Kosin Medical Journal

From articles published since 2022.

Review articles

Ethical issues in clinical research and publication: Hyoung Shin Lee; Kosin Med J. 2022;37(4):278-282. Published online December 15, 2022; DOI: https://doi.org/10.7180/kmj.22.132

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Clinical research including human participants should be based on truth, demonstrate scientific integrity, and follow ethical standards and guidelines to protect study participants. The publication of clinical research should be transparent and adhere to strict criteria for authorship. A thorough understanding and knowledge of ethical issues will limit investigator misconduct in clinical research and publication. In this article, basic ethical issues in clinical research and publication are reviewed and summarized based on recent guidelines.

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Squamous cell carcinoma of the pancreas with a pancreatic intraductal papillary mucinous neoplasm: a case report
Nam Kyung Lee
Kosin Medical Journal.2024; 39(1): 71. CrossRef
Clinical efficacy and safety of autologous serum intramuscular injection in patients with mild-to-moderate atopic dermatitis: a prospective, open-label, uncontrolled study
Gil-Soon Choi, Jong Bin Park, Young-Ho Kim, Hee-Kyoo Kim
Kosin Medical Journal.2024; 39(1): 51. CrossRef
Surgical management of giant adrenal myelolipoma using a modified Makuuchi incision: a case report
Byeong Jin Kang, Seung Hyeon Kim, Kyoungha Jang, Kyung Hwan Kim, Hong Koo Ha
Kosin Medical Journal.2024; 39(1): 75. CrossRef
Evaluating the Potential of Immersive Virtual Reality-Based Serious Games Interventions for Autism: A Pocket Guide Evaluation Framework
Sara Peretti, Maria Chiara Pino, Federica Caruso, Tania Di Mascio
Education Sciences.2024; 14(4): 377. CrossRef
Informed Consent in Clinical Studies in the Republic of Srpska
Snežana Pantović, Dijana Zrnić
Review of European and Comparative Law.2024;[Epub] CrossRef
Antifungal susceptibility and speciation of Candida isolated from blood at a tertiary care centre
Jagruti Prajapati, Arpita Shah, Hemali Parmar, Bithika Duttaroy
International Journal of Medicine and Medical Research.2024; 10(1): 32. CrossRef
Clinical outcomes of prostate artery embolization for management of benign prostate hyperplasia (prostate larger than 100 mL) with or without hematuria
Soodong Kim
Kosin Medical Journal.2023; 38(4): 259. CrossRef
Basic knowledge of endoscopic retrograde cholangiopancreatography
Jung Wook Lee
Kosin Medical Journal.2023; 38(4): 241. CrossRef

Considerations for experimental animal ethics in the research planning and evaluation process: Jaewon Shim, Jeongtae Kim; Kosin Med J. 2022;37(4):271-277. Published online December 22, 2022; DOI: https://doi.org/10.7180/kmj.22.139

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Research using experimental animals has substantially contributed to advances in science and medicine. Animal experiments are nearly essential for biomedical research and development efforts. Because many animals are sacrificed, researchers should consider the welfare of experimental animals and related ethical issues, along with the successful results of their experiments. This review introduces the criteria that should be considered in terms of experimental animal ethics, based on the principles of the 3 R’s: replacement, representing careful consideration of the need for animal experiments; reduction, representing the use of the minimal number of animals to obtain meaningful experimental results; and refinement, representing continuous effects to find alternative methods to reduce pain and distress in experimental animals. Based on these principles, the following points should be considered when planning experiments: the necessity of animal experiments; alternatives to animal experiments; the relevance of the species and numbers of experimental animals; appropriate assessment and management of pain; the proper usage of sedatives, painkillers, and anesthesia; and valid timing for humane endpoints and euthanasia. These criteria are beneficial for both experimental animals and researchers because careful handling to ensure experimental animal welfare guarantees that scientific research will yield convincing, repeatable, and accurate results.

