Kosin Medical Journal

Articles in E-pub version are posted online ahead of regular printed publication.

Original article

The conservative management of ovarian endometrioma using cyst aspiration followed by dienogest medication: a pilot study: Ha Eun Jung, Eun Hee Yu, Hyun Joo Lee, Jong Kil Joo, Yong Jin Na; Received October 10, 2024 Accepted December 17, 2024 Published online March 27, 2025; DOI: https://doi.org/10.7180/kmj.24.149 [Epub ahead of print]

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Abstract PDF PubReader ePub: Background
The aim of this study was to evaluate the efficacy of ultrasonography-guided cyst aspiration followed by dienogest medication in the management of endometriomas in selected patients.
Methods
This study included 38 female patients diagnosed with endometrioma via transvaginal ultrasonography or pelvic magnetic resonance imaging. We performed needle aspiration of the contents of endometrioma followed by the administration of dienogest (2 mg) daily orally, and assessed changes in endometrioma size, cancer antigen 125, anti-Müllerian hormone, and a visual analog scale score for dysmenorrhea before and 3 months after the procedure.
Results
The diameter of the ovarian cysts decreased from a maximum of 4.35 cm before the procedure to 2.37 cm on follow-up ultrasonography, and seven of 56 endometriomas in 38 patients resolved completely as evaluated on transvaginal ultrasonography. Malignant cells were not found in any of the cases upon a cytologic examination of endometriotic cyst fluid. The mean cancer antigen 125 level decreased from 86.69 U/mL before the procedure to approximately 37.28 U/mL. There was no statistically significant difference in anti-Müllerian hormone before and after the procedure. The visual analog scale score decreased from 3.58 to 0.97 after aspiration.
Conclusions
Ultrasonography-guided cyst aspiration followed by dienogest administration allows cytological confirmation through relatively low-burden procedures and may increase patient compliance due to the reduction in ovarian cyst size.

Review article

The role of the interatrial shunt device in the treatment of patients with heart failure with preserved ejection fraction: experience from the REDUCE LAP-HF studies: Bong-Joon Kim; Received October 12, 2024 Accepted December 11, 2024 Published online February 17, 2025; DOI: https://doi.org/10.7180/kmj.24.150 [Epub ahead of print]

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Abstract PDF PubReader ePub: Heart failure with preserved ejection fraction (HFpEF) is characterized by increased left ventricular filling pressure and elevated left atrial pressure. Despite advances in medical treatments, the management of HFpEF patients is often challenging due to multiple comorbidities, leading to polypharmacy and associated side effects. Consequently, there is an increasing demand for procedural or device-based therapies in HFpEF management. Over the past decade, the transcatheter interatrial shunt device (IASD), designed to create a passage between the left atrium and the right atrium, has emerged as a novel therapeutic option. The IASD offers potential benefits by reducing left atrial pressure at rest and during exercise. The efficacy and safety of the IASD were demonstrated in the REDUCE LAP-HF (Reduce Left Atrial Pressure in Patients with Heart Failure) study series. Furthermore, IASD has been shown to support positive cardiac remodeling. With the availability of more data, appropriate indications for the use of IASDs are becoming more evident, and criteria for patient selection in future studies are needed.

Case report

Idiopathic scoliosis with recurrent dyspnea and wheezing in an otherwise healthy female adolescent: a case report: Jin Ku Kim, Yoon Ha Hwang; Received August 20, 2024 Accepted October 23, 2024 Published online February 7, 2025; DOI: https://doi.org/10.7180/kmj.24.135 [Epub ahead of print]

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Abstract PDF PubReader ePub: A 15-year-old female visited our hospital’s outpatient and emergency department several times due to recurrent paroxysmal dyspnea for 6 months. Based on the clinical symptoms, the researchers diagnosed the patient with bronchial asthma and treated her with oral steroids and inhaled corticosteroid agents, but her patients did not significantly improve. At that time, thoracic scoliosis was observed in previous chest X-ray images. Previous records showed that the scoliosis had progressed during the rapid growth period in 2018 (patient age 10 years) and 2023 (patient age 15 years). As the symptoms did not improve despite medication, a further evaluation was performed. Contrast-enhanced chest computed tomography revealed the T8 vertebral body compressing the right bronchus intermedius. The patient rarely wore an existing brace due to discomfort, but a new custom brace was prescribed after confirmation using chest computed tomography. Since then, the patient's compliance with treatment has improved, and she has gradually increased the amount of time she wears the brace. In addition, her Cobb’s angle and pulmonary function tests have improved in outpatient follow-up. The researchers initially considered the patient's recurrent dyspnea and wheezing to be an asthma exacerbation and treated her with medication, but the symptoms did not improve. Therefore, when a patient does not respond well to asthma medications, the possibility of dyspnea or wheezing due to causes other than asthma should not be ruled out. Evaluation for scoliosis should also not be neglected, especially in growing adolescents.

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