Kosin Medical Journal

From articles published since 2022.

Review articles

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

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
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

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

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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.

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The effectiveness of Moodle's “Lesson” feature in pre-learning about arterial puncture and blood transfusion procedures
Haeyoung Lee, Sang-Shin Lee, Hyunyong Hwang
Kosin Medical Journal.2023; 38(4): 278. CrossRef

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; Kosin Med J. 2024;39(1):35-43. Published online September 25, 2023; DOI: https://doi.org/10.7180/kmj.23.137

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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 article

How to write case reports in medicine: Sung Il Im; Kosin Med J. 2022;37(2):102-106. Published online June 24, 2022; DOI: https://doi.org/10.7180/kmj.22.109

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Medical research has become an important part of providing care to patients. Case reports published in medical journals can communicate information to the medical community about rare or unreported features, conditions, complications, or interventions. Case reports are generally short, focusing on key components such as a summary and introduction, case presentation, and discussion. Authors now have access to free, continuously updated case reports of different types from multiple journals. This review introduces the process and mechanisms for how and when to prepare a case report. We briefly review the editorial process of each of these complementary journals, along with author anecdotes, hoping to inspire authors to write and continue writing case reports; and discusses the essentials of a case report, aiming to provide guidelines for improving medical writing skills.

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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
A Case of Early Malignant Change from Neurofibroma to Malignant Peripheral Nerve Sheath Tumor
Poo Reum Kang, Yeong Joon Kim, Sun Ju Oh, Hyoung Shin Lee
Korean Society for Head and Neck Oncology.2023; 39(2): 45. CrossRef
Gastric Adenocarcinoma of Fundic-gland Type Diagnosed and Treated by Endoscopic Mucosal Resection
Sung Eun Kim, Seun Ja Park, Moo In Park, Won Moon, Jae Hyun Kim, Kyoungwon Jung, Bang Ju Kim, Hee Kyung Chang
Journal of Digestive Cancer Research.2023; 11(3): 165. CrossRef
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
Kosin Medical Journal.2023; 38(4): 288. CrossRef
Selective adjuvant radiation therapy for distant lymph node metastasis in patients with stage 4B epithelial ovarian cancer: a case series
Eun Taeg Kim, Seung Yeon Oh, Sun Young Ma, Tae Hwa Lee, Won Gyu Kim
Kosin Medical Journal.2023; 38(4): 293. CrossRef

Case report

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 Med J. 2024;39(1):75-79. Published online December 14, 2023; DOI: https://doi.org/10.7180/kmj.23.132

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Abstract PDF PubReader ePub: Giant adrenal myelolipomas are rare, benign, and hormonally inactive tumors. We present the case of a 53-year-old man with a 19-cm retroperitoneal mass, initially suspected to be a retroperitoneal liposarcoma, angiomyolipoma, or adrenal myelolipoma. After conducting endocrine assessments, which were within normal ranges, we decided to perform surgical excision using a modified Makuuchi incision. The tumor was successfully removed, and the final pathological examination confirmed the diagnosis of adrenal myelolipoma. The patient was discharged with no complications and remained without disease recurrence or distant metastasis as of 1 year postoperatively. In conclusion, giant myelolipomas are rare and cause symptoms owing to their large size. Surgical removal is recommended for large or symptomatic myelolipomas. The modified Makuuchi incision allows efficient and safe tumor removal in open surgery for giant myelolipomas.

Review articles

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

Exploring the nexus between obesity, metabolic syndrome, and colorectal cancer: Jong Yoon Lee; Kosin Med J. 2024;39(1):18-25. Published online March 12, 2024; DOI: https://doi.org/10.7180/kmj.24.107

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Abstract PDF PubReader ePub: The increasing global prevalence of obesity and metabolic syndrome (MetS) is strongly associated with the incidence of colorectal cancer (CRC). Obesity and MetS detrimentally impact the treatment outcomes of CRC and share similar mechanisms that contribute to the development of CRC. Increased insulin resistance in patients with obesity is linked to CRC, and altered levels of sex hormones and adipokines affect cell growth and inflammation. Obesity and MetS also alter the gut microbiome. Bile acids, which are crucial for lipid metabolism, are elevated in patients with obesity. Moreover, specific bile acids are associated with colonic damage, inflammation, and the development of CRC. Obesity and MetS increase the risk of postoperative complications and affect the response to chemotherapy. The promotion of weight loss and the resolution of MetS can reduce the occurrence of CRC and increase treatment efficacy. Therefore, it is imperative to implement appropriate management strategies to address obesity and MetS with the aim of improving the prognosis and reducing the incidence of CRC. Moreover, additional research should be conducted to determine the optimal timing for tailored CRC screening in patients with obesity or MetS. In this review, we explore the impact of obesity and MetS on the development of CRC and examine potential strategies to mitigate CRC risk in individuals with obesity and MetS.