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Functional Analysis of Membrane-Associated Scaffolding Tight Junction (TJ) Proteins in Tumorigenic Characteristics of B16-F10 Mouse Melanoma Cells
Eun-Ji Ko, Do-Ye Kim, Min-Hye Kim, Hyojin An, Jeongtae Kim, Jee-Yeong Jeong, Kyoung Seob Song, Hee-Jae Cha
International Journal of Molecular Sciences.2024; 25(2): 833. CrossRef
General Principles, Designs, and Statistical Analyses in Experimental Animal Studies
Şengül Cangür
Düzce Tıp Fakültesi Dergisi.2024; 26(S1): 14. CrossRef
Applications and advancements in animal models for antiviral research on mosquito‐borne arboviruses
Megan Caifeng Tang, Ka Heng Wong, Adzzie Shazleen Azman, Rafidah Lani
Animal Models and Experimental Medicine.2024;[Epub] CrossRef

Prevention of myopia progression using orthokeratology: Stephanie Suzanne S. Garcia, Changzoo Kim; Kosin Med J. 2023;38(4):231-240. Published online December 26, 2023; DOI: https://doi.org/10.7180/kmj.23.141

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Abstract PDF PubReader ePub: The prevalence of myopia in children and juveniles has increased significantly in Korea and worldwide; in particular, the rates of myopia and high myopia in East Asia have grown rapidly. Myopia is easily corrected with spectacles or contact lenses. However, as children grow and mature, myopia can progress irreversibly and lead to vision-threatening complications. Thus, the prevention of myopia progression is an essential treatment goal. Many treatment strategies are being employed, including atropine eyedrops, specialized glasses, and orthokeratology (Ortho-K) lenses. Ortho-K is an effective treatment in managing myopia progression by lowering the rate of increase in refractive error and axial length. In this article, we review Ortho-K as a treatment for myopia progression, its history, mechanism, treatment regimen, and safety profile.

Role of biomarkers in the heart failure clinic: Bong-Joon Kim, Jae-Hyeong Park; Kosin Med J. 2022;37(1):4-17. Published online March 29, 2022; DOI: https://doi.org/10.7180/kmj.22.019

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Abstract PDF PubReader ePub: Heart failure (HF) is a common cardiovascular disease that has a complex pathophysiology. Because it is the final stage of many cardiovascular diseases, proper diagnosis and treatment are crucial for prolonging patients’ survival and improving their well-being. Several biomarkers have been identified in HF, and their roles in diagnosis and prognostication have been widely investigated. Among them, natriuretic peptides are key for diagnosing HF, predicting its prognosis, and monitoring the effectiveness of HF treatment. Moreover, natriuretic peptides can also be used to treat HF. In addition to natriuretic peptides, several other biomarkers were included in the most recent HF management guidelines. Thus, we reviewed the role of the biomarkers included in these guidelines and discussed future perspectives.

Bone-modifying agents for bone metastasis in patients with breast cancer: Lee Chun Park, Eun Mi Lee; Kosin Med J. 2024;39(2):83-88. Published online June 28, 2024; DOI: https://doi.org/10.7180/kmj.24.121

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Abstract PDF PubReader ePub: The bone is the most common location of breast cancer metastasis. Bone metastasis causes pain and skeletal-related events (SREs), and affects the quality of life and survival of breast cancer patients. Bone-modifying agents, including bisphosphonates and denosumab, reduce the risk of SREs in these patients. Among bisphosphonates, zoledronic acid is preferred due to its higher efficacy. Denosumab is marginally more effective than zoledronic acid in reducing the frequency of SREs. Patients with renal impairment should receive zoledronic acid with caution due to nephrotoxicity, and denosumab is an alternative option in these patients. Osteonecrosis of the jaw is a rare but severe complication of both zoledronic acid and denosumab, and all patients should undergo dental examinations before and during treatment. Although these drugs can reduce the risk of SREs in bone metastasis, no significant improvement in survival has been noted. This study reviews the effects and adverse events of bone-modifying agents for the treatment of bone metastasis from breast cancer.

