Journal of Yeungnam Medical Science

Case reports

Sciatic neurotmesis and periostitis ossificans progressiva due to a traumatic/unexpected glass injury: a case report: Berkay Yalçınkaya, Hasan Ocak, Ahmet Furkan Çolak, Levent Özçakar; J Yeungnam Med Sci. 2024;41(1):45-47. Published online November 21, 2023; DOI: https://doi.org/10.12701/jyms.2023.01018

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Abstract PDF Supplementary Material: Peripheral nerves may be affected or injured for several reasons. Peripheral nerve damage can result from trauma, surgery, anatomical abnormalities, entrapment, systemic diseases, or iatrogenic injuries. Trauma and iatrogenic injuries are the most common causes. The ulnar, median, and radial nerves are the most injured nerves in the upper extremities, while the sciatic and peroneal nerves are the most injured nerves in the lower extremities. The clinical symptoms of peripheral nerve damage include pain, weakness, numbness/tingling, and paresthesia. Therefore, early diagnosis and appropriate treatment of peripheral nerve injuries are crucial. If a peripheral nerve injury is left untreated, it can lead to severe complications and significant morbidity. The sciatic nerve is one of the most affected nerves. This nerve is generally injured by trauma and iatrogenic causes. Children are more susceptible to trauma than adults. Therefore, sciatic nerve injuries are observed in pediatric patients. When the sciatic nerve is damaged, pain, weakness, sensory loss, and gait disturbances can occur. Therefore, the diagnosis and treatment of sciatic nerve injuries are important to avoid unexpected consequences. Ultrasound can play an important role in the diagnosis of peripheral nerve injury and the follow-up of patients. The aim of this case report is twofold. First, we aimed to emphasize the critical role of ultrasonographic evaluation in the diagnosis of peripheral nerve injuries and pathologies. Second, we aimed to present this case, which has distinguishing features, such as the existence of periostitis ossificans progressiva with sciatic neurotmesis due to a traumatic glass injury.

Cardiopulmonary bypass preparation is mandatory in cardiac exploration for blunt cardiac injury patients: two case reports: Shin-Ah Son, Joon Yong Cho, Gun-Jik Kim, Young Ok Lee, Hanna Jung, Tak-Hyuk Oh; Yeungnam Univ J Med. 2021;38(4):356-360. Published online March 3, 2021; DOI: https://doi.org/10.12701/yujm.2020.00822

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Treating cardiac injuries following blunt trauma to the chest requires thorough examination, accurate diagnosis, and therapeutic plan. We present two cases; pulmonary vein rupture and left atrial appendage laceration, both as a result of blunt chest trauma. Through these cases, our team learned the importance of maintaining hemodynamic stability during the examination of injured cardiac structures. And based on the comprehensive cardiac examination, a decision to surgically intervene with median sternotomy via cardiopulmonary bypass was made, saving lives of the patient. This report introduces how such decision was made based on what supporting evidence and the diagnostic process leading to the initiation of surgical intervention. This report may help with decision-making process when confronted by blunt cardiac injury patients who need cardiac exploration.

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The role and timing of cardiopulmonary bypass in the surgical repair of traumatic cardiac injury
Mayo Kondo, Shinichi Ijuin, Tomonori Haraguchi, So Izumi, Reiko Kanno, Kazunori Sakaguchi, Kazumasa Edono, Haruki Nakayama, Satoshi Ishihara, Takuro Tsukube
General Thoracic and Cardiovascular Surgery.2023; 71(10): 561. CrossRef

Case Reports

A Case of Traumatic Bilateral Adrenal Hemorrhage Mimicking Bilateral Adrenal Adenomas.: Min Jung Lee, Gi Ae Kim, Jung Eun Jang, Hyo In Choi, Seo Hyun Lee, Gwang Beom Koh, Ga Hee Kim, Min Seon Kim; Yeungnam Univ J Med. 2012;29(1):35-37. Published online June 30, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.1.35

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Abstract PDF

Adrenal hemorrhages caused by blunt abdominal trauma have been frequently reported, and most of the lesions are unilateral. In contrast, bilateral hemorrhage of the adrenal glands after trauma rarely occurs in subjects with predisposing conditions such as coagulopathy, thromboembolism, and sepsis. Furthermore, bilateral hemorrhage of the adrenal glands is potentially fatal by inducing acute adrenal insufficiency. Here,a case of a 40-year-old man who developed traumatic bilateral adrenal hemorrhage after a car accident, without any predisposing condition, is reported. The spontaneous shrinkage of the bilateral lesions revealed in the follow-up abdominal computed tomography (CT) scansupported the aforementioned diagnosis. Fortunately, the patient had no clinical or biochemical evidence suggesting acute adrenal insufficiency. To these authors' knowledge, this is the first South Korean report of traumatic bilateral adrenal hemorrhage in a subject with no predisposing factors.

