Journal of Yeungnam medical science最新文献

The coronavirus disease 2019 (COVID-19) pandemic prompted the development of messenger RNA vaccines. Following extensive vaccination campaigns worldwide, several adverse reactions to these vaccines have been reported. This is a case series of unilateral lower extremity lymphedema after COVID-19 vaccination in two patients with a history of cervical cancer. An 82-year-old woman and a 68-year-old woman visited the outpatient clinic with unilateral leg edema after receiving a COVID-19 booster vaccine (BNT162b2; Pfizer-BioNTech) in the deltoid muscle. Both patients had a common history of cervical cancer treated with surgery, chemotherapy, and radiotherapy and were in complete remission. Gynecological evaluations, including laboratory and imaging studies, revealed no specific findings. Lymphoscintigraphy revealed delayed lymphatic drainage with diffuse dermal backflow in a unilateral lower extremity. This case series explores adverse reactions to COVID-19 vaccination in patients who are at high risk of developing lymphedema, providing novel data for similar clinical presentations.

Background: This study analyzed the status of community-based practice in public healthcare institutions in Korean medical schools and identified related needs.

Methods: We conducted an online cross-sectional survey in which 32 of 40 medical schools (80.0%) participated between March and April 2023. We developed questionnaire items aimed at ascertaining the status and perceptions of community-based practice and analyzed the response data using frequency analysis, the Mann-Whitney U test, and content analysis with word clouds.

Results: Of the 32 medical schools analyzed, 23 (71.9%) offered practical courses, and of those, 12 (52.2%) implemented practice lessons within courses. Among 20 schools, 18 (90.0%) required students to complete practical courses and over 50% offered these courses in the third and fourth years of the clerkship phase. Perceptions of community practice showed no significant differences based on whether courses were offered. Many schools have proposed that practice should be a continuous curricular element from the premedical to medical years. The primary challenges facing community-based practice were identified as faculty development, collaboration, and compensation of practice institutions. The following words were extracted from the respondents' comments: practice, community, institution, student, education, faculty, university, and public.

Conclusion: This study identified the limitations of community-based education provided by Korean medical schools and we report findings that highlight areas of improvement. Notable among these is the need to continuously incorporate community-based practice into medical education while engaging in discussions and conducting research toward developing a comprehensive and systematic curriculum.

The Consumer Electronics Show 2025 highlighted innovative technologies with considerable potential for healthcare, particularly artificial intelligence (AI) and sensor technologies. Notable advances that were showcased included products that leverage AI to personalize health management, such as devices capable of recommending binaural beat stimulation, analyzing speech patterns to detect language impairment, and predicting blood pressure through sleep data analysis. AI applications to enhance sleep quality, reduce snoring, and assess the caloric content of children's meals were presented. However, the accuracy of these products remains inadequate for clinical use, which limits their applications in community settings. This showcase also featured advances in both contact and noncontact sensor technologies. Contact-type sensors, such as wearable rings and sensors designed to measure vital signs, including pulse rate, blood glucose, and blood pressure, have been developed to mitigate discomfort while maintaining high accuracy. Noncontact sensors employing radar and remote photoplethysmography technologies have further demonstrated promise for vital sign monitoring without physical contact, although maintaining accuracy during movement remains a challenge. AI integration with sensors was further demonstrated by the development of an electronic stethoscope utilizing microelectromechanical systems and deep learning algorithms to facilitate the perception of heart and breath sounds, emulating the functionality of conventional stethoscopes. Furthermore, advances in laser-based blood glucose monitoring and wearable robotic belts designed to assist gait have underscored the progress in devices aimed at enhancing patient care and daily living. These technologies hold considerable potential to profoundly transform healthcare systems, particularly in home and community settings.

Background: Guillain-Barré syndrome (GBS) is an acute acquired autoimmune inflammatory disorder of the peripheral nerves and roots. Respiratory insufficiency is an important predictor of a poor prognosis in patients with GBS. Phrenic nerve assessment is an area of interest in GBS with respiratory failure. We aimed to analyze the characteristics of the phrenic nerve conduction study (NCS) in GBS and assess its value in predicting respiratory failure requiring ventilatory support, along with outcome assessment at 6 months as per the Hughes score.

Methods: A total of 135 patients with GBS admitted to our hospital over 3 years were thoroughly evaluated by clinical examination, blood laboratory tests, and phrenic NCS.

Results: Phrenic NCS abnormality was observed in 48 patients (35.6%) with statistically significant increases in phrenic sum compound muscle action potential (CMAP) latency (18.91±7.82 ms) and sum CMAP duration (44.65±6.84 ms), along with reduced sum CMAP amplitude (0.3246±0.132 mV) and sum CMAP area (3.56±2.62 mV·ms) occurring in those requiring ventilatory assistance. The sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios of the phrenic NCS for predicting respiratory failure in patients with GBS were 90.7%, 90.2%, 81.3%, 95.4%, 9.27, and 0.10, respectively. The results showed a statistically significant association between abnormal initial phrenic NCS scores and outcomes at 6 months.

