Kosin Medical Journal

Case report

Perioperative cutaneous complications in an elderly patient due to inappropriate use of a forced-air warming device and underbody blanket: a case report: Myounghun Kim, Soo Jee Lee, Beomseok Choi, Geunho Lee, Seunghee Ki; Received July 7, 2023 Accepted October 3, 2023 Published online December 6, 2023; DOI: https://doi.org/10.7180/kmj.23.136 [Epub ahead of print]

44 View
0 Download

Abstract PDF PubReader ePub: Forced-air warming is commonly utilized to prevent perioperative hypothermia. Underbody warming blankets are often employed to secure a larger area for patient warming. While forced-air warming systems are generally regarded as safe, improper usage poses a risk of cutaneous complications. Additionally, the influence of underbody blankets on cutaneous complications remains uncertain. We present a case of cutaneous complications resulting from the improper utilization of a forced-air warming device and an underbody blanket. A 79-year-old man presented to the hospital for robotic proctectomy under general anesthesia. The surgery lasted for 7 hours, and the forced-air warming device with underbody blanket operated continuously for 5 hours intraoperatively. The surgery was completed without any incidents. However, first-degree burns on the patient’s back, along with superficial decubitus ulcers on his right scapula, were observed after surgery. To prevent cutaneous complications, clinicians must adhere to the manufacturer's guidelines when utilizing a forced-air warming system. Compared to overbody blankets, underbody blankets have limitations in monitoring cutaneous responses. Ensuring patient safety requires selecting an appropriate blanket for scheduled operations.

Original articles

Initial experience with Retzius-sparing robot-assisted radical prostatectomy compared to the conventional method: is it a suitable option for robotic prostatectomy beginners?: Su Hwan Kang; Received August 17, 2023 Accepted September 27, 2023 Published online November 9, 2023; DOI: https://doi.org/10.7180/kmj.23.143 [Epub ahead of print]

92 View
4 Download

Abstract PDF PubReader ePub: Background
Retzius-sparing robot-assisted radical prostatectomy (rsRARP) is a surgical procedure that can minimize the resection of surrounding prostate tissue by enabling access through the anterior surface of the Douglas pouch. We reported our initial experiences with rsRARP compared to conventional robot-assisted radical prostatectomy (RARP).
Methods
Retrospective data were collected from March 2019 to June 2022, including 69 patients who underwent robotic radical prostatectomy for localized prostate cancer. The operations were performed at a single center, and we alternated between the two methods. Perioperative characteristics and oncologic and functional outcomes were analyzed.
Results
In total, 35 patients underwent RARP and 34 patients underwent rsRARP. The preoperative characteristics of the patients were similar. Oncologic and functional parameters were analyzed postoperatively. Except for early recovery of urinary incontinence (immediate, 1 month, 3 months, 6 months: p<0.001, p=0.002, p=0.004, and p=0.014, respectively), there were no significant differences between the two groups. We also analyzed trends in operation time and oncologic and functional outcomes according to the progression of rsRARP cases.
Conclusions
rsRARP has the major advantage of enabling an early recovery from urinary incontinence after surgery, and it is also a good surgical approach that shows oncologically similar results to the conventional approach. It is also highly reproducible and can be recommended to surgeons new to robotic radical prostatectomy.

Clinical outcomes of prostate artery embolization for management of benign prostate hyperplasia (prostate larger than 100 mL) with or without hematuria: Soodong Kim; Received April 25, 2023 Accepted June 5, 2023 Published online November 7, 2023; DOI: https://doi.org/10.7180/kmj.23.122 [Epub ahead of print]

