Journal of Yeungnam Medical Science

Original articles

Emergency and Critical Care Medicine
Shockable rhythm as an independent prognostic factor in patients with non-ST elevation undergoing percutaneous coronary intervention after out-of-hospital cardiac arrest: a registry-based cohort study: Su Jeong Shin, Jae Yun Ahn, Sung Bae Moon, Do Won Lee, Yun Jeong Kim, Dong Eun Lee, Jung Ho Kim, Sang Hun Lee, Jun Hoh Hyung, Hyun Wook Ryoo; J Yeungnam Med Sci. 2026;43:62. Published online September 4, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.62

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Abstract PDF Supplementary Material: Background
Although the timing and indications for coronary angiography (CAG) after out-of-hospital cardiac arrest (OHCA) have been widely studied, factors associated with favorable outcomes in patients with non-ST-elevation (non-STE) undergoing percutaneous coronary intervention (PCI) remain unclear.
Methods
This retrospective cohort study used a citywide, prospectively collected OHCA registry in Daegu, Korea (2018–2022), including adult patients with non-STE OHCA who underwent both CAG and PCI. Given the limited number of outcome events, Firth's penalized logistic regression identified factors independently associated with survival to discharge and favorable neurological outcomes (cerebral performance category 1–2).
Results
Of 5,026 patients treated by emergency medical services, 371 underwent CAG; 258 (69.5%) had non-STE, and 105 (40.7%) of these underwent PCI and formed the cohort. Sixty-nine (65.7%) survived to discharge, and 55 (52.4%) had favorable neurological outcomes. Initial shockable rhythm (adjusted odds ratio [aOR], 5.38; 95% confidence interval [CI], 1.77–18.02), prehospital return of spontaneous circulation (ROSC) (aOR, 10.30; 95% CI, 3.62–33.06), and shorter scene time interval (aOR, 0.88 per minute; 95% CI, 0.79–0.98) were independently associated with survival. Initial shockable rhythm (aOR, 11.02; 95% CI, 3.39–43.00) and prehospital ROSC (aOR, 11.69; 95% CI, 3.69–45.03) were independently associated with favorable neurological outcomes.
Conclusion
Among patients with non-STE OHCA undergoing CAG and PCI, initial shockable rhythm and prehospital ROSC were associated with both outcomes, and shorter scene time interval with survival only. As the cohort was restricted to patients who survived to undergo PCI, these findings reflect prognostic stratification and cannot infer benefit from CAG or PCI.

Cardiology and Cardiovascular Medicine
The performance of ASpirin-FREE therapy after successful percutaneous coronary intervention for acute coronary syndrome: the ASFREE prospective pilot study: Donghyeon Joo, Sungho Jo, Jeong Tae Byoun, Jae Young Cho, Kyeong Ho Yun; J Yeungnam Med Sci. 2026;43:25. Published online March 19, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.25

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Abstract PDF: Background
Dual antiplatelet therapy with aspirin and a P2Y12 inhibitor is standard after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS); however, bleeding risk remains a major concern. Early discontinuation of aspirin due to potent P2Y12 inhibition may mitigate bleeding without increasing thrombotic events.
Methods
The ASpirin-FREE therapy after successful percutaneous coronary intervention for acute coronary syndrome (ASFREE) study was an investigator-initiated, single-center, prospective, open-label, single-arm pilot study enrolling patients with ACS who underwent PCI with drug-eluting stents. All patients received a single loading dose of aspirin on the day of the PCI, followed by ticagrelor or prasugrel monotherapy. The primary efficacy endpoint was target vessel failure (TVF) at 12 months. The primary safety endpoint was definite stent thrombosis. Event rates are reported with 95% confidence intervals (CIs).
Results
In total, 228 patients were enrolled. TVF occurred in 10 patients (4.4%; 95% CI, 2.1%–7.9%). Definite stent thrombosis was observed in one patient (0.4%; 95% CI, 0.01%–2.4%), with no acute or subacute events. Major bleeding (Bleeding Academic Research Consortium type 3 or 5) occurred in two patients (0.9%; 95% CI, 0.1%–3.1%).
Conclusion
An aspirin-free strategy following a single loading dose with continuation of potent P2Y12 inhibitor monotherapy was feasible in patients with ACS undergoing PCI and was associated with low rates of thrombotic and major bleeding events. These findings should be regarded as hypothesis-generating and supporting further evaluations in adequately powered randomized controlled trials (CRIS registration: KCT0008182).

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

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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 Library, 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.

