Journal of Yeungnam Medical Science

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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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

Oncology and Cancer Research
Extracellular vesicle-associated epidermal growth factor receptor as a potential liquid biopsy biomarker in lung adenocarcinoma: a case-control study: Dian Jamel Salih; J Yeungnam Med Sci. 2025;42:36. Published online May 23, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.36

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Abstract PDF: Background
Extracellular vesicles (EVs) have recently emerged as potential noninvasive biomarkers for liquid biopsy because of the limitations of tissue biopsies in lung cancer. This study investigated the presence of EV-associated epidermal growth factor receptor (EGFR) in lung adenocarcinoma.
Methods
EVs were collected from the serum samples of 32 patients with lung adenocarcinoma, 32 healthy controls, and conditioned culture media from A549 and BEAS-2B cell lines. EVs were isolated using ultracentrifugation and size-exclusion chromatography. Their characteristic features were confirmed by transmission electron microscopy, nanoparticle tracking analysis (NTA), and western blotting.
Results
NTA revealed a two-fold increase in EV concentration in the serum of patients with lung cancer compared to healthy controls. Similarly, A549 cells secrete significantly more EVs than BEAS-2B cells. Western blotting validated the detection of canonical EV markers, such as TSG101, CD81, and flotillin-1, as well as the absence of calnexin. Notably, EGFR was highly packaged in the EVs isolated from both A549 cells and patient serum, whereas it was minimally present or absent in the EVs isolated from healthy controls and BEAS-2B cells.
Conclusion
Our findings indicated that EGFR was selectively packaged into EVs derived from lung adenocarcinoma and was absent in non-cancerous controls. EV-associated EGFR could be a noninvasive indicator for the early detection of lung adenocarcinoma through liquid biopsy.

Review article

Physical therapy, Sports Therapy, and Rehabilitation
Postoperative conditions of rehabilitative interest in lung transplantation: a systematic review: Massimiliano Polastri, Esra Pehlivan, Robert M. Reed, Allaina Eden; J Yeungnam Med Sci. 2024;41(4):235-251. Published online August 22, 2024; DOI: https://doi.org/10.12701/jyms.2024.00521

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Abstract PDF

Lung transplantation is an elective treatment option for end-stage respiratory diseases in which all medical therapy options have been exhausted. The current study aimed to identify updated information on the postoperative conditions that may impair rehabilitation after lung transplantation and to provide specific considerations of their clinical relevance during the recovery process. The present study is a systematic review conducted by searching three primary databases: the United States National Library of Medicine PubMed system, Scopus, and the Cochrane Library. The databases were searched for articles published from database inception until May 2024; at the end of the selection process, 27 documents were included in the final analysis. The retrieved material identified 19 conditions of rehabilitative interest that potentially affect the postoperative course: graft dysfunction, dysphagia, postsurgical pain, cognitive impairment, chronic lung allograft dysfunction-bronchiolitis obliterans syndrome, phrenic nerve injury, delayed extracorporeal membrane oxygenation weaning, airway clearance, refractory hypoxemia, mediastinitis, reduced oxidative capacity, sternal dehiscence, coronavirus disease 2019 (COVID-19), gastroparesis, ossification of the elbow, Takotsubo cardiomyopathy, airway dehiscence, recurrent pleural effusion, and scapular prolapse. Although some patients are not amenable to rehabilitation techniques, others can significantly improve with rehabilitation.

Citations

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The Role of Pulmonary Rehabilitation in Lung Transplantation for Cystic Fibrosis
Esra Pehlivan
OBM Transplantation.2025; 09(01): 1. CrossRef
Early mobilization after lung transplantation: A scoping review protocol
Matthieu Reffienna, Adéla Foudhaïli, Colin Sidre, Damien Vitiello, Jonathan Messika
MethodsX.2025; 14: 103404. 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

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

Citations to this article as recorded by

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

Case reports

Anesthesiology and Pain Medicine
Anesthetic management during whole-lung lavage using lung ultrasound in a patient with pulmonary alveolar proteinosis: a case report: Jae Wan Jung, Hyunho Lee, Jimi Oh; Yeungnam Univ J Med. 2021;38(4):374-380. Published online September 6, 2021; DOI: https://doi.org/10.12701/yujm.2021.01284

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Abstract PDF

Pulmonary alveolar proteinosis (PAP) is an uncommon disease characterized by progressive accumulation of lipoprotein material in the lungs due to impaired surfactant clearance. Whole-lung lavage (WLL) is the current standard treatment and consists of sequential lavage of each lung to mechanically remove the residual material from the alveoli. Although WLL is considered safe, unexpected complications can occur. Moreover, due to the rarity of the disease itself, this procedure is unknown to many physicians, and management of intraoperative complications can be challenging for anesthesiologists. Lung ultrasound (LUS) provides reliable and valuable information for detecting perioperative pulmonary complications and, in particular, quantitation of lung water content. There have been reports on monitoring the different stages of controlled deaeration of the non-ventilated lung during WLL using LUS. However, it has been limited to non-ventilated lungs. Therefore, we report the use of LUS in WLL to proactively detect pulmonary edema in the ventilated lung and implement a safe and effective anesthesia strategy. Given the limited diagnostic tools available to anesthesiologists in the operating room, LUS is a reliable, fast, and noninvasive method for identifying perioperative pulmonary complications in patients with PAP undergoing WLL.

Citations

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Effect of Whole Lung Lavage for Pulmonary Alveolar Proteinosis on Circulatory Dynamics: A Case Report
Junichi Sato, Tomohiro Chaki, Chinami Kaga, Mariko Ikeshima, Michiaki Yamakage
Cureus.2025;[Epub] CrossRef
Anesthetic management of broncho- alveolar lavage in pulmonary alveolar proteinosis: A case report
Sucheta Gaiwal, Abinav Sarvesh S P S, Nimitha Prasad
Indian Journal of Clinical Anaesthesia.2024; 11(2): 251. CrossRef

Immunology and Allergy
Idiopathic multicentric Castleman disease presenting progressive reticular honeycomb infiltration of lung and immunoglobulin G and immunoglobulin G4 dominant hypergammaglobulinemia: a case report: Hyun-Je Kim, Young-Hoon Hong; J Yeungnam Med Sci. 2022;39(2):153-160. Published online July 5, 2021; DOI: https://doi.org/10.12701/yujm.2021.01039

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Abstract PDF

Multicentric Castleman disease (MCD) is an uncommon systemic lymphoproliferative disorder that may cause multiple organ damage. Castleman disease-associated diffuse parenchymal lung disease (DPLD) has not been well studied. A 32-year-old man was referred to our hospital for progressive generalized weakness, light-headedness, and dyspnea on exertion for more than one year. Laboratory evaluations showed profound anemia, an elevated erythrocyte sedimentation rate, and an increased C-reactive protein level with polyclonal hypergammaglobulinemia. Chest radiography, computed tomography (CT), and positron emission tomography-CT scan demonstrated diffuse lung infiltration with multiple cystic lesions and multiple lymphadenopathy. In addition to these clinical laboratory findings, bone marrow, lung, and lymph node biopsies confirmed the diagnosis of idiopathic MCD (iMCD). Siltuximab, an interleukin-6 inhibitor, and glucocorticoid therapy were initiated. The patient has been tolerating the treatment well and had no disease progression or any complications in 4 years. Herein, we report this case of human herpesvirus-8-negative iMCD-associated DPLD accompanied by multiple cystic lesions, multiple lymphadenopathy, and polyclonal hypergammaglobulinemia with elevated immunoglobulin G (IgG) and IgG4 levels. We recommend a close evaluation of MCD in cases of DPLD with hypergammaglobulinemia.