87 View
1 Download

Abstract PDF PubReader ePub: Background
In this study, we report 1-year follow-up clinical results of prostate artery embolization (PAE) in patients with glandular hematuria or acute urinary retention caused by a large prostate (over 100 mL).
Methods
Twenty-one consecutive patients undergoing PAE from March 2018 to July 2020 were included in this retrospective study. Clinical follow-up was conducted for all patients 1, 3, 6, and 12 months after the procedure. The outcome measures included the International Prostate Symptom Score (IPSS), quality of life (QoL), peak urinary flow rate (Qmax), post-void residual (PVR), prostate volume, prostate-specific antigen, and complications. A p-value < 0.05 was considered statistically significant.
Results
Twenty-one patients with severe benign prostatic hyperplasia (BPH) with acute urinary retention or prostatic hematuria were enrolled in this study. Technical success rate was 90.5% (19/21), and unilateral PAE was done in 2/21 (9.5%) patients by pelvic vascular obliteration. In all patients, the mean IPSS, QoL score, Qmax, and PVR were significantly improved at 12 months post-PAE. The mean IPSS decreased from 26.1 to 12.1 points (p<0.05), mean QoL score decreased from 4.6 to 2.9 points (p<0.05), mean Qmax increased from 2.1 to 9.4 mL/s (p<0.05), and mean PVR decreased from 300.0 to 70.7 mL (p<0.05). The catheter was successfully removed from 19/21 patients and clinical success rate was 90.5%.
Conclusions
PAE was an effective and safe treatment option for patients with BPH and very large prostates (>100 mL) and urinary retention or gross hematuria associated with BPH in men unfit for surgery.

Corrigendum

Corrigendum to: Unusual Magnetic Resonance Imaging Findings Contrast-induced Encephalopathy following Cerebral Angiography: Won Ho Cho, Jung Hwan Lee, Tae Hong Lee, Chang Hwa Choi, Jun Kyeung Ko; Published online October 30, 2023; DOI: https://doi.org/10.7180/kmj.2021.36.1.51.r1 [Epub ahead of print]; Corrects: Kosin Med J 2021;36(1):51

105 View
4 Download

PDF PubReader ePub

Original article

Effects of cholecalciferol and omega-3 fatty acids on hepcidin levels in 5/6 nephrectomy rats: Yu In Jeong, Hyo Jin Jung, Mi Hwa Lee, Young Ki Son, Seong Eun Kim, Won Suk An, Su Mi Lee; Received July 19, 2023 Accepted August 23, 2023 Published online September 25, 2023; DOI: https://doi.org/10.7180/kmj.23.137 [Epub ahead of print]

197 View
2 Download

Abstract PDF PubReader ePub: Background
Anemia is a common complication of chronic kidney disease (CKD). In patients with CKD-related anemia, an inverse relationship between vitamin D and hepcidin levels has been observed. Hepcidin is a key regulator of iron homeostasis, mediated via binding to ferroportin. The aim of this study was to investigate the effects of cholecalciferol and omega-3 fatty acids (FA) on hepcidin levels using 5/6 nephrectomized (Nx) rats.
Methods
Male Sprague-Dawley rats were divided into five groups: sham control, 5/6 Nx, 5/6 Nx treated with cholecalciferol, 5/6 Nx treated with omega-3 FA, and 5/6 Nx treated with both cholecalciferol and omega-3 FA. We measured the hepcidin and ferroportin levels in the kidney and liver by enzyme-linked immunosorbent assays and Western blots. We evaluated hepcidin expression in the kidney by immunohistochemical staining.
Results
Among the five groups, 5/6 Nx rats exhibited the worst kidney function. Compared with the sham controls, 5/6 Nx rats showed significantly increased serum hepcidin levels and decreased vitamin D levels. Supplementation with either omega-3 FA or cholecalciferol decreased hepcidin and increased vitamin D levels, with a concurrent improvement of anemia. Furthermore, 5/6 Nx rats treated with omega-3 FA/cholecalciferol showed decreased ferroportin and ferritin levels, while iron and total iron-binding capacity levels increased.
Conclusions
Treatment with a combination of cholecalciferol and omega-3 FA may improve anemia in a CKD rat model by decreasing hepcidin levels.

Review articles

Do we need Moodle in medical education? A review of its impact and utility: Seri Jeong, Hyunyong Hwang; Kosin Med J. 2023;38(3):159-168. Published online September 22, 2023; DOI: https://doi.org/10.7180/kmj.23.139

