Journal of Yeungnam Medical Science

Original articles

Dentistry
Therapeutic efficacy of mesenchymal stem cells in periodontal regeneration: a systematic review and meta-analysis of clinical trials: Fiki Muhammad Ridho, Anis Irmawati, Raed Labib, Hayyu Norma Almira, Ridwan Alfatah, Bayu Cahyo Bintoro; J Yeungnam Med Sci. 2026;43:42. Published online June 24, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.42

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Abstract PDF Supplementary Material: Background
Periodontitis is a major global health problem that leads to destruction and loss of periodontal tissues. As conventional therapy has a limited capacity to restore the complex architecture of the periodontium, regenerative approaches have been explored. This meta-analysis evaluates the therapeutic efficacy of mesenchymal stem cells (MSCs) for periodontal regeneration in patients with periodontal defects.
Methods
PubMed, Scopus, Web of Science, Dentistry & Oral Sciences Source, and the Cochrane Library were searched for clinical trials. The risk of bias was assessed using Cochrane RoB2. Random- or fixed-effects meta-analyses were used in the pooled analysis and reported as mean differences (MDs) and 95% confidence intervals (CIs). Certainty of evidence was rated using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE).
Results
Ten clinical trials were included in the analysis. MSCs significantly improved probing pocket depth (MD, –0.51; 95% CI, –0.84 to –0.19; p<0.01; I2=62%), clinical attachment level (MD, –0.75; 95% CI, –0.95 to –0.54; p<0.01; I2=40%), cementoenamel junction to the base of defect (MD, –0.49; 95% CI, –0.95 to –0.02; p=0.04; I2=63%), and intrabony defect (MD, –1.09; 95% CI, –1.60 to –0.57; p<0.01; I2=71%). However, no significant improvement in gingival recession was observed (MD, –0.18; 95% CI, –0.38 to 0.01; p=0.07; I2=0%). The GRADE assessment indicated a high-to-moderate certainty.
Conclusion
MSCs represent a promising strategy for periodontal regeneration. Nevertheless, the limited number of studies and the observed heterogeneity warrant cautious interpretation. Larger methodologically rigorous trials are needed to clarify the true contribution of MSCs to periodontal regeneration.

Dentistry
Qualitative exploration of manual dental records in the digital era using sociotechnical systems theory: insights from a teaching dental institution: Syuwari Azhar Azman, Sulhi Abidin, Galvin Sim Siang Lin, Mohd Haikal Muhamad Halil; J Yeungnam Med Sci. 2026;43:9. Published online January 5, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.9

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Abstract PDF: Background
Dental records are essential repositories of patient information that support diagnosis, treatment planning, continuity of care, and medicolegal accountability, making them a fundamental component of safe, effective, and transparent dental practices. This study aimed to explore the perceptions and experiences of academic and nonacademic clinical staff regarding a paper-based patient record system at a Malaysian public dental institute.
Methods
A qualitative phenomenological design underpinned by the sociotechnical systems theory was employed. Purposive sampling recruited 20 full-time staff (10 academic, 10 nonacademic) with at least 1 year of experience using the manual record system and no prior training in electronic dental records. Semi-structured, one-on-one interviews were conducted between May 2025 and October 2025, audio-recorded, transcribed verbatim, and analyzed using Braun and Clarke’s thematic analysis. Rigor was enhanced through independent coding, member checking, reflexive journaling, and adherence to the Consolidated Criteria for Reporting Qualitative Research checklist.
Results
Four main themes were identified: (1) inefficiency and accessibility challenges; (2) accuracy, legibility, and record integrity; (3) continuity of care and patient safety risks; and (4) desire for digital transition and system improvements.
Conclusion
Although manual paper-based dental records remain central to documentation in teaching dental institutions, they present growing inefficiencies and safety concerns, highlighting the need for sociotechnical-informed strategies that align human processes, technology, and institutional support to enhance record-keeping and patient care.

Surgery
Health system disruption and oncologic consequences: a retrospective observational study of South Korea’s 2024 medical walkout: Seung Ho Song, Chang Hyun Kim, Soo Yeun Park; J Yeungnam Med Sci. 2026;43:4. Published online December 18, 2025; DOI: https://doi.org/10.12701/jyms.2026.43.4

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Abstract PDF Supplementary Material

