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JYMS : Journal of Yeungnam Medical Science

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

Original article
Right anterior mini-thoracotomy aortic valve replacement versus transcatheter aortic valve implantation in octogenarians: a single center experience: a retrospective study
Ji Eun Im, Eun Yeung Jung, Seok Soo Lee, Ho-Ki Min
Received November 7, 2023  Accepted January 26, 2024  Published online February 26, 2024  
DOI: https://doi.org/10.12701/jyms.2023.01228    [Epub ahead of print]
  • 134 View
  • 7 Download
AbstractAbstract PDF
Background
The aim of this study was to compare the early outcomes of octogenarians undergoing minimally invasive right anterior mini-thoracotomy aortic valve replacement (RAT-AVR) with those undergoing transcatheter aortic valve implantation (TAVI) for aortic valve disease.
Methods
In this single-center retrospective study, data were collected from octogenarians before and after RAT-AVR and TAVI between January 2021 and July 2022. Short-term outcomes, including the length of hospital stay, in-hospital mortality, all-cause mortality, and other major postoperative complications, were compared and analyzed.
Results
There were no significant differences in in-hospital mortality, stroke, acute kidney dysfunction requiring renal replacement therapy, length of intensive care unit stay, or length of hospital stay. However, the TAVI group had a higher incidence of permanent pacemaker insertion (10% vs. 0%, p=0.54) and paravalvular leaks (75% vs. 0%, p<0.001).
Conclusion
In the present study on octogenarians, both TAVI and RAT-AVR showed comparable short-term results. Although both procedures were considered safe and effective in the selected group, RAT-AVR had a lower incidence of complete atrioventricular block and paravalvular regurgitation.
Review articles
Comprehensive overview of the role of mitochondrial dysfunction in the pathogenesis of acute kidney ischemia-reperfusion injury: a narrative review
Min-Ji Kim, Chang Joo Oh, Chang-Won Hong, Jae-Han Jeon
Received December 9, 2023  Accepted January 10, 2024  Published online February 14, 2024  
DOI: https://doi.org/10.12701/jyms.2023.01347    [Epub ahead of print]
  • 320 View
  • 26 Download
AbstractAbstract PDF
Acute kidney ischemia-reperfusion (IR) injury is a life-threatening condition that predisposes individuals to chronic kidney disease. Since the kidney is one of the most energy-demanding organs in the human body and mitochondria are the powerhouse of cells, mitochondrial dysfunction plays a central role in the pathogenesis of IR-induced acute kidney injury. Mitochondrial dysfunction causes a reduction in adenosine triphosphate production, loss of mitochondrial dynamics (represented by persistent fragmentation), and impaired mitophagy. Furthermore, the pathological accumulation of succinate resulting from fumarate reduction under oxygen deprivation (ischemia) in the reverse flux of the Krebs cycle can eventually lead to a burst of reactive oxygen species driven by reverse electron transfer during the reperfusion phase. Accumulating evidence indicates that improving mitochondrial function, biogenesis, and dynamics, and normalizing metabolic reprogramming within the mitochondria have the potential to preserve kidney function during IR injury and prevent progression to chronic kidney disease. In this review, we summarize recent advances in understanding the detrimental role of metabolic reprogramming and mitochondrial dysfunction in IR injury and explore potential therapeutic strategies for treating kidney IR injury.
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]
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AbstractAbstract 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.
Original article
Impact of COVID-19 on the development of major mental disorders in patients visiting a university hospital: a retrospective observational study
Hee-Cheol Kim
Received November 16, 2023  Accepted December 26, 2023  Published online February 6, 2024  
DOI: https://doi.org/10.12701/jyms.2023.01256    [Epub ahead of print]
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  • 14 Download
AbstractAbstract PDF
Background
This study aimed to investigate the impact of coronavirus disease 2019 (COVID-19) on the development of major mental disorders in patients visiting a university hospital.
Methods
The study participants were patients with COVID-19 (n=5,006) and those without COVID-19 (n=367,162) registered in the database of Keimyung University Dongsan Hospital and standardized with the Observational Medical Outcomes Partnership Common Data Model. Data on major mental disorders that developed in both groups over the 5-year follow-up period were extracted using the FeederNet computer program. A multivariate Cox proportional hazards model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for the incidence of major mental disorders.
Results
The incidences of dementia and sleep, anxiety, and depressive disorders were significantly higher in the COVID-19 group than in the control group. The incidence rates per 1,000 patient-years in the COVID-19 group vs. the control group were 12.71 vs. 3.76 for dementia, 17.42 vs. 7.91 for sleep disorders, 6.15 vs. 3.41 for anxiety disorders, and 8.30 vs. 5.78 for depressive disorders. There was no significant difference in the incidence of schizophrenia or bipolar disorder between the two groups. COVID-19 infection increased the risk of mental disorders in the following order: dementia (HR, 3.49; 95% CI, 2.45–4.98), sleep disorders (HR, 2.27; 95% CI, 1.76–2.91), anxiety disorders (HR, 1.90; 95% CI, 1.25–2.84), and depressive disorders (HR, 1.54; 95% CI, 1.09–2.15).
Conclusion
This study showed that the major mental disorders associated with COVID-19 were dementia and sleep, anxiety, and depressive disorders.
