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Volume 28(1); June 2013
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Review articles
The Up-to-date Informations of Progesterone Supplementation for Prevention of Preterm Birth
Hyun Jin Cho
Kosin Med J. 2013;28(1):1-6.   Published online January 18, 2012
DOI: https://doi.org/10.7180/kmj.2013.28.1.1
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

Preterm birth (PTB) remains a major cause of neonatal mortality and morbidity, despite improvements in tocolytic treatment and neonatal care. Progesterone (17a-hydroxyprogesterone) produced naturally or synthetically can prevent PTB when applied vaginally and orally. Progesterone use may be a safe and cost-effective option in cases of singleton pregnancy with prior PTB, asymptomatically short cervix and arrested preterm labor.

Nutritional Treatment: New Strategy for Management of Chronic Pelvic Pain
Jong Soon Choi, Heung Yeol Kim
Kosin Med J. 2013;28(1):7-12.   Published online August 17, 2012
DOI: https://doi.org/10.7180/kmj.2013.28.1.7
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

Chronic pelvic pain is a common condition in women of reproductive age and can be described as chronic nociceptive, inflammatory and neuropathic pain characterized by spontaneous pain or a response to various stimuli. Oxidative stress is a component of the inflammatory reaction associated with pain processes. Iron and NF-κB are well-known inducers of oxidative stress, and reactive oxygen species (ROS) are associated with chronic pelvic pain and play an important role in the regulation of genes expressing immunoregulators, cytokines, and other molecules. Chronic pelvic pain treatment is often unsatisfactory and limited to symptom control. However, dietary treatment with antioxidants can improve the function of the immune system and overcome free radical damage. Therefore, dietary supplementation is suggested as a means to treat some chronic medical conditions that respond poorly to medication. In summary, dietary treatment with antioxidants could be considered for new strategy for treatment of chronic pelvic pain and may be better tolerated by patients than current treatments.

Original articles
The Efficacy of Carpal Tunnel Release with Mini-Open Incision
Young Ho Kwon, Jae Man Kwak
Kosin Med J. 2013;28(1):13-18.   Published online January 19, 2013
DOI: https://doi.org/10.7180/kmj.2013.28.1.13
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Objectives

We evaluated the effects of carpal tunnel release with a mini-open incision by analyzing symptom improvement.

Methods

We retrospectively reviewed 64 carpal tunnel syndrome patients who underwent carpal tunnel release with mini-open incisions between January 2001 and December 2010. The 22 males and 42 females had a mean age of 49 years and a mean follow-up of 12 months. We analyzed postoperative symptoms using The Michigan Hand Outcome Questionnaire.

Results

Patients reported complete resolution of their symptoms, and some patients who had presented with residual symptoms improved gradually. No complications or scar hypersensitivity were observed. MHQ(Michigan Hand outcomes Questionnaire) scores improved significantly between preoperative and postoperative 6 months and 12 months.

Conclusions

Carpal tunnel release with mini-open incision provides a clinically effective, reliable and safe procedure.

Endovascular or Microsurgical Treatment of Intracranial Aneurysms: Single Center Analysis
Jin Wook Kim, Won-Bae Seung, Yong Seok Park
Kosin Med J. 2013;28(1):19-26.   Published online January 19, 2013
DOI: https://doi.org/10.7180/kmj.2013.28.1.19
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Objectives

The objective of this study was to assess effectiveness and outcomes of endovascular versus microsurgical treatment for intracranial aneurysms in single hospital.

Methods

This was a retrospective study, using data collected during 4 year (between 2008 and 2011) from single hospital(Kosin University Gospel Hospital). A total of 274 treated, intracranial aneurysm cases were evaluated. The measurements used were effectiveness as measured by hospital discharge outcomes: 1) mortality (in-hospital death), 2) clinical outcomes(modified Ranking Scale: mRS).