Original article

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 Med J. 2024;39(1):51-59. Published online March 19, 2024; DOI: https://doi.org/10.7180/kmj.24.101

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Background
Autologous blood therapy (ABT) has been used to treat atopic dermatitis (AD) for over a century, even though evidence supporting its efficacy is lacking. We aimed to investigate the effectiveness and safety of autologous serum intramuscular injection (ASIM), which is a modified form of ABT, in treating mild-to-moderate AD.
Methods
This study was a 12-week, open-label, prospective, uncontrolled trial. Following a 4-week run-in period, 22 out of 25 screened patients received ASIM once a week for 4 weeks in conjunction with standard treatment. The primary outcome measure was the Eczema Area and Severity Index (EASI), while the secondary outcomes included the Scoring Atopic Dermatitis (SCORAD) score, Dermatologic Life Quality Index (DLQI), and patient ratings of pruritus, sleep difficulty, disease status, and treatment effectiveness. Safety parameters were also assessed.
Results
EASI scores showed a non-statistically significant trend toward improvement during ASIM intervention. Patients with at least a 50% improvement in the EASI score at 4 weeks were older and had lower peripheral eosinophil counts (p<0.05). Secondary endpoints, including the SCORAD score, pruritus, sleep difficulty, and DLQI, demonstrated statistically significant improvements at week 4 compared to baseline (p<0.05). No significant adverse reactions were observed.
Conclusions
This pioneering study suggests that repeated ASIM may improve the clinical symptoms of mild-to-moderate AD, particularly in terms of pruritus and overall quality of life. However, further research with a larger sample size is required to establish the clinical significance of these findings.

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What are the clinical usefulness and scientific value of intramuscular injection of autologous serum (autologous serum therapy) in patients with atopic dermatitis?
Dong-Ho Nahm
Kosin Medical Journal.2024; 39(1): 1. CrossRef

Review article

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

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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; Kosin Med J. 2024;39(1):44-50. Published online September 14, 2023; DOI: https://doi.org/10.7180/kmj.23.126

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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.

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
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

Gastric cancer and metabolic syndrome: Hyeong Ho Jo; Kosin Med J. 2024;39(1):26-34. Published online March 22, 2024; DOI: https://doi.org/10.7180/kmj.24.108

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Abstract PDF PubReader ePub: Gastric cancer (GC), a prevalent disease in Asian countries, presents a substantial global health challenge. The risk factors for GC include Helicobacter pylori infection, diet, smoking, alcohol, and metabolic syndrome (MetS). This review meticulously examines the intricate connections between MetS and GC, focusing on visceral adipocytes, hormonal factors, obesity, and their impact on survival outcomes. Visceral adipocytes, which secrete inflammatory cytokines and hormones, play a pivotal role in influencing cancer development. Hormonal factors demonstrate nuanced associations with specific GC subtypes, underscoring the complexity of their impact. Large-scale studies exploring obesity-related factors reveal sex-specific nuances and underscore the importance of considering overall weight and body composition. Furthermore, the review explores the impact of eradication therapy for H. pylori infection, which is the most significant factor in the onset of GC, on the components of MetS. Additionally, the influence of MetS on postoperative outcomes and survival in GC patients highlights the interplay between therapeutic interventions and lifestyle factors. This comprehensive exploration sheds light on the multifaceted relationship between MetS and GC, providing valuable insights for future research and preventive strategies.

Case report

Heterotopic ovarian hilus cells of the salpinx: a case report and literature review: Bomi Kim; Kosin Med J. 2024;39(1):66-70. Published online September 12, 2023; DOI: https://doi.org/10.7180/kmj.23.120

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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

What are the clinical usefulness and scientific value of intramuscular injection of autologous serum (autologous serum therapy) in patients with atopic dermatitis?: Dong-Ho Nahm; Kosin Med J. 2024;39(1):1-4. Published online March 25, 2024; DOI: https://doi.org/10.7180/kmj.24.109

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