Journal of Yeungnam Medical Science

Review article

Creativity in medical education: concepts related to creative capacity: Yura Kim, Young Hwan Lee; Yeungnam Univ J Med. 2020;37(2):79-83. Published online March 9, 2020; DOI: https://doi.org/10.12701/yujm.2019.00458

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In the 21st-century postmodernism era, which represents diversity and relativity, one of the most essential elements in the field of education is to strengthen individual human values. Accordingly, we must focus on developing capacity in order to adapt to change. It is clear that the medical field maximizes the need for new judgments to solve life-related problems constantly, and this problem-solving capacity is an essential skill for a physician. Problem-solving capacity can be achieved simultaneously with creativity to apply them in an appropriate manner based on standardized expertise and well-trained skills. Creativity is also a key element that medical education is currently pursuing. Many studies on creativity have resulted in confusion and misunderstandings on the concept of creativity due to similar terms and varied definitions, such as creation, innovation, etc. In this study, we attempt to identify the importance of creativity in medical education by comparing and organizing concepts related to creative capacity.

Citations

Citations to this article as recorded by

Creative Thinking: Its Importance and How to Cultivate It
Ahmad Munir, Omer A. Awan
Academic Radiology.2022; 29(10): 1610. CrossRef
A study on the mental health of students at a medical school during COVID-19 outbreak: a retrospective study
Yu Ra Kim, Hye Jin Park, Bon-Hoon Koo, Ji Young Hwang, Young Hwan Lee
Journal of Yeungnam Medical Science.2022; 39(4): 314. CrossRef
Value-Added Roles of Medical Students During the COVID-19 Pandemic: Assessment of Medical Students’ Perceptions and Willingness in Sri Lanka
Nuwan Darshana Wickramasinghe, Shamalee Wasana Jayarathne, Senaka Devendra Pilapitiya
International Journal of General Medicine.2021; Volume 14: 3187. CrossRef

Case report

Community-acquired Achromobacter xylosoxidans infection presenting as a cavitary lung disease in an immunocompetent patient: Chan Hee Hwang, Woo Jin Kim, Hye Young Jwa, Sung Heon Song; Yeungnam Univ J Med. 2020;37(1):54-58. Published online August 12, 2019; DOI: https://doi.org/10.12701/yujm.2019.00276

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Abstract PDF

Achromobacter xylosoxidans is a gram-negative bacterium that can oxidize xylose. It is commonly found in contaminated soil and water but does not normally infect immunocompetent humans. We report a case of a cavitary lung lesion associated with community-acquired A. xylosoxidans infection, which mimicked pulmonary tuberculosis or lung cancer in an immunocompetent man. The patient was hospitalized due to hemoptysis, and chest computed tomography (CT) revealed a cavitary lesion in the superior segment of the left lower lobe. We performed bronchoscopy and bronchial washing, and subsequent bacterial cultures excluded pulmonary tuberculosis and identified A. xylosoxidans. We performed antibiotic sensitivity testing and treated the patient with a 6-week course of amoxicillin/clavulanate. After 2 months, follow-up chest CT revealed complete resolution of the cavitary lesion.

Citations

Citations to this article as recorded by

Achromobacter species (sp.) outbreak caused by hospital equipment containing contaminated water: risk factors for infection
J. Tian, T. Zhao, R. Tu, B. Zhang, Y. Huang, Z. Shen, Y. Wang, G. Du
Journal of Hospital Infection.2024; 146: 141. CrossRef
Full characterization of plasmids from Achromobacter ruhlandii isolates recovered from a single patient with cystic fibrosis (CF)
Carla Steffanowski, Mariana Papalia, Andrés Iriarte, Mauricio Langleib, Laura Galanternik, Gabriel Gutkind, Vaughn Cooper, María Soledad Ramírez, Marcela Radice
Revista Argentina de Microbiología.2022; 54(1): 3. CrossRef
Nosocomial Achromobacter xylosoxidans Infection Presenting as a Cavitary Lung Lesion in a Lung Cancer Patient
Vinoja Sebanayagam, Paul Nguyen, Mo'ath Nassar, Ayman Soubani
Cureus.2020;[Epub] CrossRef

Case Report

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.

Reviews

Diverse clinical manifestations caused by varicella-zoster virus reactivation.: Hosun Park; Yeungnam Univ J Med. 2016;33(1):1-7. Published online June 30, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.1.1

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Abstract PDF: The two distinctive clinical features of varicella-zoster virus (VZV) are varicella (chickenpox) by primary infection and zoster (singles) by the reactivation of latent infection. In addition to the two typical clinical symptoms mentioned above, diverse clinical manifestations have been reported as a result of VZV reactivation, including chronic radicular pain without rash, visual loss, facial palsy, dysphagia, sore throat, odynophagia, otalgia, hearing loss, dizziness, headache, hemiplegia, etc. Most of these symptoms are derived from neuropathy and vasculopathy of affected nerves and arteries. Diagnosis of VZV disease can be difficult if there is no appearance of a skin rash during development of atypical symptoms. In addition to natural infection, vaccination and anti-viral agent treatment have influenced the changes of epidemics and clinical presentations of varicella and zoster. In this article, diverse clinical manifestations caused by VZV reactivation, particular without skin rash, are reviewed.

