Journal of Yeungnam Medical Science

Original articles

Infectious Disease
Safety and efficacy of early oral switch in Enterobacterales bacteremia: a systematic review and meta-analysis: Rafael Levandowski, Tae Yoon Hwang, Sangwoon Bae, Kyeong-Soo Lee; J Yeungnam Med Sci. 2026;43:12. Published online January 7, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.12

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Abstract PDF Supplementary Material: Background
Early oral switch (EOS) has been proposed as an alternative to prolonged intravenous (IV) therapy for Enterobacterales bacteremia; however, its safety and effectiveness have not been clearly established. This systematic review and meta-analysis evaluated whether EOS reduces treatment failure in uncomplicated Enterobacterales bacteremia and examined how the timing of switching affects outcomes.
Methods
We conducted a systematic review and random-effects meta-analysis of randomized controlled trials and observational studies that compared EOS with continued IV therapy in adults with uncomplicated Enterobacterales bacteremia. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using random-effects models. The primary outcome was treatment failure by ≤90 days. Prespecified analyses evaluated the timing of the switch.
Results
Across 10 studies that met the inclusion criteria, EOS was associated with lower treatment failure than continued IV therapy (RR, 0.72; 95% CI, 0.58–0.89; I²=26%). Switching within 4 days reduced the failure (RR, 0.58; 95% CI, 0.44–0.76; I²=0%), whereas switching after 4 days showed no clear advantage (RR, 0.87; 95% CI, 0.71–1.06; I²=0%). No evidence of small study effects was observed.
Conclusion
EOS was associated with a lower risk of treatment failure than prolonged IV therapy, with the greatest benefit observed when the switch occurred within 4 days. These findings should be interpreted with clinical caution given that most of the evidence is observational.

Endocrinology, Diabetes, and Metabolism
Association between perirenal fat tissue thickness and subclinical atherosclerosis in patients newly diagnosed with type 2 diabetes: a cross-sectional study: Işıl Isel, Mehmet Karagulle, Turgut Karabag; J Yeungnam Med Sci. 2026;43:10. Published online January 6, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.10

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Abstract PDF: Background
Perirenal fat is an important endocrine organ that produces and secretes bioactive cytokines and adipokines involved in the pathogenesis of cardiovascular diseases. The association of perirenal and pararenal fat tissue thickness (PPRFT) with subclinical atherosclerosis and myocardial function in patients with newly diagnosed type 2 diabetes mellitus (ND-T2DM) was investigated in this study.
Methods
The study included 111 patients with ND-T2DM (59 males; mean age, 49.7±9.6 years) and 57 individuals without any disease diagnosis as the control group (23 males; mean age, 48.5±7.2 years). PPRFT and carotid intima-media thickness (CIMT) were measured using ultrasonography. Conventional parameters, including epicardial fat tissue (EFT) thickness, were measured using transthoracic echocardiography and myocardial velocities were measured using tissue Doppler echocardiography.
Results
CIMT, EFT thickness, and PPRFT were higher in patients with ND-T2DM than in controls (p<0.001). While the E/A ratio was significantly lower in patients with ND-T2DM than in controls (p<0.001), the E wave deceleration time, and E/E′ septal and lateral ratios were significantly higher in the former (p<0.001, p<0.001, and p=0.002, respectively). PPRFT values were significantly correlated with CIMT and EFT thickness (ρ=0.490, ρ=0.517; p<0.001 and ρ=0.588, ρ=0.574; p<0.001, respectively) and negatively correlated with ejection fraction and mitral E/A ratio (ρ=–0.549, ρ=–0.530; p<0.001 and ρ=–0.512, ρ=–0.465; p<0.001, respectively).
Conclusion
PPRFT values measured using ultrasonography in patients with ND-T2DM are significantly associated with CIMT and EFT, which are indicators of subclinical atherosclerosis.

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.

Dermatology
Pulsed dye versus neodymium-doped yttrium aluminum garnet lasers for refractory warts: a systematic review and meta-analysis: Joon-Goon Kim; J Yeungnam Med Sci. 2026;43:6. Published online December 22, 2025; DOI: https://doi.org/10.12701/jyms.2026.43.6

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Abstract PDF: Background
Refractory cutaneous warts often persist despite conventional treatments. Pulsed dye lasers (PDLs) and long-pulsed neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers are commonly used in clinical practice. However, comparative data on refractory cases remain limited.
Methods
Following PRISMA 2020 guidelines, PubMed, Embase, Scopus, and Cochrane Library were searched through October 11, 2025, for studies evaluating PDL or Nd:YAG treatment for refractory warts. Head‑to‑head studies were meta-analyzed using Inverse Variance fixed‑effect odds ratios (ORs), whereas single‑arm evidence was summarized narratively following the SWiM guidelines. The primary outcome was complete clearance, with hemorrhagic complications as the key safety outcome.
Results
Fifteen studies met the inclusion criteria: three head‑to‑head (n=224; 115 PDLs and 109 Nd:YAG lasers) and 12 single‑arm series. Complete clearance was similar between PDLs and Nd:YAG lasers (OR, 1.29; 95% confidence interval [CI], 0.66–2.50; I²=0%). Hemorrhagic complications occurred less frequently with PDLs (OR, 0.23; 95% CI, 0.07–0.74; I²=22%). Single-arm studies indicated broad clearance ranges (PDL, 5.1%–89.0%; Nd:YAG, 9.1%–100%).
Conclusion
PDLs and Nd:YAG lasers demonstrated comparable efficacies in treating refractory warts, and PDLs conferred a safety advantage for hemorrhagic events. The lesion site, thickness, bleeding tolerance, and patient context should be considered when selecting the treatment modality.

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.

Psychiatry and Mental Health
Feasibility and construct validity evaluation of remote neuropsychological testing using the K-eRBANS: a preliminary single group prospective observational study: Dai Seg Bai; J Yeungnam Med Sci. 2025;42:75. Published online November 15, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.75

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Abstract PDF: Background
This study evaluated the feasibility and construct validity of the Korean electronic version of the Repeatable Battery for the Assessment of Neuropsychological Status (K-eRBANS), a tablet-based neuropsychological test designed for remote cognitive screening for the prevention and early detection of dementia.
Methods
The K-eRBANS was administered remotely using paired examiner–participant tablets with automated scoring and secure data transmission. The system was interoperable with the Clinical Data Interchange Standards Consortium (CDISC)-compliant Korean dementia standard database. Concurrent validity was examined against the Korean Mini-Mental State Examination-2 (K-MMSE-2) and Clinical Dementia Rating (CDR). Construct validity was tested using confirmatory factor analysis (CFA) of the theoretical five-factor model.
Results
A total of 150 participants (mean age, 55.0±6.5 years; 24.7% male) completed testing. Cognitive performance was generally preserved with slightly lower visuospatial/constructional abilities (mean, 83.66; standard deviation, 21.95). K-eRBANS scores were positively correlated with K-MMSE-2 (r=0.223–0.577, p<0.01) and negatively with CDR (r=−0.118 to −0.414, p<0.01). CFA results supported the hypothesized five-factor model (χ2=104.44; chi-square to degrees of freedom ratio, 2.13; root mean square error of approximation, 0.089; comparative fit index, 0.910; Tucker-Lewis index, 0.879), indicating acceptable model fit.
Conclusion
The findings demonstrate that K-eRBANS is a feasible, reliable, and psychometrically valid digital neuropsychological tool that preserves the structural integrity of the original, nonelectronic version of the tool. Its integration with the CDISC-aligned databases enables scalable remote cognitive assessment and supports data-driven dementia prevention within Korea’s national dementia care framework.

Anesthesiology and Pain Medicine
Comparison of the protective effects of infliximab and splenectomy on hepatic ischemia-reperfusion injury in rats: an experimental study: Shiback Lee, Deokhee Lee, Youngjun Jang, Dong Gun Lim, Kyung Hwa Kwak, Hoon Jung, Eun Kyung Choi; J Yeungnam Med Sci. 2025;42:72. Published online November 10, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.72

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Abstract PDF: Background
Hepatic ischemia-reperfusion injury (IRI) is a complex process involving multiple mediators that initiate inflammatory responses, ultimately leading to cell necrosis and apoptosis. During hepatic IRI, various inflammatory cytokines, including tumor necrosis factor-alpha (TNF-α), and reactive oxygen species (ROS) exacerbate liver injury. Infliximab is an antibody that neutralizes TNF-α, and suppression of TNF-α activity with infliximab treatment can protect the liver from IRI. Splenectomy also alleviates hepatic IRI by decreasing neutrophil infiltration, reducing the release of ROS into the hepatic sinusoids, and suppressing TNF-α release. This study aimed to evaluate the effects of infliximab on hepatic IRI based on inflammatory responses, oxidative stress, and apoptosis, and to compare these effects with those of splenectomy.
Methods
Twenty-four rats were randomly assigned to the following four groups: (1) sham, (2) hepatic ischemia-reperfusion (IR), (3) hepatic IR with 10 mg/kg infliximab, and (4) hepatic IR with splenectomy. Each group consisted of six rats. Hepatic ischemia was induced for 30 minutes, followed by 2 hours of reperfusion injury. Infliximab was administered intraperitoneally 1 hour before surgery and splenectomy was performed immediately before hepatic ischemia.
Results
Infliximab and splenectomy downregulated the levels of liver enzymes (aspartate aminotransferase [p<0.001 for all] and alanine aminotransferase [p<0.001 for all]), a prooxidant (malondialdehyde [p=0.006 for infliximab; p<0.001 for splenectomy]), inflammatory cytokines (TNF-α and nuclear factor kappa B [p<0.001 for all]), and an apoptotic mediator (caspase-3 [p=0.005 for infliximab; p=0.004 for splenectomy]) compared with those with hepatic IR alone.
Conclusion
Infliximab treatment and splenectomy mitigated hepatic IRI. These protective effects are likely mediated via anti-inflammatory, antioxidative, and antiapoptotic pathways within the pathophysiology of hepatic IRI.

Review articles

Infectious Disease
Vaccine trends: a narrative review: Jacob Sangwoon Bae; J Yeungnam Med Sci. 2025;42:71. Published online November 5, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.71

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Abstract PDF: Vaccination has played a central role in the historical and modern fight against infectious diseases. This review explores the evolution of infectious disease perception from ancient humoral theories to the modern “One Health” framework, reflecting the integration of environmental, animal, and human health. Vaccines have not only reduced morbidity and mortality but have also provided profound economic and developmental benefits across societies. Climate change, antimicrobial resistance, and the rapid emergence of new infectious threats have prompted innovations in vaccine technologies, including messenger RNA, DNA, viral vector, and nanoparticle-based platforms. These advances support personalized vaccine strategies, such as vaccinomics, and extend their application to noncommunicable diseases, including cancer and Alzheimer disease. Despite their success, vaccines face challenges including global access disparities, waning immunity, pathogen evolution, and vaccine hesitancy. Nonetheless, vaccination remains a cornerstone of global health security, with strong returns on investment and crucial roles in socioeconomic stabilization during pandemics. Future vaccine strategies must integrate technological innovation with equitable access and public trust, for instance, through global initiatives like the Coalition for Epidemic Preparedness Innovations and the World Health Organization COVID-19 Vaccines Global Access, and the establishment of regional manufacturing hubs to effectively respond to unpredictable threats like “Disease X.”

Anesthesiology and Pain Medicine
Anesthetic implications of psychotropic medications: a narrative review: Sung Mee Jung, Sang-Jin Park; J Yeungnam Med Sci. 2025;42:70. Published online November 5, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.70

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Abstract PDF: Psychotropic medications are widely used in the treatment of mental and nonmental disorders such as chronic pain and other off-label indications. With the increase in comorbidities of mental and physical illnesses, anesthesiologists more frequently encounter patients taking psychotropic medications who require surgical procedures. Commonly prescribed psychiatric medications include antidepressants, mood stabilizers, anxiolytics, and antipsychotics. These medications can interact with anesthetic agents or other drugs commonly used during anesthesia at both pharmacokinetic and pharmacodynamic levels, potentially precipitating life-threatening syndromes such as serotonin syndrome, neuroleptic malignant syndrome, and lithium toxicity. This review summarizes the current knowledge on the pharmacology of commonly prescribed psychiatric medications, including their adverse effects and interactions with anesthetic agents routinely used in the perioperative period. Additionally, considering the risk of withdrawal symptoms and psychiatric relapse or recurrence, current recommendations for the discontinuation or continuation of these medications during the perioperative period are discussed.

Original article

Urology
Improved patient comfort and procedural efficiency using chlorhexidine-coated hydrophilic urethral catheters: a randomized controlled trial: Seung-Kwon Choi, Jeonghyouk Choi, Dong-Gi Lee; J Yeungnam Med Sci. 2025;42:68. Published online October 28, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.68

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Abstract PDF Supplementary Material: Background
This study aimed to evaluate the efficacy and convenience of a chlorhexidine-coated hydrophilic urethral catheter compared with a conventional silicone Foley catheter, focusing on patient discomfort, procedural time, and clinician satisfaction.
Methods
This prospective randomized controlled study enrolled patients who required short-term urethral catheterization at two hospitals. The patients were randomly assigned to receive either a conventional urethral catheter (control group, n=64) or a chlorhexidine-coated hydrophilic urethral catheter (intervention group, n=67). The primary endpoints were patient-reported pain scores during catheter insertion and removal (pain scale, 0–10), procedural time (seconds), and clinician-reported satisfaction (0–10).
Results
Patients in the intervention group reported significantly less pain during catheter insertion (mean score, 4.2 vs. 6.6; p<0.01) and removal (mean score, 2.8 vs. 4.5; p<0.01). The mean procedural time was shorter in the intervention group (215 seconds vs. 386 seconds; p<0.01), and clinician satisfaction was higher (mean score, 8.2 vs. 3.6; p<0.01). Patients in the intervention group were more likely to experience mild pain during catheter insertion (score, 0–3; 26.9% vs. 12.7%; odds ratio [OR], 2.53) and removal (score, 0–3; 83.6% vs. 42.9%; OR, 6.79). A greater proportion of procedures was completed within 150 seconds (59.7% vs. 44.4%; OR, 1.85), and clinicians reported higher satisfaction with the procedure (score, 8–10; 73.1% vs. 23.4%; OR, 8.71).
Conclusion
Chlorhexidine-coated hydrophilic urethral catheters significantly reduced pain, shortened the procedural time, and improved clinician satisfaction. These findings suggest potential clinical benefits for both patients and clinicians.

Review article

Psychiatry and Mental Health
Prenatal stress and neuroendocrine pathways framing attention-deficit/hyperactivity disorder as a functionally based neurodevelopmental disorder: a narrative review: Sung-Cherl Jung; J Yeungnam Med Sci. 2025;42:67. Published online October 26, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.67

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Abstract PDF: Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental condition with a strong genetic underpinning, yet mounting evidence highlights prenatal maternal stress and depression as critical environmental risk factors. Maternal dysregulation of the hypothalamic-pituitary-adrenal axis, with elevated cortisol, corticotropin-releasing hormone, and adrenocorticotropic hormone, can cross the placenta and reprogram the fetal neuroendocrine system. These changes may disrupt dopaminergic signaling, suppress brain-derived neurotrophic factor expression, and alter glutamatergic and GABAergic balance, thus impairing synaptic plasticity and executive function. Clinical and animal studies consistently demonstrate that, unlike autism spectrum disorder and intellectual disability, ADHD is characterized less by structural abnormalities and more by functional deficits in neurotransmission and circuit dynamics. Recognizing ADHD as a functionally disrupted but structurally preserved condition reframes its etiology within a developmental perspective. This review integrates epidemiological, mechanistic, and preclinical findings to propose a mechanistic framework in which maternal stress and depression may act through neuroendocrine and dopaminergic pathways to shape the prenatal origins of ADHD, suggesting the potential importance of maternal screening and preventive strategies.

Original article

Pharmacology, Drug Therapy, and Toxicology
Characteristics and risk factors of serious adverse drug reactions in older patients using the Korea Adverse Event Reporting System data: a retrospective observational study: Minkyung Oh; J Yeungnam Med Sci. 2025;42:66. Published online October 22, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.66

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Abstract PDF: Background
Older adults are vulnerable to adverse drug reactions (ADRs) owing to physiological changes, comorbidities, and polypharmacy. Nationwide evidence in Korean is limited. This study aimed to describe the characteristics of ADRs and identify the risk factors for serious outcomes using the Korea Adverse Event Reporting System (KAERS).
Methods
KAERS reports from 2005 to 2015 were analyzed. Eligible cases were patients aged ≥65 years with causality assessed as certain, probable, or possible for orally administered drug. Serious ADRs were defined according to International Conference on Harmonization E2A and World Health Organization-Uppsala Monitoring Centre criteria. Descriptive statistics, chi-square tests, logistic regression, and disproportionality analyses were performed.
Results
Of the 889,997 ADR reports, 118,023 involved older patients (mean age 73.6 years; 57.9% female). Organ disorders included gastrointestinal, skin, and nervous system disorders. The common drug classes were analgesics, antimicrobials, and antituberculosis drugs. Overall, 6.1% of ADRs were serious, mainly involving the hepatic and biliary systems, respiratory, and bleeding/coagulopathy. The highest proportions of serious ADRs involved antineoplastic and antithrombotic agents. In multivariable analysis, male sex was independently associated with serious outcomes (adjusted odds ratio, 1.33; 95% confidence interval, 1.24–1.43), while age group was not. Disproportionality analysis identified notable drug-organ class signals, including antimicrobials associated with application site disorders and antineoplastic agents associated with disorders.
Conclusion
Serious ADRs comprised 6.1% of reports in older Koreans. Antineoplastic and antithrombotic agents were strongly associated with serious outcomes and male sex was an independent risk factor. These results indicate a need for safer prescriptions and improved pharmacovigilance for older patients.

Case report

Radiology, Radiotherapy & Diagnostic Imaging
Posterior circulation infarction after bronchial artery embolization through bronchial to left subclavian artery shunt: a case report: Jongsoo Park, Kyungsoo Hong, Suhong Kim; J Yeungnam Med Sci. 2025;42:62. Published online October 2, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.62

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Abstract PDF: Bronchial artery embolization (BAE) is an effective and minimally invasive procedure for managing massive or medically refractory hemoptysis. Despite its overall safety, BAE can be associated with complications, including nontarget embolization, with cerebral infarction being a rare but severe adverse event. We report a case of posterior circulation infarction, caused by unintended embolization of trisacryl gelatin microspheres via anastomosis between the left bronchial and left subclavian arteries, following BAE in a 45-year-old man with massive hemoptysis. After the BAE, the patient complained of nausea and vomiting. Magnetic resonance imaging (MRI) revealed multifocal bilateral posterior circulation infarctions. The patient was initially treated with aspirin. However, follow-up MRI the next day showed hemorrhagic transformation of the right thalamic infarct along with right lateral intraventricular hemorrhage. Consequently, aspirin was discontinued, and blood pressure was carefully managed. Seven days later, the patient’s symptoms improved without any neurological sequelae. This case highlights the importance of superselective catheterization, meticulous angiographic assessment, and repeat angiography during embolization to minimize neurological complications. Anticoagulation therapy may be beneficial for the management of such complications.

Original article

Public Health, Environmental, and Occupational Health
Effects of electronic smoking on daytime plasma cortisol levels and the possible ameliorating role of physical activity: a cross-sectional study: Mahmoud A. Alomari, Omar F. Khabour; J Yeungnam Med Sci. 2025;42:58. Published online September 22, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.58

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Abstract PDF Supplementary Material: Background
Cortisol is a hormone that regulates metabolism, circadian rhythm, homeostasis, immunity, and normal growth. Physical activity has numerous health benefits, and smoking is associated with several chronic conditions. This study aimed to investigate the combined effects of physical activity and smoking on circulating cortisol levels.
Methods
Diurnal plasma cortisol levels were measured among individuals (age, 35±14 years; n=974) who smoked electronic (e)-cigarettes (n=239), cigarettes (n=230), waterpipes (n=268), and those who did not smoke (n=237) according to physical activity level.
Results
Two-way analysis of covariance showed an effect on cortisol levels of moderate physical activity (p<0.02) and smoking status (p<0.001) without an interaction effect (p>0.3). Group comparisons showed increased (p<0.001) cortisol among e-cigarette users (247.1±7.4 ng/mL) compared to cigarette users (177.8±7.2 ng/mL), waterpipe users (179.8±6.2 ng/mL), and nonsmokers (181.2±7.2 ng/mL) with no statistical differences between other groups (p>0.05). In addition, among the nonsmokers and cigarette smokers, cortisol levels were reduced in individuals with higher participation in moderate physical activity compared to levels in individuals with lower participation (p<0.005).
Conclusion
These results indicate that e-cigarette use is associated with plasma cortisol levels. Physical activity appears to temper cortisol levels in both cigarette smokers and nonsmokers. However, physical activity may not be sufficient to temper plasma cortisol levels associated with e-cigarette use.

Review articles

Pulmonary and Respiratory Medicine
Creating home-based pulmonary rehabilitation programs for patients with asthma: insights from practice: Cahidenur Koçak, Massimiliano Polastri, Esra Pehlivan; J Yeungnam Med Sci. 2025;42:57. Published online September 17, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.57

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Abstract PDF: Pulmonary rehabilitation (PR) plays a crucial role in the management of asthma symptoms and addresses the physical, psychological, and social consequences of asthma. However, difficulties in accessing hospital-based PR programs could result in underutilization of these services. Alternative models such as home-based PR and telerehabilitation are promising in their potential to mitigate barriers and improve adherence. It is well known that PR has a significant positive impact on both respiratory and physical functions, as well as individual well-being. Indeed, such effects have been confirmed in several studies in which psychological symptoms (i.e., anxiety and depression), physical capacity, and health-related quality of life improved in patients with asthma. Nonetheless, to sustain treatment-related benefits in the long term, PR programs must be tailored to individual needs and planned using a multidisciplinary and holistic approach. Given the high prevalence of asthma in children, home-based PR programs may offer substantial benefits to the pediatric population and warrant further investigation. The present review describes the characteristics of home-based PR and provides evidence on current practices for the management of asthma and the development of a patient-centered therapeutic approach.

Plastic and Reconstructive Surgery
Radial artery superficial palmar branch free flap versus toe pulp free flap for finger pulp reconstruction: a narrative review: Daihun Kang; J Yeungnam Med Sci. 2025;42:56. Published online September 13, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.56

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Abstract PDF: Finger pulp reconstruction remains a challenging aspect of hand surgery and requires a careful balance between functional restoration and donor-site morbidity. Among the various microsurgical options, radial artery superficial palmar branch (RASP) and toe pulp free flaps have emerged as the two most widely used techniques, each offering distinct advantages. This narrative review comprehensively compares these two microsurgical approaches for finger pulp reconstruction. The RASP free flap harvested from the thenar region provides glabrous palmar tissue with an excellent color match, minimal donor-site morbidity, and the advantage of single-field surgery. However, it lacks the specialized architecture of native finger pulp. In contrast, the toe pulp free flap offers anatomically identical tissue with superior sensory recovery (two-point discrimination, 4–7 mm vs. 6–12 mm for the RASP free flap) and exceptional durability, representing true “like-with-like” reconstruction. Nevertheless, it requires longer operative times and carries significant donor-site morbidity, affecting gait. The selection of these techniques should be individualized based on the defect characteristics, functional demands, and patient factors. The RASP free flap is an excellent first-line option for most defects where standard functional recovery is sufficient, whereas toe pulp transfer remains the gold standard for patients requiring maximal sensory discrimination. Future research should prioritize high-quality comparative studies to evaluate the outcomes of various finger pulp reconstruction techniques.

Original articles

Neurology
Characteristics of mDIXON-Quant and proton magnetic resonance spectroscopy imaging of thigh skeletal muscles in patients with stroke-related sarcopenia: a prospective case-control study: Ruihong Yao, Bu-Lang Gao, Jihong Hu, Wei Zhao, Yang Tian, Liqing Yao, Yongneng Jiang; J Yeungnam Med Sci. 2025;42:49. Published online August 28, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.49

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Abstract PDF: Background
This study was performed to investigate the imaging features of mDIXON-Quant sequence (Philips Healthcare) and proton magnetic resonance spectroscopy (1H-MRS) of thigh muscles in patients with stroke-related sarcopenia (SRS).
Methods
This prospective case-control study was conducted in 40 patients with SRS, 40 patients without sarcopenia who had a stroke, and 40 healthy volunteers using mDIXON-Quant and 1H-MRS scanning. Skeletal muscle cross-sectional area (CSA) and fat fraction (FF) were analyzed.
Results
The skeletal muscle FF value was significantly higher (p<0.05) in patients with SRS and on the affected side. The extracellular fat content of the rectus femoris muscle in normal controls was 4× to 10× the intracellular fat content. A significant increase (p<0.05) in intra- and extracellular fat content was detected in the SRS group. The degree of fat content increase in the SRS group was significantly lower (p<0.05) for extracellular fat than intracellular fat, with a ratio of extracellular to intracellular fat content of <4. The intracellular fat content was significantly higher (p<0.05) in the SRS group. A moderate-to-strong positive correlation existed between intracellular fat content (area 1) and muscle fat percentage. The degree of decrease in CSA in the posterior muscle group was significantly greater (p<0.05).
Conclusion
Thigh muscle CSA significantly decreased in SRS, while FF increased. The intra- and extracellular fat content of the skeletal muscle was significantly increased, especially the intracellular fat content. SRS was confirmed when the ratio of extracellular fat content to intracellular fat content was <4.

