Journal of Yeungnam Medical Science

Case report

Pediatrics, Perinatology, and Child Health
Currarino syndrome associated with an isolated 7q terminal deletion in Korea: a case report: Jin Hee Jung, Juiee Jeong, Sung Hyun Kim; J Yeungnam Med Sci. 2026;43:8. Published online January 5, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.8

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Abstract PDF: The 7q terminal deletion syndrome is a rare genetic disorder caused by the deletion of the long arm of chromosome 7 between 7q32 and 7q36.3. It is characterized by various clinical symptoms, such as abnormal facial features and impaired mental and physical development. Currarino syndrome is defined by a triad of sacral bone defects, anorectal malformations, and presacral masses and is often associated with mutations in the MNX1 gene located at 7q36.3. Only a few cases of 7q terminal deletion syndrome have been reported in Korea. In one of these familial cases, Currarino syndrome was associated with a complex chromosomal rearrangement involving a 7q deletion and an 8q duplication. However, to our knowledge, cases of isolated 7q terminal deletions without other structural chromosomal abnormalities have not been described in the literature. We report the case of a 9-month-old girl who presented with the complete Currarino syndrome triad and a 7q35 to 7q36.3 (12 Mb) deletion identified by chromosomal microarray analysis. To the best of our knowledge, this is the first Korean case report of the Currarino triad caused by an isolated terminal 7q deletion.

Original article

Neurology
Predictive assessment with outcomes of phrenic nerve study in Guillain-Barré syndrome: a prospective study: Rajarshi Chakraborty, Rajesh Verma, Sarvesh Kumar Chaudhary, Harish Nigam, Ankit Khetan, Swati Shakya, Pushpita Barman, Aparajita Chakraborty; J Yeungnam Med Sci. 2025;42:45. Published online August 16, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.45

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Abstract PDF: Background
Guillain-Barré syndrome (GBS) is an acute acquired autoimmune inflammatory disorder of the peripheral nerves and roots. Respiratory insufficiency is an important predictor of a poor prognosis in patients with GBS. Phrenic nerve assessment is an area of interest in GBS with respiratory failure. We aimed to analyze the characteristics of the phrenic nerve conduction study (NCS) in GBS and assess its value in predicting respiratory failure requiring ventilatory support, along with outcome assessment at 6 months as per the Hughes score.
Methods
A total of 135 patients with GBS admitted to our hospital over 3 years were thoroughly evaluated by clinical examination, blood laboratory tests, and phrenic NCS.
Results
Phrenic NCS abnormality was observed in 48 patients (35.6%) with statistically significant increases in phrenic sum compound muscle action potential (CMAP) latency (18.91±7.82 ms) and sum CMAP duration (44.65±6.84 ms), along with reduced sum CMAP amplitude (0.3246±0.132 mV) and sum CMAP area (3.56±2.62 mV·ms) occurring in those requiring ventilatory assistance. The sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios of the phrenic NCS for predicting respiratory failure in patients with GBS were 90.7%, 90.2%, 81.3%, 95.4%, 9.27, and 0.10, respectively. The results showed a statistically significant association between abnormal initial phrenic NCS scores and outcomes at 6 months.
Conclusion
Phrenic NCS can predict respiratory failure requiring ventilator assistance in patients with GBS. Phrenic NCS can be incorporated into routine NCS protocols to predict impending respiratory failure in patients with GBS.

Case report

Endocrinology, Diabetes, and Metabolism
Bilateral adrenal adenomas with autonomous cortisol secretion from both glands and autonomous aldosterone secretion from the left adrenal: a case report: Jung Eun Han, Soyeon Yoo, Sang Ah Lee, Gwanpyo Koh; J Yeungnam Med Sci. 2025;42:33. Published online April 28, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.33

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Abstract PDF: Primary aldosteronism (PA) is the most common cause of secondary hypertension and increases the morbidity and mortality associated with cardiovascular diseases. When PA coexists with autonomous cortisol secretion (ACS), the cardiovascular risk increases significantly, especially in cases of bilateral adrenal adenomas with asymmetric hormone secretion, which poses diagnostic and therapeutic challenges. A 50-year-old female presented with hypertension and hypokalemia. PA was diagnosed based on elevated aldosterone levels, suppressed plasma renin activity, and the results of various dynamic endocrine tests. Imaging revealed bilateral adrenal adenomas, and adrenal venous sampling (AVS) confirmed aldosterone hypersecretion from the left adrenal gland and cortisol hypersecretion from both adrenal glands. The patient subsequently underwent left adrenalectomy, which resolved the aldosterone hypersecretion and normalized blood pressure and potassium levels. However, the cortisol hypersecretion persisted. This case highlights the importance of AVS in identifying the sources of hormone secretion and enabling targeted surgical treatment while avoiding bilateral adrenalectomy, which can lead to lifelong adrenal insufficiency. Comprehensive endocrine evaluation, including ACS assessment, in patients with PA is essential to help reduce the cardiovascular risks associated with PA and ACS and thus improve treatment outcomes.

Review article

Anesthesiology and Pain Medicine
Failed back surgery syndrome—terminology, etiology, prevention, evaluation, and management: a narrative review: Jinseok Yeo; J Yeungnam Med Sci. 2024;41(3):166-178. Published online June 10, 2024; DOI: https://doi.org/10.12701/jyms.2024.00339

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Abstract PDF

Amid the worldwide increase in spinal surgery rates, a significant proportion of patients continue to experience refractory chronic pain, resulting in reduced quality of life and escalated healthcare demands. Failed back surgery syndrome (FBSS) is a clinical condition characterized by persistent or recurrent pain after one or more spinal surgeries. The diverse characteristics and stigmatizing descriptions of FBSS necessitate a reevaluation of its nomenclature to reflect its complexity more accurately. Accurate identification of the cause of FBSS is hampered by the complex nature of the syndrome and limitations of current diagnostic labels. Management requires a multidisciplinary approach that may include pharmacological treatment, physical therapy, psychological support, and interventional procedures, emphasizing realistic goal-setting and patient education. Further research is needed to increase our understanding, improve diagnostic accuracy, and develop more effective management strategies.

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Association of postlaminectomy syndrome with cardiovascular events in patients undergoing posterior lumbar fusion
Yih-Cherng Wang, Wei-Thing Khor, Pang-Shuo Perng, Hong-Min Lin, Kuan-Yu Chi, Chih-Yuan Huang, Yu Chang
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Frontiers in Pain Research.2026;[Epub] CrossRef
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Rushmin Khazanchi, Divy Kumar, Robert J. Oris, Anitesh Bajaj, Daniel E. Herrera, Austin R. Chen, Rohan M. Shah, Shravan Asthana, Samuel G. Reyes, Pranav Bajaj, Wellington K. Hsu, Alpesh A. Patel, Srikanth N. Divi
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Short-term Effects of Combined Korean Medicine Treatment Including Acupotomy in a Patient with Failed Back Surgery Syndrome: A Case Report
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Shivang Patel, Matthew Thomas, Harthik Kambhampati, John Stauffer, Tony El-Hayek
Cureus.2025;[Epub] CrossRef
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Hind Chaib, Ehab Shiban
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Lara S. Burmeister, Richard L. Witkam, Kris C. P. Vissers, Martin Gotthardt, Dylan J. H. A. Henssen
Brain Sciences.2025; 15(7): 724. CrossRef
Spinal Cord Stimulation in an Elderly Patient With Severe Scoliosis and Failed Back Surgery Syndrome: A Case for Reconsidering Anatomical Contraindications
Shivang Patel, Jalal Ibrahim, Feross Habib, Harthik Kambhampati, Tony El-Hayek
Cureus.2025;[Epub] CrossRef
Mechanism of IFITM1 regulating epidural scar hyperplasia after laminectomy through SMAD3/CBR4 pathway
Haoran Wang, Zekai Zhu, Jun Liu
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A Case Report of Failed Back Surgery Syndrome Treated with Korean Medicine Focused on Ultrasoud-Guided Bee Venom Phamacopuncture
Moon Sun Kim, Seok-Hyeon Yoon, Youn-Seok Ko, Seung-Yun Oh, Soo-Jung Park
Korean Journal of Acupuncture.2025; 42(3): 212. CrossRef
Prevalence of Low Back Pain and Functional Disability in Post-Lumbar Laminectomy Patients: A Cross-sectional Study
Arbab Habib Ullah, Shabi ul Hassan, Arshad Ali, Kainat, Madeeha Khattak, Hammad Farooq
The Healer Journal of Physiotherapy and Rehabilitation Sciences.2025; 5(1): 209. CrossRef
Full-endoscopic Spine Surgery for the Treatment of Far-out Syndrome: A Case Series
Ryuichi WATANABE, Ryoji TOMINAGA, Kento TAKEBAYASHI, Yasushi OSHIMA, Hiroki IWAI, Hisashi KOGA
Neurologia medico-chirurgica.2025; 65(12): 583. CrossRef
Clinical Evaluation of the Effectiveness of Endoscopic Surgical Treatment in Patients with Lumbar Ligamentous-Foraminal Stenosis
B. A. Sychenikov, I. V. Basankin, A. A. Gyulzatyan, V. N. Nikolenko, M. D. Bartenev, D. D. Galinovskiy, M. O. Shkap
Innovative Medicine of Kuban.2025; 10(4): 16. CrossRef
Threshold-Anchored Mechanomyography Metrics for Patient Stratification in Spinal Decompression: Associations with Early Pain Outcomes
Muwaffak Abdulhak, Ross Jones, David Nay, Christopher Wybo
Journal of Personalized Medicine.2025; 15(12): 564. CrossRef
Using Key Predictors in an SVM Model for Differentiating Spinal Fractures and Herniated Intervertebral Discs in Preoperative Anesthesia Evaluation
Shih-Ying Yang, Shih-Yen Hsu, Yi-Kai Su, Nan-Han Lu, Kuo-Ying Liu, Tai-Been Chen, Kon-Ning Chiu, Yung-Hui Huang, Li-Ren Yeh
Diagnostics.2024; 14(21): 2456. CrossRef

Communications

Physical therapy, Sports Therapy, and Rehabilitation
Algorithm for multimodal medication therapy in patients with complex regional pain syndrome: Min Cheol Chang, Donghwi Park; J Yeungnam Med Sci. 2023;40(Suppl):S125-S128. Published online July 12, 2023; DOI: https://doi.org/10.12701/jyms.2023.00360

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Abstract PDF

Complex regional pain syndrome (CRPS), previously known as reflex sympathetic dystrophy and causalgia, is a clinical entity characterized by classic neuropathic pain, autonomic involvement, motor symptoms, and trophic changes in the skin, nails, and hair. Although various therapeutic modalities are used to control CRPS-related pain, severe pain due to CRPS often persists and progresses to the chronic phase. In this study, we constructed an algorithm for multimodal medication therapy for CRPS based on the established pathology of CRPS. Oral steroid pulse therapy is recommended for initial pain management in patients with CRPS. Oral steroid therapy can reduce peripheral and central neuroinflammation, contributing to the development of neuropathic pain during the acute and chronic phases. If steroid pulse therapy offers poor relief or is ineffective, treatment to control central sensitization in the chronic phase should be initiated. If pain persists despite all drug adjustments, ketamine with midazolam 2 mg before and after ketamine injection can be administered intravenously to inhibit the N-methyl D-aspartate receptor. If this treatment fails to achieve sufficient efficacy, intravenous lidocaine can be administered for 2 weeks. We hope that our proposed drug treatment algorithm to control CRPS pain will help clinicians appropriately treat patients with CRPS. Further clinical studies assessing patients with CRPS are warranted to establish this treatment algorithm in clinical practice.

Citations

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Tailoring Treatment in Complex Regional Pain Syndrome: A Comparative Study of Therapeutic Approaches in Complex Rehabilitation
Iana Andreieva, Beata Tarnacka, Adam Zalewski, Justyna Wiśniowska
Pharmaceuticals.2025; 18(8): 1114. CrossRef
Experience from a single-center study on multimodal medication therapy for patients with complex regional pain syndrome
Donghwi Park, Jin-Woo Choi, Min Cheol Chang
Journal of Back and Musculoskeletal Rehabilitation.2024; 37(3): 687. CrossRef
Problems of diagnosis and treatment of chronic pain syndrome in patients with variants of the structure of peripheral nerves. A series of clinical cases
Al'bert R. Bulatov, Tatyana A. Kolesnik, Александра A. Boykova, Igor' V. Litvinenko, Nikolay V. Tsygan
Russian Military Medical Academy Reports.2023; 42(4): 413. CrossRef

Original articles

Otorhinolaryngology
Association between fatty liver disease and hearing impairment in Korean adults: a retrospective cross-sectional study: Da Jung Jung; J Yeungnam Med Sci. 2023;40(4):402-411. Published online June 26, 2023; DOI: https://doi.org/10.12701/jyms.2023.00304

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Abstract PDF

Background
We hypothesized that fatty liver disease (FLD) is associated with a high prevalence of hearing loss (HL) owing to metabolic disturbances. This study aimed to evaluate the association between FLD and HL in a large sample of the Korean population.
Methods
We used a dataset of adults who underwent routine voluntary health checkups (n=21,316). Fatty liver index (FLI) was calculated using Bedogni’s equation. The patients were divided into two groups: the non-FLD (NFLD) group (n=18,518, FLI <60) and the FLD group (n=2,798, FLI ≥60). Hearing thresholds were measured using an automatic audiometer. The average hearing threshold (AHT) was calculated as the pure-tone average at four frequencies (0.5, 1, 2, and 3 kHz). HL was defined as an AHT of >40 dB.
Results
HL was observed in 1,370 (7.4%) and 238 patients (8.5%) in the NFLD and FLD groups, respectively (p=0.041). Compared with the NFLD group, the odds ratio for HL in the FLD group was 1.16 (p=0.040) and 1.46 (p<0.001) in univariate and multivariate logistic regression analyses, respectively. Linear regression analyses revealed that FLI was positively associated with AHT in both univariate and multivariate analyses. Analyses using a propensity score-matched cohort showed trends similar to those using the total cohort.
Conclusion
FLD and FLI were associated with poor hearing thresholds and HL. Therefore, active monitoring of hearing impairment in patients with FLD may be helpful for early diagnosis and treatment of HL in the general population.

