No abstract available.
Gastrointestinal Diseases*

Focal myositis is a rare, benign inflammatory pseudotumor of the skeletal muscle of unknown etiology. In Korea, there is no case report of focal myositis, which is not combined with connective tissue disease. We present an unusual case of focal myositis with ankle contracture, involving more than two muscles. A 26-year-old man visited our clinic complaining of right ankle contracture and leg muscle pain. Physical examination revealed no muscle weakness or any other neurological abnormality. T2-weighted magnetic resonance imaging of the right leg demonstrated diffuse high signal intensity of the right gastrocnemius, flexor digitorum longus, and tibialis anterior muscles. Needle electromyography showed profuse denervation potentials with motor unit action potentials of short duration and small amplitude from the involved muscles. All these findings suggested a diagnosis of focal inflammatory myositis and the patient was put under oral prednisolone and physical therapy.
Action Potentials ; Adult ; Animals ; Ankle ; Connective Tissue Diseases ; Contracture ; Denervation ; Electromyography ; Granuloma, Plasma Cell ; Humans ; Korea ; Leg ; Magnetic Resonance Imaging ; Muscle Weakness ; Muscle, Skeletal ; Muscles ; Myositis ; Needles ; Physical Examination ; Prednisolone

Scabies is a skin disease caused by the parasite Sarcoptes scabiei var. hominis, primarily transmitted via direct skin or sexual contact or, less commonly, via contact with infested fomites. In Korea, the incidence of scabies has decreased from approximately 50,000 people/yr in 2010 to approximately 30,000 people/yr in 2021. However, outbreaks have been consistently observed in residential facilities, such as nursing facilities, particularly among the older population. The clinical manifestations of scabies vary depending on a patient’s age, health status, number of mites, and transmission route. Typical clinical presentations of classic scabies include intense nocturnal pruritus and characteristic skin rashes (burrows and erythematous papules), with a predilection for the interdigital web spaces, inner wrists, periumbilical areas, axillae, and genital areas. Unlike classic scabies, older adults with immunodeficiency or neurological disorders exhibit hyperkeratotic scaly lesions or an atypical distribution with mild-to-non pruritus (crusted scabies). Diagnosis of scabies is based on clinical symptoms and results of diagnostic tests aimed at identifying the presence of the parasite. Although a close contact history and characteristic clinical findings are suggestive of scabies, confirmation of diagnosis requires detection of scabies mites, eggs, or scybala.This can be achieved through light microscopy of skin samples, non-invasive dermoscopy, and other high-resolution in vivo imaging techniques.

For all suspected, clinical, or confirmed cases of scabies, treatment should be initiated. Affected patients should be adequately isolated, and high-risk groups with close contact histories should be treated irrespective of their symptoms. Optimal treatment strategies can be selected based on age, clinical subtype, and patient’s health status. In Korea, commercially available preparations for scabies treatment include topical 5% permethrin, topical 10% crotamiton, and oral ivermectin. Topical 5% permethrin is the first-line selective treatment for both classic and crusted scabies. Alternative treatments are topical 10% crotamiton and oral ivermectin. Following treatment completion, a follow-up visit at 2 and 4 weeks is recommended to monitor therapeutic response. Treatment failure is considered when scabies mites or burrows are detected, upon development of new clinical characteristics, or upon aggravation of pruritus. Scabies itch should be adequately managed with emollients, oral antihistamines, and topical corticosteroids. Preventive measures, including personal hygiene, patient education, and environmental control should be rendered to reduce the transmission of scabies.

