Journal of Yeungnam Medical Science

Se Jin Lee

15 Articles

Lower limb ischemia after bee sting.: Hee Yun Ryu, Min Seok Yoo, Ji Young Park, Jae Woong Choi, Sung Kee Ryu, Seunghwan Kim, Se Jin Lee, Young Bin Kim; Yeungnam Univ J Med. 2016;33(2):134-137. Published online December 31, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.2.134

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Bee sting causes mild symptoms such as urticaria and localized pain, and severe symptoms including anaphylaxis, cardiovascular collapse, and death. We reported on a patient with arterial thrombotic occlusion and severe ischemia in the lower limb after multiple bee stings. The patient was stung 5 times and complained of pallor, pain, and coldness in the left toe, and did not have dorsalis pedis pulsation. Computed tomography angiography showed multiple thrombotic occlusion of the anterior and posterial tibial artery below the knee. Local thrombolytic therapy using urokinase was administered and the occluded arteries were successfully recanalized.

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A Rare Case of Acute Lower Limb Ischemia following Bee Sting
Jayesh Patel, Arya Patel, Shivangi Jha, Ketul S Barot, Pratiksha Patel, Dwisha Poptani
Indian Journal of Vascular and Endovascular Surgery.2023; 10(3): 231. CrossRef

Pulmonary thromboembolism combined with intracardiac thrombus occurred during the steroid reduction in nephrotic syndrome patient.: Se Jin Lee, Ji Young Park, Sung Kee Ryu, Jae Woong Choi, Won Young Chae, Hee Yun Ryu, Min Seok Yoo, Yoon Suk Bak; Yeungnam Univ J Med. 2016;33(1):25-28. Published online June 30, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.1.25

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Abstract PDF: Nephrotic syndrome is associated with a hypercoagulable state, which results in thromboembolism as one of its main complications. Various pathogenetic factors that cause the hypercoagulable state in nephrotic syndrome have been recognized. We report on a 19-year-old female with a minimal-change disease who developed pulmonary thromboembolism combined with intracardiac thrombus while on tapering steroid. Our patient showed hypoalbuminemia with an episode of shock, and was successfully treated with thrombolysis and anticoagulation therapy.

A Case of Scopolamine-Induced Central Anticholinergic Syndrome.: Dong Sung Shin, Ho Sun Lee, Se Jin Lee; Yeungnam Univ J Med. 2012;29(1):58-60. Published online June 30, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.1.58

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Abstract PDF: Central anticholinergic syndrome occurs when an anticholinergic substance works in vivo or as a result of the insufficient release of acetylcholine. Its symptoms include confusion, agitation, behavioral change, hallucination, blurred vision, and dysarthria. Occasionally, these symptoms occur with the use of a scopolamine patch. A 54-year-old female complained of behavioral change and confused mentality. She attached a scopolamine patch at the postauricular area in the morning of the day before her hospital visit. Neurological examination revealed bilateral symmetric mydriasis without light reflex. The brain MRI was normal, and electroencephalography showed nonspecific abnormalities. The patient recovered completely after the removal of the scopolamine patch.

Medulla Oblangata Injury Caused by Non-Penetrating Trauma by Chopsticks.: Hyeon Ju Jin, Jae Seong Yu, Yu Kyung Kim, Ho Seok Gang, Se Jin Lee; Yeungnam Univ J Med. 2010;27(2):122-126. Published online December 31, 2010; DOI: https://doi.org/10.12701/yujm.2010.27.2.122

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It is common in childhood that children suffer intracavity or head injury, falling down backward, having chopsticks in their mouth. But most of them have paralysis of upper and lower extremity because of secondary damage by penetrating injury of brainstem and spine. We could not find this case which have shown infaction of medulla oblangata on MRI and paralysis by impact only without clear penetrating evidence. So the authors report this case with study of literature because we experience one case that have high signal density in brainstem on MRI, Loss of consciousness, and left hemiplegia without clear penetrating evidence after falling down backward, having chopsticks in her mouth and regard it rare case.

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Undetected Metallic Chopstick Stabbed on Neck Resulting Tinnitus and Foreign Body Sensation
Sun A Choi, Sung Bum Kim, Seung Youp Shin, Young Gyu Eun
Journal of Korean Neurosurgical Society.2015; 57(2): 140. CrossRef

A Case of Idiopathic Isolated Hypoglossal Nerve Palsy.: Doo Hyun Kim, Se Jin Lee; Yeungnam Univ J Med. 2010;27(1):74-77. Published online June 30, 2010; DOI: https://doi.org/10.12701/yujm.2010.27.1.74

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Isolated hypoglossal nerve palsy is a rare clinical condition and it causes deviation of the tongue and dysarthria. A 50-year-old female presented with tongue deviation to the left and mild dysarthria. She had no remarkable past medical history except several recent upper respiratory infections. On examination, the other cranial nerves were intact and she had no focal neurological signs. The findings of MRI and MR angiography were normal. Cerebrospinal fluid analysis revealed only mild elevation of protein. We diagnosed her as suffering with idiopathic isolated hypoglossal nerver palsy and we administered steroid therapy. The dysarthria was improved, but the tongue deviation still remained at 50 days after onset. We report here on a rare case of idiopathic isolated hypoglossal nerve palsy.

