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Volume 30(1); June 2015
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Review articles
Medical treatment of functional dyspepsia
Sung Eun Kim
Kosin Med J. 2015;30(1):1-11.   Published online January 20, 2015
DOI: https://doi.org/10.7180/kmj.2015.30.1.1
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Abstract

Functional dyspepsia (FD) is a condition in which upper abdominal symptoms, such as epigastralgia, postprandial discomfort, and bloating, occur in the absence of any organic or metabolic disease that could explain the symptoms. The prevalence of FD is increasing, presumably because of an increasingly stressful environment, as well as overlap with other motility disorders such as gastroesophageal reflux diseases and irritable bowel syndrome. Numerous studies have attempted to determine the pathophysiological mechanisms of FD and establish effective FD treatment, with little success. Several therapeutic options have been explored, including Helicobacter pylori eradication, proton pump inhibitors, prokinetic agents, anti-depressant and anxiolytic agents, and acotiamide, a recent emerging drug. Through the many trials evaluating the efficacy of drugs for FD treatment, we found that it is necessary to treat according to the symptoms of FD and to use a combination of therapeutic options. Additional well-designed, prospective studies are needed to confirm the management of FD.

Uterine leiomyoma research
Tae Hee Kim, Hae Hyeog Lee
Kosin Med J. 2015;30(1):13-22.   Published online January 20, 2015
DOI: https://doi.org/10.7180/kmj.2015.30.1.13
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Abstract

Uterine leiomyoma is the most common type of benign tumor in women of reproductive age. This disease is rare before menarche, and its incidence decreases after menopause. Uterine leiomyoma is known to be related to hormonal changes, but the precise underlying mechanism has yet to be determined. Although it is a benign disease, the most common form of management involves surgical intervention. Uterine leiomyoma is also related to infertility and obstetric complications. Here, we present a review of the literature regarding uterine leiomyoma and discuss management of this disease.

Original articles
Percutaneous Cardiopulmonary Support Experience of a National University Hospital in Busan
Dong Hun Shin, Min Jin Lee, Hae Jung Na, Sun Mi Jang, Jun-Hyok Oh
Kosin Med J. 2015;30(1):23-28.   Published online January 20, 2015
DOI: https://doi.org/10.7180/kmj.2015.30.1.23
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Abstract Objectives

Cardiopulmonary support has been used to treat the patients with refractory cardiogenic shock since 1950s. In advent of portable system its use has been widened considerably. In this retrospective study, we report our single center experience concerning possible indications, complications and outcomes of percutanous cardiopulmonary support (PCPS)

Methods

From January 2013 to March 2014, we searched the patients who were supported by PCPS system by reviewing the medical records in cardiology department at our Hospital. Infectious organism was limited to what was identified within 2 weeks after weaning of PCPS.

Results

A total of 9 patients were supported by PCPS with CAPIOX CX® system (Terumo inc., Tokyo, Japan) initially for ST-segment elevation myocardial infarction/non ST-segment elevation myocardial infarction in 4 patients, myocarditis in 3 patients, valvular heart disease in 1 patient, and acute respiratory distress syndrome in 1 patient. The mean duration of PCPS support was 79.1±76.6 hours and 5 of them were recovered and discharged alive. All the patients needed transfusions of various forms of blood products. And there was one major stroke and one hyperbilirubinemia in related to PCPS treatment.

Conclusions

PCPS treatment was a valuable means to treat the patients with cardiovascular collapse, but not without costs. Efforts to reduce its associated complications should be made to improve outcomes.

Therapeutic comparison of Surgery combined with chemotherapy and chemotherapy alone for Primary Gastrointestinal Lymphoma: A single center study
Je Hun Kim, Ho Sup Lee, Jun Seop Lee, Jin Young Lee, Su Young Kim, Cheol Su Kim, Joung Wook Yang, Ga In You
Kosin Med J. 2015;30(1):29-39.   Published online January 20, 2015
DOI: https://doi.org/10.7180/kmj.2015.30.1.29
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Abstract Objectives

There is still no consensus on the optimal treatment for primary gastrointestinal lymphoma (PGIL). The aim of this study was to compare surgery combined with chemotherapy and chemotherapy alone in PGIL.

Methods

We retrospectively reviewed and analyzed the treatment outcomes of 107 patients with primary gastrointestinal lymphoma diagnosed between March 1999 and December 2009 at Kosin University Gospel Hospital. Patients were divided into two groups: 35 patients who underwent surgery combined with chemotherapy (group A) and 72 patients who were treated with chemotherapy alone (group B). And we analyzed prognostic factors associated with short survival.