Citations

Citations to this article as recorded by

Cytomegalovirus Retinitis Across the Immunosuppression Spectrum: A Contemporary Framework for Risk Stratification, Diagnosis, and Vision-Preserving Therapy
Shuai Su, Yulin Yang, Jiaying Wu, Yi Xiao
Journal of Clinical Medicine.2026; 15(19): 7482. CrossRef

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

Citations to this article as recorded by

Feasibility, Safety and Outcomes of Early Mobilization in the ICU Following Lung Transplantation: A Scoping Review
Matthieu Reffienna, Adéla Foudhaïli, Jonathan Messika, Damien Vitiello
Clinical Transplantation.2026;[Epub] CrossRef
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

Original articles

Neurosurgery
Personal experience with microvascular decompression and partial sensory rhizotomy for trigeminal neuralgia: Jung Hwan Lee, Jae Meen Lee, Chang Hwa Choi; Yeungnam Univ J Med. 2021;38(3):202-207. Published online November 23, 2020; DOI: https://doi.org/10.12701/yujm.2020.00745

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Abstract PDF

Background
Trigeminal neuralgia (TN) is a severe, paroxysmal pain in the distribution of the fifth cranial nerve. Microvascular decompression (MVD) is the most widely used surgical treatment for TN. We undertook this study to analyze the effects of and complications of MVD and to refine the surgical procedure for treating TN.
Methods
A total of 88 patients underwent for TN underwent surgery at our hospital. Among them, 77 patients underwent MVD alone, and 11 underwent partial sensory rhizotomy (PSR) with or without MVD. The medical records of these patients were retrospectively analyzed for patient characteristics, clinical results, offending vessels, and complications if any.
Results
The mean follow-up duration was 43.2 months (range, 3–216 months). The most common site of pain was V2+V3 territory (n=27), followed by V2 (n=25) and V3 (n=23). The most common offending vessels were the superior cerebellar artery and anterior inferior cerebellar artery in that order. The overall rate of postoperative complications was 46.1%; however, most complications were transient. There were two cases of permanent partial hearing disturbance. In the MVD alone group, the cure rate was 67.5%, and the improvement rate was 26.0%. Among 11 patients who underwent PSR with or without MVD, the cure rate was 50.0%, and the improvement rate was 30.0%.
Conclusion
The clinical results of MVD were satisfactory. Although the outcomes of PSR were not as favorable as those of pure MVD in this study, PSR can be considered in cases where there is no significant vascular compressive lesion or uncertainty of the causative vessel at the surgery.

Citations

Citations to this article as recorded by

Beyond the Pain: Rethinking Chronic Pain Management Through Integrated Therapeutic Approaches—A Systematic Review
Nicole Quodling, Norman Hoffman, Frederick Robert Carrick, Monèm Jemni
International Journal of Molecular Sciences.2026; 27(3): 1231. CrossRef
Partial sensory rhizotomy in therapy-refractory and recurrent trigeminal neuralgia – a single center experience
Ina Lange, Ehab El Refaee, Marc Matthes, Henry W. S. Schroeder, Jörg Baldauf
Acta Neurochirurgica.2026;[Epub] CrossRef
Revisiting the Efficacy of Redo Microvascular Decompression for Trigeminal Neuralgia
Zhongding Zhang, Hua Zhao, Yinda Tang, Baimiao Wang, Qing Yuan, Ying Zhang, Yihua Li, Jun Zhong, Shiting Li
World Neurosurgery.2024; 186: e335. CrossRef
A systematic review on the efficacy of adjunctive surgical strategies during microvascular decompression for trigeminal neuralgia without intraoperative evidence of neurovascular conflict
Nicola Montano, Grazia Menna, Alessandra Musarra, Renata Martinelli, Alessandro Izzo, Quintino Giorgio D’Alessandris, Manuela D’Ercole, Alessandro Olivi
Neurosurgical Review.2024;[Epub] CrossRef
Progress in Surgical Treatment of Trigeminal Neuralgia
滨何
Advances in Clinical Medicine.2023; 13(02): 2313. CrossRef
How Far Has Radiofrequency Thermocoagulation Come Along as a Treatment Procedure in Treating Trigeminal Neuralgia Patients?
Stephen D Howard, Varun Soti
Cureus.2023;[Epub] CrossRef
Historical aspects of the problem of treatment of trigeminal neuralgia and the role of neurosurgical methods in its solution (literature review)
A. N. Zhurkin, A. V. Semenov, V. A. Sorokovikov, N. V. Bartul
Acta Biomedica Scientifica.2021; 6(4): 123. CrossRef
Trigeminal Neuralgia: Current Approaches and Emerging Interventions
Risheng Xu, Michael E Xie, Christopher M Jackson
Journal of Pain Research.2021; Volume 14: 3437. CrossRef

Nephrology
The relationship between disability and clinical outcomes in maintenance dialysis patients: Seok Hui Kang, Jun Young Do, Jun Chul Kim; Yeungnam Univ J Med. 2021;38(2):127-135. Published online October 15, 2020; DOI: https://doi.org/10.12701/yujm.2020.00346