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Adrenal hematoma following falling in a 5-year-old boy
Fateme Guitynavard, Seyed Saeed Tamehri Zadeh, Hossein Zabihi Mahmoudabadi, Seyed Mohammad Kazem Aghamir
Urology Case Reports.2021; 34: 101480. CrossRef

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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Abstract PDF

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

Original Articles

The Effect of Gabapentin for the Clinical Symptoms in the Traumatic Neuropathic Pain.: Yeung Ki Kim, Yun Woo Cho; Yeungnam Univ J Med. 2004;21(1):82-90. Published online June 30, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.1.82

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Abstract PDF: BACKGROUND
Gabapentin is widely used for the relief of neuropathic pain. But, there is no study of gabapentin in relation to traumatic neuropathic pain. The aim of this study is to assess the efficacy and effectiveness of gabapentin for the various clinical symptoms of traumatic neuropathic pain MATERIALS AND METHODS: 50 patients with traumatic nerve injury were assigned to receive gabapentin, titrated to 900 mg/day over 9 days, followed by further increases to a maximum of 2400 mg/day. Continuous pain, paroxysmal pain, allodynia and thermal evoked pain were measured in mean daily pain scores, based on the 11-point Likert scale. The primary efficacy parameter was compared from the baseline to the final study week. RESULTS: Over the 4.5 week study, this pain score decreased by 2.6 points in the continuous pain, 3.6 points in the paroxysmal pain, 3.1 points in the allodynia, and 2.5 points in the thermal evoked pain. The percentage of patients with over 50% improvement in pain scores was 33% in the continuous pain, 67% in the paroxysmal pain, 53% in the allodynia and 36% in the thermal evoked pain. There was no significant correlation between the effect of gabapentin and the time difference of the onset of symptoms and start of medication. CONCLUSIONS: This study shows that gabapentin reduced neuropathic pain in patients with traumatic peripheral nerve injury. Among the various characteristics of neuropathic pain, the reduction of paroxysmal pain and allodynia was greatest.

Clinical Presentation of th patients with Non-traumatic Chest Pain in Emergency Department.: Jun Young Chung, Sam Beom Lee, Byung Soo Do, Jong Seon Park, Dong Gu Shin, Young Jo Kim; Yeungnam Univ J Med. 1999;16(2):283-295. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.283

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Abstract PDF: BACKGROUND
Patients with acute non-traumatic chest pain are among the most challenging patients for care by emergency physicians, so the correct diagnosis and triage of patients with chest pain in the emergency department(ED) becomes important. To avoid discharging patients with acute myocardial infarction(AMI) without medical care, most emergency physicians attempt to admit almost all patients with acute chest pain and order many laboratory tests for the patients. But in practice, many patients with non-cardiac pain can be discharged with simple tests and treatment. These patients occupy expensive intensive care beds, substantially increasing financial cost and time of stay at ED for the diagnosis and treatment of myocardial ischemia and AMI. Despite vigorous efforts to identify patients with ischemic heart disease, approximately 2% to 5% of patients presented to the ED with AMI and chest pain are inadvertently discharged. If the cause for the chest pain is known, rapid and accurate diagnosis can be implemented, preventing wastes in time and money and inadvertent discharge. Methods and Results: The medical records of 488 patients from Jan. 1 to Dec. 31, 1997 were reviewed. There were 320(angina pectoris 140, AMI 128) cases of cardiac diseases, and 168(atypical chest pain 56, pneumothorax 47) cases of non-cardiac diseases. The number of associated symptoms were 1.1+/-0.9 in non-cardiac diseases, 1.4+/-1.1 in cardiac diseases and 1.7+/-1.1 in AMI(p<0.05). In laboratory finding the sensitivity of electrocardiography(EKG) was 96.1%, while the sensitivity of myoglobin test ranked 45.1%. Admission rate was 71.6% in for cardiac diseases and 50.6% for non-cardiac diseases(p<0.01). Mortality rate was 8.8% in all cases, 13.8% in cardiac diseases, 0.6% in non-cardiac diseases, and 28.1% especially in AMI. CONCLUSION: In conclusion, all emergency physicians should have thorough knowledge of the clinical characteristics of the diseases which cause non-traumatic chest pain, because a patient with any of these life-threatening diseases would require immediate treatment. Detailed history on the patient should be taken and physical examination performed. Then, the most simple diagnostic approach should be used to make an early diagnosis and to provide treatment.

Review

Non-traumatic Avascular Necrosis of the Femoral Head.: Se Dong Kim; Yeungnam Univ J Med. 1999;16(1):1-9. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.1

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Abstract PDF: Avascular necrosis of the femoral head is a debilitating disease that leads to destruction of the hip joint in patients who are in the third, fourth, or fifth decade of life. The total societal cost is so high because these patients are generally young, hold jobs, and have a considerable life expectancy. Therefore, we have to delay or eliminate the need for total hip replacement as possible as we can. The purpose of this review id to provide a current perspective of avascular necrosis of the femoral head.

Original Article

Effect of the Early Traumatic Experience on the Mental Health of the Elderly.: Kwang Hun Lee, Jung Hoon Lee, Jong Bum Lee, Byung Tak Park, Seung Douk Cheung; Yeungnam Univ J Med. 1990;7(2):67-77. Published online December 31, 1990; DOI: https://doi.org/10.12701/yujm.1990.7.2.67

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Abstract PDF: This study was intended to analyze the relation between the psychic traumatic experience and the psychological health of the aged. The authors carried out this study by means of the combined anxiety-depression scale (CADS) and the preadolescence traumatic experience scale (PTES) with 278 aged men and women residing in Taegu from September to October 1988. The results were as follows: 1. Based on the scores evaluated by CADS, the scores of the both groups showed that comparative group was accounted for 40.15±6.19, while the experimental group for 57.75±6.37, which showed significantly higher score in the experimental group (p<0.001). 2. The experimental group showed significantly higher early experience score than the comparative group in the dietary difficulty, alcoholism among family members, disunion between husband and wife, trouble between mother and children, early mother loss, parent's indifference and unwanted birth (p<0.001). 3. The experimental group showed higher early experience score than the comparative group by sex, age, marital status and grown location (p<0.001). 4. When the subjects were included in the unemployed and in the middle or low classes and their parents were engaged in agriculture and commercial business and believing in buddhism or no-religion, showed higher experience score (p<0.001).

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