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영남대학교 의과대학> 영남의대학술지

영남의대학술지 update

YeungNam University journal of medicine

  • : 영남대학교 의과대학
  • : 의약학분야  >  기타(의약학)
  • : KCI등재
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  • : 연속간행물
  • : 연3회
  • : 1225-7737
  • : 2384-0293
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수록정보
수록범위 : 1권1호(1984)~36권2호(2019) |수록논문 수 : 1,413
영남의대학술지
36권2호(2019년 05월) 수록논문
최근 권호 논문
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KCI등재

1Pharmacologic therapy for nonalcoholic steatohepatitis focusing on pathophysiology

저자 : In Cheol Yoon , Jong Ryeol Eun

발행기관 : 영남대학교 의과대학 간행물 : 영남의대학술지 36권 2호 발행 연도 : 2019 페이지 : pp. 67-77 (11 pages)

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The paradigm of chronic liver diseases has been shifting. Although hepatitis B and C viral infections are still the main causes of liver cirrhosis and hepatocellular carcinoma (HCC), the introduction of effective antiviral drugs may control or cure them in the near future. In contrast, the burden of nonalcoholic fatty liver disease (NAFLD) has been increasing for decades, and 25 to 30% of the general population in Korea is estimated to have NAFLD. Over 10% of NAFLD patients may have nonalcoholic steatohepatitis (NASH), a severe form of NAFLD. NASH can progress to cirrhosis and HCC. NASH is currently the second leading cause to be placed on the liver transplantation list in the United States. NAFLD is associated with obesity, type 2 diabetes, dyslipidemia, and metabolic syndrome. The pathophysiology is complex and associated with lipotoxicity, inflammatory cytokines, apoptosis, and insulin resistance. The only proven effective treatment is weight reduction by diet and exercise. However, this may not be effective for advanced fibrosis or cirrhosis. Therefore, effective drugs are urgently needed for treating these conditions. Unfortunately, no drugs have been approved for the treatment of NASH. Many pharmaceutical companies are trying to develop new drugs for the treatment of NASH. Some of them are in phase 2 or 3 clinical trials. Here, pharmacologic therapies in clinical trials, as well as the basic principles of drug therapy, will be reviewed, focusing on pathophysiology.

KCI등재

2Trends in the study on medical education over the last 10 years, based on paper titles

저자 : Seong Yong Kim

발행기관 : 영남대학교 의과대학 간행물 : 영남의대학술지 36권 2호 발행 연도 : 2019 페이지 : pp. 78-84 (7 pages)

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Medical education research subjects are incredibly diverse and have changed over time. This work in particular aims to compare and analyze research trends in medical education through the words used in the titles of these research papers. Academic Medicine (the journal of the Association of American Medical Colleges), Medical Teacher (the journal of the Association of Medical Education in Europe), the Korean Journal of Medical Education (KJME), and Korean Medical Education Review (KMER) were selected and analyzed for the purposes of this research. From 2009 to 2018, Academic Medicine and Medical Teacher published approximately 10 to 20 times more papers than the KJME and KMER. Frequently used words in these titles include “medical,” “student,” “education,” and “learning.” The words “clinical” and “learning” were used relatively often (7.80% to 13.66%) in Korean journals and Medical Teacher, but Academic Medicine used these phrases relatively less often (6.47% and 4.41%, respectively). Concern with such various topics as problem-based learning, team-based learning, program evaluations, burnout, e-learning, and digital indicates that Medical Teacher seems to primarily deal with teaching and learning methodologies, and Academic Medicine handles all aspects of medical education. The KJME and KMER did not cover all subjects, as they publish smaller papers. However, it is anticipated that research on new subjects, such as artificial intelligence in medical education, will occur in the near future.