Clinical Application of Cardiac Hybrid Imaging in Coronary Artery Disease.: Ihn Ho Cho, Eun Jung Kong; Yeungnam Univ J Med. 2009;26(1):15-23. Published online June 30, 2009; DOI: https://doi.org/10.12701/yujm.2009.26.1.15

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Abstract PDF: Constant technological developments in coronary artery disease have contributed to the assessment of both the presence of coronary stenosis and its hemodynamic consequences. Hence, noninvasive imaging helps guide therapeutic decisions by providing complementary information on coronary morphology and on myocardial perfusion and metabolism. This can be done using single photon emission computed tomography(SPECT) or positron emission tomography(PET) and multidetector CT(MDCT). Advances in image-processing software and the advent of SPECT/CT and PET/CT have paved the way for the combination of image datasets from different modalities, giving rise to hybrid imaging. Three dimensional cardiac hybrid imaging helped to confirm hemodynamic significance in many lesions, add new lesions such as left main coronay artery disease, exclude equivocal defects, correct the corresponding arteries to their allocated defects and identify culprit segment. Cardiac hybrid imaging avoids the mental integration of functional and morphologic images and facilitates a comprehensive interpretation of coronary lesions and their pathophysiologic adequacy by three dimensional display of fused images, and allows the best evaluation of myocardial territories and the coronary-artery branches that serve each territory. This integration of functional and morphological information were feasible to intuitively convincing and might facilitate developmnt of a comprehensive non-invasive assessment of coronary artery disease.

Case Reports

Three Cases of Fever Unknown Origin with Lymphoproliferative Features and a Unique Pattern of 18-FDG Uptake on the Fusion PET/CT.: Dae Young Yun, Young Hoon Hong, Yong Uk Jung, Myung Jin Oh, Choong Ki Lee; Yeungnam Univ J Med. 2008;25(1):64-71. Published online June 30, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.1.64

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Abstract PDF: Evaluation of a fever of unknown origin (FUO) is complex. Recently, PET scanning has been approved for screening in FUO evaluation. We treated three cases of FUO associated with increased FDG uptake in the bone marrow of the femur and tibia on the fusion PET/CT; all three had the same pattern of uptake. Bone marrow biopsies revealed mature lymphocyte and histiocyte infiltration and myxoid changes in one case, and cortical bone involvement in another case. The cases were all young females who had fever with neutropenia and relative lymphocytosis that lasted for several weeks and then remitted spontaneously. Even though the results of the studies were not diagnostic, the unique uptake pattern on PET/CT and the histology might be related to the cause of the illness and should be studied further to assess the association with classic FUO.

A Case of Varicella Pneumonia Associated with Chickenpox in Immunocompetent Patient.: Won Jong Park, Sung Ken Yu, Kyeong Cheol Shin, Jin Hong Chung, Kwan Ho Lee; Yeungnam Univ J Med. 2007;24(2):339-343. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.339

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Abstract PDF: Varicella is a contagious infection in childhood disease typically affecting children aged 2-8 years and usually follows benign outcome. In the adult, clinical presentation is more severe and more commonly associated with complications. Varicella pneumonia, although rare, is a potentially life-threatening complication that should be suspected in any adult with varicella and respiratory symptoms. We report a case of varicella pneumonia in immunocompetent patient. The characteristic radiographic findings consisted of diffuse scattered coarse nodular infiltrations, less than 1cm sized, with ground glass opacity and consolidation in both lung fields. The patients was started on intravenous acyclovir. The chest radiograph performed 2 weeks later showed complete resolution of the pulmonary lesions.

Original Articles

The Usefulness of Integrated PET/CT to Distinguish between Benignancy and Malignancy in Solitary Pulmonary Nodule.: Won Jong Park, Dong Hee Kim, Sung Ken Yu, Kyeong Cheol Shin, Jin Hong Chung, Kwan Ho Lee, Kyung Ah Chun, Ihn Ho Cho; Yeungnam Univ J Med. 2006;23(2):205-212. Published online December 31, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.2.205

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Abstract PDF: BACKGROUND
Malignant pulmonary nodules account for about 30 to 40 percent of solitary pulmonary nodules (SPN). Therefore, tissue characterization of SPNs is very important. Recently, PET/CT has been widely used for tissue characterization, and has become of importance. The purpose of this study was to compare and to assess multiple factors in PET/CT comparing benign and malignant nodules. MATERIALS AND METHOD: Nineteen patients with SPN underwent PET/CT and biopsy. The difference of standardized uptake value 1 (SUV1), standardized uptake value 2 (SUV2) and retention index in PET/CT between malignancy and benignancy were compared by Levene's test. RESULT: There were twelve malignant and seven benign nodules. SUV1 and SUV2 were significantly different between malignant nodule and benign nodule (p=0.006 and 0.022), but retention index was not significantly different between malignant nodule and benign nodule (p=0.526). By receiver-operating-characteristic (ROC) analysis, the sensitivity was 66.7% and the specificity was 71.4% at a cut off value of 5.40 in SUV1. The sensitivity was 75% and the specificity was 71.4% at cut off value of 7.45 in SUV2. CONCLUSION: There was a statistically significant difference in SUV1 and SUV2 between benign and malignant nodules. However, the cut off value of SUV1 and SUV2 by receiver-operating-characteristic (ROC) analysis was 5.40 and 7.45 which is different from previous studies. Therefore, studies on a larger sample of patients are required for confirmation.