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Striking effectiveness of siltuximab-based treatment in refractory idiopathic multicentric Castleman disease resembling IgG4-related disease
Xing Gong, Weiwei Yan, Feng Zhang, Dongdong Zhang
Journal of Chemotherapy.2025; : 1. CrossRef

Focused Review article

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

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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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R. N. Islamov, R. A. Sharipov, M. A. Bagirov, R. K. Tukfatullin, G. V. Chitorelidze, E. V. Pavlova, R. K. Yagafarova
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Simona-Maria Roșu, Denisa Maria Mitroi, Oana Maria Catană, Viorel Biciușcă, Sorina Ionelia Stan, Beatrice Mahler, Oana-Andreea Parliteanu, Adina Andreea Mirea, Mara Amalia Bălteanu
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Tomohiro Akaba, Ken Arimura, Keiko Kan-o, Miki Kubo, Mitsuko Kondo, Musashi Ueda, Osamitsu Yagi, Atsushi Kurokawa, Naoko Kawashima, Yutaro Horie, Yuno Shiota, Etsuko Tagaya
Respiratory Investigation.2025; 63(6): 1174. CrossRef
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Ang Li, Ming Lei, Zachary Burns, George Cheng, Zhaowei Liu
Biomedical Optics Express.2025; 16(11): 4243. CrossRef
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He Zhang, De-Xing Wang, Hai-Ming Yu
Srpski arhiv za celokupno lekarstvo.2025; 153(9-10): 504. CrossRef
Disposable Versus Reusable Bronchoscopes: A Narrative Review of Cost-effectiveness, Risk of Cross-contamination and Environmental Impact
Illaa Smesseim, Johannes M.A. Daniels, Jouke Annema, Peter I. Bonta, Dirk-Jan Slebos
Archivos de Bronconeumología.2024; 60(4): 250. CrossRef
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Andreea Ionela Dumachi, Cătălin Buiu
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Mohammad M. Seyedshahabedin, Timothy P. Howarth, Lin Mo, Edwina Biancardi, Subash S. Heraganahally
Internal Medicine Journal.2023; 53(9): 1634. CrossRef
Endobronchial ultrasound‐guided re‐biopsy of non–small cell lung cancer with acquired resistance after EGFR tyrosine kinase inhibitor treatment
Kyung Soo Hong, Jinmo Cho, Jong Geol Jang, Min Hye Jang, June Hong Ahn
Thoracic Cancer.2023; 14(4): 363. CrossRef
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Fateh Kashkash, Abdullah Khorri
Annals of Medicine & Surgery.2023; 85(2): 146. CrossRef
Invasive Diagnostic Procedures from Bronchoscopy to Surgical Biopsy—Optimization of Non-Small Cell Lung Cancer Samples for Molecular Testing
Nensi Lalić, Aleksandra Lovrenski, Miroslav Ilić, Olivera Ivanov, Marko Bojović, Ivica Lalić, Spasoje Popević, Mihailo Stjepanović, Nataša Janjić
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Utility of Radial Probe Endobronchial Ultrasound Guided Transbronchial Lung Biopsy in Bronchus Sign Negative Peripheral Pulmonary Lesions
Kyung Soo Hong, Kwan Ho Lee, Jin Hong Chung, Kyeong-Cheol Shin, Hyun Jung Jin, Jong Geol Jang, June Hong Ahn
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Radial Probe Endobronchial Ultrasound Using Guide Sheath-Guided Transbronchial Lung Biopsy in Peripheral Pulmonary Lesions without Fluoroscopy
Kyung Soo Hong, Heeyun Ahn, Kwan Ho Lee, Jin Hong Chung, Kyeong-Cheol Shin, Hyun Jung Jin, Jong Geol Jang, Seok Soo Lee, Min Hye Jang, June Hong Ahn
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Advances in the science and treatment of respiratory diseases
Jin Hong Chung
Yeungnam University Journal of Medicine.2020; 37(4): 251. CrossRef

Case report

Pulmonary and Respiratory Medicine
Whole lung lavage using a rapid infusion system to treat a patient with pulmonary alveolar proteinosis: Seung Won Ra, Soon Eun Park, Hyung Kwan Lee, Il Sang Han, Se Hun Park; Yeungnam Univ J Med. 2020;37(1):67-72. Published online October 17, 2019; DOI: https://doi.org/10.12701/yujm.2019.00360

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Abstract PDF

Whole lung lavage (WLL) is a therapeutic procedure to remove accumulated material by infusing and draining the lungs with lavage fluid. This procedure has been regarded as the current standard of care to treat pulmonary alveolar proteinosis. However, the WLL protocol has not yet been standardized and the technique has been refined and modified a number of times. A rapid infusion system is a device used to infuse blood or other fluids at precise rates and normothermic conditions. This device is not typically used in WLL, which relies on the passive infusion of fluids using the gravitational force. However, in this study we performed WLL using a rapid infusion system, since we aimed to take advantage of its shorter operation time and greater degree of control over fluid volume and temperature. The patient’s symptoms improved without the occurrence of any complications.

Citations

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Pulmonary Alveolar Proteinosis
Christopher Morton, Erin DeBiasi
Clinics in Chest Medicine.2025; 46(2): 373. CrossRef
Autoimmune Pulmonary Alveolar Proteinosis: A Review of Pathogenesis and Emerging Therapies
Akshay Mathavan, Akash Mathavan, Swaminathan Perinkulam Sathyanarayanan, Cormac McCarthy, Ali Ataya
Current Pulmonology Reports.2024; 13(3): 233. CrossRef
Whole-Lung Lavage—a Narrative Review of Anesthetic Management
Santiago M. Mata-Suarez, Agustina Castro-Lalín, Santiago Mc Loughlin, Juan De Domini, Juan C. Bianco
Journal of Cardiothoracic and Vascular Anesthesia.2022; 36(2): 587. CrossRef
Lung injury induced by different negative suction pressure in patients with pneumoconiosis undergoing whole lung lavage
Mingyuan Yang, Baoping Li, Bin Wang, Lei Li, Yurong Ji, Yunzhi Zhou, Rui Huang, Qinghao Cheng
BMC Pulmonary Medicine.2022;[Epub] CrossRef
Anesthetic management during whole-lung lavage using lung ultrasound in a patient with pulmonary alveolar proteinosis: a case report
Jae Wan Jung, Hyunho Lee, Jimi Oh
Yeungnam University Journal of Medicine.2021; 38(4): 374. CrossRef

Review article

Pathology and Forensic Medicine
Pathological interpretation of connective tissue disease-associated lung diseases: Kun Young Kwon; Yeungnam Univ J Med. 2019;36(1):8-15. Published online January 15, 2019; DOI: https://doi.org/10.12701/yujm.2019.00101