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Abstract PDF

Background
Dialysis patients are prone to having disabilities. We aimed to evaluate the association between disability and various clinical outcomes in Korean dialysis patients.
Methods
This study consisted of 1,615 dialysis patients from 27 centers. We evaluated disability by using four questions on the activities of daily living (ADLs) concerning whether help was needed for feeding, dressing/undressing, getting in/out of bed, or taking a bath/shower. We divided the patients into three groups: no disability (Non-D, none of the four ADL domains required help; n=1,312), mild disability (Mild-D, one ADL domain required some/full help; n=163), or moderate to severe disability (MS-D, two or more ADL domains required some/full help; n=140). We evaluated falls, frailty, health-related quality of life (HRQoL), mortality, and hospitalization.
Results
The numbers of participants with a fall during the last 1 year were 199 (15.2%), 42 (25.8%), and 44 (31.4%) in the Non-D, Mild-D, and MS-D groups, respectively (p<0.001). The numbers of participants with frailty in the Non-D, Mild-D, and MS-D groups were 381 (29.0%), 84 (51.5%), and 93 (66.4%), respectively (p<0.001). In both univariate and multivariate analyses, the physical component scale and mental component scale scores decreased as the grade of disability increased (p<0.001 for both scores). Hospitalization-free survival rate at 500 days was 64.2%, 56.7%, and 51.1% in the Non-D, Mild-D, and MS-D, respectively (p=0.001 for trend). Patient survival rate at 500 days was 95.3%, 89.5%, and 92.3% in the Non-D, Mild-D, and MS-D, respectively (p=0.005 for trend).
Conclusion
Disability was associated with falls, frailty, HRQoL scales, and survival trends in Korean dialysis patients.

Citations

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Characterizing Interventions Used to Promote Life Participation in Adults on Peritoneal Dialysis Therapy: A Scoping Review
Alexia Kateb, Kaleigh McCarthy, Janine Farragher
Canadian Journal of Kidney Health and Disease.2024;[Epub] CrossRef
The effect of workability-related factors in patients with end-stage kidney disease undergoing hemodialysis
Mahsa Motiei, Mirsaeed Attarchi, Elham Ramezanzadeh
BMC Nephrology.2024;[Epub] CrossRef
The predictive role of hope and social relational quality in disability acceptance among Iranian patients under hemodialysis
Nilofar Pasyar, Mostafa Jowkar, Masoume Rambod
BMC Nephrology.2023;[Epub] CrossRef
Prevalence of Sarcopenia and Its Association With Diabetes: A Meta-Analysis of Community-Dwelling Asian Population
Seung Min Chung, Jun Sung Moon, Min Cheol Chang
Frontiers in Medicine.2021;[Epub] CrossRef

Case report

Urology
Ureterosciatic hernia causing obstructive uropathy successfully managed with minimally invasive procedures: Yeong Uk Kim, Jae Ho Cho, Phil Hyun Song; Yeungnam Univ J Med. 2020;37(4):337-340. Published online July 29, 2020; DOI: https://doi.org/10.12701/yujm.2020.00402

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110 Download
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Abstract PDF

Ureterosciatic hernia is extremely rare. In ureteral herniation, ureter prolapses occur through either the greater or lesser sciatic foramen. Atrophy of the piriformis muscle, hip joint diseases, and defects in the parietal pelvic fascia are predisposing factors for the development of ureterosciatic hernia. Most symptomatic patients have been treated surgically, with conservative treatment reserved only for asymptomatic patients. To the best of our knowledge, long-term follow-up outcomes after ureterosciatic hernia management are sparse. In this paper, we report the case of a 68-year-old woman who presented with colicky left abdominal pain. After computed tomography (CT) scan and anterograde pyelography, she was diagnosed ureterosciatic hernia with obstructive uropathy. We performed ureteral balloon dilatation and double-J ureteral stent placement. After this minimally invasive procedure, CT scan demonstrated that the left ureter had returned to its normal anatomical position without looping into the sciatic foramen. The patient remained asymptomatic with no adverse events 7 years after the minimally invasive procedures. This brief report describes ureterosciatic hernia successfully managed with minimally invasive procedures with long-term follow-up outcomes.

Citations

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Recurrent Left Ureterosciatic Herniation With Obstructive Hydronephrosis: A Case Report
Venkatesh Perumalla, Thomas Neerhut, Eve Brown, John Blazak, Chandra Perumalla, Abigail Attwell-Heap, Kalyani Sen
Case Reports in Urology.2026;[Epub] CrossRef
Management of sciatic hernia as a unique cause of hip pain: laparoscopic transabdominal preperitoneal (TAPP) repair with LiquiBandFIX8 anchoring technique
Hannah Mathews, Balakrishnan Saravanan, Paul Wilson
BMJ Case Reports.2025; 18(9): e267492. CrossRef
Ureterosciatic Hernia in Focus: A Narrative Review of the Literature
Mohamed Mustafa, Afiq Pouzi, Peter Senada, Lokesh Suraparaju, Suresh Gupta
Cureus.2023;[Epub] CrossRef
Urosepsis secondary to ureterosciatic hernia corrected with ureteral stent placement: a case report and literature review
Kohei Kakimoto, Mayu Hikone, Ko Nagai, Jun Yamakawa, Kazuhiro Sugiyama, Yuichi Hamabe
International Journal of Emergency Medicine.2021;[Epub] CrossRef

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