Polycystic liver disease: an overview of clinical manifestations, diagnosis, and treatment: Joonho Jeong, Hyun Joon Park; Kosin Med J. 2023;38(2):75-86. Published online June 28, 2023; DOI: https://doi.org/10.7180/kmj.23.128

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Polycystic liver disease (PLD) is a hereditary disease characterized by the presence of 20 or more liver cysts. It is classified into three types: isolated autosomal dominant PLD, PLD with autosomal dominant polycystic kidney disease, and PLD with autosomal recessive polycystic kidney disease. Genetic alterations, ciliary dysfunction of the biliary epithelial cells, and aberrant cell signaling pathways are the main factors contributing to the pathophysiology of PLD; however, other complicated mechanisms are also involved. The Gigot and Schnelldorfer classifications are widely used in clinical practice. Most patients with PLD are asymptomatic; however, a few patients with advanced-stage disease may develop symptoms and complications that impair their quality of life and require treatment. The known treatment options for PLD are somatostatin analogues, aspiration with sclerotherapy, fenestration, hepatic resection, and liver transplantation. Although liver transplantation remains the only curative treatment for PLD, medical therapies are gradually being developed with the increasing knowledge of the disease’s pathophysiology. This review focuses on the clinical manifestations and diagnosis of PLD, as well as treatment strategies, to support clinicians regarding the clinical management of the disease.

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Predicting Safe Liver Resection Volume for Major Hepatectomy Using Artificial Intelligence
Chol Min Kang, Hyung June Ku, Hyung Hwan Moon, Seong-Eun Kim, Ji Hoon Jo, Young Il Choi, Dong Hoon Shin
Journal of Clinical Medicine.2024; 13(2): 381. CrossRef

Surgical management of recurrent laryngeal nerve invasion by papillary thyroid carcinoma: Jae Hong Park, Hyoung Shin Lee; Kosin Med J. 2024;39(2):94-98. Published online June 18, 2024; DOI: https://doi.org/10.7180/kmj.24.117

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Abstract PDF PubReader ePub: Preservation of the recurrent laryngeal nerve (RLN) is a priority for surgeons during thyroidectomy in patients with papillary thyroid cancer (PTC). RLN invasion by PTC in a patient presenting with preoperative vocal fold paralysis may require resection of the nerve with the tumor. However, the decision should be made regarding whether to preserve or sacrifice a functioning RLN invaded by PTC. Under certain conditions, preservation of the nerve with incomplete tumor resection could be considered. An RLN that has been resected due to PTC invasion may be managed by various reinnervation techniques to improve vocal outcomes. This article reviews clinical considerations and rationales for surgical decisions related to patients with PTC invasion of the RLN.

Original articles

Clinical features of coronavirus disease 2019 in Korean pediatric patients: a single-center retrospective study: Ji Eun Jeong, Hai Lee Chung, Young Hwan Kim, Nawon Lee, Younghyun Kim, Yoon Young Jang; Kosin Med J. 2024;39(2):99-111. Published online June 10, 2024; DOI: https://doi.org/10.7180/kmj.24.106

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Background
To address the public’s fear of coronavirus disease 2019 (COVID-19), understanding the clinical features of the disease is essential. However, research on the clinical features of COVID-19, including illness duration and post-acute COVID-19, in Korean pediatric patients has been limited. Therefore, this study investigated the clinical features of COVID-19 based on the medical records of pediatric patients with a history of COVID-19 who visited a single center.
Methods
In total, 311 patients were included in this study. The presence and duration of 19 symptoms were examined. Additionally, clinical features were investigated by dividing the patients into different age ranges. Patients aged 6 and above were further categorized according to the presence of asthma, while adolescent patients were divided into vaccinated and unvaccinated groups.
Results
Fever and cough were the most common symptoms. The mean illness duration was 2–4 days. Only 3.5% of the patients were asymptomatic. Post-acute COVID-19 was observed in 13.2% of the patients. The incidence of most symptoms tended to increase with age. Post-acute COVID-19 was observed more frequently in patients with asthma than in those without asthma. Vaccinated patients experienced less fever, vomiting, and fatigue than unvaccinated patients.
Conclusions
Our data suggest that most patients had mild disease lasting less than a week, and the clinical course may differ depending on the presence of asthma. The findings also indicate that vaccination may alleviate the symptoms of COVID-19 in breakthrough infections.

