Ewha Medical Journal最新文献

{"title":"Pneumocephalus with suspected cerebrospinal fluid leakage after epiduroscopic epidural neuroplasty: a case report.","authors":"Min Jeong Kang, Bo Kyung Kang, Seung Hee Yoo, Won-Joong Kim","doi":"10.12771/emj.2026.01459","DOIUrl":"10.12771/emj.2026.01459","url":null,"abstract":"<p><p>Pneumocephalus is a rare complication of neuraxial procedures and is usually associated with inadvertent dural puncture or the use of air during epidural space identification. Epiduroscopic epidural neuroplasty (EEN) is performed without air injection and permits direct visualization of the epidural space; therefore, pneumocephalus after this procedure is extremely uncommon. A 71-year-old woman with a history of lumbar spine surgery underwent EEN via a caudal approach without sedation. No dural puncture was identified during the procedure. Approximately 12 hours later, she developed a non-orthostatic headache. Brain computed tomography revealed pneumocephalus in the basal cistern and left lateral ventricle. Her symptoms improved with oxygen therapy but worsened 5 days later despite radiologic resolution of the pneumocephalus. Suspected cerebrospinal fluid (CSF) leakage was treated with an epidural blood patch, which resolved her symptoms. Pneumocephalus may occur after EEN without clinically or endoscopically recognized dural injury and may coexist with CSF leakage; an occult microdural defect cannot be excluded as the underlying mechanism. Prompt imaging should be considered in patients who develop early or atypical postprocedural headache.</p>","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":" ","pages":"e23"},"PeriodicalIF":0.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence as a pragmatic adjunct to molecular classification in endometrial cancer.","authors":"Gunvanti Rathod, Pragnesh Parmar","doi":"10.12771/emj.2026.01158","DOIUrl":"10.12771/emj.2026.01158","url":null,"abstract":"","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":" ","pages":"e25"},"PeriodicalIF":0.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical phenotypes and clustering patterns of human toxocariasis in PubMed-indexed case reports: an Antigravity-assisted systematic scoping review.","authors":"Eun Hee Ha","doi":"10.12771/emj.2026.01221","DOIUrl":"10.12771/emj.2026.01221","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to characterize co-occurrence patterns, statistical associations, and phenotypic clusters of clinical manifestations reported in human toxocariasis case reports indexed in PubMed from 2005 through 2025, inclusive.</p><p><strong>Methods: </strong>PubMed-indexed case reports from 2005 through 2025 were identified using the query (\"Toxocariasis\" OR \"Toxocara\") AND \"Case Reports\" [Publication Type] AND 2005:2025[dp] AND ffrft[Filter]. Free full-text articles were retrieved through PubMed Central and other links indexed in PubMed using the ffrft filter. After 7 nonhuman reports and 5 reports without objective diagnostic confirmation were excluded, 139 case reports were included. Antigravity was used to support data extraction, standardization, statistical analysis, and figure generation. Clinical features were mapped to standardized symptom and organ-involvement variables. Pairwise co-occurrence was assessed using 2×2 contingency tables and Fisher's exact test; association strength was measured using Pearson correlation coefficients; and k-means clustering was used to identify distinct clinical phenotypes.</p><p><strong>Results: </strong>Four principal clusters were identified: subclinical disease, ocular larva migrans, visceral larva migrans, and neurotoxocariasis/multisystemic disease. The ocular larva migrans and visceral larva migrans clusters were largely distinct, whereas ocular features were frequently co-reported in the neurotoxocariasis/multisystemic cluster. Eosinophilia was strongly associated with systemic manifestations, including fever, dyspnea, cough, pruritus, hepatomegaly, headache, and meningitis, but was not significantly associated with ocular features. Neurotoxocariasis-related features, including headache, meningitis, and seizures, clustered closely.</p><p><strong>Conclusion: </strong>This artificial intelligence-assisted scoping review identified exploratory clinical association and clustering patterns in human toxocariasis case reports. These findings may support clinical awareness, but they require validation in curated clinical datasets before they are used for diagnosis, risk stratification, or practice guidance.</p>","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":" ","pages":"e19"},"PeriodicalIF":0.