{"title":"Diagnostic performance of immunohistochemistry and rapid urease test in detecting Helicobacter pylori, emphasizing bacterial localization and mucosal changes: a retrospective cross-sectional study.","authors":"Kongsak Loharamtaweethong, Chalermpak Supakatitham","doi":"10.12701/jyms.2025.42.41","DOIUrl":"https://doi.org/10.12701/jyms.2025.42.41","url":null,"abstract":"<p><strong>Background: </strong>Accurate detection of Helicobacter pylori is essential for the diagnosis and management of gastritis and related gastrointestinal disorders. This study aimed to evaluate the diagnostic performance of the rapid urease test (RUT) and immunohistochemistry (IHC) using four antibodies (from BioGenex, Tokyo Medical and Dental University [TMDU], Cell Marque, and Dako), with a focus on bacterial localization (surface vs. subepithelial) and associated mucosal changes.</p><p><strong>Methods: </strong>Gastric biopsy specimens from patients who underwent upper endoscopy at Vajira Hospital between June and December 2022 were retrospectively analyzed. Histological evaluations included hematoxylin and eosin staining, RUT, and IHC. The sensitivity of each antibody for detecting H. pylori was compared, with special attention paid to subepithelial colonization and histopathological patterns.</p><p><strong>Results: </strong>The BioGenex antibody exhibited the highest sensitivity in detecting H. pylori, followed by TMDU, Cell Marque, and Dako antibodies. RUT demonstrated the lowest sensitivity, particularly in cases of chronic nonactive gastritis or minimal mucosal changes. Among the IHC antibodies, BioGenex detected the greatest number of subepithelial H. pylori cases, many of which were missed by the other antibodies and RUT. Subepithelial colonization typically presented as dot-like signals suggestive of coccoid forms or bacterial remnants. The BioGenex antibody identified all subepithelial cases detected by the TMDU antibody, highlighting the former's superior sensitivity. Statistical analysis confirmed the significantly higher diagnostic accuracy of the BioGenex antibody across multiple histological subgroups (p<0.05).</p><p><strong>Conclusion: </strong>Subepithelial H. pylori colonization is clinically relevant and often undetected by RUT or less sensitive IHC antibodies. The BioGenex antibody was the most effective in identifying H. pylori in both surface and subepithelial regions. Patients with suspected subepithelial infection, particularly those without detectable surface bacteria, should undergo further evaluation using urea breath tests or stool antigen assays, in accordance with current clinical guidelines.</p>","PeriodicalId":74020,"journal":{"name":"Journal of Yeungnam medical science","volume":"42 ","pages":"41"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Asem Ali Ashraf, Sayantani Nag, Vimal Kumar Karnaker
{"title":"Unusual Serratia marcescens pleural infection in secondary spontaneous pneumothorax: a case report.","authors":"Asem Ali Ashraf, Sayantani Nag, Vimal Kumar Karnaker","doi":"10.12701/jyms.2025.42.35","DOIUrl":"10.12701/jyms.2025.42.35","url":null,"abstract":"<p><p>Serratia marcescens is an opportunistic gram-negative pathogen that causes pneumonia, bloodstream infections, and urinary tract infections, particularly in individuals who are immunocompromised. Although commonly associated with pulmonary infections, its involvement in pneumothorax-related infections is exceedingly rare. Secondary spontaneous pneumothorax (SSP) is a life-threatening condition that can complicate underlying lung diseases, such as chronic obstructive pulmonary disease (COPD). This case report describes a rare presentation of S. marcescens infection in a patient with SSP complicated by a bronchopleural fistula. A 64-year-old male with a history of COPD, chronic smoking, and alcohol use presented with progressive dyspnea, cough, and left-sided chest pain. Clinical evaluation revealed tachypnea, tracheal deviation, and reduced breath sounds in the left lung. Laboratory investigations revealed leukocytosis with marked neutrophilia and an elevated erythrocyte sedimentation rate. Chest imaging confirmed pneumothorax, necessitating intercostal drain (ICD) placement. Pleural fluid cultures identified multidrug-resistant S. marcescens, prompting antibiotic escalation to intravenous meropenem and oral