BACKGROUND: Due to its less invasive nature and superior visual field, video-assisted thoracoscopic excision of mediastinal mass is thought to be comparable to open thoracotomy. MATERIAL AND METHOD: From January 1995 to August 2001, the medical records of 38 patients who underwent video-assisted thoracoscopic excision of mediastinal mass was retrospectively analyzed. The outcome of these patients were compared with 5 patients who converted to thoracotomy. RESULT: Male to female ratio was 13(34.2%) : 25(65.8%), and mean age was 39.2 +/-35.4 years. Regarding the pathology, there were 8 neurilemmomas(21.1%), 6 thymic cysts (15.8%), 5 teratomas(13.2%), 5 ganglioneuromas(13.2%), 4 bronchogenic cysts(10.5%), 3 pericardial cysts(7.9%), 3 thymomas(7.9%), and 2 lymphangiomas(5.3%). The mean operation time was 110.6+/-7.0 minutes, mean postoperative tube stay was 4.2+/-0.4 days, mean postoperative hospital stay was 5.2+/-0.4 days, and mean number of injection of analgesics was 1.9+/-0.4 times. Although the mean values for the above indices were less than those of the thoracotomy conversion cases, they were statistically insignificant. Postoperative complications of video- assisted thoracoscopic excision included chylothorax, prolonged air leakage, and unilateral phrenic nerve palsy, all of which recovered before patient discharge. There was, however, permanent unilateral ptosis in one patient. CONCLUSION: As video-assisted thoracoscopic excision of mediastinal mass is safe, less painful, conducive to earlier recovery and cosmetically more appealing, a more active application of this technique is recommeded.
Analgesics ; Chylothorax ; Female ; Humans ; Length of Stay ; Male ; Mediastinal Cyst ; Mediastinal Neoplasms ; Medical Records ; Paralysis ; Pathology ; Patient Discharge ; Phrenic Nerve ; Postoperative Complications ; Retrospective Studies ; Thoracoscopy ; Thoracotomy ; Visual Fields

A 45-year-old woman who complained of weight gain and irregular menstruation was diagnosed as having Cushing's syndrome due to a 3 cm sized left adrenal adenoma. She underwent left adrenalectomy, and she also underwent combined anterior pituitary tests before and 9 months after the surgery. The growth hormone and adrenocorticotropic hormone levels failed to respond to hypoglycemia before the surgery, but their responses recovered after the surgery. Cortisol and thyroid stimulating hormone failed to respond to hypoglycemia and thyrotropin releasing hormone (TRH) before the surgery, respectively, but these were improved after the surgery. Luteinizing hormone, follicle stimulating hormone, and prolactin adequately responded to gonadotropin-releasing hormone and TRH, respectively, before and after the surgery. However, the basal levels of these hormones were higher after adrenalectomy, suggesting that hypercortisolemia had a significant influence on all the pituitary hormones.
Adenoma* ; Adrenalectomy ; Adrenocorticotropic Hormone ; Cushing Syndrome* ; Female ; Follicle Stimulating Hormone ; Gonadotropin-Releasing Hormone ; Growth Hormone ; Humans ; Hydrocortisone ; Hypoglycemia ; Hypopituitarism ; Luteinizing Hormone ; Menstruation ; Middle Aged ; Pituitary Hormones ; Prolactin ; Thyrotropin ; Thyrotropin-Releasing Hormone ; Weight Gain

Rare side effects of bromocriptine, such as, trigermial neuralgia, have been reported in patients with pituitary adenoma but no such case has been reported in post-stroke patients. This case reports on a stroke patient who developed trigeminal neuralgia after bromocriptine therapy. A 48-year-old man, diagnosed with left middle cerebral artery territory infarction and transcortical motor aphasia, was prescribed with 2.5 mg of bromocriptine. After two days, he complained of pain in the right trigeminal nerve distribution. Brain MRI, facial EMG, blink reflex, revealed no abnormalities. His pain showed no relief to various pharmacological agents. However, pain disappeared with discontinuation of bromocriptine and recurred again with readministration. In addition, pain intensity correlated with increase of bromocriptine dosage. Based on these findings, we concluded that patient' trigerminal neuralgia was related to bromocriptine administration. An antidote, which consisted of a dopamine antagonist was prescribed together with bromocriptine and the patient subsequently showed relief of pain and improvement of aphasia.
Aphasia ; Aphasia, Broca ; Blinking ; Brain ; Bromocriptine ; Dopamine ; Humans ; Infarction ; Middle Aged ; Middle Cerebral Artery ; Neuralgia ; Pituitary Neoplasms ; Stroke ; Trigeminal Nerve ; Trigeminal Neuralgia

