Journal of Yeungnam Medical Science

Original article

Optimal examination for traumatic nerve/muscle injuries in earthquake survivors: a retrospective observational study: Berkay Yalçınkaya, Büşranur Tüten Sağ, Mahmud Fazıl Aksakal, Pelin Analay, Hasan Ocak, Murat Kara, Bayram Kaymak, Levent Özçakar; J Yeungnam Med Sci. 2024;41(2):120-127. Published online April 5, 2024; DOI: https://doi.org/10.12701/jyms.2024.00087

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Abstract PDF Supplementary Material: Background
Physiatrists are facing with survivors from disasters in both the acute and chronic phases of muscle and nerve injuries. Similar to many other clinical conditions, neuromusculoskeletal ultrasound can play a key role in the management of such cases (with various muscle/nerve injuries) as well. Accordingly, in this article, a recent single-center experience after the Turkey-Syria earthquake will be rendered.
Methods
Ultrasound examinations were performed for various nerve/muscle lesions in 52 earthquake victims referred from different cities. Demographic features, type of injuries, and applied treatment procedures as well as detailed ultrasonographic findings are illustrated.
Results
Of the 52 patients, 19 had incomplete peripheral nerve lesions of the brachial plexus (n=4), lumbosacral plexus (n=1), and upper and lower limbs (n=14).
Conclusion
The ultrasonographic approach during disaster relief is paramount as regards subacute and chronic phases of rehabilitation. Considering technological advances (e.g., portable machines), the use of on-site ultrasound examination in the (very) early phases of disaster response also needs to be on the agenda of medical personnel.

Focused Review article

The pathophysiology of diabetic foot: a narrative review: Jiyoun Kim; J Yeungnam Med Sci. 2023;40(4):328-334. Published online October 5, 2023; DOI: https://doi.org/10.12701/jyms.2023.00731

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An aging population and changes in dietary habits have increased the incidence of diabetes, resulting in complications such as diabetic foot ulcers (DFUs). DFUs can lead to serious disabilities, substantial reductions in patient quality of life, and high financial costs for society. By understanding the etiology and pathophysiology of DFUs, their occurrence can be prevented and managed more effectively. The pathophysiology of DFUs involves metabolic dysfunction, diabetic immunopathy, diabetic neuropathy, and angiopathy. The processes by which hyperglycemia causes peripheral nerve damage are related to adenosine triphosphate deficiency, the polyol pathway, oxidative stress, protein kinase C activity, and proinflammatory processes. In the context of hyperglycemia, the suppression of endothelial nitric oxide production leads to microcirculation atherosclerosis, heightened inflammation, and abnormal intimal growth. Diabetic neuropathy involves sensory, motor, and autonomic neuropathies. The interaction between these neuropathies forms a callus that leads to subcutaneous hemorrhage and skin ulcers. Hyperglycemia causes peripheral vascular changes that result in endothelial cell dysfunction and decreased vasodilator secretion, leading to ischemia. The interplay among these four preceding pathophysiological factors fosters the development and progression of infections in individuals with diabetes. Charcot neuroarthropathy is a chronic and progressive degenerative arthropathy characterized by heightened blood flow, increased calcium dissolution, and repeated minor trauma to insensate joints. Directly and comprehensively addressing the pathogenesis of DFUs could pave the way for the development of innovative treatment approaches with the potential to avoid the most serious complications, including major amputations.

Citations

Citations to this article as recorded by

Diabetic foot – prevention and control challenges
Vitorino Modesto dos Santos, Taciana Arruda Modesto Sugai, Lister Arruda Modesto dos Santos
Belize Journal of Medicine.2024;[Epub] CrossRef
Integrated genetic analysis of diabetic complications: Bioinformatics insights into foot ulcers, neuropathy and peripheral artery disease
Jiaru Liang, Xiaoyang Gong, Xuyang Hu, Chong You, Jiaqi Zhou, Yuling Gao, Junwei Zong, Yong Liu
International Wound Journal.2024;[Epub] CrossRef
Unveiling the challenges of diabetic foot infections: diagnosis, pathogenesis, treatment, and rehabilitation
Chul Hyun Park
Journal of Yeungnam Medical Science.2023; 40(4): 319. CrossRef

Case reports

Sciatic nerve neurolymphomatosis as the initial presentation of primary diffuse large B-cell lymphoma: a rare cause of leg weakness: Kyoung Tae Kim, Se Il Kim, Young Rok Do, Hye Ra Jung, Jang Hyuk Cho; Yeungnam Univ J Med. 2021;38(3):258-263. Published online April 15, 2021; DOI: https://doi.org/10.12701/yujm.2021.00983