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Repurposing Renin–Angiotensin System Drugs for the Treatment of Audiovestibular Disorders
Grant Podhajsky, Kiran S. Marla, Alec P. Marticoff, Kenny Nguyen, Tanner Kempton, Sepehr Salehpour, Caden Duffy, Douglas M. Bennion
Journal of Clinical Medicine.2026; 15(2): 743. CrossRef
Metabolic-dysfunction-associated steatohepatitis impairs cochlear integrity and delays auditory recovery after noise trauma
Sheng Jin, Soo Jeong Kim, Ah-Ra Lyu, Sun-Ae Shin, Tae Hwan Kim, Long Jin, Jun Young Heo, Min Jung Park, Yong-Ho Park
Cell Communication and Signaling.2026;[Epub] CrossRef
Association of multimorbidity and its patterns with risk of mortality among the elderly in Shenzhen, China
Yijin Zheng, Xueli Yuan, Wenqing Ni, Hongmin Zhang, Yan Zhang, Yuan Wei, Jian Xu
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Association of Metabolic Dysfunction‐Associated Steatotic Liver Disease With Sudden Sensorineural Hearing Loss Among Older Adults
Eun Seok Kang, Seohui Jang, Hye Jun Kim, Kyuwoong Kim, Meng Sha, Yun Hwan Oh, Michelle J. Suh, Seogsong Jeong
Laryngoscope Investigative Otolaryngology.2025;[Epub] CrossRef
A Higher Liver Fibrosis-4 Index Is Associated With More Severe Hearing Loss in Idiopathic Sudden Sensorineural Hearing Loss
Yukihide Maeda, Soshi Takao, Ryotaro Omichi, Mizuo Ando
Cureus.2025;[Epub] CrossRef
Multifactorial Analysis of Congenital Hearing Loss: Demographic, Hematological, and Biochemical Perspectives
Lucky Thakkar, Manjunath Dandinarasaiah, Shubhangi Pingle, S. Veeresh, Suresh Basavaraj Arakera
Journal of the Scientific Society.2025; 52(3): 213. CrossRef
The inflammatory and metabolic status of patients with sudden-onset sensorineural hearing loss
Jônatas Bussador do Amaral, Kelly Abdo Peron, Tracy Lima Tavares Soeiro, Marina Cançado Passarelli Scott, Flávia Tatiana Pedrolo Hortense, Michelly Damasceno da Silva, Carolina Nunes França, Luiz Henrique da Silva Nali, André Luis Lacerda Bachi, Norma de
Frontiers in Neurology.2024;[Epub] CrossRef
Which Environmental Pollutants Are Toxic to Our Ears?—Evidence of the Ototoxicity of Common Substances
Gregory M. Zarus, Patricia Ruiz, Rae Benedict, Stephan Brenner, Krystin Carlson, Layna Jeong, Thais C. Morata
Toxics.2024; 12(9): 650. CrossRef

Dentistry
Evaluation of periodontal status in women with polycystic ovary syndrome versus healthy women: a cross-sectional study: Sandhya Pavankumar, Pavan Kumar Yellarthi, Sandeep JN, Ramanarayana Boyapati, Trinath Kishore Damera, Naveen Vital Kumar G; J Yeungnam Med Sci. 2023;40(Suppl):S17-S22. Published online May 8, 2023; DOI: https://doi.org/10.12701/jyms.2023.00143

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Abstract PDF

Background
Polycystic ovary syndrome (PCOS) affects approximately 4% to 12% of females of reproductive age. Previous studies have shown an association between systemic and periodontal diseases. This study aimed to compare the prevalence of periodontal disease in women with PCOS and healthy women.
Methods
A total of 196 women aged 17 to 45 years were included in this study. Oral hygiene index-simplified (OHI-S), gingival index (GI), community periodontal index (CPI), and loss of attachment (LA) were assessed. Individuals who smoked, were pregnant, had any systemic disease (such as type 1 or type 2 diabetes mellitus, cardiovascular disease, malignancy, osteoporosis, and thyroid dysfunction), had a history of systemic antibiotic use in the past three months, or received any periodontal intervention in the past 6 months of screening were excluded. Student t-test was used to analyze the data. A p-value of <0.05 was considered statistically significant.
Results
Despite similar OHI-S scores (p=0.972) in the two groups, women with PCOS had significantly higher GI, CPI, and LA scores than healthy women (p<0.001).
Conclusion
Periodontal disease was more prevalent in women with PCOS than in healthy women. This finding may be due to the synergistic effects of PCOS and periodontitis on proinflammatory cytokines. PCOS may have an effect on periodontal disease, and vice versa. Hence, education on periodontal health and early detection and intervention for periodontal diseases is of paramount importance in patients with PCOS.

Citations

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A Potential Link Between Oral Microbiota and Female Reproductive Health
Justyna Marcickiewicz, Małgorzata Jamka, Jarosław Walkowiak
Microorganisms.2025; 13(3): 619. CrossRef
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Vincenzo Bitonti, Tiziana Perri, Lorenzo Cigni, Domenico Familiari, Giuseppe Vazzana, Rocco Franco
Dentistry Journal.2025; 13(5): 188. CrossRef
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Regenerative Therapy.2024; 26: 1159. CrossRef

Case reports

Internal Medicine
Endovascular treatment of Takayasu arteritis in a middle-aged woman with syncope and limb claudication: a case report: Ha-Young Choi, Sunggun Lee, Jino Park, Yeo-Jeong Song, Dong-Kie Kim, Ki-Hun Kim, Sang-Hoon Seol, Doo-Il Kim, Seunghwan Kim; J Yeungnam Med Sci. 2023;40(4):448-453. Published online April 26, 2023; DOI: https://doi.org/10.12701/jyms.2023.00122

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Abstract PDF

Takayasu arteritis (TA) is a disease that causes inflammation and stenosis of medium to large blood vessels. We report a case of a 50-year-old female patient with newly developed hypertension, syncope, and claudication of the extremities. Total occlusion of the left subclavian artery at the origin was found and significant stenosis of the right common iliac artery was revealed by hemodynamic analysis. She was successfully treated with percutaneous angioplasty for multiple peripheral arterial diseases and was finally diagnosed with TA. In consultation with a rheumatologist, medical treatment for TA was initiated, the patient’s hypertension disappeared, and her claudication symptoms improved.

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Claudication and Hypertension From Aortic Occlusion in Takayasu Arteritis: Revascularization With Excimer Laser and Drug-Eluting Stent
Sicheng Yao, Xiao Di, Yuexin Chen
Vascular and Endovascular Surgery.2026;[Epub] CrossRef
Long-term successfully endovascular treatment of a complicated Takayasu’s arteritis with thrombectomy and stenting: a case report
Claudio Chirico, Andrea Giorgianni, Veronica Clivio, Silvia Malnati, Tonia Gatta, Francesco Alberto Vizzari, Carlo Pellegrino, Massimo Fusco, Filippo Piacentino, Massimo Venturini, Federico Fontana
Journal of Medical Case Reports.2025;[Epub] CrossRef

Endocrinology, Diabetes, and Metabolism
Interleukin-6-producing paraganglioma as a rare cause of systemic inflammatory response syndrome: a case report: Yin Young Lee, Seung Min Chung; J Yeungnam Med Sci. 2023;40(4):435-441. Published online March 7, 2023; DOI: https://doi.org/10.12701/jyms.2022.00766

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Abstract PDF

Pheochromocytomas and paragangliomas (PPGLs) may secrete hormones or bioactive neuropeptides such as interleukin-6 (IL-6), which can mask the clinical manifestations of catecholamine hypersecretion. We report the case of a patient with delayed diagnosis of paraganglioma due to the development of IL-6-mediated systemic inflammatory response syndrome (SIRS). A 58-year-old woman presented with dyspnea and flank pain accompanied by SIRS and acute cardiac, kidney, and liver injuries. A left paravertebral mass was incidentally observed on abdominal computed tomography (CT). Biochemical tests revealed increased 24-hour urinary metanephrine (2.12 mg/day), plasma norepinephrine (1,588 pg/mL), plasma normetanephrine (2.27 nmol/L), and IL-6 (16.5 pg/mL) levels. 18F-fluorodeoxyglucose (FDG) positron emission tomography/CT showed increased uptake of FDG in the left paravertebral mass without metastases. The patient was finally diagnosed with functional paraganglioma crisis. The precipitating factor was unclear, but phendimetrazine tartrate, a norepinephrine-dopamine release drug that the patient regularly took, might have stimulated the paraganglioma. The patient’s body temperature and blood pressure were well controlled after alpha-blocker administration, and the retroperitoneal mass was surgically resected successfully. After surgery, the patient’s inflammatory, cardiac, renal, and hepatic biomarkers and catecholamine levels improved. In conclusion, our report emphasizes the importance of IL-6-producing PPGLs in the differential diagnosis of SIRS.

Citations

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Interleukin-6-producing non-secreting cervical paraganglioma presenting with fever of unknown origin and systemic inflammatory response syndrome
Valentina Rusconi, Angelica Clivio, Matteo Ferrante, Elisa Febbraro, Luisa Chasseur, Eleonora Duregon, Luca Scaglione, Mirko Parasiliti-Caprino
BMJ Case Reports.2026; 19(4): e272208. CrossRef
PHEOCHROMOCYTOMA AND PARAGANGLIOMA: CLINICAL PICTURE, DIAGNOSIS, TREATMENT, FOLLOW-UP AND PROGNOSIS - A LITERATURE REVIEW
Dominika Żyła, Kornelia Rojek, Andrzej Zuzak, Katarzyna Zych, Sylwia Koziej, Adam Jakubas, Mateusz Korga, Milena Krawczyk
International Journal of Innovative Technologies in Social Science.2025;[Epub] CrossRef
Screening and treatment of endocrine hypertension focusing on adrenal gland disorders: a narrative review
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Anesthesiology and Pain Medicine
Intra-abdominal hypertension during hip arthroscopy: a case report: Saeyoung Kim, Hyun-Su Ri, Ji Hyun Kim, Jiyong Yeom; J Yeungnam Med Sci. 2023;40(1):102-105. Published online September 23, 2022; DOI: https://doi.org/10.12701/jyms.2022.00430

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Abstract PDF

Symptomatic extravasation of irrigation fluid is a rare complication of hip arthroscopy. However, depending on the amount of fluid, intra-abdominal hypertension (IAH) may occur and even develop into abdominal compartment syndrome, which can seriously alter hemodynamic circulation. Therefore, it is important for anesthesiologists to promptly recognize the abnormal signs of IAH for early diagnosis and better clinical outcomes. Nevertheless, these signs are difficult to detect because they are usually obscured when the patient is under anesthesia and masked by surgical drapes. We report a case of IAH under general anesthesia during hip arthroscopy to highlight possible symptoms and signs.

Citations

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Massive peritoneal effusion following hip arthroscopy: a case report and review of the literature
Ze Wang, Lingchuan Gu, Ying Zhang, Tiao Su, Jiangming Luo, Ran Xiong, Chengjun Huang, Xin Chen, Guangxing Chen
Journal of Medical Case Reports.2025;[Epub] CrossRef
Heated Irrigation Fluids Did Not Reduce the Prevalence of Rectally Measured Hypothermia During Hip Arthroscopic Surgery Compared With Room-Temperature Fluids: A Prospective Randomized Trial
Ahmet Fırat, Enejd Veizi, İlknur Kalaycı, Başak Sinem Sezgin, Yasin Erdoğan, Safa Gürsoy, Bruno Capurro-Soler, Christos Koutserimpas
Orthopaedic Journal of Sports Medicine.2025;[Epub] CrossRef

Neurology
Cerebral fat embolism syndrome: diagnostic challenges and catastrophic outcomes: a case series: Hussein A. Algahtani, Bader H. Shirah, Nawal Abdelghaffar, Fawziah Alahmari, Wajd Alhadi, Saeed A. Alqahtani; J Yeungnam Med Sci. 2023;40(2):207-211. Published online September 7, 2022; DOI: https://doi.org/10.12701/jyms.2022.00360

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Abstract PDF

Fat embolism syndrome is a rare but alarming, life-threatening clinical condition attributed to fat emboli entering the circulation. It usually occurs as a complication of long-bone fractures and joint reconstruction surgery. Neurological manifestations usually occur 12 to 72 hours after the initial insult. These neurological complications include cerebral infarction, spinal cord ischemia, hemorrhagic stroke, seizures, and coma. Other features include an acute confusional state, autonomic dysfunction, and retinal ischemia. In this case series, we describe three patients with fat embolism syndrome who presented with atypical symptoms and signs and with unusual neuroimaging findings. Cerebral fat embolism may occur without any respiratory or dermatological signs. In these cases, diagnosis is established after excluding other differential diagnoses. Neuroimaging using brain magnetic resonance imaging is of paramount importance in establishing a diagnosis. Aggressive hemodynamic and respiratory support from the beginning and consideration of orthopedic surgical intervention within the first 24 hours after trauma are critical to decreased morbidity and mortality.

