• Journal of Yeungnam Medical Science
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• 제40권3호
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• pp.225-232
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• 2023

Cognitive dysfunction is relatively less considered a complication of hypertension. However, there is sufficient evidence to show that high blood pressure in middle age increases the risk of cognitive decline and dementia in old age. The greatest impact on cognitive function in those with hypertension is on executive or frontal lobe function, similar to the area most damaged in vascular dementia. Possible cognitive disorders associated with hypertension are vascular dementia, Alzheimer disease, and Lewy body dementia, listed in decreasing strength of association. The pathophysiology of cognitive dysfunction in individuals with hypertension includes brain atrophy, microinfarcts, microbleeds, neuronal loss, white matter lesions, network disruption, neurovascular unit damage, reduced cerebral blood flow, blood-brain barrier damage, enlarged perivascular damage, and proteinopathy. Antihypertensive drugs may reduce the risk of cognitive decline and dementia. Given the high prevalence of dementia and its impact on quality of life, treatment of hypertension to reduce cognitive decline may be a clinically relevant intervention.

• Journal of Yeungnam Medical Science
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• 제39권1호
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• pp.3-11
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• 2022

Lymphoma is the most common primary tumor of the orbit, accounting for 55% of all orbital malignancies. When divided into histopathological subtypes, extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) comprises the largest proportion. Clinical manifestations are unspecific, but in patients with slow-growing painless orbital mass, or red conjunctival lesion suggestive of 'salmon patch', ocular adnexa lymphoma (OAL) should be suspected. Although the pathogenetic mechanism of ocular adnexal MALT lymphoma (OAML) is not yet fully understood, the relationship between OAML and Chlamydia psittaci has been hypothesized recently, similar to that between gastric MALT lymphoma and Helicobacter pylori. This suggests a new treatment option for OAML; bacterial eradication therapy with systemic antibiotics. Several other treatment methods for OAML have been introduced, but no treatment guidelines have been established yet. In this article, we summarize the current knowledge on the clinical features, pathogenesis, diagnostic methods, therapeutic strategies, and prognosis of OAML.

• Journal of Yeungnam Medical Science
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• 제39권1호
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• pp.12-17
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• 2022

Anatomical endoscopic enucleation of the prostate (AEEP) differs from other endoscopic modalities for bladder outlet obstruction (BOO) because it extracts the whole benign prostatic hyperplasia component. AEEP has been launched for almost 40 years as a first-line treatment method for BOO regardless of prostate size according to several guidelines. However, it remains underperformed worldwide. In this review article, we elaborate on the advantages and disadvantages of AEEP compared to other surgical modalities for BOO to investigate its efficacy and safety as a gold standard surgical management option for males with BOO.

• Journal of Yeungnam Medical Science
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• 제40권2호
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• pp.115-122
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• 2023

Hepatic ischemia-reperfusion injury is a major complication of liver transplantation, trauma, and shock. This pathological condition can lead to graft dysfunction and rejection in the field of liver transplantation and clinical hepatic dysfunction with increased mortality. Although the pathological mechanisms of hepatic ischemia-reperfusion injury are very complex, and several intermediators and cells are involved in this phenomenon, oxidative stress and inflammatory responses are the key processes that aggravate hepatic injury. This review summarizes the current understanding of oxidative stress and inflammatory responses and, in that respect, addresses the therapeutic approaches to attenuate hepatic ischemia-reperfusion injury.

• Journal of Yeungnam Medical Science
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• 제40권2호
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• pp.123-135
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• 2023

Advances in perinatal and pediatric intensive care and recent advances in mechanical ventilation during the last two decades have resulted in an exponential increase in the number of children undergoing home mechanical ventilation (HMV) treatment. Although its efficacy in chronic respiratory failure is well established, HMV in children is more complex than that in adults, and there are more considerations. This review outlines clinical considerations for HMV in children. The goal of HMV in children is not only to correct alveolar hypoventilation but also to maximize development as much as possible. The modes of ventilation and ventilator settings, including ventilation masks, tubing, circuits, humidification, and ventilator parameters, should be tailored to the patient's individual characteristics. To ensure effective HMV, education for the parent and caregiver is important. HMV continues to change the scope of treatment for chronic respiratory failure in children in that it decreases respiratory morbidity and prolongs life spans. Further studies on this topic with larger scale and systemic approach are required to ensure the better outcomes in this population.

• Journal of Yeungnam Medical Science
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• 제40권4호
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• pp.352-363
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• 2023

Sarcopenia is a condition in which muscle mass and strength are decreased and muscle function is impaired. It is an indicator of frailty and loss of independence in older adults. It is also associated with increased physical disability, which increases the risk of falls. As a multifactorial disease, sarcopenia is caused by a combination of factors including aging, hormonal changes, nutritional deficiencies, and physical inactivity. Understanding the underlying pathophysiology of sarcopenia and identifying its different causes is critical to developing effective prevention and treatment strategies. This review summarizes the pathophysiology, consequences, diagnostic methods, and multidisciplinary approaches to sarcopenia.

