Journal of Yeungnam Medical Science

Original articles

Outcomes in patients with out-of-hospital cardiac arrest according to prehospital advanced airway management timing: a retrospective observational study: Sang-Hun Lee, Hyun Wook Ryoo; J Yeungnam Med Sci. 2024;41(4):288-295. Published online July 18, 2024; DOI: https://doi.org/10.12701/jyms.2024.00332

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Abstract PDF: Background
In patients with out-of-hospital cardiac arrest (OHCA), guidelines recommend advanced airway (AA) management at the advanced cardiovascular life support stage; however, the ideal timing remains controversial. Therefore, we evaluated the prognosis according to the timing of AA in patients with OHCA.
Methods
We conducted a retrospective observational study of patients with OHCA at six major hospitals in Daegu Metropolitan City, South Korea, from August 2019 to June 2022. We compared groups with early and late AA and evaluated prognosis, including recovery of spontaneous circulation (ROSC), survival to discharge, and neurological evaluation, according to AA timing.
Results
Of 2,087 patients with OHCA, 945 underwent early AA management and 1,142 underwent late AA management. The timing of AA management did not influence ROSC in the emergency department (5–6 minutes: adjusted odds ratio [aOR], 0.97; p=0.914; 7–9 minutes: aOR, 1.37; p=0.223; ≥10 minutes: aOR, 1.32; p=0.345). The timing of AA management also did not influence survival to discharge (5–6 minutes: aOR, 0.79; p=0.680; 7–9 minutes: aOR, 1.04; p=0.944; ≥10 minutes: aOR, 1.86; p=0.320) or good neurological outcomes (5–6 minutes: aOR, 1.72; p=0.512; 7–9 minutes: aOR, 0.48; p=0.471; ≥10 minutes: aOR, 0.96; p=0.892).
Conclusion
AA timing in patients with OHCA was not associated with ROSC, survival to hospital discharge, or neurological outcomes.

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.

Clinical impact of spine magnetic resonance imaging as a valuable prognostic tool for patients with multiple myeloma: a retrospective study: Jung Min Lee, Hee Jeong Cho, Joon-Ho Moon, Sang Kyun Sohn, Byunggeon Park, Dong Won Baek; J Yeungnam Med Sci. 2022;39(4):300-308. Published online March 23, 2022; DOI: https://doi.org/10.12701/jyms.2021.01648

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Abstract PDF Supplementary Material

Background
This study investigated the prognostic impact of spine magnetic resonance imaging (MRI) in patients newly diagnosed with multiple myeloma (MM).
Methods
We retrospectively evaluated 214 patients who were newly diagnosed with MM between March 2015 and December 2019. The patients were classified into five different infiltration patterns based on spine MRI as follows: (1) normal appearance, (2) focal, (3) diffuse, (4) combined focal and diffuse infiltration, and (5) “salt-and-pepper.”
Results
Forty patients (18.7%) showed a normal appearance, whereas focal, diffuse, combined focal and diffuse infiltration, and “salt-and-pepper” patterns were identified in 68 (31.8%), 40 (18.7%), 52 (24.3%), and 14 patients (6.5%), respectively. The patients with normal and “salt-and-pepper” patterns were younger than patients with other patterns (median age, 61.6 vs. 66.8 years; p=0.001). Moreover, 63% and 59.3% of patients with normal and “salt-and-pepper” patterns were scored International Staging System (ISS) stage I and revised ISS (R-ISS) stage I, respectively, whereas only 12.5% of patients with other patterns were scored ISS stage I and R-ISS stage I. Patients with normal and “salt-and-pepper” patterns had a better prognosis than those with other patterns, whereas relapse and death rates were significantly higher in patients with focal, diffuse, and combined MRI patterns.
Conclusion
Characteristic MRI findings have a significant prognostic value for long-term survival in patients newly diagnosed with MM. In particular, focal, diffuse, and combined focal and diffuse infiltration patterns are unfavorable prognostic factors.