Neurology
Predictive assessment with outcomes of phrenic nerve study in Guillain-Barré syndrome: a prospective study: Rajarshi Chakraborty, Rajesh Verma, Sarvesh Kumar Chaudhary, Harish Nigam, Ankit Khetan, Swati Shakya, Pushpita Barman, Aparajita Chakraborty; J Yeungnam Med Sci. 2025;42:45. Published online August 16, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.45

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Abstract PDF: Background
Guillain-Barré syndrome (GBS) is an acute acquired autoimmune inflammatory disorder of the peripheral nerves and roots. Respiratory insufficiency is an important predictor of a poor prognosis in patients with GBS. Phrenic nerve assessment is an area of interest in GBS with respiratory failure. We aimed to analyze the characteristics of the phrenic nerve conduction study (NCS) in GBS and assess its value in predicting respiratory failure requiring ventilatory support, along with outcome assessment at 6 months as per the Hughes score.
Methods
A total of 135 patients with GBS admitted to our hospital over 3 years were thoroughly evaluated by clinical examination, blood laboratory tests, and phrenic NCS.
Results
Phrenic NCS abnormality was observed in 48 patients (35.6%) with statistically significant increases in phrenic sum compound muscle action potential (CMAP) latency (18.91±7.82 ms) and sum CMAP duration (44.65±6.84 ms), along with reduced sum CMAP amplitude (0.3246±0.132 mV) and sum CMAP area (3.56±2.62 mV·ms) occurring in those requiring ventilatory assistance. The sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios of the phrenic NCS for predicting respiratory failure in patients with GBS were 90.7%, 90.2%, 81.3%, 95.4%, 9.27, and 0.10, respectively. The results showed a statistically significant association between abnormal initial phrenic NCS scores and outcomes at 6 months.
Conclusion
Phrenic NCS can predict respiratory failure requiring ventilator assistance in patients with GBS. Phrenic NCS can be incorporated into routine NCS protocols to predict impending respiratory failure in patients with GBS.

Original Article

Pathology and Forensic Medicine
Diagnostic performance of immunohistochemistry and rapid urease test in detecting Helicobacter pylori, emphasizing bacterial localization and mucosal changes: a retrospective cross-sectional study: Kongsak Loharamtaweethong, Chalermpak Supakatitham; J Yeungnam Med Sci. 2025;42:41. Published online July 13, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.41

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Abstract PDF

Background
Accurate detection of Helicobacter pylori is essential for diagnosing and managing gastritis and related gastrointestinal disorders. This study evaluated the diagnostic performance of the rapid urease test (RUT) and immunohistochemistry (IHC) using four antibodies (BioGenex, MBL, Cell Marque, and Dako), focusing on bacterial localization (surface vs. subepithelial) and associated mucosal changes.
Methods
Gastric biopsy specimens from patients undergoing upper endoscopy at Vajira Hospital (June–December 2022) were retrospectively analyzed. Histological evaluations included hematoxylin and eosin staining, RUT, and IHC. Sensitivity of each antibody for detecting H. pylori was compared, emphasizing subepithelial colonization and histopathological patterns.
Results
The BioGenex antibody exhibited the highest sensitivity, followed by MBL, Cell Marque, and Dako antibodies. RUT demonstrated the lowest sensitivity, particularly in cases of chronic nonactive gastritis or minimal mucosal changes. BioGenex detected the greatest number of subepithelial H. pylori cases, many of which were missed by the other antibodies and RUT. Subepithelial colonization appeared as dot-like signals indicative of coccoid forms or bacterial remnants. The BioGenex antibody identified all subepithelial cases detected by the TMDU antibody, highlighting the former’s superior sensitivity. Statistical analysis confirmed the significantly higher diagnostic accuracy of the BioGenex antibody across multiple histological subgroups (p<0.05).
Conclusion
Subepithelial H. pylori colonization is clinically important but often missed by RUT and less sensitive IHC antibodies. The BioGenex antibody showed superior detection of both surface and subepithelial bacteria. Patients suspected of subepithelial infection without surface bacteria should undergo urea breath or stool antigen testing per guidelines.

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COMPARISON OF RAPID UREASE TEST WITH IMMUNOHISTOCHEMICAL EXAMINATION OF GASTRIC MUCOSA SPECIMEN IN THE DIAGNOSTICS OF HELICOBACTER PYLORI INFECTION AMONG OUTPATIENTS
Anna Bryczkowska, Tomasz Arłukowicz, Leszek Paweł Gromadziński
Polish Journal of Natural Sciences.2025; 40(3): 181. CrossRef

Communications

Physical therapy, Sports therapy, and Rehabilitation
The feasibility of conducting successful pulmonary rehabilitation in India: Manivel Arumugam, Senthilkumar Ramasamy, Pitchaimani Govindharaj, Mahendran Murugan; J Yeungnam Med Sci. 2025;42:40. Published online June 28, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.40

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Abstract PDF

Pulmonary rehabilitation (PR) is a highly effective evidence-based treatment with multidisciplinary and comprehensive individualized interventions that reduce morbidity by improving functional capacity and managing respiratory symptoms. It can contribute to overall wellness, reduce symptoms related to respiratory conditions, and facilitate routine work and social activities. Hence, it is a vital component of integrated care for patients with chronic respiratory diseases. In India, PR faces several challenges arising from patients, society, and hospitals. Recent evidence suggests that PR has significant benefits in chronic respiratory diseases, including reduced morbidity and mortality, improved quality of life, and cost savings. Nevertheless, it has been significantly underutilized and has not received the necessary attention in India. The lack of proper utilization of PR can be attributed to several factors, including a lack of awareness and understanding among healthcare professionals regarding its advantages, insufficient referrals to PR programs, scarcity of specialized professionals trained in PR, and a general lack of awareness among patients about its benefits. This article aims to outline the obstacles to PR, identify the factors that influence its successful implementation, and propose possible solutions to overcome these barriers.

Citations

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Creating home-based pulmonary rehabilitation programs for patients with asthma: insights from practice
Cahidenur Koçak, Massimiliano Polastri, Esra Pehlivan
Journal of Yeungnam Medical Science.2025; 42: 57. CrossRef

Original article

Gastroenterology and Hepatology
Clinical association between histological activity at diagnosis and endoscopic response in patients with ulcerative colitis: a retrospective study: Jae-Sung Yoo, Kyeong Ok Kim, Min Cheol Kim, Byung Ik Jang; J Yeungnam Med Sci. 2025;42:39. Published online June 22, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.39

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Abstract PDF: Background
Histological activity in ulcerative colitis (UC) has been accepted to be associated with clinical outcomes. This study aimed to investigate the association between the histological activity at diagnosis and endoscopic findings, either at diagnosis or at the first follow-up, in patients with UC.
Methods
Through a retrospective review of 1 year of medical records, this study evaluated the association between histological and endoscopic activity in 51 patients newly diagnosed with UC at a tertiary hospital in Korea between March 2015 and February 2022. The Nancy histological index was used to assess histological activity, classifying patients into low (0–2) and high (3–4) groups. The Mayo Endoscopic Subscore and the Ulcerative Colitis Endoscopic Index of Severity (UCEIS) were used for endoscopic activity scoring.
Results
At diagnosis, UCEIS demonstrated no statistically significant difference histologically (p=0.065), and histological and endoscopic activities were not significantly correlated (r=0.18, p=0.200). During the first follow-up, 40 patients (78.4%) exhibited low histological activity, and the number of patients with high histological activity decreased after treatment. The first follow-up endoscopy revealed that 30 patients (58.8%) achieved an endoscopic response, including 9 (56.2%) and 21 patients (60.0%) in the high and low groups, respectively, with no significant difference (p=0.800). However, the high group at diagnosis demonstrated a positive correlation with UCEIS endoscopic activity during the first follow-up (r=0.37, p<0.001).
Conclusion
High histological activity at diagnosis was positively correlated with endoscopic activity at the first follow-up. More active care should be provided to patients with high histological activity during diagnosis.

Case report

Microbiology
Unusual Serratia marcescens pleural infection in secondary spontaneous pneumothorax: a case report: Asem Ali Ashraf, Sayantani Nag, Vimal Kumar Karnaker; J Yeungnam Med Sci. 2025;42:35. Published online May 15, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.35

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Abstract PDF: Serratia marcescens is an opportunistic gram-negative pathogen that causes pneumonia, bloodstream infections, and urinary tract infections, particularly in individuals who are immunocompromised. Although commonly associated with pulmonary infections, its involvement in pneumothorax-related infections is exceedingly rare. Secondary spontaneous pneumothorax (SSP) is a life-threatening condition that can complicate underlying lung diseases, such as chronic obstructive pulmonary disease (COPD). This case report describes a rare presentation of S. marcescens infection in a patient with SSP complicated by a bronchopleural fistula. A 64-year-old male with a history of COPD, chronic smoking, and alcohol use presented with progressive dyspnea, cough, and left-sided chest pain. Clinical evaluation revealed tachypnea, tracheal deviation, and reduced breath sounds in the left lung. Laboratory investigations revealed leukocytosis with marked neutrophilia and an elevated erythrocyte sedimentation rate. Chest imaging confirmed pneumothorax, necessitating intercostal drain (ICD) placement. Pleural fluid cultures identified multidrug-resistant S. marcescens, prompting antibiotic escalation to intravenous meropenem and oral faropenem. Despite prolonged antimicrobial therapy and ICD placement, persistent pneumothorax with a bronchopleural fistula was noted. Bronchoscopy with Fogarty balloon placement and cyanoacrylate closure was performed. However, owing to financial constraints, the patient declined follow-up cultures and high-resolution computed tomography imaging, and was discharged with an ICD in situ. This case underscores the need for heightened clinical awareness of S. marcescens in pneumothorax-associated infections. Early microbiological identification and targeted therapy are crucial for the management of rare yet challenging presentations, particularly in resource-limited settings.

Original article

Dentistry
Hydrogen-rich electrolyzed water is a useful mouthwash due to its biofilm-control properties: an in vitro and in vivo study: Ha-Young Youn, Ji-Hye Kim, Min-Jeong Cho, Su-Hyung Hong, Eun-Kyong Kim; J Yeungnam Med Sci. 2025;42:34. Published online May 8, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.34

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Abstract PDF: Background
Previous studies have demonstrated the inhibitory effect of hydrogen-rich water on biofilm formation. However, hydrogen-rich electrolyzed water (HEW) has not been evaluated as mouthwash, despite being economical, convenient, and biologically safe. We assessed the antibiofilm effects of HEW on Streptococcus mutans and its potential as a mouthwash.
Methods
The effect of HEW on S. mutans growth was assessed by measuring bacterial colony-forming units, and biofilm formation capacity was examined by crystal violet staining after culturing on a polystyrene plate. The effect of HEW on biofilm formation-related gene expression in S. mutans was assessed by real-time polymerase chain reaction. Finally, the effect of HEW on salivary S. mutans and plaque maturation was evaluated in 24 participants; after gargling with HEW twice daily, the salivary S. mutans count was quantified using a Caries Risk Test bacteria kit (Ivoclar Vivadent AG), and plaque maturation was compared using quantitative light-induced fluorescence imaging.
Results
Exposure to HEW resulted in no significant changes in S. mutans growth but a significant reduction in biofilm formation in vitro (p<0.001). Furthermore, the gene expression of glucosyltransferases (gtfB, gtfC) was significantly lower than that in the control group treated with tap water (p<0.05, p<0.01). S. mutans counts and plaque maturation were significantly lower in participants who gargled with HEW than in those who gargled with tap water (p<0.01).
Conclusion
Our data suggest that oral rinsing with HEW exerts antibiofilm effects on S. mutans, indicating that it can be used as a mouthwash to treat dental biofilm-dependent diseases.

Communications

Medical Informatics
Emerging technologies in the field of medicine presented at the Consumer Electronics Show 2025: Jong-Ryul Yang, Min Cheol Chang; J Yeungnam Med Sci. 2025;42:31. Published online April 1, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.31

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Abstract PDF

The Consumer Electronics Show 2025 highlighted innovative technologies with considerable potential for healthcare, particularly artificial intelligence (AI) and sensor technologies. Notable advances that were showcased included products that leverage AI to personalize health management, such as devices capable of recommending binaural beat stimulation, analyzing speech patterns to detect language impairment, and predicting blood pressure through sleep data analysis. AI applications to enhance sleep quality, reduce snoring, and assess the caloric content of children’s meals were presented. However, the accuracy of these products remains inadequate for clinical use, which limits their applications in community settings. This showcase also featured advances in both contact and noncontact sensor technologies. Contact-type sensors, such as wearable rings and sensors designed to measure vital signs, including pulse rate, blood glucose, and blood pressure, have been developed to mitigate discomfort while maintaining high accuracy. Noncontact sensors employing radar and remote photoplethysmography technologies have further demonstrated promise for vital sign monitoring without physical contact, although maintaining accuracy during movement remains a challenge. AI integration with sensors was further demonstrated by the development of an electronic stethoscope utilizing microelectromechanical systems and deep learning algorithms to facilitate the perception of heart and breath sounds, emulating the functionality of conventional stethoscopes. Furthermore, advances in laser-based blood glucose monitoring and wearable robotic belts designed to assist gait have underscored the progress in devices aimed at enhancing patient care and daily living. These technologies hold considerable potential to profoundly transform healthcare systems, particularly in home and community settings.

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A review of the application of nanotechnology-based, non-contact remote patient monitoring in intelligent nursing for the prevention of major adverse cardiovascular events
Xiaoya Liu, Li Min, Yuandong Tao, Li Han, Lingfei Su, Ling Wu, Xuhong Pan, Ming Zhang, Fangming Guo, Xueqin Ding
Nanomedicine.2026; 21(2): 255. CrossRef

Original articles

Obstetrics, Gynecology, and Reproductive Medicine
Patient-specific predictors of successful frozen embryo transfer using the freeze-all protocol: a retrospective observational study: Hyun Joo Lee, Eun Hee Yu, Jong Kil Joo; J Yeungnam Med Sci. 2025;42:28. Published online February 25, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.28

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Abstract PDF: Background
The aim of this study was to examine various patient factors affecting first programmed embryo transfer (ET) outcomes under the freeze-all policy at a single tertiary university infertility center.
Methods
This retrospective observational study reviewed the medical records of 243 couples who underwent their first ET using blastocysts collected under the freeze-all antagonist-controlled ovarian stimulation (COS) protocol from 2015 to 2023. Patients were grouped into pregnant and nonpregnant groups, and their data, including demographics, COS and ET outcomes, and embryo storage duration, were analyzed.
Results
Patient body mass index, cause of infertility, follicle-to-oocyte index, distribution of blastocyst grades, number of transferred embryos, and embryo storage duration were not significantly different between the groups. In a simple comparative analysis, patients with successful clinical pregnancy tended to have significantly lower female and male age (33.83±3.67 and 35.32±4.54 years vs. 37.07±4.15 and 39.33±5.60 years, respectively), higher anti-Müllerian hormone levels (6.27±5.32 ng/mL vs. 4.14±3.82 ng/mL) and antral follicle counts (14.20±8.26 vs. 10.04±5.75), and higher numbers of retrieved oocytes and metaphase II oocytes (13.74±6.92 and 9.64±6.19 vs. 11.21±6.04 and 7.53±5.56, respectively). Multivariate logistic regression analysis of these variables revealed that only male age was a significant factor for successful clinical pregnancy (odds ratio, 4.768; 95% confidence interval, 1.252–18.162; p=0.022).
Conclusion
During the first programmed ET using blastocysts collected under the freeze-all antagonist COS protocol, male age and correspondingly the quality of gametes for fertilization were crucial for successful pregnancy, having more importance than calculated female ovarian reserve and embryo storage duration.

Cardiology and Cardiovascular Medicine
Complete or incomplete revascularization in patients with left main culprit lesion acute myocardial infarction with multivessel disease: a retrospective observational study: Sun Oh Kim, Hong-Ju Kim, Jong-Il Park, Kang-Un Choi, Jong-Ho Nam, Chan-Hee Lee, Jang-Won Son, Jong-Seon Park, Sung-Ho Her, Ki-Yuk Chang, Tae-Hoon Ahn, Myung-Ho Jeong, Seung-Woon Rha, Hyo-Soo Kim, Hyeon-Cheol Gwon, In-Whan Seong, Kyung-Kuk Hwang, Seung-Ho Hur, Kwang-Soo Cha, Seok-Kyu Oh, Jei-Keon Chae, Ung Kim; J Yeungnam Med Sci. 2025;42:18. Published online December 19, 2024; DOI: https://doi.org/10.12701/jyms.2025.42.18

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Abstract PDF: Background
Complete revascularization has demonstrated better outcomes in patients with acute myocardial infarction (AMI) and multivessel disease. However, in the case of left main (LM) culprit lesion AMI with multivessel disease, there is limited evidence to suggest that complete revascularization is better.
Methods
We reviewed 16,831 patients in the Korea Acute Myocardial Infarction Registry who were treated from July 2016 to June 2020, and 399 patients were enrolled with LM culprit lesion AMI treated with percutaneous coronary intervention. We categorized the patients as those treated with complete revascularization (n=295) or incomplete revascularization (n=104). The study endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause death, myocardial infarction, ischemia-driven revascularization, stent thrombosis, and stroke. We performed propensity score matching (PSM) and analyzed the incidence of MACCE at 1 year.
Results
After PSM, the two groups were well balanced. There was no significant difference between the two groups in MACCE at 1 year (12.1% vs. 15.2%; hazard ratio, 1.28; 95% confidence interval, 0.60–2.74; p=0.524) after PSM. The components of MACCE and major bleeding were also not significantly different.
Conclusion
There was no significant difference in clinical outcomes between the groups treated with complete or incomplete revascularization for LM culprit lesion AMI with multivessel disease.

Medical Informatics
Large language model usage guidelines in Korean medical journals: a survey using human-artificial intelligence collaboration: Sangzin Ahn; J Yeungnam Med Sci. 2025;42:14. Published online December 11, 2024; DOI: https://doi.org/10.12701/jyms.2024.00794

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Abstract PDF Supplementary Material

Background
Large language models (LLMs), the most recent advancements in artificial intelligence (AI), have profoundly affected academic publishing and raised important ethical and practical concerns. This study examined the prevalence and content of AI guidelines in Korean medical journals to assess the current landscape and inform future policy implementation.
Methods
The top 100 Korean medical journals determined by Hirsh index were surveyed. Author guidelines were collected and screened by a human researcher and AI chatbot to identify AI-related content. The key components of LLM policies were extracted and compared across journals. The journal characteristics associated with the adoption of AI guidelines were also analyzed.
Results
Only 18% of the surveyed journals had LLM guidelines, which is much lower than previously reported in international journals. However, the adoption rates increased over time, reaching 57.1% in the first quarter of 2024. High-impact journals were more likely to have AI guidelines. All journals with LLM guidelines required authors to declare LLM tool use and 94.4% prohibited AI authorship. The key policy components included emphasizing human responsibility (72.2%), discouraging AI-generated content (44.4%), and exempting basic AI tools (38.9%).
Conclusion
While the adoption of LLM guidelines among Korean medical journals is lower than the global trend, there has been a clear increase in implementation over time. The key components of these guidelines align with international standards, but greater standardization and collaboration are needed to ensure the responsible and ethical use of LLMs in medical research and writing.

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Jaime A. Teixeira da Silva, Joshua Wang
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Inbok RHEE
The Korean Journal of International Relations.2025; 65(3): 257. CrossRef
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Raju Biswas, Atanu Mukhopadhyay, Santanu Mukhopadhyay
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Case report

Medical Informatics
Development of an automated foot contact area measurement program for podoscopes using ChatGPT-4: a case report: Min Cheol Chang; J Yeungnam Med Sci. 2025;42:13. Published online December 3, 2024; DOI: https://doi.org/10.12701/jyms.2024.01326

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Abstract PDF

Accurate measurement of the foot contact area is crucial for diagnosing pes planus (flatfoot) and pes cavus (high arch), which significantly affect pressure distribution across the plantar surface. This study aimed to develop a program using ChatGPT-4 to automate foot contact area measurements using a podoscope, thereby enhancing diagnostic precision. A 53-year-old female volunteer stood on a podoscope to capture images of her feet, which were processed to isolate the foot contours and measure the contact areas. A program developed utilizing ChatCPT-4 was designed to outline the feet, detect contact areas, and calculate their sizes and ratios. The results demonstrated clear visualization of foot contours with automated calculation of the contact area and its ratio to the total foot area. The entire foot area measured 1,091,381.00 pixels, with a contact area of 604,252.50 pixels. The ratio of the ground contact area to the entire foot area was calculated as 55.37%. This method, which employs advanced image-processing techniques powered by ChatGPT-4, demonstrates the potential for integrating artificial intelligence into clinical applications. This approach could improve diagnostic precision and patient outcomes through personalized treatment strategies.

Citations

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Emerging technologies in the field of medicine presented at the Consumer Electronics Show 2025
Jong-Ryul Yang, Min Cheol Chang
Journal of Yeungnam Medical Science.2025; 42: 31. CrossRef
What should researchers do in the era of artificial intelligence?
Min Cheol Chang
Journal of Yeungnam Medical Science.2025; 43: 2. CrossRef

Review article

Psychiatry and Mental Health
Advances, challenges, and prospects of electroencephalography-based biomarkers for psychiatric disorders: a narrative review: Seokho Yun; J Yeungnam Med Sci. 2024;41(4):261-268. Published online September 9, 2024; DOI: https://doi.org/10.12701/jyms.2024.00668

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Abstract PDF

Owing to a lack of appropriate biomarkers for accurate diagnosis and treatment, psychiatric disorders cause significant distress and functional impairment, leading to social and economic losses. Biomarkers are essential for diagnosing, predicting, treating, and monitoring various diseases. However, their absence in psychiatry is linked to the complex structure of the brain and the lack of direct monitoring modalities. This review examines the potential of electroencephalography (EEG) as a neurophysiological tool for identifying psychiatric biomarkers. EEG noninvasively measures brain electrophysiological activity and is used to diagnose neurological disorders, such as depression, bipolar disorder (BD), and schizophrenia, and identify psychiatric biomarkers. Despite extensive research, EEG-based biomarkers have not been clinically utilized owing to measurement and analysis constraints. EEG studies have revealed spectral and complexity measures for depression, brainwave abnormalities in BD, and power spectral abnormalities in schizophrenia. However, no EEG-based biomarkers are currently used clinically for the treatment of psychiatric disorders. The advantages of EEG include real-time data acquisition, noninvasiveness, cost-effectiveness, and high temporal resolution. Challenges such as low spatial resolution, susceptibility to interference, and complexity of data interpretation limit its clinical application. Integrating EEG with other neuroimaging techniques, advanced signal processing, and standardized protocols is essential to overcome these limitations. Artificial intelligence may enhance EEG analysis and biomarker discovery, potentially transforming psychiatric care by providing early diagnosis, personalized treatment, and improved disease progression monitoring.

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Original article

Physical therapy, Sports Therapy, and Rehabilitation
How much does clinical prediagnosis correlate with electrophysiological findings?: a retrospective study: Selda Çiftci İnceoğlu, Aylin Ayyıldız, Figen Yılmaz, Banu Kuran; J Yeungnam Med Sci. 2024;41(3):220-227. Published online July 5, 2024; DOI: https://doi.org/10.12701/jyms.2024.00381

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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.

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Review article

Physical therapy, Sports Therapy, and Rehabilitation
Ultrasound imaging and guidance in the management of myofascial pain syndrome: a narrative review: Wei-Ting Wu, Ke-Vin Chang, Vincenzo Ricci, Levent Özçakar; J Yeungnam Med Sci. 2024;41(3):179-187. Published online June 17, 2024; DOI: https://doi.org/10.12701/jyms.2024.00416

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12 Crossref

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.