Conclusion: Phrenic NCS can predict respiratory failure requiring ventilator assistance in patients with GBS. Phrenic NCS can be incorporated into routine NCS protocols to predict impending respiratory failure in patients with GBS.

Background: This study aimed to compare the surgical outcomes of pediatric patients with intermittent exotropia who underwent simultaneous eyelid and exotropia surgery and those who underwent exotropia surgery alone.

Methods: The medical records of patients aged <18 years who underwent surgery for intermittent exotropia were retrospectively reviewed. The patients were grouped according to whether they underwent simultaneous eyelid surgery. In the simultaneous surgery group, the association between clinical factors, including the type of eyelid procedure, and surgical success was also analyzed. A favorable outcome was defined as an ocular alignment of ≤10 prism diopters (PD) for exodeviation and ≤4 PD for esodeviation at the final follow-up.

Results: This study included 118 patients, of whom 31 underwent simultaneous eyelid and exotropia surgery and 87 underwent exotropia surgery alone. Bilateral repair of lower eyelid epiblepharon was the most common eyelid procedure (27/31, 87.1%). Success rates did not differ significantly between the two groups (log-rank test, p=0.291). In the simultaneous surgery group, no clinical factors, including the type of eyelid surgery, were significantly associated with favorable outcomes (all p>0.05).

Conclusion: Simultaneous eyelid and exotropia surgery produced surgical outcomes comparable to those of exotropia surgery alone, validating the safety and feasibility of the combined procedure in appropriately selected pediatric patients.

Artificial intelligence (AI) has shown promise for revolutionizing healthcare. This narrative review focuses on the evolving discussion of the utility of AI and clinical informatics in critical care and acute care medicine, specifically focusing on digital twin (DT) technology. The improved computational power and iterative validation of these intelligent tools have enhanced medical education, in silico research, and clinical decision support in critical care settings. Integrating DTs into critical care opens vast opportunities, but simultaneously poses complex challenges, from data safety and privacy concerns to potentially increasing healthcare disparities. In medicine, DTs can significantly improve the efficiency of critical care systems. Stakeholder investment is essential for successful implementation and integration of these technologies.

The coronavirus disease 2019 pandemic has underscored the limitations of traditional diagnostic methods, particularly in ensuring the safety of healthcare workers and patients during infectious outbreaks. Smartphone-based digital stethoscopes enhanced with artificial intelligence (AI) have emerged as potential tools for addressing these challenges by enabling remote, efficient, and accessible auscultation. Despite advancements, most existing systems depend on additional hardware and external processing, increasing costs and complicating deployment. This review examines the feasibility and limitations of smartphone-based digital stethoscopes powered by AI, focusing on their ability to perform real-time analyses of audible and inaudible sound frequencies. We also explore the regulatory barriers, data storage challenges, and diagnostic accuracy issues that must be addressed to facilitate broader adoption. The implementation of these devices in veterinary medicine is discussed as a practical step toward refining their applications. With targeted improvements and careful consideration of existing limitations, smartphone-based AI stethoscopes could enhance diagnostic capabilities in human and animal healthcare settings.

Background: Chronic periodontitis is associated with various systemic inflammatory diseases; however, research on its association with chronic kidney disease (CKD) is relatively limited. Because both conditions share common risk factors, systemic inflammation plays a key role in the progression of these diseases. Galectin-3 (Gal-3) is a proinflammatory cytokine that plays an important role in chronic inflammatory diseases and is a potential biomarker. This study aimed to measure salivary Gal-3 levels in patients with periodontitis and CKD to better understand their association and evaluate Gal-3 as a diagnostic biomarker for these conditions.

Methods: Seventy-five patients were categorized into three groups: Group I, patients with CKD and periodontitis (n=25); Group II, patients with chronic periodontitis who were systemically healthy (n=25); and Group III, patients with CKD without chronic periodontitis (n=25). Demographic characteristics and periodontal and renal parameters were recorded for each patient. Saliva samples were collected to evaluate Gal-3 levels using an enzyme-linked immunosorbent assay.

Results: Patients with chronic periodontitis and CKD and those with chronic periodontitis alone (Groups I and II, respectively) showed significantly higher salivary Gal-3 levels than patients with CKD alone (Group III) (p<0.001). Bivariate correlation analysis indicated a strong relationship between clinical parameters and Gal-3 levels across all three groups.

Conclusion: Salivary Gal-3 level is a valuable early diagnostic marker of chronic periodontitis and CKD.