Citations

Citations to this article as recorded by

Lesions of the spinal cord caused by multiple myeloma: A systematic review and meta-analysis regarding the neurosurgical aspects of patient management
Daniel Encarnacion, Gennady E Chmutin, Ismail Bozkurt, Jack Wellington, Emmanuel Batista Geraldino, Bipin Chaurasia
Journal of Craniovertebral Junction and Spine.2023; 14(4): 313. CrossRef

Prognostic impact of chromogranin A in patients with acute heart failure: Hong Nyun Kim, Dong Heon Yang, Bo Eun Park, Yoon Jung Park, Hyeon Jeong Kim, Se Yong Jang, Myung Hwan Bae, Jang Hoon Lee, Hun Sik Park, Yongkeun Cho, Shung Chull Chae; Yeungnam Univ J Med. 2021;38(4):337-343. Published online July 8, 2021; DOI: https://doi.org/10.12701/yujm.2020.00843

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Abstract PDF Supplementary Material

Background
Chromogranin A (CgA) levels have been reported to predict mortality in patients with heart failure. However, information on the prognostic value and clinical availability of CgA is limited. We compared the prognostic value of CgA to that of previously proven natriuretic peptide biomarkers in patients with acute heart failure.
Methods
We retrospectively evaluated 272 patients (mean age, 68.5±15.6 years; 62.9% male) who underwent CgA test in the acute stage of heart failure hospitalization between June 2017 and June 2018. The median follow-up period was 348 days. Prognosis was assessed using the composite events of 1-year death and heart failure hospitalization.
Results
In-hospital mortality rate during index admission was 7.0% (n=19). During the 1-year follow-up, a composite event rate was observed in 12.1% (n=33) of the patients. The areas under the receiver-operating characteristic curves for predicting 1-year adverse events were 0.737 and 0.697 for N-terminal pro-B-type natriuretic peptide (NT-proBNP) and CgA, respectively. During follow-up, patients with high CgA levels (>158 pmol/L) had worse outcomes than those with low CgA levels (≤158 pmol/L) (85.2% vs. 58.6%, p<0.001). When stratifying the patients into four subgroups based on CgA and NT-proBNP levels, patients with high NT-proBNP and high CgA had the worst outcome. CgA had an incremental prognostic value when added to the combination of NT-proBNP and clinically relevant risk factors.
Conclusion
The prognostic power of CgA was comparable to that of NT-proBNP in patients with acute heart failure. The combination of CgA and NT-proBNP can improve prognosis prediction in these patients.

Citations

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The Role of Congestion Biomarkers in Heart Failure with Reduced Ejection Fraction
Michele Correale, Francesco Fioretti, Lucia Tricarico, Francesca Croella, Natale Daniele Brunetti, Riccardo M. Inciardi, Anna Vittoria Mattioli, Savina Nodari
Journal of Clinical Medicine.2023; 12(11): 3834. CrossRef
Novel Biomarkers of Renal Dysfunction and Congestion in Heart Failure
Agata Zdanowicz, Szymon Urban, Barbara Ponikowska, Gracjan Iwanek, Robert Zymliński, Piotr Ponikowski, Jan Biegus
Journal of Personalized Medicine.2022; 12(6): 898. CrossRef

Usefulness of presepsin in predicting the prognosis of patients with sepsis or septic shock: a retrospective cohort study: Jeong Suk Koh, Yoon Joo Kim, Da Hyun Kang, Jeong Eun Lee, Song-I Lee; Yeungnam Univ J Med. 2021;38(4):318-325. Published online June 15, 2021; DOI: https://doi.org/10.12701/yujm.2021.01018

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Abstract PDF

Background
The diagnosis and prediction of prognosis are important in patients with sepsis, and presepsin is helpful. In this study, we aimed to examine the usefulness of presepsin in predicting the prognosis of sepsis in Korea.
Methods
Patients diagnosed with sepsis according to the sepsis-3 criteria were recruited into the study and classified into surviving and non-surviving groups based on in-hospital mortality. A total of 153 patients (33 and 121 patients with sepsis and septic shock, respectively) were included from July 2019 to August 2020.
Results
Among the 153 patients with sepsis, 91 and 62 were in the survivor and non-survivor groups, respectively. Presepsin (p=0.004) and lactate (p=0.003) levels and the sequential organ failure assessment (SOFA) scores (p<0.001) were higher in the non-survivor group. Receiver operating characteristic curve analysis revealed poor performances of presepsin and lactate in predicting the prognosis of sepsis (presepsin: area under the curve [AUC]=0.656, p=0.001; lactate: AUC=0.646, p=0.003). The SOFA score showed the best performance, with the highest AUC value (AUC=0.751, p<0.001). The prognostic cutoff point for presepsin was 1,176 pg/mL. Presepsin levels of >1,176 pg/mL (odds ratio [OR], 3.352; p<0.001), lactate levels (OR, 1.203; p=0.003), and SOFA score (OR, 1.249; p<0.001) were risk factors for in-hospital mortality.
Conclusion
Presepsin levels were higher in non-survivors than in survivors. Thus, presepsin may be a valuable biomarker in predicting the prognosis of sepsis.