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The Comparative Efficacy of Treatments for Cervicogenic Headache: A Systematic Review and Network Meta‐Analysis of Randomised Controlled Trials
Nantawan Koonalinthip, Prut Koonalintip, Chernkhuan Stonsaovapak
European Journal of Pain.2026;[Epub] CrossRef
Blood Flow of the Infraspinatus Muscle in Individuals With and Without Shoulder Pain and Myofascial Trigger Points
Jace Brown, Gary Kearns, Emily Hedges, Samantha Samaniego, Sharon Wang‐Price
Journal of Ultrasound in Medicine.2025; 44(1): 127. CrossRef
Ultrasound-Guided vs Non-Guided Pharmacopuncture for Cervical Myofascial Pain Syndrome: A Multi-Center Prospective Comparative Study Protocol
Kwangho Kim, Juhwan Song, Hongmin Chu, Robin Kwon, Seongjun Park, Junhui Kwon, Hyeon Joon Hong, Youngyun Lee, Sanghyuk Kwon, Kyungho Kang, Jungtae Leem, Cheol-Hyun Kim
Journal of Pain Research.2025; Volume 18: 1417. CrossRef
Integrating Ultrasound-Guided Injections and Peripheral Magnetic Stimulation in Chronic Myofascial/Lumbar Pain
Wei-Ting Wu, Ke-Vin Chang, Kamal Mezian, Vincenzo Ricci, Levent Özçakar
Life.2025; 15(4): 563. CrossRef
Ultrasound-guided 10% dextrose interfascial hydrodissection for patients with myofascial pain syndrome: A retrospective observational study
Tao Wu, Bao Ru, Haixin Song, Zhiping Liao, Xiaotian Yang, Fangchao Wu, Jianhua Li
Medicine.2025; 104(25): e42587. CrossRef
Importance of Myofascial Pain Syndrome of the Psoas Major Muscle and Ultrasound-Guided Treatment Algorithm
Aylin Ayyıldız, Burak Tayyip Dede, Mustafa Hüseyin Temel, Bülent Alyanak, Mustafa Turgut Yıldızgören, Fatih Bağcıer
Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders.2025;[Epub] CrossRef
Comparative effectivenesss of dry needling and deep friction massage in myofascial pain syndrome: an original research
Dies Izah Qonita, Aryadi Arsyad, Andi Ariyandy, Meutiah M. Abdullah, Andi R. A. Hasyar
Bulletin of Rehabilitation Medicine.2025; 24(4): 44. CrossRef
Pneumothorax After Dry Needling of Intrascapular Muscles Using a Rib Bracketing Technique: Insights From the Clinician, Patient, and Clinical Expert
Paul E Mintken, Blair Denman, Jan Dommerholt
Physical Therapy.2025;[Epub] CrossRef
Anatomy of the deltoid muscle trigger points
Leonardo Henrique Alves Rocha, Lucas Hara, Larissa Barbosa Lima, Ana Itezerote, Flávio Hojaij, Mauro Andrade, Alfredo Jacomo, Flavia Akamatsu
Clinics.2025; 80: 100795. CrossRef
Ultrasound elastography to guide compression therapy for gastrocnemius trigger points in runners
Ingrid C. Landfald, Michał Podgórski, Łukasz Olewnik
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Integrating Ultrasound-Guided Multifidus Injections with Repeated Peripheral Magnetic Stimulation for Low Back Pain: A Feasibility Study
Wei-Ting Wu, Ke-Vin Chang, Levent Özçakar
Journal of Pain Research.2024; Volume 17: 2873. CrossRef
Ultrasound-guided fascial plane blocks in chronic pain: a narrative review
Francesco Marrone, Carmine Pullano, Alessandro De Cassai, Pierfrancesco Fusco
Journal of Anesthesia, Analgesia and Critical Care.2024;[Epub] CrossRef

Communications

Pulmonary and Respiratory Medicine
Rehabilitative goals for patients undergoing lung retransplantation: Massimiliano Polastri, Robert M. Reed; J Yeungnam Med Sci. 2024;41(2):134-138. Published online April 5, 2024; DOI: https://doi.org/10.12701/jyms.2024.00241

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Abstract PDF

Lung retransplantation (LRT) involves a second or subsequent lung transplant (LT) in a patient whose first transplanted graft has failed. LRT is the only treatment option for irreversible lung allograft failure caused by acute graft failure, chronic lung allograft dysfunction, or postoperative complications of bronchial anastomosis. Prehabilitation (rehabilitation before LT), while patients are on the waiting list, is recognized as an essential component of the therapeutic regimen and should be offered throughout the waiting period from the moment of listing until transplantation. LRT is particularly fraught with challenges, and prehabilitation to reduce frailty is one of the few opportunities to address modifiable risk factors (such as functional and motor impairments) in a patient population in which there is clearly room to improve outcomes. Although rehabilitative outcomes and quality of life in patients receiving or awaiting LT have gained increased interest, there is a paucity of data on rehabilitation in patients undergoing LRT. Frailty is one of the few modifiable risk factors of retransplantation that is potentially preventable. As such, it is imperative that professionals involved in the field of retransplantation conduct research specifically exploring rehabilitative techniques and outcomes of value for patients receiving LRT, because this area remains unexplored.

Citations

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Experimental and Clinical Transplantation.2024;[Epub] CrossRef
Postoperative conditions of rehabilitative interest in lung transplantation: a systematic review
Massimiliano Polastri, Esra Pehlivan, Robert M. Reed, Allaina Eden
Journal of Yeungnam Medical Science.2024; 41(4): 235. CrossRef
Seven-day rehabilitation services in hospital settings: benefits and drawbacks
Massimiliano Polastri, Luciana Scuotto
International Journal of Therapy and Rehabilitation.2024; 31(12): 1. CrossRef

Original article

Thoracic and Cardiovascular Surgery
Right anterior mini-thoracotomy aortic valve replacement versus transcatheter aortic valve implantation in octogenarians: a single-center retrospective study: Ji Eun Im, Eun Yeung Jung, Seok Soo Lee, Ho-Ki Min; J Yeungnam Med Sci. 2024;41(2):96-102. Published online February 26, 2024; DOI: https://doi.org/10.12701/jyms.2023.01228

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Abstract 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.

Citations

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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
Journal of Yeungnam Medical Science.2024; 41(3): 213. CrossRef
Sutureless Aortic Prosthesis Valves versus Transcatheter Aortic Valve Implantation in Intermediate Risk Patients with Severe Aortic Stenosis: A Literature Review
Laura Asta, Adriana Sbrigata, Calogera Pisano
Journal of Clinical Medicine.2024; 13(18): 5592. CrossRef

Review article

Molecular Biology
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; J Yeungnam Med Sci. 2024;41(2):61-73. Published online February 14, 2024; DOI: https://doi.org/10.12701/jyms.2023.01347

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Abstract 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.

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Mitochondrial function in intestinal ischemia-reperfusion injury: mechanisms and therapeutic perspectives
Xuena Han, Zekun Lang, Xinghua Lv, Yang Xing, Min Hou, Zhiguo Tan, Yan Zhang, Yufang Leng
Molecular Biology Reports.2025;[Epub] CrossRef
Hyperoside mitigates amphotericin B-induced nephrotoxicity in HK-2 cells via bioenergetic and oxidative stress modulation
Ekramy M. Elmorsy, Huda A. Al Doghaither, Ayat B. Al-Ghafari, Badriah Abdullah Hifni, Najlaa M.M. Jawad, Noor A. Hakim, Manal S. Fawzy, Nagwa M. Aly
BMC Pharmacology and Toxicology.2025;[Epub] CrossRef
The lactic dehydrogenase-to-albumin ratio predicts acute kidney injury in patients with intracerebral hemorrhage: a multicenter cohort study
Taotao Dong, Yangchun Xiao, Xiang Yuan, Peng Wang, Chao You, Fang Fang, Yu Zhang
Frontiers in Neurology.2025;[Epub] CrossRef
ZNRF2 integrates ubiquitination-driven ferroptosis and mitochondrial quality control in renal ischemia–reperfusion injury
Kangyu Wang, Yun Deng, Changhong Xu, Rui Yan, Hao Wang, Yalong Zhang, Jiangwei Man, Li Yang
Biomedicine & Pharmacotherapy.2025; 192: 118584. CrossRef
The role of gut microbiota–mitochondrial crosstalk in kidney disease: a bibliometric analysis
Qin Hu, Hua Jin, Lan Hu, Xu Li
International Urology and Nephrology.2025;[Epub] CrossRef
Arfgef3 knockout ameliorates ischemia reperfusion-induced acute kidney injury via mitochondrial dysfunction alleviation in mice
Longyu Wang, Lu Yao, Danshu Xie, Wei Ding
Renal Failure.2025;[Epub] CrossRef

Case report

Emergency and Critical Care Medicine
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; J Yeungnam Med Sci. 2024;41(2):128-133. Published online February 5, 2024; DOI: https://doi.org/10.12701/jyms.2023.01319

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Abstract 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.

Citations

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Aortic dissection and pulmonary embolism: a fatal combination: а case report
Yu. V. Gavrilov, O. O. Manuilova, A. V. Melekhov, O. P. Mishutchenko, I. G. Nikitin, N. V. Petrenko, A. V. Salikov, V. S. Suryakhin, A. G. Tevosyan
Russian Journal of Cardiology.2025; 30(5S): 6082. CrossRef

Review article

Medical Education
Patient-physician interaction education in Korea: a systematic review: Hwan Ho Lee, Yu Ra Kim, Hye Jin Park; J Yeungnam Med Sci. 2024;41(2):74-79. Published online February 5, 2024; DOI: https://doi.org/10.12701/jyms.2023.01109

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Abstract 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.

Citations

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Student Learning Outcomes and Program Evaluation in Medical Humanities Education in Korea: A Systematic Review
Gyoungmin Park, Tae Yang Yu
Korean Medical Education Review.2025; 27(Suppl1): S18. CrossRef

Original article

Dentistry
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; J Yeungnam Med Sci. 2024;41(2):80-85. Published online January 22, 2024; DOI: https://doi.org/10.12701/jyms.2023.00934; Correction in: J Yeungnam Med Sci 2024;41(3):233

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Abstract 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.

Citations

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3D evaluation of fit accuracy of different ceramic inlays using two digital measurement methods
Sining Huang, Haixia Li, Jing Liang, Wenjie Cheng, Linglu Zhan, Qiong Li
Journal of Prosthodontics.2025;[Epub] CrossRef

Case report

Urology
DaVinci SP-based simultaneous bilateral partial nephrectomy from the midline transperitoneal approach: a case report: Young Hwii Ko, Jong Gyun Ha, Jae Yoon Jang, Yeung Uk Kim; J Yeungnam Med Sci. 2024;41(1):48-52. Published online January 4, 2024; DOI: https://doi.org/10.12701/jyms.2023.01032

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Abstract PDF

While simultaneous bilateral partial nephrectomy with a conventional multiport robot has been consistently reported since the 2010s, the introduction of the DaVinci SP system (Intuitive Surgical, Sunnyvale, CA, USA) could provide a novel way to perform surgery on bilateral kidneys while innovatively reducing the number of incisions. In our first report worldwide, the patient with bilateral small renal mass (2.0 cm for the left and 1.5 cm for the right side) and preoperative normal renal function was placed in the lateral decubitus position on an inverted bed. After tilting the bed to be as horizontal as possible, a 4-cm incision was made in the lower part of the umbilicus for the floating trocar technique. The partial nephrectomy was performed reliably as with the conventional transperitoneal approach, and then the patient could be repositioned to the contralateral side for the same procedure, maintaining all trocars. Total operation time (skin to skin), total console time, and the left- and right-side warm ischemic times were 260, 164, 27, and 23 minutes, respectively, without applying the early declamping technique. The estimated blood loss was 200 mL. The serum creatinine right after the operation, on the first day, 3 days, and 90 days after surgery were 0.92, 0.77, 0.79, and 0.81 mg/dL, respectively. For 90 days after the procedure, no complications or radiologic recurrence were observed. Further clinical studies will reveal the advantages of using the DaVinci SP device for this procedure over traditional multiport surgery, maximizing the benefit of a single port-based approach.

Citations

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Robot-assisted laparoscopic simultaneous bilateral partial nephrectomy for bilateral renal carcinoma: a case report
Zhenyu Cui, Ce Qin, Yong Suo, Shichao Song, Hongmei Li, Tao Ma
Frontiers in Medicine.2026;[Epub] CrossRef

Original article

Dentistry
Incidence and severity of medication-related osteonecrosis of the jaw in patients with osteoporosis using data from a Korean nationwide sample cohort in 2002 to 2019: a retrospective study: Su-Youn Ko, Tae-Yoon Hwang, Kiwook Baek, Chulyong Park; J Yeungnam Med Sci. 2024;41(1):39-44. Published online January 3, 2024; DOI: https://doi.org/10.12701/jyms.2023.01116

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Abstract PDF

Background
Medication-related osteonecrosis of the jaw (MRONJ) is a significant concern, particularly among patients taking bisphosphonates (BPs), denosumab, and selective estrogen receptor modulators (SERMs) for osteoporosis. Despite the known risks, large-scale cohort studies examining the incidence and severity of MRONJ are lacking. We aimed to ascertain the incidence and risk of MRONJ among these patients, whom we stratified by age groups, medication types, and duration of use.
Methods
We utilized data from the National Health Insurance Service’s sample cohort database, focusing on patients aged 40 years and above diagnosed with osteoporosis. The patients were divided into three groups: those prescribed BPs only, those prescribed SERMs only, and those prescribed both.
Results
The overall incidence rate of MRONJ was 0.17%. A significantly higher incidence rate was observed among those taking osteoporosis medications, particularly among females with a relative risk of 4.99 (95% confidence interval, 3.21–7.74). The SERM group also had an incidence rate comparable to that of the BP group. Severity was assessed based on the invasiveness of the treatment methods, with 71.3% undergoing invasive treatment in the medication group.
Conclusion
This study provides valuable insights into the incidence and severity of MRONJ among a large cohort of patients with osteoporosis. It underscores the need for comprehensive guidance on MRONJ risks across different medication groups and sets the stage for future research focusing on specific populations and treatment outcomes.

Citations

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Asia-Pacific consensus statement on medication-related osteonecrosis of the jaw in patients with osteoporosis
Akira Taguchi, Daisuke Inoue, Jin-Woo Kim, Keskanya Subbalekha, Wai Sin Chan, Hee Dong Chae, Chung-Hwan Chen, Ching-Lung Cheung, Eddie Siu Lun Chow, Yoon-Sok Chung, Linsey Gani, Muhammad Kamil bin Hassan, Unnop Jaisamrarn, Chakorn Vorakulpipat, Nutchada S
Osteoporosis and Sarcopenia.2026;[Epub] CrossRef
Medication-related osteonecrosis of the jaw in patients with cancer using zoledronic acid and denosumab: Single-center retrospective study
Motohiko Sano, Mai Amano, Miki Yamada, Yosuke Iijima, Shunsuke Hino, Hiroshi Sakagami, Norio Horie, Takahiro Kaneko
Journal of Oncology Pharmacy Practice.2025;[Epub] CrossRef
Incidence of medication-related osteonecrosis of the jaw and associated antiresorptive drugs in adult Finnish population
Miika Kujanpää, Ville Vuollo, Antti Tiisanoja, Marja-Liisa Laitala, György K. Sándor, Saujanya Karki
Scientific Reports.2025;[Epub] CrossRef
Effects of antiresorptives and Co-medications on 3D gingival cell Co-cultures
Heidi Maria Ekholm-Kerppola, Eliisa Löyttyniemi, Tero Soukka, Jaana Rautava
Human & Experimental Toxicology.2025;[Epub] CrossRef
Medication-Related Osteonecrosis of the Jaw: An Evidence-Based 2025 Position Statement from a Korean Multidisciplinary Task Force
Jin-Woo Kim, Sung-Hye Kong, Jae-Young Kim, Mi Kyung Kwak, Jun-Young Kim, Ji-Hyeon Oh, Hyung-Youl Park, BeomTaek Kim, Young-Kyun Lee, Jeong Joon Han, Moon-Young Kim, Yong Jun Choi, Yong-Dae Kwon, Kwang-Sup Song, Beom-Jun Kim, Sun-Jong Kim, Seung-Hoon Baek,
Endocrinology and Metabolism.2025; 40(6): 787. CrossRef
Medication-related osteonecrosis of the jaw: an evidence-based 2025 position statement from a Korean multidisciplinary task force
Jin-Woo Kim, Sung-Hye Kong, Jae-Young Kim, Mi Kyung Kwak, Jun-Young Kim, Ji-Hyeon Oh, Hyung-Youl Park, BeomTaek Kim, Young-Kyun Lee, Jeong Joon Han, Moon-Young Kim, Yong Jun Choi, Yong-Dae Kwon, Kwang-Sup Song, Beom-Jun Kim, Sun-Jong Kim, Seung-Hoon Baek,
Journal of the Korean Association of Oral and Maxillofacial Surgeons.2025; 51(6): 333. CrossRef

Communications

Physical therapy, Sports Therapy, and Rehabilitation
The applicability of noncontact sensors in the field of rehabilitation medicine: Yoo Jin Choo, Jun Sung Moon, Gun Woo Lee, Wook-Tae Park, Min Cheol Chang; J Yeungnam Med Sci. 2024;41(1):53-55. Published online December 26, 2023; DOI: https://doi.org/10.12701/jyms.2023.01144

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Abstract PDF

A noncontact sensor field is an innovative device that can detect, measure, or monitor physical properties or conditions without direct physical contact with the subject or object under examination. These sensors use a variety of methods, including electromagnetic, optical, and acoustic technique, to collect information about the target without physical interaction. Noncontact sensors find wide-ranging applications in various fields such as manufacturing, robotics, automobiles, security, environmental monitoring, space industry, agriculture, and entertainment. In particular, they are used in the medical field, where they provide continuous monitoring of patient conditions and offer opportunities in rehabilitation medicine. This article introduces the potential of noncontact sensors in the field of rehabilitation medicine.

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Emerging technologies in the field of medicine presented at the Consumer Electronics Show 2025
Jong-Ryul Yang, Min Cheol Chang
Journal of Yeungnam Medical Science.2025; 42: 31. CrossRef
Application of noncontact sensors for cardiopulmonary physiology and body weight monitoring at home: A narrative review
Yoo Jin Choo, Jun Sung Moon, Gun Woo Lee, Wook-Tae Park, Heeyeon Won, Min Cheol Chang
Medicine.2024; 103(36): e39607. CrossRef
Thinking machines: artificial intelligence in rehabilitation and beyond
Massimiliano Polastri
International Journal of Therapy and Rehabilitation.2024; 31(10): 1. CrossRef

Focused Review article

Orthopedics and Sports Medicine
The pathophysiology of diabetic foot: a narrative review: Jiyoun Kim; J Yeungnam Med Sci. 2023;40(4):328-334. Published online October 5, 2023; DOI: https://doi.org/10.12701/jyms.2023.00731

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Abstract PDF

An aging population and changes in dietary habits have increased the incidence of diabetes, resulting in complications such as diabetic foot ulcers (DFUs). DFUs can lead to serious disabilities, substantial reductions in patient quality of life, and high financial costs for society. By understanding the etiology and pathophysiology of DFUs, their occurrence can be prevented and managed more effectively. The pathophysiology of DFUs involves metabolic dysfunction, diabetic immunopathy, diabetic neuropathy, and angiopathy. The processes by which hyperglycemia causes peripheral nerve damage are related to adenosine triphosphate deficiency, the polyol pathway, oxidative stress, protein kinase C activity, and proinflammatory processes. In the context of hyperglycemia, the suppression of endothelial nitric oxide production leads to microcirculation atherosclerosis, heightened inflammation, and abnormal intimal growth. Diabetic neuropathy involves sensory, motor, and autonomic neuropathies. The interaction between these neuropathies forms a callus that leads to subcutaneous hemorrhage and skin ulcers. Hyperglycemia causes peripheral vascular changes that result in endothelial cell dysfunction and decreased vasodilator secretion, leading to ischemia. The interplay among these four preceding pathophysiological factors fosters the development and progression of infections in individuals with diabetes. Charcot neuroarthropathy is a chronic and progressive degenerative arthropathy characterized by heightened blood flow, increased calcium dissolution, and repeated minor trauma to insensate joints. Directly and comprehensively addressing the pathogenesis of DFUs could pave the way for the development of innovative treatment approaches with the potential to avoid the most serious complications, including major amputations.

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Kehkashan Parveen, Malik Asif Hussain, Sadaf Anwar, Halima Mustafa Elagib, Mohd Adnan Kausar
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Kajol Patil, Pramod S. Salve, Ujban Md Hussain Hussain, Amol Tatode, Mohammad Qutub
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Michelle Maartens, Mare Vlok, Mari van de Vyver
Molecular and Cellular Endocrinology.2025; 601: 112519. CrossRef
Risk Factors Associated with Diabetic Foot Ulcers: A Multivariate Analysis
Ajeet Saoji, Nitesh Upadhyay, Prachi Saoji, Kartik Khurana
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Esra Erdogan, Azize Yetisgen, Lezzan Keskin, Elif Seren Tanriverdi, Isilay Gokce Benk Ugur
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DİABETİK ANGİOPATİYALARIN ULTRASƏS DOPLEROQRAFİYASI İLƏ QİYMƏTLƏNDİRİLMƏSİ
G.S. Əliyeva, C.T. Əliyeva, A.T. Bədəlova
Azerbaijan Medical Journal.2025; (1): 150. CrossRef
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Purwono Purwono, Yessica Nataliani, Hindriyanto Dwi Purnomo, Ivanna K. Timotius
Biomedical Signal Processing and Control.2025; 108: 107902. CrossRef
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Zahid Miyan, Arwa Hatim, Saniya Khakwani, Khalid Abdul Basit
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Prithiviraj Nagarajan, Rajalaksmi Prithiviraj, Sharangouda J. Patil, Suresh Babu Naidu Krishna, Vasanthrie Naidoo
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Riani Erna, Arief S. Kartasasmita, Shanti F. Boesoirie, Wijana Hasansulama, Ramzi Amin
Journal of Wound Management and Research.2025; 21(2): 58. CrossRef
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Idris Ajibola Omotosho, Noorasyikin Shamsuddin, Hasniza Zaman Huri, Wei Lim Chong, Inayat Ur Rehman
International Journal of Molecular Sciences.2025; 26(14): 6909. CrossRef
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Amit Lather, Pratibha Rathee, Manish Kumar Gautam, Kalicharan Sharma, Tanuj Hooda
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Mark Mendeszoon, Ewald Mendeszoon, Hayley Iosue
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Clinical Evaluation of Diabetic Foot Ulcers Using the SINBAD (Site, Ischemia, Neuropathy, Bacterial Infection, Area, and Depth) Scoring System: A Prospective Study
Hrudaya Charan Kunda, Madhu A Yadav, Tanissha Sanjay Raj Kalpana, Dhrushti Premal Patel, Sivanandhini Sivanoli, Naman Dimpal Shah, Shahista Shahista, Jitenkumar Panchal
Cureus.2025;[Epub] CrossRef
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Daniela Martins-Mendes, Raquel Costa, Ilda Rodrigues, Óscar Camacho, Pedro Barata Coelho, Vítor Paixão-Dias, Carla Luís, Ana Cláudia Pereira, Rúben Fernandes, Jorge Lima, Raquel Soares
Cells.2025; 14(15): 1196. CrossRef
Battery-free, sprayable, wireless photothermal micro/nanofibre dressing with thermal-induced crosslinked polypyrrole for accelerated diabetic wound healing
Chun-Chi Chang, Ting-Chiau Huang, Jia-Wei Liang, Sih-Chi Chuang, Ching-Cheng Huang, Hieu Trung Nguyen, Hsien-Tsung Lu, Ke-Hung Tsui, Andrew E.-Y. Chuang
Journal of Drug Delivery Science and Technology.2025; 114: 107392. CrossRef
Progressive Hydrogel Applications in Diabetic Foot Ulcer Management: Phase-Dependent Healing Strategies
Priyanka Mallanagoudra, Sai Samanvitha M Ramakrishna, Sowmya Jaiswal, Dhruthi Keshava Prasanna, Rithika Seetharaman, Arunkumar Palaniappan, Sudarshan Kini
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Fiona S. Gruzmark, Gabriela E. Beraja, Ivan Jozic, Hadar A. Lev‐Tov
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Ewelina Bąk, Grzegorz Zawiła, Robert Skalik, Sylwia Krzemińska, Bogusława Kupczak-Wiśniowska, Lukas Kober, Elena Gurková
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A review of the basic science of the diabetic foot and its complications
Catherine Flood, David Okata, Valliammai Muthuganesan, Chi Fung Antony Yiu, Stephen Bendall
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Liyi Li, Haitao Zhang, Jinan Chen, Guangyuan Xiang, Yuedong Chen, Aiping Wang
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Somaye Rashki, Mohammad Hossein Haddadi, Zeynab Marzhoseyni, Mansoor Khaledi, Mina Yekani, Mahdi Shooraj, Foroogh Neamati, Richard Bright
Journal of Diabetes Research.2025;[Epub] CrossRef
Screening and monitoring of diabetic polyneuropathy in clinical practice: present and future with connected devices
Jean-Pascal Lefaucheur
Frontiers in Neurology.2025;[Epub] CrossRef
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Chao Lei, Wen-zhou Huang, Lin Mei, Kuo Sun, Xin-zhan Mao
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Reem Alsalamah
Journal of Medicine and Life.2025; 18(9): 893. CrossRef
Genetic polymorphisms and diabetic foot ulcer susceptibility: a systematic review and meta-analysis of Indian populations
Y. Santhosh Kumar, A. Saroja Megha, M. Ramula, Murugesan Ramachandran
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Advances in diabetic wound healing: from pathophysiology to emerging therapies
Swati Swagatika Swain, Veera Venkata Satyanarayana Reddy Karri, Md Ekhtiar Uddin, Kuppuswamy Gowthamarajan, Manimaran Bhaskaran, Vetriselvan Subramaniyan
Acta Diabetologica.2025;[Epub] CrossRef
Monitoring of IL-1β and MCP-1 Levels in Diabetic Patients with Foot Ulcer Infections
Mays Ibrahim Al-Wakeel
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P.V. Seliverstov, V.V. Zakrevsky, A.S. Ivaniuk, А.М. Kerimova, S.E. Maltsev, K.M. Tokarev
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International Wound Journal.2024;[Epub] CrossRef
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Original article

