No abstract available.
Nail Diseases ; Nails, Malformed ; Melanoma ; Skin Neoplasms

Brainstem infarction can be a critical condition, typically due to ischemic mechanisms such as large artery atherosclerosis, small vessel disease, or cardioembolic sources. In rare instances, infectious or inflammatory etiologies may lead to brainstem infarction, posing substantial diagnostic complexities. We report the case of a 74-year-old man presenting bilateral pontine infarctions secondary to clival osteomyelitis and an adjacent abscess, which was further complicated by a basilar artery pseudoaneurysm and subsequent subarachnoid hemorrhage. This case highlights the importance of considering uncommon infectious causes of brainstem infarction, especially in patients with intricate medical backgrounds and immunosuppression.

Eosinophilic lung diseases are heterogenous disorder which are characterized by the presence of pulmonary symptoms or an abnormal chest radiograph accompanied by inflammatory cellular infiltrates in the airways and lung parenchyma which contain large numbers of eosinophils. The incidence of drug-induced pulmonary disorder is increasing, with at least 40 drug entities having been reported to cause this pulmonary disease. However, nonsteroidal anti-inflammatory drugs (NSAIDs) are rarely mentioned in the lists of drugs in published articles describing drug induced eosinophilic pneumonia. The following is a case of eosinophilic pneumonia that we believe was related to ibuprofen therapy.
Anti-Inflammatory Agents, Non-Steroidal ; Eosinophils* ; Ibuprofen* ; Incidence ; Lung ; Lung Diseases ; Pulmonary Eosinophilia* ; Radiography, Thoracic

PURPOSE: The purpose of the present study was to evaluate the perioperative changes in bladder wall thickness and detrusor wall thickness after transurethral prostatectomy. MATERIALS AND METHODS: Fifty-one men who were treated for benign prostatic hyperplasia/lower urinary tract symptoms with transurethral prostatectomy were prospectively analyzed from May 2012 to July 2013. Prostate size, detrusor wall thickness, and bladder wall thickness were assessed by transrectal and transabdominal ultrasonography perioperatively. All postoperative evaluations were performed 1 month after the surgery. RESULTS: The patients' mean age was 69.0 years, the mean prostate-specific antigen concentration was 8.1 ng/mL, and the mean prostate volume was 63.2 mL. The mean bladder wall thickness was 5.1 mm (standard deviation [SD], +/-1.6), 5.1 mm (SD, +/-1.6), and 5.0 mm (SD, +/-1.4) preoperatively and 4.5 mm (SD, +/-1.5), 4.5 mm (SD, +/-1.3), and 4.6 mm (SD, +/-1.2) postoperatively in the anterior wall, dome, and trigone, respectively (p=0.178, p=0.086, and p=0.339, respectively). The mean detrusor wall thickness was 0.9 mm (SD, +/-0.4) preoperatively and 0.7 mm (SD, +/-0.3) postoperatively (p=0.001). A subgroup analysis stratifying patients into a large prostate group (weight, > or =45 g) and a high Abrams-Griffiths number group (>30) showed a significant decrease in detrusor wall thickness (p=0.002, p=0.018). CONCLUSIONS: There was a decrease in detrusor wall thickness after transurethral prostatectomy. The large prostate group and the high Abrams-Griffiths number group showed a significant decrease in detrusor wall thickness after surgery.
Humans ; Lower Urinary Tract Symptoms* ; Male ; Prospective Studies ; Prostate ; Prostate-Specific Antigen ; Transurethral Resection of Prostate ; Ultrasonography ; Urinary Bladder* ; Urinary Tract

PURPOSE: People with a family history of mood disorder are more likely to have depression. This study compared the characteristics of non-psychotic major depression disorder according to family history of depression. METHOD: Subjects were total of 817 persons recruited for the CRESCEND-K multicenter trial. Characteristics of depression and suicide history of patients with and without a family history of depression were assessed. Family history was determined through self-report. RESULTS: Of 817 participants, 12.4% had a positive family history of depression. Those with family history of depression reported an earlier age at onset of MDD, and more psychiatric comorbidity. Severity of depression and anxiety were not different according to family history of depression. There were no difference in attempted suicide history, number of attempted suicide and age at onset of 1st attempted suicide according to such a family history. CONCLUSION: Patients with family history of depression reported earlier onset of MDD and more history of psychiatric comorbidity.
Anxiety ; Comorbidity ; Depression ; Depressive Disorder, Major ; Humans ; Mood Disorders ; Suicide ; Suicide, Attempted

Niemann-Pick disease type C (NPC) is a neurovisceral lysosomal storage disorder caused by mutations in the NPC1 and NPC2 genes. These mutations cause the accumulation of unesterified cholesterol and other lipids in the lysosomes. NPC has a broad spectrum of clinical manifestations, depending on the age of onset. A 15-day-old infant presented at the Seoul National University Children's Hospital with neonatal cholestasis and hepatosplenomegaly, with the onset of jaundice at 5 days of age. Despite supportive treatment, the patient was considered for a liver transplant because of progressive liver failure. Unfortunately, the patient died from gastrointestinal bleeding before undergoing the transplant. The neonatal cholestasis gene panel revealed two novel likely pathogenic variants in the NPC1 gene (c.1145C>G [p.Ser382*] and c.2231_2233del [p.Val744del]). The patient was diagnosed with NPC, and both parents were found to be carriers of each variant. In infants presenting with neonatal cholestasis, a gene panel can help diagnose NPC.

