Kosin Medical Journal

Volume 39(3); September 2024

Editorial

Exploring the impact of capsule endoscopy in Kazakhstan: a significant milestone: Jong Yoon Lee; Kosin Med J. 2024;39(3):151-152. Published online September 9, 2024; DOI: https://doi.org/10.7180/kmj.24.134

178 View
6 Download

PDF PubReader ePub

Review articles

Oncoplastic breast-conserving surgery: evolution, techniques, and the emerging role of acellular dermal matrix: Jun Ho Choi, Yoonsoo Kim; Kosin Med J. 2024;39(3):153-159. Published online September 26, 2024; DOI: https://doi.org/10.7180/kmj.24.129

152 View
5 Download

Abstract PDF PubReader ePub: Oncoplastic breast-conserving surgery (OBCS) has revolutionized breast cancer treatment, aiming to achieve optimal oncological outcomes while preserving an aesthetically favorable appearance. This review explores the evolution, techniques, and outcomes of OBCS, with a particular focus on the emerging role of acellular dermal matrix in volume replacement techniques. We conducted a comprehensive literature review using PubMed, Medline, and Cochrane databases, focusing on studies published between 2010 and 2024. OBCS demonstrates comparable oncological safety to traditional breast-conserving surgery, with local recurrence rates ranging from 2.7% to 5.7% at 5 years. Patient satisfaction rates are consistently high, with 85% to 95% reporting good to excellent aesthetic outcomes. Volume replacement techniques using acellular dermal matrix show promising results, with one study reporting that 94% of patients were highly satisfied with cosmetic outcomes. Although the current results are encouraging, future advancements in OBCS may require innovative approaches, including the integration of robotic surgery and artificial intelligence technologies.

Current understanding of modulated electro-hyperthermia in cancer treatment: Sungmin Kim, Jesang Yu, Jihun Kang, Yunkyung Kim, Taek Yong Ko; Kosin Med J. 2024;39(3):160-168. Published online September 23, 2024; DOI: https://doi.org/10.7180/kmj.24.127

162 View
5 Download

Abstract PDF PubReader ePub: Traditional hyperthermia involves increasing the temperature at the tumor site to above 39 ℃, inducing death in cancer cells. Although hyperthermia is an effective cancer treatment, its clinical application has decreased due to potential complications, including damage to surrounding normal tissue. In recent years, modulated electro-hyperthermia (mEHT) has emerged as an effective and safe treatment modality. mEHT selectively heats tumor cells to 42–43 °C, while reducing the average temperature in the treatment area, including the surrounding normal tissue, compared to conventional methods. Additionally, mEHT may be used in combination with systemic chemotherapy and radiation therapy in tumor treatment, providing a synergistic effect to increase efficacy. As chemotherapy and radiation therapy technologies advance, the application of combined mEHT may improve clinical outcomes. In this study, we review and discuss reports on the clinical outcomes of mEHT combined with chemotherapy and/or radiation therapy, which are established anticancer treatments.

Fat embolism syndrome: a review in cosmetic surgery: Hongil Kim, Bommie Florence Seo, Gregory Randolph Dean Evans; Kosin Med J. 2024;39(3):169-178. Published online September 25, 2024; DOI: https://doi.org/10.7180/kmj.24.126

183 View
7 Download

Abstract PDF PubReader ePub: The growing popularity of cosmetic procedures such as liposuction and fat grafting has been accompanied by a rise in associated side effects. Among these, fat embolism syndrome stands out as a potential complication that sometimes has critical consequences. It is important to recognize that fat embolism affects organs through distinct mechanisms from those involved with other types of embolisms. Early diagnosis is crucial. Unfortunately, no effective treatments have been established for this condition. Therefore, starting with a more detailed categorization of diagnoses, developing new treatment methods for each subtype is essential.

Original articles

Capsule endoscopy in Kazakhstan: a multicenter clinical experience: Sang Jun Sohn, Kanat Batyrbekov, Ainura Galiakbarova, Laura Yerdaliyeva, Jamilya Kaibullayeva, Jeongwoo Ju, Haejin Lee, Yeoun Joo Lee; Kosin Med J. 2024;39(3):179-185. Published online July 26, 2024; DOI: https://doi.org/10.7180/kmj.24.116

345 View
17 Download
1 Citations

Abstract PDF PubReader ePub

Background
By analyzing small bowel capsule endoscopy (SBCE) performed in two large hospitals in Kazakhstan, we aimed to explore the characteristics of patients representative of Central Asia and the technical characteristics of SBCE.
Methods
SBCE cases were retrospectively analyzed. A descriptive analysis was conducted on the patients’ demographic data, diagnosis, and clinical symptoms. The results of SBCE, such as the lesions found, transit time and retention rate in the stomach and small bowel, and bowel visualization quality, were analyzed. Complications related to SBCE were investigated.
Results
SBCE was performed in 123 patients. Abdominal pain (81.3%) and chronic diarrhea (66.7%) were the most common symptoms, followed by weight loss (25.2%) and gastrointestinal bleeding (15.4%). The most common disease was Crohn’s disease (52.0%). Definite lesions, such as ulcers, polyps, and bleeding, were identified in 55.3% of patients. SBCE was successfully completed in all cases except for 11 (9.1%). The average small bowel transit time was 4 hours and 28 minutes. Excellent visualization (>75% of mucosa) was reported in 82.5% of patients. No patients experienced complications.
Conclusions
SBCE performed in Kazakhstan showed a high diagnostic yield with high-quality patient selection and no complications.

