Wernicke's encephalopathy is a reversible but potentially critical disease caused by thiamine deficiency. Most patients complain of symptoms such as ophthalmoplegia, ataxia and confusion. Heavy alcohol drinking is commonly associated with the disease, but other clinical conditions also can provoke it. In pregnant women, hyperemesis gravidarum can lead to the depletion of body thiamine due to poor oral intake and a high metabolic demand. We report a case of Wernicke's encephalopathy following hyperemesis gravidarum in a 36-year-old female at 20 weeks of pregnancy, who visited our hospital because of shock with vaginal bleeding. This case suggests that although the initial presentation may include atypical symptoms (e.g., shock or bleeding), Wernicke's encephalopathy should be considered, and thiamine replacement should be performed in pregnant women with neurologic symptoms and poor oral intake.
Acute Kidney Injury ; Adult ; Alcohol Drinking ; Ataxia ; Female ; Humans ; Hyperemesis Gravidarum* ; Neurologic Manifestations ; Ophthalmoplegia ; Pregnancy ; Pregnant Women ; Shock ; Thiamine ; Thiamine Deficiency ; Uterine Hemorrhage ; Wernicke Encephalopathy*

Isolated collagenoma usually occurs on the plantar area and is frequently associated with Proteus syndrome. A few reports have described isolated collagenoma on extra-plantar areas such as palm, scalp, face, thigh and finger. Herein, we report a case of isolated collagenoma on the periungual area, which was confused with digital mucous cyst. A 26-year-old man visited our clinic with an asymptomatic, 0.8x0.7 cm-sized, firm, skin-colored nodule on the periungual area of the left fourth finger. The distal nail of the nodule showed a longitudinal groove. Histopathologic findings from periungual nodule showed thickened collagen bundles packing reticular dermis.
Adult ; Collagen ; Dermis ; Fingers ; Humans ; Nails ; Proteus Syndrome ; Scalp ; Thigh

No abstract available.
Eosinophilia ; Eosinophils ; Folliculitis ; Skin Diseases, Vesiculobullous ; Tacrolimus

No abstract available.
Eosinophils* ; Mouth Mucosa* ; Ulcer*

No abstract available.
Granuloma* ; Syphilis, Cutaneous*

A giant thrombosed extracranial internal carotid artery aneurysm (ECCA) is extremely rare and its treatment is challenging. Despite the advance of endovascular technique, open surgery is still considered a first-line treatment in giant thrombosed ECCA. We describe a case of giant thrombosed ECCA which was successfully treated by aneurysmectomy and graft interposition with the technical details.

The silver nanocrystalline is widely used for biological field because of its biocompatibility and anti-microbial effect. The objective of this study was to evaluate the therapeutic efficacy of the silver nanocrystalline ointment on the temporomandibular joint (TMJ) capsulitis. Total 39 patients were included in this study and all patients were received single topical application of the silver nanocrystalline ointment (group A, n=30) or placebo ointment (group B, n=19). Measured variables were maximum mouth opening (MMO), visual analog scale (VAS) for pain, and VAS for function. In results, we could not assess any therapeutic efficacy of single application in the chronic TMJ capsulitis (p>0.05). However, the single application of silver nanocrystalline ointment showed significant improvement in MMO and VAS for pain compared to placebo effect in the acute TMJ capsulitis (p<0.05). We could not find any complications related to ointment application in both groups. In conclusion, the single application of silver nanocrystalline ointment was effective in improving patient's symptom in acute TMJ capsulitis without any noticing complications.
Humans ; Mouth ; Placebo Effect ; Silver* ; Temporomandibular Joint* ; Visual Analog Scale