Background
In February 2024, a sudden government policy to drastically increase medical school admissions triggered the mass resignations of medical trainees across South Korea, severely disrupting hospital operations. This study aimed to evaluate the impact of the resulting healthcare workforce disruptions on short-term clinical outcomes and the timing of colorectal cancer surgeries.
Methods
This retrospective comparative study analyzed patients with colorectal cancer treated at two national university hospitals in Daegu and Gwangju, South Korea. Patients who first visited the colorectal surgery department between March and August of 2023 and 2024 were included. Data from 2020 to 2022 were used for extended comparisons. The primary outcome was the interval from initial outpatient visit to surgery. Secondary outcomes included treatment modality distribution, tumor staging, and postoperative complications.
Results
A total of 895 patients in 2023 and 853 in 2024 were included. In 2024, only 39.5% of patients (337/853) underwent upfront surgery compared to 63.5% (569/895) in 2023. The median time to surgery increased from 30 days (interquartile range [IQR], 22–44 days) to 52 days (IQR, 30–72 days) (p=0.001). Clinical T3–4 tumors increased from 49.9% to 59.3% (p=0.018), lymph node-positive cases increased from 25.9% to 51.3% (p=0.001), and postoperative complication rates increased from 12.0% to 28.2% (p=0.001).
Conclusion
The abrupt healthcare workforce crisis in early 2024 significantly delayed colorectal cancer surgeries and was associated with worse short-term oncologic outcomes. These findings highlight the critical importance of maintaining a stable healthcare workforce to protect access to timely cancer care.

Citations

Citations to this article as recorded by

Vascular Anchoring Bias in a Type A Aortic Dissection Survivor: Diagnostic Delays in Acute Care Evaluation of Hepatic and Urologic Pathology
Jason Park, Michail Koutentakis, Issac Park, Emmanuel Faluade, Rodolfo J Oviedo
Cureus.2026;[Epub] CrossRef
Changes in American Society of Anesthesiologists Physical Status Distribution and Prognostic Performance During the 2024 South Korean Healthcare Crisis: A Large-Scale Retrospective Cohort Study
Chan-Sik Kim, Sang-Wook Lee
Journal of Clinical Medicine.2026; 15(11): 4261. CrossRef

Emergency and Critical Care Medicine
Comparing emergency medical system governance in Japan and South Korea: lessons for high-income countries from a multisource comparative health systems analysis: Kentaro Kajino, Jung Ho Kim, Jeong Ho Park, Kyoung-Jun Song, Mohamud R. Daya, Yasuyuki Kuwagata; J Yeungnam Med Sci. 2026;43:3. Published online December 18, 2025; DOI: https://doi.org/10.12701/jyms.2026.43.3

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Abstract PDF Supplementary Material: Background
Japan and South Korea, two advanced East Asian nations with universal health coverage and similar demographic challenges, have developed markedly different emergency medical services (EMS) systems. Despite growing interest in international benchmarking, structured, comparative studies that yield policy-relevant insights remain limited.
Methods
We conducted a multisource comparative health-systems analysis using statutory laws, government publications, academic society reports, peer-reviewed literature, and national statistics. Key domains included EMS governance, workforce, prehospital organization, hospital-based emergency care, legal obligations for EMS patient transport and hospital acceptance, and governance and quality assurance mechanisms. Data were synthesized in comparative tables and narrative summaries to highlight structural and operational differences.
Results
Japan’s EMS system operates under decentralized municipal control through 722 fire departments, serving 4,100 designated emergency institutions with 6,139 board-certified emergency physicians. In 2023, over 6.64 million ambulance dispatches occurred, and 8.6% were classified as critical cases (1.3% death and 7.3% severe). Korea’s EMS system is centrally governed with 412 designated facilities in a tiered system and 2,464 specialists. Annual ambulance activations exceeded 3.5 million, with severe cases accounting for approximately 5% to 10%. Japan employs a multilayered legal–institutional structure, primarily involving the Fire Service Act and the Medical Practitioners Act, allowing clinical discretion, whereas Korea enforces unified regulations with stricter obligations and criminal penalties for hospital refusal of emergency patients.
Conclusion
The contrasting systems suggest that hybrid governance that combines centralized standard settings with local operational flexibility may optimize EMS performance. These findings provide lessons for EMS reform, cross-border collaboration, and disaster preparedness in high-income nations facing similar demographic and healthcare challenges.

Public Health, Environmental, and Occupational Health
Significant reduction in norovirus outbreaks and secondary transmission of acute gastroenteritis in Seoul schools following the COVID-19 pandemic: a retrospective epidemiological study: Euncheol Son, Young-Hoon Kim; J Yeungnam Med Sci. 2025;42:65. Published online October 14, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.65

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Abstract PDF Supplementary Material

Background
Unexpectedly, during the coronavirus disease 2019 (COVID-19) pandemic (2020–2022), it was reported that the number of acute gastroenteritis outbreaks (AGEOs) increased abruptly in childcare centers and kindergartens due to the increase in norovirus GII.4 transmission. However, changes in AGEOs in schools have not been reported during the same period. Therefore, this study aimed to compare the characteristics of AGEOs in schools before and after 2020.
Methods
We analyzed the results of AGEO epidemiological investigation reports in Seoul.
Results
The number of AGEO cases in schools decreased after 2020. Norovirus was identified as the causative pathogen in 10 of 11 cases in 2019, while only five cases were caused by norovirus among the 12 cases between 2020 and 2022. The average attack rate decreased from 10.2% in 2019 to 5.2% between 2020 and 2022. The average duration of patient occurrence also decreased from 7.5 days in 2019 to 4 days between 2020 and 2022. Secondary transmission occurred in all 2019 cases. However, secondary transmission was not observed in half of the cases between 2020 and 2022.
Conclusion
Norovirus outbreaks and secondary transmission in schools declined after the onset of the COVID-19 pandemic, probably because of infection control measures implemented to prevent COVID-19 transmission.