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SKYVaricella (a live attenuated varicella vaccine) safety issues revisited.","authors":"Joowon Lee","doi":"10.12771/emj.2026.01263","DOIUrl":"10.12771/emj.2026.01263","url":null,"abstract":"","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":" ","pages":"e18"},"PeriodicalIF":0.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of ultrasound-guided bilateral rectus sheath block on postoperative pain control after robotic single-site gynecologic surgery: a randomized controlled study.","authors":"Sunyoung Moon, Sooyoung Cho, Youn Jin Kim, Seunghee Yoo, Jong Wha Lee, Hye-Won Oh, Eunbi Cho","doi":"10.12771/emj.2026.01396","DOIUrl":"10.12771/emj.2026.01396","url":null,"abstract":"<p><strong>Purpose: </strong>Rectus sheath block (RSB) is a simple abdominal wall block that can be readily applied. This study evaluated the postoperative analgesic efficacy of ultrasound-guided bilateral RSB in robotic single-site gynecologic surgery.</p><p><strong>Methods: </strong>Sixty patients were randomly assigned to the RSB group (n=30) or the control group (n=30). After induction of general anesthesia, patients in the RSB group received ultrasound-guided bilateral RSB with 30 mL of 0.25% ropivacaine. Pain intensity was assessed using a verbal numerical rating scale (VNRS) at 0, 1, 6, 12, 24, and 48 hours postoperatively. Intravenous patient-controlled analgesia was provided to all patients, and fentanyl was administered as rescue analgesia on request.</p><p><strong>Results: </strong>VNRS scores at 0, 1, and 6 hours were significantly lower in the RSB group than in the control group (all P<0.05). Rescue fentanyl use in the post-anesthesia care unit was also significantly lower in the RSB group than in the control group (19.8±21.0 μg vs. 46.3±27.6 μg, P<0.001). Subgroup analysis showed that RSB was associated with lower VNRS scores in patients undergoing ovarian surgery or myomectomy, whereas no significant difference was observed in patients undergoing hysterectomy.</p><p><strong>Conclusion: </strong>Ultrasound-guided bilateral RSB reduced early postoperative pain and rescue analgesic requirements after robotic single-site gynecologic surgery.</p>","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":" ","pages":"e20"},"PeriodicalIF":0.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unrecognized tooth aspiration mimicking a hilar lesion in a patient with COVID-19 pneumonia.","authors":"Pang-Yen Chen, Chien-Wei Chen, Yu-Jang Su","doi":"10.12771/emj.2026.01445","DOIUrl":"10.12771/emj.2026.01445","url":null,"abstract":"","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":" ","pages":"e24"},"PeriodicalIF":0.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary breast leiomyosarcoma-pathological challenges and immunohistochemical insights into the diagnosis of a rare tumor: a case report.","authors":"Ashwini Pitambra, Ashutosh Rath, Immanuel Pradeep, Krishna Ramavath, Chandramouli Ramalingam","doi":"10.12771/emj.2026.01249","DOIUrl":"10.12771/emj.2026.01249","url":null,"abstract":"<p><p>Primary leiomyosarcoma of the breast is an extremely rare malignancy, accounting for less than 1% of all breast tumors. Diagnosis is challenging because its morphology overlaps with that of other spindle cell lesions, and standardized treatment guidelines are currently unavailable. A 44-year-old woman presented with a rapidly enlarging, firm, 15×15 cm mass in the left breast. She had previously undergone surgery elsewhere, with diagnoses of leiomyoma and desmoid-type fibromatosis. Imaging demonstrated a lobulated mass without evidence of metastasis. Excision revealed pleomorphic spindle cells arranged in intersecting fascicles, with necrosis and dermal invasion. Primary breast leiomyosarcoma was confirmed by immunohistochemistry, which demonstrated smooth muscle actin and desmin positivity and negative staining for pancytokeratin, p63, S100, CD34, and BCL2. The patient underwent modified radical mastectomy followed by adjuvant radiotherapy and chemotherapy. Primary breast leiomyosarcoma is a rare entity that remains diagnostically challenging. Immunohistochemistry is essential for accurate diagnosis, and optimal management requires a dedicated multidisciplinary approach.</p>","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":" ","pages":"e21"},"PeriodicalIF":0.