Osteoid osteoma of the third metatarsal bone: A case report

Moon, Dae Gon,Nam, Kwang Woo,Hyun, Chang Lim,Seo, Kyu Bum Institute for Medical Science 2018 The Journal of Medicine and Life Science Vol.15 No.1

Osteoid osteoma is a benign bone tumor composed of osteoid and atypical bone. The most commonly known sites of following tumor are long tubular bones, especially femur and tibia. Yet, development of osteoid osteoma in the foot is unusual, and there aren't much reported literatures of metatarsal osteoid osteoma. In this article, we report a case of the osteoid osteoma in the 3rd metatarsal bone of a 14-year-old male patient.

Severe anemia caused by secondary myelofibrosis in a patient with angioimmunoblastic peripheral T-cell lymphoma

Jo, Jaemin,Kang, Jeong Ho Institute for Medical Science 2020 The Journal of Medicine and Life Science Vol.17 No.3

Bone marrow failure, such as aplastic or myelophthisic anemia, can occur due to an underlying lymphoid malignancy and cause life-threatening events. A 58-year-old man diagnosed with angioimmunoblastic T-cell lymphoma had recently visited the emergency department because of an altered level of consciousness caused by acute severe anemia. The laboratory findings were strongly suggestive of bone marrow failure syndrome. Bone marrow examination was immediately performed and, subsequently, dexamethasone was initiated to control the underlying lymphoma. Intravenous immunoglobulin was also administered in combination due to combined immune hemolytic anemia and thrombocytopenia. Bone marrow examination revealed a packed marrow with marked fibrosis and lymphoma involvement. A diagnosis of secondary myelofibrosis related to the underlying lymphoma was made, and sequential combination chemotherapy was introduced despite the presence of severe anemia and thrombocytopenia. After combination chemotherapy, his hematologic profile and underlying lymphoma improved. Better understanding of various hematologic manifestations and knowledge of the rare condition of lymphoma are essential for appropriate diagnostic approaches and treatment.

Progressive nicotine poisoning by multiple transdermal nicotine patches

Kang, Jeong Ho,Lee, Sung Kgun Institute for Medical Science 2021 The Journal of Medicine and Life Science Vol.18 No.2

The pharmacokinetic properties of transdermal nicotine patches (TNPs) are different from those of other routes of nicotine administration; further, acute nicotine poisoning by TNPs may present with different clinical features. In the present report, we describe the case of a 23-year-old woman who was admitted to emergency department (ED) at Jeju National University Hospital with loss of consciousness. Five hours before the ED visit, she used multiple TNPs to attempt suicide. Initially, nausea and vomiting occurred, and the symptoms worsened over time. We immediately removed the TNPs, and the application sites were gently washed with sterile water. The patient's level of consciousness gradually improved, and she fully recovered an altered mental status 5 hours later. Her initial urinary cotinine level was 324 ng/mL. Physicians should be aware that acute nicotine poisoning by TNPs can cause various toxic symptoms.

Injury trends among foreign and domestic tourists in Jeju from 2008 to 2018

Hwang, Ki Sang,Lee, Sung Kgun,Song, Sung Wook,Kim, Woo Jeong,Kang, Young Joon,Kang, Kyeong Won,Park, Hyun Soo,Park, Chang Bae,Kang, Jeong Ho,Bu, Ji Hwan,Ko, Seo Young Institute for Medical Science 2022 The Journal of Medicine and Life Science Vol.19 No.1

Jeju is the largest island in Korea and one of its key tourist attractions. As the number of foreign tourists steadily increases, so does the number of injuries incurred there. Accordingly, this study aimed to describe and compare the characteristics of injuries suffered by foreign tourists versus those of domestic tourists. As a cross-sectional study of a retrospective medical record survey, the study was conducted with reference to the Jeju Injury Surveillance System from the 11-year period of January 2008 to December 2018. The following factors were investigated: demographic data, mechanism of injury, place of occurrence, activity when injured, patient outcome, and mortality. A total of 92,095 injured Jeju Island visitors was recorded during this time, a number that included 88,050 Koreans and 4,045 foreigners. The gender ratio showed similar patterns between the two groups and there were no significant age differences. In both groups, the most common mechanism of injury was collisions/cuts. Also, more foreigners experienced falls than Koreans. Regarding the location, Koreans had the most road accidents, while foreigners were most likely to be injured at outdoor locations, such as seas and rivers. Furthermore, more foreigners experienced severe injuries requiring hospitalization. Notably, this study showed the differences in injury between foreign and Korean tourists visiting Jeju Island and its findings lend support to targeted safety promotion programs.

