Journal of Yeungnam Medical Science

Case reports

Pudendal nerve entrapment syndrome caused by ganglion cysts along the pudendal nerve: Young Je Kim, Du Hwan Kim; Yeungnam Univ J Med. 2021;38(2):148-151. Published online July 21, 2020; DOI: https://doi.org/10.12701/yujm.2020.00437

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Pudendal nerve entrapment (PNE) syndrome refers to the condition in which the pudendal nerve is entrapped or compressed. Reported cases of PNE associated with ganglion cysts are rare. Deep gluteal syndrome (DGS) is defined as compression of the sciatic or pudendal nerve due to a non-discogenic pelvic lesion. We report a case of PNE caused by compression from ganglion cysts and treated with steroid injection; we discuss this case in the context of DGS. A 77-year-old woman presented with a 3-month history of tingling and burning sensations in the left buttock and perineal area. Ultrasonography showed ganglion cystic lesions at the subgluteal space. Magnetic resonance imaging revealed cystic lesions along the pudendal nerve from below the piriformis to the Alcock’s canal and a full-thickness tear of the proximal hamstring tendon. Aspiration of the cysts did not yield any material. We then injected steroid into the cysts, which resolved her symptoms. Steroid injection into a ganglion cyst should be considered as a treatment option for PNE caused by ganglion cysts.

Citations

Citations to this article as recorded by

Pudendal neuralgia
I. V. Borodulina, G. V. Kovalev
Neuromuscular Diseases.2024; 13(4): 83. CrossRef
Overview of the anatomical basis of the piriformis syndrome‑dissection with magnetic resonance correlation
Ofelia-Costina Goidescu, Mihaly Enyedi, Adrian-Daniel Tulin, Raluca Tulin, Ileana Vacaroiu, Adriana Nica, Dorin Dragos, Dorin Ionescu, Dragos Georgescu, Adrian Miron, Florin-Mihail Filipoiu
Experimental and Therapeutic Medicine.2021;[Epub] CrossRef

Imatinib-induced hepatitis treated by corticosteroids in a patient with metastatic gastrointestinal stromal tumor: Min Kyu Kang, Heon Ju Lee, Joon Hyuk Choi; Yeungnam Univ J Med. 2019;36(2):155-158. Published online January 21, 2019; DOI: https://doi.org/10.12701/yujm.2019.00115

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Abstract PDF

Imatinib mesylate is currently used as the first-line treatment for metastatic gastrointestinal stromal tumors (GISTs). Imatinib-induced hepatotoxicity in patients with GIST is very rare. Its features vary from subclinical elevation of serum aminotransferase to clinically apparent acute hepatitis, which is associated with immunologic reactions. Imatinib-induced hepatotoxicity with autoimmune-like features can be treated by the discontinuation of imatinib mesylate and the administration of oral steroids. Here, we report a case of late-onset imatinib-induced hepatitis with autoimmune-like features in a patient with metastatic GIST, which was improved by oral corticosteroids.

Citations

Citations to this article as recorded by

The prevalence of hepatic and thyroid toxicity associated with imatinib treatment of chronic myeloid leukaemia: a systematic review
Mansour Tobaiqy, Nawal Helmi, Katie MacLure, Sylvia Saade
International Journal of Clinical Pharmacy.2024; 46(2): 368. CrossRef
Antioxidant-Based Preventive Effect of Phytochemicals on Anticancer Drug-Induced Hepatotoxicity
Ji Eon Park, Chi-Hoon Ahn, Hyo-Jung Lee, Deok Yong Sim, Su Yeon Park, Bonglee Kim, Bum Sang Shim, Dae Young Lee, Sung-Hoon Kim
Antioxidants & Redox Signaling.2023; 38(16-18): 1101. CrossRef

Case Reports

Central serous chorioretinopathy associated with low dose systemic corticosteroid treatment of Behcet's disease: Sungwook Cha, Kyung Jin Kim, Seongmin Kweon, Sinae Lee, Byungchul Min, Eunsung Kim, Jungwook Lee; Yeungnam Univ J Med. 2017;34(1):111-114. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.111