1,100 View
57 Download

Abstract PDF PubReader ePub: Various learning management systems (LMSs) are available to facilitate the development, management, and distribution of digital resources for both face-to-face and online instruction. In recent decades, these methods have shown potential for greater efficiency compared to traditional "chalk and talk" approaches. Additionally, they have paved the way for the establishment of ubiquitous learning environments, marking a new era in education. In a trend accelerated by the coronavirus disease 2019 pandemic, LMSs have been increasingly adopted to overcome the restrictions inherent to in-person education. In medical education, LMSs such as Moodle, Canvas, Blackboard Learn, and others have been introduced and used to support teaching, learning, and assessment activities. Of these, Moodle stands out as the most popular choice for many medical schools and institutions, primarily due to its flexibility, functionality, and user-friendliness. The learning environment is gradually transforming from traditional in-person teaching to a hybrid educational approach, driven by the need to fulfill diverse educational demands. Numerous research studies have examined the usability of Moodle in medical education, demonstrating its effectiveness in addressing challenges related to adaptive personalized learning, collaborative learning, blended learning, and more. Consequently, Moodle has emerged as a valuable solution for medical educators seeking a versatile and robust platform to enhance their teaching methodologies. The present review focuses on the practical utilization of Moodle in medical education and the advantages it offers to this field.

Gut microbiota and nonalcoholic fatty liver disease: Boyeon Kim, Bukyung Kim; Kosin Med J. 2023;38(3):169-175. Published online September 22, 2023; DOI: https://doi.org/10.7180/kmj.23.138

913 View
20 Download

Abstract PDF PubReader ePub: The gut microbiota has been reported to exert a significant influence on various physiological responses of hosts. Extensive evidence has recently emerged linking metabolic and cardiovascular disorders to the gut microbiota. Nonalcoholic fatty liver disease (NAFLD) is the most common underlying metabolic disorder, and its prevalence is increasing worldwide. In this study, we aim to review the relationship between the gut microbiota and NAFLD, and explore the potential of the gut microbiota as a novel target for NAFLD treatment.

Application of Raman spectroscopy in breast cancer surgery: Yikeun Kim, Sung Ui Jung, Jinhyuk Choi; Kosin Med J. 2023;38(3):176-183. Published online September 14, 2023; DOI: https://doi.org/10.7180/kmj.23.129

630 View
19 Download

Abstract PDF PubReader ePub: The incidence of breast cancer is increasing worldwide. As cancer screening has become more widespread, the rate of early breast cancer detection has increased and treatment methods have changed. Partial mastectomy is performed more often than total mastectomy for the surgical treatment of early breast cancer, and sentinel lymph node biopsy plays an important role. A high level of accuracy is necessary for the intraoperative examination of surgical margins and sentinel lymph nodes to identify malignancies. Therefore, several examination techniques, including Raman spectroscopy, that replace or supplement the currently used frozen-section methods are being studied. Raman spectroscopy has the ability to diagnose cancer in normal tissue by providing in real time a chemical fingerprint that can be used to differentiate between cells and tissues. Numerous studies have investigated the utilization of Raman spectroscopy to identify cancer in the margins of resected tissues and sentinel lymph nodes during breast cancer surgery, showing the potential of this technique for clinical applications. This article introduces and reviews the research on Raman spectroscopy for breast cancer surgery.

Original article

Human resources and medical supplies consumption during the COVID-19 pandemic: a single-center study: Hye Jin Park, Yu Bin Seo, Jin Ju Park, Sun Hee Na, Jacob Lee; Received May 24, 2023 Accepted August 7, 2023 Published online September 14, 2023; DOI: https://doi.org/10.7180/kmj.23.126 [Epub ahead of print]

213 View
0 Download

Abstract PDF PubReader ePub: Background
In the face of the unexpected coronavirus disease 2019 (COVID-19) pandemic, every country has struggled with insufficient human resources and medical supplies. This study aims to provide the statistical information necessary for discussing how to model stockpiles of medical resources.
Methods
This study was conducted at the Hallym University Kangnam Sacred Heart Hospital, in South Korea. The study duration was 2 weeks, centered on March 16, 2022, when the number of daily confirmed patients with COVID-19 in Korea peaked. The number of human resources was obtained by counting the number of healthcare workers using CCTV. Drug prescriptions and medical device usage were obtained from electronic medical records.
Results
In total, 117 inpatients and 26,485 outpatients were managed at this hospital during the 2-week study period. Daily visits were highest among nurses in all units, followed by doctors and radiology technicians. The mean daily consumption of personal protective equipment (PPE) per bed was 4.3 sets in the intensive care unit (ICU), 1.8 in the semi-ICU, and 1.4 in the ward. Despite the four-fold difference in the number of patients, there was no statistically significant difference between the two wards in the number of daily visits. Drug prescription rates were higher among inpatients than at-home patients.
Conclusions
The higher the COVID-19 severity, the higher the consumption of PPE per patient. Among healthcare workers, nurses had the highest number of inpatient treatment visits for COVID-19. To efficiently utilize, PPE, structures containing more isolation beds in a single negative pressure isolation system would be preferred.