KCI등재

3Endoscopic features aiding the diagnosis of gastric mucosa-associated lymphoid tissue lymphoma

저자 : Byung Sam Park , Si Hyung Lee

발행기관 : 영남대학교 의과대학 간행물 : 영남의대학술지 36권 2호 발행 연도 : 2019 페이지 : pp. 85-91 (7 pages)

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The incidence of gastric mucosa-associated lymphoid tissue (MALT) lymphoma is increasing worldwide, but the diagnosis is difficult. Most patients are asymptomatic or complain of nonspecific gastrointestinal symptoms. As the endoscopic features of gastric MALT lymphoma are variable and nonspecific, the possibility of this condition may be overlooked during esophagogastroduodenoscopy, and it remain undiagnosed. Therefore, this condition needs to be considered when an abnormal mucosa is observed during this procedure. Biopsy performed during endoscopy is the primary diagnostic test, but false negative results are possible; large numbers of samples should be collected from both normal and abnormal mucosae. Endoscopic ultrasonography is useful to assess the depth of invasion and to predict the treatment response. After treatment, follow-up tests are required every 3 months until complete remission is achieved, and annually thereafter. Early diagnosis of gastric MALT lymphoma is difficult, and its diagnosis and follow-up require wide experience and competent endoscopic technique.

KCI등재

4Forefoot disorders and conservative treatment

저자 : Chul Hyun Park , Min Cheol Chang

발행기관 : 영남대학교 의과대학 간행물 : 영남의대학술지 36권 2호 발행 연도 : 2019 페이지 : pp. 92-98 (7 pages)

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Forefoot disorders are often seen in clinical practice. Forefoot deformity and pain can deteriorate gait function and decrease quality of life. This review presents common forefoot disorders and conservative treatment using an insole or orthosis. Metatarsalgia is a painful foot condition affecting the metatarsal (MT) region of the foot. A MT pad, MT bar, or forefoot cushion can be used to alleviate MT pain. Hallux valgus is a deformity characterized by medial deviation of the first MT and lateral deviation of the hallux. A toe spreader, valgus splint, and bunion shield are commonly applied to patients with hallux valgus. Hallux limitus and hallux rigidus refer to painful limitations of dorsiflexion of the first metatarsophalangeal joint. A kinetic wedge foot orthosis or rocker sole can help relieve symptoms from hallux limitus or rigidus. Hammer, claw, and mallet toes are sagittal plane deformities of the lesser toes. Toe sleeve or padding can be applied over high-pressure areas in the proximal or distal interphalangeal joints or under the MT heads. An MT off-loading insole can also be used to alleviate symptoms following lesser toe deformities. Morton's neuroma is a benign neuroma of an intermetatarsal plantar nerve that leads to a painful condition affecting the MT area. The MT bar, the plantar pad, or a more cushioned insole would be useful. In addition, patients with any of the above various forefoot disorders should avoid tight-fitting or high-heeled shoes. Applying an insole or orthosis and wearing proper shoes can be beneficial for managing forefoot disorders.

KCI등재

5Efficacy of ramosetron in combination with polyethylene glycol of preparing for a colonoscopy

저자 : Min Kyu Kang , Byung Ik Jang , Jun Suk Park , Kyeong Ok Kim

발행기관 : 영남대학교 의과대학 간행물 : 영남의대학술지 36권 2호 발행 연도 : 2019 페이지 : pp. 99-104 (6 pages)

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Background: Because of its efficacy and safety, polyethylene glycol (PEG) is generally used to prepare for colonoscopy. However, the side effects of PEG, including nausea, vomiting, abdominal discomfort, pain, and general weakness, tend to decrease patient compliance and satisfaction. The aim of this study is to investigate the efficacy and safety of PEG with 0.1 mg ramosetron on colonoscopy patients who had difficulty taking PEG due to side effects or large volume.
Methods: From January to August in 2012, 28 patients who visited Yeungnam University hospital for a colonoscopy were prospectively enrolled. All enrolled patients were previous history underwent colonoscopy using PEG only in our hospital. The efficacy and safety of ramosetron were assessed through the use of a questionnaire, and compared previous bowel preparation.
Results: Compared to previous examination, the patients using the ramosetron reported less nausea, vomiting, abdominal discomfort, and abdominal pain, as well as a higher degree of compliance and satisfaction of the patient. There were no side effects reported with the use of ramosetron. However, overall bowel preparation quality was not better than the previous examination.
Conclusion: In case of the use of ramosetron in combination with PEG for bowel preparation, patients experienced a higher rate of compliance and tolerance. Looking forward, ramosetron may become an option of pretreatment for bowel preparation.