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Abstract PDF

Connective tissue diseases (CTDs) can affect all compartments of the lungs, including airways, alveoli, interstitium, vessels, and pleura. CTD-associated lung diseases (CTD-LDs) may present as diffuse lung disease or as focal lesions, and there is significant heterogeneity between the individual CTDs in their clinical and pathological manifestations. CTD-LDs may presage the clinical diagnosis a primary CTD, or it may develop in the context of an established CTD diagnosis. CTD-LDs reveal acute, chronic or mixed pattern of lung and pleural manifestations. Histopathological findings of diverse morphological changes can be present in CTD-LDs airway lesions (chronic bronchitis/bronchiolitis, follicular bronchiolitis, etc.), interstitial lung diseases (nonspecific interstitial pneumonia/fibrosis, usual interstitial pneumonia, lymphocytic interstitial pneumonia, diffuse alveolar damage, and organizing pneumonia), pleural changes (acute fibrinous or chronic fibrous pleuritis), and vascular changes (vasculitis, capillaritis, pulmonary hemorrhage, etc.). CTD patients can be exposed to various infectious diseases when taking immunosuppressive drugs. Histopathological patterns of CTD-LDs are generally nonspecific, and other diseases that can cause similar lesions in the lungs must be considered before the diagnosis of CTD-LDs. A multidisciplinary team involving pathologists, clinicians, and radiologists can adequately make a proper diagnosis of CTD-LDs.

Citations

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Multidisciplinary Approach to the Diagnosis of Idiopathic Interstitial Pneumonias: Focus on the Pathologist’s Key Role
Stefano Lucà, Francesca Pagliuca, Fabio Perrotta, Andrea Ronchi, Domenica Francesca Mariniello, Giovanni Natale, Andrea Bianco, Alfonso Fiorelli, Marina Accardo, Renato Franco
International Journal of Molecular Sciences.2024; 25(7): 3618. CrossRef
Acute fibrinous and organizing pneumonia: two case reports and literature review
Haihong Chen, Yukun Kuang, Xinyan Huang, Ziyin Ye, Yangli Liu, Canmao Xie, Ke-Jing Tang
Diagnostic Pathology.2021;[Epub] CrossRef

Original Articles

Anesthesiology and Pain Medicine
Effects of small tidal volume and positive end-expiratory pressure on oxygenation in pressure-controlled ventilation-volume guaranteed mode during one-lung ventilation: Sung Hye Byun, So Young Lee, Jin Yong Jung; Yeungnam Univ J Med. 2018;35(2):165-170. Published online December 20, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.165

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Abstract PDF

Background
The purpose of this study was to investigate whether tidal volume (TV) of 8 mL/kg without positive end-expiratory pressure (PEEP) and TV of 6 mL/kg with or without PEEP in pressure-controlled ventilation-volume guaranteed (PCV-VG) mode can maintain arterial oxygenation and decrease inspiratory airway pressure effectively during one-lung ventilation (OLV).
Methods
The study enrolled 27 patients undergoing thoracic surgery. All patients were ventilated with PCVVG mode. During OLV, patients were initially ventilated with TV 8 mL/kg (group TV8) without PEEP. Ventilation was subsequently changed to TV 6 mL/kg with PEEP (5 cmH2O; group TV6+PEEP) or without (group TV6) in random sequence. Peak inspiratory pressure (Ppeak), mean airway pressure (Pmean), and arterial blood gas analysis were measured 30 min after changing ventilator settings. Ventilation was then changed once more to add or eliminate PEEP (5 cmH2O), while maintaining TV 6 mL/kg. Thirty min after changing ventilator settings, the same parameters were measured once more.
Results
The Ppeak was significantly lower in group TV6 (19.3±3.3 cmH2O) than in group TV8 (21.8±3.1 cmH2O) and group TV6+PEEP (20.1±3.4 cmH2O). PaO2 was significantly higher in group TV8 (242.5±111.4 mmHg) than in group TV6 (202.1±101.3 mmHg) (p=0.044). There was no significant difference in PaO2 between group TV8 and group TV6+PEEP (226.8±121.1 mmHg). However, three patients in group TV6 were dropped from the study because PaO2 was lower than 80 mmHg after ventilation.
Conclusion
It is postulated that TV 8 mL/kg without PEEP or TV 6 mL/kg with 5 cmH2O PEEP in PCV-VG mode during OLV can safely maintain adequate oxygenation.

Citations

Citations to this article as recorded by

Driving Pressure-Guided Tidal Volume Titration Reduces Lung Injury in Thoracic Surgery with One-Lung Ventilation: A Randomized Clinical Trial
Yun Yan, Xiaowen Liu, Zhen Liu, Zhe Li, Huamei Cai, Weixia Li, Jing Zhao
Journal of Cardiothoracic and Vascular Anesthesia.2025;[Epub] CrossRef
Pressure‐Controlled Ventilation‐Volume Guaranteed Mode Combined with an Open‐Lung Approach Improves Lung Mechanics, Oxygenation Parameters, and the Inflammatory Response during One‐Lung Ventilation: A Randomized Controlled Trial
Jianli Li, Baogui Cai, Dongdong Yu, Meinv Liu, Xiaoqian Wu, Junfang Rong, Jürgen Bünger
BioMed Research International.2020;[Epub] CrossRef

Anesthesiology and Pain Medicine
Comparison of sevoflurane and propofol anesthesia on the incidence of hyperglycemia in patients with type 2 diabetes undergoing lung surgery: Hyuckgoo Kim, Jisoo Han, Sung Mee Jung, Sang-Jin Park, Nyeong Keon Kwon; Yeungnam Univ J Med. 2018;35(1):54-62. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.54

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Abstract PDF

Background
The type and regimen of anesthesia may affect perioperative hyperglycemia following major surgical stress. This study compared the effects of sevoflurane and propofol on the incidence of hyperglycemia and clinical outcomes in diabetic patients undergoing lung surgery.
Methods
This retrospective study included 176 patients with type 2 diabetes mellitus who had undergone lung surgery. Blood glucose levels and clinical outcomes from the preoperative period to the first 2 postoperative days (PODs) were retrospectively examined in patients who received sevoflurane (group S, n= 87) and propofol (group P, n=89) for maintenance of general anesthesia. The primary endpoint was the incidence of persistent hyperglycemia (2 consecutive blood glucose levels >180 mg/dL [10.0 mmol/L]) during the perioperative period. The secondary composite endpoint was the incidence of major postoperative complications and 30-day mortality rate after surgery.
Results
Blood glucose levels similarly increased from the preoperative period to the second POD in both groups (p=0.857). Although blood glucose levels at 2 hours after surgery were significantly lower in group P than in group S (p=0.022; 95% confidence interval for mean difference, -27.154 to -2.090), there was no difference in the incidence of persistent hyperglycemia during the perioperative period (group S, 70%; group P, 69%; p=0.816). The composite of major postoperative complications and all-cause in-hospital and 30-day mortality rates were also comparable between the two groups.
Conclusion
Sevoflurane and propofol were associated with a comparable incidence of perioperative hyperglycemia and clinical outcomes in diabetic patients undergoing lung surgery.