Citations

Citations to this article as recorded by

Exploring the impact of capsule endoscopy in Kazakhstan: a significant milestone
Jong Yoon Lee
Kosin Medical Journal.2024; 39(3): 151. CrossRef

Preliminary data on computed tomography-based radiomics for predicting programmed death ligand 1 expression in urothelial carcinoma: Chang Mu Lee, Seung Baek Hong, Nam Kyung Lee, Hong Koo Ha, Kyung Hwan Kim, Byeong Jin Kang, Suk Kim, Ja Yoon Ku; Kosin Med J. 2024;39(3):186-194. Published online July 18, 2024; DOI: https://doi.org/10.7180/kmj.24.103

682 View
7 Download

Abstract PDF Supplementary Material PubReader ePub: Background
Programmed death ligand 1 (PD-L1) expression cannot currently be predicted through radiological findings. This study aimed to develop a prediction model capable of differentiating between positive and negative PD-L1 expression through a radiomics-based investigation of computed tomography (CT) images in patients with urothelial carcinoma.
Methods
Sixty-four patients with urothelial carcinoma who underwent immunohistochemical testing for PD-L1 were retrospectively reviewed. The number of patients in the positive and negative PD-L1 groups (PD-L1 expression >5%) was 14 and 50, respectively. CT images obtained 90 seconds after contrast medium administration were selected for radiomic extraction. For all tumors, 1,691 radiomic features were extracted from CT using a manually segmented three-dimensional volume of interest. Univariate and multivariate logistic regression analyses were performed to identify radiomic features that were significant predictors of PD-L1 expression. For the radiomics-based model, a receiver operating characteristic (ROC) analysis was performed.
Results
Among 64 patients, 14 were included in the PD-L1 positive group. Logistic regression analysis found that the following radiomic features significantly predicted PD-L1 expression: wavelet-low-pass, low-pass, and high-pass filters (LLH)_gray-level size-zone matrix (GLSZM)_SmallAreaEmphasis, wavelet-LLH_firstorder_Energy, log-sigma-0-5-mm-3D_GLSZM_SmallAreaHighGrayLevelEmphasis, original_shape_Maximum2DDiameterColumn, wavelet-low-pass, low-pass, and low-pass filters (LLL)_gray-level run-length matrix (GLRLM)_ShortRunEmphasis, and exponential_firstorder_Kurtosis. The radiomics signature was –4.0934+21.6224 (wavelet-LLH_GLSZM_SmallAreaEmphasis)+0.0044 (wavelet-LLH_firstorder_Energy)–4.7389 (log-sigma-0-5-mm-3D_GLSZM_SmallAreaHighGrayLevelEmphasis)+0.0573 (original_shape_Maximum2DDiameterColumn)–29.5892 (wavelet-LLL_GLRLM_ShortRunEmphasis)–0.4324 (exponential_firstorder_Kurtosis). The area under the ROC curve model representing the radiomics signature for differentiating cases that were deemed PD-L1 positive based on immunohistochemistry was 0.96.
Conclusions
This preliminary radiomics model derived from contrast-enhanced CT predicted PD-L1 positivity in patients with urothelial cancer.

Satellite cell distribution in the medial rectus muscle in cadavers: Chang Zoo Kim, Sang Joon Lee; Kosin Med J. 2024;39(3):195-200. Published online September 10, 2024; DOI: https://doi.org/10.7180/kmj.24.124

139 View
3 Download

Abstract PDF PubReader ePub: Background
This study aimed to elucidate the potential usefulness of the medial rectus muscle of cadavers for research on satellite cells.
Methods
Twenty-four medial rectus muscles were obtained from 12 cadavers. The control group included six medial rectus muscles from three live adults without brain activity. The muscle fiber diameter and distribution of satellite cells were measured and compared. Immunohistochemistry for myosin heavy chain and the transcription factor PAX7 was performed, and the distributions of myocytes and satellite cells were evaluated.
Results
The average muscle fiber diameter was 142.18±36.49 μm in the cadaver group and 149.34±15.26 μm in the control group, and there was no significant difference between the two groups (p=0.38). The ratio of PAX7(+) cells to the number of muscle fibers was 0.056±0.015 in the control group and 0.006±0.006 in the cadaver group, reflecting a significant difference (p<0.05).
Conclusions
The medial rectus muscles of cadavers can be helpful in studying anatomical morphology; however, their usefulness in muscle satellite cell research appears to be limited.