Citations

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Free Radical–Associated Gene Signature Predicts Survival in Sepsis Patients
Anlin Feng, Marissa D. Pokharel, Ying Liang, Wenli Ma, Saurabh Aggarwal, Stephen M. Black, Ting Wang
International Journal of Molecular Sciences.2024; 25(8): 4574. CrossRef
Presepsin in Critical Illness: Current Knowledge and Future Perspectives
Paolo Formenti, Miriam Gotti, Francesca Palmieri, Stefano Pastori, Vincenzo Roccaforte, Alessandro Menozzi, Andrea Galimberti, Michele Umbrello, Giovanni Sabbatini, Angelo Pezzi
Diagnostics.2024; 14(12): 1311. CrossRef
Diagnostic and Prognostic Roles of C-Reactive Protein, Procalcitonin, and Presepsin in Acute Kidney Injury Patients Initiating Continuous Renal Replacement Therapy
Suyeon Han, Moo-Jun Kim, Ho-Joon Ko, Eu-Jin Lee, Hae-Ri Kim, Jae-Wan Jeon, Young-Rok Ham, Ki-Ryang Na, Kang-Wook Lee, Song-I. Lee, Dae-Eun Choi, Heyrim Park
Diagnostics.2023; 13(4): 777. CrossRef
Existe Relação entre Miocardite Aguda e a Permeabilidade Intestinal? Dois Biomarcadores nos Ajudam a Responder a esta Pergunta
Fernando Arturo Effio Solis, Adriana Brentegani, Marcelo Luiz Campos Vieira
Arquivos Brasileiros de Cardiologia.2023;[Epub] CrossRef
Biomarkers in sepsis-looking for the Holy Grail or chasing a mirage!
Neelmani Ahuja, Anjali Mishra, Ruchi Gupta, Sumit Ray
World Journal of Critical Care Medicine.2023; 12(4): 188. CrossRef
Presepsin as a Novel Biomarker in predicting In‐hospital Mortality in Patients With COVID‐19 Pneumonia
Hebatallah Hany Assal, Safaa Mohamed Abdelrahman, Maha AlyAlden Abdelbasset, Mai Abdelaziz, Irene Mohamed Sabry, Marwa Moawad Shaban
International Journal of Infectious Diseases.2022; 118: 155. CrossRef

Case report

High-grade mucoepidermoid carcinoma in the thyroid gland with poor prognosis: Hyeong Chan Shin; Yeungnam Univ J Med. 2021;38(2):169-174. Published online March 5, 2021; DOI: https://doi.org/10.12701/yujm.2021.00941

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Abstract PDF

Mucoepidermoid carcinoma (MEC) is the most common malignant neoplasm of the salivary gland, but primary thyroid MEC has rarely been reported and usually has a good prognosis. Herein, I report a case of thyroidal MEC with a poor prognosis in an 82-year-old woman with an anterior neck mass. Ultrasonography and computed tomography revealed a thyroid mass. The patient initially underwent fine-needle aspiration, was diagnosed with malignancy, and underwent a right lobectomy. On gross examination, a 4.0×3.6×2.6 cm-sized ill-defined, unencapsulated, and infiltrative tan to whitish mass with necrosis was identified. Microscopically, epidermoid tumor cell nests or solid sheets were identified. Mucous cells that were positive for periodic acid–Schiff and mucicarmine stains were also identified within epidermoid cell nests. Frequent mitosis and necrosis were observed. Immunohistochemical staining for p40 and p63 was positive, and that for thyroid transcription factor-1 and PAX8 was focally positive. According to the Armed Forces Institute of Pathology grading system for salivary gland MEC, the current case was classified as high-grade MEC. After surgery, the patient suffered from dyspnea due to a remnant neck mass that compressed and obstructed the trachea; therefore, the patient refused further treatment. Thyroidal MECs are considered low-grade with a favorable prognosis, but there are several reported cases of thyroidal MEC with poor prognosis. The current case is a rare presentation of high-grade thyroidal MEC with a poor prognosis.