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Abstract PDF: Central serous chorioretinopathy may induce poor eyesight and serous retinal detachment. However, its exact cause has not been well established thus far. It can be associated with systemic high-dose corticosteroid treatment mainly for young and middle-aged men and may spontaneously regress or recur after withdrawal from corticosteroid. After corticosteroid administration for Behcet's disease, it is necessary to identify any ocular symptoms. Behcet's disease can lead to the development of ocular complications, such as uveitis, hypopyon, retinal vasculitis, optic neuritis, angiogenesis, secondary cataract, and glaucoma. It is possible to diagnose any of these complications via optical coherence tomography and digital indocyanine green angiography. It is easy to neglect an ocular symptom that may appear after a low-dose corticosteroid treatment as an ocular complication in patients with Behcet's disease. Thus, we report on a case concerning high-dose corticosteroid treatment with a literature review.

Rapidly resolved IgG4-related retroperitoneal fibrosis after steroid pulse therapy.: Soomin Jeung, Hyosang Kim, Yuri Seo, Hee Young Yoon, Nah Kyum Lee, Shinhee Park, Bomi Seo, Su Yeon Park, Su Kil Park; Yeungnam Univ J Med. 2016;33(1):40-43. Published online June 30, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.1.40

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Abstract PDF: Retroperitoneal fibrosis (RF) is a disorder characterized by the presence of a retroperitoneal mass and concurrent systemic inflammation. Some cases of RF are recognized as belonging to the spectrum of immunoglobulin G4-related disease (IgG4-RD). Glucocorticoids are highly effective for treatment of retroperitoneal fibrosis, although the optimal dose and duration of therapy have not been established. An initial dose of prednisone (40-60 mg) daily is usually administered with a tapering scheme. We report on a 55-year-old man diagnosed with IgG4-related RF and successfully treated with a 3-day course of daily 250 mg (4 mg/kg) intravenous methylprednisolone, which resulted in the prompt resolution of urinary obstruction and systemic symptoms.

Immune thrombocytopenia associated with sarcoidosis.: Da Eun Jeong, Min Kyoung Kim, Sung Ae Koh, Kyoung Hee Lee, Joon Hyuk Choi, Young Hoon Hong, Jae Ho Cho, Eun Ju Goo, Myung Soo Hyun; Yeungnam Univ J Med. 2015;32(1):26-30. Published online June 30, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.1.26

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Abstract PDF: Sarcoidosis is a systemic disease of unknown cause involving multiple organs and is characterized by noncaseating granuloma. Immune thrombocytopenia (ITP) is an autoimmune disease characterized by increased peripheral platelet destruction due to the presence of an antibody to the platelet and abnormal platelet production. There is no known pathogenesis that occurs concurrently with ITP and sarcoidosis. However, considering together of 2 known pathogenesis, abnormal immune response triggers either ITP or sarcoidosis. The disease that develops first stimulates secondary disease. After development of secondary disease, they stimulate each other. A few cases of ITP associated with sarcoidosis are well documented in English; however, the disease has rarely been reported in Korea. Here, we report on a case of ITP with sarcoidosis in a 29-year-old man. He suffered from easy bruising. The chest X-ray and the contrast-enhanced computed tomography scan showed bihilar lymphadenopathy and reticulonodular infiltrates. Bone marrow study and fluoroscopy-guided percutaneous needle biopsy were performed and the patient was diagnosed with sarcoidosis and ITP. He was put on 400 mg/kg of intravenous immunoglobulin for 5 days and administered oral steroids and further follow-up will be carried out. He has shown a good response without significant bleeding event. However, administration of more oral steroid and additional follow-up is required than for single disease, whether sarcoidosis or ITP.