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Idiopathic Ninth, Tenth, and Twelfth Cranial Nerve Palsy with Ipsilateral Headache: A Case Report
Seung-Ho Sun
Journal of Pharmacopuncture.2012; 15(4): 66. CrossRef

A Case of Severe Hypoglycemic Encephalopathy with Extensive Brain Lesions in Non-diabetics and Alcoholism.: Chang Hun Bin, Min Su Park, Se Jin Lee; Yeungnam Univ J Med. 2010;27(1):37-41. Published online June 30, 2010; DOI: https://doi.org/10.12701/yujm.2010.27.1.37

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Hypoglycemic encephalopathy is a rare problem among diabetic patients who are receiving treatment with insulin or other glucose-lowering drugs. The MRIs of patients with hypoglycemic encephalopathy commonly show scattered lesions in the cerebral cortex, hippocampus and basal ganglia, but lesions in the cerebellum or brain stem are extremely rare. A 44-year-old alcoholic woman without diabetes was admitted with a semicomatose mentality and seizure with severe hypoglycemic encephalopathy with extensive brain lesions seen on MRI at the middle cerebellar peduncle and midbrain, as well as in the other brain areas.

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Consideration of Prognostic Factors in Hypoglycemic Encephalopathy
Ik-Kwon Seo, Woo-Ik Choi, Sang-Chan Jin, Hyuk-Won Chang
Korean Journal of Critical Care Medicine.2012; 27(4): 209. CrossRef

Relationship between Clinical Grading of Carpal Tunnel Syndrome and Electrophysiological Parameter: Hyun Chul Do, Jun Lee, Se Jin Lee, Mee Young Park, Jung Sang Hah; Yeungnam Univ J Med. 2007;24(2 Suppl):S407-415. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S407

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Abstract PDF: Background
：To investigate the relationship between clinical grading and electrophysiological parameter in carpal tunnel syndrome. Materials and Methods：This studies examined 75 outpatients (100 hands) who were diagnosed as carpal tunnel syndrome at neurologic clinic from March to July in 2006. They were divided into three groups by clinical grading and then each groups were compared with sensory nerve conduction velocity (SNCV) and sensory compound nerve action potential (CNAP) amplitude of I-W, F-W, and P-W segments, motor terminal latency (TL), motor compound muscle action potential (CMAP) amplitude of distal segment, and disto-proximal ratio on the third finger.
Results
：The first group(mild) was 46 (51 hands) patients, second group(moderate) was 29 (35 hands) patients, and the third group (severe) was 14(14 hands) patients. The mean ages were 55.9, 57.4 and 57.0 years in each group, and there were no statistical differences in age and sex between 3 groups. SNCV of I-W, F-W and P-W segments and motor TL were different significantly between 3 groups, but disto-proximal ratio on the third finger was not different significantly(P<0.05). Motor TL was correlated with clinical grading. And also sensory CNAP amplitude of I-W, F-W, and P-W segments, and motor CMAP amplitude of distal segment were different significantly between 3 groups. Especially, sensory CNAP amplitude of P-W segment and motor TL were correlated with higher clinical grading groups(2, 3 groups)(p<0.05).
Conclusion
：SNCV of F-W and P-W segments, motor TL, motor CMAP amplitude of distal segment and sensory CNAP amplitude of each segments were correlated with the clinical grading of carpal tunnel syndrome.

Effect of Sleep on Epileptiform Discharges in Epileptic Patients with Structural Lesion: Based on Routine EEG.: Se Jin Lee, Jeong Sang Hah; Yeungnam Univ J Med. 2007;24(2):107-118. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.107