Citations

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Primary mucoepidermoid carcinoma of the thyroid with concomitant MAML2 gene rearrangement and BRAF V600E mutation – A case report
Frederica Loghides, Brigid Aherne
Oral Oncology Reports.2024; 9: 100154. CrossRef
Mucoepidermoid carcinoma of the pancreas: A case report and literature review
Huan Zhang, Shuyan Wang, Chunnian Wang
Medicine.2024; 103(4): e36993. CrossRef
Primary Thyroid Mucoepidermoid Carcinoma (MEC) Is Clinically, Prognostically, and Molecularly Different from Sclerosing MEC with Eosinophilia: A Multicenter and Integrated Study
Hieu Trong Le, Truong P. X. Nguyen, Mitsuyoshi Hirokawa, Ryohei Katoh, Norisato Mitsutake, Michiko Matsuse, Ayaka Sako, Tetsuo Kondo, Nilesh Vasan, Young Mi Kim, Ying Liu, Lewis Hassell, Kennichi Kakudo, Huy Gia Vuong
Endocrine Pathology.2023; 34(1): 100. CrossRef
Overview of the 2022 WHO Classification of Thyroid Neoplasms
Zubair W. Baloch, Sylvia L. Asa, Justine A. Barletta, Ronald A. Ghossein, C. Christofer Juhlin, Chan Kwon Jung, Virginia A. LiVolsi, Mauro G. Papotti, Manuel Sobrinho-Simões, Giovanni Tallini, Ozgur Mete
Endocrine Pathology.2022; 33(1): 27. CrossRef

Original article

What are the most important prognostic factors in patients with residual rectal cancer after preoperative chemoradiotherapy?: Sol-Min Kim, Ghilsuk Yoon, An Na Seo; Yeungnam Univ J Med. 2019;36(2):124-135. Published online April 1, 2019; DOI: https://doi.org/10.12701/yujm.2019.00157

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Abstract PDF

Background
We aimed to establish robust histoprognostic predictors on residual rectal cancer after preoperative chemoradiotherapy (CRT).
Methods
Analyzing known histoprognostic factors in 146 patients with residual disease allows associations with patient outcome to be evaluated.
Results
The median follow-up time was 77.8 months, during which 59 patients (40.4%) experienced recurrence and 41 (28.1%) died of rectal cancer. On univariate analysis, residual tumor size, ypT category, ypN category, ypTNM stage, downstage, tumor regression grade, lymphatic invasion, perineural invasion, venous invasion, and circumferential resection margin (CRM) were significantly associated with recurrence free survival (RFS) or/and cancer-specific survival (CSS) (all p<0.005). On multivariate analysis, higher ypTNM stage and CRM positivity were identified as independent prognostic factors for RFS (ypTNM stage, p=0.024; CRM positivity, p<0.001) and CSS (p=0.022, p=0.017, respectively). Furthermore, CRM positivity was an independent predictor of reduced RFS, irrespective of subgrouping according to downstage (non-downstage, p=0.001; downstage, p=0.010) or lymph node metastasis (non-metastasis, p=0.004; metastasis, p=0.007).
Conclusion
CRM status may be as powerful as ypTNM stage as a prognostic indicator for patient outcome in patients with residual rectal cancer after preoperative CRT.

Citations

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Poor nutrition and sarcopenia are related to systemic inflammatory response in patients with rectal cancer undergoing preoperative chemoradiotherapy
Shinya Abe, Hiroaki Nozawa, Kazushige Kawai, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Junko Kishikawa, Tsuyoshi Ozawa, Yuichiro Yokoyama, Yuzo Nagai, Hiroyuki Anzai, Hirofumi Sonoda, Soichiro Ishihara
International Journal of Colorectal Disease.2022; 37(1): 189. CrossRef
Preoperative sarcopenia is a poor prognostic factor in lower rectal cancer patients undergoing neoadjuvant chemoradiotherapy: a retrospective study
Shinya Abe, Kazushige Kawai, Hiroaki Nozawa, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Junko Kishikawa, Hiroaki Ishii, Yuichiro Yokoyama, Yuzo Nagai, Hiroyuki Anzai, Hirofumi Sonoda, Koji Oba, Soichiro Ishihara
International Journal of Clinical Oncology.2022; 27(1): 141. CrossRef
A Four-Methylated lncRNAs-Based Prognostic Signature for Hepatocellular Carcinoma
Le-En Liao, Dan-Dan Hu, Yun Zheng
Genes.2020; 11(8): 908. CrossRef

