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Reviews

[English]
Impact of pulmonary tuberculosis on lung cancer screening: a narrative review
Jeong Uk Lim
Received February 16, 2025  Accepted March 17, 2025  Published online March 26, 2025  
DOI: https://doi.org/10.12771/emj.2025.00052    [Epub ahead of print]
Lung cancer remains a leading cause of cancer-related mortality worldwide. Low-dose computed tomography (LDCT) screening has demonstrated efficacy in reducing lung cancer mortality by enabling early detection. In several countries, including Korea, LDCT-based screening for high-risk populations has been incorporated into national healthcare policies. However, in regions with a high tuberculosis (TB) burden, the effectiveness of LDCT screening for lung cancer may be influenced by TB-related pulmonary changes. Studies indicate that the screen-positive rate in TB-endemic areas differs from that in low-TB prevalence regions. A critical challenge is the differentiation between lung cancer lesions and TB-related abnormalities, which can contribute to false-positive findings and increase the likelihood of unnecessary invasive procedures. Additionally, structural lung damage from prior TB infections can alter LDCT interpretation, potentially reducing diagnostic accuracy. Nontuberculous mycobacterial infections further complicate this issue, as their radiologic features frequently overlap with those of TB and lung cancer, necessitating additional microbiologic confirmation. Future research incorporating artificial intelligence and biomarkers may enhance diagnostic precision and facilitate a more personalized approach to lung cancer screening in TB-endemic settings.
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Special topic: cutting-edge technologies in radiation therapy

[English]
Challenges and opportunities to integrate artificial intelligence in radiation oncology: a narrative review
Chiyoung Jeong, YoungMoon Goh, Jungwon Kwak
Ewha Med J 2024;47(4):e49.   Published online October 31, 2024
DOI: https://doi.org/10.12771/emj.2024.e49

Artificial intelligence (AI) is rapidly transforming various medical fields, including radiation oncology. This review explores the integration of AI into radiation oncology, highlighting both challenges and opportunities. AI can improve the precision, efficiency, and outcomes of radiation therapy by optimizing treatment planning, enhancing image analysis, facilitating adaptive radiation therapy, and enabling predictive analytics. Through the analysis of large datasets to identify optimal treatment parameters, AI can automate complex tasks, reduce planning time, and improve accuracy. In image analysis, AI-driven techniques enhance tumor detection and segmentation by processing data from CT, MRI, and PET scans to enable precise tumor delineation. In adaptive radiation therapy, AI is beneficial because it allows real-time adjustments to treatment plans based on changes in patient anatomy and tumor size, thereby improving treatment accuracy and effectiveness. Predictive analytics using historical patient data can predict treatment outcomes and potential complications, guiding clinical decision-making and enabling more personalized treatment strategies. Challenges to AI adoption in radiation oncology include ensuring data quality and quantity, achieving interoperability and standardization, addressing regulatory and ethical considerations, and overcoming resistance to clinical implementation. Collaboration among researchers, clinicians, data scientists, and industry stakeholders is crucial to overcoming these obstacles. By addressing these challenges, AI can drive advancements in radiation therapy, improving patient care and operational efficiencies. This review presents an overview of the current state of AI integration in radiation oncology and insights into future directions for research and clinical practice.

Citations

Citations to this article as recorded by  
  • Cutting-edge technologies in external radiation therapy
    Jun Won Kim
    The Ewha Medical Journal.2024;[Epub]     CrossRef
  • Institution-Specific Autosegmentation for Personalized Radiotherapy Protocols
    Wonyoung Cho, Gyu Sang Yoo, Won Dong Kim, Yerim Kim, Jin Sung Kim, Byung Jun Min
    Progress in Medical Physics.2024; 35(4): 205.     CrossRef
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  • 1 Web of Science
  • 2 Crossref

Review Article

Review Articles

[English]
What is the role of artificial intelligence in general surgery?
Seung Min Baik, Ryung-Ah Lee
Ewha Med J 2024;47(2):e22.   Published online April 30, 2024
DOI: https://doi.org/10.12771/emj.2024.e22