Disseminated and recurrent infundibulo-folliculitis is an infrequent entity of unknown etiology that was first described in 1968, by Hitch and Lund. Most patient reports have been on young black male adults. It is rarely reported in Asian, and there has been only 1 case reported in the Korean medical literature in the year 1984. The syndrome has been characterized as tiny uniform, skin-colored papules similar to 'goose-bumps' of skin. These papules predominantly involve the trunk and proximal extremities, and are usually accompanied by mild pruritus. In this report, we presented a 33-year-old man with a 10-year history of generalized skin-colored, follicular papules on the chest and back with intermittent pruritus. The clinical initial differential diagnosis included keratosis pilaris, lichen spinulosus, lichen nitidus, folliculitis, and disseminated and recurrent infundibulo-folliculitis. A histopathologic examination showed predominant mononuclear cell infiltration around the infundibular portion of hair follicles, follicular spongiosis and lack of hyperkeratosis. Herein, we reported a rare case of disseminated and recurrent infundibulo-folliculitis with typical clinical and histopathological findings in a 33-year-old Korean man.
Abnormalities, Multiple ; Adult ; Asian Continental Ancestry Group ; Darier Disease ; Diagnosis, Differential ; Extremities ; Eyebrows ; Folliculitis ; Hair Follicle ; Humans ; Keratosis ; Lichen Nitidus ; Lichens ; Male ; Pruritus ; Skin ; Thorax

Purpose: Recent clinical trials have reported response rates < 50% among patients treated with programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors for microsatellite instability‒high (MSI-H) colorectal cancer (CRC), and factors predicting treatment response have not been fully identified. This study aimed to identify potential biomarkers of PD-1/PD-L1 inhibitor treatment response among patients with MSI-H CRC. Materials and Methods: MSI-H CRC patients enrolled in three clinical trials of PD-1/PD-L1 blockade at Asan Medical Center (Seoul, Republic of Korea) were screened and classified into two groups according to treatment response. Their histopathologic features and expression of 730 immune-related genes from the NanoString platform were evaluated, and a machine learning–based classification model was built to predict treatment response among MSI-H CRCs patients. Results: A total of 27 patients (15 responders, 12 non-responders) were included. A high degree of lymphocyticeutrophilic infiltration and an expansile tumor border were associated with treatment response and prolonged progression-free survival (PFS), while mucinous/signet-ring cell carcinoma was associated with a lack of treatment response and short PFS. Gene expression profiles revealed that the interferon-γ response pathway was enriched in the responder group. Of the top eight differentially expressed immune-related genes, PRAME had the highest fold change in the responder group. Higher expression of PRAME was independently associated with better PFS along with histologic subtypes in the multivariate analysis. The classification model using these genes showed good performance for predicting treatment response. Conclusion We identified histologic and immune-related gene expression characteristics associated with treatment response in MSI-H CRC, which may contribute to optimal patient stratification.

BACKGROUND: Although itch is a cardinal symptom of urticaria, its clinical characteristics are not well elucidated in Korean urticaria patients. OBJECTIVE: To characterize the clinical patterns and sensory, affective and therapeutic dimensions of itch in Korean patients with chronic idiopathic urticaria (CIU). METHODS: A face-to-face structured questionnaire based on the McGill pain questionnaire was given to 83 patients with CIU. RESULTS: All of the 83 patients recruited in the study have fully filled-out the questionnaire. In 71.1 percent of the total CIU patients, itch appeared on a daily basis. Patients experienced exacerbation of itch during winter (41.0%) and at night (37.3%). The buttock (50.6%) and front of the thigh (50.6%) were major sites of involvement with itchiness. Patients perceived itch as burning (62.7%), stinging (44.6%) and crawling sensations (42.2%), rather than stabbing (25.3%), tickling (24.1%) and pinching (10.8%). The main associated symptom was heating sensation (60.2%). The majority of the patients answered that itch was annoying (84.3%), worrisome (80.7%) and bothersome (78.3%). Korean CIU patients answered that stress (36.1%) and hot climate (33.7%) aggravated the itch, and medications (55.4%) alleviated it. Among antihistamines, systemic corticosteroids and topical corticosteroids, antihistamines were the most effective treatment for management of itch in patients with CIU. CONCLUSION: This study highlights the detailed description and characteristics of itch in Korean CIU patients. Moreover, we tried to emphasize the clinical differences of itch in CIU patients in comparison with that in atopic dermatitis patients.
Adrenal Cortex Hormones ; Bites and Stings ; Burns ; Buttocks ; Climate ; Dermatitis, Atopic ; Heating ; Histamine Antagonists ; Hot Temperature ; Humans ; Pain Measurement ; Sensation ; Thigh ; Urticaria ; Surveys and Questionnaires