Results

The 5-year progression free survival rates (PFS) of group A and B were 86.7% and 66.1%, respectively (P = 0.037), while the 5-year overall survival rates (OS) were 86.8% and 68.4%, respectively (P = 0.129). In multivariate analysis, Both PFS and OS were not changed by treatment strategies (surgery combined with chemotherapy or chemotherapy only). The international prognostic index (IPI) was the only independent predictive factor for PFS.

Conclusions

In our study, surgery combined with chemotherapy and chemotherapy only make no difference of survival rate. And further randomized prospective studies are needed to confirm a treatment strategies at improving survival outcomes in PGIL patients.

Effects of L-ascorbic acid on the production of pro-inflammatory and anti-inflammatory cytokines in C57BL/6 mouse splenocytes
Eun Hee Kong, Sun Young Ma, Jee Yeong Jeong, Kwang Hyuk Kim
Kosin Med J. 2015;30(1):41-49.   Published online January 20, 2015
DOI: https://doi.org/10.7180/kmj.2015.30.1.41
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Abstract Objective

The imbalance between pro-inflammatory and anti-inflammatory cytokines may underlie different pain states. Although ascorbic acid is the most important physiological antioxidant that affects host defense mechanisms and immune homeostasis, there is limited information on the effects of ascorbic acid on the production of cytokines.

Methods

In this study, we investigated the in vitro effect of L-ascorbic acid (AA) on the production of pro-inflammatory and anti-inflammatory cytokines by stimulating C57BL/6 mouse splenocytes with the polyclonal activators lipopolysaccharide or concanavalin A.

Results

AA significantly downregulated the expression of IL-6, IL-12, and TNF-α at 48 h and 72 h in mouse splenocytes treated with a combination of polyclonal activators and AA. AA treatment also resulted in upregulation of IL-4 and IL-10 at 72 h. These findings demonstrated that AA significantly potentiated production of anti-inflammatory cytokines whereas there was an inverse association between AA and expression of pro-inflammatory cytokines in mouse splenocytes.

Conclusion

AA may have potential applications in the reduction of inflammatory pain because of its function in modulating the production of cytokines. However, further in vivo investigations are necessary to elucidate the mechanisms involved.

Comparison of Social Nicotine Dependence Using the KTSND-K Questionnaire between patients with lung cancer and non-cancer people
Jin Young Lee, Chul Ho Oak, Tae Won Jang, Maan Hong Jung, Seong Jin Nam, Su Kyung Son, Ji Hyun Lee, Eun Joo Jo, Sang Joon Lee
Kosin Med J. 2015;30(1):51-58.   Published online January 20, 2015
DOI: https://doi.org/10.7180/kmj.2015.30.1.51
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Abstract Objectives

Smoking is one of the most important leading causes of lung cancer. Smoking habit is recognized as nicotine dependence, which consists of physical and psychosocial dependence. To evaluate social nicotine dependence, the Kano Test for Social Nicotine Dependence (KTSND) working group developed a new questionnaire. We examined the social nicotine dependence among high school students, university students and patients with lung cancer.

Method

We applied Korean version of KTSND(KTSND-K) questionnaire to high school students, university students and patients with lung cancer. Complete data obtained from the 1333 responders were analyzed.

Results

Among the responders, current smokers, past-smokers, and never-smokers were 17.3%, 16.4%, and 66.3% respectively. According to smoking status, the total KTSND-K scores of current smokers were significantly higher than those of past-smokers, and of never-smokers (17.7±6.6 versus 13.7±5.7, and 10.9±5.15, P<0.001). The total KTSND-K scores of males were higher than those of females, suggesting that males have a propensity for depending nicotine socially much more than females (13.2±6.2 and 11.7±5.7 respectively, P<0.05). And the total KTSND scores of the patients with lung cancer, medical students, nursing students, and high school students were 11.2±3.8, 14.9±4.8, 14.6±5.8 and 15.6±5.9 respectively. The scores of patients with lung cancer were significantly lower than non-cancer people(P<0.01). Our study suggested that the KTSND-K questionnaire could be a useful method to evaluate psychosocial aspects of smoking in patients with lung cancer and non-cancer people.

Factors Associated with Post Stroke Shoulder Subluxation
Jae Hyun Lee, Woo Hyun Jeon, Ho Joong Jeong, Ghi Chan Kim, Young Joo Sim
Kosin Med J. 2015;30(1):59-67.   Published online January 20, 2015
DOI: https://doi.org/10.7180/kmj.2015.30.1.59
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Abstract Objectives

Shoulder subluxation is common complication after stroke. And it can result in delayed neurological recovery in hemiplegic stroke patients. The aim of this study is identifying the incidence and associating factors of shoulder subluxation in stroke patients.

Methods

Stroke patients from 1 rehabilitation center from January 2008 to January 2012 were enrolled in the present study. The basic demographic data were registered at the time of admission or transfer to rehabilitation center. To assess the shoulder subluxation, we have used fingers'breadth method and plain radiography. We diagnosed shoulder subluxation with vertical distance (VD) were more than 12.4cm on plain anteroposteior view. And then shoulder subluxation was analyzed with associated factors.