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Abdulrahim Saleh Alrasheed, Amna Mutasim Elazrag, Mohammad Salem Alqahtani, Faisal Alabbas
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Fat Embolism Syndrome Treated with Methylprednisolone
Daisuke Baba, Yugo Yamashita, Yuki Fukuda, Kyohei Yamaji, Hiroki Shiomi, Takahiro Horie, Shin Watanabe, Koh Ono
Internal Medicine.2025; 64(13): 1993. CrossRef
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A Case of Delayed Unexpected Isolated Cerebral Fat Embolism
Abhishek Mishra, Shalendra Singh, K. G. Ashwath, Ankit Mathur
Neurology India.2025; 73(3): 573. CrossRef
Diagnóstico de síndrome de embolia grasa paradójica tras artroplastia de cadera cementada
S. Maia, A. Carneiro, M. Vargas, B. Xavier, S. Caramelo
Revista Española de Anestesiología y Reanimación.2025; 72(10): 501841. CrossRef
Fat embolism syndrome before surgical treatment of open tibial and fibular shaft fracture: a case report
Kareem S. Khalil, Samah A. Ibrahim, Nada A. Yakout
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Micro‐Embolic Events and Their Clearing in the Brain. A Narrative Review
Kevin Mol, Inge A. Mulder, Ed van Bavel
Acta Physiologica.2025;[Epub] CrossRef
Diagnosing paradoxical fat embolism syndrome after cemented hip arthroplasty
S. Maia, A. Carneiro, M. Vargas, B. Xavier, S. Caramelo
Revista Española de Anestesiología y Reanimación (English Edition).2025; 72(10): 501841. CrossRef
Severe Traumatic Cerebral Fat Embolism Following Pelvic Fracture: A Case Report and Literature Review
Jung Woo Hyung, Maru Kim, Tae-Kyu Lee, Min Ho Lee
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Fat Embolism Syndrome: Evolving Perspectives on Diagnosis and Care
Nissar Shaikh, Bakri Alali, Umm E Amara, Umm E Nashrah, Naeem Alkheamy, Firdos Ummunnisa, Sayed Ghouri
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Gregory S Huang, C. Michael Dunham, Elisha A Chance
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Neurology
Invasive sphenoid sinus aspergillosis with normal findings on initial diagnostic tests that mimics Tolosa-Hunt syndrome—a diagnostic dilemma: a case report: Yu Hun Jeong, Jongsuk Choi, Byung-Jo Kim, Hung Youl Seok; J Yeungnam Med Sci. 2023;40(2):198-201. Published online March 11, 2022; DOI: https://doi.org/10.12701/jyms.2021.01494

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Abstract PDF

Invasive sphenoid sinus aspergillosis can mimic Tolosa-Hunt syndrome (THS), leading to frequent misdiagnoses and potentially fatal consequences. We report a case of invasive sphenoid sinus aspergillosis initially misdiagnosed as THS. A 79-year-old man presented with right periorbital pain, ophthalmoplegia, and loss of vision. Initial evaluations including magnetic resonance imaging (MRI), were normal. He was first diagnosed with THS based on clinical features. The disease progressed despite high-dose intravenous steroid treatment, and an enhancing mass-like lesion was found in the right orbital apex, cavernous sinus, and sphenoid sinus on follow-up MRI. Aspergillosis was eventually confirmed by sphenoid sinus biopsy. The patient developed cerebral infarction and finally died despite being treated with amphotericin B. Given that invasive sphenoid sinus aspergillosis may initially resemble THS, high suspicion and rapid histological examination are important for diagnosis.

Citations

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Tolosa–Hunt syndrome in children and adolescents: A systematic review
H. Shafeeq Ahmed, Purva Reddy Jayaram, Sukriti Khar
Headache: The Journal of Head and Face Pain.2025; 65(6): 1027. CrossRef
Updates of Tolosa-Hunt Syndrome
Nam-Hee Kim, Soo-Hyun Park
Korean Journal of Neuromuscular Disorders.2024; 16(2): 27. CrossRef
Invasive Aspergillosis Mimicking Tolosa-Hunt Syndrome: A Case Report
Soo-Im Jang, Seong Yeon Park, Sungim Choi, Eun-Ja Lee, Soo-Hyun Park, Nam-Hee Kim
Korean Journal of Neuromuscular Disorders.2023; 15(2): 46. CrossRef
Challenging Diagnosis of Invasive Sinus Aspergillosis Mimicking Gradenigo’s Syndrome in an Elderly Patient with T-Cell Lymphoma
Victoria Ramos de Ascanio, Gloria Liaño-Esteso, David Roldán, Teresa Collazo-Lorduy, Sara Martínez-Flores, José Ángel Hernández-Rivas, Isabel González-Gascón-y-Marín
Geriatrics.2023; 9(1): 4. CrossRef

Obstetrics, Gynecology, and Reproductive Medicine
Posterior reversible encephalopathy syndrome related to anemia correction in a patient with uterine myoma: a case report: Jisun Lee, Hyun Jung Lee; J Yeungnam Med Sci. 2022;39(4):336-340. Published online September 23, 2021; DOI: https://doi.org/10.12701/yujm.2021.01375

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Abstract PDF Supplementary Material

Although posterior reversible encephalopathy syndrome (PRES) is induced by various causes, a few cases have occurred after severe anemia correction. In this case report, a 45-year-old female patient visited emergency department with a chief complaint of dizziness due to severe anemia related to hypermenorrhea caused by uterine myoma. Before her operation, she had an abrupt headache and seizure during anemia correction with transfusion and injection of gonadotropin-releasing hormone agonist. Immediately after the operation, she experienced visual disturbances, followed by limb weakness and tonic-clonic movements. Magnetic resonance imaging showed alterations in parietal and occipital lobes suggesting cerebrovascular edema with hypoperfusion. Here, we presented and discussed the clinical and radiologic features of PRES related to anemia correction.

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Posterior reversible encephalopathy syndrome following blood transfusion and GnRH agonist
Sanjai Subha, Donal Skelly, Damian Jenkins
Practical Neurology.2026; : pn-2025-004949. CrossRef
Blood transfusion induced posterior reversible encephalopathy syndrome in a case of abnormal uterine bleeding-polyps with chronic very severe anaemia
Anindya S. Ghatak, Tapas Sarangi
International Journal of Research in Medical Sciences.2026; 14(5): 2128. CrossRef
Posterior Reversible Encephalopathy Syndrome (PRES) following blood transfusion in a polytrauma victim, an atypical occurrence
Erum Shariff, Nehad Mahmoud Soltan
Turkish Journal of Emergency Medicine.2024; 24(3): 180. CrossRef
Fatal posterior reversible encephalopathy syndrome after blood transfusion in a patient with myelodysplastic syndromes
Ken Takigawa, Takahiro Shima, Chiaki Kubara, Shun Akamine, Sae Utsumi, Teruhiko Yoshino, Mariko Minami, Masayasu Hayashi, Yayoi Matsuo, Takuro Kuriyama, Reiko Yoneda, Shuichi Taniguchi, Tetsuya Eto
Transfusion.2024; 64(9): 1791. CrossRef

Obstetrics, Gynecology, and Reproductive Medicine
Twin anemia polycythemia sequence in a dichorionic diamniotic pregnancy: a case report: Soo-Young Lee, Jin Young Bae, Seong Yeon Hong; J Yeungnam Med Sci. 2022;39(2):150-152. Published online July 2, 2021; DOI: https://doi.org/10.12701/yujm.2021.01060

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Abstract PDF

Complications related to the vascular anastomosis of the placental vessels in monochorionic twins are fatal. The clinical syndromes of feto-fetal transfusion include twin anemia polycythemia sequence (TAPS), twin-twin transfusion syndrome, and twin reversed arterial perfusion sequence. We present an extremely rare case of TAPS in a dichorionic diamniotic pregnancy. A 36-year-old woman, gravida 0, para 0, was referred to our hospital with suspected preterm premature membrane rupture. Although her pelvic examination did not reveal specific findings, the non-stress test result showed minimal variability in the first fetus and late deceleration in the second one. An emergency cesarean section was performed. The placenta was fused, and one portion of the placenta was pale, while the other portion was dark red. The hemoglobin level of the first fetus was 7.8 g/dL and that of the second one was 22.2 g/dL.

Citations

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Twin Anemia-Polycythemia Sequence (TAPS) bei dichorialer Geminigravidität
Kathrin Haßdenteufel, Tina Heinzmann, Kristina Killinger, Julia Spratte, Christoph Berg, Ingo Gottschalk, Hans-Peter Sinn, Michael Elsässer, Alexandra von Au
Geburtshilfe und Frauenheilkunde.2025; 85(05): 487. CrossRef
Unusual Twin Anemia-polycythemia Sequence in a Dichorionic Diamniotic Pregnancy. A Case Report and Systematic Review

Journal of Medical Clinical Case Reports.2025;[Epub] CrossRef
Twin Anemia-Polycythemia Sequence With Spontaneous Resolution in Dichorionic Diamniotic Twin Pregnancy: A Case Report and a Review of the Literature
Yoshihiro Yoshimura, Katsusuke Ozawa, HIroyuki Goto, Yu Yamazaki, Hitoshi Isohata, Daigo Ochiai
Cureus.2024;[Epub] CrossRef
Suspected twin anemia polycythemia sequence in a dichorionic, diamniotic twin pregnancy: a case report
Tania Jeyaseelan, Panicos Shangaris, Athina Efthymiou, Linzi Martin, Lisa Story, Surabhi Nanda, Neelam Gupta, Mudher Al-Adnani, Andreas Marnerides, Kypros H. Nicolaides, Srividhya Sankaran
Journal of Medical Case Reports.2023;[Epub] CrossRef

Physical therapy, Sports Therapy, and Rehabilitation
Serotonin syndrome in a patient with chronic pain taking analgesic drugs mistaken for psychogenic nonepileptic seizure: a case report: Mathieu Boudier-Revéret, Min Cheol Chang; Yeungnam Univ J Med. 2021;38(4):371-373. Published online April 5, 2021; DOI: https://doi.org/10.12701/yujm.2021.00948

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Abstract PDF Supplementary Material

Serotonin syndrome (SS) is a potentially life-threatening condition that is caused by the administration of drugs that increase serotonergic activity in the central nervous system. We report a case of serotonin syndrome in a patient with chronic pain who was taking analgesic drugs. A 36-year-old female with chronic pain in the lower back and right buttock area had been taking tramadol hydrochloride 187.5 mg, acetaminophen 325 mg, pregabalin 150 mg, duloxetine 60 mg, and triazolam 0.25 mg daily for several months. After amitriptyline 10 mg was added to achieve better pain control, the patient developed SS, which was mistaken for psychogenic nonepileptic seizure. However, her symptoms completely disappeared after discontinuation of the drugs that were thought to trigger SS and subsequent hydration with normal saline. Various drugs that can increase serotonergic activity are being widely prescribed for patients with chronic pain. Clinicians should be aware of the potential for the occurrence of SS when prescribing pain medications to patients with chronic pain.

Citations

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Diagnosis and treatment of serotonin syndrome
Je Sung You, Sung Phil Chung
Journal of The Korean Society of Clinical Toxicology.2024; 22(2): 11. CrossRef

Focused Review article

Pulmonary and Respiratory Medicine
Novel respiratory infectious diseases in Korea: Hyun Jung Kim; Yeungnam Univ J Med. 2020;37(4):286-295. Published online September 23, 2020; DOI: https://doi.org/10.12701/yujm.2020.00633

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Abstract PDF

Respiratory infections are very common and highly contagious. Respiratory infectious diseases affect not only the person infected but also the family members and the society. As medical sciences advance, several diseases have been conquered; however, the impact of novel infectious diseases on the society is enormous. As the clinical presentation of respiratory infections is similar regardless of the pathogen, the causative agent is not distinguishable by symptoms alone. Moreover, it is difficult to develop a cure because of the various viral mutations. Various respiratory infectious diseases ranging from influenza, which threaten the health of mankind globally, to the coronavirus disease 2019, which resulted in a pandemic, exist. Contrary to human expectations that development in health care and improvement in hygiene will conquer infectious diseases, humankind’s health and social systems are threatened by novel infectious diseases. Owing to the development of transport and trading activity, the rate of spread of new infectious diseases is increasing. As respiratory infections can threaten the members of the global community at any time, investigations on preventing the transmission of these diseases as well as development of effective antivirals and vaccines are of utmost importance and require a worldwide effort.