Physical therapy, Sports Therapy, and Rehabilitation
Incidence and risk factors of deep vein thrombosis and pulmonary thromboembolism after spinal cord disease at a rehabilitation unit: a retrospective study: Yoonhee Kim, Minjae Jeong, Myung Woo Park, Hyun Iee Shin, Byung Chan Lee, Du Hwan Kim; J Yeungnam Med Sci. 2023;40(Suppl):S56-S64. Published online September 20, 2023; DOI: https://doi.org/10.12701/jyms.2023.00689

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Abstract PDF

Background
Deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) are major complications of spinal cord disease. However, studies of their incidence in Korean patients are limited. Thus, this study investigated the incidence and risk factors of DVT and PTE in Korean patients with spinal cord disease.
Methods
We retrospectively analyzed the medical records of 271 patients with spinal cord disease who were admitted to a rehabilitation unit within 3 months of disease onset at a tertiary hospital. The presence of DVT and PTE was mainly determined using Doppler ultrasonography and chest embolism computed tomography. Risk factor analysis included variables such as sex, age, obesity, completeness of motor paralysis, neurological level of injury, cause of injury, lower extremity fracture, active cancer, and functional ambulation category (FAC) score.
Results
The incidences of DVT and PTE in the patients with spinal cord disease were both 6.3%. Risk factor analysis revealed that age of ≥65 years (p=0.031) and FAC score of ≤1 (p=0.023) were significantly associated with DVT development. Traumatic cause of injury (p=0.028) and DVT (p<0.001) were significant risk factors of PTE.
Conclusion
Patients with spinal cord disease developed DVT and PTE within 3 months of disease onset with incidence rates of 6.3% and 6.3%, respectively. Age of ≥65 years and an FAC of score ≤1 were risk factors for DVT. Traumatic cause of injury and DVT were risk factors for PTE. However, given the inconsistent results of previous studies, the risk factors for DVT and PTE remain inconclusive. Therefore, early screening for DVT and PTE should be performed in patients with acute-to-subacute spinal cord disease regardless of the presence or absence of these risk factors.

Citations

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Trends and Impact of Pharmacological VTE Prophylaxis Timing for Traumatic Cervical Spinal Cord Injury Across North American Trauma Centers
Ahmad Essa, Armaan K. Malhotra, Husain Shakil, James P. Byrne, Jetan Badhiwala, Avery B. Nathens, Tej D. Azad, Eva Y. Yuan, Yingshi He, Andrew S. Jack, Francois Mathieu, Jefferson R. Wilson, Christopher D. Witiw
Journal of Bone and Joint Surgery.2026; 108(1): 51. CrossRef
Safety and efficacy of botulinum toxin in Human T-Lymphotropic Virus-1-Associated Myelopathy/Tropical Spastic Paraparesis: A randomized clinical trial
Matheus Sales, Giselle Barbara De Almeida Scaldafferri, Matheus Henrique Almeida, Vítor Melo, Tatiana Dias, Paulo Canas Rodrigues, Ailton Melo, Nildo Manoel Da Silva Ribeiro
The Journal of Spinal Cord Medicine.2026; : 1. CrossRef
Assessing the Incidence and Risk Factors of Deep Vein Thrombosis in Traumatic Spinal Cord Injury Patients at Tertiary Care Hospital in India
Sushil Chugh, Dhananjay B. Alagundagi, Shwetha Shetty Kalladka, Prakash Patil, Kurian Zachariah
Indian Journal of Physical Medicine and Rehabilitation.2025; 35(3): 191. CrossRef
Associations of RBC counts and incidence of DVT in patients with spinal cord injury: a five year observational retrospective study
Zhang Jinlong, Wang Cheng, He Chengqi
Journal of Orthopaedic Surgery and Research.2024;[Epub] CrossRef
Coagulation parameters correlate to venous thromboembolism occurrence during the perioperative period in patients with spinal fractures
Yong Jiao, Xiaohong Mu
Journal of Orthopaedic Surgery and Research.2023;[Epub] CrossRef

Case report

Neurosurgery
Shunt fracture as a sequela of cervical spine manipulation: a case report: El Kim; J Yeungnam Med Sci. 2023;40(Suppl):S109-S112. Published online July 17, 2023; DOI: https://doi.org/10.12701/jyms.2023.00479

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Abstract PDF: Shunt disconnection is an unreported complication of spinal mobilization and manipulation. We present the case of a young adult who underwent cystoperitoneal (CP) shunt placement for an arachnoid cyst at the age of 6 years. The shunt remained functional during a follow-up period of 11 years. The patient was admitted with headache and diplopia that started after cervical manipulation by a chiropractor. Radiography revealed fracture of the distal catheter and resultant enlargement of the temporosylvian cyst. The patient required replacement of the disconnected tubing caudal to the shunt valve. The distal catheter ruptured immediately below the outlet connector of the valve. The symptoms and signs resolved completely after insertion of a new distal tube into the peritoneum. This case report demonstrates that chiropractic manipulation of the neck may be a cause of tubing breakage in patients with CP shunts.

Original article

Urology
Risk factors for prostate-specific antigen persistence in pT3aN0 prostate cancer after robot-assisted laparoscopic radical prostatectomy: a retrospective study: Jun Seop Kim, Jae Hoon Chung, Wan Song, Minyong Kang, Hyun Hwan Sung, Hwang Gyun Jeon, Byong Change Jeong, Seong Il Seo, Hyun Moo Lee, Seong Soo Jeon; J Yeungnam Med Sci. 2023;40(4):412-418. Published online June 28, 2023; DOI: https://doi.org/10.12701/jyms.2023.00234

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Abstract PDF

Background
The aim of this study was to evaluate the risk factors for prostate-specific antigen (PSA) persistence in pathological stage T3aN0 prostate cancer (PCa) after robot-assisted laparoscopic radical prostatectomy (RALP).
Methods
A retrospective study was performed on 326 patients with pT3aN0 PCa who underwent RALP between March 2020 and February 2022. PSA persistence was defined as nadir PSA of >0.1 ng/mL after RALP, and the risk factors for PSA persistence were evaluated using logistic regression analysis.
Results
Among 326 patients, 61 (18.71%) had PSA persistence and 265 (81.29%) had PSA of <0.1 ng/mL after RALP (successful radical prostatectomy [RP] group). In the PSA persistence group, 51 patients (83.61%) received adjuvant treatment. Biochemical recurrence occurred in 27 patients (10.19%) in the successful RP group during the mean follow-up period of 15.22 months. Multivariate analysis showed that the risk factors for PSA persistence were large prostate volume (hazard ratio [HR], 1.017; 95% confidence interval [CI], 1.002–1.036; p=0.046), lymphovascular invasion (LVI) (HR, 2.605; 95% CI, 1.022–6.643; p=0.045), and surgical margin involvement (HR, 2.220; 95% CI, 1.110–4.438; p=0.024).
Conclusion
Adjuvant treatment may be needed for improved prognosis in patients with pT3aN0 PCa after RALP with a large prostate size, LVI, or surgical margin involvement.

Citations

Citations to this article as recorded by

Exosomal non-coding RNAs: orchestrators of intercellular crosstalk in the prostate cancer tumor microenvironment
Huanglin Duan, Baisheng Xu, Peiyue Luo, Tao Chen, Jun Zou
Frontiers in Immunology.2025;[Epub] CrossRef

Review articles

Dentistry
Role of gene therapy in treatment of cancer with craniofacial regeneration—current molecular strategies, future perspectives, and challenges: a narrative review: Himanshu Singh; J Yeungnam Med Sci. 2024;41(1):13-21. Published online May 23, 2023; DOI: https://doi.org/10.12701/jyms.2023.00073

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Abstract PDF

Gene therapy involves the introduction of foreign genetic material into host tissue to alter the expression of genetic products. Gene therapy represents an opportunity to alter the course of various diseases. Hence, genetic products utilizing safe and reliable vectors with improved biotechnology will play a critical role in the treatment of various diseases in the future. This review summarizes various important vectors for gene therapy along with modern techniques for potential craniofacial regeneration using gene therapy. This review also explains current molecular approaches for the management and treatment of cancer using gene therapy. The existing literature was searched to find studies related to gene therapy and its role in craniofacial regeneration and cancer treatment. Various databases such as PubMed, Science Direct, Scopus, Web of Science, and Google Scholar were searched for English language articles using the keywords “gene therapy,” “gene therapy in present scenario,” “gene therapy in cancer,” “gene therapy and vector,” “gene therapy in diseases,” and “gene therapy and molecular strategies.”

Citations

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Integrated cell membrane encapsulated PQDs-TK quantum dot nanoclusters with ROS-responsive triggering for efficient and visualized DNA delivery
Tiange Wang, Yanlin Sun, Dong Zeng, Mengying Wang, Yajing Zhang, Gang Liu, Xin Chen, Liang Liu
Journal of Colloid and Interface Science.2025; 683: 393. CrossRef

Musculoskeletal Disorders
Octacalcium phosphate, a promising bone substitute material: a narrative review: Jooseong Kim, Sukyoung Kim, Inhwan Song; J Yeungnam Med Sci. 2024;41(1):4-12. Published online May 9, 2023; DOI: https://doi.org/10.12701/jyms.2023.00010

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Abstract PDF

Biomaterials have been used to supplement and restore function and structure by replacing or restoring parts of damaged tissues and organs. In ancient times, the medical use of biomaterials was limited owing to infection during surgery and poor surgical techniques. However, in modern times, the medical applications of biomaterials are diversifying owing to great developments in material science and medical technology. In this paper, we introduce biomaterials, focusing on calcium phosphate ceramics, including octacalcium phosphate, which has recently attracted attention as a bone graft material.

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Harnessing and Optimizing α-TCP for Oral Tissue Engineering and Regenerative Dentistry
Wenbo Du, Yadong Guo, Janak Lal Pathak, Chen Xiaoshi, Hanfu Su, Liping Wang
International Dental Journal.2026; 76(1): 109288. CrossRef
Bone-Healing Enhancement Using Particulate Biomaterials and Fibrin-Based Compounds: A Narrative Literature Review of Evidence in Animal Models
Lívia Maluf Menegazzo Bueno, Camila Pascoal Correia dos Santos, Paola Tatiana Espinosa Cruel, Gabriela Romanini, Lithiene Ribeiro Castilho Padula, Cindel Regina dos Santos Oliveira, Daniela Vieira Buchaim, Rogerio Leone Buchaim
Materials.2026; 19(2): 224. CrossRef
Influence of Proteins in Octacalcium Phosphate Synthesis for the Development of Biomimetic Synthetic Bone Substitutes
Riessa Nanda Mertamani, Jooseong Kim, Sukyoung Kim
Polymer.2025; : 128532. CrossRef
Three Dimensionally Printed Octacalcium Phosphate via Binder Jetting for Use in Bone Grafting Applications
Autcharaporn Srion, Faungchat Thammarakcharoen, Watchara Chokevivat, Waraporn Suvannapruk, Jintamai Suwanprateeb
International Journal of Molecular Sciences.2025; 26(12): 5633. CrossRef
Advances in Drug Delivery Systems for Osteochondral Tissue Regeneration
Jun Shang, Jianping Zhang, Linhong Liu, Wenjuan Kou, Pingping Zhang, Guangwei Sun, Huishuang Zhou, Weihan Shi, Yaning Zhang, Chaozong Liu, Bin Li
BIO Integration.2025;[Epub] CrossRef
Improvement of bone regeneration by a synergistic combination of octacalcium phosphate and water glass
Won-Pyo Lee, Euisin Yang, Woong Kim, Riessa Nanda Mertamani, Hana Lee, Se Eun Kim, Kyung Mi Shim, Seong Soo Kang, Sukyoung Kim, Seok-Jun Kim, Jooseong Kim
Materials & Design.2024; 248: 113484. CrossRef
Development of Hydroxyapatite Coatings for Orthopaedic Implants from Colloidal Solutions: Part 1—Effect of Solution Concentration and Deposition Kinetics
Bríd Murphy, Mick A. Morris, Jhonattan Baez
Nanomaterials.2023; 13(18): 2577. CrossRef

Original articles

Dentistry
Evaluation of periodontal status in women with polycystic ovary syndrome versus healthy women: a cross-sectional study: Sandhya Pavankumar, Pavan Kumar Yellarthi, Sandeep JN, Ramanarayana Boyapati, Trinath Kishore Damera, Naveen Vital Kumar G; J Yeungnam Med Sci. 2023;40(Suppl):S17-S22. Published online May 8, 2023; DOI: https://doi.org/10.12701/jyms.2023.00143

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Abstract PDF

Background
Polycystic ovary syndrome (PCOS) affects approximately 4% to 12% of females of reproductive age. Previous studies have shown an association between systemic and periodontal diseases. This study aimed to compare the prevalence of periodontal disease in women with PCOS and healthy women.
Methods
A total of 196 women aged 17 to 45 years were included in this study. Oral hygiene index-simplified (OHI-S), gingival index (GI), community periodontal index (CPI), and loss of attachment (LA) were assessed. Individuals who smoked, were pregnant, had any systemic disease (such as type 1 or type 2 diabetes mellitus, cardiovascular disease, malignancy, osteoporosis, and thyroid dysfunction), had a history of systemic antibiotic use in the past three months, or received any periodontal intervention in the past 6 months of screening were excluded. Student t-test was used to analyze the data. A p-value of <0.05 was considered statistically significant.
Results
Despite similar OHI-S scores (p=0.972) in the two groups, women with PCOS had significantly higher GI, CPI, and LA scores than healthy women (p<0.001).
Conclusion
Periodontal disease was more prevalent in women with PCOS than in healthy women. This finding may be due to the synergistic effects of PCOS and periodontitis on proinflammatory cytokines. PCOS may have an effect on periodontal disease, and vice versa. Hence, education on periodontal health and early detection and intervention for periodontal diseases is of paramount importance in patients with PCOS.

Citations

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A Potential Link Between Oral Microbiota and Female Reproductive Health
Justyna Marcickiewicz, Małgorzata Jamka, Jarosław Walkowiak
Microorganisms.2025; 13(3): 619. CrossRef
The Association Between Periodontal Disease and Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis
Vincenzo Bitonti, Tiziana Perri, Lorenzo Cigni, Domenico Familiari, Giuseppe Vazzana, Rocco Franco
Dentistry Journal.2025; 13(5): 188. CrossRef
Insight of the interrelationship and association mechanism between periodontitis and diabetes mellitus
Yongqiang Yang, Xia Sun, Yucheng Yang, Yingchun Qie
Regenerative Therapy.2024; 26: 1159. CrossRef

Dentistry
Cytotoxicity of dental self-curing resin for a temporary crown: an in vitro study: Jae-wan Ko, Joon Sakong, Sohee Kang; J Yeungnam Med Sci. 2023;40(Suppl):S1-S8. Published online April 26, 2023; DOI: https://doi.org/10.12701/jyms.2023.00080

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Abstract PDF

Background
Residual monomer tests using high-performance liquid chromatography and cytotoxicity tests were performed to analyze the effect on the oral mucosa of a self-curing resin for provisional crown production.
Methods
A cytotoxicity test was performed to confirm whether leaked residual monomers directly affected oral mucosal cells. The cytotoxicity of the liquid and solid resin polymers was measured using a water-soluble tetrazolium (WST) test and microplate reader.
Results
In the WST assay using a microplate reader, 73.4% of the cells survived at a concentration of 0.2% liquid resin polymer. The cytotoxicity of the liquid resin polymer was low at ≤0.2%. For the solid resins, when 100% of the eluate was used from each specimen, the average cell viability was 91.3% for the solid resin polymer and 100% for the hand-mixed self-curing resin, which is higher than the cell viability standard of 70%. The cytotoxicity of the solid resin polymer was low.
Conclusion
Because the polymerization process of the self-curing resin may have harmful effects on the oral mucosa during the second and third stages, the solid resin should be manufactured indirectly using a dental model.

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Wannes Van Holm, Katleen Vandamme, Jill Hadisurya, Ferda Pamuk, Naiera Zayed, Merve Kübra Aktan, Annabel Braem, Andy Temmerman, Wim Teughels
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Andrzej Małysa, Janka Jenčová, Joanna Weżgowiec
Materials.2025; 18(18): 4323. CrossRef

Gastroenterology and Hepatology
Diagnostic value of serum procalcitonin and C-reactive protein in discriminating between bacterial and nonbacterial colitis: a retrospective study: Jae Yong Lee, So Yeon Lee, Yoo Jin Lee, Jin Wook Lee, Jeong Seok Kim, Ju Yup Lee, Byoung Kuk Jang, Woo Jin Chung, Kwang Bum Cho, Jae Seok Hwang; J Yeungnam Med Sci. 2023;40(4):388-393. Published online April 3, 2023; DOI: https://doi.org/10.12701/jyms.2023.00059

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Abstract PDF

Background
Differentiating between bacterial and nonbacterial colitis remains a challenge. We aimed to evaluate the value of serum procalcitonin (PCT) and C-reactive protein (CRP) in differentiating between bacterial and nonbacterial colitis.
Methods
Adult patients with three or more episodes of watery diarrhea and colitis symptoms within 14 days of a hospital visit were eligible for this study. The patients’ stool pathogen polymerase chain reaction (PCR) testing results, serum PCT levels, and serum CRP levels were analyzed retrospectively. Patients were divided into bacterial and nonbacterial colitis groups according to their PCR. The laboratory data were compared between the two groups. The area under the receiver operating characteristic curve (AUC) was used to evaluate diagnostic accuracy.
Results
In total, 636 patients were included; 186 in the bacterial colitis group and 450 in the nonbacterial colitis group. In the bacterial colitis group, Clostridium perfringens was the commonest pathogen (n=70), followed by Clostridium difficile toxin B (n=60). The AUC for PCT and CRP was 0.557 and 0.567, respectively, indicating poor discrimination. The sensitivity and specificity for diagnosing bacterial colitis were 54.8% and 52.6% for PCT, and 52.2% and 54.2% for CRP, respectively. Combining PCT and CRP measurements did not increase the discrimination performance (AUC, 0.522; 95% confidence interval, 0.474–0.571).
Conclusion
Neither PCT nor CRP helped discriminate bacterial colitis from nonbacterial colitis.

Citations

Citations to this article as recorded by

Procalcitonin and C-Reactive Protein as Diagnostic Biomarkers for Bacterial Gastroenteritis: A Retrospective Analysis
Hyunseok Cho, Jung Ho Lee, Sung Chul Park, Sung Joon Lee, Hee-Jeong Youk, Seung-Joo Nam, Jin Myung Park, Tae Suk Kim, Ji Hyun Kim, San Ha Kim, Sang Hoon Lee
Journal of Clinical Medicine.2025; 14(7): 2135. CrossRef

Case report

Oncology and Cancer Research
Intraabdominal abscess mimicking gastric cancer recurrence: a case report: Yong-Eun Park; J Yeungnam Med Sci. 2023;40(4):426-429. Published online February 1, 2023; DOI: https://doi.org/10.12701/jyms.2022.00864

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Abstract PDF

Surgical site infection is a common healthcare-associated infection that rarely occurs several months after surgery. Herein, a case is described in which an abdominal mass lesion was found at a 6-month follow-up visit after gastrectomy was performed for early gastric cancer. Positron emission tomography-computed tomography revealed a 2.5 cm-sized mass with a high maximal standard uptake value (8.32), located above a previous anastomosis site. Locoregional recurrence of gastric cancer was diagnosed by multidisciplinary team discussion, and explorative laparotomy was performed. However, surgical and pathologic findings revealed that the mass was an intraabdominal abscess. In conclusion, differential diagnosis of delayed abscess formation should be considered if the possibility of tumor recurrence is low, especially after early gastric cancer surgery.

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ChatGPT-4o outperforms gemini advanced in assisting multidisciplinary decision-making for advanced gastric cancer
Huizi Li, Jiaobao Huang, Kuntang Liu, Jibiao Liu, Queling Liu, Zhiyong Zhou, Zhen Zong, Shengxun Mao
European Journal of Surgical Oncology.2025; 51(8): 110096. CrossRef

Review article

Pediatrics, Perinatology, and Child Health
Advances in management of pediatric chronic immune thrombocytopenia: a narrative review: Jae Min Lee; J Yeungnam Med Sci. 2023;40(3):241-246. Published online January 9, 2023; DOI: https://doi.org/10.12701/jyms.2022.00745

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Abstract PDF

Immune thrombocytopenia (ITP) is a disease in which thrombocytopenia occurs because of immune-mediated platelet destruction and decreased platelet production. Although many pediatric patients with ITP experience spontaneous remission or reach remission within 12 months of first-line therapy, approximately 20% progress to chronic ITP. Patients who do not respond to first-line treatment or experience frequent relapses are of great concern to physicians. This review summarizes recent treatments for second-line treatment of pediatric chronic ITP.

Citations

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Beta-Thalassemia with Initial Presentation as Immune Thrombocytopenia: A Case Report
Hyun Sik Kang
Clinical Pediatric Hematology-Oncology.2023; 30(1): 42. CrossRef

Original article

Alternative Medicine
Auricular acupuncture for sleep quality in participants with mental and behavioral disorders due to prior multiple drug use: a retrospective consecutive case series: Yuri Gimelfarb, Eran Goldstien; J Yeungnam Med Sci. 2023;40(1):78-85. Published online November 28, 2022; DOI: https://doi.org/10.12701/jyms.2022.00542

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Abstract PDF

Background
Poor sleep quality is associated with psychoactive substance abuse/addiction/withdrawal. Auricular acupuncture (AA) is a nonpharmacological method used for the treatment of sleep disturbances. This study aimed to examine the quality of sleep before and after AA in participants with mental and behavioral disorders due to prior multiple drug use in the therapeutic community.
Methods
This was a consecutive case series of 27 participants (25 male [92.6%]). The median age was 35.0 years (interquartile range [IQR], 29.0–37.2 years), methadone/buprenorphine were not used, and the participants were treated with AA (median number of treatments, 15.0 [IQR, 12.0–18.0]) during a median period of 51.0 days (IQR, 49.0–51.0 days) according to the National Acupuncture Detoxification Association (NADA)-Acudetox protocol. Sleep quality was determined using the Pittsburgh Sleep Quality Index (PSQI), a self-rated questionnaire that assesses sleep quality and disturbances over a 1-month interval.
Results
The global PSQI score dropped (indicating better sleep quality) by a median of 3.0 points (IQR, 0.0–8.0 points) after treatment. In the multivariate logistic regression analysis, with an increase in global PSQI score during AA by 1 point, there was a 0.73-fold reduction in the risk of poor sleep quality post-AA (adjusted odds ratio, 0.73; 95% confidence interval, 0.52–1.01; p<0.055; Nagelkerke's R2=0.66).
Conclusion
The results revealed a positive effect of AA (by the NADA-Acudetox protocol) on sleep quality (as measured by PSQI) among participants in a treatment center with mental and behavioral disorders due to multiple drug use.