Original Articles

Prognostic role of preoperative carcinoembryonic antigen levels in colorectal cancer: propensity score matching: Cho Shin Kim, Sohyun Kim; Yeungnam Univ J Med. 2017;34(2):216-221. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.216

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Abstract PDF: BACKGROUND
This study was conducted to investigate preoperative carcinoembryonic antigen (CEA) as a prognostic factor in colorectal cancer. METHODS: Between January 2000 and July 2011, 1298 patients with primary adenocarcinoma colorectal cancer without metastasis, who underwent curative resection were retrospectively identified. The patients were divided into two groups according to serum CEA level at primary diagnosis: a high CEA (HCEA) group (serum CEA ≥6 ng/mL) and a normal CEA (NCEA) group (serum CEA <6 ng/mL). A 1:1 propensity score matching analysis was applied to reduce bias. Finally, 364 patients were enrolled in this study. Matched variables were age, gender, preoperative chemoradiotherapy, tumor site, cell differentiation and pathologic stage. RESULTS: The clinicopathological characteristics of the two groups did not differ significantly difference. The systemic metastasis rate was 16.5% (30/182) and 25.3% (46/182) in the NCEA and HCEA groups, respectively (p=0.039). There were no significant differences in local recurrence or metastatic sites between groups. The 5-year disease-free survival (DFS) rate of the HCEA group was worse than that of the NCEA group; however, there was no significant difference in overall survival between the two groups. CONCLUSION: Elevated preoperative CEA was related to frequent systemic recurrence and low DFS. Therefore, elevated preoperative CEA could be considered a prognostic factor for worse clinical outcomes in patients with colorectal cancer.

Prognostic Factors in Postpsychotic Depressive Disorder of Schizophrenia.: Jin Sung Kim, Jong Bum Lee, Wan Seok Seo, Bon Hoon Koo, Yi Youg Kim, Jung Youp Kim; Yeungnam Univ J Med. 2005;22(2):150-165. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.150

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Abstract PDF: PURPOSE: This study was conducted to investigate the prognostic factors of postpsychotic depressive symptoms in patients with schizophrenia. MATERIALS AND METHODS: Eighty patients were selected based on the diagnostic criteria from the DSM-IV, PANSS and ESRS. For all patients information was collected on demographic and clinical characteristics. The subjective depressive symptoms and the objective depressive symptoms, as well as patients insight regarding psychosis were evaluated. The subjective depressive symptoms were evaluated by BDI and ZDS; the objective depressive symptoms were evaluated by HDRS and CDSS, and patient insight into the psychosis was evaluated by KISP. RESULTS: The comparisons using demographic and clinical characteristics showed that HDRS and CDSS had significant difference with regard to gender and suicide attempts; the BDI was associated with difference in education level and age of onset. The patients with scores above cuff-off score for each scale were 20 (25.0%) for the BDI, 16 (20.0%) for the ZDS, 18 (22.5%) for the CDSS and 6 (7.5%) for the HDRS. The results of the stepwise multiple regression analysis showed that the scores for the KISP, education levels, gender and suicide attempts were the main prognostic factors in patients with the psychotic depressive disorder of schizophrenia. CONCLUSION: The main prognostic factors in psychotic depressive disorder of schizophrenia included: insight into psychosis, suicidal attempts. Insight into the psychosis was the most reliable prognostic factor but this characteristic had a negative relationship to the with depressive symptoms.

Review

Kawasaki Disease.: Young Hwan Lee; Yeungnam Univ J Med. 2000;17(2):99-107. Published online December 31, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.2.99

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Abstract PDF

Kawasaki disease, an acute febrile illness which primarily affects in children under the age of six, was first described by Tomisaku Kawasaki in 1967. It has been reported that Kawasaki disease is probable driven by abnormalities of the immune system after an infectious insult, but this has not been confirmed. It mainly affects small and medium-sized arteries, particularly the coronary arteries. Deaths may occur at any time with cardiovascular complications. The early recognition and treatment with follow-up evaluation for the coronary arterial lesion is very important in a case of Kawasaki disease.

Citations

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Risk factors for the occurrence and persistence of coronary aneurysms in Kawasaki disease
Soo-kyeong Jeon, Geena Kim, Hoon Ko, Joung-Hee Byun, Hyoung Doo Lee
Korean Journal of Pediatrics.2019; 62(4): 138. CrossRef

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