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Jingbo Yu, Hao Yu, Yuming Wang, Qiang Zeng
Infectious Disease Modelling.2026; 11(3): 947. CrossRef
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Liliang Yu, Min Liu, Qing Tan, Dan Wang, Xiaoyun Chen, Mingming Zhao, Jiang Long, Mingyue Fan, Daikun Zheng
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Barriers to and facilitators of populational adherence to prevention and control measures of COVID-19 and other respiratory infectious diseases: a qualitative evidence synthesis
Tácito Zaildo, Thayla Amorim Santino, Gabriela Chaves, Baldomero Antonio Kato da Silva, João Carlos Alchieri, Cecilia M. Patino, Sarah Leite, Kleber Giovanni Luz, Ricardo Oliveira Guerra, Tito Hugo Soares da Penha, Gabriel Rodrigues da Silva, Ada Cristina
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Diarylpentanoids, the privileged scaffolds in antimalarial and anti‐infectives drug discovery: A review
Amirah H. Ramli, Siti M. Mohd Faudzi
Archiv der Pharmazie.2023;[Epub] CrossRef
Infectious Respiratory Diseases Decreased during the COVID-19 Pandemic in South Korea
Da Hae Kim, Thi Mai Nguyen, Jin Hee Kim
International Journal of Environmental Research and Public Health.2021; 18(11): 6008. CrossRef
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Case report

Endocrinology, Diabetes, and Metabolism
Cushing syndrome in pregnancy, diagnosed after delivery: Han Byul Kim, Mi Kyung Kim, El Kim, Keun Soo Ahn, Hye Soon Kim, Nam Kyung Kim; Yeungnam Univ J Med. 2021;38(1):60-64. Published online May 22, 2020; DOI: https://doi.org/10.12701/yujm.2020.00290

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Abstract PDF

Cushing syndrome (CS) is rare in pregnancy, and few cases have been reported to date. Women with untreated CS rarely become pregnant because of the ovulatory dysfunction induced by hypercortisolism. It is difficult to diagnose CS in pregnancy because of its very low incidence, the overlap between the clinical signs of hypercortisolism and the physiological changes that occur during pregnancy and the changes in hypothalamus-pituitary-adrenal axis activity that occur during pregnancy and limit the value of standard diagnostic testing. However, CS in pregnancy is associated with poor maternal and fetal outcomes; therefore, its early diagnosis and treatment are important. Here, we report two patients with CS that was not diagnosed during pregnancy, in whom maternal and fetal morbidity developed because of hypercortisolism.

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Cushing’s disease with twin pregnancy and diabetes mellitus: a case report and literature review
Hideyasu Asai, Ikuo Yamamori, Shigeru Hagimoto, Kyoichi Okumura, Koki Sakakibara
Endocrine Journal.2024; 71(10): 1003. CrossRef
Endogenous Cushing’s syndrome during pregnancy
Nada Younes, Matthieu St-Jean, Isabelle Bourdeau, André Lacroix
Reviews in Endocrine and Metabolic Disorders.2023; 24(1): 23. CrossRef
Cushing Syndrome in Pregnancy: A Case Presentation and Review of Literature
HamidReza Samimagham, Ava Ziaei, Mohammad Tamaddondar, Mitra Kazemi Jahromi
Journal of Kermanshah University of Medical Sciences.2023;[Epub] CrossRef

Case Report

Anesthesiology and Pain Medicine
Successful difficult airway management using GlideScope video laryngoscope in a child with Cornelia de Lange Syndrome: Sang-Jin Park, Eun Kyung Choi, Suyong Park, Kunjin Bae, Deokhee Lee; Yeungnam Univ J Med. 2018;35(2):219-221. Published online December 31, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.219

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Abstract PDF: Management of airway in a child with Cornelia de Lange Syndrome (CdLS) should be given due consideration because most of them have the problems related to difficult airway. The GlideScope video laryngoscope can be attempted during routine intubation, however it is mostly used in case of difficulty. With adequate preoperative airway assessment, we used the pediatric video laryngoscope as useful alternative airway device in a child with CdLS and orotracheal intubation proceeded uneventfully.

Original Article

Pediatrics, Perinatology, and Child Health
Risk factors for respiratory distress syndrome in full-term neonates: Jin Hyeon Kim, Sang Min Lee, Young Hwan Lee; Yeungnam Univ J Med. 2018;35(2):187-191. Published online December 31, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.187

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Abstract PDF

Background
Respiratory distress syndrome (RDS) is a one of the most common cause of respiratory morbidity and mortality in neonates. This study was conducted to investigate the risk factors for RDS in full-term neonates.
Methods
We conducted this retrospective study using medical records. The study group included 80 full-term neonates diagnosed with RDS and hospitalized in the neonatal intensive care unit between January 2012 and December 2016, at Yeungnam University Hospital. We analyzed sex, gestational age, birth weight, delivery method, maternal age, number of pregnancy, history of abortion, and complication of pregnancy. The control group included 116 full-time neonates who were hospitalized with jaundice during the same period.
Results
The incidence of full-term RDS was more common in males (odds ratio [OR], 3.288; 95% confidence interval [CI], 1.446-7.479), cesarean section (OR, 15.03; 95% CI, 6.381-35.423), multiparity (OR, 4.216; 95% CI, 1.568-11.335). The other factors rendered no significant results.
Conclusion
The risk factors for RDS in full-tern neonates were identified as male sex, cesarean section, and multiparity. Further studies involving more institutions are needed to clarify the risk factors for RDS in fullterm infants.

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Patricia Silveyra, Maksat Babayev, Carolyn Damilola Ekpruke
Physiological Reviews.2026; 106(1): 53. CrossRef
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Shaked Yarza, Ran Matot, Asaf Romano, Or Lee Rak, Ohad Houri, Nir Sokolover, Anat Shmueli, Eran Hadar, Yossi Geron
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Evaluating the efficacy of LDH and inflammatory indices in discriminating neonatal respiratory distress syndrome from transient tachypnea of the newborns
Hala M. Sakhr, Fayed HM, Amany E. Abdel Aziz, Heba M. Qubaisy
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Incidence and predictors of respiratory distress among neonates admitted to neonatal intensive care unit, Northwest Ethiopia
Dereje Woldeyes, Ayenew Negesse, Alehegn Aderaw Alamneh, Selamawit Shita Jemberie, Abateneh Addis Anteneh, Molla Yigzaw Birhanu
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Tenaw Belay Shitie, Daniel Mengistu Bekele, Feven Mulugeta Ashagrie, Tirusew Nigussie Kebede
BMC Pediatrics.2025;[Epub] CrossRef
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Suda Jaihow, Wipawan Chaoum Pensuksan, Nonthapan Phasuk, Udomsak Narkkul, Stephen J. Scholand, Chuchard Punsawad
The Journal of Maternal-Fetal & Neonatal Medicine.2025;[Epub] CrossRef
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Keren Fang, Shaojie Yue, Shuo Wang, Mingjie Wang, Xiaohe Yu, Ying Ding, Mei Lv, Yang Liu, Chuanding Cao, Zhengchang Liao
BMC Pediatrics.2024;[Epub] CrossRef
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Vanderlei Amadeu da Rocha, Sanseray da Silveira Cruz-Machado, Isília Aparecida Silva, Pedro Augusto Carlos Magno Fernandes, Regina Pekelmann Markus, Mariana Bueno
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Namita Gupta, Rajasri G Yaliwal, Subhashchandra Mudanur, Shreedevi Kori
Cureus.2024;[Epub] CrossRef
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Frontiers in Reproductive Health.2022;[Epub] CrossRef
Novel predictor markers for early differentiation between transient tachypnea of newborn and respiratory distress syndrome in neonates
Mohamed Shawky Elfarargy, Ghada M Al-Ashmawy, Sally Abu-Risha, Haidy Khattab
International Journal of Immunopathology and Pharmacology.2021;[Epub] CrossRef
The Underlying Causes of Respiratory Distress in Late-Preterm and Full-Term Infants Are Different From Those of Early-Preterm Infants
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Iranian Journal of Pediatrics.2020;[Epub] CrossRef

Case report

Ophthalmology
Surgical treatment of esotropia and unilateral ptosis in a patient with Cornelia de Lange syndrome: Won Jae Kim; Yeungnam Univ J Med. 2019;36(2):152-154. Published online December 17, 2018; DOI: https://doi.org/10.12701/yujm.2019.00066

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Abstract PDF: Cornelia de Lange syndrome (CdLS) is a rare multisystemic disorder that is characterized by mental retardation, prenatal and postnatal growth retardation, limb anomalies, and distinctive facial features, which include arched eyebrows that often meet in the middle (synophrys), long eyelashes, low-set ears, small and widely spaced teeth, and a small and upturned nose. Ophthalmic manifestations include long eyelashes, nasolacrimal duct obstruction, myopia, ptosis, and strabismus. There has been no report of surgical treatment for esotropia and unilateral ptosis in patients with CdLS in Korea. We report a patient with CdLS who underwent surgical treatment for esotropia and unilateral ptosis with a good surgical outcome.

Case Reports

Pulmonary and Respiratory Medicine
Partial spontaneous remission of small cell lung carcinoma with neurologic symptom: Kyung Hyun Yun, Sung Heon Song, Chung Hyoun Kim, Chan Hee Hwang, Jun Ho Lee, Je Hyoung Choi, Sun Young Kim; Yeungnam Univ J Med. 2017;34(2):275-278. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.275

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Abstract PDF: Small cell lung carcinoma (SCLC) is a cancer that shows aggressive behavior, early spread to distant sites, and frequent association with distinct paraneoplastic syndromes. Spontaneous remission of cancer, particularly of SCLC, is a rare biological event. Cases involving spontaneous regression of SCLC were reported, and were associated with paraneoplastic syndromes of the nervous system. This article reports on a 78-year-old man with SCLC in remission, with neurological symptoms. The patient visited the hospital because of generalized weakness, and imaging studies revealed a mass in the lower lobe of the left lung, pathological evaluation showed SCLC. The patient refused oncologic treatment and was treated only with conservative care. In follow-up study the diameter of the mass had decreased from initial 32 mm, 9 months after admission to 20 mm, 17 months after admission to 13 mm. The patient kept complaining of generalized weakness, dizziness, and paresthesia of limbs. We assumed that, in this case, the spontaneous remission of lung cancer was related to the immunologic response directed against the tumor, which is believed to be an important factor in the pathogenesis of paraneoplastic neurologic syndromes.

Gastroenterology and Hepatology
Budd-Chiari syndrome with antiphospholipid syndrome and systemic lupus erythematosus in a patient with Klinefelter's syndrome: Mingee Lee, Jin Young Huh, Ji Hyang Lee, Sun myoung Kang, Jae Yong Lee, Oh Chan Kwon, Eun Na Kim, Jihun Kim, Danbi Lee; Yeungnam Univ J Med. 2017;34(2):260-264. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.260

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Abstract PDF: Klinefelter's syndrome is the most common congenital abnormality that causes primary hypogonadism. It is associated with diseases that predominantly affect women, such as systemic lupus erythematosus (SLE), and it can sometimes cause veno-occlusive disease. We experienced a case of Budd-Chiari syndrome (BCS) in a 33-year-old man with Klinefelter's syndrome presented with hematemesis and edema in both lower extremities. The clinical and laboratory findings were compatible with SLE, antiphospholipid syndrome, and BCS. To the best of our knowledge, this is the first case report to describe a simultaneous presentation of these four clinical syndromes in a single patient.

Endocrinology, Diabetes, and Metabolism
Insulin autoimmune syndrome associated with alpha-lipoic acid in a young woman with no concomitant disease: Sang Bae Lee, Min Young Lee, Ji Hong You, Seong Han Kim, Ji Sun Nam; Yeungnam Univ J Med. 2017;34(1):115-118. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.115

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Abstract PDF: Insulin autoimmune syndrome (IAS) is characterized by spontaneous hypoglycemia, extremely high serum insulin levels, and high titers of autoantibodies against endogenous insulin, in the absence of exogenous insulin injection. IAS often occurs following exposure to sulfhydryl-containing drugs, including alpha-lipoic acid (ALA). A 30-year-old woman without diabetes visited our outpatient clinic with recurrent hypoglycemia. She had been taken ALA for weight reduction since 3 weeks ago. Further hypoglycemia work up revealed very high insulin levels, C-Peptide levels and positive insulin antibodies. And conventional imaging examinations were negative for insulinoma or other pancreatic tumors. Finally, the diagnosis of Insulin autoimmune syndrome (IAS) was made. Following the cessation of ALA, hypoglycemia improved, with no medication, and the patient experienced no further hypoglycemic attacks over the next month. The use of ALA as a nutritional supplement is increasing. We report a case of IAS associated with ALA in a non-diabetic patient.

Rheumatology
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.

Review Article

Neurology
Approach to pupillary abnormalities via anatomical pathways: Sung Hee Kim; Yeungnam Univ J Med. 2017;34(1):11-18. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.11

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Abstract PDF

The pupillary size and movement are controlled dynamically by the autonomic nervous system; the parasympathetic system constricts the iris, while the sympathetic system dilates the iris. Under normal conditions, these constrictions and dilations occur identically in both eyes. Asymmetry in the pupillomotor neural input or output leads to impaired pupillary movement on one side and an unequal pupil size between both eyes. Anisocoria is one of the most common signs in neuro-ophthalmology, and the neurological disorders that frequently cause anisocoria include serious diseases, such as vascular dissection, fistula, and aneurysm. A careful history and examination can identify and localize pupillary disorders and provide a guide for appropriate evaluations.

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Case Reports

Rheumatology
Rheumatoid arthritis accompanied by Gitelman syndrome: Min Gi Park, Ji Hyun Lee, Sung Jun Kim, Su Ho Park, Suk Ki Park, Joon Sul Choi, Ji Yeon Hwang; Yeungnam Univ J Med. 2017;34(1):101-105. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.101

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Abstract PDF: Gitelman syndrome is a condition caused by a mutation of the thiazide sensitive Na-Cl cotransporter gene on the distal convoluted tubule. It results in a variety of clinical features, including hypokalemia, hypomagnesemia, hypocalciuria, and metabolic alkalosis. It is often diagnosed in asymptomatic adults presented with unexplained hypokalemia; however, it is sometimes associated with muscular cramps, numbness, fatigue, weakness, or paralysis. We experienced a case of rheumatoid arthritis accompanied by Gitelman syndrome, presented with hand tremor. We diagnosed her using renal clearance study and genetic analysis. Here, we report our experiences regarding this case along with a literature review.

