Journal of Yeungnam Medical Science

Review article

Ophthalmology
Efficacy of high-dose vs. low-dose intravitreal ganciclovir for cytomegalovirus retinitis: a systematic review and meta-analysis: Seongyong Jeong, Areum Jeong, Jae Rock Do, Yong Koo Kang, Min Sagong; J Yeungnam Med Sci. 2026;43:13. Published online January 14, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.13 [Epub ahead of print]

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Abstract PDF: Background
Intravitreal ganciclovir is widely used to achieve effective local antiviral concentrations for cytomegalovirus (CMV) retinitis; however, to our knowledge, standardized dosing strategies have not been established, and the reported regimens vary considerably across studies. In this study, we evaluated dose-dependent treatment outcomes of intravitreal ganciclovir for CMV retinitis.
Methods
The PubMed, Embase, Cochrane, and Scopus databases were searched through November 2025. Eligible studies included intravitreal ganciclovir monotherapy, with or without systemic antiviral therapy. Cumulative first-week intravitreal dose was calculated and classified as low dose (<4,000 µg) or high dose (≥4,000 µg). The pooled proportions for resolution, visual outcomes, recurrence, and retinal detachment were estimated using a random-effects model.
Results
Eighteen studies comprising 1132 eyes were included across all outcomes. The pooled proportion of anatomical resolution was 89% (95% confidence interval, 0.77–0.95), and 74% of eyes maintained stable or improved vision. Recurrence and retinal detachment occurred in 12% and 9% of the eyes, respectively. High-dose regimens achieved a significantly higher resolution than low-dose regimens (94% vs. 73%, p=0.019). Visual outcomes did not differ according to dose (77% vs. 73%, p=0.646). Recurrence also showed no dose-dependent difference (14% vs. 8%, p=0.654) and was observed predominantly in patients before the introduction of highly active antiretroviral therapy. The retinal detachment rates were similar (9% vs. 10%, p=0.780).
Conclusion
Initial intravitreal dosing at ≥4,000 µg within the first week achieved better retinitis resolution, supporting the benefit of a higher local ganciclovir concentration in the treatment of CMV retinitis.

Original article

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 [Epub ahead of print]

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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.

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.”

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.

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The Role of Pulmonary Rehabilitation in Lung Transplantation for Cystic Fibrosis
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Seven-day rehabilitation services in hospital settings: benefits and drawbacks
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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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Xuena Han, Zekun Lang, Xinghua Lv, Yang Xing, Min Hou, Zhiguo Tan, Yan Zhang, Yufang Leng
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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
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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
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ZNRF2 integrates ubiquitination-driven ferroptosis and mitochondrial quality control in renal ischemia–reperfusion injury
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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

Medical Education
Evaluation research in Korean medical education: a systematic review: Hye Jin Park, Yu Ra Kim; J Yeungnam Med Sci. 2023;40(3):233-240. Published online December 5, 2022; DOI: https://doi.org/10.12701/jyms.2022.00563

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Abstract PDF Supplementary Material

The purpose of this study aims to analyze research trends related to ‘evaluation’ in Korean medical education through a systematic review. This study used a systematic review method, which is a research methodology for research trends and ‘literature analysis.’ Researchers searched the Korean journal literature published until the end of December 2020 in the Korean research database with keywords related to medicine and evaluation. Thus, 5,205 cases were identified. Based on these data, 143 papers were selected through a logical screening process, requiring 1 month to complete the data search and analysis process. In terms of publications, medical journals overwhelmingly outnumbered nonmedical journals until 2015; however, after 2016, the number of papers published in nonmedical journals increased, and the number of published papers was similar to that of medical journals. In terms of evaluation-related research, research on student and program evaluations has been very active compared to that on accreditation. As the number of evaluation studies has gradually decreased over the past 10 years, preparing a plan to revitalize them in Korean medical education is necessary. Considering that the role of evaluation in education has been emphasized in recent years, research on reestablishing the concept of evaluation; developing evaluation indicators; analyzing the status of student evaluation, program evaluation, and accreditation; and deriving measures to improve medical education through evaluation is required.

Citations

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Patient-physician interaction education in Korea: a systematic review
Hwan Ho Lee, Yu Ra Kim, Hye Jin Park
Journal of Yeungnam Medical Science.2024; 41(2): 74. CrossRef

Psychiatry and Mental Health
Hypertension and cognitive dysfunction: a narrative review: Eun-Jin Cheon; J Yeungnam Med Sci. 2023;40(3):225-232. Published online November 29, 2022; DOI: https://doi.org/10.12701/jyms.2022.00605

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Abstract PDF

Cognitive dysfunction is relatively less considered a complication of hypertension. However, there is sufficient evidence to show that high blood pressure in middle age increases the risk of cognitive decline and dementia in old age. The greatest impact on cognitive function in those with hypertension is on executive or frontal lobe function, similar to the area most damaged in vascular dementia. Possible cognitive disorders associated with hypertension are vascular dementia, Alzheimer disease, and Lewy body dementia, listed in decreasing strength of association. The pathophysiology of cognitive dysfunction in individuals with hypertension includes brain atrophy, microinfarcts, microbleeds, neuronal loss, white matter lesions, network disruption, neurovascular unit damage, reduced cerebral blood flow, blood-brain barrier damage, enlarged perivascular damage, and proteinopathy. Antihypertensive drugs may reduce the risk of cognitive decline and dementia. Given the high prevalence of dementia and its impact on quality of life, treatment of hypertension to reduce cognitive decline may be a clinically relevant intervention.