faropenem. Despite prolonged antimicrobial therapy and ICD placement, persistent pneumothorax with a bronchopleural fistula was noted. Bronchoscopy with Fogarty balloon placement and cyanoacrylate closure was performed. However, owing to financial constraints, the patient declined follow-up cultures and high-resolution computed tomography imaging, and was discharged with an ICD in situ. This case underscores the need for heightened clinical awareness of S. marcescens in pneumothorax-associated infections. Early microbiological identification and targeted therapy are crucial for the management of rare yet challenging presentations, particularly in resource-limited settings.</p>","PeriodicalId":74020,"journal":{"name":"Journal of Yeungnam medical science","volume":"42 ","pages":"35"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082570","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}
Soo Hyun Ahn, Mathieu Boudier-Revéret, Seoyon Yang, Min Cheol Chang
{"title":"A 30-year-old male patient who experienced recurring weakness in bilateral upper and lower extremities: a clinical vignette.","authors":"Soo Hyun Ahn, Mathieu Boudier-Revéret, Seoyon Yang, Min Cheol Chang","doi":"10.12701/jyms.2025.42.27","DOIUrl":"10.12701/jyms.2025.42.27","url":null,"abstract":"","PeriodicalId":74020,"journal":{"name":"Journal of Yeungnam medical science","volume":"42 ","pages":"27"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442838","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}
Jae-Sung Yoo, Kyeong Ok Kim, Min Cheol Kim, Byung Ik Jang
{"title":"Clinical association between histological activity at diagnosis and endoscopic response in patients with ulcerative colitis: a retrospective study.","authors":"Jae-Sung Yoo, Kyeong Ok Kim, Min Cheol Kim, Byung Ik Jang","doi":"10.12701/jyms.2025.42.39","DOIUrl":"https://doi.org/10.12701/jyms.2025.42.39","url":null,"abstract":"<p><strong>Background: </strong>Histological activity in ulcerative colitis (UC) has been accepted to be associated with clinical outcomes. This study aimed to investigate the association between the histological activity at diagnosis and endoscopic findings, either at diagnosis or at the first follow-up, in patients with UC.</p><p><strong>Methods: </strong>Through a retrospective review of 1 year of medical records, this study evaluated the association between histological and endoscopic activity in 51 patients newly diagnosed with UC at our hospital between March 2015 and February 2022. The Nancy histological index was used to assess histological activity, classifying patients into low (0-2) and high (3-4) groups. The Mayo Endoscopic Subscore and the Ulcerative Colitis Endoscopic Index of Severity (UCEIS) were used for endoscopic activity scoring.</p><p><strong>Results: </strong>At diagnosis, UCEIS demonstrated no statistically significant difference histologically (p=0.065), and histological and endoscopic activities were not significantly correlated (r=0.18, p=0.200). During the first follow-up, 40 patients (78.4%) exhibited low histological activity, and the number of patients with high histological activity decreased after treatment. The first follow-up endoscopy revealed that 30 patients (58.8%) achieved an endoscopic response, including 9 (56.2%) and 21 patients (60.0%) in the high and low groups, respectively, with no significant difference (p=0.800). However, the high group at diagnosis demonstrated a positive correlation with UCEIS endoscopic activity during the first follow-up (r=0.37, p<0.001).</p><p><strong>Conclusion: </strong>High histological activity at diagnosis was positively correlated with endoscopic activity at the first follow-up. More active care should be provided to patients with high histological activity during diagnosis.</p>","PeriodicalId":74020,"journal":{"name":"Journal of Yeungnam medical science","volume":"42 ","pages":"39"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Patient-specific predictors of successful frozen embryo transfer using the freeze-all protocol: a retrospective observational study.","authors":"Hyun Joo Lee, Eun Hee Yu, Jong Kil Joo","doi":"10.12701/jyms.2025.42.28","DOIUrl":"10.12701/jyms.2025.42.28","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to examine various patient factors affecting first programmed embryo transfer (ET) outcomes under the freeze-all policy at a single tertiary university infertility center.