Pulmonary and Respiratory Medicine
Lymphocytic interstitial pneumonia in a patient with Sjögren's syndrome.: Eun Hye Lee, Ji Eun Park, Eun Kyong Goag, Young Joo Kim, In Young Jung, Chi Young Kim, Young Mok Park, Jung Mo Lee, Moo Suk Park; Yeungnam Univ J Med. 2016;33(2):112-115. Published online December 31, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.2.112

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Abstract PDF: Lymphocytic interstitial pneumonia (LIP) is a rare benign lymphoproliferative disorder characterized by diffuse infiltration of the pulmonary parenchymal interstitium by polyclonal lymphocytes and plasma cells. LIP has been associated with a variety of clinical conditions; such as connective tissue disorders and other immune system abnormalities. Treatment usually involves administration of corticosteroids and other immunosuppressants. We report on a 38-year-old female patient who complained of shortness of breath, dry mouth, and dry eyes for more than 1 month, and was positive for Raynaud's phenomenon. Based on surgical biopsy, she was diagnosed as having LIP accompanied by Sjögren's syndrome. The patient was treated with high-dose steroids followed by maintenance therapy for approximately 2 years, and her condition improved.

Endocrinology, Diabetes, and Metabolism
Adrenocorticotropic hormone (ACTH)-producing pheochromocytoma presented as Cushing syndrome and complicated by invasive aspergillosis.: Jae Ho Cho, Da Eun Jeong, Jae Young Lee, Jong Geol Jang, Jun Sung Moon, Mi Jin Kim, Ji Sung Yoon, Kyu Chang Won, Hyoung Woo Lee; Yeungnam Univ J Med. 2015;32(2):132-137. Published online December 31, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.2.132

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Abstract PDF

Adrenocorticotropic hormone (ACTH)-producing pheochromocytoma has been rarely reported, whereas only a few cases of Cushing syndrome accompanied by opportunistic infections have been reported. We experienced a patient with pheochromocytoma with ectopic Cushing syndrome complicated by invasive aspergillosis. A 35-year-old woman presented with typical Cushingoid features. Her basal plasma cortisol, ACTH, and 24-hour urine free cortisol levels were significantly high, and 24-hour urine metanephrine and catecholamine levels were slightly elevated. The endogeneous cortisol secretion was not suppressed by either low- or high-dose dexamethasone. Abdominal computed tomography (CT) revealed a heterogeneous enhancing mass measuring approximately 2.5 cm in size in the left adrenal gland. No definitive mass lesion was observed on sellar magnetic resonance imaging. On fluorine-18 fluorodeoxyglucose positron emission tomography/CT, a hypermetabolic nodule was observed in the left upper lung. Thus, we performed a percutaneous needle biopsy, which revealed inflammation, not malignancy. Thereafter, we performed a laparoscopic left adrenalectomy, and its pathologic finding was a pheochromocytoma with positive immunohistostaining for ACTH. After surgery, the biochemistry was normalized, but the clinical course was fatal despite intensive care because of the invasive aspergillosis that included the lungs, retina, and central nervous system.

Citations

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Ectopic ACTH- and/or CRH-Producing Pheochromocytomas
Patrick F Elliott, Thomas Berhane, Oskar Ragnarsson, Henrik Falhammar
The Journal of Clinical Endocrinology & Metabolism.2021; 106(2): 598. CrossRef
Ectopic adrenocorticotrophic hormone syndrome (EAS) with phaeochromocytoma: a challenging endocrine case with a happy ending
Sharifah Faradila Wan Muhamad Hatta, Leoni Lekkakou, Ananth Viswananth, Harit Buch
BMJ Case Reports.2019; 12(8): e230636. CrossRef
Severe Cushing Syndrome Due to an ACTH-Producing Pheochromocytoma: A Case Presentation and Review of the Literature
Jenan N Gabi, Maali M Milhem, Yara E Tovar, Emhemmid S Karem, Alaa Y Gabi, Rodhan A Khthir
Journal of the Endocrine Society.2018; 2(7): 621. CrossRef

Rheumatology
An overlap syndrome of Churg-Strauss syndrome and rheumatoid arthritis.: Seung Il Bae, Jong Geol Jang, Hun Tae Kim, Hee Yun Ahn, Min Jung Kim, Hyun Je Kim, Choong Ki Lee, Young Hoon Hong; Yeungnam Univ J Med. 2015;32(2):127-131. Published online December 31, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.2.127

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Abstract PDF: Churg-Strauss syndrome (CSS) is a necrotizing vasculitis with extra-, peri-vascular eosinophilic infiltration. Chronic symmetric polyarthritis with the presence of rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody are the mainstay of rheumatoid arthritis (RA) diagnosis. Mononeuritis multiplex is a peripheral neuropathy involving more than 2 separate nerve areas. A 62-year-old male patient was referred for left foot drop and polyarthritis of both hands and feet for 4 months. During evaluation, mononeuritis multiplex was detected on nerve conduction study and electromyography tests: vasculitis with neutrophil, eosinophil, and lymphocyte infiltration on peroneal nerve biopsy. A positive response to methacholin and bronchodilator was observed on the pulmonary function test. Radiologic tests showed peri-articular soft tissue swelling and osteopenia on both hand and foot. Marked peripheral eosinophilia, high RF, and positive perinuclear anti-neutrophil cytoplasmic antibody were detected on blood tests. Here, we report on a patient with overlap syndrome of CSS and RA with review of the relevant literature, from which a few references to overlap syndrome of CSS and RA were available.

Gastroenterology and Hepatology
Tumor lysis syndrome following sorafenib treatment in hepatocellular carcinoma.: Shin Young Kim, Hee Yeon Kim, Yu Seung Kim, Sang Min Lee, Chang Wook Kim; Yeungnam Univ J Med. 2015;32(1):47-49. Published online June 30, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.1.47

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Abstract PDF

Sorafenib is indicated for the treatment of advanced hepatocellular carcinoma (HCC), but although rare, tumor lysis syndrome (TLS) can be fatal in HCC patients with a large tumor burden. The authors describe the case of a 55-year-old hepatitis B carrier who visited our clinic with progressive dyspnea for 3 weeks. Chest and abdominal computed tomography revealed a huge HCC in the left lobe of the liver with invasion of the inferior vena cava, right atrium, and pulmonary arteries. After 8 days of sorafenib administration, TLS was diagnosed based on the characteristic findings of hyperuricemia, hyperkalemia, and acute kidney injury with massive tumor necrosis by follow-up imaging. Despite discontinuation of sorafenib and supportive care, the patient's clinical course rapidly deteriorated. The authors describe a rare but fatal complication that occurred soon after sorafenib initiation for HCC. Careful follow-up is required after commencing sorafenib therapy for the early diagnosis and management of TLS.

Citations

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A case of hepatocellular carcinoma caused severe tumor lysis by ramucirumab
Yuhi Sakamoto, Keizo Kato, Hiroshi Abe, Takeshi Yonezawa, Sadahiro Ito, Makiko Ika, Kiichiro Yoza, Mamika Ohara, Shogo Sakasai, Shohei Shimizu, Shinji Endo
Kanzo.2021; 62(3): 129. CrossRef
Sorafenib-induced tumor lysis syndrome in a patient with metastatic hepatocellular carcinoma ☆
Sardar Zakariya Imam, Mohammad Faizan Zahid, Muhammad Asad Maqbool
Hematology/Oncology and Stem Cell Therapy.2020; 13(3): 168. CrossRef

Anesthesiology and Pain Medicine
Prolonged blepharoptosis following repeated stellate ganglion block in a patient with brachial plexopathy after thoracoscopic surgery.: Kangil Kim, Sang Hyun Lee, Eun Hui Seo, Young Woo Cho; Yeungnam Univ J Med. 2014;31(2):135-138. Published online December 31, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.2.135

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Abstract PDF: A 34-year-old female was suffered from pain and numbness of right arm for 2 months after undergoing a thoracoscopic procedure for a posterior mediastinal mass that was diagnosed as neurilemmoma. The patient was diagnosed as a complex regional pain syndrome type 2 with brachial plexopathy developed during thoracoscopic excision of posterior mediastinal mass, and stellate ganglion block (SGB) with 0.2% ropivacaine 10 mL was performed every 3-4 days. The patient revealed slightly prolonged blepharoptosis as Horner syndrome accompanied after every SGB and recovered. However, following the 23rd SGB, the blepharoptosis persisted and patient was recovered spontaneously from blepharoptosis after about 12 months. The possibility that the persistent blepharoptosis might be caused by brachial plexopathy related to patient's pathology or surgical manipulation and/or repeated SGB. If Horner syndrome occurs, its etiology should be assessed, and it would be necessary to explain and to assure the patient the possibility of recovery spontaneously from the complication within a year, without any sequelae.

Nephrology
Furosemide induced medullary nephrocalcinosis mimicking Bartter syndrome.: Sohee Kim, Chanhee Kyung, Yong Hoon Kim, Jang Ho Cho, Changhyeok Hwang, Jung Eun Lee; Yeungnam Univ J Med. 2014;31(1):21-24. Published online June 30, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.1.21

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Abstract PDF: Clinical presentation of Bartter syndrome is similar to surrepitious vomiting or use of diuretics. Therefore, precise differential diagnosis of Bartter syndrome is crucial. We report a case of medullary nephrocalcinosis (MNC) induced by furosemide mimicking Bartter syndrome. A 55-year-old female patient visited our hospital with renal dysfunction on basis of hypokalemia and metabolic alkalosis. She had no history of hypertension or drug use except allopurinol and atorvastatin. She did not complain of nausea or vomiting on presentation and the serum magnesium level was normal. We performed ultrasonography, that showed MNC. For these reasons, we suspected Bartter syndrome and corrected the electrolyte imbalance. During outpatient follow up, we found that the patient had been taking 400 mg of furosemide daily for 30 years. We could diagnose furosemide induced MNC, and recommended to her to reduce the amount of furosemide.

Rheumatology
A Case of Successful Treatment of Refractory Synovitis Acne Pustulosis Hyperostosis Osteitis (SAPHO) Syndrome with Adalimumab.: Jin Taek Yoo, Young Hwan Kim, Soon Myung Jung, Sang Chang Kwon, Seung Min Ryu, Jun Ouk Ha, Joung Wook Lee; Yeungnam Univ J Med. 2013;30(1):55-57. Published online June 30, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.1.55

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Abstract PDF: Synovitis acne pustulosis hyperostosis osteitis (SAPHO) syndrome is a rare disease that involves the skin, bones and joints. It is thought to be caused by infection with low-toxicity bacteria and to be the result of reactive infectious osteitis. However, this hypothesis has not yet been clearly established. New SAPHO syndrome treatment methods are needed because the disease does not respond to treatment in many cases. In this paper, a case is reported of SAPHO syndrome with pain in the acromioclavicular joint and with squamous and pustular macules on the palms and soles. First, the patient was treated with aceclofenac, prednisolon and sulfasalazine for two weeks. However, the symptoms were not relieved, so methotrexate and pamidronate were added to the treatment. Since no improvement was seen after four weeks of treatment, adalimumab was prescribed. The skin lesions were relieved two weeks later, and the bone pain and arthralgia, four weeks later. No recurrence or adverse effects were observed at the 22-week follow-up.

Nephrology
A Case of Osmotic Demyelination Syndrome in a Patient with Severe Hyponatremia Complicated by Rhabdomyolysis.: Da Young Lee, Chang Woo Hong, In Hee Lee; Yeungnam Univ J Med. 2013;30(1):25-30. Published online June 30, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.1.25

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Abstract PDF

Hyponatremia, the most common electrolyte disorder, has been rarely reported as causing rhabdomyolysis. Osmotic demyelination syndrome (ODS), a demyelinating disease of the central pons and/or other areas of the brain, is infrequently reported as associated with rapid correction of hyponatremia. This paper reports a case of ODS after correction of severe hyponatremia complicated by rhabdomyolysis. A 47-year-old female with a history of chronic alcoholism presented herself at the hospital with altered consciousness after three days of nausea and vomiting. She was on a thiazide diuretic for essential hypertension. Her blood tests upon her hospital admission showed hyponatremia (Na+ 98 mEq/L), hypokalemia (K+ 3.0 mEq/L), and elevation of her serum creatine phosphokinase (3,370 IU/L) with an increase in her serum myoglobin level 11,267 ng/mL). She was treated with intravenous fluid therapy that included isotonic and hypertonic salines along with potassium chloride. She became more alert, and her neurological condition gradually improved after the first five days of her therapy. On the ninth day after her admission, she developed progressive quadiaresis associated with dysarthria, dysphagia, and dystonia despite the resolution of her hyponatremia. Magnetic resonance imaging of her brain on 16th day revealed symmetrical areas of signal hyperintensity in her central pons, basal ganglia, and precentral gyrus in T2-weighted images, which are consistent with ODS. Her neurological symptoms steadily improved after six weeks with only supportive treatment and rehabilitation.