Citations

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Feasibility of Auricular Acupressure Therapy for Neuropathic Pain in Cancer Patients
Eunhea You, William Holzemer, Xiaomei Cong, Hermine Poghosyan, Heon Joon Lee, Jeffrey Paul Aleski
Pain Management Nursing.2026;[Epub] CrossRef

Communications

Endocrinology, Diabetes, and Metabolism
The art of diabetes care: guidelines for a holistic approach to human and social factors: Muhammad Jawad Hashim; J Yeungnam Med Sci. 2023;40(2):218-222. Published online November 11, 2022; DOI: https://doi.org/10.12701/jyms.2022.00577

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Abstract PDF: A holistic approach to diabetes considers patient preferences, emotional health, living conditions, and other contextual factors, in addition to medication selection. Human and social factors influence treatment adherence and clinical outcomes. Social issues, cost of care, out-of-pocket expenses, pill burden (number and frequency), and injectable drugs such as insulin, can affect adherence. Clinicians can ask about these contextual factors when discussing treatment options with patients. Patients’ emotional health can also affect diabetes self-care. Social stressors such as family issues may impair self-care behaviors. Diabetes can also lead to emotional stress. Diabetes distress correlates with worse glycemic control and lower overall well-being. Patient-centered communication can build the foundation of a trusting relationship with the clinician. Respect for patient preferences and fears can build trust. Relevant communication skills include asking open-ended questions, expressing empathy, active listening, and exploring the patient’s perspective. Glycemic goals must be personalized based on frailty, the risk of hypoglycemia, and healthy life expectancy. Lifestyle counseling requires a nonjudgmental approach and tactfulness. The art of diabetes care rests on clinicians perceiving a patient’s emotional state. Tailoring the level of advice and diabetes targets based on a patient’s personal and contextual factors requires mindfulness by clinicians.

Case report

Dentistry
Three-dimensional printing of temporary crowns with polylactic acid polymer using the fused deposition modeling technique: a case series: Eun-Kyong Kim, Eun Young Park, Sohee Kang; J Yeungnam Med Sci. 2023;40(3):302-307. Published online November 4, 2022; DOI: https://doi.org/10.12701/jyms.2022.00612

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Abstract PDF

With recent developments in digital dentistry, research on techniques and materials for three-dimensional (3D) printing is actively underway. We report the clinical applications and outcomes of 3D printing of temporary crowns fabricated with polylactic acid (PLA) using a fused deposition modeling (FDM) printer. Five participants were recruited from among patients scheduled to be treated with a single full-coverage crown at a dental clinic in a university medical center from June to August 2022. We used 3D-printed crowns fabricated with PLA using an FDM printer as temporary crowns and were assessed for discomfort, fracture, and dislodging. The 3D-printed temporary crowns were maintained without fracture, dislodging, or discomfort until the permanent prosthesis was ready. The average time required for printing the temporary crowns was approximately 7 minutes. The 3D printing of temporary crowns with PLA using an FDM printer is a convenient process for dentists. However, these crowns have some limitations, such as rough surface texture and translucency; therefore, the 3D printing process should be improved to produce better prostheses.

Citations

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Evaluation of Shear Bond Strength and Surface Morphology (via SEM) of Different Provisional Crowns and Surface Treatments to PMMA
Pattarawadee Krassanairawiwong, Jirat Srihatajati, Murilo Baena Lopes
International Journal of Dentistry.2026;[Epub] CrossRef
Advances in 3D printing for dentistry: clinical applications and future perspectives
Partha Protim Borthakur, Jon Jyoti Sahariah, Malita Sarma, Aparoop Das, Kalyani Pathak, Mohammad Zaki Ahmad, Basel A. Abdel-Wahab
Exploration of Medicine.2025;[Epub] CrossRef
The Applications of 3D-Printing Technology in Prosthodontics: A Review of the Current Literature
Mohammed H Alyami
Cureus.2024;[Epub] CrossRef
Cytotoxicity of dental self-curing resin for a temporary crown: an in vitro study
Jae-wan Ko, Joon Sakong, Sohee Kang
Journal of Yeungnam Medical Science.2023; 40(Suppl): S1. CrossRef
Wear resistance of dental resin crowns in accordance with different additive manufacturing technologies and abrader types during chewing simulations
Myoung Ji Choi, Jae-Sung Kwon
Korean Journal of Dental Materials.2023; 50(4): 217. CrossRef

Original articles

Obstetrics, Gynecology, and Reproductive Medicine
Rates and subsequent clinical course of fetal congenital anomalies detected by prenatal targeted ultrasonography of 137 cases over 5 years in a single institute: a retrospective observational study: Haewon Choi, Hyo-Shin Kim, Joon Sakong; J Yeungnam Med Sci. 2023;40(3):268-275. Published online November 2, 2022; DOI: https://doi.org/10.12701/jyms.2022.00514

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Abstract PDF

Background
With the establishment of international guidelines and changes in insurance policies in Korea, the role of targeted ultrasonography has increased. This study aimed to identify the rates and clinical course of anomalies detected using prenatal targeted ultrasonography.
Methods
This study was a retrospective analysis of all pregnancies with targeted ultrasonography performed in a single secondary medical center over 5 years.
Results
Fetal anomalies were detected by targeted ultrasonography in 137 of the 8,147 cases (1.7%). The rates of anomalies were significantly higher in female fetuses (2.0% vs. 1.3%). In cases of female fetuses, the rate of anomalies was significantly higher in the advanced maternal age group (2.4% vs. 1.2%). In cases of male fetuses, the rate of anomalies was significantly higher in nulliparous (2.4% vs. 1.5%) and twin (5.7% vs. 1.9%) pregnancies. Pulmonary anomalies were significantly more common in the multiparity group (17.6% vs. 5.8%). Among the 137 cases, 17.5% terminated the pregnancy, 16.8% were diagnosed as normal after birth, and 42.3% were diagnosed with anomalies after birth or required follow-up.
Conclusion
Through the first study on the rates and clinical course of anomalies detected by targeted ultrasonography at a single secondary center in Korea, we found that artificial abortions were performed at a high rate, even for relatively mild anomalies or anomalies with good prognosis. We suggest the necessity of a nationwide study to establish clinical guidelines based on actual incidences or prognoses.

Citations

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Application of AI to Ultrasonographic Images to Aid the Clinical Care of Pregnant Women With Pre-eclampsia in Uganda: A Protocol for a Pilot Study
Mugyenyi R Godfrey, Fredrick Atwiine, Esther C Atukunda, Leo Anthony Celi, Rogers Mwavu, Fred Kaggwa, Jessica E Haberer, William Wasswa
Cureus.2026;[Epub] CrossRef
Clinical profile of Korean children with spina bifida: a single-center prospective cohort study
Hyeseon Yun, Seung Hyeon Yang, Hooyun Lee, Sang Woon Kim, Yong Seung Lee, Yoonhye Ji, Jieun Park, Jeong-Eun Ji, Eun Kyoung Choi
BMC Pediatrics.2024;[Epub] CrossRef

Nutrition and Dietetics
Impact of Controlling Nutritional Status score on short-term outcomes after carotid endarterectomy: a retrospective cohort study: Hee Won Son, Gyeongseok Yu, Seung Jun Lee, Jimi Oh; J Yeungnam Med Sci. 2023;40(3):259-267. Published online October 26, 2022; DOI: https://doi.org/10.12701/jyms.2022.00507

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Abstract PDF: Background
Malnutrition and impaired immune responses significantly affect the clinical outcomes of patients with atherosclerotic stenosis. The Controlling Nutritional Status (CONUT) score has recently been utilized to evaluate perioperative immunonutritional status. This study aimed to evaluate the relationship between immunonutritional status, indexed by CONUT score, and postoperative complications in patients undergoing carotid endarterectomy (CEA).
Methods
We retrospectively evaluated 188 patients who underwent elective CEA between January 2010 and December 2019. The preoperative CONUT score was calculated as the sum of the serum albumin concentration, total cholesterol level, and total lymphocyte count. The primary outcome was postoperative complications within 30 days after CEA, including major adverse cardiovascular events, pulmonary complications, stroke, renal failure, sepsis, wounds, and gastrointestinal complications. Cox proportional hazards regression analysis was used to estimate the factors associated with postoperative complications during the 30-day follow-up period.
Results
Twenty-five patients (13.3%) had at least one major complication. The incidence of postoperative complications was identified more frequently in the high CONUT group (12 of 27, 44.4% vs. 13 of 161, 8.1%; p<0.001). Multivariate analyses showed that a high preoperative CONUT score was independently associated with 30-day postoperative complications (hazard ratio, 5.98; 95% confidence interval, 2.56–13.97; p<0.001).
Conclusion
Our results showed that the CONUT score, a simple and readily available parameter using only objective laboratory values, is independently associated with early postoperative complications.

Case report

Orthopedics and Sports Medicine
Transient osteoporosis of the hip with a femoral neck fracture during follow-up: a case report: Yusuke Tabata, Shuhei Matsui, Masabumi Miyamoto, Koichiro Omori, Yoichiro Tabata, Tokifumi Majima; J Yeungnam Med Sci. 2023;40(2):212-217. Published online September 26, 2022; DOI: https://doi.org/10.12701/jyms.2022.00479

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Abstract PDF

We report a case of transient osteoporosis of the hip with a femoral neck fracture found during follow-up. A 53-year-old man presented with left hip pain without trauma. The pain did not improve after 2 weeks and he was brought to our hospital by ambulance. Magnetic resonance imaging (MRI) of the left hip joint showed diffuse edema in the bone marrow, which was identified by low signal intensity on T1-weighted images, high signal intensity on T2-weighted images, and increased signal intensity on short tau inversion recovery. This edema extended from the femoral head and neck to the intertrochanteric area. He was diagnosed with transient osteoporosis of the left hip. Rest gradually improved his pain; however, 3 weeks later, his left hip pain worsened without trauma. X-ray, computed tomography, and MRI results of the hip joint demonstrated a left femoral neck fracture, and osteosynthesis was performed. Differential diagnoses included avascular necrosis of the femoral head, infection, complex regional pain syndrome, rheumatoid arthritis, leukemia, and other cancers. Transient osteoporosis of the hip generally has a good prognosis with spontaneous remission within a few months to 1 year. However, a sufficient length of follow-up from condition onset to full recovery is necessary to avoid all probable complications such as fractures.

Citations

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Stress Fracture Along with Transient Osteoporosis in a 72-Year-Old Female with Hip Pain: A Case Report
Khalil Kargar Shooraki, Arash Aris, Masih Rikhtehgar
Orthopedic Research and Reviews.2026; Volume 18: 1. CrossRef
Cracking the Case: Post-pregnancy Bilateral Femoral Fragility, a Rare Clinical Challenge
Jijisha Ali, Janaki Gopalan, Youssef Fallaha, Shriganesh Patil, Rida M Maryum
Cureus.2025;[Epub] CrossRef
Core decompression combined with allogeneic fibular grafting for refractory transient osteoporosis of the hip: a case report and literature review
Cong Chen, Tian-en Xu, Hua-sha Jiang, Chun-lan Shi, Xu Wang, Ya-yi Xia, Ya-peng Wang
BMC Surgery.2025;[Epub] CrossRef
Hip effusion/synovitis influences results after multiple drilling core decompression for bone marrow edema syndrome of hip
Hua-zhang Xiong, Yan-li Peng, Yu-hong Deng, Ying Jin, Ming-hong Tu, Shu-hong Wu
BMC Surgery.2023;[Epub] CrossRef

Original article

Anesthesiology and Pain Medicine
Comparison of the efficacy of erector spinae plane block according to the difference in bupivacaine concentrations for analgesia after laparoscopic cholecystectomy: a retrospective study: Yoo Jung Park, Sujung Chu, Eunju Yu, Jin Deok Joo; J Yeungnam Med Sci. 2023;40(2):172-178. Published online September 23, 2022; DOI: https://doi.org/10.12701/jyms.2022.00500

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Abstract PDF

Background
Laparoscopic cholecystectomy (LC) is a noninvasive surgery, but postoperative pain is a major problem. Studies have indicated that erector spinae plane block (ESPB) has an analgesic effect after LC. We aimed to compare the efficacy of different ESPB anesthetic concentrations in pain control in patients with LC.
Methods
This retrospective study included patients aged 20 to 75 years scheduled for LC with the American Society of Anesthesiologists physical status classification I or II. ESPB was administered using 0.375% bupivacaine in group 1 and 0.25% in group 2. Both groups received general anesthesia. Postoperative tramadol consumption and pain scores were compared and intraoperative and postoperative fentanyl requirements in the postanesthesia care unit (PACU) were measured.
Results
Eighty-five patients were included in this analysis. Tramadol consumption in the first 12 hours, second 12 hours, and total 24 hours was similar between groups (p>0.05). The differences between postoperative numeric rating scale (NRS) scores at rest did not differ significantly. The postoperative NRS scores upon bodily movement were not statistically different between the two groups, except at 12 hours. The mean intraoperative and postoperative fentanyl requirements in the PACU were similar. The difference in the requirement for rescue analgesics was not statistically significant (p=0.788).
Conclusion
Ultrasound-guided ESPB performed with different bupivacaine concentrations was effective in both groups for LC analgesia, with similar opioid consumption. A lower concentration of local anesthetic can be helpful for the safety of regional anesthesia and is recommended for the analgesic effect of ESPB in LC.

Citations

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Overview of ultrasound-guided plane blocks performed within the scope of multimodal anesthesia applications in lower and upper abdominal surgeries
Mert Yetgin, Hülya Sungurtekin, Hale Yetgin
Pamukkale Medical Journal.2025; 18(4): 21. CrossRef
Surgeon-Delivered Bupivacaine Achieves Analgesic Efficacy Comparable to ESP and TAP Blocks in Laparoscopic Cholecystectomy: A Randomized Controlled Trial
Melih Can Gül, Ramazan Koray Akbudak
Surgeries.2025; 6(4): 90. CrossRef
Bilateral erector spinae plane block on opioid-sparing effect in upper abdominal surgery: study protocol for a bi-center prospective randomized controlled trial
Changzhen Geng, Li Wang, Yaping Shi, Xinnan Shi, Hanyi Zhao, Ya Huang, Qiufang Ji, Yuanqiang Dai, Tao Xu
Trials.2024;[Epub] CrossRef
Erector Spinae Plane Block with 0.375% Bupivacaine vs 0.25% Bupivacaine in Laparoscopic Cholecystectomy Patients: Effect on Postoperative Analgesia, Shoulder Tip Pain, and Postoperative Stress Markers
Mohammad Mohsin, Asna Jamal, Ali Saloda, Kharat M Batt, Shantnu Bhanwala
Research & Innovation in Anesthesia.2024; 9(1): 1. CrossRef

Case reports

Physical therapy, Sports Therapy, and Rehabilitation
Crowned dens syndrome as a rare cause of anterior neck pain after transurethral resection of the prostate: a case report: Myeong Geun Jeong, Bum Soon Park, Eun-Seok Son, Jang Hyuk Cho; J Yeungnam Med Sci. 2023;40(3):289-292. Published online August 5, 2022; DOI: https://doi.org/10.12701/jyms.2022.00388

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Abstract PDF

We describe the case of a 79-year-old man who presented with progressive aggravation of severe axial neck pain and fever 3 days after transurethral resection of the prostate (TURP), despite maintaining neutral neck posture during surgery. Laboratory examination revealed markedly elevated C-reactive protein levels and erythrocyte sedimentation rates. Computed tomography revealed crown-like calcifications surrounding the odontoid process. We diagnosed crowned dens syndrome (CDS) as the cause of acute-onset neck pain after TURP. The patient was treated with nonsteroidal anti-inflammatory drugs for 5 days, and his symptoms resolved completely. CDS is a rare disease characterized by calcific deposits around the odontoid process with acute onset of severe neck pain and restricted motion. Evidence of inflammation on serological testing and fever are typical of CDS. However, the prevalence and pathophysiology of CDS remain unclear. We hypothesized that systemic inflammation after prostate surgery may have induced a local inflammatory response involving calcification around the odontoid process.

Citations

Citations to this article as recorded by

CRYSTAL ARTHRITIS IN THE DIFFERENTIAL DIAGNOSIS OF NECK PAIN: A CASE OF CROWNED DENS SYNDROME
Halise Hande Gezer, Hamza Özer, Özlem Pehlivan, Mehmet Tuncay Duruöz
Anti-Aging Eastern Europe.2025; 4(2): 128. CrossRef
Spontaneous Cervical Epidural Hematoma Mimicking Crowned Dens Syndrome: A Case Report
Katsuyuki Shiose, Koki Tsuchiya, Ichiro Okano, Yoshifumi Kudo
Cureus.2025;[Epub] CrossRef

Hematology
Severe congenital neutropenia mimicking chronic idiopathic neutropenia: a case report: Juhyung Kim, Soyoon Hwang, Narae Hwang, Yeonji Lee, Hee Jeong Cho, Joon Ho Moon, Sang Kyun Sohn, Dong Won Baek; J Yeungnam Med Sci. 2023;40(3):283-288. Published online July 28, 2022; DOI: https://doi.org/10.12701/jyms.2022.00353

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Abstract PDF Supplementary Material

Severe chronic neutropenia is classified as severe congenital, cyclic, autoimmune, or idiopathic. However, there is a lot of uncertainty regarding the diagnosis of severe congenital neutropenia (SCN) and chronic idiopathic neutropenia, and this uncertainty affects further evaluations and treatments. A 20-year-old man presented with fever and knee abrasions after a bicycle accident. On admission, his initial absolute neutrophil count (ANC) was 30/µL. He had no medical history of persistent severe neutropenia with periodic oscillation of ANC. Although his fever resolved after appropriate antibiotic therapy, ANC remained at 80/µL. Bone marrow (BM) aspiration and biopsy were performed, and a BM smear showed myeloid maturation arrest. Moreover, genetic mutation test results showed a heterozygous missense variant in exon 4 of the neutrophil elastase ELANE: c597+1G>C (pV190-F199del). The patient was diagnosed with SCN. After discharge, we routinely checked his ANC level and monitored any signs of infection with minimum use of granulocyte colony-stimulating factor (G-CSF), considering its potential risk of leukemic transformation. Considering that SCN can be fatal, timely diagnosis and appropriate management with G-CSF are essential. We report the case of a patient with SCN caused by ELANE mutation who had atypical clinical manifestations. For a more accurate diagnosis and treatment of severe chronic neutropenia, further studies are needed to elucidate the various clinical features of ELANE.

Citations

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Zahnmedizinische Betreuung seltener Erkrankungen: Fallberichte zu hereditärer sensorischer und autonomer Neuropathie sowie zu schwerer chronischer Neutropenie
Wieland Elger
Kinder- und Jugendmedizin.2025; 25(03): 162. CrossRef
Severe Congenital Neutropenia in a Newborn Caused by a Novel Mutation in the ELANE Gene—First Report From North Macedonia and a Literature Review: A Case Report
Nikolina Zdraveska, Teodora Trajkovska, Aleksandra Jovanovska, Arjeta Hasani, Mica Kimovska Hristova, Vjekoslav Krzelj
Case Reports in Pediatrics.2025;[Epub] CrossRef
ПЕРВИННІ МІНОРНІ ІМУНОДЕФІЦИТИ ЯК ПРИЧИНА РОЗВИТКУ ІМУНОЗАЛЕЖНОЇ ПАТОЛОГІЇ У ЛЮДЕЙ: ЕТІОЛОГІЯ, ЕПІДЕМІОЛОГІЯ, КЛАСИФІКАЦІЯ, ДІАГНОСТИКА І ЛІКУВАННЯ (СИСТЕМАТИЧНИЙ ОГЛЯД)
Dmytro Maltsev
Immunology and Allergology: Science and Practice.2024; (3-4): 37. CrossRef

Original article

Urology
Novel cystography parameter to predict early recovery from urinary continence after radical prostatectomy for prostate cancer: a retrospective study: Yeong Uk Kim; J Yeungnam Med Sci. 2023;40(3):252-258. Published online July 21, 2022; DOI: https://doi.org/10.12701/jyms.2022.00311

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Abstract PDF

Background
The purpose of this study was to investigate whether postoperative cystography findings can predict early and long-term recovery from incontinence after radical prostatectomy (RP), compared with the other cystography parameters.
Methods
I retrospectively reviewed 118 patients who underwent robot-assisted RP (RARP) for localized prostate cancer at single institution between January 2016 and April 2021. One hundred and seven patients were included in the study. Postoperative cystography was routinely performed 7 days after surgery. The bladder neck to pubic symphysis ratio, vesicourethral angle, and bladder neck anteroposterior length (BNAP) ratio (the bladder neck-posterior margin distances divided by the anteroposterior lengths) were evaluated. Continence was defined as cessation of pad use. The association between these variables and urinary incontinence was also analyzed.
Results
The urinary incontinence recovery rates 1, 3, 6, and 12 months after RARP were 43.92%, 66.35%, 87.85%, and 97.19%, respectively. Multivariate logistic regression analysis demonstrated that a lower BNAP ratio and wider vesicourethral angle were significantly associated with continence restoration at 1, 3, and 6 months after surgery. In addition, in terms of days of pad usage, lower BNAP ratio, wider vesicourethral angle, and bladder neck preservation were significantly associated with recovery from urinary incontinence within 12 months as assessed by Cox proportional hazard analysis.
Conclusion
This study demonstrated that vesicourethral angle and BNAP ratio were independent predictors of early recovery from post-prostatectomy incontinence. I suggest that both the sagittal and coronal views of postoperative cystography help anticipate early continence restoration after RARP.

Citations

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Prognostic factors for urinary incontinence after robot-assisted radical prostatectomy: a systematic review and meta-analysis
Haoxin Huang, Keke Cai
Journal of Robotic Surgery.2025;[Epub] CrossRef
A single‐center retrospective comparative analysis of urinary continence in robotic prostatectomy with a combination of umbilical ligament preservation and Hood technique
Hiroaki Shimmura, Taro Banno, Kazutaka Nakamura, Anju Murayama, Haruki Shigeta, Toyoaki Sawano, Yukiko Kouchi, Akihiko Ozaki, Fumito Yamabe, Junpei Iizuka, Toshio Takagi
International Journal of Urology.2023; 30(10): 889. CrossRef

Case report

Neurosurgery
The endoscopic transnasal approach to the lesions of the craniocervical junction: two case reports: Baraa Dabboucy, Wissem Lahiani, Damien Bresson, Nouman Aldahak; J Yeungnam Med Sci. 2023;40(1):96-101. Published online July 20, 2022; DOI: https://doi.org/10.12701/jyms.2022.00234

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Abstract PDF: The endoscopic endonasal approach (EEA) to the craniovertebral junction (CVJ) has recently been considered a safer alternative and less invasive approach than the traditional transoral approach because the complications associated with the latter are avoided or minimized. Here, we present two challenging cases of CVJ pathologies. The first case involved os odontoideum associated with anterior displacement of the occipitocervical junction where the EEA was used, followed by C0-C1-C2 fusion using a posterior approach to decompress the CVJ, and was complicated by rhinorrhea and Candida albicans meningitis. The second case involved basilar invagination with syringomyelia previously treated using a posterior approach, where aggravation of neuropathic symptoms required combined treatment with EEA and occipitocervical fusion of C0-C2-C3-C4, with the postoperative course challenged by operative site infection requiring drainage with debridement and antibiotic therapy. The EEA is an alternative approach for accessing the CVJ in well-selected patients. Knowledge of EEA complications is crucial for the optimal care of patients.