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Coronavirus disease 2019 infection in pediatric patients in Korea: insights and implications
Yu Jin Jung
Kosin Medical Journal.2024; 39(2): 81. CrossRef

Orbital complications of acute rhinosinusitis in adults: a 21-year experience: Yung Jin Jeon, Woohyen Jin, Yeon-Hee Joo, Hyun-Jin Cho, Sang-Wook Kim; Kosin Med J. 2024;39(2):120-126. Published online June 4, 2024; DOI: https://doi.org/10.7180/kmj.24.111

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Abstract PDF PubReader ePub: Background
Orbital complications arising from acute rhinosinusitis (ARS) are a major concern for clinicians and serve as important warning indicators of ARS. Prompt recognition and appropriate management are crucial for preventing potential vision-threatening sequelae. Orbital complications of rhinosinusitis are markedly more common in children than in adults. The aim of this study was to investigate the clinical characteristics and treatment outcomes of orbital complications of ARS in adult patients.
Methods
This retrospective observational cohort study analyzed the medical records of 176 patients admitted for orbital cellulitis/abscess (ICD code: H050) who underwent orbit or paranasal computed tomography from January 2001 to February 2022 at a tertiary hospital.
Results
Eighteen adults with a mean age of 53.2±18.9 years were diagnosed with orbital complications due to ARS: five (27.8%) had preseptal cellulitis, eight (44.4%) had orbital cellulitis, and five (27.8%) had subperiosteal orbital abscess. None of the patients had an orbital abscess or cavernous sinus thrombosis. All patients had unilateral orbital complications (7 right and 11 left) and were managed with intravenous antibiotics for an average of 10.3±6.6 days. Five patients with subperiosteal orbital abscesses underwent intranasal endoscopic drainage at an average of 1.4±1.9 days after admission, while two patients required additional external drainage. Complete recovery was observed in all patients.
Conclusions
Conservative antimicrobial therapy can be effective for treating orbital complications from ARS, and not all adult patients require immediate surgical intervention for subperiosteal abscesses. Nonetheless, careful monitoring is essential, and an ophthalmologist must check patients’ visual acuity to prevent irreversible blindness.

Review articles

Treatment of pediatric obstructive sleep apnea: Tae Kyung Koh, Jooyeon Kim; Kosin Med J. 2024;39(2):89-93. Published online June 21, 2024; DOI: https://doi.org/10.7180/kmj.24.120

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Abstract PDF PubReader ePub: In the majority of cases, pediatric obstructive sleep apnea (OSA) is associated with adenotonsillar hypertrophy. Therefore, adenotonsillectomy is typically considered as the first line of treatment. However, the severity of pediatric OSA is not always directly correlated with the size of the adenoids and tonsils. Other factors, such as upper airway anatomy or obesity, may interact in a multifactorial manner to contribute to its occurrence. For these reasons, sleep apnea in obese children may resemble the condition in adults. Furthermore, in these cases, if adenotonsillar hypertrophy is present, adenotonsillectomy is likely to be prioritized. Reevaluation should be conducted 6 to 8 weeks post-surgery, and additional treatment for residual sleep apnea should be performed thereafter when necessary.

Mucinous carcinoma of the breast: distinctive histopathologic and genetic characteristics: Minjung Jung; Kosin Med J. 2022;37(3):176-186. Published online August 25, 2022; DOI: https://doi.org/10.7180/kmj.22.022

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Mucinous carcinoma is a rare histologic type of breast cancer that, when classified with favorable histology, can be treated with different therapeutic options. This study reviews the histologic findings of mucinous carcinoma that support or exclude favorable histology and emphasizes the necessity of an appropriate gross examination with radiologic findings for an accurate diagnosis. In addition, unusual findings such as micropapillary arrangements and lobular differentiation in mucinous carcinoma and their implications for prognosis and treatment are reviewed. Mucinous carcinoma involves upregulation of MUC2, a mucus-associated gene common in mucinous carcinoma of the breast as well as various other organs. In mucinous carcinoma, the fraction of genome altered and tumor mutation burden are lower than those of invasive carcinoma of no special type, the most common histology of breast cancer. In addition, the genetic alterations found in mucinous carcinoma are diverse, unlike the pathognomonic genetic alterations observed in other histologic types of breast cancer. These genetic features support the importance of conventional microscopic evaluations for the pathologic differential diagnosis of mucinous carcinoma of the breast in routine practice. A variety of breast lesions, including mucinous cystadenocarcinoma and mucocele-like lesions, as well as mucinous carcinoma from other organs, can mimic mucinous carcinoma of the breast. In order to obtain an accurate pathologic diagnosis, careful evaluation of the overall histopathologic characteristics and ancillary testing are required to provide information on appropriate treatment and prognosis.