Background: Coronary artery calcification and carotid plaque are recognized indicators of atherosclerosis, both linked to elevated cardiovascular and cerebrovascular risks. This study investigates the association between coronary artery calcification and carotid plaque and examines key risk factors associated with carotid plaque presence. Methods: We enrolled 2,620 participants who underwent coronary artery calcium scoring via computed tomography and carotid ultrasound for health check-up from January 2017 to December 2022. Patient data, including age, sex, hypertension, diabetes mellitus, dyslipidemia, smoking history, body mass index, glucose, cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and lipoprotein(a), were collected. Logistic regression analyses were performed to explore the relationship between coronary artery calcification and carotid plaque, adjusting for major cerebrovascular risk factors. Results: Coronary artery calcification was present in 44.7% of participants, and carotid plaque was detected in 43.5%. Univariable analysis showed a significant association between coronary artery calcification and carotid plaque (unadjusted odds ratio: 4.393, p<0.001). In the multivariable model, which included age, sex, hypertension, dyslipidemia, glucose, low-density lipoprotein cholesterol, and coronary artery calcification presence, coronary artery calcification remained an independent predictor of carotid plaque (adjusted odds ratio: 2.327, p<0.001). The model’s area under the receiver operating characteristic curve was 0.768. Conclusion Our study demonstrates that coronary artery calcification is independently and significantly associated with carotid plaque in a health check-up population. Carotid imaging, such as carotid ultrasound, may be beneficial for early detection and management of carotid atherosclerosis in patients with coronary artery calcification.

Background: Carotid plaque formation is a major global health issue and contributes in pathogenesis of vascular diseases. Lipoprotein(a), similar to low-density lipoprotein, may influence atherogenesis by promoting inflammation and thrombosis. However, the association between lipoprotein(a) levels and presence of carotid plaques has been debated. This study investigated the correlation between these parameters. Methods: We retrospectively analyzed 4,896 individuals who underwent lipoprotein(a) measurement and carotid ultrasonography at Gangnam Severance Hospital between January 2017 and December 2022. The relationship between lipoprotein(a) levels and the presence of carotid plaques was evaluated using logistic regression analysis adjusted for factors such as age, sex, hypertension (HTN), dyslipidemia, and diabetes mellitus (DM). Results: Among the 4,896 enrolled participants, those with carotid plaques were older, more likely to be men, and had a higher prevalence of HTN, DM, and dyslipidemia. The analysis showed a significant association between the presence of carotid plaques and a level of lipoprotein(a) ≥50 mg/dL in both univariable (unadjusted odds ratio=1.508, p<0.001, 95% confidence interval: 1.192–1.907) and multivariable (adjusted odds ratio=1.335, p=0.029, 95% confidence interval: 1.030–1.731) models. Conclusion Elevated lipoprotein(a) level emerged as an independent risk factor for carotid plaque formation, emphasizing the need for integrated risk assessment. Targeting lipoprotein(a) could enhance preventive strategies against cerebrovascular events. Therefore, further research is warranted to elucidate this disease’s underlying mechanisms and evaluate therapeutic interventions.

Adrenal insufficiency during the treatment of pulmonary tuberculosis is a troublesome condition and can at times be lifethreatening if untreated. Rifampin is one of the most widely prescribed anti-tuberculosis agents. Furthermore, rifampin has been known to be capable of affecting the metabolism of various medications, including glucocorticoids. In this paper, a case of recurrent adrenal insufficiency induced by rifampin during the treatment of pulmonary tuberculosis is reported. The patient was a 63-year-old man who was diagnosed with Addison's disease 17 years earlier and had been undergoing glucocorticoid replacement therapy. Five months before, the patient manifested pulmonary tuberculosis and was immediately given anti-tuberculosis medication that included rifampin. After one week of medication, general weakness and hyponatremia occurred. Despite the increased dose of the glucocorticoid medication, the adrenal insufficiency recurred many times. Since the substitution of levofloxacin for rifampin, the episodes of adrenal insufficiency have not recurred so far.
Addison Disease ; Adrenal Insufficiency ; Glucocorticoids ; Humans ; Hyponatremia ; Middle Aged ; Ofloxacin ; Rifampin ; Tuberculosis, Pulmonary