The capabilities of artificial intelligence (AI) have recently surged, largely due to advancements in deep learning inspired by the structure and function of the neural networks of the human brain. In the medical field, the impact of AI spans from diagnostics and treatment recommendations to patient engagement and monitoring, considerably improving efficiency and outcomes. The clinical integration of AI has also been examined in specialties, including pathology, radiology, and oncology. General surgery primarily involves manual manipulation and includes preoperative, intraoperative, and postoperative care, all of which are critical for saving lives. Other fields have strived to utilize and adopt AI; nonetheless, general surgery appears to have retrogressed. In this review, we analyzed the published research, to understand how the application of AI in general surgery differs from that in other medical fields. Based on previous research in other fields, the application of AI in the preoperative stage is nearing feasibility. Ongoing research efforts aim to utilize AI to improve and predict operative outcomes, enhance performance, and improve patient care. However, the use of AI in the operating room remains significantly understudied. Moreover, ethical responsibilities are associated with such research, necessitating extensive work to gather evidence. By fostering interdisciplinary collaboration and leveraging lessons from AI success stories in other fields, AI tools could be specifically tailored for general surgery. Surgeons should be prepared for the integration of AI into clinical practice to achieve better outcomes; therefore, the time has come to consider ethical and legal implications.

Citations

Citations to this article as recorded by  
  • Gender equity in medicine, artificial intelligence, and other articles in this issue
    Sun Huh
    The Ewha Medical Journal.2024;[Epub]     CrossRef
  • 323 View
  • 6 Download
  • 1 Crossref

Original Article

[English]
Verification of the Performance of the Panbio COVID-19 Ag Rapid Test Device for Implementation in the Clinical Laboratory
Hae-Sun Chung, Ji Su Chung, Yeo-Jin Lee, Seonwoo Lee, Juhyun Jeong, Min-Kyung So, Miae Lee
Ewha Med J 2023;46(1):e2.   Published online January 31, 2023
DOI: https://doi.org/10.12771/emj.2023.e2
ABSTRACT Objectives:

The Panbio COVID-19 Ag Rapid Test Device (Panbio COVID-19 Ag, Abbott Rapid Diagnostics) is a lateral flow immunochromatographic assay targeting the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleoprotein in nasopharyngeal specimens for the diagnosis of coronavirus disease 2019 (COVID-19). This study aimed to verify the performance of the Panbio COVID-19 Ag for implementation in clinical laboratories.

Methods:

Sixty nasopharyngeal swab specimens (30 positive and 30 negative) dipped in transport medium, and COVID-19 was confirmed using real-time RT-PCR using Allplex SARS-CoV-2 assay (Seegene), were tested using the Panbio COVID-19 Ag. Reproducibility was evaluated using positive and negative control materials. Sensitivity and specificity were calculated based on the results of real-time RT-PCR as the standard test method.

Results:

Reproducibility was confirmed by the consistent results of repeated tests of the quality control materials. The overall sensitivity and specificity of Panbio COVID-19 Ag were 50.0% and 100.0%, respectively. Panbio COVID-19 Ag demonstrated high sensitivity (88.2%) in analyzing the detection limit cycle threshold (Ct) value of 26.67 provided by the manufacturer as a positive criterion, and the sensitivity was 100.0% for the positive criterion of Ct values <25, although it was less sensitive for Ct ≥25.

Conclusion:

Considering the high sensitivity for positive samples with Ct values <25 and the rapid turnaround of results, Panbio COVID-19 Ag can be used in clinical laboratories to diagnose COVID-19 in limited settings.

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Case Reports

[English]
ABSTRACT

A 25-year-old female visited the clinic with abdominal pain and poor oral intake. She was diagnosed with Crohn’s disease and had a history of using infliximab for 4 years. She had no previous operative history. Magnetic resonance enterography demonstrated the progression of a penetrating complication that involved the distal ileum and complex entero-enteric fistula between the terminal ileum and sigmoid colon. Surgery was conducted using the da Vinci SP surgical system. In the operative field, severe adhesion was observed between the terminal ileum, adjacent ileum, cecum, and the sigmoid colon. After adhesiolysis of the small bowel and right colon was performed, the fistula tract between the sigmoid colon and terminal ileum was identified and resected. Then, simultaneous ileocecectomy and anterior resection was performed. The operation was completed without any intraoperative complications and patient’s recovery was uneventful. She was discharged postoperatively, after 8 days.