Pulmonary Cryptococcosis in Immunocompetent Patients: CT Findings.: Jae Kyo Lee; Yeungnam Univ J Med. 2004;21(1):74-81. Published online June 30, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.1.74

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Abstract PDF: PURPOSE: To evaluate the computed tomography (CT) findings of pulmonary cryptococcosis in immunocompetent patients. MATERIALS AND METHODS: CT scans of 25 patients with biopsy-proven cryptococcosis [surgery (n=3), percutaneous needle biopsy (n=21), and bronchoscopic biopsy (n=1) ] were analyzed. Thirteen patients were men and 12 patients were women, with a mean age of 53.7 years. Presenting symptoms were cough, sputum, and dyspnea and 12 patients presented with incidentally found chest radiographic abnormalities. RESULTS: Nodule or multiple conglomerate nodules (n=10, 40%) and segmental or lobular consolidation (n=9, 36%) were most common, followed by mixed patterns (n=5, 20%). Predilection sites were lower lobe (n=21/37, 57%) and subpleural areas (n=23, 92%). Air bronchograms within consolidations (n=11/14, 79%) with mild volume loss (n=10/14, 71%) were common. While interlobular septal thickening (n=11, 44%) and cavitation or central low-attenuations (n=11, 44%) were relatively common, lymphadenopathy (n=2, 8%) or free pleural effusions (n=1, 4%) were uncommon. CONCLUSION: Nodules or airspace consolidation with a predilection of lower lobe and subpleural area are the most common appearances of pulmonary cryptococcosis in immunocompetent patients.

Diagnostic Sensitivity of Several Muscles in Repetitive Nerve Stimulation Test for Myasthenia Gravis.: Hyun Jic Kim, Sung Hwan Lim, Seung Yeop Lee, Jung Sang Hah, Wook Nyeon Kim; Yeungnam Univ J Med. 2001;18(2):277-286. Published online December 31, 2001; DOI: https://doi.org/10.12701/yujm.2001.18.2.277

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Abstract PDF: BACKGROUND
This study was undertaken to evaluate the diagnostic sensitivity of several muscles in repetitive nerve stimulation test (RNST) for myasthenia gravis (MG) patients. MATERIALS AND METHODS: The study population consisted of 39 MG patients classified by modified Ossermann's classification. Using Stalberg's method, RNST was systematically performed in facial (orbicularis oculi and nasalis) and upper extremity (flexor carpi ulnaris, abductor digiti quinti and anconeus) muscles. RESULTS: The significant electrodecremental response of RNST were noted in orbicularis oculi (58.9%), nasalis (51.3%), flexor carpi ulnaris (42%), anconeus (41%) and abductor digiti quinti muscles (27%). Among the 3 muscles of upper extremity (abductor digiti quinti, flexor carpi ulnaris and anconeus), the positive electrodecremental response of anconeus muscles was significantly higher than other two muscles (p<0.05) in type IIa, IIb and there were no statistical differences of the positive electrodecremental response between orbicularis oculi and nasalis muscles. The facial muscles showed more prominent decremental responses than upper extremity muscles in type I MG(p<0.05). In type IIa MG patients, there were no significant statistical differences between facial and upper extremity muscles but significant statistical differences among upper extremity muscles. In type IIb MG patients, there were no significant statistical differences in all tested muscles in spite of the increased positive electrodecremental response of RNST. CONCLUSION: On the basis of this study, RNST would be initially performed for the orbicularis or nasalis in type I MG and for the anconeus in type IIa or IIb MG.

Optimization of Correction Factor for Linearization with Tc-99m HM PAO and Tc-99m ECD Brain SPECT.: Ihn Ho Cho, Kohei Hayashida, Kyu Chang Won, Hyoung Woo Lee, Hiroshi Watabe, Norihiko Kume, Chikao Uyama; Yeungnam Univ J Med. 1999;16(2):237-243. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.237

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Abstract PDF: No abstract available.

Effect on the management of postherpetic neuralgia.: Bon Up Koo, Dae Pal Park; Yeungnam Univ J Med. 1991;8(1):136-141. Published online June 30, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.1.136

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Abstract PDF: Fifteen patients was analyzed on effect of the management of postherpetic neuralgia by local anesthesia on the special region at pain clinic in Youngnam University Hospital. The results were on follows: 1) The frequency of occurrence of sex and the lesion side were similar in all patients. 2) The age of incidence was between 50 and 70 years old. 3) The most frequent site of lestons was the neck. 4) There was no relationship between age and treatment time. 5) Whole patients was done average 7-10 time local injection.

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