</p><p><strong>Methods: </strong>This retrospective observational study reviewed the medical records of 243 couples who underwent their first ET using blastocysts collected under the freeze-all antagonist-controlled ovarian stimulation (COS) protocol from 2015 to 2023. Patients were grouped into pregnant and nonpregnant groups, and their data, including demographics, COS and ET outcomes, and embryo storage duration, were analyzed.</p><p><strong>Results: </strong>Patient body mass index, cause of infertility, follicle-to-oocyte index, distribution of blastocyst grades, number of transferred embryos, and embryo storage duration were not significantly different between the groups. In a simple comparative analysis, patients with successful clinical pregnancy tended to have significantly lower female and male age (33.83±3.67 and 35.32±4.54 years vs. 37.07±4.15 and 39.33±5.60 years, respectively), higher anti-Müllerian hormone levels (6.27±5.32 ng/mL vs. 4.14±3.82 ng/mL) and antral follicle counts (14.20±8.26 vs. 10.04±5.75), and higher numbers of retrieved oocytes and metaphase II oocytes (13.74±6.92 and 9.64±6.19 vs. 11.21±6.04 and 7.53±5.56, respectively). Multivariate logistic regression analysis of these variables revealed that only male age was a significant factor for successful clinical pregnancy (odds ratio, 4.768; 95% confidence interval, 1.252-18.162; p=0.022).</p><p><strong>Conclusion: </strong>During the first programmed ET using blastocysts collected under the freeze-all antagonist COS protocol, male age and correspondingly the quality of gametes for fertilization were crucial for successful pregnancy, having more importance than calculated female ovarian reserve and embryo storage duration.</p>","PeriodicalId":74020,"journal":{"name":"Journal of Yeungnam medical science","volume":"42 ","pages":"28"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494992","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":"Advances in hepatocellular carcinoma: hepatocarcinogenesis, role of exosomal noncoding RNAs, and diagnostic pathology.","authors":"Joon Hyuk Choi","doi":"10.12701/jyms.2024.01221","DOIUrl":"10.12701/jyms.2024.01221","url":null,"abstract":"","PeriodicalId":74020,"journal":{"name":"Journal of Yeungnam medical science","volume":" ","pages":"2"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591300","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":"Overview of hepatocarcinogenesis focusing on cellular origins of liver cancer stem cells: a narrative review.","authors":"Jong Ryeol Eun","doi":"10.12701/jyms.2024.01088","DOIUrl":"10.12701/jyms.2024.01088","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) accounts for 85% to 90% of primary liver cancers and generally has a poor prognosis. The hierarchical model, which posits that HCC originates from liver cancer stem cells (CSCs), is now widely accepted, as it is for other cancer types. As CSCs typically reside in the G0 phase of the cell cycle, they are resistant to conventional chemotherapy. Therefore, to effectively treat HCC, developing therapeutic strategies that target liver CSCs is essential. Clinically, HCCs exhibit a broad spectrum of pathological and clinical characteristics, ranging from well-differentiated to poorly differentiated forms, and from slow-growing tumors to aggressive ones with significant metastatic potential. Some patients with HCC also show features of cholangiocarcinoma. This HCC heterogeneity may arise from the diverse cellular origins of liver CSCs. This review explores the normal physiology of liver regeneration and provides a comprehensive overview of hepatocarcinogenesis, including cancer initiation, isolation of liver CSCs, molecular signaling pathways, and microRNAs. Additionally, the cellular origins of liver CSCs are reviewed, emphasizing hematopoietic and mesenchymal stem cells, along with the well-known hepatocytes and hepatic progenitor cells.</p>","PeriodicalId":74020,"journal":{"name":"Journal of Yeungnam medical science","volume":" ","pages":"3"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633213","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}
Riva Satya Radiansyah, Yuri Pamungkas, Ilham Ikhtiar