Case report
Atypical presentation of DeBakey type I aortic dissection mimicking pulmonary embolism in a pregnant patient: a case report
Sou Hyun Lee, Ji Hee Hong, Chaeeun Kim
Received December 4, 2023  Accepted December 28, 2023  Published online February 5, 2024  
DOI: https://doi.org/10.12701/jyms.2023.01319    [Epub ahead of print]
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AbstractAbstract PDF
Aortic dissection in pregnant patients results in an inpatient mortality rate of 8.6%. Owing to the pronounced mortality rate and speed at which aortic dissections progress, efficient early detection methods are crucial. Here, we highlight the importance of early chest computed tomography (CT) for differentiating aortic dissection from pulmonary embolism in pregnant patients with dyspnea. We present the unique case of a 38-year-old pregnant woman with elevated D-dimer and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, initially suspected of having a pulmonary embolism. Initial transthoracic echocardiography did not indicate aortic dissection. Surprisingly, after an emergency cesarean section, a chest CT scan revealed a DeBakey type I aortic dissection, indicating a diagnostic error. Our findings emphasize the need for early chest CT in pregnant patients with dyspnea and elevated D-dimer and NT-proBNP levels. This case report highlights the critical importance of considering both aortic dissection and pulmonary embolism in the differential diagnosis of such cases, which will inform future clinical practice.
Review article
Patient-physician interaction education in Korea: a systematic review
Hwan Ho Lee, Yu Ra Kim, Hye Jin Park
Received October 17, 2023  Accepted December 19, 2023  Published online February 5, 2024  
DOI: https://doi.org/10.12701/jyms.2023.01109    [Epub ahead of print]
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AbstractAbstract PDF
Patient-physician interaction (PPI) is an important area in medical education, but in-depth discussions on the content of the outcome of patient-doctor education are rare. Therefore, in this study, we will systematically analyze the research on PPI education in Korea. In this study, papers searched with keywords related to PPI education from Korea’s academic journal service were targeted according to a systematic literature analysis method. The scope of the study was to include papers published in academic journals that are candidates for Korea Citation Index registration, excluding dissertations, research reports, posters, conference presentations, books, and internet materials. The content included papers targeting medical education and medical school students was set as the range. As a result of the analysis, although communication between PPI has many positive effects in the PPI in medical education at medical schools, obstacles do occur, and various ways to overcome them were suggested. Therefore, although medical interview training between patients and doctors in medical schools is necessary, it was analyzed as being based on overseas research or lacking in specific content. The core of PPI education appears to be medical interviews, and it seems necessary to discuss whether empathy or patient-centered medical care are appropriate as the main principles of PPI education in Korea. Therefore, education on the patient-doctor relationship is an important element in medical humanities and medical humanities education, and it is expected that research and education on this will progress more actively.
Imagerys
Spring of Cheongsando island
Published online January 24, 2024  
DOI: https://doi.org/10.12701/jyms.2024.00059    [Epub ahead of print]
  • 141 View
  • 0 Download
PDF
Cosmos in full autumn
Published online January 24, 2024  
DOI: https://doi.org/10.12701/jyms.2024.00052    [Epub ahead of print]
  • 123 View
  • 1 Download
PDF
Trumpet creepers in summer alleyway
Published online January 24, 2024  
DOI: https://doi.org/10.12701/jyms.2024.00045    [Epub ahead of print]
  • 131 View
  • 1 Download
PDF
Original article
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
Received August 14, 2023  Accepted November 24, 2023  Published online January 22, 2024  
DOI: https://doi.org/10.12701/jyms.2023.00934    [Epub ahead of print]
  • 272 View
  • 11 Download
AbstractAbstract PDF
Background
This study aimed to compare and evaluate the marginal fit of nanocomposite computer-aided design/computer-aided manufacturing (CAD/CAM) inlays. Three types of nanocomposite CAD/CAM blocks (HASEM, VITA Enamic, and Lava Ultimate) were used as materials.
Methods
Class II disto-occlusal inlay restorations were prepared on a typodont mandibular right first molar using diamond rotary instruments. The inlays were fabricated using CAD/CAM technology and evaluated using the silicone replica technique to measure marginal gaps at five locations on each inlay. The data were analyzed by two-way analysis of variance and Tukey post hoc tests ( α=0.05).
Results
There were no significant differences in the marginal gaps based on the type of nanocomposite CAD/CAM inlay used (p=0.209). However, there was a significant difference in the marginal gaps between the measurement regions. The gingival region consistently exhibited a larger marginal gap than the axial and occlusal regions (p<0.001).
Conclusion
Within the limitations of this in vitro study, the measurement location significantly influenced the marginal fit of class II disto-occlusal inlay restorations. However, there were no significant differences in the marginal gaps among the different types of CAD/CAM blocks. Furthermore, the overall mean marginal fits of the class II disto-occlusal inlay restorations made with the three types of nanocomposite CAD/CAM blocks were within the clinically acceptable range.

JYMS : Journal of Yeungnam Medical Science