Citations

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Severe hyponatremia and seizures after bowel preparation with low-volume polyethylene glycol plus ascorbic acid solution
Jae Young Lee, Byung Ik Jang, Yoon Jeong Nam, Jay Song, Min Cheol Kim, Seung Min Chung, Jong Geol Jang, Jae Ho Cho
Yeungnam University Journal of Medicine.2015; 32(1): 55. CrossRef

Review Article

Pediatrics, Perinatology, and Child Health
Obesity and Insulin Resistance in Childhood.: Kwang Hae Choi; Yeungnam Univ J Med. 2012;29(2):73-76. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.73

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Abstract PDF: More and more children are becoming obese and overweight due to several factors that include a high energy density in the diet (a high fat intake) and low energy expenditure. Consequently childhood obesity is becoming a significant health problem. Fat tissue releases many cytokines such as resistin, tumor necrosis factor-alpha, leptin, interleukin-6. These adipocytokines induce obesity-related insulin resistance. Insulin resistance is a key component of obesity-related metabolic problems such as hypertension, type 2 diabetes mellitus, dyslipidemia, non-alcoholic steatohepatitis, acanthosis nigricans and polycystic ovarian syndrome. This review article focused on insulin resistance and its related metabolic diseases.

Case Reports

Nephrology
A Case of Chronic Renal Failure Associated with Systemic Capillary Leak Syndrome.: Seon Ha Baek, Nara Shin, Hyo Jin Kim, Mi Yeun Han, Dong Ju Choi, Soo Mee Bang, Sejoong Kim, Jin Ho Paik; Yeungnam Univ J Med. 2012;29(2):145-149. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.145

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Abstract PDF

Systemic capillary leak syndrome (SCLS) is an unusual entity characterized by hypovolemic shock, hemoconcentration, and hypo-albuminemia associated with paraproteinemia as a result of marked capillary hyperpermeability. Complications of this syndrome can include compartment syndromes, pulmonary edema, thrombosis, and acute kidney injury. This paper reports a case of severe SCLS accompanied by acute tubular necrosis caused by hypoperfusion and myoglobinuria secondary to rhabdomyolysis, which resulted in chronic kidney disease that necessitated hemodialysis. However, there have been rare data of residual end-organ damage after acute attacks in Korea. Therefore, this paper reports a case of complicated SCLS enough to hemodialysis and that developed into chronic kidney disease.

Citations

Citations to this article as recorded by

Fatal Systemic Capillary Leak Syndrome after SARS-CoV-2Vaccination in Patient with Multiple Myeloma
Gwang-Jun Choi, Seon Ha Baek, Junmo Kim, Jung Ho Kim, Geun-Yong Kwon, Dong Keun Kim, Yeon Haw Jung, Sejoong Kim
Emerging Infectious Diseases.2021; 27(11): 2973. CrossRef
Systemic capillary leak syndrome (Clarkson's disease) during elective pylorus-preserving pancreaticoduodenectomy: case report
Kun Moo Choi, Cheon Soo Park, Mi Hye Kim
Korean Journal of Hepato-Biliary-Pancreatic Surgery.2014; 18(1): 38. CrossRef

Gastroenterology and Hepatology
A Case of Basal Cell Carcinoma in a Patient with Membranous Glomerulonephritis.: Chan Hee Kyung, So Hee Kim, Beom Jin Lim, Hee Sung Ko, Hee Jin Park, Hae Won Kim, Dong Ha Park, Jung Eun Lee; Yeungnam Univ J Med. 2012;29(2):141-144. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.141

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Abstract PDF: Membranous glomerulonephritis can manifest as a paraneoplastic syndrome. The presence of evidence that supports the relationship between malignancy and membranous glomerulonephritis remains unresolved, though. Membranous glomerulonephritis has been commonly reported as associated with solid or hematologic malignancy, such as lung cancer, prostate cancer, and gastro-intestinal cancer, but its concomitant existence with skin cancer is rare. This paper reports a case of membranous glomerulonephritis combined with basal cell carcinoma that was successfully treated with the excision of the basal skin cell carcinoma.

Endocrinology, Diabetes, and Metabolism
A Case of Adrenocortical Carcinoma Secreting Cortisol and Aldosterone.: Jiyoon Ha, Min Kyung Kim, Yoon Jin Cha, Seung Kyu Kim, Gi Young Yun, Kwangwon Rhee, Joon Seong Park, Eun Suk Cho, Chul Woo Ahn, Jong Suk Park; Yeungnam Univ J Med. 2012;29(2):132-135. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.132

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Abstract PDF

Adrenocortical carcinomas are rare and frequently aggressive tumors that may be functional (hormone-secreting) and may cause Cushing's syndrome or virilization, or non-functional and manifest as an abdominal mass. This paper reports the case of a 77-year-old woman with cortisol- and aldosterone-secreting adrenal carcinoma. The patient complained of general weakness, a moon face, and weight gain. She also had hypokalemia and hypertension. Her endocrinological data showed excessive aldosterone production and non-suppressible cortisol production in a low-dose dexamethasone suppresion test. Her abdominal CT showed a right adrenal mass. She underwent right adrenalectomy, and her histology revealed the presence of adrenocortical carcinoma. After adrenalectomy, her hypokalemia returned to normal and she is being treated with hydrocortisone.

Citations

Citations to this article as recorded by

Adrenocortical Carcinoma Presenting With Concurrent Cushing Syndrome and Primary Hyperaldosteronism
Naseem Eisa
AACE Endocrinology and Diabetes.2026;[Epub] CrossRef

Nephrology
A Case of Neurotoxicity Induced by Valaciclovir in a Continuous Ambulatory Peritoneal Dialysis Patient.: Joon Seok Kim, Jee Eun Yang, Bo Young Lee, Seohyun Lee, Hee Jung Park, Sunpyo Lee, Sang Koo Lee; Yeungnam Univ J Med. 2012;29(2):121-124. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.121

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Abstract PDF

Valaciclovir is metabolized to acyclovir after ingestion and thereafter exerts its antiviral activity. Because of its superior pharmacokinetic profile, it has quickly replaced acyclovir in the treatment of herpesvirus infection. Neurotoxicity caused by valaciclovir has been reported, however, among patients with pre-existing impaired renal function. This paper reports a case of neurotoxicity of valaciclovir in a patient with end-stage renal disease who was undergoing continuous ambulatory peritoneal dialysis (CAPD). A 67-year-old female on CAPD took 500 mg of valaciclovir twice for herpes zoster. After she took her second dose orally, she developed confusion and disorientation, along with involuntary movements. Her mental confusion progressed to a coma. Discontinuation of valaciclovir showed no rapid improvement. There- fore, hemodialysis was started. After two sessions of hemodialysis, the patient became alert; and after four sessions of hemodialysis, her neurological abnormalities were completely reversed. In conclusion, valaciclovir can induce life-threatening neurotoxicity, especially in CAPD patients, even with appropriate dose reduction, which can be effectively managed by hemodialysis.

Citations

Citations to this article as recorded by

Comparison of Renal Function Indicators According to Hydration Volume in Patients Receiving Intravenous Acyclovir With CNS Infection
Sanghee Kim, Youngsoon Byun
Biological Research For Nursing.2015; 17(1): 55. CrossRef
Valacyclovir-Induced Neurotoxicity in a Maintenance Hemodialysis Patient
June Seong Hwang, Hyo Yoep Song, Hoon Gil Jo, Song I Lee, Byung Hun Lim, Jung Sub Song, Seon Ho Ahn
Journal of the Korean Geriatrics Society.2014; 18(2): 85. CrossRef

Neurology
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.

Cardiology and Cardiovascular Medicine
Superior Vena Cava Syndrome Without Thrombosis Found in Behcet's Disease.: Hyun Soo Kim, Hyung Jun Kim, Ki Hwan Hur, Kyung Rok Kim, Jae Won Choi, Dong Woo Kang; Yeungnam Univ J Med. 2012;29(1):38-41. Published online June 30, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.1.38

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Abstract PDF

Behcet's disease is a rare multisystemic disorder whose main pathological defectis vasculitis, and superior vena cava (SVC) syndrome without thrombosis is a very rare manifestation of the disease. These authors encountered a case of SVC syndrome without thrombosis caused by Behcet's disease. A 33-year-old man visited the hospital for aggravated dyspnea without any related medical and familial history. He had a three-day history of abrupt swelling of the face, neck, and right arm. He suffered from recurrent oral ulcer, and there were acneiform nodules on his face as well as redness and swelling at the site of the intravenous injection. On the multi-detected computed tomography (CT) chest angiograms (chest angio MDCT), the SVC narrowed without thrombosis. Venogram was carried out, and percutaneous transluminal balloon angioplasty of the SVC stenotic site was performed. The following day, the swelling was found to have subsided. The details of the case are reported herein.

Citations

Citations to this article as recorded by

Recurrent onycholysis in a patient with Behcet's disease
Hyeon Seok Kim, Dong Seok Lee, Seung Hwan Lee, Woo Hyuk Kwon, Yun Jeong Kim
Yeungnam University Journal of Medicine.2016; 33(1): 56. CrossRef

Anesthesiology and Pain Medicine
Anesthetic Experience for Trans-Sphenoidal Surgery of Pituitary Adenoma on a Patient with Brugada Syndrome: A Case Report.: Min Jung Heo, Sae Yeon Kim; Yeungnam Univ J Med. 2009;26(2):148-155. Published online December 31, 2009; DOI: https://doi.org/10.12701/yujm.2009.26.2.148

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Abstract PDF: Brugada syndrome is characterized by an ECG pattern of right bundle branch block and ST segment elevation in the right precordial leads (V(1)-V(3)) without structural heart disease. It is also characterized by sudden cardiac death that's caused by ventricular fibrillation. This is a familial syndrome with an autosomal dominant inheritance pattern and it may be considerably more common in Southeast Asia. Many factors during anesthesia can precipitate malignant dysrrhythmia in these patients, so careful choice of anesthetics is required. We experienced a case of Brugada syndrome in a 59-year-old male patient who was under general anesthesia for trans-sphenoidal surgery to treat a pituitary adenoma, and the patient was diagnosed as having Brugada syndrome without any untoward cardiovascular events.

Anesthesiology and Pain Medicine
General Anesthesia for Extracorporeal Shockwave Lithotripsyin Child with Lesch-Nyhan Syndrome.: Sang Jin Park, Il chi Kwon, Won Ki Lee, Deok Hee Lee; Yeungnam Univ J Med. 2008;25(1):78-83. Published online June 30, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.1.78

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Abstract PDF: Lesch-Nyhan syndrome is an inborn error of purine metabolism resulting from hypoxanthine-guanine-phosphoribosyltransferase (HGPRT) deficiency and leading to excess purine production and uric acid over-production. It is a very rare X-linked recessive disorder, characterized by movement disorder, cognitive deficits, and self-injurious behavior. However, because of the high incidence of calculi, patients may present for surgery of urinary tract, and have increased risk of difficult intubation, aspiration pneumonia, renal insufficiency or sudden death. We report the case of a 5-year-old boy with Lesch-Nyhan syndrome who underwent successive extracorporeal shockwave lithotripsy under general anesthesia.

Pediatrics, Perinatology, and Child Health
A Case of Hemiconvulsion-Hemiplegia-Epilepsy Syndrome: Han Ku Moon; Yeungnam Univ J Med. 2007;24(2 Suppl):S689-695. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S689

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Abstract PDF: Hemiconvulsion-Hemiplegia-Epilepsy syndrome is characterized by a prolonged unilateral convulsion in the form of status producing a persisting hemiplegia during a febrile illness, followed by epilepsy. It occurs in a child, between 5 months and 4 years old, with a peak incidence during the first 2 years of life. Although the etiologies of this syndrome are diverse, preexisting asymptomatic lesion of perinatal or prenatal origin is found in a number of cases. I experienced a case of HHE syndrome in a 11 month old girl with abnormal perinatal history and developmental delay, who showed predominant right sided focal motor seizures followed by right hemiparesis.

Laboratory Medicine
A Case of Swyer Syndrome: Soon Il Jung, Hee Soon Cho, Chae Hoon Lee, Kyung Dong Kim; Yeungnam Univ J Med. 2007;24(2 Suppl):S665-670. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S665

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Abstract PDF: 46,XY pure gonadal dysgenesis is a sex-reversal disorder, that is characterized by the presence of a female phenotype, with a normal to tall stature, primary amenorrhea and sexual infantilism. The internal genitalia are female with a uterus and vagina being present, however, there are bilateral dysgenetic gonads. In addition, neoplasia occurs in 20∼30% of patients who have gonadal dysgenesis and a Y chromosome. A 34 year old woman presented to our hospital with the chief complaint of primary amenorrhea. Physical examination revealed no secondary sexual characteristics and no somatic abnormality. Peripheral blood karyotype was 46,XY, and polymerase chain reaction (PCR) for the Sex determining Region Y (SRY) gene was positive. Sequencing analysis of the SRY gene revealed a single nucleotide polymorphism. A laparoscopic gonadectomy was performed to remove both gonads, and no tumor cells were observed. Estrogen replacement therapy was instituted.

Cardiology and Cardiovascular Medicine
Enoxaparin Induced Fatal Retroperitoneal Hematoma in Elderly Patient with Acute Coronary Syndrome －Case Report－: Sang-Hee Lee, Jong-Seon Park, Woong Kim, Geu-Ru Hong, Dong-Gu Shin, Young-Jo Kim, Bong-Sub Shim; Yeungnam Univ J Med. 2007;24(2 Suppl):S642-646. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S642

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Abstract PDF

Anticoagulation and antiplatelet therapy became a cornerstone of the primary treatment strategy in the case of acute coronary syndrome patients which planned to receive medical treatment or percutaneous coronary intervention. The anticoagulation regimen is unfractionated heparins and low molecular weight heparins enoxaparin. Despite of some debates, enoxaparin has replaced unfractionated heparins recently due to its demonstrated advantages. When we encountered acute coronary syndrome patients without contraindication for enoxaparin, it tends to be administered with no hesitation. However, a few patients treated with enoxaparin could be suffered from bleeding complication. Also, in case of bleeding into the retroperitoneal space, the result can be fatal. We report a patient who developed a fatal retroperitoneal hematoma during enoxaparin treatment for acute coronary syndrome.