Case reports

Remimazolam in pediatric surgery under general anesthesia: a case series: Hong-Sik Shon, Seyeon Park, Jung-Pil Yoon, Yeong Min Yoo, Jimin Lee, Da Eun Lee, Hee Young Kim; Kosin Med J. 2024;39(3):201-206. Published online May 9, 2024; DOI: https://doi.org/10.7180/kmj.24.105

717 View
24 Download

Abstract PDF PubReader ePub: Remimazolam is a promising drug for general anesthesia due to its rapid onset, short duration, and short context-sensitive half-life. However, its use in pediatric patients remains off-label, and limited prospective data have been published. Herein, we report successful anesthesia using remimazolam in pediatric patients who had a history of epilepsy or required shared airway surgery. In all cases, remimazolam provided general anesthesia, and flumazenil was used for reversal with rapid recovery. Remimazolam offers advantages for pediatric anesthesia in scenarios with a risk of seizure or shared airway surgery. However, the potential for higher bispectral index values and the risk of anaphylaxis in dextran-allergic patients necessitate caution and further research.

Heavy-chain deposition disease associated with multiple myeloma: a case report: Young Rong Lee, Jin Hyeog Lee, Beom Jin Lim, Yoon Jung Choi, Soo Jeong Kim, Jung Eun Lee; Kosin Med J. 2024;39(3):207-213. Published online June 10, 2024; DOI: https://doi.org/10.7180/kmj.24.110

565 View
2 Download

Abstract PDF PubReader ePub: Heavy-chain deposition disease (HCDD) is a rare disorder characterized by the deposition of monoclonal immunoglobulin. Due to the disease's rarity and diagnostic challenges, its prognosis is generally poor. Herein, we report a case of successful treatment of HCDD coexisting with multiple myeloma. A 56-year-old man presented at an outpatient clinic with complaints of whole-body pain, edema, and dyspnea that had persisted for 2 weeks. Diagnostic tests confirmed nephrotic syndrome, hematuria, and progressive renal failure. Serum immunofixation electrophoresis identified the presence of IgG kappa paraprotein. A diagnosis of multiple myeloma was established following a bone marrow biopsy. A renal biopsy revealed antibodies specific to the heavy chains of IgG on immunofluorescence, and electron microscopy showed diffuse electron-dense "powdery" densities in the glomerular basement membrane. Based on these findings, the patient was diagnosed with both HCDD and multiple myeloma. Following the diagnosis, the patient immediately began anti-plasma cell therapy using bortezomib, lenalidomide, and dexamethasone. Intermittent hemodialysis was initiated due to persistent azotemia during the diagnostic process; however, renal function improved significantly after only 1 month of therapy, allowing the discontinuation of dialysis. Early intervention with anti-plasma cell therapy, such as bortezomib, is known to improve prognosis in the early stages of the disease. This case report is presented to enhance understanding of HCDD and underscore the importance of prompt diagnosis and treatment in managing this rare condition.

Effective protocol for continuous pericapsular nerve group block in femur fracture patients undergoing hip surgery: two case reports: Younghoon Jung, Sangmin Choi, Siyoung Lee, Nara Kim, Eunsoo Kim; Kosin Med J. 2024;39(3):214-219. Published online July 24, 2024; DOI: https://doi.org/10.7180/kmj.24.114

440 View
5 Download

Abstract PDF PubReader ePub: Pericapsular nerve group (PENG) block was introduced as an effective way to control postoperative pain in patients who have undergone hip surgery. Therefore, we would like to discuss how to perform PENG block accurately on the basis of two cases, both of which involved hip fracture patients. Ultrasound-guided continuous PENG block was performed, and postoperative pain was adequately controlled in both cases. To mount the catheter in the correct position, it should be inserted after the needle enters at the lowest angle possible. If it is confirmed that the psoas tendon is pushed upward without an increase in injection pressure during drug injection, an accurate continuous PENG block has been achieved. We also analyzed fluoroscopic images to determine how the drug spread, and we observed that the drug spread around the hip capsule along the iliacus and psoas muscle.

A fatal pediatric case of acute fulminant cerebral edema with COVID-19 in Korea: a case report: Minyoung Jung, Chi Eun Oh, Yujin Nam, Dalo Jung, Gyu Min Yeon; Kosin Med J. 2024;39(3):220-225. Published online September 10, 2024; DOI: https://doi.org/10.7180/kmj.24.102

143 View
2 Download

Abstract PDF PubReader ePub: Although most children with coronavirus disease 2019 (COVID-19) infection present with mild symptoms, a few pediatric patients develop severe neurological manifestations. Herein, we describe the case of a pediatric patient who presented with rapidly progressive diffuse and fatal cerebral edema associated with COVID-19. A previously healthy 6-year-old boy was diagnosed with acute fulminant cerebral edema (AFCE), which resulted in transtentorial downward herniation within 48 hours after the initial onset of fever. Detailed history-taking, close monitoring of the consciousness level with serial neurological examinations, and prompt diagnosis and treatment are required in patients suspected to have AFCE. Further research is needed to identify the pathogenesis of AFCE associated with COVID-19 and the related risk factors.

First
Prev
Page of 1
Next
Last

Current issue