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[English]
Postherpetic Neuralgia Aggravated by Upper Complete Denture
Hyun Joo Heo, Yu Yil Kim, Ji Hye Lee, So Mang Im, Ok Hyun Kim, Han Gyeol Lee
Ewha Med J 2018;41(4):82-85.   Published online October 29, 2018
DOI: https://doi.org/10.12771/emj.2018.41.4.82

Postherpetic neuralgia (PHN) is a chronic and refractory pain disease. It requires longterm treatment and follow-up. Comorbid diseases can change or aggravate the pain condition and responsiveness of patients to PHN treatment. In such cases, the cause of pain should be identified through proper testing, and appropriate treatment should be administered. Herein, we report the case of a 67-year-old man with PHN in the maxillary nerve. As the pain was being controlled with medication and infraorbital nerve block, the patient experienced deterioration of pain caused by a newly worn upper complete denture. The patient's pain was relieved following correction of the upper complete denture.

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Original Articles

[English]
Role of β1-Integrin in Colorectal Cancer: Case-Control Study
Bo Young Oh, Kwang Ho Kim, Soon Sup Chung, Kyoung Sook Hong, Ryung-Ah Lee
Ewha Med J 2017;40(2):77-86.   Published online April 28, 2017
DOI: https://doi.org/10.12771/emj.2017.40.2.77
Objectives

In the metastatic process, interactions between circulating tumor cells (CTCs) and the extracellular matrix or surrounding cells are required. β1-integrin may mediate these interactions. The aim of this study was to investigate whether β1-integrin is associated with the detection of CTCs in colorectal cancer.

Methods

We enrolled 30 patients with colorectal cancer (experimental group) and 30 patients with benign diseases (control group). Blood samples were obtained from each group, carcinoembryonic antigen (CEA) mRNA for CTCs marker and β1-integrin mRNA levels were estimated by using reverse transcription-polymerase chain reaction, and the results were compared between the two groups.

Results

CEA mRNA was detected more frequently in colorectal cancer patients than in control patients (P=0.008). CEA mRNA was significantly reduced after surgery in the colorectal cancer patients (P=0.032). β1-integrin mRNA was detected more in colorectal cancer patients than in the patients with benign diseases (P<0.001). In colorectal cancer patients, expression of β1-integrin mRNA was detected more for advanced-stage cancer than for early-stage cancer (P=0.033) and was significantly decreased after surgery (P<0.001). In addition, expression of β1-integrin mRNA was significantly associated with that of CEA mRNA in colorectal cancer patients (P=0.001).

Conclusion

In conclusion, β1-integrin is a potential prognostic factor following surgical resection in colorectal cancer patients. β1-integrin may be a candidate for use as a marker for early detection of micrometastatic tumor cells and for monitoring the therapeutic response in colorectal cancer patients.

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[English]
Objective

Elevated serum lgE and pheripheral blood eosinophilia are immunologic hallmark in helminthic infections. Recently, these responses are known to be regulated by Th2-specific cytokine IL-4 and IL-5, respectively. And also, the antagonistic effects of IFN-γ on Th2 cell proliferation were shown in vitro. However, few studies on the effect of IFN-γ on Th2 cytokine responses in Paragonimus westermani infection are reported, In this study, effects of rIFN-γ on serum lgE production and the number of pheripheral blood eosinophils in mice infected with P.westermani were examined.

Methods

5-6week old male BALB/c mice treated with IFN-γ were divided into 3 groups. All the mice were inoculated orally with 20 metacercariae of P.westermani. GroupImice(0-14days) were treated intraperitoneally with 2×103 unit of rIFN-γ at daily intervals from the time of the infection to 4th day infection, group II mice(5-14 days) were treated with rIFN-γ from the 5th to the 14th day of infection and group III mice(8-14 days) were treated from the 8th to the 14th of infection. Total serum lgE and the number of pheripheral blood eosinophils were examined in infected mice treated with rIFN-γ.