Results

Of 154 stroke patients, this retrospective study included 109 patients who met the inclusion criteria, 28 patients had shoulder subluxation. After univariated analysis, shoulder subluxation was significantly associated with motor power of shoulder and elbow, loss of proprioception, stroke duration and functional ability. Especially elbow extensor less than poor grade is mostly related to shoulder subluxation among the motor powers. Then multivariated analysis was carried out including all significant subjects, elbow extensor less than poor grade, loss of proprioception and stroke duration more than 6 months were related to shoulder subluxation.

Conclusions

Post stroke shoulder subluxation was commonly observed, and the incidence was 25.6% in this study. Shoulder subluxation was correlated with muscle power of elbow(less than F grade), loss of proprioception and stroke duration more than 6 months

Case reports
A Case of Focal Segmental Glomerulosclerosis in Turner Syndrome
A Rum Han, Young Ki Lee, Hyun Yon Jung, Jae Hyun Park, Jung-Woo Noh, Eun Suk Nam
Kosin Med J. 2015;30(1):69-72.   Published online January 20, 2015
DOI: https://doi.org/10.7180/kmj.2015.30.1.69
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Abstract

Turner syndrome is usually accompanied with various anomalies. Congenital urological and renal abnormalities are often associated with this syndrome. The occurrence of glomerulonephritis is uncommon. An 18-year-old woman showed fatigue and profound proteinuria. She had been diagnosed with Turner syndrome in her age of 15. The kidney biopsy specimen examined by light microscopy, immunofluorescence and electron microscopic examination revealed focal segmental glomerulosclerosis. This is the first case report of focal segmental glomerulosclerosis in turner syndrome in South Korea.

Simultaneous Laparoscopy-Assisted Resection for Colorectal Cancer and Metastases
Seung Hyun Lee, Joong Jae Yoo, Sung Dal Park, Byung Kwon Ahn, Sung Uhn Baek
Kosin Med J. 2015;30(1):73-79.   Published online January 20, 2015
DOI: https://doi.org/10.7180/kmj.2015.30.1.73
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Abstract

With advancement of minimal invasive surgery, a simultaneous laparoscopy-assisted resection for colorectal cancer and metastasis has become feasible. Hence, we report three cases of simultaneous laparoscopic surgery for colorectal cancer with liver or lung metastasis. In the first case, laparoscopic right hemicolectomy and left lateral segmentectomy of liver was performed for ascending colon cancer and liver metastasis. In the second case, laparoscopic right hemicolectomy and wedge resection of right lower lung was performed for cecal cancer and lung metastasis. In the third case, laparoscopic right hemicolectomy and wedge resection of left lower lung was performed for ascending colon cancer and lung metastasis. In the first two cases, patients quickly returned to normal activity. In the third case, postoperative bleeding was observed, but spontaneously stopped. There was no postoperative mortality. Simultaneous laparoscopic surgery represents a feasible option for colorectal cancer with metastases on the other organs.

Tricuspid and pulmonary valve endocarditis associated with double-chambered right ventricle
Jin Cheol Myeong, Jung Yeon Chin, Jin Ho Choi, Young Min Rah, Jun Hyung Park
Kosin Med J. 2015;30(1):81-85.   Published online January 20, 2015
DOI: https://doi.org/10.7180/kmj.2015.30.1.81
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Abstract

We report a rare case of tricuspid valve and pulmonary valve endocarditis associated with a double-chambered right ventricle in an adult female with pulmonary artery aneurysm and septic pulmonary embolism by Streptococcus mitis. She was treated with aggressive antibiotic therapy followed by debridement of the infective lesion of tricuspid valve, pulmonary valve replacement using xenograft and resection of obstructing muscular bundles in right ventricle.

Peritoneal and gastric metastasis from invasive lobular breast carcinoma: a case report
Yoon Seok Kim, Eun Ae Jae, Dong Won Ryu, Chung Han Lee
Kosin Med J. 2015;30(1):87-92.   Published online January 20, 2015
DOI: https://doi.org/10.7180/kmj.2015.30.1.87
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Abstract

Peritoneal and gastrointestinal metastasis from breast cancer is very rare. We report here a rare case of metastatic peritoneal and gastric cancer from breast lobular carcinoma after modified radical mastectomy. A 65-year old woman presented with anorexia, nausea, vomiting and dyspepsia for several weeks at 44 months after surgery. Radiologic study showed peritoneal metastasis, and surgical histopathology reported peritoneal and omental metastatic carcinoma. Esophagogastroduodenoscopic (EGD) biopsy also confirmed metastatic carcinoma originated from breast primary.


KMJ : Kosin Medical Journal