Citations

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Effects of Intravenous or Inhalation Anesthesia on Blood Glucose in Patients with Type 2 Diabetes Mellitus: A PRISMA-Compliant Systematic Review and Meta-Analysis
Sang Min Yoon, Hyun Kang, Yoon Ji Choi, Sang Hun Kim, Seongtae Jeong, Sejong Jin
Medicina.2026; 62(1): 128. CrossRef
Propofol-Induced Hyperglycemia in the Critically Ill: An Unfamiliar Side Effect of a Common Anesthetic
Muhammad A Qureshi, Greeshma A Thomas, Tijin Mathew, FNU Anshul
Cureus.2024;[Epub] CrossRef
The Maternal and Neonatal Glycemic Stress Response in Normal Vaginal Delivery: A Comparative Study Between Epidural and Parenteral Opioids Analgesia
Ala”a Alhowary, Omar Altal, Diab Bani Hani, Anas Alrusan, Yaser Ba Jusair, Rania Al-Bataineh, Ahmed Al Sharie, Abdelwahab Aleshawi
Local and Regional Anesthesia.2024; Volume 17: 117. CrossRef
Strategies for intraoperative glucose management: a scoping review
Nathaniel Morin, Sarah Taylor, Danae Krahn, Leyla Baghirzada, Michael Chong, Tyrone G. Harrison, Anne Cameron, Shannon M. Ruzycki
Canadian Journal of Anesthesia/Journal canadien d'anesthésie.2023; 70(2): 253. CrossRef
Impact of total intravenous anesthesia and total inhalation anesthesia as the anesthesia maintenance approaches on blood glucose level and postoperative complications in patients with type 2 diabetes mellitus: a double-blind, randomized controlled trial
Xinghui Xiong, Yong He, Cheng Zhou, Qin Zheng, Chan Chen, Peng Liang
BMC Anesthesiology.2023;[Epub] CrossRef
Current trends in management of hyperglycaemia in surgical patients with diabetes mellitus: a review
Vladimir N. Kuklin, J. Matri, N. P. Barlow, S. H. Tveit, J. E. Kvernberg, E. -M. Ringvold, V. Dahl
Annals of Critical Care.2022; (4): 33. CrossRef
Effects of sevoflurane anesthesia and abdominal surgery on the systemic metabolome: a prospective observational study
Yiyong Wei, Donghang Zhang, Jin Liu, Mengchan Ou, Peng Liang, Yunxia Zuo, Cheng Zhou
BMC Anesthesiology.2021;[Epub] CrossRef

Case Reports

Pathology and Forensic Medicine
Glandular papilloma of the lung with malignant transformation: Woo Jung Sung; Yeungnam Univ J Med. 2017;34(2):298-302. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.298

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Abstract PDF

Glandular papilloma of the lung is one of three histologic types of solitary endobronchial papillomas. It is known as an uncommon benign neoplasm. No malignant glandular papillomas have been reported. Herein, the first case of granular papilloma with malignant transformation is reported. A 74-year-old man with huge right lung mass extended upper and lower lobe was admitted to the hospital complaining of progressive cough and dyspnea. An open lung biopsy was performed. Microscopically, the tumor showed papillary growth pattern with thick fibrovascular cores. The stroma of the fibrovascular cores shown the infiltration of lymphoplasmacytic cells and proliferation of capillaries. The epithelial cells surrounding the papillary fronds were cilliated columnar cells with focal cellar atypia, and frequent mitoses. Suspicious pleural invasion foci were identified. The Ki-67 labeling index was about 24.3% and p53 labeling index was about 31.7%. Glandular papilloma is known as a benign neoplasm, which is lack of atypia and mitosis. In present case, there were several indications of malignant transformation, such as cellular atypia, frequent mitosis, architectural distortion, and pleural invasion. Pathologists must be aware that glandular papilloma can have a changes of malignant transformation. Further studies about disease behavior and molecular characteristics are needed.

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Glanduläres Papillom im linken Hauptbronchus – eine extrem seltene bronchoskopische Diagnose
Constantin Blanke-Roeser, Christoph Petermann, Keith Koreuber, Wera Weisser, Gunther H. Wiest
Pneumologie.2025; 79(12): 971. CrossRef
Adenocarcinoma-Papillary Cystic Pattern Arising in a Mixed Squamous and Glandular Papilloma of the Lung
Ae Ri An, Seung Yong Park, Jong Hun Kim, Kum Ju Chae, Myoung Ja Chung
International Journal of Surgical Pathology.2020; 28(6): 658. CrossRef

Pulmonary and Respiratory Medicine
Partial spontaneous remission of small cell lung carcinoma with neurologic symptom: Kyung Hyun Yun, Sung Heon Song, Chung Hyoun Kim, Chan Hee Hwang, Jun Ho Lee, Je Hyoung Choi, Sun Young Kim; Yeungnam Univ J Med. 2017;34(2):275-278. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.275

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Abstract PDF: Small cell lung carcinoma (SCLC) is a cancer that shows aggressive behavior, early spread to distant sites, and frequent association with distinct paraneoplastic syndromes. Spontaneous remission of cancer, particularly of SCLC, is a rare biological event. Cases involving spontaneous regression of SCLC were reported, and were associated with paraneoplastic syndromes of the nervous system. This article reports on a 78-year-old man with SCLC in remission, with neurological symptoms. The patient visited the hospital because of generalized weakness, and imaging studies revealed a mass in the lower lobe of the left lung, pathological evaluation showed SCLC. The patient refused oncologic treatment and was treated only with conservative care. In follow-up study the diameter of the mass had decreased from initial 32 mm, 9 months after admission to 20 mm, 17 months after admission to 13 mm. The patient kept complaining of generalized weakness, dizziness, and paresthesia of limbs. We assumed that, in this case, the spontaneous remission of lung cancer was related to the immunologic response directed against the tumor, which is believed to be an important factor in the pathogenesis of paraneoplastic neurologic syndromes.

Pulmonary and Respiratory Medicine
Double primary lung adenocarcinoma diagnosed by epidermal growth factor receptor mutation status: Oh Jung Kwon, Min Hyeok Lee, Sung Ju Kang, Seul Gi Kim, In Beom Jeong, Ji Yun Jeong, Eun Jung Cha, Do Yeun Cho, Young Jin Kim, Ji Woong Son; Yeungnam Univ J Med. 2017;34(2):270-274. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.270

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Abstract PDF: A nodular density was detected on a chest radiograph taken from a 57-year-old Korean woman who was visiting a hospital for a routine check. Chest computed tomography revealed a 4.8 cm lobulated mass in the right lung and another focal nodular lesion in the left lung; biopsies of both lungs revealed adenocarcinoma. We conducted DNA sequencing and peptide nucleic acid clamping to investigate the potential double primary lung cancer. The results verified that the mass in the right lung had a mutation in the epidermal growth factor receptor, whereas the nodule in the left lung had a wild-type sequence, showing that these two were genetically different cancers from one another. Thus, we demonstrate that genetic testing is useful in determining double primary lung cancer, and we herein report on this case.

Oncology and Cancer Research
Multifocal nodular lymphoid hyperplasia of the lung: Gil Tae Lee, Eun Kyoung Kim, Eirie Cho, Seung Sook Lee, Seo Yun Kim, Cheol Hyeon Kim, Hye Ryoun Kim; Yeungnam Univ J Med. 2017;34(1):84-87. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.84

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Abstract PDF: Nodular lymphoid hyperplasia (NLH) is a benign lymphoproliferative disease that can affect the lung. Because of its rarity, little is known about the etiology and natural history of NLH. Most cases are usually asymptomatic and found incidentally on imaging studies. Imaging finding of NLH has shown most commonly as a solitary lesion, although multifocal pulmonary nodules may be seen. Surgical resection has proved curative in the cases previously described. We report a rare case of NLH in a 55 year-old man who presented with bilateral multiple pulmonary nodules on chest radiography. Open biopsy was performed from the upper and lower lobe of the left lung. The lesions were pathologically diagnosed as pulmonary NLH. Multifocal residual nodules in both lungs remain stable without spontaneous regression during the 3 years of follow-up.