Results

Among total of 274 cases, unruptured intracranial aneurysm cases were 132 cases and ruptured cases were 142 cases. Among unruptured 132 cases, 65 cases were treated by microsurgical treatment and 67 cases were treated by endovascular treatment. Among ruptured 142 cases, 61 cases were treated by microsurgical treatment and 81 cases were treated by endovascular treatment. In unruptured cases, there was not any fatal complication and same adverse outcomes (3% versus 3%). In ruptured case, in regards of treatment modality (i.e., endovascular versus microsurgical treatment), each clinical outcomes were as followings; good clinical outcome was 53.1% (43/81) versus 41.0% (25/61), moderate clinical outcome was 13.6% (1/81) versus 9.8% (6/61), severe clinical outcome was 18.5% (15/81) versus 22.9% (29/142) and fatal outcome was 14.8 (12/81) versus 26.2% (16/61).

Conclusions

This analysis of single hospital data indicates that endovascular therapy is associated with significantly less morbidity, less mortality, compared with conventional microsurgical treatment for all intracranial aneurysms. Endovascular therapy, as a treatment alternative to microsurgical clipping, should be offered as a viable therapeutic option for all patients considering treatment of an intracranial aneurysm.

Laparoscopy-assisted Distal Gastrectomy with Systemic D2 Lymphadenectomy for Gastric Cancer: Usefulness of Noncompliance Rate to Validate the Completion of D2
Kyung Won Seo, Kae Won Park, Ki Young Yoon
Kosin Med J. 2013;28(1):27-33.   Published online January 19, 2013
DOI: https://doi.org/10.7180/kmj.2013.28.1.27
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Objectives

Laparoscopy-assisted distal gastrectomy (LADG) is a common surgical procedure that has recently been accepted as safe and feasible for the treatment of early gastric cancer. There have been many efforts to expand the indications of LADG to include the treatment of advanced gastric cancer. The aim of this study was to determine the usefulness of noncompliance rate as an indicator for D2 lymph node dissection (LND) validation in LADG.

Methods

The subjects were 48 patients who underwent distal gastrectomy with D2 LND at Kosin University Gospel Hospital from October to December 2010. Of them, 28 underwent LADG and 20 underwent open distal gastrectomy (ODG). We compared several factors including noncompliance rate to validate D2 LND.

Results

There were no significant differences in clinicopathologic factors except for BMI and tumor depth between the two groups. The average number of retrieved lymph nodes was significantly greater in the ODG group (45.9 ± 2.9) than in the LADG group (35.5 ± 2.0). The noncompliance rate was 43% in the LADG group and 40% in the ODG group with no significant difference.

Conclusions

In terms of no difference of noncompliance rate, LADG with D2 lymph node dissection is a safe, feasible and oncologicallycamparable with open gastrectomy. A large scaled prospective randomized trial should be needed to confirm the benefit of LADG.

The Association Between Serum GGT Level and Bone Mineral Density in Postmenopausal Women
Heung Yeol Kim, Eun Hee Kong
Kosin Med J. 2013;28(1):35-41.   Published online January 19, 2013
DOI: https://doi.org/10.7180/kmj.2013.28.1.35
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Objectives

The aim of this study was to identify the relationship between serum gamma-glutamyltransferase (GGT) and bone mineral density (BMD) in postmenopausal women.

Methods

We evaluated 200 postmenopausal women who were visiting a health promotion center at a university hospital from January 2009 to December 2011. Their current medical diseases and medication history were collected through medical records. Basic physical examinations and laboratory tests were performed on all subjects.

Results

The levels of serum GGT within their normal range were positively correlated with waist circumference (P = 0.01), triglycerides (P <0.001), alkaline phosphatase (P = 0.009), and uric acid (P = 0.01). The serum GGT within their normal range were negatively associated with the femur neck BMD (P = 0.002). In adjusted analysis including age and body mass index, the BMD of the femur neck was more strongly associated with a high-normal serum GGT level among the postmenopausal women as compared with those with a low-normal serum GGT level (P = 0.02).

Conclusions

Serum GGT within its normal range is negatively correlated with the BMD in the femur neck among postmenopausal women. It can be useful for selecting a group that is at high risk for the bone fracture regardless of the underlying mechanism.