Development of Steroid Myopathy during Polymyositis Treatment.: Ji Hoon Lee, Shin Young Hyun, Choong Ki Kim, Su Hwan Lee, A Ra Choi, Seong Woo Kim, Sung Hye Park, Chan Hee Lee; Yeungnam Univ J Med. 2011;28(2):173-179. Published online December 31, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.2.173

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Abstract PDF: Polymyositis is diffuse, inflammatory myopathy with proximal-muscle weakness due to lymphocyte infiltration to the muscle layer. The exact cause of the muscle weakness is unclear but may be related with an immunologic mechanism. Using high-dose steroid is the treatment of choice for polymyositis. It is difficult to distinguish steroid-resistant polymyositis from steroid myopathy, however, in the course of high-dose steroid therapy. These authors encountered a steroid myopathy patient during polymyositis treatment with high-dose steroid. A 57-year-old woman was diagnosed with polymyositis and was treated with high-dose steroid. Her condition was initially improved, but in the course of the treatment, her symptom was aggravated without increasing the muscle enzymes. Her muscle weakness was improved by reducing the steroid dosage.

Review

Nonsteroidal Anti-inflammatory Drugs.: Choong Ki Lee; Yeungnam Univ J Med. 2000;17(1):1-11. Published online June 30, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.1.1

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Abstract PDF: Inhibition of cyclooxygenase(COX), and thus prevention of the formation of prostaglandins, provided a unifying explanation of the therapeutic and toxic actions of nonsteroidal anti-inflammatory drugs(NSAIDs). Recently, the discovery of the two isoforms of COX was made by molecular biologists studying neoplastic transformation in chick embryo cells. The constitutive enzyme, COX-1, is obviously responsible for the production of prostaglandins involved in housekeeping functions such as maintenance of integrity of the gastric mucosa, renal blood flow and platelet aggregation. The inducible form of COX(COX-2) is responsible for the formation of prostaglandins that pathologic effects of inflammation, pain and fever. Clearly, all the experimental and clinical data support the hypothesis that the beneficial effects of NSAIDs are due to inhibition of the COX-2 enzyme, whereas the gastrotoxicity is due to inhibition of COX-1. The COX-2/COX-1 ratios of the NSAIDs in common use have been measured and compared with epidemiological data on their side effects. there is little evidence to suggest that one NSAID is clearly more efficacious than another and substantial individual variability is present with respect to the pharmacology and pharmacokinetics of these drugs, it is essential to adjust the dosage and choose specific drug to the patient`s response.

Original Article

An Analysis of 94 Percutaneous Renal Biopsies.: Ho Jung Kang, Sang Woo Lim, Joo Yeung Do, Kyung Woo Yoon; Yeungnam Univ J Med. 1995;12(1):84-95. Published online June 30, 1995; DOI: https://doi.org/10.12701/yujm.1995.12.1.84

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Abstract PDF: A clinical and histopathological study was performed on ninety-four patients with nephrotic syndrome (91 idiopathic and 3 secondary) who were admitted to Department of Internal Medicine, Yeungnam University Hospital during the period of nine years, from January 1985 to May 1994. The results were as following. 1. the ratio of male to female was 1.76:1. In young age group, minimal change was the most predominant type. In old age group, membranous glomerulonephritis and focal glomerulosclerosis were predominant types. 2.- The primary nephrotic syndromes were 96.8% and secondary nephrotic syndromes were 3.2%. Histopathologic findings of 94 renal biopsy tissue were classified into minimal change (43.6%) mesangial proliferative glomerulonephritis (29.8%), membranous glomerulonephritis (12.8%), Typel membranous proliferative glomerulonephritis (4.3%), focal glomerulosclerosis (3.2%) .and others (6.4%). 3. The response of eighty-six patients treated with steroid showed complete remission in 51.2%, partial remission in 20.9%, steroid dependent in 2.3%, and no effect in 25.6% of cases respectively. The response to steroid therapy was most effective in the patients with minimal change lesion. 4. In the patient with membranous proliferative glomerulonephlitis, long-term angiotensin converting enzyme inhibitor treatment showed less deterioration of renal function.

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