Citations

Citations to this article as recorded by

Sudden pertussis outbreaks in Guro-gu, Seoul: epidemiological characteristics and contributing factors in 2024
Woosuk Han, Heejin Kimm, Yeun Soo Yang, Jun Wook Kwon, Euncheol Son
Child Health Nursing Research.2026; 32(2): 203. CrossRef

Review article

Psychiatry and Mental Health
Glucagon-like peptide-1 receptor agonists and mental health: a narrative review of emerging benefits and risks: JinWoo Kim; J Yeungnam Med Sci. 2025;42:61. Published online September 29, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.61

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Abstract PDF: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), originally developed for type 2 diabetes mellitus and obesity, are increasingly recognized for their significant impact on the central nervous system, leading to reports of both beneficial and adverse mental health effects. This review summarizes the current evidence on the effects of GLP-1 RAs on various psychiatric and neurocognitive conditions to evaluate their clinical benefits and potential risks. The literature has revealed a complex and multifaceted psychiatric profile. For depression and anxiety, the evidence is conflicting, with large observational studies showing contradictory results that are largely attributable to confounding by indication or methodological differences in the study design. In contrast, consistent and positive evidence suggests therapeutic potential for substance use disorders, particularly alcohol use disorders. Furthermore, emerging data indicate a significant neuroprotective role, with several cohort studies indicating a reduced risk of dementia. The major public and regulatory attention regarding suicidality appears to be driven by the methodological limitations of the initial reports, as well-controlled active comparator studies have not found an increased risk. However, the safety of GLP-1 RAs in high-risk psychiatric populations has not been established. In conclusion, while GLP-1 RAs show considerable therapeutic potential, their unresolved safety profile in patients with preexisting psychiatric conditions necessitates a cautious clinical approach. Future large-scale randomized controlled trials that include psychiatric populations are crucial for clarifying the direct neuromodulatory effects of these agents and establishing guidelines for their safe use.

Original articles

Dentistry
Charting the use of mini-clinical evaluation exercise (mini-CEX) in nursing and dental education: a bibliometric analysis from the Web of Science database: Galvin Sim Siang Lin, Annabell Ying Ying Sim, Erlyn Aclan Sana, Gideon U. Johnson; J Yeungnam Med Sci. 2025;42:43. Published online August 6, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.43

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Abstract PDF Supplementary Material: Background
Workplace-based assessments, such as the mini-clinical evaluation exercise (mini-CEX), are increasingly used to evaluate clinical competence in authentic healthcare settings. This study aimed to map and evaluate the global research landscape of mini- CEX in nursing and dental education through bibliometric analysis.
Methods
A literature search was conducted in the Web of Science Core Collection on July 1, 2025, using the terms “mini-CEX,” “mini clinical evaluation exercise,” “nursing,” “nurse,” “dental,” and “dentistry.” Eligible articles were studies published in English that involved learners or educators in nursing or dental education. Data such as publication metrics, authorship, affiliations, keyword co-occurrence, journal impact, and Sustainable Development Goal (SDG) alignment were extracted and analyzed.
Results
Thirty-seven articles were included. They received 229 citations, with an h-index of nine and an average of 6.19 citations per article. Most were indexed in the Science Citation Index Expanded or the Social Sciences Citation Index (67.6%), and 42.9% were published in Quartile 1 journals. The majority aligned with SDG 04 (Quality Education). Nursing-focused studies outnumbered dental studies. Authorship networks were fragmented, with limited cross-institutional collaboration. BMC Medical Education was the leading journal, and 2022 saw the highest number of publications. From 2020 onwards, both publication and citation counts increased significantly (p<0.01). Iran and China contributed the most articles. Keyword analysis revealed five clusters: “skills,” “mini-CEX,” “clinical competence,” “competence,” and “impact.”
Conclusion
Research on mini-CEX in nursing and dental education is expanding, yet enhanced interprofessional collaboration is needed to maximize its global scholarly and practical impact.

Medical Education
Stress and sleep quality among medical students in Bangladesh: a cross-sectional study: Tamal Kanti Kairi, Sanghamitra Dey, Rifat Jahan, Shahnewaz Fuad; J Yeungnam Med Sci. 2025;42:42. Published online August 5, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.42

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