Oncology and Cancer Research
Pumpless extracorporeal interventional lung assist for bronchiolitis obliterans after allogenic peripheral blood stem cell transplantation for acute lymphocytic leukemia.: Yeon Hee Park, Chae Uk Chung, Jae Woo Choi, Sang Ok Jung, Sung Soo Jung, Jeong Eun Lee, Ju Ock Kim, Jae Young Moon; Yeungnam Univ J Med. 2015;32(2):98-101. Published online December 31, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.2.98

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Abstract PDF: Bronchiolitis obliterans (BO), which is associated with graft-versus-host disease after allogenic hematopoietic stem cell transplantation, is a major obstacle to survival after bone marrow transplantation due to its gradual progress, eventually leading to respiratory failure. Pumpless extracorporeal interventional lung assist (iLA) is effective in treatment of reversible hypercapnic respiratory failure. In this paper, we present a 23-year-old female patient who underwent allogeneic peripheral blood stem cell transplantation (PBSCT) for acute lymphocytic leukemia. After 6 months, she complained of shortness of breath and was diagnosed with BO. Five months later, she developed an upper respiratory tract infection that worsened her BO and caused life-threatening hypercapnia. Since mechanical ventilation failed to eliminate CO2 effectively, iLA was applied as rescue therapy. Her hypercapnia and respiratory acidosis showed significant improvement within a few hours, and she was successfully weaned off iLA after 12 days. This is the first case report of iLA application for temporarily aggravated hypercapnia of PBSCT-associated BO followed by successful weaning. This rescue therapy should be considered in ventilator-refractory reversible hypercapnia in BO patients.

Original Article

Pulmonary and Respiratory Medicine
Weekly irinotecan and carboplatin for patients with small cell lung cancer.: Hye Won Lee, Eu Gene Jeong, Dong Hyun Kim, Hyuk Lee, Bo Hyoung Kang, Soo Jung Um, Meesook Roh, Choonhee Son; Yeungnam Univ J Med. 2014;31(2):82-88. Published online December 31, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.2.82

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Abstract PDF: BACKGROUND
Lung cancer is the most common cause of cancer-related death worldwide and in Korea, and small cell lung cancer (SCLC) is the most deadly tumor type in the different lung cancer histology. Chemotherapy is the main strategy of the treatment for SCLC, and etoposide and platinum regimen has been the only standard chemotherapy for about 30 years. To test feasibility of weekly divided dose irinotecan and carboplatin for Korean patients is the aim of this study. METHODS: Patients with histologically or cytologically confirmed extensive stage SCLC were included. Patients with limited stage (LD), who could not tolerate concurrent chemoradiotherapy were also included. All the patients received irinotecan 60 mg/m2, carboplatin 2 area under the curve at day 1, 8, and 15 every 4 weeks. Study regimen was discontinued when the disease progressed or intolerable side effects occurred. No more than 6 cycles of chemotherapy were given. RESULTS: Total 47 patients were enrolled, among them 9 patients were LD. Overall response rate was 74.5% (complete response, 14.9%; partial response, 59.6%). Side effects greater than grade 3 were neutropenia (25.5%), fatigue (12.8%), thrombocytopenia (8.5%), sepsis (4.3%), and pancytopenia (2.1%). There was no treatment related death. CONCLUSION: Weekly divided irinotecan and carboplatin regimen is effective, and safe as a first line therapy for both stage of SCLC. Large scaled, controlled study is feasible.

Case Report

Dermatology
Fast-growing multiple symmetric lipomatosis.: Jin Hwa Choi, Byung Su Kim, Seung Hyun Sohng, Hyo Jin Lee, Dong Hoon Shin, Jong Soo Choi, Young Kyung Bae; Yeungnam Univ J Med. 2014;31(1):48-51. Published online June 30, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.1.48

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Abstract PDF: Multiple symmetric lipomatosis (MSL) is a rare disease characterized by symmetrical massive fatty deposits on the face, neck, shoulders, and upper trunk. We report a 74-year-old man who complained of painless subcutaneous nodules on his posterior neck that developed 3 weeks earlier. In a week, variably-sized similar lesions developed on both his shoulders and upper extremities. At the time of his hospital visit, several firm nodules as big as a walnut to a child's fist and with the normal-skin-hue were observed on his posterior neck, both shoulders, upper extremities, and trunk. The histological examination of his upper left arm revealed more mature adipocytes without encapsulation in the subcutaneous tissue. MSL was generally known to occur slowly over months or years. However, this is an unusual case that showed a fast-growing nature.

Review

Thoracic and Cardiovascular Surgery
Perioperative Management of Lung Resection Patients.: Jang Hoon Lee; Yeungnam Univ J Med. 2012;29(1):9-13. Published online June 30, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.1.9

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2 Crossref

Abstract PDF

Lung resection has various and commonly occurring postoperative complications. Pulmonary complication is well known as one of the most important among them, exerting a negative influence on the postoperative course and resulting in mortality. Thus, the prevention of pulmonary complication after lung resection is very important. To prevent postoperative pulmonary complication, the perioperative management must be optimal. Perioperative management begins long before the surgery and does not end until the patient leaves the hospital. The goal of perioperative management is to identify the high-risk patients, to provide appropriate intervention, to prevent postoperative complications, and to obtain the best outcomes.

Citations

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Case Report of a Soeumin Patient with Yang Collapse Syndrome Mistreated with Soeumin Gwakhyangjunggi-san
Ji-eun Lee, Min-woo Kim, Se-eun Chun, Yong-jeen Shin, Sun-ho Shin
The Journal of Internal Korean Medicine.2021; 42(2): 95. CrossRef
Factors Influencing Complications after Therapeutic Lung Resection in Lung Cancer Patients
Soojin Son, Jihyun Kim
Journal of Korean Academy of Fundamentals of Nursing.2020; 27(2): 106. CrossRef

Original Article

Oncology and Cancer Research
Early or Late Gefitinib, Which is Better for Survival?: Retrospective Analysis of 228 Korean Patients with Advanced or Metastatic NSCLC.: Dong Gun Kim, Min Kyoung Kim, Sung Hwa Bae, Sung Ae Koh, Sung Woo Park, Hyun Je Kim, Myung Jin Kim, Hyo Jin Jang, Kyung Hee Lee, Kwan Ho Lee, Jin Hong Chung, Kyung Chul Shin, Hun Mo Ryoo, Myung Soo Hyun; Yeungnam Univ J Med. 2011;28(1):31-44. Published online June 30, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.1.31

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Abstract PDF: BACKGROUND
The optimal timing of treatment with EGFR-tyrosine kinase inhibitors (EGFR-TKI) in NSCLC patients has not yet been determined. METHODS: We separated 228 patients with advanced/metastatic NSCLC treated with gefitinib into an early gefitinib group (patients who received gefitinib as first- or second-line treatment) and a delayed gefitinib group (patients who received gefitinib as third or fourth-line treatment) and attempted to determine whether the timing of gefitinib treatment affected clinical outcomes. RESULTS: Median overall survival (OS), progression free survival (PFS), and median OS from first-line treatment of advanced/metastatic disease (OSt) for 111 patients in the early gefitinib group were 6.2 months, 3.3 months, and 11.6 months. However, median OS, PFS, and OSt for 84 patients in the delayed gefitinib group were 7.8 months, 2.3 months, and 22.7 months. No differences in OS and PFS were observed between the 2 groups. However, OSt was significantly longer in the delayed gefitnib group. Timing of gefitinib therapy was one of the independent predictors of OSt. Hb > or = 10 g/dl, and having never smoked, and ECOG performance status < or =1 were independent predictors of better PFS. CONCLUSION: Deferral of gefitinib therapy in patients with advanced or metastatic NSCLC may be preferable if they are able to tolerate chemotherapy.