Results

The serum lgE levels in groupIand II were decreased compared with those of infected mice with no treatment with rIFN-γ, but not significantly. The number of pheripheral blood eosinophils in group I and II were decreased compared with those of infected mice with no treatment with rIFN-γ, especially significant(p<0.05) reduction was shown in group I. However, the serum lgE levels and number of pheripheral blood eosinophils in group III were similar to those of infected mice with no treatment with rIFN-γ.

Conclusion

These results suggest that IFN-γ decreases Th2 cytokine response in P.westermani-infected mice. However, IFN-γ treatment has less of an effect once the production of Th2-associated cytokines has become established.

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[English]
Objective

This study was performed to investigate the prevalence of abnormal behavior, ada-ptability and intelligence of child and adolescents and the usefulness of KAS(Korean Attitude System) as a screening method to detect the psychopathology of child and adolescents.

Method

478 child and adolescents were completed the instruments of KAS that focused on development of behavior, adaptability and intelligence at the children's medical examination center.

Results

The most influenced subcategories to the disturbance of behavior of the subjects were leadership, cooperation, and emotion (in order). The preference of adaptability was high in the fields of literature, law, technology, medicine and sociology. The mean I.Q. of the subjects was high average and not different in both sex. The subjects with below average of I.Q. were three cases(0.6%) and the two of them were boderline and only one case was mild mental retardation. The total number of patients referred to the department of psychiatry was eight cases(1.7%) and revealed the disturbance of behavior, affect, and thought.

Conclusions

Finally the authors concluded that KAS test performed at the children's medical examination center was useful primary screening method to detect the psychopathology of child and adolescents.

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Case Report

[English]
Pseudomembranous Colitis: A Complicated Case with Transient Increase of Carcinoembryonic Antigen
Dong In Nam, Chung Kang, Il Hyung Jung, Hyun Gee Moon, Bo Ram Youn, Nam Hun Lee
Ewha Med J 2015;38(1):54-58.   Published online March 26, 2015
DOI: https://doi.org/10.12771/emj.2015.38.1.54

Pseudomembranous colitis (PMC) is a frequent cause of morbidity and mortality among hospitalized patients. Although diarrhea is the most common manifestation, PMC may be associated with intraperitoneal fluid accumulation in the severe cases. And a few cases showing both ascites and pleural effusion have been reported in patients with PMC. We report a case of PMC who showed elevated serum and ascites levels of carcinoembryonic antigen (CEA) with a normal CEA level in pleural effusion and who successfully recovered after oral administration of metronidazole. After treatment, the serum CEA level returned to the reference range.

Citations

Citations to this article as recorded by  
  • A Rare Case of Pseudomembranous Colitis Presenting with Pleural Effusion and Ascites with Literature Review
    Hossain Salehi, Amir Mohammad Salehi, Yoshihiro Moriwaki
    Case Reports in Gastrointestinal Medicine.2021; 2021: 1.     CrossRef
  • Serum tumor markers in chronic kidney disease: as clinical tool in diagnosis, treatment and prognosis of cancers
    Fateme Shamekhi Amiri
    Renal Failure.2016; 38(4): 530.     CrossRef
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  • 2 Crossref
Original Article
[English]
Huge Dentigerous Cyst
Chong Nahm Kim, Sang Il Park, Jae Yeon Lee, Yoon Hee Cho
Ihwa Ŭidae chi 1998;21(3):157-160.   Published online September 30, 1998
DOI: https://doi.org/10.12771/emj.1998.21.3.157

Dentigerous cyst represents cystic enlargement of the follicle of an impacted tooth. It is the sites of predilection mirror the favored sites if impacted teeth : mandibular third molars, maxillary third molars, and maxillary canines. These cysts are most prevalent in the second to fourth decades. Most cysts are asymmetric and are discovered on routine dental radiographs, but large examples can cause displacement or resorption of adjacent teeth and infection. Microscopical examination discloses a stratified squamous epithelium covering a fibrocollagenous cyst wall.

In this case, authors present a case of huge dentigerous cyst on right piriform fossa across the midline that enucleated successfully through the right gingivobuccal approach.

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