Case reports
Extended Spectrum β-lactamase–producing E. coli-related Nosocomial Peritonitis Treated Successfully with Meropenem in a Patient on Peritoneal Dialysis
Seong Kyu Jeong, Yeong Hee Ham, Jin Hyuk Jo, Yeong Sin Sin, Dong Heo, Hark Rim
Kosin Med J. 2013;28(1):43-47.   Published online January 19, 2013
DOI: https://doi.org/10.7180/kmj.2013.28.1.43
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

Peritonitis is a common and potentially serious infection in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). The most common organisms usually associated with CAPD peritonitis are Staphylococcus aureus and Staphylococcus epidermidis. Rarely, aerobic gram negative bacilli have been the causative agents of CAPD peritonitis. The treatment of CAPD peritonitis requires removal of the peritoneal catheter and treatment with parenteral antibiotics active against the causative pathogen. While hospitalized for CAPD peritonitis, a 55-year-old man on CAPD had nosocomial peritonitis secondary to infection by ESBL–producing E. coli, that was sensitive to imipenem and meropenem. He was treated successfully with a 4-week course of intraperitoneal meropenem therapy without subsequent relapse, loss of peritoneal catheter, ultrafiltration failure, or dialysis inadequacy.

Two Cases of Increased Parasympathetic Nerve System in Irritable Bowel Syndrome with Diarrhea as a Predominant Symptom
Eui Kyu Kang, Jong Soon Choi
Kosin Med J. 2013;28(1):49-54.   Published online January 19, 2013
DOI: https://doi.org/10.7180/kmj.2013.28.1.49
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

The irritable bowel syndrome(IBS) is a chronic functional gastrointestinal disorder, characterized by abdominal pain, bloating and bowel disturbance. The pathophysiology of IBS is very complicated. Recent studies indicate that the most important mechanisms include visceral hypersensitivity, abnormal gut motility, autonomic nervous system(ANS) dysfunction and disorder of regulation of the brain-gut axis. Patients with IBS frequently present impaired autonomic regulation. Heart rate variability(HRV) is an acknowledged tool for estimating autonomic function. We experienced two cases of increased parasympathetic nervous system by HRV in irritable bowel syndrome with diarrhea as a predominant symptom

Treatment of Stent Dislodgement Complicated by Coronary Artery Dissection using Parallel Wire Technique and Small Balloon
Su Young Kim, Seung-Hee Han, Kyung Han Kim, Moo Hyun Kim, Jong Sung Park
Kosin Med J. 2013;28(1):55-60.   Published online January 19, 2013
DOI: https://doi.org/10.7180/kmj.2013.28.1.55
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

Stent dislodgement is a rare complication of complex percutaneous coronary artery intervention and is often associated with significant morbidity. We report a case of stent dislodgement complicated by coronary artery dissection and acute total occlusion of left circumflex coronary artery. Direct expansion of the dislodged stent was performed using parallel wire technique and small balloon. An overlapping stent was implanted for remained coronary artery dissection. Coronary artery flow was restored and ST segment elevation was normalized after successful intervention.

Giant Right Atrial Thrombus associated with Tunneled Cuffed Hemodialysis Catheter: A Case of Successful Treatment with Thrombolytic Agent and Anticoagulant
Young Jin Song, Young-Ki Lee, Sun Ryoung Choi, Ji-Hyun Kim, Sun Woo Kim, Jung-Woo Noh
Kosin Med J. 2013;28(1):61-65.   Published online January 19, 2013
DOI: https://doi.org/10.7180/kmj.2013.28.1.61
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

There are a variety of tunneled cuffed hemodialysis catheter-related complications including infection, thrombus formation, and catheter dysfunction. Catheter-related thrombus in right atrium is a rare complication and treatment guideline for atrial thrombus does not exist. A 3.0×2.8 cm sized giant atrial thrombus was found in a 35-year-old female hemodialysis patient. She was treated with catheter removal, thrombolysis and anticoagulation therapy. Size of atrial thrombus was gradually decreased and left ventricular systolic function was clearly improved after treatment. We experienced and reported a case of giant right atrial thrombus associated with tunneled cuffed hemodialysis catheter that was successful treated with thrombolytic agent and anticoagulant.


KMJ : Kosin Medical Journal