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Mucinous Carcinoma of the Breast With Neuroendocrine Differentiation: A Case Report of Cyto-Histopathology Findings
Anita B Sajjanar, Suhit Naseri, Pratibha Dawande, Sunita Vagha
Cureus.2024;[Epub] CrossRef

Original article

Troponin I and D-dimer levels as triaging biomarkers to distinguish acute pulmonary thromboembolism from myocardial infarction: Soo-Jin Kim, Moo Hyun Kim, Kwang Min Lee, Jin Woo Lee, Young Shin Cha, Da Eun Koh, Joo Yeong Hwang, Jong Sung Park; Kosin Med J. 2023;38(4):252-258. Published online December 20, 2023; DOI: https://doi.org/10.7180/kmj.23.133

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Background
Acute pulmonary thromboembolism (APTE) is often confused with myocardial infarction. Previous studies have shown that patients with APTE exhibit lower initial and peak cardiac troponin I (CTI) levels, but higher D-dimer (DD) levels, than patients with myocardial infarction. The present study aimed to reaffirm the tree model algorithm using an entirely new set of data.
Methods
We reviewed retrospective clinical and laboratory data from patients who were diagnosed with APTE or non-ST-elevation myocardial infarction (NSTEMI) between 2015 and 2016. Subjects who were not classified with a diagnosis or did not have their CTI or DD levels assessed were excluded. We categorized patients according to the previous algorithm and compared the outcomes with the previous test dataset.
Results
The analysis involved data from 156 patients with APTE and 363 patients with NSTEMI. In the validation data set, the APTE group showed higher initial DD levels (9.80±10.84 μg/mL) and lower initial CTI levels (0.17±0.54 μg/mL) than the NSTEMI group. The accuracy rate for the test dataset and the validation set were similar. The test set accuracy rate was 91.0%, while the accuracy rate in the validation set improved to 88.6%.
Conclusions
Patients with APTE exhibited lower initial and peak CTI levels, but higher DD levels than NSTEMI patients. The accuracy rate estimates were similar between the test set obtained from the tree model algorithm and the validation set. The study findings demonstrate that the assessment of cardiac biomarkers can be useful for differentiating between APTE and NSTEMI.

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The old biomarkers you know are still useful: D-dimer and troponin I
Sanghyun Lee
Kosin Medical Journal.2023; 38(4): 229. CrossRef

Review articles

How to write an original article in medicine and medical science: Gwansuk Kang, Sung Eun Kim; Kosin Med J. 2022;37(2):96-101. Published online June 24, 2022; DOI: https://doi.org/10.7180/kmj.22.105

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Excellent research in the fields of medicine and medical science can advance the field and contribute to human health improvement. In this aspect, research is important. However, if researchers do not publish their research, their efforts cannot benefit anyone. To make a difference, researchers must disseminate their results and communicate their opinions. One way to do this is by publishing their research. Therefore, academic writing is an essential skill for researchers. However, preparing a manuscript is not an easy task, and it is difficult to write well. Following a structure may be helpful for researchers. For example, the standard structure of medical and medical science articles includes the following sections: introduction, methods, results, and discussion (IMRAD). The purpose of this review is to present an introduction for researchers, especially novices, on how to write an original article in the field of medicine and medical science. Therefore, we discuss how to prepare and write a research manuscript for publication, using the IMRAD structure. We also included specific tips for writing manuscripts in medicine and medical science.