Citations

Citations to this article as recorded by

Enoxaparin-induced spontaneous massive retroperitoneal hematoma with fatal outcome
Nikolaos S. Salemis, Ioannis Oikonomakis, Emanuel Lagoudianakis, Georgios Boubousis, Christos Tsakalakis, Sotirios Sourlas, Stavros Gourgiotis
The American Journal of Emergency Medicine.2014; 32(12): 1559.e1. CrossRef

Original Articles

Neurology
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.

Social and Family Medicine
Chronic Fatigue Syndrome.: Seung Pil Jung, Keun Mi Lee; Yeungnam Univ J Med. 2007;24(1):1-10. Published online June 30, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.1.1

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The chronic fatigue immune dysfunction syndrome (abbreviated CFIDS or CFS) is a disorder characterized by debilitating fatigue(over 6 months), along with cognitive, musculoskeletal, and sleep abnormalities. The etiology of this illness is unlikely to be a single agent. Findings to date suggest that physiological and psychological factors work together to predispose and perpetuate the illness. Diagnosis is made difficult by the nonspecific clinical findings and no available diagnostic testing. With no known cause or cure for the chronic fatigue and immune dysfunction syndrome, treatment is based on relieving symptoms and improving the quality of life of affected patients. There is emerging evidence that chronic fatigue syndrome may be familial. In the future, studies will examine the extent to which genetic and environmental factors play a role in the development of chronic fatigue syndrome. Most patients with CFS have psychiatric problems such as a generalized anxiety disorder, or major or minor depression, therefore, these mental health disorders may be correlated with the pathophysiology of the CFS. The treatment for CFS must be individualized, due to the heterogeneity of the CFS population. Also the treatment of CFS is built on a foundation of patient-physician relationship, respect and advocacy.

Citations

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Consumptive Disease and Chronic Fatigue Improved by Nokyonggunbi-tang and Other Korean Medical Treatments: A Case Report
Mu-jin Park, So-ri Jin, Eun-jae Oh, Woo-sub Song, Hyun-seok Lee, Kyu-hyun Hwang, Seung-ju Oh, Ah-ra Ju, Su-in Baek
The Journal of Internal Korean Medicine.2021; 42(5): 738. CrossRef

Case Report

Pulmonary and Respiratory Medicine
A Case of Gefitinib (Iressa(R))-associated Tumor Lysis Syndrome in Adenocarcinoma of the Lung.: Kyu Jin Kim, Won Jong Park, Sung Ken Yu, Kyeong Cheol Shin, Jin Hong Chung, Myung Soo Hyun, Kwan Ho Lee; Yeungnam Univ J Med. 2006;23(2):221-226. Published online December 31, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.2.221

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Abstract PDF: The tumor lysis syndrome has been described as biochemical disturbances associated with rapid destruction of tumor cells and subsequent synchronized massive release of cellular breakdown products sufficient to overwhelm excretory mechanisms and the body's normal reutilization capacity. The cardinal signs of the tumor lysis syndrome are hyperkalemia, hyperphosphatemia, hypocalcemia and hyperuricemia. Gefitinib (Iressa) is an oral, selective epidermal growth factor receptor (EGFR) inhibitor that has activity in female, non-smoker and non-small cell lung cancer with an EGFR mutation. Gefitinib is a well tolerated drug with few side effects. It has been associated with skin rash, diarrhea, nausea, a decrease in liver function and interstitial lung disease. However, there is no prior report of the tumor lysis syndrome associated with gefitinib. We report a case of a 54 year-old woman who developed tumor lysis syndrome that might have been induced by gefitinib after the treatment of adenocarcinoma of lung with an EGFR mutation.

Original Articles

Neurology
Clinical and Electrophysiological Study on Guillain-Barre Syndrome.: Sung Hwan Yun, Jung Sang Hah, Sung Gyun Joo, Yong Kook Cho, Jung Hyun Kim, Ji Yeun Chung; Yeungnam Univ J Med. 2005;22(1):52-61. Published online June 30, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.1.52

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BACKGROUND
Guillain-Barre syndrome is defined as a recognizable clinical entity that is characterized by rapidly evolving symmetric limb weakness, the loss of tendon reflexes, absent or mild sensory signs, and variable autonomic dysfunctions. This study evaluated the clinical and electrophysiological findings retrospectively. MATERIALS AND METHODS: Forty-five patients with Guillain-Barre syndrome, who were admitted to the Yeungnam University Hospital for six years from Jan. 1994 to Dec. 1999 were investigated. The correlation between the clinical manifestation and the electrophysiological study was evaluated. RESULTS: The male to female ratio was 1.8: 1 and there was a peak seasonal incidence in the winter. A preceding illness was noted in 66.7% of cases, and an upper respiratory tract infection was the most common one. The most common clinical manifestations were a loss of tendon reflex and ascending muscle weakness and paralysis. The cerebrospinal fluid examinations revealed, albuminocytologic dissociation in 33 cases (73.3%). Intravenous immunoglobulin therapy was performed in 29 cases (64.4%). The sequential electrophysiological abnormalities were most marked at 2 to 4 weeks after onset. At that time the most significant change was a decrease in the compound muscle action potential amplitude. These 45 patients with Guillain-Barre syndrome were subclassified using the clinical and electrophysiological data. CONCLUSION: The result in this study, concured with other research on the clinical and electrophysiological data of Guillain-Barre syndrome. However, an extensive and dynamic investigation is necessary to determine the reason for the peak seasonal incidence in winter.

Citations

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A Case of Combined Korean Medicine Treatment for Recurrent Limb Weakness after Guillain-Barré Syndrome Improvement: Case Report
Song-Mi Park, Sung-Woo Cho
Journal of Korean Medicine Rehabilitation.2019; 29(4): 135. CrossRef

Radiology, Radiotherapy & Diagnostic Imaging
Acute Pulmonary Embolism by Silicone Injection: Radiologic Findings.: Jae Kyo Lee; Yeungnam Univ J Med. 2004;21(2):215-223. Published online December 31, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.2.215

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Abstract PDF: Silicone is widely used for medical purposes in breast augmentation and other cosmetic procedures. Illegal injections of silicone in human beings might have adverse effects and one of the serious problems is a silicone embolism. We experienced five cases of unusual respiratory difficulties after an injection of liquid silicone in the breast, vagina, uterus, and hip. They were all young adult females, who were previously healthy. One of them died after the injection. The three remaining patients were admitted because of dyspnea, coughing, chest discomfort and bilateral pulmonary infiltration after the silicone injection. A transbronchial lung biopsy and autopsy disclosed many oil like materials filling the alveolar septal capillaries. Three patients underwent a computed tomogram (CT), which revealed multifocal airspace consolidations at the peripheral and non-dependent portions of both lungs, which is a different finding from other thromboembolisms. Lung scans of the disclosed abnormalities were compatible with silicone induced pulmonary embolism.

Case Report

Pediatrics, Perinatology, and Child Health
A case of Dubin-Johnson Syndrome.: Ae Jung Kwak, Mi jung Kim, Min Jung Cho, Kwang Hae Choi; Yeungnam Univ J Med. 2002;19(1):68-72. Published online June 30, 2002; DOI: https://doi.org/10.12701/yujm.2002.19.1.68

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Abstract PDF: Dubin-Johnson Syndrome is a form of benign, familial idiopathic jaundice presenting with chronic intermittentconjugated hyperbilirubinnmia and a melamin-like pigment has been found in the parenchymal liver cells. This disorder is rarely diagnosed in the neonatal period. We report a case of Dubin-Johnson syndrome presenting with neonatal cholestasis.

Original Article

Pediatrics, Perinatology, and Child Health
Treatment of Henoch-Sch?nlein Purpura with Intravenous Immunoglobulin.: Hyo Seok Chung, Won Duck Kim, Eun Sil Lee, Kwang Hae Choi, Yong Hoon Park, Yong Jin Kim; Yeungnam Univ J Med. 2001;18(2):246-252. Published online December 31, 2001; DOI: https://doi.org/10.12701/yujm.2001.18.2.246

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Abstract PDF: We report the result of a high-dose intravenous immunoglobulin therapy in a Henoch-Sch?nlein purpura patient with severe abdominal pain and nephrotic syndrom who did not respond to methylprednisolone pulse therapy. Kidney bbiopsy showed diffuse mesangial cell proliferative glomerulonephritis with fibrocellular crescent formation in approximately 50% of glomeruli. Mesangium of all glomeruli were strong positive for IgA and C3 antibodies. High-dose intravenous immunoglobulin treatment was introduced and dramatic improvement of gastrointestinal symptom and proteinuria as well as hematuria was noted. Immunoglobulin administration should be considered in Henoch-Schnlein purpura patients with sterois-resistant intractable dastrointestinal manifestation and renal involvenment.

Review Article

Pathology and Forensic Medicine
Tests for Acute Coronary Syndrome.: Kyung Dong Kim; Yeungnam Univ J Med. 2001;18(1):13-29. Published online June 30, 2001; DOI: https://doi.org/10.12701/yujm.2001.18.1.13

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Abstract PDF

The enzyme activities of creatine kinase(CK), its isoenzyme MB(CK-MB) and of lactate dehydrogenase isoenzyme 1(LD-1) have been used for years in diagnosing patients with chest pain in order to differentiate patients with acute myocardial infarction(AMI) from non-AMI patients. These methods are easy to perform as automated analyses, but they are not specific for cardiac muscle damage. During the early 90's the situation changed. First, creatine kinase MB mass(CK-MB mass) replaced the measurement of CK-MB activity. Subsequently cardiac-specific proteins, troponin T(cTnT) and troponin I(cTnI) appeared and displacing LS-1 analysis. However troponin concentration in blood increase only from four to six hours after onset of chest pain. Therefore a rapid marker such as myoglobin, fatty acid binding protein or glycogen phosphorylase BB could be used in early diagnosis of AMI. On the other hand, CK-MB isoforms alone may also be useful in rapid diagnosis of cardiac muscle damage. Myoglobin, CK-MB mass, cTnT and cTnI are nowadays wisely used in diagnosing patients with acute chest pain. Myoglobin is not cardiac-specific and therefore requires supplementation with some other analysis such as troponins to support the myoglobin value. Troponins are very highly cardiac-specific. Only the sera of some patients with severe renal failure, which requires hemodialysis, have elevated cTnT and/or cTnI without there being any evidence of cardiac damage. The latest studies have shown that elevated troponin levels in sera of hemodialysis patients point to an increased risk of future cardiac events in a similar manner to the elevated troponin values in sera of patiets with unstable angina pectoris. In addition, the bedside tests for cTnT and cTnI alone or together with myoglobin and CK-MB mass can be used instead of quantitative analyses in the diagnosis of patients with chest pain. These rapid tests are easy to perform and they do not require expensive instrumentation. For the diagnosis patients with chest pain, routinely myoglobin and CK-MB mass measurements should be performed whenever they are requested (24 h/day) and cTnT and cTnI on admission to the hospital and then 4-6 and 12 hours later and maintained less than 10% imprecision.

Citations

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The Usefulness of Rapid Triple Test for Cardiac Marker in Forensic Paragnosis of Sudden Cardiac Death
Chae-Won Lim, Jin-Gak Kim
The Korean Journal of Clinical Laboratory Science.2017; 49(2): 108. CrossRef

Original Article

Pediatrics, Perinatology, and Child Health
The Preventive Effect of Antenatal Administration of Ambroxol on the Neonatal Respiratory Distress Syndrome.: Eun Sil Lee, Kyung Ah Kim, Son Moon Shin, Min Whan Koh, Tae Hyung Lee; Yeungnam Univ J Med. 1999;16(1):52-59. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.52

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Abstract PDF: This study was conducted to evaluate the effect of antenatal ambroxol administration to the mothers who were imminent preterm delivery on preventing the neonatal respiratory distress syndrome. Forty-two preterm newborn infants who were delivered at Yeungnam University Hospital from January 1996 to December 1997 were divided into two groups, twenty-one ambroxol-treated group and twenty-one control group. Six cases of respiratory distress syndromes developed from 21 ambroxol-treated infants. but thirteen cases of RDS developed from 21 control infants. It indicated significant reduction of occurrence of RDS by antenatal administration of ambroxol (p<0.05). There were no differences in the occurrence of adverse effects of ambroxol in mothers between two groups, ambroxol-treated and control groups. There was also no difference between pre- and post-treatment hematologic and biochemical parameters in ambroxol-treated group. In conclusion, when premature delivery is expected, administration of ambroxol before delivery enhances lung maturation in premature newborn infants and prevents the occurrence of respiratory distress syndromes without significant adverse effects.