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Abstract PDF: BACKGROUND
It is well known that non-rapid eye movement(NREM) sleep activates the occurrence of interictal epileptiform discharges(IED) in many epileptic syndromes. We performed this study to assess the effect of NREM sleep on IED in epileptic patients with organic brain lesions. MATERIALS AND METHODS: We analyzed awake and sleep electroencephalopathy(EEG) recorded simultaneously after partial sleep deprivation in 50 patients. We calculated the awake and sleep spike index (ASI and SSI, spikes/epoch), and the percentage increase of ASI and SSI during sleep. RESULTS: In the 50 patients, the IEDs were recorded exclusively during the awake state in 1 (2%) patient, and during the sleep state in 13(26%) patients. The SSI was higher in 44 (88%) patients, and the ASI was higher in 5 (10%) patients. The mean ASI and the SSI in patients with organic brain lesions were 0.058+/-0.121 and 0.148+/-0.187, and it was 0.081+/-0.150 and 0.174 +/-0.226 in patients without organic brain lesions. There were significant increases in the spike index (P<0.05) during NREM sleep in both groups (n=36), but no significant difference in the percent increase of spike index (P>0.05). CONCLUSION: The IEDs were activated significantly during NREM sleep both in patients with and without organic brain lesions, but there were no differences in the degree of activation in both groups. The activating effect of NREM sleep was not correlated with clinical factors such as, frequent nocturnal seizures, frequent generalized tonic clonic seizures, type of epilepsy and taking anticonvulsants. We conclude that the routine EEG used to evaluate epileptiform discharges in epileptic patients should include sleep recordings after partial sleep deprivation.

A case of Bilateral Near Blindness Secondary to Isolated Sphenoid Sinus Aspergillosis with Headache.: Jun Pil Yoon, Se Jin Lee, Jun Lee, Ju Hyun Kim, Hyun Doo Noh; Yeungnam Univ J Med. 2007;24(1):79-84. Published online June 30, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.1.79

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Abstract PDF: Sphenoid sinus aspergillosis is notorious for its serious complications, such as permanent cranial nerve deficits and possible death. The most common associated symptoms are headache, followed by visual changes, and cranial nerve palsies. Because of an insidious onset, frequently resulting in missed and delayed diagnosis, sphenoid sinus aspergillosis is a potentially lethal medical condition. We report a case of visual loss secondary to isolated sphenoid sinus aspergillosis. A 69-year-old man presented to our hospital with the complaint of headache. The headache started one year previously and was described as severe dull pain localized bilaterally to the temporo-orbital region. The patient took daily NSAIDs for the pain. The neurological examination was normal. The MRI of the brain showed a left sphenoid sinusitis. A transnasal endoscopic superior meatal sphenoidotomy was performed. Aspergillosis was confirmed after a surgical biopsy was obtained. The patient was discharged from hospital without antifungal therapy. One month later, the patient complained of headache and loss of vision bilaterally. The orbital MRI showed a left cavernous sinus and bilateral optic nerve invasion. The loss of visions was permanent. In our case, the diagnosis was delayed; antifungal agents were not administered after surgery and the patient lost his vision as a result. Therefore, early diagnosis and proper treatment are important. Although the treatment of an invasive type of aspergillus has not been established, surgical removal of a nidus and aggressive antifungal therapy are recommended.

A Case of Systemic Lupus Erythematosus Presenting with Amaurosis Fugax without Antiphospholipid Antibodies Syndrome.: Jung Hyun Kim, Jung Sang Hah, Mee Young Park, Se Jin Lee, Jun Lee; Yeungnam Univ J Med. 2006;23(1):113-117. Published online June 30, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.1.113

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Abstract PDF: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that may affect many organ systems including the nervous system. The immune response in patients with SLE can cause inflammation and other damage that can cause significant injury to the arteries and tissues. A 48-year-old woman was admitted to the hospital because of transient monocular blindness. Magnetic resonance imaging and conventional angiography showed severe stenosis of the distal intracranial internal carotid artery. The patient was diagnosed as having SLE but the antiphospholipid antibodies were negative. Amaurosis fugax has not been previously reported as an initial manifestation of SLE in Korea. We report a patient with a retinal transient ischemic attack as the first manifestation of SLE.

A Case of Wernicke's Encephalopathy Associated with Hyperemesis Gravidarum.: Seung Hyun Lee, Se Jin Lee, Yun Kyung Lee, Jung Sang Ha, Jun Lee; Yeungnam Univ J Med. 2004;21(1):91-95. Published online June 30, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.1.91

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Abstract PDF: Wernicke's encephalopathy is an acute-onset illness characterized by mental confusion, ataxia and ophthalmoplegia due to a thiamine deficiency. Immediate administration of thiamine prevents progression of the disease and reverses brain lesions. We have experienced a case of Wernicke's encephalopathy associated with hyperemesis gravidarum. As Wernicke's encephalopathy is mostly associated with chronic alcoholism, the possibility of Wernicke's encephalopathy may be ignored in young women. We emphasize the need for thiamine supplementation in the patient requiring intravenous alimentation such as hyperemesis gravidarum.