Case report

Heterotopic ovarian hilus cells of the salpinx: a case report and review of the literature: Bomi Kim; Received April 20, 2023 Accepted August 6, 2023 Published online September 12, 2023; DOI: https://doi.org/10.7180/kmj.23.120 [Epub ahead of print]

162 View
4 Download

Abstract PDF Supplementary Material PubReader ePub: Ovarian hilus cells (OHCs), a counterpart of testicular Leydig cells, are usually found in the ovarian poles and produce androstenedione. Their origin remains a matter of debate, although OHCs are assumed to come from the adrenogenital primordium. OHCs are rarely observed around the poles of the ovary, including the mesoovarium, stroma (perisalpinx) of the salpinx, and the wall of paratubal cysts. Their clinical and pathological characteristics are not well-known because of their rarity. Herein, we present a case of ectopic OHCs in a 48-year-old woman. The patient underwent total hysterectomy and bilateral salpingectomy for vaginal bleeding due to multiple leiomyomas. We incidentally found OHCs in the stroma of the infundibulum of the salpinx, just beneath the tubal epithelium. Their size was less than 1 mm, and they were composed of large cells with central round nuclei and abundant clear or granular cytoplasm. OHCs share morphological and immunohistochemical profiles with ectopic adrenal glands, and the differential diagnosis is sometimes difficult. They do not exhibit microscopic encapsulation or the normal adrenal cortex zonation pattern. The patient was discharged and did not show any abnormal findings during 19 months of follow-up. Analyzing the characteristics of testicular Leydig cells will help understand how OHCs develop and why heterotopic OHCs occur in and around the salpinges.

Editorial

Omega-3 fatty acids: promising therapeutic agents for combating kidney injuries: Hee-Jae Cha; Kosin Med J. 2023;38(3):157-158. Published online September 7, 2023; DOI: https://doi.org/10.7180/kmj.23.135

459 View
12 Download

PDF PubReader ePub

Case reports

Primary gastric leiomyosarcoma: a case report and literature review: Yedaun Lee; Received April 10, 2023 Accepted July 5, 2023 Published online August 18, 2023; DOI: https://doi.org/10.7180/kmj.23.118 [Epub ahead of print]

240 View
4 Download

Abstract PDF PubReader ePub: After separating gastrointestinal (GI) stromal tumors from true smooth muscle tumors of the GI tract, leiomyosarcoma (LMS) of the GI tract has become a rare tumor. Gastric LMS is extremely rare and accounts for 0.1% of all cases of LMS in the GI tract. There are few English-language reports of gastric LMS describing radiologic findings. Here, we report a case of gastric LMS and review the recent literature focusing on radiologic findings. An 80-year-old female patient was referred for evaluation of a gastric mass accompanied by severe anemia. The physical examination revealed no specific findings except for an anemic conjunctiva. Laboratory data showed a low hemoglobin level of 5.1 g/dL. Endoscopy revealed a huge subepithelial mass in the posterior wall of the gastric body. Contrast-enhanced computed tomographic images showed an intraluminal protruding enhancing mass with an internal stalk appearance in the gastric body. There was no internal necrosis or calcification. The patient underwent subtotal gastrectomy and was diagnosed with primary gastric LMS. The diagnosis of gastric LMS is challenging due to its rarity. Our case report suggests that the presence of an internal stalk or spouting appearance can help prompt the radiologist to consider gastric LMS in the differential diagnosis.

Squamous cell carcinoma of the pancreas with a pancreatic intraductal papillary mucinous neoplasm: a case report: Nam Kyung Lee; Received April 27, 2023 Accepted July 5, 2023 Published online August 17, 2023; DOI: https://doi.org/10.7180/kmj.23.123 [Epub ahead of print]

183 View
1 Download

Abstract PDF PubReader ePub: Squamous cell carcinoma (SCC) of the pancreas is very rare. No reports have described SCC accompanied by intraductal papillary mucinous neoplasm (IPMN) of the pancreas. This report presents the first known case of SCC with IPMN of the pancreas in a 71-year-old man, with a focus on radiologic findings. Here, the imaging features of SCC with IPMN of the pancreas were similar to those of IPMN of the pancreas with high-risk stigmata features.