Case Report

Rheumatology
A case of primary antiphospholipid antibody syndrome showing vegetation on the mitral valve through echocardiography.: Seung Yeop Lee, Seung Kwon Park, Sung Hwan Yun, Yun Seok Jung, Hyen Jik Kim, Sung Hwan Lim, Jung Sang Hah, Wook Nyeun Kim; Yeungnam Univ J Med. 1998;15(2):350-358. Published online December 31, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.2.350

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Abstract PDF: Antiphospholipid antibody syndrome(APS) is a well-known clinical syndrome characterized by recurrent arterial or venous thromboses, recurrent fetal loss, thrombocytopenia, together with high titers of sustained anticardiolipin antibody(aCL) or lupus anticoagulant(LA). Although systemic lupus erythematosus(SLE) and APS may coexist, a high proportion of patients manifesting the APS do not suffer from classical lupus or other connective tissue disease. The patient has been defined as having a primary antiphospholipid antibody syndrome. We experienced one case of primary APS with recurrent fetal loss, recurrent cerebral infarctions, positive anticardiolipin antibody IgG and fluttering vegetation on the mitral valve, without other connective tissue diseases including SLE. Forty-three old female had 2 out of 11 criteria for the diagnosis of SLE, such as thrombocytopenia and positive antinuclear antibody, but did not meet whole criteria. The patient was treated with ticlopidine, and anticoagulant therapy was recommended.

Original Articles

Public Health, Environmental, and Occupational Health
Sick building syndrome in 130 underground workers.: Ree Joo, Joon Sakong, Jong Hak Chung, Sang Whan Park, Dong Hee Kim, Dong Min Kim, Eun Kyong Choi, Hyun Geon Cho; Yeungnam Univ J Med. 1998;15(2):325-339. Published online December 31, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.2.325

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Abstract PDF

A cross-sectional study was conducted to evaluate the relationship between sick building syndrome(SBS) and the environmental factors affecting SBS on 130 underground workers and 60 controls. The study consisted of 1) a review of environmental condition 2) measurement of temperature, O2, CO2, CO, and formaldehyde and 3) a questionnaire survey of symptom prevalence and perception of environmental conditions using Indoor Air Quality questionnaire by National Institute for Occupational Safety and Health Bronchitis and dust allergy were more prevalent in underground workers significantly(p<0.05). Among the 18 symptoms related to the indoor air pollution, the experience rate of dry, itching or irritated eyes, sore or dry throat, chest tightness, tired or strained eyes and dry or itchy skin symptom is significantly different between the underground workers and controls. The diagnostic criteria of SBS was defined as at least one symptom is experienced 1-3 times a week during the last 1 month among 18 indoor air pollution related symptoms which can be relieved by moving out of the underground. Applying the criteria, the mean symptom score was significant higher in underground workers than controls significantly(p<0.05). These results indicated that underground workers are under inappropriate ergonomic and physical condition and inadequate ventilation. Their experience rate of symptoms related to indoor air pollution and prevalence of SBS was significantly higher than controls. To reduce the prevalence of SBS in underground workers, the surveillance system of indoor air quality, restriction of using fuel in underground and legislative regulations for the environment are needed to establish a better indoor air quality. Early detection, treatment and prevention of SBS through medical attention is also needed.

Citations

Citations to this article as recorded by

Investigation on the impacts of natural lighting on occupants' wayfinding behavior during emergency evacuation in underground space
Dachuan Wang, Shuang Liang, Binbin Chen, Cailing Wu
Energy and Buildings.2022; 255: 111613. CrossRef
Review of the potential health effects of light and environmental exposures in underground workplaces
Ei Ei Khaing Nang, Gulifeiya Abuduxike, Pawel Posadzki, Ushashree Divakar, Nanthini Visvalingam, Nuraini Nazeha, Gerard Dunleavy, George I. Christopoulos, Chee-Kiong Soh, Krister Jarbrink, Michael Soljak, Josip Car
Tunnelling and Underground Space Technology.2019; 84: 201. CrossRef

Nephrology
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.

Case Reports

Obstetrics, Gynecology, and Reproductive Medicine
A case of meigs' syndrome occured in pregnancy.: Dae Hyun Cho, Sang Heon Kim, Min Whan Koh, Tae Hyung Lee, Sung Ho Lee; Yeungnam Univ J Med. 1992;9(1):197-202. Published online June 30, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.1.197

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Abstract PDF: Meigs' syndrome consists of an ovarian fibroma, or fibroma-like benign tumor, associated with fluid in both abdomen and chest. Characteristically, the ascites and hydrothorax disappeared and do not recurred following removal of the ovarian tumor. The authors presented a case of Meigs' syndrome that was cured by surgical removal of ovarian tumor and resulted in normal pregnancy outcome in 27-year-old pregnant woman with a brief review of literatures.

Endocrinology, Diabetes, and Metabolism
A case of SIADH in small cell lung cancer.: Kyu Chang Won, Jong Sik Lim, Chan Woo Lee, Hyoung Woo Lee, Choong Ki Lee, Jin Hong Chung, Myoung Soo Hyun, Bong Sup Shim, Hyun Woo Lee; Yeungnam Univ J Med. 1991;8(2):227-234. Published online December 31, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.2.227

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Abstract PDF: The syndrome of inappropriate ADH secretion is a disorder characterized by hyponatremia which results from water retention attributable to ADH release. The hallmark of SIADH is hyponatremia due to water retention, in the presence of urinary osmolality above plasma osmolality. The SIADH was initially described by Schwartz et al (1957). This syndrome, first recognized in patients with bronchogenic carcinoma, has now been observed in a variety of other illnesses. Recently, we encountered a 59 year-old female with small cell lung cancer, also she had SIADH. Thus, we present a case and review the literature on the subject.

Neurosurgery
Lumbar synovial cyst associated with retrolis thesis: a case report.: Sang Joon Choi, Sam Kyu Ko, Oh Lyong Kim, Yong Chul Chi, Byung Yearn Choi, Soo Ho Cho; Yeungnam Univ J Med. 1991;8(2):222-226. Published online December 31, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.2.222

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Abstract PDF: In advent of high-resolutional CT and MRI, it is not so difficult to detect the lumbar synovial cyst, however the unusual disease should be included in the differential diagnosis of cauda equine compression syndromes. The case of a 55-year-old man who had a low back pain and severe radiating pain on both legs showed a retrolisthesis at L3-4 and L4-5 and epidural enhancing mass just around L4-5 facet joint on MRI. Microscopically a lining of synovial tissue was demonstrated. After surgery of the total resection of synovial cyst and stabilization, the patient's presenting symptoms were improved.

Original Article

Neurology
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.

Case Reports

Otorhinolaryngology
A case of otopalatodigital syndrome.: Kyeong Jong Choi, Sung Hyung Lee, Sun Jin Eun, Kei Won Song; Yeungnam Univ J Med. 1991;8(1):246-251. Published online June 30, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.1.246

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Abstract PDF: In 1962, a case of “generalized skeletal dysplasia with multiple anomalies” was reported by Taybi as a new clinical syndrome. The most characteristic features of the syndrome seemed to be hearing loss, cleft palate and peculiar digital anomalies, so, the syndrome designated as otopalatodigital syndrome by Dudding, et al. Recently, the authors have experienced a case of OPD syndrome who visited Yeungnam University Hospital with the chief complaint of hypernasality, and underwent pharyngoplasty for correction of VPI. We present here a new case and review the literature on the subject.

Surgery
A Case of Type II Mirizzi Syndrome.: Hong Jin Kim, Joo Hyeong Lee, Myeong Jun Shin, Koing Bo Kwun, Jae Chun Chang, Moon Kwan Chung; Yeungnam Univ J Med. 1990;7(2):197-202. Published online December 31, 1990; DOI: https://doi.org/10.12701/yujm.1990.7.2.197

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Abstract PDF: Mechanical obstruction of the common hepatic duct includes the following causes; choledocholithiasis, sclerosis, cholangitis, pancreatic carcinoma, cholangiocarcinoma, postoperative stricture, primary hepatic duct carcinoma, enlarged cystic duct lymph nodes, and metastatic nodal involvement of the porta hepatis. Partial mechanical obstruction of the common hepatic duct caused by impaction of stones and inflammation surrounding the vicinity of the neck of the gallbladder had been reported on the “syndrome del conducto hepatico” in 1948 by Mirizzi. Nowadays, this disease was named by Mirizzi syndrome. Mrizzi syndrome is a rare entity of common hepatic duct obstruction that results from an inflammatory response secondary to a gallstone impacted in the cystic duct or neck of the gallbladder. It results from an almost parallel course and low insertion of the cystic duct into the common hepatic duct. In a variant of Mirizzi's syndrome, the cause of the common hepatic duct obstruction was a primary cystic duct carcinoma rather than gallstone disease. A 71-year-old man was admitted with a four-day history of right upper quadrant abdominal pain. Past medical history was unremarkable. On physical examination, the patient had a temperature of 38℃, icteric sclera and right upper quadrant tenderness. Pertinent laboratory findings included WBC 18,000/cm3; albumin 2.6 g/dl (normal 0-1) with the direct bilirubin, 4.4 mg/dl (normal 0-0.4). Ultrasonography revealed a dilated extrahepatic biliary tree. ERCP showed that the superior margin was angular and more consistent with a calculus causing partial CHD obstruction (Mirizzi syndrome). At surgery a diseased gallbladder containing calculi was found. In addition, there was two calculi partially eroding through the proximal portion of the cystic duct and compressing the common hepatic duct. A cholecystectomy and excision of common bile duct was performed, with Roux-en-Y hepaticojejunostomy. The postoperative course was uneventful.

Original Article

Pulmonary and Respiratory Medicine
The Clinical Review of Superior Vena Cava Syndrome.: Joung Sun Kang, Sam Beom Lee, Choong Ki Lee, Jin Hong Chung, Hyoung Woo Lee, Kwan Ho Lee, Myung Soo Hyun, Hyun Woo Lee, Sei One Shin, Myung Se Kim; Yeungnam Univ J Med. 1990;7(2):151-158. Published online December 31, 1990; DOI: https://doi.org/10.12701/yujm.1990.7.2.151

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Abstract PDF: We reviewed 30 cases of superior vena cava syndrome in adult patients who were seen at the Yeungnam University Hospital from January 1985 to June 1990. The results were as follows: 1. The male-to-female ratio was 6.5:1, and the most patients were in the age group between the sixth and seventh decades. 2. The most common symptoms were dyspnea (87%) and followed by cough (63%), facial swelling (63%) and chest pain (44%) and the physical signs were dilated neck vein (97%), facial edema (93%) and facial flushing (45%) in order of frequency. 3. The simple chest x-ray findings were superior mediastinal widening (90%), right hilar mass (77%) and pleural effusion (31%). 4. Diagnosis was made by history and physical examination (100%), chest C-T scan (100%), simple chest x-ray (97%), bronchoscopy with biopsy (40%) and so on. 5. 21 cases of patients were confirmed by histology: 14 cases (46%) of bronchogenic ca, 4 cases (14%) of lymphoma, 3 cases (10%) of metastatic lung ca. Of bronchogenic ca, small cell ca was 7 cases (23%), squamous cell ca, 5 cases (17%), and unclassified cawas 2 cases (6%). 6. In response of treatment, the clinical improvement was achieved in 18 cases with radiotherapy alone, 1 case with chemotherapy only, and 6 cases with radio-chemotherapy.

Case Reports

Surgery
Spontaneous renal artery dissection in Ehlers-Danlos syndrome.: Byung Hun Lim, Song I Lee, Jae Hong Lim, Su Jin Oh, Min Su Chu, Seon Ho Ahn, Seung Jae Byun; Yeungnam Univ J Med. 2016;33(1):44-47.; DOI: https://doi.org/10.12701/yujm.2016.33.1.44

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Abstract PDF: Primary dissection of the renal artery is rare. Spontaneous renal artery dissection can be associated with diseases such as medial degeneration, neurofibromatosis, syphilitic arteritis, tuberculosis, polyarteritis nodosa, Marfan syndrome, fibromuscular dysplasia, or Ehlers-Danlos syndrome (EDS). Among these causes, EDS related renal artery dissection is very rare worldwide and has not been previously reported in Korea. EDS are a group of heritable connective tissue disorders characterized by fragility of the skin and hypermobility of the joints. We describe the case history of a young man who presented with left side flank pain, hypermobility of the hand joints and showed left renal artery dissection on computed tomography and angiography that turned out to be the first complication of vascular type EDS.

Pulmonary and Respiratory Medicine
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.; 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.

Oncology and Cancer Research
POEMS syndrome misdiagnosed as bone metastasis in a patient with thyroid cancer.: Sang Ah Baek, Hun Mo Ryoo, Sung Hwa Bae, Yoon Young Cho, Seong gyu Kim, Ga Young Kim, Min Keun Kim; Yeungnam Univ J Med. 2015;32(2):122-126.; DOI: https://doi.org/10.12701/yujm.2015.32.2.122

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Abstract PDF: Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome is a monoclonal plasma cell disorder. Patients with POEMS syndrome also have various clinical manifestations including generalized edema, pleural effusion, ascites, papilledema, and sclerotic bone lesions. These manifestations can lead to a misdiagnosis or delayed diagnosis. We recently experienced a 51-year-old male patient with POEMS syndrome whose sclerotic bone lesion was misdiagnosed as malignant bone metastasis of papillary thyroid carcinoma. We reassessed the patient and found polyneuropathy, hepatosplenomegaly, hypothyroidism, partial hypopituitarism, immunoglobulin G lambda-type monoclonal gammopathy, hypertrichosis, ascites, and multiple sclerotic bone lesions, all of which led us to a diagnosis of POEMS syndrome. Treatment with thalidomide and dexamethasone resulted in clinical and radiological improvement. The patient has remained in remission after peripheral blood stem cell transplantation.

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