{"title":"Magnesium as an adjunct to nimodipine in subarachnoid hemorrhage: a meta-analysis.","authors":"Riva Satya Radiansyah, Yuri Pamungkas, Ilham Ikhtiar","doi":"10.12701/jyms.2025.42.26","DOIUrl":"10.12701/jyms.2025.42.26","url":null,"abstract":"<p><strong>Background: </strong>Subarachnoid hemorrhage (SAH) is a devastating neurological condition with high morbidity and mortality rates. Although nimodipine is widely used in the management of SAH, the potential benefits of magnesium as adjunct therapy remain unclear. This meta-analysis aimed to evaluate the efficacy and safety of combining magnesium with nimodipine for the management of SAH.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using PubMed, ScienceDirect, Google Scholar, and the Cochrane Library. Randomized controlled trials and prospective cohort studies comparing magnesium plus nimodipine versus nimodipine alone in patients with SAH were included. Key outcomes included cerebral vasospasm (CV), delayed cerebral ischemia (DCI), functional outcomes, mortality, and adverse events.</p><p><strong>Results: </strong>Twelve studies involving 2,338 patients were included. The combination of magnesium and nimodipine significantly reduced the incidence of CV (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.29-0.95; p=0.03) and DCI (OR, 0.52; 95% CI, 0.31-0.87; p=0.01) compared to nimodipine alone. However, no significant differences were found in functional outcomes (modified Rankin Scale: OR, 0.97; p=0.75; Glasgow Outcome Scale: OR, 0.81; p=0.24), mortality (OR, 0.97; p=0.83), or secondary cerebral infarction (OR, 0.38; p=0.12). The incidence of adverse events was higher in the combination group; however, this difference was not statistically significant (OR, 3.14; p=0.33).</p><p><strong>Conclusion: </strong>Adding magnesium to nimodipine therapy in patients with SAH may help reduce CV and DCI incidence but does not significantly improve functional outcomes or mortality. Further large-scale studies are needed to optimize the dosing regimens and confirm these findings.</p>","PeriodicalId":74020,"journal":{"name":"Journal of Yeungnam medical science","volume":"42 ","pages":"26"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082129","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":"Intrameniscal ossicle: an overlooked cause of knee pain.","authors":"Berkay Yalçınkaya, Ahmet Furkan Çolak, Murat Kara","doi":"10.12701/jyms.2025.42.38","DOIUrl":"10.12701/jyms.2025.42.38","url":null,"abstract":"","PeriodicalId":74020,"journal":{"name":"Journal of Yeungnam medical science","volume":"42 ","pages":"38"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The feasibility of conducting successful pulmonary rehabilitation in India.","authors":"Manivel Arumugam, Senthilkumar Ramasamy, Pitchaimani Govindharaj, Mahendran Murugan","doi":"10.12701/jyms.2025.42.40","DOIUrl":"https://doi.org/10.12701/jyms.2025.42.40","url":null,"abstract":"<p><p>Pulmonary rehabilitation (PR) is a highly effective evidence-based treatment with multidisciplinary and comprehensive individualized interventions that reduce morbidity by improving functional capacity and managing respiratory symptoms. It can contribute to overall wellness, reduce symptoms related to respiratory conditions, and facilitate routine work and social activities. Hence, it is a vital component of integrated care for patients with chronic respiratory diseases. In India, PR faces several challenges arising from patients, society, and hospitals. Recent evidence suggests that PR has significant benefits in chronic respiratory diseases, including reduced morbidity and mortality, improved quality of life, and cost savings. Nevertheless, it has been significantly underutilized and has not received the necessary attention in India. The lack of proper utilization of PR can be attributed to several factors, including a lack of awareness and understanding among healthcare professionals regarding its advantages, insufficient referrals to PR programs, scarcity of specialized professionals trained in PR, and a general lack of awareness among patients about its benefits. This article aims to outline the obstacles to PR, identify the factors that influence its successful implementation, and propose possible solutions to overcome these barriers.</p>","PeriodicalId":74020,"journal":{"name":"Journal of Yeungnam medical science","volume":"42 ","pages":"40"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}