Original articles

Gastroenterology and Hepatology
The effect and therapeutic compliance of adjuvant therapy in patients with cholangiocarcinoma after R0 resection: a retrospective study: Han Taek Jeong, Joonkee Lee, Hyeong Ho Jo, Ho Gak Kim, Jimin Han; J Yeungnam Med Sci. 2023;40(1):65-77. Published online May 26, 2022; DOI: https://doi.org/10.12701/jyms.2022.00213

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Abstract PDF

Background
This study aimed to compare clinical outcomes between surveillance and adjuvant therapy (AT) groups after R0 resection for cholangiocarcinoma (CCA).
Methods
A total of 154 patients who underwent R0 resection for CCA at the Daegu Catholic University Medical Center between January 2010 and December 2019 were included. Overall survival (OS) and progression-free survival (PFS) were analyzed.
Results
The median follow-up duration was 899 days. There were 109 patients in the AT group and 45 patients in the surveillance group. The patients in the AT group were younger (67 years vs. 74 years, p<0.001) and included more males (64.2% vs. 46.7%, p=0.044). The proportion of patients with stage III CCA was larger in the AT group than in the surveillance group (13.8% vs. 2.2%, p=0.005). In addition, AT did not improve OS (5-year OS rate, 69.3% in the AT group vs. 64.2% in the surveillance group, p=0.806) or PFS (5-year PFS rate, 42.6% in the AT group vs. 48.9% in the surveillance group, p=0.113). In multivariate analysis using the Cox proportional hazards model, stage III CCA (hazard ratio [HR], 10.81; 95% confidence interval [CI], 2.92–40.00; p<0.001) was a significant predictor of OS. American Society of Anesthesiologists classification II (HR, 0.50; 95% CI, 0.31–0.81; p=0.005), and American Joint Committee on Cancer stages II (HR, 3.14; 95% CI, 1.25–7.89; p=0.015) and III (HR, 8.08; 95% CI, 2.80–23.32; p<0.001) were independent predictors of PFS.
Conclusion
AT after R0 resection for CCA did not improve OS or PFS.

Citations

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Robotic Complete ALPPS (rALPPS)—First German Experiences
Jörg Arend, Mareike Franz, Alexander Rose, Christine March, Mirhasan Rahimli, Aristotelis Perrakis, Eric Lorenz, Roland Croner
Cancers.2024; 16(5): 1070. CrossRef

Public Health, Environmental, and Occupational Health
Satisfaction of industrial health care managers regarding the work of industrial hygiene engineers: a cross-sectional study: Byung Sik Choi, Min Keun Kim, Joon Sakong; J Yeungnam Med Sci. 2023;40(1):58-64. Published online May 24, 2022; DOI: https://doi.org/10.12701/jyms.2022.00073

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Abstract PDF: Background
A group health service is a system that delegates workplace health management to an entrusted institution. There have been various studies on group health services to date, but recent changes, such as an increase in foreign workers, are rapidly changing industry characteristics.
Methods
Satisfaction was assessed using a 27-question survey distributed among 203 workplaces employing health professionals. The survey items consisted of general characteristics, comprehensive satisfaction, requirements for health professionals’ work, and satisfaction with work environment management, ergonomic management, and healthcare management. Multiple regression and frequency analyses were performed.
Results
The comprehensive satisfaction was 4.08 points on average, out of 5. The comprehensive satisfaction of health professionals in the industry was positively correlated with each factor. Hazardous materials and chemical management (material safety data sheets, MSDSs) were the most common requirements.
Conclusion
A low level of satisfaction with work environment management indicates high demand for healthcare management. The working environment should be improved by identifying characteristics of the workplace, examining harmful substances, inspecting equipment, and enhancing worker methods. The shorter the work experience of health professionals, the more dependent they are on group health services. The variables affecting comprehensive satisfaction were the period of work, healthcare management satisfaction, and work environment management satisfaction. Most of the requirements of health professionals in the workplace were practical improvement case presentations, MSDSs, and legal document management.

Case report

Obstetrics, Gynecology, and Reproductive Medicine
Laparoscopic excision and repair of a cesarean scar pregnancy in a woman with uterine didelphys: a case report: Seong-Eon Park, Ji-Eun Ryu, Tae-Kyu Jang; J Yeungnam Med Sci. 2023;40(2):202-206. Published online May 16, 2022; DOI: https://doi.org/10.12701/jyms.2022.00115

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Abstract PDF

Cesarean scar pregnancy (CSP) is a rare complication that occurs in less than 1% of ectopic pregnancies, and uterine didelphys is one of the rarest uterine forms. We report a successful laparoscopic excision and repair of CSP in a woman with uterine didelphys and a double vagina. A 34-year-old gravida one, para one woman with a history of low transverse cesarean section presented to our hospital with a suspected CSP. She was confirmed to have uterine didelphys with a double vagina during an infertility examination 7 years earlier. Magnetic resonance imaging showed a 2.5-cm gestational sac-like cystic lesion in the lower segment of the right uterus at the cesarean scar. We decided to perform a laparoscopic approach after informing the patient of the surgical procedure. The lower segment of the previous cesarean site was excised with monopolar diathermy to minimize bleeding. We identified the gestational sac in the lower segment of the right uterus, which was evacuated using spoon forceps. The myometrium and serosa of the uterus were sutured layer-by-layer using synthetic absorbable sutures. No remnant gestational tissue was visible on follow-up ultrasonography one month after the surgery. This laparoscopic approach to CSP in a woman with uterine didelphys is an effective and safe method of treatment. In women with uterine anomalies, it is important to confirm the exact location of the gestational sac by preoperative imaging for successful surgery.

Citations

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Clinical study of two reversible arterial blockade methods in the treatment of scar pregnancy under combined hysterolaparoscopy
Wei Wei
American Journal of Translational Research.2024; 16(11): 6770. CrossRef

Focused Review article

Anesthesiology and Pain Medicine
Ultrasound-guided interventions for controlling the thoracic spine and chest wall pain: a narrative review: Donghwi Park, Min Cheol Chang; J Yeungnam Med Sci. 2022;39(3):190-199. Published online April 26, 2022; DOI: https://doi.org/10.12701/jyms.2022.00192

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Abstract PDF

Ultrasound-guided injection is useful for managing thoracic spine and chest wall pain. With ultrasound, pain physicians perform the injection with real-time viewing of major structures, such as the pleura, vasculature, and nerves. Therefore, the ultrasound-guided injection procedure not only prevents procedure-related adverse events but also increases the accuracy of the procedure. Here, ultrasound-guided interventions that could be applied for thoracic spine and chest wall pain were described. We presented ultrasound-guided thoracic facet joint and costotransverse joint injections and thoracic paravertebral, intercostal nerve, erector spinae plane, and pectoralis and serratus plane blocks. The indication, anatomy, Sonoanatomy, and technique for each procedure were also described. We believe that our article is helpful for clinicians to conduct ultrasound-guided injections for controlling thoracic spine and chest wall pain precisely and safely.

Citations

Citations to this article as recorded by

Spine Pain
Vernon B. Williams
Continuum.2024; 30(5): 1344. CrossRef
The blind spot and challenges in pain management
Min Cheol Chang
Journal of Yeungnam Medical Science.2022; 39(3): 179. CrossRef

Original article

Pediatrics, Perinatology, and Child Health
Incidence of congenital hypothyroidism by gestational age: a retrospective observational study: Ha Young Jo, Eun Hye Yang, Young Mi Kim, Soo-Han Choi, Kyung Hee Park, Hye Won Yoo, Su Jeong Park, Min Jung Kwak; J Yeungnam Med Sci. 2023;40(1):30-36. Published online April 12, 2022; DOI: https://doi.org/10.12701/jyms.2022.00059

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Abstract PDF

Background
Congenital hypothyroidism (CH) is the leading cause of preventable physical and intellectual disabilities. This study aimed to assess the incidence and clinical characteristics of CH in newborns.
Methods
We retrospectively reviewed the medical records of all newborns delivered at the Pusan National University Hospital between January 2011 and March 2021. The incidence of CH was compared according to gestational age, birth weight, and small for gestational age (SGA). The patients aged ≥3 years who could not maintain normal thyroid function and required levothyroxine treatment were diagnosed with permanent CH. Logistic regression analysis was performed to compare CH risks.
Results
Of 3,722 newborns, 40 were diagnosed with CH (1.07%). Gestational age and birth weight were significantly associated with CH incidence. The odds ratios (ORs) of CH in infants delivered at 32–37, 28–31, and <28 weeks were 2.568 (95% confidence interval [CI], 1.141–5.778), 5.917 (95% CI, 2.264–15.464), and 7.441 (95% CI, 2.617–21.159) times higher, respectively, than those delivered at term. The ORs of CH in infants weighing 1,500–2,499 g, 1,000–1,499 g, and <1,000 g were 4.664 (95% CI, 1.928–11.279), 11.076 (95% CI, 4.089–29.999), and 12.544 (95% CI, 4.350–36.176) times greater, respectively, than those in infants weighing ≥2,500 g. The OR of CH was 6.795 (95% CI, 3.553–13.692) times greater in SGA than in non-SGA infants.
Conclusion
The CH incidence in South Korea has increased significantly compared with that in the past. Gestational age, birth weight, and SGA were significantly associated with CH incidence.

Citations

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I Dananjaya, I Arimbawa, Ni Purniti, I Windiani, Made Sukmawati, Ni Yantie
American Journal of Pediatrics.2025; 11(2): 93. CrossRef
Permanent Congenital Hypothyroidism in Very Low Birth Weight Infants: A Single Center’s Experience
Joo Hyung Roh, Tae-Gyeong Kim, Keon Hee Seol, Chae Young Kim, Soo Hyun Kim, Ji Yoon Jeong, Ja Hye Kim, Euiseok Jung, Jin-Ho Choi, Byong Sop Lee
Neonatal Medicine.2025; 32(1): 30. CrossRef
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Si-Hwa Gwag, Kyu Hyun Park, Eungu Kang, Hyo-Kyoung Nam, Young-Jun Rhie, Kee-Hyoung Lee
Annals of Pediatric Endocrinology & Metabolism.2025; 30(3): 127. CrossRef
Congenital Hypothyroidism: Long‐Term Growth and Intellectual Outcomes With a Lower Initial Levothyroxine Dose
Jun‐Hong Park, Jae Hyuk Oh, Min Hyung Cho, Young Suk Shim, Hae Sang Lee
Clinical Endocrinology.2025; 103(6): 895. CrossRef
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Maria José Costeira, Patrício Costa, Susana Roque, Ivone Carvalho, Laura Vilarinho, Joana Almeida Palha
International Journal of Neonatal Screening.2024; 10(1): 16. CrossRef
CONGENITAL HYPOTHYROIDISM IN NEWBORN AND ASSOCIATION WITH SOCIODEMOGRAPHIC PARAMETERS AMONG NEONATE DELIVERED AT MILITARY HOSPITAL IN A CITY OF CENTRAL INDIA
ANISHA BEEGUM, SRUTI KRITI
Asian Journal of Pharmaceutical and Clinical Research.2024; : 38. CrossRef
Perbedaan Perubahan Kadar Hormon Tiroid pada Bayi Kurang Bulan melalui Pemeriksaan Fungsi Tiroid Serial
Nandia Permata Rahma Al Khusna, Dwi Hidayah, Annang Giri Moelyo
Sari Pediatri.2024; 26(2): 85. CrossRef
The prevalence of hypothyroxinemia in premature newborns
Renata Stawerska, Marzena Nowak-Bednarek, Tomasz Talar, Marzena Kolasa-Kicińska, Anna Łupińska, Maciej Hilczer, Ewa Gulczyńska, Andrzej Lewiński
Frontiers in Endocrinology.2022;[Epub] CrossRef

Review article

Endocrinology, Diabetes, and Metabolism
Beneficial effects of intermittent fasting: a narrative review: Dae-Kyu Song, Yong-Woon Kim; J Yeungnam Med Sci. 2023;40(1):4-11. Published online April 4, 2022; DOI: https://doi.org/10.12701/jyms.2022.00010

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Abstract PDF

Caloric restriction is a popular approach to treat obesity and its associated chronic illnesses but is difficult to maintain for a long time. Intermittent fasting is an alternative and easily applicable dietary intervention for caloric restriction. Moreover, intermittent fasting has beneficial effects equivalent to those of caloric restriction in terms of body weight control, improvements in glucose homeostasis and lipid profiles, and anti-inflammatory effects. In this review, the beneficial effects of intermittent fasting are discussed.

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Histopathological examination of healing in bone defects in intermittent fasting: An experimental study
Umit Koray Can, Murat Tanrisever, Erhan Cahit Ozcan, Delil Dogan, Ozmen Istek, Tugce Donmezer, Burak Karabulut, Serkan Dundar
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Intermittent Fasting Improves Social Interaction and Decreases Inflammatory Markers in Cortex and Hippocampus
Martín García-Juárez, Adamary García-Rodríguez, Gabriela Cruz-Carrillo, Orlando Flores-Maldonado, Miguel Becerril-Garcia, Lourdes Garza-Ocañas, Ivan Torre-Villalvazo, Alberto Camacho-Morales
Molecular Neurobiology.2025; 62(2): 1511. CrossRef
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M. Khalil, H. Abdallah, G. Garruti, A.Di Ciaula, P. Portincasa
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Journal of Psychiatric Research.2025; 181: 215. CrossRef
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Mohammed Hamsho, Wijdan Shkorfu, Yazan Ranneh, Abdulmannan Fadel
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Jun Zhang, Yujie Gong, Yidan Zhu, Qingduo Zeng, Hao Zhang, Ruili Han, Yujie Guo, Donghua Li, Yadong Tian, Xiangtao Kang, Yawei Yang, Zhuanjian Li, Ruirui Jiang
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Jordan Beveridge, Allison Montgomery, George Grossberg
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Ridwan Aji Budi Prasetyo, Fatiya Halum Husna, Yuli Rahmawati, Cantik Ummi Salsabila
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Sexual dimorphism in response to intermittent fasting and its impact on the brain
Keshari H. Sudasinghe, Zachary J. White, Stephanie E. Hall
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Original article

Thoracic and Cardiovascular Surgery
Intensive care unit management of uncomplicated type B aortic dissection in relation to treatment period: a retrospective observational study: Chul Ho Lee, Jae Seok Jang, Jun Woo Cho; J Yeungnam Med Sci. 2022;39(4):294-299. Published online February 10, 2022; DOI: https://doi.org/10.12701/jyms.2021.01690

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Abstract PDF: Background
Medical therapy is the standard treatment for uncomplicated acute type B aortic dissection (ATBAD), but there is little evidence of the need for intensive care unit (ICU) management. Therefore, we aimed to investigate the effects of ICU treatment on uncomplicated ATBAD.
Methods
We retrospectively studied patients with uncomplicated ATBAD who were medically treated between January 2010 and July 2020. Patients were divided into long-term ICU stay (LIS) and short-term ICU stay (SIS) groups, according to a 48-hour cutoff of ICU stay duration. The incidence of pneumonia and delirium, rate of aortic events, hospital mortality, and survival rate were compared.
Results
Fifty-five patients were treated for uncomplicated ATBAD (n=26 for LIS and n=29 for SIS). The incidence of pneumonia (7.7% vs. 3.6%) and delirium (34.6% vs. 14.3%) was higher in the LIS group than in the SIS group, but the differences were not statistically significant. The survival rates at 1, 3, and 5 years were not different between the two groups (LIS: 96.2%, 88.0%, and 54.2% vs. SIS: 96.4%, 92.2%, and 75.5%, respectively; p=0.102). Multivariate Cox regression analysis for aortic events showed that using a calcium channel blocker lowered the risk of aortic events.
Conclusion
Long-term ICU treatment is unlikely to be necessary for the treatment of uncomplicated ATBAD. Active use of antihypertensive agents, such as calcium channel blockers, may be needed during the follow-up period.

Communications

Infectious Disease
The pros and cons of entry restrictions: are entry restrictions really effective in preventing the spread of SARS-CoV-2?: Donghwi Park, Mathieu Boudier-Revéret, Min Cheol Chang; J Yeungnam Med Sci. 2022;39(4):344-346. Published online January 14, 2022; DOI: https://doi.org/10.12701/yujm.2021.01599

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Abstract PDF

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread worldwide, leading the World Health Organization to declare coronavirus disease 2019 (COVID-19) a pandemic. To curb the unchecked spread of SARS-CoV-2 infection, most countries have enforced travel restrictions. However, it is debatable whether such restrictions are effective in containing infections and preventing pandemics. Rather, they may negatively impact economies and diplomatic relationships. Each government should conduct an extensive and appropriate analysis of its national economy, diplomatic status, and COVID-19 preparedness to decide whether it is best to restrict entering travelers. Even if travelers from other countries are allowed entry, extensive contact tracing is required to prevent the spread of COVID-19. In addition, governments can implement “travel bubbles,” which allow the quarantine-free flow of people among countries with relatively low levels of community transmission. An accurate evaluation of the benefits and losses due to entry restrictions during the COVID-19 pandemic would be helpful in determining whether entry restrictions are an effective measure to reduce the spread of infection in future pandemics.

Citations

Citations to this article as recorded by

“Exceptionally challenging time for all of us”: Qualitative study of the COVID-19 experiences of partners of diplomatic personnel
Samantha K. Brooks, Dipti Patel, Neil Greenberg, Joseph Adu
PLOS ONE.2023; 18(11): e0293557. CrossRef

Case report

Musculoskeletal Disorders
Septic arthritis of the hip joint caused by Klebsiella pneumoniae: a case report: Jeong-Bo Moon, Jun-Hwan Lee, Byung-Ju Ryu; J Yeungnam Med Sci. 2023;40(2):193-197. Published online January 13, 2022; DOI: https://doi.org/10.12701/yujm.2021.01613

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1 Crossref

Abstract PDF

Klebsiella pneumoniae is an uncommon cause of septic arthritis in adults. However, late detection can cause serious complications, including joint destruction and immobility. The purpose of this study was to report a case of successfully treated septic arthritis of the hip joint (SAHJ) caused by K. pneumoniae. A 49-year-old female patient presented to our hospital with fever and progressive severe pain in the right hip area. Although there was no abnormality on plain radiographs, ultrasonography revealed diffuse swelling of the right hip joint. Under ultrasonography guidance, the hip joint fluid was aspirated, and Gram staining and culturing were performed. The patient’s pain was significantly reduced after the joint aspiration. The Gram staining and culturing revealed gram-negative bacilli, which were subsequently identified as K. pneumoniae. According to the results, systemic intravenous antibiotic (ceftriaxone) was administered without complications, and the patient was discharged on oral antibiotic (ciprofloxacin). Clinical cases of septic arthritis of the knee or sacroiliac joint have been occasionally reported in adults, but cases of SAHJ are rare. Moreover, K. pneumonia-induced SAHJ has not been reported to date. Therefore, we report this very rare case and its successful treatment.

Citations

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Management outcome of knee septic arthritis in neonates and infants:A systematic review
Hilmi Muhammad, Rahadyan Magetsari, Alfin Ihza Trimahendra, Paramita Ayu Saraswati
Journal of Orthopaedic Reports.2025; 4(2): 100518. CrossRef

Original articles

Surgery
Assessment of normal anal sphincter anatomy using transanal ultrasonography in healthy Korean volunteers: a retrospective observational study: Daeho Shon, Sohyun Kim, Sung Il Kang; J Yeungnam Med Sci. 2022;39(3):230-234. Published online December 2, 2021; DOI: https://doi.org/10.12701/yujm.2021.01515

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Abstract PDF

Background
To date, there have been no studies on the normal anatomic values of the anal sphincter in healthy Koreans. Therefore, this study aimed to determine the normal anatomic values of transanal ultrasonography (TAUS).
Methods
The thickness of the external anal sphincter (EAS) and internal anal sphincter (IAS) was measured by TAUS from healthy Korean volunteers between September 2019 and August 2021.
Results
Thirty-six volunteers with a median age of 37 years (range, 20–77 years) and a median body mass index (BMI) of 23.5 kg/m2 (range, 17.2–31.2 kg/m2) were examined. The median thickness of the EAS at 4 cm and 2 cm from the anal verge was 7.4 mm (range, 5.8–8.8 mm) and 6.5 mm (range, 5.6–8.0 mm), respectively. The median thickness of the IAS at 2 cm from the anal verge was 1.8 mm (range, 0.8-4.3 mm). There were no differences in sphincter muscle thickness between the sexes. However, the EAS tended to thicken as the BMI increased (EAS at 2 cm and 4 cm from the anal verge, Spearman rho=0.433, 0.363; p=0.008 and p=0.029, respectively).
Conclusion
In healthy Korean, the median thickness of the IAS at 2 cm from the anal verge was 1.8 mm and the median thickness of the EAS at 2 cm and 4 cm from the anal verge was 6.5 mm and 7.4 mm respectively. There were no differences in anal sphincter thickness between sexes, but BMI was related to EAS thickness.

Citations

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Change in faecal incontinence pattern after gastric bypass surgery: related to change in anal sphincter thickness?
Jeff Wennerlund, David Thalén, Anton Östevind, Ulf Gunnarsson, Karin Strigård
International Journal of Colorectal Disease.2026;[Epub] CrossRef
Anal Sphincter Defect and Fecal Incontinence
Sherief Mansi, Karla Vaz, Neha R. Santucci, Khalil El‐Chammas, Kahleb Graham, Nelson G. Rosen, Ajay Kaul
JPGN Reports.2022;[Epub] CrossRef

Anesthesiology and Pain Medicine
Infection prevention measures and outcomes for surgical patients during a COVID-19 outbreak in a tertiary hospital in Daegu, South Korea: a retrospective observational study: Kyung-Hwa Kwak, Jay Kyoung Kim, Ki Tae Kwon, Jinseok Yeo; J Yeungnam Med Sci. 2022;39(3):223-229. Published online November 5, 2021; DOI: https://doi.org/10.12701/yujm.2021.01431

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Abstract PDF: Background
The first large coronavirus disease 2019 (COVID-19) outbreak outside China occurred in Daegu. In response, we developed infection prevention measures for surgical patients during the outbreak at our hospital and retrospectively reviewed the outcomes of COVID-19–related surgical patients.
Methods
We reviewed the medical records of 118 COVID-19–related surgical patients and monitored their clinical outcomes until March 31, 2021. We also interviewed healthcare workers who participated in their perioperative care at Kyungpook National University Chilgok Hospital. The perioperative management guidelines for COVID-19–related patients were prepared through multidisciplinary discussions, including the infection control department, surgical departments, and anesthesiology department before and during the COVID-19 outbreak.
Results
One standard operating room was temporarily converted to a negative-pressure room by increasing the exhaust air volume, creating a relative pressure of −11.3 Pa. The healthcare workers were equipped with personal protective equipment according to the patient's classification of the risk of COVID-19 transmission. The 118 COVID-19–related patients underwent emergent surgery in the negative-pressure room, including three COVID-19–confirmed patients and five COVID-19–exposed patients.
Conclusion
All surgeries of the COVID-19–related patients were performed without specific adverse events or perioperative COVID-19 transmission. Our experience setting up a negative-pressure operating room and conservative perioperative protocol to prevent COVID-19 transmission will help plan and execute infection control measures in the future.

Case report

Anesthesiology and Pain Medicine
Reverse Takotsubo cardiomyopathy with left bundle branch block after anesthesia induction in a patient with subarachnoid hemorrhage: a case report: Eun Kyung Choi, Jong-Hoon Kim, Minhyun Kim; J Yeungnam Med Sci. 2022;39(2):172-178. Published online October 25, 2021; DOI: https://doi.org/10.12701/yujm.2021.01354

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Abstract PDF

Cardiac dysfunction after subarachnoid hemorrhage (SAH) is described as Takotsubo or reverse Takotsubo cardiomyopathy that shows transient left ventricular wall motion abnormalities with electrocardiogram (ECG) changes. ST change followed by T inversion is a common ECG finding complicated with these disorders, left bundle branch block (LBBB) may be a potential ECG pattern which is seen. In this case, we describe the clinical profile and outcomes of a patient with LBBB and reverse Takotsubo cardiomyopathy after anesthetic induction, which was scheduled as an emergent external ventricular drainage after SAH. This is the first report of an LBBB pattern in reverse Takotsubo cardiomyopathy.