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Endocrinology, Diabetes, and Metabolism
Long-term management of Graves disease: a narrative review: Hyo-Jeong Kim; J Yeungnam Med Sci. 2023;40(1):12-22. Published online November 4, 2022; DOI: https://doi.org/10.12701/jyms.2022.00444

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Abstract PDF

Graves disease (GD) is the most common cause of hyperthyroidism, accounting for more than 90% of cases in Korea. Patients with GD are treated with any of the following: antithyroid drugs (ATDs), radioactive iodine (RAI) therapy, or thyroidectomy. Most patients begin treatment with ATDs, and clinical guidelines suggest that the appropriate treatment period is 12 to 18 months. While RAI treatment and surgery manage thyrotoxicosis by destroying or removing thyroid tissue, ATDs control thyrotoxicosis by inhibiting thyroid hormone synthesis and preserving the thyroid gland. Although ATDs efficiently control thyrotoxicosis symptoms, they do not correct the main etiology of GD; therefore, frequent relapses can follow. Recently, a large amount of data has been collected on long-term ATDs for GD, and low-dose methimazole (MMZ) is expected to be a good option for remission. For the long-term management of recurrent GD, it is important to induce remission by evaluating the patient’s drug response, stopping ATDs at an appropriate time, and actively switching to surgery or RAI therapy, if indicated. Continuing drug treatment for an extended time is now encouraged in patients with a high possibility of remission with low-dose MMZ. It is also important to pay attention to the quality of life of the patients. This review aimed to summarize the appropriate treatment methods and timing of treatment transition in patients who relapsed several times while receiving treatment for GD.

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Focused Review article

Anesthesiology and Pain Medicine
The mechanism of action of pulsed radiofrequency in reducing pain: a narrative review: Donghwi Park, Min Cheol Chang; J Yeungnam Med Sci. 2022;39(3):200-205. Published online April 7, 2022; DOI: https://doi.org/10.12701/jyms.2022.00101

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Abstract PDF

Pain from nervous or musculoskeletal disorders is one of the most common complaints in clinical practice. Corticosteroids have a high pain-reducing effect, and their injection is generally used to control various types of pain. However, they have various adverse effects including flushing, hyperglycemia, allergic reactions, menstrual changes, immunosuppression, and adrenal suppression. Pulsed radiofrequency (PRF) is known to have a pain-reducing effect similar to that of corticosteroid injection, with nearly no major side effects. Therefore, it has been widely used to treat various types of pain, such as neuropathic, joint, discogenic, and muscle pain. In the current review, we outlined the pain-reducing mechanisms of PRF by reviewing previous studies. When PRF was first introduced, it was supposed to reduce pain by long-term depression of pain signaling from the peripheral nerve to the central nervous system. In addition, deactivation of microglia at the level of the spinal dorsal horn, reduction of proinflammatory cytokines, increased endogenous opioid precursor messenger ribonucleic acid, enhancement of noradrenergic and serotonergic descending pain inhibitory pathways, suppression of excitation of C-afferent fibers, and microscopic damage of nociceptive C- and A-delta fibers have been found to contribute to pain reduction after PRF application. However, the pain-reducing mechanism of PRF has not been clearly and definitely elucidated. Further studies are warranted to clarify the pain-reducing mechanism of PRF.

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Reviews

Medical Ethics
Mission and Operation of Institutional Review Board.: Yong Jin Kim; Yeungnam Univ J Med. 2013;30(2):73-78. Published online December 31, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.2.73

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Abstract PDF: An institutional review board (IRB) should independently safeguard the right, safety, and well-being of all clinical trial subjects. It should consist of members who are qualified and experienced to review and evaluate the science, medical aspects, and ethics of the proposed trial. They have to pursue continuing efforts to improve the standards of review. The levels of review include the full board review, expedited review, continuing review, or exempt from review, while the levels of decision-making include approval, conditional approval, deferred approval, and disapproval. Investigators must follow the approved protocols and regulations honestly, and it is the IRB's mission to audit clinical trial sites as well.

Microbiology
Efficacy of Pneumococcal Vaccines.: Hosun Park; Yeungnam Univ J Med. 2012;29(1):1-8. Published online June 30, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.1.1

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16 Download
2 Crossref

Abstract PDF

Streptococcus pneumonia is a very important pathogen for children and elderly people. Two types of pneumococcal vaccines are available in the market: pneumococcal polysaccharide vaccine (PPSV) and pneumococcal conjugate vaccine (PCV). PPSVs have been used for more than 30 years, and PCVs for about 10 years. There have been many reports concerning the evaluation of the vaccines' efficacies in preventing pneumococcal diseases such as meningitis, pneumonia, and otitis media and bacteremia, but the clinical trials had been performed with different conditions, such as diverse vaccine valencies, age groups, races, target outcomes, immunological cut-off values, and follow-up periods. PPSV is recommended for elderly people and chronic disease patients such as asthma, diabetes mellitus, chronic renal failure, and hyposplenic patients. According to the data from several systemic reviews and population-based surveillances, PPSV is effective for pneumococcal pneumonia and vaccine-type bacteremia among healthy adults. Until now, however, there is insufficient evidence of the effectiveness of PPSV among high-risk adults. PCV is very effective in preventing vaccine-type invasive pneumococcal disease (IPD) among children, but its efficacy for pneumonia is very low among children. The incidence of vaccine-related or non-vaccine-type IPDs is increasing after the introduction of 7-valent PCV (PCV7) as a routine immunization for children. Recently, 10- and 13-valent PCVs have been used for children, instead of PCV7. Therefore, continuous surveillance for serotype change among pneumococcal diseases is necessary to evaluate the vaccines' efficacy.

Citations

Citations to this article as recorded by

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