KCI등재

6Impact of calcineurin inhibitors on rat glioma cells viability

저자 : Jeong Hun Seong , Woo Yeong Park , Jin Hyuk Paek , Sung Bae Park , Seungyeup Han , Kyo-cheol Mun , Kyubok Jin

발행기관 : 영남대학교 의과대학 간행물 : 영남의대학술지 36권 2호 발행 연도 : 2019 페이지 : pp. 105-108 (4 pages)

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Background: Although kidney transplantation outcomes have improved dramatically after using calcineurin inhibitors (CNIs), CNI toxicity continues to be reported and the mechanism remains uncertain. Here, we investigated the neurotoxicity of CNIs by focusing on the viability of glioma cells.
Methods: Glioma cells were treated with several concentrations of CNIs for 24 hours at 37°C and their cell viability was evaluated using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay.
Results: Exposure to 0, 0.25, 0.5, 2.5, 5.0, and 10.0 mM concentrations respectively showed 100%, 64.3%, 61.3%, 68.1%, 62.4%, and 68.6% cell viability for cyclosporine and 100%, 38.6%, 40.8%, 43.7%, 37.8%, and 43.0% for tacrolimus. The direct toxic effect of tacrolimus on glioma cell viability was stronger than that of cyclosporine at the same concentration.
Conclusion: CNIs can cause neurological side effects by directly exerting cytotoxic effects on brain cells. Therefore, we should carefully monitor the neurologic symptoms and level of CNIs in kidney transplant patients.

KCI등재

7Digital subtraction angiography vs. real-time fluoroscopy for detection of intravascular injection during transforaminal epidural block

저자 : Kibeom Park , Saeyoung Kim

발행기관 : 영남대학교 의과대학 간행물 : 영남의대학술지 36권 2호 발행 연도 : 2019 페이지 : pp. 109-114 (6 pages)

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Background: Transforaminal epidural block (TFEB) is an effective treatment option for radicular pain. To reduce complications from intravascular injection during TFEB, use of imaging modalities such as real-time fluoroscopy (RTF) or digital subtraction angiography (DSA) has been recommended. In this study, we investigated whether DSA improved the detection of intravascular injection during TFEB at the whole spine level compared to RTF.
Methods: We prospectively examined 316 patients who underwent TFEB. After confirmation of final needle position using biplanar fluoroscopy, 2 mL of nonionic contrast medium was injected at a rate of 0.5 mL/s under RTF; 30 s later, 2 mL of nonionic contrast medium was injected at a rate of 0.5 mL/s under DSA.
Results: Thirty-six intravascular injections were detected for an overall rate of 11.4% using RTF, with 45 detected for a rate of 14.2% using DSA. The detection rate using DSA was statistically different from that using RTF (p=0.004). DSA detected a significantly higher proportion of intravascular injections at the cervical level than at the thoracic (p=0.009) and lumbar (p=0.011) levels.
Conclusion: During TFEB at the whole spine level, DSA was better than RTF for the detection of intravascular injection. Special attention is advised for cervical TFEB, because of a significantly higher intravascular injection rate at this level than at other levels.

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8Clinical significance of lymph node size in locally advanced cervical cancer treated with concurrent chemoradiotherapy

저자 : Jinju Oh , Ki Ho Seol , Youn Seok Choi , Jeong Won Lee , Jin Young Bae

발행기관 : 영남대학교 의과대학 간행물 : 영남의대학술지 36권 2호 발행 연도 : 2019 페이지 : pp. 115-123 (9 pages)