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Predicting Safe Liver Resection Volume for Major Hepatectomy Using Artificial Intelligence
Chol Min Kang, Hyung June Ku, Hyung Hwan Moon, Seong-Eun Kim, Ji Hoon Jo, Young Il Choi, Dong Hoon Shin
Journal of Clinical Medicine.2024; 13(2): 381. CrossRef
Changes in parents’ health concerns by post-preterm birth period in South Korea: a cross-sectional study
Yu Jin Jung, Hun Ha Cho
Child Health Nursing Research.2024; 30(2): 118. CrossRef
Troponin I and D-dimer levels as triaging biomarkers to distinguish acute pulmonary thromboembolism from myocardial infarction
Soo-Jin Kim, Moo Hyun Kim, Kwang Min Lee, Jin Woo Lee, Young Shin Cha, Da Eun Koh, Joo Yeong Hwang, Jong Sung Park
Kosin Medical Journal.2023; 38(4): 252. CrossRef
Prevention of myopia progression using orthokeratology
Stephanie Suzanne S. Garcia, Changzoo Kim
Kosin Medical Journal.2023; 38(4): 231. CrossRef
Basic knowledge of endoscopic retrograde cholangiopancreatography
Jung Wook Lee
Kosin Medical Journal.2023; 38(4): 241. CrossRef
How does quiz activity affect summative assessment outcomes? An analysis of three consecutive years’ data on self-directed learning
Chi Eun Oh, Hyunyong Hwang
Kosin Medical Journal.2022; 37(3): 228. CrossRef
The effects of rebamipide, sucralfate, and rifaximin against inflammation and apoptosis in radiation-induced murine intestinal injury
Won Moon, Sangwook Lim, Yeonsoon Jung, Yuk Moon Heo, Seun Ja Park, Moo In Park, Sung Eun Kim, Jae Hyun Kim, Kyoungwon Jung
Kosin Medical Journal.2022; 37(4): 320. CrossRef

Safety issues regarding melatonin use in child and adolescent patients with sleep problems: Eunsoo Moon, Jung Hyun Lee; Kosin Med J. 2022;37(4):264-270. Published online December 23, 2022; DOI: https://doi.org/10.7180/kmj.22.142

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Abstract PDF PubReader ePub: Several studies have reported that melatonin may be effective in treating sleep problems in children and adolescents. However, evidence regarding the safety of melatonin use in children and adolescents in their growth and developmental stages is warranted. Therefore, we aimed to summarize the literature on the safety of melatonin use in children and adolescents with insomnia and sleep disturbances. According to existing evidence, there are no serious adverse effects of long-term melatonin use in children and adolescents. The common adverse effects reported in long-term studies are fatigue, somnolence, and mood swings. In addition, there is no evidence that long-term use of melatonin inhibits the natural secretion of melatonin. It is necessary to monitor potential drug interactions with medications such as inhibitors and enhancers of cytochrome P450 1A2 (CYP1A2). Furthermore, low CYP1A2 expression in young children requires proper dose adjustment. Although sufficient experience of melatonin use in children and adolescents has yet to be attained, accumulating evidence suggests that the use of melatonin in children and adolescents with sleep problems might be effective and tolerable. Considering the abuse or overdose risk of hypnotics or benzodiazepines, melatonin supplements may be a good therapeutic alternative. Future studies on the long-term safety of melatonin for physiological and mental function in children and adolescents are required to establish certainty about melatonin use in children and adolescents.

Faculty development: the need to ensure educational excellence and health care quality: Hyekyung Shin, Min-Jeong Kim; Kosin Med J. 2023;38(1):4-11. Published online March 27, 2023; DOI: https://doi.org/10.7180/kmj.23.109

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The definition of faculty development has been refined and expanded over the past few decades, and various definitions have been used in higher education. Initially, faculty development was defined as activities that help teachers improve teaching skills, design better curricula, and improve the organizational environment for education. Since then, as the focus of faculty development has shifted from individual professors to institutional needs, faculty development is now defined as the personal and professional development of professors, clinicians, researchers, and managers to meet institutional goals, visions, and missions in social terms and moral responsibility to the community. Faculty development in medical education is universally needed to recognize and cope with widespread changes in education, including the traditional role of professors, advances in pedagogical theory, changes in learning styles, innovative curriculum models, and evaluation philosophy. However, critics have pointed out that most universities could not actively implement faculty development or accept professors’ various demands. In this paper, various reports related to faculty development are reviewed to summarize how faculty development has progressed and present future directions for accepting various opinions to improve educational excellence and the quality of health care.

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Needs and gaps of faculty development for medical schools
Ji Hyun Im, Wha Sun Kang, Seung Hee Lee, Dae Chul Jeong, Dae Hyun Kim, Man-Sup Lim, Miran Kim, Ji-Hyun Seo, Dong Hyeon Lee
Korean Journal of Medical Education.2024; 36(2): 189. CrossRef

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