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compound heterozygosity with methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C mutations likely causing recurrent thrombotic events in a middle-aged man: a case report.","authors":"Yalini Suppu Saravanan, Viswanathan Pandurangan, Devasena Srinivasan","doi":"10.12771/emj.2025.00941","DOIUrl":"10.12771/emj.2025.00941","url":null,"abstract":"<p><p>Methylenetetrahydrofolate reductase (MTHFR) gene mutations, particularly homozygous mutations, have been associated with a higher incidence of venous thrombosis, coronary heart disease, and obstetric complications. We report the case of a 41-year-old man who presented with multiple vascular thrombotic events over a period of 4-5 years, including deep vein thrombosis with pulmonary thromboembolism, cerebral venous thrombosis and posterior circulation stroke. The patient was found to have elevated serum homocysteine levels and subsequently underwent genetic testing for MTHFR mutations after other potential prothrombotic conditions were excluded. This case is notable because compound heterozygous mutations of the MTHFR gene (C677T and A1298C) were identified in association with recurrent vascular thrombotic events. Management focused on long-term anticoagulation and supplementation with vitamin B6, vitamin B12, and folic acid.</p>","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":" ","pages":"e11"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13149946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Jokbo-based learning among Korean medical students.","authors":"Chul Han","doi":"10.12771/emj.2026.01214","DOIUrl":"10.12771/emj.2026.01214","url":null,"abstract":"<p><p>When the physician-government conflict was triggered by the Korean government's plan to increase medical school enrollment by 2,000 students, the government proposed the establishment of a \"Jokbo Sharing Center.\" In Korean medical education, jokbo refers to collections of previous examination questions, summarized notes, and anticipated topics compiled by senior students and transmitted across cohorts. Their scope extends beyond preclinical education and written examinations to include practical tips and informal norms passed down during clinical clerkships and internship rotations. More than a mere compilation of study resources, jokbo functions as a form of hidden curriculum within medical education. As a learning culture that has emerged organically among students, it operates implicitly beneath the formal curriculum. The creation and sharing of jokbo can foster solidarity and a sense of belonging, and may serve as a process through which students begin to internalize the professional culture essential to their future roles as physicians. Nevertheless, reliance on jokbo- based learning may undermine the depth and quality of learning over time, impeding critical thinking, problem-solving skills, and the acquisition of integrated medical knowledge. Unregulated distribution of such materials also raises concerns about examination fairness, and their reproduction without faculty consent raises legitimate ethical concerns. At the same time, given their demonstrable educational benefits, some argue for institutionalizing jokbo through transparent procedures for constructive use in medical education. Despite its widespread presence, research on jokbo remains virtually nonexistent. This study aims to establish a scholarly and policy foundation for discussion of jokbo in Korean medical education by reviewing international cases of examination material sharing and providing a comprehensive analysis of jokbo in Korea.</p>","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":" ","pages":"e9"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13149952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147311214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atherosclerotic changes in an intrasellar persistent trigeminal artery in a patient presenting with dizziness: a case report from Korea.","authors":"Jieun Byun, Boeun Lee","doi":"10.12771/emj.2025.00969","DOIUrl":"10.12771/emj.2025.00969","url":null,"abstract":"<p><p>We present a rare case of a 68-year-old woman who experienced dizziness, nausea, vomiting, and imbalance for 2 months. Imaging studies, including magnetic resonance imaging, magnetic resonance angiography, and digital subtraction angiography, revealed an intrasellar course of the persistent trigeminal artery (PTA) with atherosclerotic changes. Additionally, hypoplasia of the basilar artery and left vertebral artery was observed. The anatomically rare intrasellar PTA, combined with atherosclerosis and vertebrobasilar hypoplasia, likely contributed to compromised posterior circulation and the patient's symptoms. This case highlights the importance of considering vascular anomalies and the associated pathological changes in patients with otherwise unexplained posterior circulation symptoms.</p>","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":" ","pages":"e12"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13149949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}