Citations

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Diagnosis and Management of Takotsubo Syndrome in Acute Aneurysmal Subarachnoid Hemorrhage: A Comprehensive Review
Dorottya Szántó, Péter Luterán, Judit Gál, Endre V. Nagy, Béla Fülesdi, Csilla Molnár
Reviews in Cardiovascular Medicine.2023;[Epub] CrossRef

Original article

Hematology
The clinical outcomes of second-line chemotherapy in patients with advanced pancreatic cancer: a retrospective study: Hyun yeb Jung, Eun Mi Lee; J Yeungnam Med Sci. 2022;39(2):124-132. Published online October 19, 2021; DOI: https://doi.org/10.12701/yujm.2021.01347

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Abstract PDF

Background
Despite recent advances in first-line chemotherapy for advanced pancreatic cancer, standard treatment after the failure of initial chemotherapy has not been established. Hence, we aimed to retrospectively analyze the clinical characteristics and outcomes of second-line chemotherapy in patients with advanced pancreatic cancer.
Methods
We reviewed the clinical data of patients with advanced pancreatic cancer who underwent palliative chemotherapy at Kosin University Gospel Hospital between January 2013 and October 2020.
Results
Among 366 patients with advanced pancreatic cancer who had received palliative chemotherapy, 104 (28.4%) underwent at least one cycle of second-line chemotherapy. The median age of the patients at the time of initiating second-line treatment was 62 years (interquartile range, 57–62 years), and 58.7% (61 patients) of them were male. The common second-line chemotherapy regimens were 5-fluorouracil (FU) plus leucovorin, irinotecan, and oxaliplatin (33 patients, 31.7%); gemcitabine/nab-paclitaxel (29, 27.9%), gemcitabine±erlotinib (13, 12.5%); and oxaliplatin and 5-FU/leucovorin (12, 11.5%). The median overall survival (OS) and progression-free survival were 6.4 months (95% confidence interval [CI], 4.5–8.6 months) and 4.5 months (95% CI, 2.7–6.3 months), respectively. In a multivariate analysis, poor performance status (PS) (hazard ratio [HR], 2.247; p=0.021), metastatic disease (HR, 2.745; p=0.011), and elevated carcinoembryonic antigen (CEA) levels (HR, 1.939; p=0.030) at the beginning of second-line chemotherapy were associated with poor OS.
Conclusion
The survival outcome of second-line chemotherapy for advanced pancreatic cancer remains poor. However, PS, disease extent (locally advanced or metastatic), and CEA level may help determine patients who could benefit from second-line treatment.

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Kavin Sugumar, Andrew Alabd, Andre Alabd, Jonathan J. Hue, Josh Lyons, Sherri Fields, Zev Wainberg, Lei Zheng, Brianna Coogle, Anup Kasi, Nicholas Grewal, Hedy L. Kindler, Jason Starr, Ashwin R. Sama, Jordan M. Winter
Oncotarget.2025; 16(1): 427. CrossRef
Second-line therapy adjustment for advanced pancreatic cancer using circulating tumor cells: Preliminary results
Joachim Drevs, Mandeep Singh Malhotra, Huseyin Sahinbas, Aggelos Iliopoulos, George Beis, Panagiotis Apostolou, Ioannis Papasotiriou
Cancer Treatment and Research Communications.2025; 44: 100956. CrossRef
Efficacy and tolerance of LV5FU2-carboplatin chemotherapy in patients with advanced pancreatic ductal adenocarcinoma after failure of standard regimens
Thomas Chaigneau, Lina Aguilera Munoz, Caroline Oger, Clémence Gourdeau, Olivia Hentic, Lucie Laurent, Nelly Muller, Marco Dioguardi Burgio, Marie-Pauline Gagaille, Philippe Lévy, Vinciane Rebours, Pascal Hammel, Louis de Mestier
Therapeutic Advances in Medical Oncology.2023;[Epub] CrossRef
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Bianca Varzaru, Razvan A. Iacob, Adina E. Croitoru, Speranta M. Iacob, Cristina E. Radu, Stefania M. Dumitrescu, Cristian Gheorghe
Cancers.2023; 15(13): 3500. CrossRef

Focused Review article

Psychiatry and Mental Health
An update on the cause and treatment of sleep disturbance in children and adolescents with autism spectrum disorder: Wan Seok Seo; Yeungnam Univ J Med. 2021;38(4):275-281. Published online September 13, 2021; DOI: https://doi.org/10.12701/yujm.2021.01410

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Abstract PDF

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by abnormalities in social communication/interaction and restrictive, repetitive patterns of behavior. ASD is a relatively common psychiatric disorder, with a prevalence of approximately 1.7% in children. Although many children and adolescents with ASD visit the hospital for medical help for emotional and behavioral problems such as mood instability and self-harming behavior, there are also many visits for sleep disturbances such as insomnia and sleep resistance. Sleep disturbances are likely to increase fatigue and daytime sleepiness, impaired concentration, negatively impact on daytime functioning, and pose challenges in controlling anger and aggressive behavior. Sleep disturbance in children and adolescents with ASD negatively affects the quality of life, nothing to say the quality of life of their families and school members. In this review, sleep disturbances that are common in children and adolescents with ASD and adolescents are presented. The developmental and behavioral impacts of sleep disturbances in ASD were also considered. Finally, non-pharmacological and pharmacological treatments for sleep disturbances in children and adolescents with ASD and adolescents are reviewed.

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Eva Arias Vivas, Adrián García Ron, Elena González Alguacil, Marta Bote Gascón, María Teresa de Santos Moreno, Elsa Santana Cabrera, Guillermo Ruiz-Ocaña de las Cuevas, Juan José García Peñas, Rafael Sánchez-del Hoyo, Víctor Soto Insuga
Annals of Child Neurology.2025; 33(1): 1. CrossRef
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Geir Bjørklund, Oleksandra Oleshchuk, Yana Ivankiv, Olena Venger, Olha Liuta, Khrystyna Mocherniuk, Mariana Lukanyuk, Mariia Shanaida
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Hatice Altun, Semiha Cömertoğlu Arslan
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Muhammed Emin Boylu, İlker Taşdemir, Mehmet Doğan, Tuba Özcanlı
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Pattern of sleep disorders among children with autism spectrum disorder
Muaath Ahmed Mohammed, Elham Mohammed Abdalkhalig, Ibrahim Abdelrhim Ali, Salma Shakir Hassan, Hayat Osman
BMC Psychiatry.2024;[Epub] CrossRef
Review of Sleep Disorders and Therapeutic Approaches in Patients With Autism Spectrum Disorder and Rett Syndrome
Katelyn Bricker, Bradley V. Vaughn
Sleep Medicine Research.2024; 15(4): 228. CrossRef
Sleep and Autism Spectrum Disorder: A Comprehensive Review of Diagnosis, Markers, Interventions, and Treatments
Deepa Burman, Karthikeyan Ramanujam, Dilshad Manzar, Vijay Kumar Chattu, David Warren Spence, Nevin F. W. Zaki, Haitham Jahrami, Seithikurippu R. Pandi-Perumal
Sleep and Vigilance.2023; 7(1): 9. CrossRef
Efficacy of Melatonin for Insomnia in Children with Autism Spectrum Disorder: A Meta-analysis
Mei Xiong, Fang Li, Zhaohua Liu, Xin Xie, Hongli Shen, Weiteng Li, Liping Wei, Rongfang He
Neuropediatrics.2023; 54(03): 167. CrossRef
Sleep disturbances and emotional dysregulation in young children with autism spectrum, intellectual disability, or global developmental delay
Irene Favole, Chiara Davico, Daniele Marcotulli, Roberta Sodero, Barbara Svevi, Federico Amianto, Federica S. Ricci, G. Maurizio Arduino, Benedetto Vitiello
Sleep Medicine.2023; 105: 45. CrossRef
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Sleep Disturbances in Children Affected by Autism Spectrum Disorder
Jessica Galli, Erika Loi, Lucrezia Maria Visconti, Paola Mattei, Anna Eusebi, Stefano Calza, Elisa Fazzi
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Analysis of sleep problem in children aged 1–3 years with autism spectrum disorder in Zhejiang province, China
Dan Yao, Shasha Wang, Fangfang Li, Minjie Gao, Jie Shao
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Understanding sleep and sleep disturbances in autism spectrum disorder, and management of insomnia: an update
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Original article

Radiation Oncology
Clinical performance of FractionLab in patient-specific quality assurance for intensity-modulated radiotherapy: a retrospective study: Se An Oh, Sung Yeop Kim, Jaehyeon Park, Jae Won Park, Ji Woon Yea; J Yeungnam Med Sci. 2022;39(2):108-115. Published online September 9, 2021; DOI: https://doi.org/10.12701/yujm.2021.01123

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Abstract PDF

Background
This study was aimed at comparing and analyzing the results of FractionLab (Varian/Mobius Medical System) with those of portal dosimetry that uses an electronic portal imaging device. Portal dosimetry is extensively used for patient-specific quality assurance (QA) in intensity-modulated radiotherapy (IMRT).
Methods
The study includes 29 patients who underwent IMRT on a Novalis-Tx linear accelerator (Varian Medical System and BrainLAB) between June 2019 and March 2021. We analyzed the multileaf collimator (MLC) DynaLog files generated after portal dosimetry to evaluate the same condition using FractionLab. The results of the recently launched FractionLab at various gamma indices (0.1%/0.1 mm–1%/1 mm) are analyzed and compared with those of portal dosimetry (3%/3 mm).
Results
The average gamma passing rates of portal dosimetry (3%/3 mm) and FractionLab are 98.1 (95.5%–100%) and 97.5% (92.3%–99.7%) at 0.6%/0.6 mm, respectively. The results of portal dosimetry (3%/3 mm) are statistically comparable with the QA results of FractionLab (0.6%/0.6 mm–0.9%/0.9 mm).
Conclusion
This paper presents the clinical performance of FractionLab by the comparison of the QA results of FractionLab using portal dosimetry with various gamma indexes when performing patient-specific QA in IMRT treatment. Further, the appropriate gamma index when performing patient-specific QA with FractionLab is provided.

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Impact of Multileaf Collimator Width and Normal Tissue Objective on Radiation Dose Distribution in Stereotactic Radiosurgery Using HyperArc for Single Brain Lesions
Se An Oh, Jae Won Park, Ji Woon Yea, Jaehyeon Park, Yoon Young Jo
Current Oncology.2025; 32(5): 272. CrossRef
Clinical Performance of FractionLab Using Log Files for Patient-Specific Quality Assurance in Stereotactic Radiosurgery Using Truebeam Equipped with HyperArc
Ji Young Bae, Sung Yeop Kim, Jae Won Park, Jaehyeon Park, Ji Woon Yea, Yoon Young Jo, Se An Oh
Progress in Medical Physics.2025; 36(2): 27. CrossRef

Review article

Radiology, Radiotherapy & Diagnostic Imaging
Avulsion injuries: an update on radiologic findings: Changwon Choi, Sun Joo Lee, Hye Jung Choo, In Sook Lee, Sung Kwan Kim; Yeungnam Univ J Med. 2021;38(4):289-307. Published online August 13, 2021; DOI: https://doi.org/10.12701/yujm.2021.01102

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Abstract PDF

Avulsion injuries result from the application of a tensile force to a musculoskeletal unit or ligament. Although injuries tend to occur more commonly in skeletally immature populations due to the weakness of their apophysis, adults may also be subject to avulsion fractures, particularly those with osteoporotic bones. The most common sites of avulsion injuries in adolescents and children are apophyses of the pelvis and knee. In adults, avulsion injuries commonly occur within the tendon due to underlying degeneration or tendinosis. However, any location can be involved in avulsion injuries. Radiography is the first imaging modality to diagnose avulsion injury, although advanced imaging modalities are occasionally required to identify subtle lesions or to fully delineate the extent of the injury. Ultrasonography has a high spatial resolution with a dynamic assessment potential and allows the comparison of a bone avulsion with the opposite side. Computed tomography is more sensitive for depicting a tiny osseous fragment located adjacent to the expected attachment site of a ligament, tendon, or capsule. Moreover, magnetic resonance imaging is the best imaging modality for the evaluation of soft tissue abnormalities, especially the affected muscles, tendons, and ligaments. Acute avulsion injuries usually manifest as avulsed bone fragments. In contrast, chronic injuries can easily mimic other disease processes, such as infections or neoplasms. Therefore, recognizing the vulnerable sites and characteristic imaging features of avulsion fractures would be helpful in ensuring accurate diagnosis and appropriate patient management. To this end, familiarity with musculoskeletal anatomy and mechanism of injury is necessary.

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Anuja Dubey, Chapala Shashank, Rizwana Farween Rajmohamed, Ankit Shah, Gaurav Kant Sharma
Apollo Medicine.2026; 23(1): 82. CrossRef
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Qizheng Wang, Suwei Liu, Yupeng Zhu, Xiaoxi Ji, Yan Zhang, Qiang Zhao, Aihui Di, Yang Lv, Ning Lang
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Samson Onsando, Wycliffe Masanta, Andrew Nyerere, Moses Njire, Gervason Moriasi, Mabel Kamweli Aworh
PLOS One.2025; 20(6): e0326048. CrossRef
Iliac Epiphyseal Avulsion Repair Using a Suture Bridge and Lag Screw Construct
Nicholas D. Cominos, Saif L. Juma, Jamil Haddad, Annamarie Pantuso, Lafi S. Khalil
Arthroscopy Techniques.2025; 14(10): 103803. CrossRef
Pediatric knee avulsion fractures: A systematic review of injury patterns, treatment strategies, and outcomes
Yasmin Youssef, Lukas F. Heilmann, Nils Mühlenfeld, Bastian Mester, Johannes Weber, Kai Fehske, Orla Klatte, Doreen Schneidmüller, Peter Strohm, Ralf Henkelmann
European Journal of Trauma and Emergency Surgery.2025;[Epub] CrossRef
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Matthieu Van Herck, Filip M. Vanhoenacker, Koenraad Verstraete
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Dong-Ju Lim
International Journal of Surgery Case Reports.2024; 114: 109195. CrossRef
Ischial Tuberosity Avulsion Fracture Mimicking Calcified Mass on Plain Films: A Case Report
Mason A Williams, Lena Naffaa
Cureus.2024;[Epub] CrossRef
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Anagha P. Parkar, Miraude E. A. P. M. Adriaensen
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Josh Landers, Evan Rosenzweig
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Michael Hofer, Carl A. Germann, Peter Croft, Timothy Sweeney
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Miodrag Glisic, Vladan Stevanovic, Aleksandar Jevtic, Uros Jovicevic, Ivan Jankovic
Vojnosanitetski pregled.2023; 80(3): 279. CrossRef

Case reports

Neurology
Recovery of the ascending reticular activating system and consciousness following comprehensive management in a patient with traumatic brain injury: a case report: Sung Ho Jang, Young Hyeon Kwon; J Yeungnam Med Sci. 2022;39(4):332-335. Published online August 12, 2021; DOI: https://doi.org/10.12701/yujm.2021.01172

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Abstract PDF: We report on changes in the ascending reticular activating system (ARAS) concurrent with the recovery of impaired consciousness following rehabilitation and cranioplasty in a patient with traumatic brain injury (TBI), which were demonstrated on diffusion tensor tractography (DTT). A 34-year-old male patient was diagnosed with a traumatic intracerebral hemorrhage after falling from a height of approximately 7 m and underwent a right frontoparietotemporal decompressive craniectomy and hematoma removal. At 5 months after onset, when starting rehabilitation, the patient showed impaired consciousness, with a Glasgow Coma Scale (GCS) score of 4. Comprehensive rehabilitative therapy was provided until 14 months after onset, and his GCS score improved to 8. Cranioplasty was performed using auto-bone at 14 months after onset. One month after cranioplasty, his GCS score improved to 12. On the 15-month DTT, the deviated lower dorsal ARAS was restored on both sides, and the right side had become thicker. The right lower ventral ARAS was reconstructed, and increased neural connectivity of the upper ARAS was detected in both the prefrontal cortices. Thus, changes in the ARAS were demonstrated in a patient with TBI during recovery of consciousness following rehabilitation and cranioplasty.

Gastroenterology and Hepatology
Primary hepatic sarcoidosis presenting with cholestatic liver disease and mimicking primary biliary cholangitis: a case report: Young Joo Park, Hyun Young Woo, Moon Bum Kim, Jihyun Ahn, Jeong Heo; J Yeungnam Med Sci. 2022;39(3):256-261. Published online August 10, 2021; DOI: https://doi.org/10.12701/yujm.2021.01151

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Abstract PDF Supplementary Material

Sarcoidosis often involves the liver. However, primary hepatic sarcoidosis confined to the liver without evidence of systemic involvement is rare. We report the case of a 37-year-old man with hepatic sarcoidosis who initially presented with elevated liver enzymes and suspicious cirrhotic nodules on computed tomography. The patient had cirrhosis but did not have portal hypertension. Based on the initial histopathologic finding of chronic granulomatous inflammation and the common clinical characteristics of sarcoidosis, he was initially diagnosed with primary biliary cholangitis, and his daily dosage of ursodeoxycholic acid was increased to 900 mg. After 14 months of treatment, his total serum bilirubin concentration was 10.9 mg/dL (upper normal limit, 1.2 mg/dL). Additionally, a transjugular liver biopsy revealed multiple noncaseating granulomas. He was diagnosed with primary hepatic sarcoidosis involving the lungs, heart, spleen, kidneys, and skin. Treatment with methylprednisolone was initiated. Two weeks later, he was started on azathioprine, and the dose of steroid was simultaneously reduced. These findings indicate the importance of including hepatic sarcoidosis as a possible diagnosis in patients with elevated liver enzymes or cryptogenic cirrhosis.

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Hepatic Sarcoidosis Mimicking a Metastatic Tumor
Naohiro Nakamura, Yoshiki Matsuno, Kazunori Aoi, Hisashi Kosaka, Sanshiro Kobayashi, Yu Takahashi, Tomomitsu Tahara, Yuri Noda, Koji Tsuta, Makoto Naganuma
Internal Medicine.2025; 64(16): 2439. CrossRef
Liver biopsy as a useful diagnostic tool for hepatic sarcoidosis: A case report
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Gastrointestinal Manifestations of Sarcoidosis: A State-of-the-Art, Comprehensive Review of the Literature—Practical Clinical Insights and Many Unmet Needs on Diagnosis and Treatment
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An Incidental Case of Sarcoidosis in a Young Male Patient Presenting With Symptomatic Chronic Cholecystitis
Kelsey A Clabby, Yelena Piazza, Vladimir Neychev
Cureus.2024;[Epub] CrossRef

Surgery
Pedunculated mucinous cystic neoplasm of the liver: a case report: Sang-Woo Ha, Shin Hwang, Hyejin Han, Song Ie Han, Seung-Mo Hong; J Yeungnam Med Sci. 2022;39(3):250-255. Published online August 3, 2021; DOI: https://doi.org/10.12701/yujm.2021.01256

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Abstract PDF: In 2010, the World Health Organization classified mucin-producing bile duct tumors of the liver into two distinct entities; mucinous cystic neoplasm of the liver (MCN-L) and intraductal papillary mucinous neoplasm of the bile duct. We present the case of a patient with MCN-L having a uniquely pedunculated shape. A 32‐year‐old woman was referred to our institution with a diagnosis of biliary cystic neoplasm. She had undergone left salpingo-oophorectomy for ovarian cancer 15 years ago. Imaging studies showed an 8 cm-sized well defined, multiloculated cystic lesion suggesting a mucinous cystic neoplasm. The cystic mass was pedunculated at the liver capsule and pathologically diagnosed as MCN-L. The mass was resected with partial hepatectomy. The patient recovered uneventfully. She was discharged 7 days postoperatively. The patient has been doing well for 6 months after the operation. The patient will be followed up annually because of the favorable postresection prognosis of MCN-L.

Original article

Radiology, Radiotherapy & Diagnostic Imaging
Puncture needle with a hard plastic sheath and plastic wings minimizes repuncture attempts in ultrasound-guided paracentesis: a retrospective case-control study: Il Wan Son, Suk Kim, Seung Baek Hong, Nam Kyung Lee, Mi Ri Jeong, Sung Yong Han, Hyun Young Woo; J Yeungnam Med Sci. 2022;39(1):18-23. Published online July 12, 2021; DOI: https://doi.org/10.12701/yujm.2021.01109

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Abstract PDF: Background
This study was performed to evaluate periprocedural factors, complications, and repuncture rate of the newly developed puncture needle and compare it with the routinely used puncture needle for ultrasound (US)-guided paracentesis.
Methods
We retrospectively identified 137 patients who underwent US-guided paracentesis between July 2018 and March 2019. Among them, 82 patients underwent US-guided paracentesis with a newly developed puncture needle. The other 55 patients underwent US-guided paracentesis with a routinely used puncture needle. The periprocedural factors, complications, and repuncture rate were compared between the two groups using the Mann-Whitney U test and Fisher exact test. The repuncture-associated factors were assessed using logistic regression analysis.
Results
There were no major or minor complications in either group. The rate of repuncture was significantly lower in the group using the newly developed puncture needle compared with the group using the routinely used puncture needle (p=0.01). The duration of the procedure was significantly shorter with the newly developed puncture needle compared with the routinely used puncture needle (p=0.01). In univariate analysis, the thickness of the abdominal wall (p=0.04) and the use of the newly developed puncture needle (p=0.01) were significantly associated with the rate of repuncture. In multivariate analysis, only the use of the newly developed puncture needle was significantly associated with the rate of repuncture.
Conclusion
Using this novel puncture needle with a hard plastic sheath and plastic wings, the rate of repuncture and the duration of the procedure were decreased without complications of US-guided paracentesis.

Case reports

Surgery
Congenital web of the common bile duct combined with multiple intrahepatic duct stricture: a case report of successful radiological intervention: Hanseul Lim, Shin Hwang, Gi-Young Ko, Hyejin Han; J Yeungnam Med Sci. 2022;39(2):161-167. Published online July 8, 2021; DOI: https://doi.org/10.12701/yujm.2021.01179

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Abstract PDF: Congenital web formations are extremely rare anomalies of the extrahepatic biliary tree. We herein report a case of common bile duct septum combined with multiple intrahepatic bile duct strictures in a 74‐year‐old female patient who was successfully treated with radiological intervention. The patient initially visited the hospital because of upper abdominal pain. Imaging studies revealed multifocal strictures with dilatation in both intra- and extrahepatic ducts; the final clinical diagnosis was congenital common bile duct web combined with multiple intrahepatic duct strictures. Surgical treatment was not indicated because multiple biliary strictures were untreatable, and the disease was clinically diagnosed as benign. The multiple strictures were extensively dilated twice through bilateral percutaneous transhepatic biliary drainage (PTBD) for 2 months. After 1 month of observation, PTBD catheters were successfully removed. The patient is doing well at 6 months after completion of the radiological intervention, with the maintenance of normal liver function. Congenital web of the bile duct is very rare, and its treatment may vary depending on the patterns of biliary stenosis. In cases where surgical intervention is not indicated for congenital web and its associated disease, radiological intervention with balloon dilatation can be a viable therapeutic option.

Infectious Disease
Coinfection of Sphingomonas paucimobilis meningitis and Listeria monocytogenes bacteremia in an immunocompetent patient: a case report: Sang Woon Bae, Jong Ho Lee; J Yeungnam Med Sci. 2022;39(1):67-71. Published online June 7, 2021; DOI: https://doi.org/10.12701/yujm.2021.01074

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Abstract PDF

This report describes a case of coinfection of Sphingomonas paucimobilis meningitis and Listeria monocytogenes bacteremia in a 66-year-old immunocompetent female patient. The patient had undergone traditional procedures, including acupuncture, which possibly caused the coinfection. During treatment with susceptible antibiotics for bacterial meningitis, she developed hydrocephalus on the third day. Consequently, the patient recovered with a mild neurological deficit of grade 4 motor assessment in both upper and lower extremities at discharge. S. paucimobilis and L. monocytogenes are rare pathogens in developed countries, occurring only during environmental outbreaks. S. paucimobilis meningitis is rarely reported. Hence, the various presentations of S. paucimobilis meningitis and the antibiotic regimen for its treatment are hereby reported, in addition to a review of other similar reported cases. This case is a possible traditional procedure-related infection. Appropriate oversight and training should be emphasized regarding preventive measures of this kind of infection. A team approach with neurologists and neurosurgeons is imperative in treating patients with hydrocephalus-complicated meningitis.

Citations

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Review article

Psychiatry and Mental Health
Psychiatric understanding and treatment of patients with amputations: So-Hye Jo, Suk-Hun Kang, Wan-Seok Seo, Bon-Hoon Koo, Hye-Geum Kim, Seok-Ho Yun; Yeungnam Univ J Med. 2021;38(3):194-201. Published online May 11, 2021; DOI: https://doi.org/10.12701/yujm.2021.00990

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Abstract PDF

Amputation changes the lives of patients and their families. Consequently, the patient must adapt to altered body function and image. During this adaptation process, psychological problems, such as depression, anxiety, and posttraumatic stress disorder, can occur. The psychological difficulties of patients with amputation are often accepted as normal responses that are often poorly recognized by patients, family members, and their primary physicians. Psychological problems can interfere with rehabilitation and cause additional psychosocial problems. Therefore, their early detection and treatment are important. A multidisciplinary team approach, including mental health professionals, is ideal for comprehensive and biopsychosocial management. Mental health professionals could help patients set realistic goals and use adaptive coping styles. Psychiatric approaches should consider the physical, cognitive, psychological, social, and spiritual functions and social support systems before and after amputation. The abilities and limitations of physical, cognitive, psychological, and social functions should also be considered. To improve the patient’s adaptation, psychological interventions such as short-term psychotherapy, cognitive behavioral therapy, mindfulness meditation, biofeedback, and group psychotherapy can be helpful.

