with pain of VNS 7 to 10.
Conclusion
Among the factors related to dancer training, practice time, group practice, and dance type affect the occurrence of pain.

Effect of pitavastatin on erythrocyte membrane fatty acid content in patients with chronic kidney disease: two-arm parallel randomized controlled trial: Minna Kim, Seong Eun Kim, Su Mi Lee, Won Suk An; Received January 26, 2024 Accepted April 2, 2024 Published online May 8, 2024; DOI: https://doi.org/10.12701/jyms.2024.00094 [Epub ahead of print]

859 View
39 Download

Abstract PDF Supplementary Material: Background
Statins reduce the risk of cardiovascular events in patients with chronic kidney disease (CKD). Although diabetes mellitus (DM) is a reported side effect of statin treatment, some studies have indicated that pitavastatin does not cause DM. The present study investigated the effect of pitavastatin on the fatty acid (FA) content of erythrocyte membranes, which affects the occurrence of DM and cardiovascular diseases. In addition, changes in adiponectin and glycated hemoglobin (HbA1c) levels were evaluated after pitavastatin treatment.
Methods
A total of 45 patients were enrolled, 28 of whom completed the study. Over 24 weeks, 16 patients received 2 mg pitavastatin and 12 patients received 10 mg atorvastatin. Dosages were adjusted after 12 weeks if additional lipid control was required. There were 10 and nine patients with DM in the pitavastatin and atorvastatin groups, respectively. Erythrocyte membrane FAs and adiponectin levels were measured using gas chromatography and enzyme-linked immunosorbent assay, respectively.
Results
In both groups, saturated FAs, palmitic acid, trans-oleic acid, total cholesterol, and low-density lipoprotein cholesterol levels were significantly lower than those at baseline. The arachidonic acid (AA) content in the erythrocyte membrane increased significantly in the pitavastatin group, but adiponectin levels were unaffected. HbA1c levels decreased in patients treated with pitavastatin. No adverse effects were associated with statin treatment.
Conclusion
Pitavastatin treatment in patients with CKD may improve glucose metabolism by altering erythrocyte membrane AA levels. In addition, pitavastatin did not adversely affect glucose control in patients with CKD and DM.

Review article

Clinical significance of exosomal noncoding RNAs in hepatocellular carcinoma: a narrative review: Jae Sung Yoo, Min Kyu Kang; Received October 30, 2023 Accepted December 30, 2023 Published online February 8, 2024; DOI: https://doi.org/10.12701/jyms.2023.01186 [Epub ahead of print]

1,077 View
31 Download

Abstract PDF: Hepatocellular carcinoma (HCC) is one of the most lethal malignancies worldwide, with poor prognosis owing to its high frequency of recurrence and metastasis. Moreover, most patients are diagnosed at an advanced stage owing to a lack of early detection markers. Exosomes, which are characterized by their cargos of stable intracellular messengers, such as DNA, RNA, proteins, and lipids, play a crucial role in regulating cell differentiation and HCC development. Recently, exosomal noncoding RNAs (ncRNAs), including microRNAs, long ncRNAs, and circular RNAs, have become increasingly important diagnostic, prognostic, and predictive markers of HCC. Herein, we discuss the clinical implications of exosomal ncRNAs, specifically those within the HCC regulatory network.

Imagery

Cosmos in full autumn: Published online January 24, 2024; DOI: https://doi.org/10.12701/jyms.2024.00052 [Epub ahead of print]

476 View
2 Download

PDF

First
Prev
Page of 2
Next
Last

Ahead-of print