Case Reports

Pulmonary and Respiratory Medicine
A Case of Paragonimiasis Suspected Lung Cancer.: Yeong Ha Ryu, Dae Hyung Woo, Jung Eun Park, Hyun Jung Kim, Kyeong Cheol Shin, Jin Hong Chung, Kwan Ho Lee; Yeungnam Univ J Med. 2010;27(1):69-73. Published online June 30, 2010; DOI: https://doi.org/10.12701/yujm.2010.27.1.69

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Abstract PDF

A paragonimiasis infestation is caused by the paragonimus species. Paragonimiasis mainly occurs by ingestion of raw or undercooked freshwater crabs or crayfish. In our country, the prevalence of paragonimiasis was high until late 1960s due to eating habits, but after the 1970s the prevalence of the disease has markedly decreased and now the disease is rarely seen. The diagnosis of tuberculosis by Chest X-ray is often confused with pulmonary carcinoma, bacillary and parasitic infections, and chronic mycosis. Pulmonary paragonimiasis must be considered in the differential diagnosis of lung cancer especially in the appropriate clinical setting because effective treatment with praziquantel can be rewarding. We report a case of a 58-year-old woman with pulmonary paragonimiasis that was suspicious for lung cancer, as detected by biopsy.

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A Case of Delayed Diagnosis of Pulmonary Paragonimiasis due to Improvement after Anti-tuberculosis Therapy
Suhyeon Lee, Yeonsil Yu, Jinyoung An, Jeongmin Lee, Jin-Sung Son, Young Kyung Lee, Sookhee Song, Hyeok Kim, Suhyun Kim
Tuberculosis and Respiratory Diseases.2014; 77(4): 178. CrossRef

Pulmonary and Respiratory Medicine
A Case of Lymphangioleiomyomatosis in Lung.: Jung Eun Park, Hyun Jung Kim, Dae Hyung Woo, Yung Ha Ryu, Kwan Ho Lee, Jin Hong Chung, Kyeong Cheol Shin; Yeungnam Univ J Med. 2010;27(1):63-68. Published online June 30, 2010; DOI: https://doi.org/10.12701/yujm.2010.27.1.63

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Abstract PDF: Lymphangioleiomyomatosis (LAM) is a rare, cystic lung disease that is associated with mutation in the tuberous sclerosis genes, renal angiomyolipomas, lymphatic spread and a remarkable female gender predilection. The pathology of LAM is represented by the proliferation of immature smooth muscle cells in the walls of airways, and venules and lymphatic vessels in the lung. The clinical course of LAM is characterized by progressive dyspnea on exertion, recurrent pneumothorax and collections of chylous fluid. The diagnosis of pulmonary LAM can be made on chest X-ray, a high-resolution CT scan and lung biopsy. We experienced a case of pulmonary lymphangioleiomyomatosis in a 28-years-old female patient who had suffered from progressive dyspnea on exertion, so we report on it along with a brief review of the relevant literature.

Original Articles

Pulmonary and Respiratory Medicine
Effect of on Aerosolized Vitamin E Pretreatment on Interleukin-1 Induced Acute Lung Injury in Rats: Jin Hong Chung, Kyeong-Cheol Shin; Yeungnam Univ J Med. 2007;24(2 Suppl):S365-372. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S365

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Abstract PDF: Background
：Interleukin-1 (IL-1) and neutrophil appear to contribute to the pathogenesis of acute respiratory distress syndrome (ARDS). Reactive oxygen species, as well as elastase released from activated neutrophil, are thought to play pivotal roles in the experimental models of acute lung leak. This study investigated whether aerosolized vitamin E can attenuate acute lung injury induced by IL-1 in rats. Materials and Methods：We intratracheally instilled either saline or IL-1 with and without pretreatment with aerosolized vitamin E in rats. After 5 hours of intratracheal instillation, lung lavage neutrophils, lung lavage protein concentration, lung myeloperoxidase(MPO) activity and lung wet weight to dry weight ratio(WW/DW) were measured in rat.
Results
：In rats given IL-1 intratracheally, lung lavage neutrophils, lung lavage protein concentration, lung MPO activity and WW/DW were higher. Pretreatment with aerosolized vitamin E decreased lung lavage neutrophils, lung MPO activity and WW/DW in rats given IL-1 intratracheally.
Conclusion
：These results suggest that direct pulmonary supplement of vitamin E decreases lung inflammation and leak in rats given IL-1 intratracheally.

Thoracic and Cardiovascular Surgery
Comparison of Postoperative Results after Pneumonectomy between Lung Cancer and Infectious Lung Disease Groups: Jang Hoon Lee, Jung Cheul Lee; Yeungnam Univ J Med. 2007;24(2 Suppl):S304-309. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S304

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Abstract PDF: Background
：Pneumonectomy has been known with higher rate of morbidity and mortality. Thereby, we evaluated patients who received pneumonectomy for lung cancer and infectious lung disease related to postoperative morbidity and mortality. Materials and methods：The retrospective study was undertaken in 55 patients who had undergone pneumonectomy at Yeungnam University Hospital from January 1996 to December 2004. We devided into two groups, lung cancer group (group A, n=40) and infectious lung disease group (group B, n=15) and then compared and analyzed.
Results
：The mean age was higher in group A and there was statistical significance (60.8 9.4 vs 45.7 12.1, p<0.001). With preoperative pulmonary function test, FEV1, FVC were higher in group A and there were statistical significane (p<0.001, p=0.006). With preoperative lung perfusion scan, the perfusion ratio of affected lung and postoperative predicted FEV1 were higher in group A and there were statistical significance (p<0.001, p=0.007). According to MRC dyspnea scale, change of respiratory difficulty of group A had statistical significance (p<0.001). There were a total 20 postoperative complications (36.4%) of which arrhythmia 7, postoperative bleeding 5, empyema and/or bronchopleural fistula 3, pneumonia 2, adult respiratory distress syndrome 1, vocal cord palsy 1. The postoperative complication rate was no difference between two groups (37.5% vs 33.3%) but arrhythmia developed in group A only. There were 3 postoperative mortalities, all in group A.
Conclusion
：Preoperative pulmonary function test and postoperative predicted FEV1 were lower in group B, however, postoperative complication rate was no difference between two groups and mortality developed in group A only. Because of lesser resected lung volume and well adopted in long term diseased period, there was lesser hemodynamic change in infectious lung disease. So postoperative mortality not developed in infectious lung disease group due to arrhythmia and respiratory failure.