Original articles

Post-percutaneous core needle biopsy sputum cytology: diagnostic value and factors for positive prediction in diagnosing malignancy: Sang Kyu Lee, Hee Kang, Min Jung Jung, Sekyoung Park, Ki Nam Lee; Kosin Med J. 2023;38(3):201-209. Published online August 16, 2023; DOI: https://doi.org/10.7180/kmj.23.127

779 View
10 Download

Abstract PDF PubReader ePub: Background
This study evaluated the diagnostic yield and positive predictive factors of post-percutaneous core needle biopsy (PCNB) sputum cytology in diagnosing malignancy.
Methods
This retrospective study included patients who underwent PCNB at a single center from January 2014 to March 2022. Patient demographics, lung lesion characteristics on computed tomography, underlying lung disease, post-PCNB complications, histopathologic results of PCNB, post-PCNB sputum specimens, and final diagnoses were reviewed. The diagnostic yields and related factors were analyzed.
Results
Overall, 177 consecutive patients with sputum specimens obtained after PCNB for intrapulmonary lesions were enrolled. Among them, 152 patients had a final diagnosis of malignancy. Diagnostic sputum specimens with atypical or malignant cells were obtained in 12 patients. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of sputum cytology were 7.89%, 100%, 20.90%, 100%, and 15.15%, respectively. Lesion size, air-bronchogram, lesion multiplicity, and the cell type of squamous cell and adenocarcinoma differed significantly between the groups with diagnostic versus non-diagnostic sputum (p<0.05). The lesion size (odds ratio [OR], 1.035; 95% confidence interval [CI], 1.008–1.064; p=0.013), presence of air-bronchogram (OR, 23.485; 95% CI, 2.532–217.316; p=0.005), and squamous cell carcinoma (OR, 7.397; 95% CI, 1.773–30.865; p=0.006) were significantly associated with a diagnostic sputum specimen post-PCNB.
Conclusions
Although post-PCNB sputum cytology had low sensitivity in diagnosing lung cancer, it showed diagnostic results in some peripheral lung cancer patients who have squamous cell types, relatively large tumors, and air-bronchograms in the lesions.

The COVID-19 pandemic's impact on prostate cancer screening and diagnosis in Korea: Byeong Jin Kang, Kyung Hwan Kim, Hong Koo Ha; Kosin Med J. 2023;38(3):193-200. Published online August 16, 2023; DOI: https://doi.org/10.7180/kmj.23.116

775 View
12 Download

Abstract PDF PubReader ePub: Background
The global coronavirus disease 2019 (COVID-19) pandemic, which started in early 2020, has had multiple impacts on cancer care. This study assessed how the COVID-19 pandemic influenced prostate cancer (PCa) screening and diagnosis in South Korea.
Methods
Patients who visited the outpatient clinic at a single institution for PCa evaluation were included in this study and divided into a pre-COVID-19 group and a COVID-19 pandemic group, based on the start of the COVID-19 pandemic and social distancing policies on March 1, 2020. The number of prostate-specific antigen (PSA) tests, patients with elevated PSA levels, and prostate biopsy results were analyzed.
Results
In total, 8,926 PSA tests were administered during the COVID-19 pandemic, compared to 15,654 before the pandemic (p<0.05). Of 2,132 patients with high PSA levels, 1,055 (49.5%) received prostate biopsies before the pandemic and 1,077 (50.5%) did so during the COVID-19 pandemic. The COVID-19 pandemic group had a higher detection rate of PC, and increased rates of Gleason scores (GS) 7 and 9–10, while the rate of GS 6 decreased compared to the pre-COVID-19 group (p<0.05). The rate of clinically significant PCa (csPCa) was also higher during the pandemic (p<0.05). In both magnetic resonance imaging-guided and standard biopsies, the GS 6 rate decreased, and the csPCa rate increased during the COVID-19 pandemic (each, p<0.05).
Conclusions
During the COVID-19 pandemic, the detection rate of prostate biopsies and the rate of csPCa increased significantly. Thus, PCa was diagnosed at a more advanced state in Korea during the COVID-19 pandemic.

First
Prev
Page of 84
Next
Last

Article category