Safety and efficacy of pemetrexed for the treatment of lung adenocarcinoma in patients with various stages of chronic kidney disease

Yang, Jieun,park, Ji Eun,Jo, Jaemin,Kim, Young Ree,Chang, Jee Won,Han, Sang Hoon,Han, Chi Wha Institute for Medical Science 2022 The Journal of Medicine and Life Science Vol.19 No.1

We investigated the safety and efficacy of pemetrexed monotherapy in patients with lung adenocarcinoma and various renal conditions, including chronic kidney disease. We also analyzed whether baseline renal function affected progression-free survival (PFS). We retrospectively analyzed 71 patients who received maintenance-and second-line pemetrexed monotherapy. Patients were divided into two groups according to estimated glomerular filtration rate (eGFR): fair eGFR (>60 mL/min/1.73 m²) and lower eGFR (59 mL/min/1.73 m² or less). The safety and efficacy were evaluated for each group. Median ages were 73.2 years in the lower eGFR group (n=28) and 64.5 years in the fair eGFR group (n=43). Patients with a lower eGFR achieved a median PFS of 4.7 months, while the median PFS for patients with a fair eGFR was 2.7 months. The difference between the two groups was not statistically significant (P=0.075). Both groups showed treatment-related low-grade hematological and non-hematological adverse events. Pemetrexed monotherapy is safe and effective in patients with lung adenocarcinoma with a lower eGFR.

Colonic cryptococcosis presenting with chronic diarrhea in a person with advanced human immunodeficiency virus disease: a case report

Oh, Hyunjoo,Kim, Misun,Yoo, Jeong Rae,Boo, Sun-Jin,Heo, Sang Taek Institute for Medical Science 2022 The Journal of Medicine and Life Science Vol.19 No.1

Cryptococcus neoformans infection usually occurs in patients with advanced human immunodeficiency virus (HIV) infection or with a CD4 T lymphocyte count of <100 cells/µL. Pulmonary and central nervous system infections are the most frequently encountered forms of cryptococcosis; however, colonic cryptococcosis is uncommon. We describe the case of a 41-year-old antiretroviral-naïve man with HIV infection diagnosed eight years prior and intermittent diarrhea for 4 months who presented to the emergency department with a 1-day history of low-grade fever and confusion. Brain magnetic resonance imaging and cerebrospinal fluid analysis revealed normal results; however, he was diagnosed with Pneumocystis jirovecii pneumonia based on chest computed tomography and bronchoalveolar lavage analysis. Trimethoprim-sulfamethoxazole administration was initiated followed by antiretroviral treatment. Although his condition gradually improved, he developed fever and abdominal discomfort, and the diarrhea worsened. Endoscopy revealed a small ulcer in the distal transverse colon. Histopathological examination of a colon tissue sample revealed cryptococcal infection. He improved substantially during liposomal amphotericin B and fluconazole treatment. We encountered a rare case of colonic cryptococcosis that caused chronic diarrhea in a patient with advanced HIV infection. Colonic cryptococcosis should be considered when patients with acquired immune deficiency syndrome present with gastrointestinal symptoms.