Comparison of the Repetitive Nerve Stimulation Test(RNST) Findings Between in Upper and Lower Extremity Muscles in Myasthenia Gravis.: Yun Seuk Jung, Jun Lee, Se Jin Lee, Jung Sang Hah, Wook Nyeon Kim; Yeungnam Univ J Med. 2000;17(2):129-136. Published online December 31, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.2.129

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Abstract PDF: BACKGROUND
AND PURPOSE: This study was undertaken to compare the sensitivity of the Repetitive Nerve Stimulation Test (RNST) between the upper and lower extremity muscles in myasthenia gravis(MG) patients. MATERIALS AND METHODS: The study population consisted of 20 normal persons(control group) and 10 MG patients(MG group). Using Stalberg's method. RNST was systemically performed in orbicularis oculi muscle. upper extremity muscles(flexor carpi ulnaris. abductor digiti quinti), and lower extremity muscles(tibialis anterior. extensor digitorum brevis. vastus medialis). RESULTS: There were statistical differences of decremental response(mean+/-SD) in orbicularis oculi and upper extremity muscles between the control and MG groups(p<0.05 or p<0.01). However, there was no statistical difference of decremental response(mean+/-SD) to RNST in lower extremity muscles between the control and MG groups. There were highersensitivity in orbicularis oculi and upper extremity muscles than lower extremity muscles. Although positive reponse were detected in the lower extremity muscles, the positive response rates of lower extremity muscles were lower than o.oculi and upper extremity muscles. CONCLUSIONS: When the response rates of RNST in facial and upper extremity muscles are normal, may not be required RNST in lower extremity muscles.

A Case of Leber's Hereditary Optic Nouropathy Showing 11778 Point Mutation of Mitochondrial DNA.: Yun Seok Jung, Seung Kwon Park, Seung Yeop Lee, Jung Sang Hah, Mee Yeoung Park, Se Jin Lee, Jun Lee; Yeungnam Univ J Med. 1999;16(1):114-118. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.114

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Abstract PDF: Leber's hereditary optic neuropathy(LHON) is an optic nerve disease that causes blindness and is associated with maternally inherited mitochondrial DNA(mt DNA) mutations. The most common mitochondrial DNA mutation among LHON patients is a point mutation at the nucleotide 11778 in the subunit 4 of complex I. In one 45-year old male LHON patient with bilateral optic neuropathy, we investigated the presence of a point mutation of mitochondrial DNA and identified a single guanine to adenine transition mutation in the mitochondrial DNA at nucleotide point 11778.

The Factors Related to Intractability in Patients with Partial Epilepsy.: Yeung Ki Lee, Yeing Ju Byun, Mee Yeong Park, Jung Sang Hah, Se Jin Lee; Yeungnam Univ J Med. 1995;12(2):306-318. Published online December 31, 1995; DOI: https://doi.org/10.12701/yujm.1995.12.2.306

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Abstract PDF: To evaluate the intractability of partial epileptic patients by variables, the author studied 113 patients (uncontrolled: 45, controlled: 68) who were admitted to the Department of Neurology, College of Medicine, Yeungnam University from January, 1991 to August, 1993. The results were as follows. The items related to complex partial seizures, multiple seizure types and a histories of status epilepticus or clusters of seizures were significantly associated with drug-refractoriness (p<0.01). A high frequency of seizures before evaluation was associated with a poor outcome(p<0.01). The presences of known etiology of seizures, neurologic abnormalities and psychiatric disturbance were associated with limited treatment responses(p<0.01, p<0.05, p<0.01). An abnormal EEG findings such as background slowing, focal slowing, epileptiform discharges or secondarily bilateral synchrony were statistically significant (p<0.01). Age at onset, sex, distribution of epileptic foci, duration of seizure before evaluation, family history and abnormal neuroradiologic findings were not statistically significant. By these results, it was suggested that having at least four factors of the above variables were associated with limited treatment response.

Study on the changes of nerve conduction with wrist fixation in carpal tunnel syndrome.: Se Jin Lee, Kyung Yoon O, Mee Yeong Park, Jung Sang Hah, Yeung Ju Byun, Choong Suh Park; Yeungnam Univ J Med. 1991;8(1):79-85. Published online June 30, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.1.79

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Abstract PDF: The author studied 20 healthy adults (20 hands) as a control and 30 patients (40 hands) with carpal tunnel syndrome to evaluate the clinical usefulness of measuring nerve conduction velocity after wrist flexion in diagnosis of carpal tunnel syndrome. The median nerve conduction velocity over wrist to finger segment was measured before and after wrist flexion for 1, 2 and 5 minutes, using belly-tendon method for motor nerve distal latency (MNDL) and antidromic method for sensory nerve conduction velocity (SNCV). The results were as follows: 1. In control group, MNDL increased in 1 hand and SNCV decreased in 2 hands after wrist flexion. In patient group, MNDL increased in 2 hands and SNCV decreased in 3 hands after wrist flexion. 2. In both control and patient group, there were no significant changes in mean values of SNCV and MNDL between before and after wrist flexion. 3. Phalen's wrist flexion test was positive in 5 percent of control and 60 percent of patient group. 4. Tinel's sign was present in 10 percent of control and 33 percent of patient group.

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