PURPOSE: This study aimed to determine the prognostic value of new quantitative parameters of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT), including metabolic tumor volume (MTV), in patients with locally advanced and metastatic gallbladder cancer (GBC). MATERIALS AND METHODS: In total, 83 patients initially diagnosed with locally advanced and metastatic GBC and who underwent 18F-FDG PET/CT at the time of initial diagnosis were retrospectively reviewed. The metabolic volume-based PET parameters of primary tumors and metastatic lesions were measured, including maximum and average standardized uptake values (SUV), MTV, and total lesion glycolysis. An overall survival (OS) analysis was performed using the Kaplan-Meier method with PET and clinical parameters. A Cox proportional hazards regression analysis was performed to determine independent prognostic factors. RESULTS: In univariate analysis, pathologic differentiation (p<0.001), performance status (PS; p=0.003), C-reactive protein (CRP) level (p=0.009), and PET-related SUVmt max (the highest SUV among the metastatic lesions) (p=0.040) and MTVtotal (the sum of the MTVs of both the primary and metastatic lesions) (p=0.031), were significant for OS. In multivariate analysis, MTVtotal (hazard ratio: 2.07; 95% confidence interval: 1.23–3.48; p=0.006) remained significant for the prediction of OS, as did differentiation (p=0.001), PS (p=0.001), and CRP (p=0.039). CONCLUSION: In locally advanced and metastatic GBC, volume-based PET/CT parameters of the total tumor burden of malignancy, such as MTVtotal, were found to be useful for the identification of patients with poor prognosis.
C-Reactive Protein ; Diagnosis ; Electrons ; Fluorodeoxyglucose F18 ; Gallbladder Neoplasms ; Gallbladder ; Glycolysis ; Humans ; Methods ; Multivariate Analysis ; Neoplasm Metastasis ; Positron-Emission Tomography and Computed Tomography ; Prognosis ; Retrospective Studies ; Tumor Burden

BACKGROUND: Although warts are common viral infections of the skin, no single optimal treatment has been determined and most warts are resistant to the current treatment modalities. As a result, many patients suffer from viral warts. Nevertheless, there have been few studies on the patients' quality of life and the economic burden associated with viral warts. Objective: The purpose of this study is to assess the quality of life and the economic burden in the population affected by viral warts by administering a survey questionnaire. METHODS: A questionnaire quoted from the Dermatology life Quality Index was administered to one hundred twenty patients who had viral warts. RESULTS: The data for the quality of life revealed that warts do not particularly affect the patient's daily living activities nor their psychological status. However, the data indicated that the treatment of warts had significantly negative effects on the quality of life of our patients. With regard to treatment satisfaction, many were unsatisfied with 'the pain associated with treatment'. The estimated cost for the treatment of warts was 45,900 won per treatment and the estimated total treatment expenditure of each patient was 236,800 won. CONCLUSION: These results suggest that warts significantly affect the patients' quality of life and especially due to its resistance to treatment and the pain associated with the treatment. Moreover, warts can impose a considerable economic burden.
Activities of Daily Living ; Dermatology ; Health Expenditures ; Humans ; Quality of Life ; Questionnaires ; Skin ; Warts

BACKGROUND: Although warts are common viral infections of the skin, no single optimal treatment has been determined and most warts are resistant to the current treatment modalities. As a result, many patients suffer from viral warts. Nevertheless, there have been few studies on the patients' quality of life and the economic burden associated with viral warts. Objective: The purpose of this study is to assess the quality of life and the economic burden in the population affected by viral warts by administering a survey questionnaire. METHODS: A questionnaire quoted from the Dermatology life Quality Index was administered to one hundred twenty patients who had viral warts. RESULTS: The data for the quality of life revealed that warts do not particularly affect the patient's daily living activities nor their psychological status. However, the data indicated that the treatment of warts had significantly negative effects on the quality of life of our patients. With regard to treatment satisfaction, many were unsatisfied with 'the pain associated with treatment'. The estimated cost for the treatment of warts was 45,900 won per treatment and the estimated total treatment expenditure of each patient was 236,800 won. CONCLUSION: These results suggest that warts significantly affect the patients' quality of life and especially due to its resistance to treatment and the pain associated with the treatment. Moreover, warts can impose a considerable economic burden.
Activities of Daily Living ; Dermatology ; Health Expenditures ; Humans ; Quality of Life ; Questionnaires ; Skin ; Warts