Correlation of responsiveness to pain intensity and functional status measurements after lumbar epidural steroid injection in patients with lower back pain

Park, Sun Kyung,Lee, Aeryoung,Cho, Suk Ju,Park, Sang Hyun,Yun, So Hui,Lee, Bang Won,Na, Changrock,Choi, Yun Suk Institute for Medical Science 2022 The Journal of Medicine and Life Science Vol.19 No.1

This study aimed to examine the changes in the Numerical Rating Scale (NRS), Oswestry Disability Index (ODI), and Roland Morris Disability Questionnaire (RMDQ) scores before and after epidural steroid injection (ESI) in patients with lower back pain, and the correlation between the three scales in patients with reduced scores on these scales. Patients completed the NRS, ODI, and RMDQ before and after receiving ESI. A paired t-test was performed to compare the mean scores obtained before and after ESI. The correlations between the scores were estimated by calculating the difference between the baseline and follow-up scores. Of the 49 patients, 37 completed both questionnaire assessments. Among them, 26 patients (70%) presented a post-ESI decrease in scores obtained on all three scales. The NRS score decreased from 6.81±1.91 points at baseline to 3.66±2.22 points at follow-up (P<0.0001); similarly, the ODI score decreased from 41.65±14.76 to 30.38±16.16 points (P=0.0025); and the RMDQ score decreased from 11.11±5.68 to 7.64±5.74 points (P=0.011). Of the 37 patients who completed the two questionnaires, 26 had reduced NRS, ODI, and RMDQ scores. The intraclass correlation coefficients between the NRS and ODI, NRS and RMDQ, and ODI and RMDQ scores were 0.7943, 0.6615, and 0.7182, respectively. The concordance correlation coefficients between the NRS and ODI, NRS and RMDQ, and ODI and RMDQ scores were 0.6020, 0.4938, and 0.5202, respectively. Among the measurements, the correlation between the NRS and ODI scores was the highest, and a moderate correlation was found between the scores obtained using the other instruments.

Auricular conchal cartilage for treatment of empty nose syndrome

Min Jai Cho,Hahn Jin Jung Institute for Medical Science 2023 The Journal of Medicine and Life Science Vol.20 No.4

Empty nose syndrome is an uncommon complication of turbinoplasty and other nasal operations. It presents with various manifestations, with the most common symptom being paradoxical nasal obstruction. Here, we report the case of a 67-year-old male patient diagnosed with empty nose syndrome 20 years after turbinoplasty. Autologous auricular conchal cartilage was harvested and implanted into the lateral wall of the inferior turbinate to reduce nasal volume. The patient experienced significant relief from subjective nasal obstruction symptoms immediately after surgery. Over a 23-month follow-up period, no side effects or symptom recurrence was reported.

Pathologic change of an arterialized giant venous aneurysm of a brachiocephalic arteriovenous fistula

Su Wan Kim,Jonggeun Lee,Seogjae Lee,Jee Won Chang,Chang Lim Hyun Institute for Medical Science 2023 The Journal of Medicine and Life Science Vol.20 No.4

Aneurysmal venous dilatation is a frequent complication of arterio venous fistulas (AVFs) created for hemodialysis. Venous aneurysm rupture can lead to lethal hemorrhage. A 49-year-old male patient presented with a giant aneurysmal dilatation of his AVF 10 years after its creation. The patient had complaints of pulsating pain and discomfort due to swelling of the left forearm. We performed an aneurysm resection and revised the overlying dermal lesion through a brachial plexus block. Here, we describe the pathological features of the arterialized venous aneurysm compared to simple venous aneurysms.

Risk factors for blood transfusion after Cesarean section in patients with partial placenta previa

Hyun Jung Kim,Woo Hee Lim,Young Sun Kim Institute for Medical Science 2023 The Journal of Medicine and Life Science Vol.20 No.4

This study assessed risk factors for blood transfusion after Cesarean section in patients with partial placenta previa. We retrospectively reviewed the medical records of 149 patients who underwent Cesarean sections for partial placenta previa between January 2010 and October 2021. Clinical characteristics were compared between the two groups: the blood transfusion group (n=22), defined as patients who received a blood transfusion during surgery or within 24 hours after surgery, and the non-blood transfusion group (n=127), which included other patients. Multivariable logistic regression analysis identified two risk factors independently associated with blood transfusion: antenatal hemorrhage (adjusted odds ratio [aOR], 16.283; 95% confidence interval [CI], 4.405-60.190; P<0.001) and preoperative hemoglobin (g/dL) (aOR, 0.427; 95% CI, 0.246-0.739; P=0.002). Thus, patients who are at risk for these two factors should be carefully managed with sufficient preparation for blood transfusion and anesthetic management.