• Journal of Yeungnam Medical Science
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• 제41권1호
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• pp.13-21
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• 2024

Gene therapy involves the introduction of foreign genetic material into host tissue to alter the expression of genetic products. Gene therapy represents an opportunity to alter the course of various diseases. Hence, genetic products utilizing safe and reliable vectors with improved biotechnology will play a critical role in the treatment of various diseases in the future. This review summarizes various important vectors for gene therapy along with modern techniques for potential craniofacial regeneration using gene therapy. This review also explains current molecular approaches for the management and treatment of cancer using gene therapy. The existing literature was searched to find studies related to gene therapy and its role in craniofacial regeneration and cancer treatment. Various databases such as PubMed, Science Direct, Scopus, Web of Science, and Google Scholar were searched for English language articles using the keywords "gene therapy," "gene therapy in present scenario," "gene therapy in cancer," "gene therapy and vector," "gene therapy in diseases," and "gene therapy and molecular strategies."

• Journal of Yeungnam Medical Science
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• 제41권1호
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• pp.22-29
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• 2024

Breakthrough pain is transitory pain that occurs despite the use of opioids for background pain control. Breakthrough pain occurs in 40% to 80% of patients with cancer pain. Despite effective analgesic therapy, patients and their caregivers often feel that their pain is not sufficiently controlled. Therefore, an improved understanding of breakthrough pain and its management is essential for all physicians caring for patients with cancer. This article reviews the definition, clinical manifestations, accurate diagnostic strategies, and optimal treatment options for breakthrough pain in patients with cancer. This review focuses on the efficacy and safety of rapid-onset opioids, which are the primary rescue drugs for breakthrough pain.

• Clinical and Experimental Reproductive Medicine
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• 제50권4호
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• pp.223-229
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• 2023

Endometriosis is characterized by the implantation of endometrial cells outside the uterus. This hormone-dependent disease is highly prevalent among women of reproductive age. Clinical symptoms of endometriosis include dysmenorrhea, pelvic pain, and infertility, which can negatively impact the overall quality of life of those affected. The medical treatment of endometriosis serves as an important therapeutic option, aimed at alleviating pain associated with the condition and suppressing the growth of endometriotic lesions. As such, it is employed as an adjuvant therapy following surgery or an empirical treatment after the clinical diagnosis of endometriosis. Dienogest, a fourth-generation progestin, has received approval for the treatment of endometriosis in many countries. A growing body of evidence has demonstrated its efficacy in managing endometriosis-associated pain, preventing symptoms, and reducing lesion recurrence. In this review, we examine the clinical efficacy, safety, and tolerability of dienogest in treating endometriosis. We also provide updated findings, drawing from clinical studies that focus on the long-term use of this medication in patients with endometriosis.

• 대중서사연구
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• 제25권2호
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• pp.169-216
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• 2019

본 연구는 서사물 장르와 사회 사이의 공진화(共進化)를 분석하기 위한 도구로 바흐친의 크로노토프(Chronotope) 개념을 제안한다. 바흐친은 크로노토프 개념을 통해 문학작품이 시간과 공간 축이 교차되는 토대 위에 있으며, 그러한 교차 위에 서 있는 문학작품이 언제나 사회적이고 역사적인 크로노토프와 대화하고 상호 침투하고 있다고 말한다. 따라서 문학작품, 또 그것에서 확장된 영화나 드라마 등 서사물 일반의 크로노토프를 찾아내고 분석하는 일은 서사물의 크로노토프와 사회의 크로노토프가 어떤 공명 과정을 통해 특정한 사회적 실재들을 만들어왔는가를 밝히는 일이다. 이러한 개념을 분석적으로 활용하기 위해 '크로노토프 드라마 분석 방법'을 제안하고 구체적으로 한국 메디컬 드라마 장르를 분석했다. 의료와 건강, 질병이라는 자연화된 범주들은 실제로 사회적으로 구성된 실재들이며, 이러한 사회적 구성 과정에 큰 영향을 미치는 대중서사물에 대한 분석은 중요하지만 과소하게 이루어진 작업이다. 분석 결과, 한국 메디컬 드라마의 크로노토프는 <종합병원> 이래로 등장한 '학교의 크로노토프'와 <하얀거탑> 이래로 등장한 '밀실의 크로노토프'를 변주하며 발달하고 있었다. 이때 장르적 크로노토프는 공간적으로는 확장되고 시간적으로는 응집되어가고 있었다. 다시 말해 장르 내 구조와 체계의 영향력은 커지고, 개별 주체들의 역량은 작아졌다. 이러한 크로노트프의 변화는 신자유주의적인 공간 팽창과 동시적 생산이라는 사회적 현실의 크로노토프와 공명하는 것으로 해석되었다. 한국 사회를 지배하고 있는 신자유주의적 흐름은 의료라는 범주를 포섭해 나갔으며 나아가 드라마 텍스트의 크로노토프에 영향을 미치고 있었다. 또한 메디컬 드라마 장르가 만들어내는 의료에 대한 대중적 이해는 다시 의료라는 사회적 실재를 구성하는 과정에 틈입했을 것으로 짐작할 수 있다.