Oncology and Cancer Research
Phase II Study of Paclitaxel and Cisplatin as Second-line Chemotherapy in Advanced Non-small Cell Lung Cancer.: Yeoung Tae Seo, Bong Seog Kim, Ji Young Go, Dong Suk Choi, Seong Ho Choi, Hye Jin Kim, Young Mi Ahn, Yong Ho Roh, Kyung Hee Lee; Yeungnam Univ J Med. 2004;21(2):198-206. Published online December 31, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.2.198

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Abstract PDF: BACKGROUND
To evaluate the efficacy and safety of paclitaxel and cisplatin against advanced non-small cell lung cancer (NSCLC) as a second-line chemotherapy. SUBJECTS AND METHODS: Twenty-five patients were enrolled. The patients received 200 mg/m2 paclitaxel as a 3-hour intravenous infusion and 60 mg/m2 cisplatin as 30-minute intravenous infusion with vigorous hydration on day 1 every 28 days. The response was assessed every 2 cycles. RESULTS: All 25 patients were assessed for their response and toxicity. Partial responses were observed in 5 patients. The overall response rate was 20% (95% confidence interval, 4%~36%) and the median response duration was 4.5 (range, 2-11) months. The median time to progression was 3.3 (range, 0-14) months. The median overall survival of all patients was 7.4 (range, 1.3-39) months. The hematologic toxicities were minor and easily controlled. CONCLUSION: The combination chemotherapy of paclitaxel and cisplatin as a second-line treatment has a moderate efficacy with an acceptable toxicity in patients with advanced NSCLC.

Pulmonary and Respiratory Medicine
Effect of Neutrophil Elastase inhibitor, ICI 200,355, on Interleukin-1 Induced acute lung injury in rats.: Jin Hong Chung, Yeung Chul Mun, Hye Jung Park, Kyeong Cheol Shin, Kwan Ho Lee; Yeungnam Univ J Med. 2002;19(1):55-62. Published online June 30, 2002; DOI: https://doi.org/10.12701/yujm.2002.19.1.55

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Abstract PDF: BACKGROUND
Interleukin-1 (IL-1) and neutrophil appear to contribute to the pathogenesis of acute respiratory distress syndrome (ARDS). Elastase, as well as reactive oxygen species released from activated neutrophil, are thought to play pivotal roles in the experimental models of acute lung leak. This study investigated whether ICI 200,355, a synthetic elastase inhibitor, can attenuate acute lung injury induced by IL-1 in rats. MATERIALS AND METHODS: We intratracheally instilled either saline or IL-1 with and without treatment of ICI 200,355 in rats. Lung lavage neutrophils, lung lavage cytokine-induced neutrophil chemoattractant(CINC) concentration, lung lavage protein concentration, lung myeloperoxidase(MPO) activity and lung leak index were measured at 5 hours of intratracheal treatment. RESULTS: In rats given IL-1 intratracheally, lung lavage neutrophils, lung lavage CINC concentration, lung lavage protein concentration, lung MPO activity and lung leak index were higher. Intratracheal ICI 200,355 administration decreased lung lavage neutrophils, lung MPO activity and lung leak index, respectively, but did not decreased lung lavage CINC concentration. CONCLUSION: These results suggest that ICI 200,355 decreases lung inflammation and leak without decreasing lung lavage CINC concentration in rats given IL-1 intratracheally.

Radiation Oncology
Imaging Feature of Radiation Induced Lung Disease.: Jae Gyo Lee, Byeung Hak Rho, Jae Chun Chang, Mung Se Kim; Yeungnam Univ J Med. 2000;17(2):146-154. Published online December 31, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.2.146

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Abstract PDF: BACKGROUND
AND PURPOSE: Radioopaque lesions are commonly seen in patients who received thoracic radiotherapy for various kinds of thoracic neoplasm, But therir exact diagnos are sometimes uncertain. PATIENTS AND METHODS: We examined simple chest radiograph and computed tomogram(CT) of 69 patients who received thoracic radiotherapy for lung cancer and were follow up at least 6 months in Yeungnam University Medical Center. RESULTS: Of the 69 patients. thirty-eight patients showed radioopaque lesions in their chest radiographs except radiation fibrosis; radiation pneumonitis was witnessed in 24 patients. infectious pneumonia in 8 patients, and recurrence in 6 patients. In radiateionpneumonitis patients, the pneumonitis occurred usually between 50 to 130 days after receiving radiation therapy, and interval between pneumonitis and fibrosis is 21 to 104 days. Simple chest radiographs of radiation pneumonitis(24 patients) represented ground glass opacities or consolidation in 4 cases(type I, 17%), reticular of reticulonodular opacities in 10 cases(type II, 42%), irregular patichy consolidations in 2 cases( type III, 8%), and consolidation with fibrosis in 8 cases(type IV, 33%), CT represent ground glass opacities or consolidation in 5 cases(type I, 29%), irregular nodular opacities in 3 cases(type II, 19%), irregular opacity beyond radiation fields in 3 cases(type III, 18%), and consolidation with fibrosis in 6 cased(typeIV, 35%). The CT of four patients who represented type II on simple chest radiographs reveal type I and III, and CT of two patients with clinical symptoms who had no abnormal finding on simple radiograph revealed type I. CONCLUSIONS: In conclusion, computed tomogram is superior to the simple radiograph when trying to understand the pathologic process of radiation pneumonitis and provide confidence in the diagnosis of radiation induced lung disease.

Oncology and Cancer Research
A Clinical study on the Hypercalcemia in Primary Bronchogenic Carcinoma.: Hye Jung Park, Kyeong Cheol Shin, Young Chul Moon, Jin Hong Chung, Kwan Ho Lee, Cha Kyung Sung, Hyun Woo Lee; Yeungnam Univ J Med. 1999;16(2):208-218. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.208

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Abstract PDF: BACKGROUND
Lung cancer-associated hypercalcemia is one of the most disabling and life-threatening paraneoplastic desorders. Humoral hypercalcemia is responsible for most lung cancer-associated hypercalcemia. Patients with hypercalcemia are usually in the advenced atage with obvious bulky tumor and carry a poor prognosis. MATERIALS AND METHODS: Total 29 patients satisfied the following criteria: histologically proven primary lung cancer, corrected calcium level> or =10.5 mg/dL, and symptons which could possibly be attributed to hypercalcemia. In this retrospective study, we evalluated the various clinical aspects of hypercalcemia, in relation to cancer stage, histologic cell type, mass size, bone metastasis, performance status, and other possible characteristics RESULTS: Total 29 lung cancer patients with hypercalcemia were studied, and most of them had squamous cell carcinoma in their histologic finding. The incidence of hypercalcemia was significantly higher between 50 and 69 years of age, and in the advancement of cancer stage. Although serum calcium level showed positive correlation with mass size, performance statusm and bone ore frequent in the patients with higher serum calcium level. There were no differences in effectiveness among therapeutic regimens. Hypercalcemia was more frequently in the later stage of disease than during the initial diagnosis of lung cancer. Most of the patients died within 1 month after development of hypercalcemia. CONCLUSION: We concluded that hypercalcemia in lung cancer is related to extremely poor prognosis, and may be one of the causes of drath and should be treated aggressively to prevent sudden deterioration or death.