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Original article

Urology
Significance of albumin to globulin ratio as a predictor of febrile urinary tract infection after ureteroscopic lithotripsy: Seung Yun Yi, Dong Jin Park, Kyungchan Min, Jae-Wook Chung, Yun-Sok Ha, Bum Soo Kim, Hyun Tae Kim, Tae-Hwan Kim, Eun Sang Yoo; Yeungnam Univ J Med. 2021;38(3):225-230. Published online April 20, 2021; DOI: https://doi.org/10.12701/yujm.2021.00955

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Abstract PDF

Background
We aimed to analyze the effectiveness of albumin to globulin ratio (AGR) in predicting postoperative febrile urinary tract infection (fUTI) after ureteroscopic lithotripsy (URS) and retrograde intrarenal surgery (RIRS).
Methods
From January 2013 to May 2018, 332 patients underwent URS and RIRS. The rate of postoperative fUTI and risk factors for postoperative fUTI were analyzed using logistic regression. Patients were divided into postoperative fUTI and non-postoperative fUTI (non-fUTI) groups. AGR with other demographic and perioperative data were compared between the two groups to predict the development of fUTI after URS.
Results
Of the 332 patients, postoperative fUTI occurred in 41 (12.3%). Preoperative pyuria, microscopic hematuria, diabetes mellitus, hypoalbuminemia, and hyperglobulinemia were more prevalent in the fUTI group. Patients in the fUTI group had larger stone size, lower preoperative AGR, longer operation time, and longer preoperative antibiotic coverage period. In a multivariable logistic analysis, preoperative pyuria, AGR, and stone size were independently correlated with postoperative fUTI (p<0.001, p=0.008, and p=0.041, respectively). Receiver operating curve analysis showed that the cutoff value of AGR that could predict a high risk of fUTI after URS was 1.437 (sensitivity, 77.3%; specificity, 76.9%), while the cutoff value of stone size was 8.5 mm (sensitivity, 55.3%; specificity, 44.7%).
Conclusion
This study demonstrated that preoperative pyuria, AGR, and stone size can serve as prognostic factors for predicting fUTI after URS.

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Case report

Radiology, Radiotherapy & Diagnostic Imaging
Multilocular cystic hemangioma of the liver mimicking mucinous cystic neoplasm: a case report: Nam Kyung Lee, Suk Kim, Seung Baek Hong, So Jeong Lee, Hyung Il Seo; J Yeungnam Med Sci. 2022;39(1):53-57. Published online April 7, 2021; DOI: https://doi.org/10.12701/yujm.2021.00969

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Abstract PDF

Hepatic hemangiomas infrequently exhibit atypical imaging features, which may cause diagnostic confusion with hepatic malignancies and lead to unnecessary surgery. We report a rare case of multilocular cystic hemangioma of the liver mimicking a mucinous cystic neoplasm of the liver in a 48-year-old female, focusing on computed tomography and magnetic resonance imaging features and their differential diagnosis.

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Adem Ceri, Andreas Busse-Coté, Delphine Weil, Eric Delabrousse, Vincent Di Martino, Paul Calame
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Review article

Microbiology
Lactate: a multifunctional signaling molecule: Tae-Yoon Lee; Yeungnam Univ J Med. 2021;38(3):183-193. Published online February 18, 2021; DOI: https://doi.org/10.12701/yujm.2020.00892

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Abstract PDF

Since its discovery in 1780, lactate has long been misunderstood as a waste by-product of anaerobic glycolysis with multiple deleterious effects. Owing to the lactate shuttle concept introduced in the early 1980s, a paradigm shift began to occur. Increasing evidence indicates that lactate is a coordinator of whole-body metabolism. Lactate is not only a readily accessible fuel that is shuttled throughout the body but also a metabolic buffer that bridges glycolysis and oxidative phosphorylation between cells and intracellular compartments. Lactate also acts as a multifunctional signaling molecule through receptors expressed in various cells and tissues, resulting in diverse biological consequences including decreased lipolysis, immune regulation, anti-inflammation, wound healing, and enhanced exercise performance in association with the gut microbiome. Furthermore, lactate contributes to epigenetic gene regulation by lactylating lysine residues of histones, accounting for its key role in immune modulation and maintenance of homeostasis.

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Original articles

Surgery
Clinical effectiveness of omental transposition in facilitating perineal wound healing after abdominoperineal resection: a systematic review: Sungjin Kim, Sung Il Kang, Sohyun Kim, Jae Hwang Kim; Yeungnam Univ J Med. 2021;38(3):219-224. Published online February 9, 2021; DOI: https://doi.org/10.12701/yujm.2020.00871

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Abstract PDF

Background
Omental transposition has been used to facilitate perineal wound healing in patients undergoing abdominoperineal resection (APR). However, there is no high-level evidence supporting the effectiveness of omental transposition in this regard. This study aimed to investigate the clinical efficacy of omental transposition in facilitating perineal wound healing after APR.
Methods
In this systematic review, we systematically searched the PubMed/MEDLINE, Embase, Scopus, Cochrane Library, and Web of Science databases for literature regarding the topic of our study. Studies published since the inception of each database were considered for review. The outcomes of interest were the perineal wound healing rate at 1 and 3 months postoperatively, perineal wound infection rate, and perineal wound healing period.
Results
Of the 1,923 studies identified, four articles representing 819 patients (omental transposition patients, n=295) were included in the final analysis. The wound healing rates at 1 and 3 months postoperatively in the omental transposition group (68.5% and 79.7%, respectively) did not significantly differ from those in the control group (57.4% and 78.7%, respectively) (p=0.759 and p=0.731, respectively). Perineal wound infection and chronic wound complication rates, including sinus, dehiscence, and fistula rates, also did not significantly differ between the omental transposition (8% and 7%, respectively) and control (11% and 7%, respectively) groups (p=0.221 and p=0.790, respectively).
Conclusion
Our results suggest that omental transposition does not affect perineal wound healing in patients who undergo APR.

Citations

Citations to this article as recorded by

The Human Omental Adipose Depot Mitigates Inflammation, Immune Response, and Oxidative Stress Pathways in Response to Injury via Its Secretome
Meredith Krause-Hauch, Rekha S. Patel, Bangmei Wang, Brianna Jones, Paul Albear, Niketa A. Patel
Biology.2025; 14(11): 1509. CrossRef
Perineal Wound Healing Following Abdominoperineal Resection of the Rectum
Muhammad Ali Khattak, Awais Nawaz Khan, Salman Jafferi, Yasir Iqbal, Habeeb Abdulrasheed, David McArthur
Cureus.2024;[Epub] CrossRef

Obstetrics, Gynecology, and Reproductive Medicine
Effect of in vitro testicular spermatozoa culture on pregnancy outcomes: an experience at a single university hospital: Jisun Lee, Jung Hyeon Yoo, Jae Hun Lee, Hyun Soo Ahn, Kyung Joo Hwang, Miran Kim; Yeungnam Univ J Med. 2021;38(1):53-59. Published online December 9, 2020; DOI: https://doi.org/10.12701/yujm.2020.00773

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78 Download
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Abstract PDF

Background
There are no guidelines for the optimal incubation time or temperature to improve pregnancy outcomes in testicular sperm extraction-intracytoplasmic sperm injection (TESE-ICSI) cycles. We aimed to evaluate whether a 24-hour in vitro culture of testicular spermatozoa affects pregnancy outcomes in TESE-ICSI cycles.
Methods
This was a retrospective study of 83 TESE-ICSI cycles using testicular spermatozoa in 46 couples with male partners suffering from nonobstructive or obstructive azoospermia. Sperm retrieval was performed either on the oocyte retrieval (OR) day (65 cycles in 33 couples; group A) or on the day before OR (18 cycles in 13 couples; group B) followed by in vitro culture for 24 hours. The clinical characteristics and pregnancy outcomes, including the number of retrieved oocytes, fertilization rates, embryo transfer rates, implantation and clinical pregnancy rates, were compared between the two groups.
Results
There were no differences in terms of clinical characteristics except for the levels of luteinizing hormone (LH) in males. Group B had higher LH levels than group A (4.56±1.24 IU/L vs. 3.67±1.07 IU/L, p=0.017). Group B showed higher fertilization rate (72.4±32.1% vs. 59.2±21.7%, p=0.045), implantation rate (35.0±34.1% vs. 14.0±21.5%, p=010), pregnancy rate per cycle (80% vs. 39%, p=0.033), and clinical pregnancy rate per cycle (80% vs. 37.5%, p=0.024) than those of group A.
Conclusion
Testicular sperm retrieval performed on the day before OR followed by in vitro culture can potentially improve pregnancy outcomes.

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Urology
Association between cystographic anastomotic urinary leakage following retropubic radical prostatectomy and early urinary incontinence: Se Yun Kwon; Yeungnam Univ J Med. 2021;38(2):142-147. Published online November 19, 2020; DOI: https://doi.org/10.12701/yujm.2020.00682

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Abstract PDF

Background
This study was performed to investigate the association between cystographic anastomotic urinary leakage (UL) after radical retropubic prostatectomy (RRP) and early urinary incontinence (UI).
Methods
The medical records of 53 patients who had undergone cystography after RRP at our institution between January 2015 and December 2018 were retrospectively analyzed. Cystography was performed 7 to 10 days after surgery. The duration of catheterization depended on the degree of UL, which was classified as mild, moderate, or severe. The study subjects were divided into the non-UL group and the UL group. Continence was defined as the use of no pads. The prostate was dissected in an antegrade fashion, and urethrovesical anastomosis was performed with a continuous suture.
Results
Incontinence rates at 1 and 3 months postoperatively were significantly higher in the UL group than the non-UL group (83.3% vs. 52.2%, p=0.014 and 76.7% vs. 47.8%, p=0.030, respectively); however, those at 6 and 12 months were not significantly different (23.3% vs. 17.4%, p=0.597 and 4.3% vs. 10.0%, p=0.440, respectively). The presence of cystographic anastomotic UL was found to be predictive of UI during the first 3 postoperative months (odds ratio, 3.3; p=0.045). The continence rates during the first 3 postoperative month continence rate showed significant difference with non-UL group regardless of the degree of UL.
Conclusion
The presence of anastomotic UL on cystography was associated with higher rates of UI in the early postoperative period, however the grade of UL was not related to the late recovery of UI. Incontinence rates in patients with or without anastomotic UL immediately after RRP equalized at 6 months.

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Integrating clinical and image-based parameters for prediction of early post-prostatectomy incontinence recovery: simplified nomogram approach
I-Hung Shao, Sy-Yuan Chen, Hung-Yi Chen, Ting-Wen Sheng, Ying-Hsu Chang, Chung-Yi Liu, Liang-Kang Huang, Hung-Chen Kan, Po-Hung Lin, Kai-Jie Yu, Cheng-Keng Chuang, See-Tong Pang, Chun-Te Wu
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Recognition of Postoperative Cystography Features by Artificial Intelligence to Predict Recovery from Postprostatectomy Urinary Incontinence: A Rapid and Easy Way to Predict Functional Outcome
I-Hung Shao, Hung-Cheng Kan, Hung-Yi Chen, Ying-Hsu Chang, Liang-Kang Huang, Yuan-Cheng Chu, Po-Hung Lin, Kai-Jie Yu, Cheng-Keng Chuang, See-Tong Pang, Chun-Te Wu
Journal of Personalized Medicine.2023; 13(1): 126. CrossRef

Nephrology
Analysis of the risk factors of acute kidney injury after total hip or knee replacement surgery: Yoo Jin Lee, Bong Soo Park, Sihyung Park, Jin Han Park, Il Hwan Kim, Junghae Ko, Yang Wook Kim; Yeungnam Univ J Med. 2021;38(2):136-141. Published online October 27, 2020; DOI: https://doi.org/10.12701/yujm.2020.00542

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Abstract PDF

Background
Postoperative acute kidney injury (AKI), which increases the risk of postoperative morbidity and mortality, poses a major concern to surgeons. We conducted this study to analyze the risk factors associated with the occurrence of AKI after orthopedic surgery.
Methods
This was a retrospective study that included 351 patients who underwent total hip or knee replacement surgery at Inje University Haeundae Paik Hospital between January 2012 and December 2016.
Results
AKI occurred in 13 (3.7%) of the 351 patients. The patients’ preoperative estimated glomerular filtration rate (eGFR) was 66.66±34.02 mL/min/1.73 m2 in the AKI group and 78.07±21.23 mL/min/1.73 m2 in the non-AKI group. The hemoglobin levels were 11.21±1.65 g/dL in the AKI group and 12.39±1.52 g/dL in the non-AKI group. Hemoglobin level was related to increased risk of AKI (odds ratio [OR], 0.13; 95% confidence interval [CI], 0.02–0.68; p=0.016). Administration of crystalloid or colloid fluid alone and the perioperative amount of fluid did not show any significant relationship with AKI. Further analysis of the changes in eGFR was performed using a cutoff value of 7.54. The changes in eGFR were significantly related to decreased risk of AKI (OR, 0.74; 95% CI, 0.61–0.89; p=0.002).
Conclusion
Renal function should be monitored closely after orthopedic surgery if patients have chronic kidney disease and low hemoglobin level. Predicting the likelihood of AKI occurrence, early treatment of high-risk patients, and monitoring perioperative laboratory test results, including eGFR, will help improve patient prognosis.

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Review articles

Nuclear Medicine
F-18 fluorodeoxyglucose positron emission tomography/computed tomography in the infection of heart: Eunjung Kong; Yeungnam Univ J Med. 2021;38(2):95-106. Published online October 15, 2020; DOI: https://doi.org/10.12701/yujm.2020.00479

14,044 View
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Abstract PDF

Infections involving the heart are becoming increasingly common, and a timely diagnosis of utmost importance, despite its challenges. F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is a recently introduced diagnostic tool in cardiology. This review focuses on the current evidence for the use of FDG PET/CT in the diagnosis of infective endocarditis, cardiac implantable device infection, left ventricular assist device infection, and secondary complications. The author discusses considerations when using FDG PET/CT in routine clinical practice, patient preparation for reducing physiologic myocardial uptake, acquisition of images, and interpretation of PET/CT findings. This review also functions to highlight the need for a standardized acquisition protocol.

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Antonio Rosario Pisani, Dino Rubini, Corinna Altini, Rossella Ruta, Maria Gazzilli, Angela Sardaro, Francesca Iuele, Nicola Maggialetti, Giuseppe Rubini
Journal of Personalized Medicine.2024; 14(1): 65. CrossRef
The detection of infectious endocarditis may be enhanced by a repeat FDG-PET while maintaining patients on a ketogenic diet
Marine Germaini, Caroline Boursier, François Goehringer, Christine Selton-Suty, Benjamin Lefevre, Véronique Roch, Laetitia Imbert, Marine Claudin, Elodie Chevalier, Pierre-Yves Marie
Journal of Nuclear Cardiology.2022; 29(6): 3256. CrossRef

Endocrinology, Diabetes, and Metabolism
Can antioxidants be effective therapeutics for type 2 diabetes?: Soyoung Park, So-Young Park; Yeungnam Univ J Med. 2021;38(2):83-94. Published online October 8, 2020; DOI: https://doi.org/10.12701/yujm.2020.00563

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Abstract PDF

The global obesity epidemic and the growing elderly population largely contribute to the increasing incidence of type 2 diabetes. Insulin resistance acts as a critical link between the present obesity pandemic and type 2 diabetes. Naturally occurring reactive oxygen species (ROS) regulate intracellular signaling and are kept in balance by the antioxidant system. However, the imbalance between ROS production and antioxidant capacity causes ROS accumulation and induces oxidative stress. Oxidative stress interrupts insulin-mediated intracellular signaling pathways, as supported by studies involving genetic modification of antioxidant enzymes in experimental rodents. In addition, a close association between oxidative stress and insulin resistance has been reported in numerous human studies. However, the controversial results with the use of antioxidants in type 2 diabetes raise the question of whether oxidative stress plays a critical role in insulin resistance. In this review article, we discuss the relevance of oxidative stress to insulin resistance based on genetically modified animal models and human trials.

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Focused Review articles

Pulmonary and Respiratory Medicine
Novel respiratory infectious diseases in Korea: Hyun Jung Kim; Yeungnam Univ J Med. 2020;37(4):286-295. Published online September 23, 2020; DOI: https://doi.org/10.12701/yujm.2020.00633

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Abstract PDF

Respiratory infections are very common and highly contagious. Respiratory infectious diseases affect not only the person infected but also the family members and the society. As medical sciences advance, several diseases have been conquered; however, the impact of novel infectious diseases on the society is enormous. As the clinical presentation of respiratory infections is similar regardless of the pathogen, the causative agent is not distinguishable by symptoms alone. Moreover, it is difficult to develop a cure because of the various viral mutations. Various respiratory infectious diseases ranging from influenza, which threaten the health of mankind globally, to the coronavirus disease 2019, which resulted in a pandemic, exist. Contrary to human expectations that development in health care and improvement in hygiene will conquer infectious diseases, humankind’s health and social systems are threatened by novel infectious diseases. Owing to the development of transport and trading activity, the rate of spread of new infectious diseases is increasing. As respiratory infections can threaten the members of the global community at any time, investigations on preventing the transmission of these diseases as well as development of effective antivirals and vaccines are of utmost importance and require a worldwide effort.

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Pulmonary and Respiratory Medicine
Biological treatments for severe asthma: Hyun Jung Jin; Yeungnam Univ J Med. 2020;37(4):262-268. Published online September 11, 2020; DOI: https://doi.org/10.12701/yujm.2020.00647

10,360 View
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Abstract PDF

Severe asthma patients comprise about 3% to 13% of all asthma patients, but they have higher hospital utilization rates and higher medical costs than those of nonsevere asthma patients. Treatment methods for severe asthma patients are still lacking; however, the recent development of biologics is expected to have a positive effect. The biological therapies developed so far are mainly aimed at treating asthma patients with type 2 inflammation. These biologics have been found to reduce symptoms of asthma, improve lung function, reduce the use of oral corticosteroids, and improve quality of life of patients. This article reviews the mechanism of action and indications for approved biologics and discusses what should be considered when choosing biologics.

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Pulmonary and Respiratory Medicine
An update on the role of bronchoscopy in the diagnosis of pulmonary disease: June Hong Ahn; Yeungnam Univ J Med. 2020;37(4):253-261. Published online August 28, 2020; DOI: https://doi.org/10.12701/yujm.2020.00584

16,336 View
290 Download
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Abstract PDF

Bronchoscopy has evolved over the past few decades and has been used by respiratory physicians to diagnose various airway and lung diseases. With the popularization of medical check-ups and growing interest in health, early diagnosis of lung diseases is essential. With the development of endobronchial ultrasound, ultrathin bronchoscopy, and electromagnetic navigational bronchoscopy, bronchoscopy has been able to widen its scope in diagnosing pulmonary diseases. In this review, we have described the brief history, role, and complications of bronchoscopy used in diagnosing pulmonary lesions, from simple flexible bronchoscopy to bronchoscopy combined with several up-to-date technologies.

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Review article

Obstetrics, Gynecology, and Reproductive Medicine
Classification of endometriosis: Soo-Young Lee, Yu-Jin Koo, Dae-Hyung Lee; Yeungnam Univ J Med. 2021;38(1):10-18. Published online August 7, 2020; DOI: https://doi.org/10.12701/yujm.2020.00444

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Abstract PDF

Endometriosis is a chronic disease associated with pelvic pain and infertility. Several classification systems for the severity of endometriosis have been proposed. Of these, the revised American Society for Reproductive Medicine classification is the most well-known. The ENZIAN classification was developed to classify deep infiltrating endometriosis and focused on the retroperitoneal structures. The endometriosis fertility index was developed to predict the fertility outcomes in patients who underwent surgery for endometriosis. Finally, the American Association of Gynecological Laparoscopists classification is currently being developed, for which 30 endometriosis experts are analyzing and researching data by assigning scores to categories considered important; however, it has not yet been fully validated and published. Currently, none of the classification systems are considered the gold standard. In this article, we review the classification systems, identify their pros and cons, and discuss what improvements need to be made to each system in the future.

Citations

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Original article

Medical Education
A study on evaluator factors affecting physician-patient interaction scores in clinical performance examinations: a single medical school experience: Young Soon Park, Kyung Hee Chun, Kyeong Soo Lee, Young Hwan Lee; Yeungnam Univ J Med. 2021;38(2):118-126. Published online August 6, 2020; DOI: https://doi.org/10.12701/yujm.2020.00423

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Abstract PDF

Background
This study is an analysis of evaluator factors affecting physician-patient interaction (PPI) scores in clinical performance examination (CPX). The purpose of this study was to investigate possible ways to increase the reliability of the CPX evaluation.
Methods
The six-item Yeungnam University Scale (YUS), four-item analytic global rating scale (AGRS), and one-item holistic rating scale (HRS) were used to evaluate student performance in PPI. A total of 72 fourth-year students from Yeungnam University College of Medicine in Korea participated in the evaluation with 32 faculty and 16 standardized patient (SP) raters. The study then examined the differences in scores between types of scale, raters (SP vs. faculty), faculty specialty, evaluation experience, and level of fatigue as time passes.
Results
There were significant differences between faculty and SP scores in all three scales and a significant correlation among raters’ scores. Scores given by raters on items related to their specialty were lower than those given by raters on items out of their specialty. On the YUS and AGRS, there were significant differences based on the faculty’s evaluation experience; scores by raters who had three to ten previous evaluation experiences were lower than others’ scores. There were also significant differences among SP raters on all scales. The correlation between the YUS and AGRS/HRS declined significantly according to the length of evaluation time.
Conclusion
In CPX, PPI score reliability was found to be significantly affected by the evaluator factors as well as the type of scale.

Citations

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Focused Review article

Pulmonary and Respiratory Medicine
Therapeutic potential of targeting kinase inhibition in patients with idiopathic pulmonary fibrosis: Suji Kim, Jae Hyang Lim, Chang-Hoon Woo; Yeungnam Univ J Med. 2020;37(4):269-276. Published online July 22, 2020; DOI: https://doi.org/10.12701/yujm.2020.00458

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260 Download
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Abstract PDF

Fibrosis is characterized by excessive accumulation of extracellular matrix components. The fibrotic process ultimately leads to organ dysfunction and failure in chronic inflammatory and metabolic diseases such as pulmonary fibrosis, advanced kidney disease, and liver cirrhosis. Idiopathic pulmonary fibrosis (IPF) is a common form of progressive and chronic interstitial lung disease of unknown etiology. Pathophysiologically, the parenchyma of the lung alveoli, interstitium, and capillary endothelium becomes scarred and stiff, which makes breathing difficult because the lungs have to work harder to transfer oxygen and carbon dioxide between the alveolar space and bloodstream. The transforming growth factor beta (TGF-) signaling pathway plays an important role in the pathogenesis of pulmonary fibrosis and scarring of the lung tissue. Recent clinical trials focused on the development of pharmacological agents that either directly or indirectly target kinases for the treatment of IPF. Therefore, to develop therapeutic targets for pulmonary fibrosis, it is essential to understand the key factors involved in the pathogenesis of pulmonary fibrosis and the underlying signaling pathway. The objective of this review is to discuss the role of kinase signaling cascades in the regulation of either TGF--dependent or other signaling pathways, including Rho-associated coiled-coil kinase, c-jun N-terminal kinase, extracellular signal-regulated kinase 5, and p90 ribosomal S6 kinase pathways, and potential therapeutic targets in IPF.

Citations

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M2 Macrophage‐Derived TGF‐β1 Drives Tendon Fibrosis in Rodent Tendinopathy Models
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Journal of Orthopaedic Research.2026;[Epub] CrossRef
Targeting Growth Factor and Cytokine Pathways to Treat Idiopathic Pulmonary Fibrosis
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Frontiers in Pharmacology.2022;[Epub] CrossRef
Vitamin D3 alleviates pulmonary fibrosis by regulating the MAPK pathway via targeting PSAT1 expression in vivo and in vitro
Wenxiang Zhu, Qi Ding, Lu Wang, Gonghao Xu, Yirui Diao, Sihao Qu, Sheng Chen, Yuanyuan Shi
International Immunopharmacology.2021; 101: 108212. CrossRef
Advances in the science and treatment of respiratory diseases
Jin Hong Chung
Yeungnam University Journal of Medicine.2020; 37(4): 251. CrossRef
Effects of Pirfenidone and Nintedanib on Markers of Systemic Oxidative Stress and Inflammation in Patients with Idiopathic Pulmonary Fibrosis: A Preliminary Report
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