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Background: This study aimed to assess the in-field lymph node (LN) failure rate according to LN size and to investigate effect of LN size on the survival outcome of patients with locally advanced cervical carcinoma treated with concurrent chemoradiotherapy (CCRT).
Methods: A total of 310 patients with locally advanced cervical carcinoma treated with CCRT were enrolled in retrospective study. LN status was evaluated by magnetic resonance imaging. All patients received conventional external beam irradiation and high-dose rate brachytherapy, and concurrent cisplatin-based chemotherapy. In-field LN failure rate according to LN size was analyzed.
Results: The median follow-up period was 83 months (range, 3-201 months). In-field LN failure rate in patients with pelvic LN size more than 10 mm was significantly higher than that in patients with pelvic LN size less than 10 mm (p<0.001). A similar finding was observed in the in-field para-aortic LN (PALN) failure rate (p=0.024). The pelvic and PALN size (≥10 mm) was a significant prognostic factor of overall-survival (OS) and disease-free survival rate in univariate and multivariate analyses. The OS rate was significantly different between groups according to LN size (<10 mm vs. ≥10 mm).
Conclusion: A LN of less than 10 mm in size in an imaging study is controlled by CCRT. On the other hand, in LN of more than 10 mm in size, the in-field LN failure rate increase and the prognosis deteriorate. Therefore, a more aggressive treatment strategy is needed.

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9What are the most important prognostic factors in patients with residual rectal cancer after preoperative chemoradiotherapy?

저자 : Sol-min Kim , Ghilsuk Yoon , An Na Seo

발행기관 : 영남대학교 의과대학 간행물 : 영남의대학술지 36권 2호 발행 연도 : 2019 페이지 : pp. 124-135 (12 pages)

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Background: We aimed to establish robust histoprognostic predictors on residual rectal cancer after preoperative chemoradiotherapy (CRT).
Methods: Analyzing known histoprognostic factors in 146 patients with residual disease allows associations with patient outcome to be evaluated.
Results: The median follow-up time was 77.8 months, during which 59 patients (40.4%) experienced recurrence and 41 (28.1%) died of rectal cancer. On univariate analysis, residual tumor size, ypT category, ypN category, ypTNM stage, downstage, tumor regression grade, lymphatic invasion, perineural invasion, venous invasion, and circumferential resection margin (CRM) were significantly associated with recurrence free survival (RFS) or/and cancer-specific survival (CSS) (all p<0.005). On multivariate analysis, higher ypTNM stage and CRM positivity were identified as independent prognostic factors for RFS (ypTNM stage, p=0.024; CRM positivity, p<0.001) and CSS (p=0.022, p=0.017, respectively). Furthermore, CRM positivity was an independent predictor of reduced RFS and CSS, irrespective of subgrouping according to downstage (non-downstage, p<0.001 and p<0.001; downstage, p=0.002 and p=0.002) or lymph node metastasis (non-metastasis, p<0.001 and p=0.001; metastasis, p<0.001 and p<0.001).
Conclusion: CRM status may be as powerful as ypTNM stage as a prognostic indicator for patient outcome in patients with residual rectal cancer after preoperative CRT.

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10Factors affecting complications after treatment of epidermal cyst

저자 : Man Ki Choi , Kyu Jin Chung

발행기관 : 영남대학교 의과대학 간행물 : 영남의대학술지 36권 2호 발행 연도 : 2019 페이지 : pp. 136-140 (5 pages)

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Background: Epidermal cysts are the most common benign epithelial tumors in humans. The curative treatment of epidermal cyst is surgical excision. However, only few studies have investigated the cause and mechanism of postoperative complications of epidermal cysts. Therefore, this study aimed to evaluate the factors affecting complications of epidermal cyst after surgical treatment.
Methods: Patients with histologically diagnosed epidermal cysts were selected from among 98 consecutive patients with excised benign cystic tumors from March 2014 to August 2017. Sex, age, size, mobility, site of occurrence, history of infection, history of incision and drainage, complications, history of reoperation, and method of overcoming complications was obtained by analyzing medical records retrospectively.
Results: Five of the 98 patients had wound dehiscence due to surgical infection. Three of them underwent wound healing with conservative treatment without a second operation. The other two patients underwent a second operation and showed signs of preoperative infection. None of the factors showed statistical significance in relation to the occurrence of complications.
Conclusion: Postoperative complications occurred when the excision of the epidermal cyst was performed at preoperative infection sites or at sites with high tension, so attention should be paid to postoperative care.

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