Case Report

Endocrinology, Diabetes, and Metabolism
A case of SIADH in small cell lung cancer.: Kyu Chang Won, Jong Sik Lim, Chan Woo Lee, Hyoung Woo Lee, Choong Ki Lee, Jin Hong Chung, Myoung Soo Hyun, Bong Sup Shim, Hyun Woo Lee; Yeungnam Univ J Med. 1991;8(2):227-234. Published online December 31, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.2.227

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Abstract PDF: The syndrome of inappropriate ADH secretion is a disorder characterized by hyponatremia which results from water retention attributable to ADH release. The hallmark of SIADH is hyponatremia due to water retention, in the presence of urinary osmolality above plasma osmolality. The SIADH was initially described by Schwartz et al (1957). This syndrome, first recognized in patients with bronchogenic carcinoma, has now been observed in a variety of other illnesses. Recently, we encountered a 59 year-old female with small cell lung cancer, also she had SIADH. Thus, we present a case and review the literature on the subject.

Original Articles

Pulmonary and Respiratory Medicine
The Clinical Review of Superior Vena Cava Syndrome.: Joung Sun Kang, Sam Beom Lee, Choong Ki Lee, Jin Hong Chung, Hyoung Woo Lee, Kwan Ho Lee, Myung Soo Hyun, Hyun Woo Lee, Sei One Shin, Myung Se Kim; Yeungnam Univ J Med. 1990;7(2):151-158. Published online December 31, 1990; DOI: https://doi.org/10.12701/yujm.1990.7.2.151

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Abstract PDF: We reviewed 30 cases of superior vena cava syndrome in adult patients who were seen at the Yeungnam University Hospital from January 1985 to June 1990. The results were as follows: 1. The male-to-female ratio was 6.5:1, and the most patients were in the age group between the sixth and seventh decades. 2. The most common symptoms were dyspnea (87%) and followed by cough (63%), facial swelling (63%) and chest pain (44%) and the physical signs were dilated neck vein (97%), facial edema (93%) and facial flushing (45%) in order of frequency. 3. The simple chest x-ray findings were superior mediastinal widening (90%), right hilar mass (77%) and pleural effusion (31%). 4. Diagnosis was made by history and physical examination (100%), chest C-T scan (100%), simple chest x-ray (97%), bronchoscopy with biopsy (40%) and so on. 5. 21 cases of patients were confirmed by histology: 14 cases (46%) of bronchogenic ca, 4 cases (14%) of lymphoma, 3 cases (10%) of metastatic lung ca. Of bronchogenic ca, small cell ca was 7 cases (23%), squamous cell ca, 5 cases (17%), and unclassified cawas 2 cases (6%). 6. In response of treatment, the clinical improvement was achieved in 18 cases with radiotherapy alone, 1 case with chemotherapy only, and 6 cases with radio-chemotherapy.

Pulmonary and Respiratory Medicine
Clinical Observations of the Solitary Pulmonary Nodules.: Jin Woo Roh, Byeong Ik Jang, Jong Sun Park, Jin Hong Chung, Hyung Woo Lee, Kwan Ho Lee, Hyun Woo Lee, Jung Cheul Lee, Sung Sae Han; Yeungnam Univ J Med. 1990;7(2):141-149. Published online December 31, 1990; DOI: https://doi.org/10.12701/yujm.1990.7.2.141

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Abstract PDF: The authors conducted a clinical observation of 55 cases of solitary pulmonary nodules at Yeungnam University Hospital from June 1986 to October 1990, and the following results were obtained: 1. The age distribution was ranged from 18 to 77 years, and the male-to female ratio was 1.8:1. 2. Among 55 cases of nodules, 28 cases were benign and 27 cases were malignant nodules, and of malignant nodules, the primary lung cancer was 23 cases and of benign nodules, 18 cases were tuberculoma. 3. 23 cases (41.8%) was asymptomatic and the other 32 cases were symptomatic; chest pain 12 cases, hemoptysis; 8 cases, cough; 8 cases and dyspnea; 4 cases. 4. The non-smoker-to-smoker ratio was 1:1.04, but among 23 smoker over 20 pack years, 14 cases were malignant nodules. 5. According to nodular size, there is no striking differences between benign and malignant nodules except 3-4 cm sized nodules. 6. The lobar distribution of nodules, 35 cases were in the right lung (upper lobe; 14 cases, middle lobe; 11 cases, and lower lobe; 10 cases) and 23 cases were in the left lung (upper lobe; 9 cases, lower lobe; 11 cases), and the malignant nodules were most commonly observed in the right upper lung.

Case Report

Pathology and Forensic Medicine
Sclerosing hemangioma of lung: 3 case report.: Dong Sug Kim, Won Hee Choi, Tae Sook Lee; Yeungnam Univ J Med. 1990;7(1):145-149. Published online June 30, 1990; DOI: https://doi.org/10.12701/yujm.1990.7.1.145

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Abstract PDF: Sclerosing hemangioma of the lung is uncommon benign neoplasm of uncertain histogenesis. Their radiologic appearance is relatively distinct and well defined. Recently we experienced 3 cases of sclerosing hemangioma of the lung in 54, 52, 51 years old women. The light microscopic findings are similar to the features reported by Liebow and Hubbell (1956).

Original Article

Pulmonary and Respiratory Medicine
Microbiologic distribution and clinical features of nontuberculous mycobacteria in the tertiary hospital in Daegu.: Kyung Soo Hong, June Hong Ahn, Eun Young Choi, Hyun Jung Jin, Kyeong Cheol Shin, Jin Hong Chung, Kwan Ho Lee; Yeungnam Univ J Med. 2015;32(2):71-79.; DOI: https://doi.org/10.12701/yujm.2015.32.2.71

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BACKGROUND
Recent studies have shown that the nontuberculosis mycobacterium (NTM) recovery rate in clinical cultures has increased within Korea. However, another study conducted by a secondary hospital within Daegu reported different results. Therefore, the purpose of this study is to understand and evaluate the microbiological distribution and clinical features of NTM in Daegu. METHODS: A retrospective study was conducted on 11,672 respiratory specimens undergoing acid fast bacilli (AFB) culture from 6,685 subjects who visited Yeungnam University Respiratory Center from January 2012 to December 2013. RESULTS: Of the 11,672 specimens undergoing AFB culture, 1,310 specimens (11.2%) showed positive results. Of these specimens, NTM was recovered from 587 specimens, showing a recovery rate of 44.8%. Identification test for NTM was performed on 191 subjects; the results were as follows: M. avium-intracellulare complex (MAC) 123 (64.4%), M. abscessus 20 (10.5%), M. kansasii 12 (6.3%), and 33 other NTM germ strains. Of the 382 subjects with NTM, 167 were diagnosed with pulmonary NTM disease (43.7%), however virulence differed depending on NTM strain. Multivariate analysis showed that nodular bronchiectasis, the nodules, and finding consistent with cavity under imaging study were statistically significant for triggering pulmonary NTM disease. AFB culture showing MAC and M. abscessus was statistically significant as well. Positive predictive value for NTM polymerase chain reaction (NTM-PCR) was 88.6%. CONCLUSION: Results for NTM recovery rate within the Daegu area were similar to those for the Seoul metropolitan area. We can assume that NTM infection is increasing in our community, therefore AFB-positive subjects (1) should undergo NTM-PCR, (2) should have their culture results checked for differentiation of mycobacterium tuberculosis complex (MTB) from NTM, and (3) undergo NTM identification test to confirm its type. Administration of treatment with the above results should be helpful in improving the patients' prognosis.

Citations

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