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Abstract PDF

Neurolymphomatosis (NL) is defined as the involvement of the peripheral nervous system in lymphocytic invasion. It is a very rare form of lymphoma that may occur as an initial presentation or recurrence. It affects various peripheral nervous structures and can therefore mimic disc-related nerve root pathology or compressive mononeuropathy. NL often occurs in malignant B-cell non-Hodgkin lymphomas. Notwithstanding its aggressiveness or intractability, NL should be discriminated from other neurologic complications of lymphoma. Herein, we present a case of primary NL as the initial presentation of diffuse large B-cell lymphoma (DLBCL) of the sciatic nerve. The patient presented with weakness and pain in his left leg but had no obvious lesion explaining the neurologic deficit on initial lumbosacral and knee magnetic resonance imaging (MRI). NL of the left sciatic nerve at the greater sciatic foramen was diagnosed based on subsequent hip MRI, electrodiagnostic test, positron emission tomography/computed tomography, and nerve biopsy findings. Leg weakness slightly improved after chemotherapy and radiotherapy. We report a case wherein NL, a rare cause of leg weakness, manifested as the initial presentation of primary DLBCL involving the sciatic nerve at the greater sciatic foramen.

Citations

Citations to this article as recorded by

Primary peripheral nerve lymphoma: a case report and literature review
Di Wu, Hui Liu, Lingyu Hao, Xu Han, Sihan Wang, Yijia Xiang, Shizhu Yu, Yi Wang
Neurological Sciences.2024; 45(4): 1447. CrossRef
A case report of surgical management of a solitary Non-Hodgkin's Lymphoma (NHL) arising from the proximal sciatic nerve
Sivakumaran Gobinath, Ganeshamoorthy Sritharan, Subramaniam Bakeerathan, Paramanathan Shathana, Umesh Jayarajah
International Journal of Surgery Case Reports.2023; 111: 108817. CrossRef

Clinical characteristics of hereditary neuropathy with liability to pressure palsy presenting with monoparesis in the emergency department: Changho Kim, Jin-Sung Park; Yeungnam Univ J Med. 2020;37(4):341-344. Published online July 31, 2020; DOI: https://doi.org/10.12701/yujm.2020.00472

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Abstract PDF: Hereditary neuropathy with liability to pressure palsy (HNPP) is a rare neurological genetic disease caused by deletion of the peripheral myelin protein 22 gene and presents in childhood or young adulthood. We report four cases of HNPP with typical and rare presentations, reflecting the broad clinical spectrum of this disease. Two patients presented with mononeuropathies that are frequently observed in HNPP; the remaining two presented with bilateral neuropathy or mononeuropathy anatomically present in the deep layer. This reflects the broad clinical presentation of HNPP, and clinicians should differentiate these conditions in young patients with monoparesis or bilateral paresis. Although HNPP is currently untreatable, early diagnosis in the emergency department can lead to early detection, eventually resulting in less provocation and recurrence which may cause early motor nerve degeneration.

Rapid progression from trochlear nerve palsy to orbital apex syndrome as an initial presentation of advanced gastric cancer: Eunjung Kong, Sung Ae Koh, Won Jae Kim; Yeungnam Univ J Med. 2019;36(2):159-162. Published online February 15, 2019; DOI: https://doi.org/10.12701/yujm.2019.00129

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Abstract PDF

The most cases with orbital metastases have been reported in patients with a prior established diagnosis of cancer and widespread systemic involvement. However, ocular symptoms can be developed as an initial presentation of cancer in patients without cancer history. We report a case of rapid progression from trochlear nerve palsy to orbital apex syndrome as an initial presentation of advanced gastric cancer.

Citations

Citations to this article as recorded by

Neoplastic nerve lesions
Deep K. Patel, Kelly G. Gwathmey
Neurological Sciences.2022; 43(5): 3019. CrossRef

Review

Diverse clinical manifestations caused by varicella-zoster virus reactivation.: Hosun Park; Yeungnam Univ J Med. 2016;33(1):1-7. Published online June 30, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.1.1

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Abstract PDF: The two distinctive clinical features of varicella-zoster virus (VZV) are varicella (chickenpox) by primary infection and zoster (singles) by the reactivation of latent infection. In addition to the two typical clinical symptoms mentioned above, diverse clinical manifestations have been reported as a result of VZV reactivation, including chronic radicular pain without rash, visual loss, facial palsy, dysphagia, sore throat, odynophagia, otalgia, hearing loss, dizziness, headache, hemiplegia, etc. Most of these symptoms are derived from neuropathy and vasculopathy of affected nerves and arteries. Diagnosis of VZV disease can be difficult if there is no appearance of a skin rash during development of atypical symptoms. In addition to natural infection, vaccination and anti-viral agent treatment have influenced the changes of epidemics and clinical presentations of varicella and zoster. In this article, diverse clinical manifestations caused by VZV reactivation, particular without skin rash, are reviewed.

Case Report

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

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

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