Baricitinib, janus kinase (JAK) 1/2 inhibitor, can significantly improve the patients with moderate to severe atopic dermatitis (AD). However, the concerns about its hematological safety have raised. A 57-year-old man with severe AD started taking baricitinib due to ineffectiveness and side effects of conventional treatments. After 16 weeks, hemoglobin level decreased to 7.5 g/dL. He started taking folate and multivitamin supplements for anemia with baricitinib suspension, and hemoglobin level increased after 2 weeks. Baricitinib affects hemoglobin levels and other hematological parameters by inhibiting the action of erythrocyte production, which is promoted by JAK2 signaling.When treating AD patients with baricitinib, periodic blood test is required to confirm the occurrence of hematological abnormalities.

Baricitinib, janus kinase (JAK) 1/2 inhibitor, can significantly improve the patients with moderate to severe atopic dermatitis (AD). However, the concerns about its hematological safety have raised. A 57-year-old man with severe AD started taking baricitinib due to ineffectiveness and side effects of conventional treatments. After 16 weeks, hemoglobin level decreased to 7.5 g/dL. He started taking folate and multivitamin supplements for anemia with baricitinib suspension, and hemoglobin level increased after 2 weeks. Baricitinib affects hemoglobin levels and other hematological parameters by inhibiting the action of erythrocyte production, which is promoted by JAK2 signaling.When treating AD patients with baricitinib, periodic blood test is required to confirm the occurrence of hematological abnormalities.

Baricitinib, janus kinase (JAK) 1/2 inhibitor, can significantly improve the patients with moderate to severe atopic dermatitis (AD). However, the concerns about its hematological safety have raised. A 57-year-old man with severe AD started taking baricitinib due to ineffectiveness and side effects of conventional treatments. After 16 weeks, hemoglobin level decreased to 7.5 g/dL. He started taking folate and multivitamin supplements for anemia with baricitinib suspension, and hemoglobin level increased after 2 weeks. Baricitinib affects hemoglobin levels and other hematological parameters by inhibiting the action of erythrocyte production, which is promoted by JAK2 signaling.When treating AD patients with baricitinib, periodic blood test is required to confirm the occurrence of hematological abnormalities.

Baricitinib, janus kinase (JAK) 1/2 inhibitor, can significantly improve the patients with moderate to severe atopic dermatitis (AD). However, the concerns about its hematological safety have raised. A 57-year-old man with severe AD started taking baricitinib due to ineffectiveness and side effects of conventional treatments. After 16 weeks, hemoglobin level decreased to 7.5 g/dL. He started taking folate and multivitamin supplements for anemia with baricitinib suspension, and hemoglobin level increased after 2 weeks. Baricitinib affects hemoglobin levels and other hematological parameters by inhibiting the action of erythrocyte production, which is promoted by JAK2 signaling.When treating AD patients with baricitinib, periodic blood test is required to confirm the occurrence of hematological abnormalities.

Meningiomas are common intracranial tumors; however, reports on extracranial cutaneous meningiomas are exceedingly rare. A 77-year-old woman visited our hospital with an asymptomatic child fist-sized mass on the scalp.Biopsy results indicated nuclear atypia and mitoses of sarcomatous cells. Brain magnetic resonance imaging revealed a subgaleal mass with strong enhancement. Suspecting sarcoma, wide excision was performed jointly by the departments of plastic surgery and neurosurgery, during which no evidence of cranial invasion was noted. In the surgical specimen, numerous mitoses of sarcomatous cells and poorly formed nests of epithelioid cells were observed. This led to the diagnosis of anaplastic meningioma without intracranial origin. Subsequently, the patient received adjuvant radiotherapy and is currently under close follow-up. Anaplastic meningioma is rare, but early diagnosis is important as it enables timely and appropriate treatment, thus, improving survival rates. Dermatologists should remain vigilant as meningiomas can manifest as cutaneous scalp nodules, and their accurate diagnosis can profoundly impact prognosis.

Methotrexate (MTX) is commonly employed in the management of chronic inflammatory skin diseases. We report the case of a 73-year-old man who presented with a persistent cough lasting for 1 month. He had an 11-year history of psoriasis and had received MTX (10.0 mg/wk) over the past 21 months. High-resolution chest computed tomography revealed diffuse ground-glass opacities and bronchiectasis affecting both lung fields. Based on clinical and radiological assessments, the patient was diagnosed with MTX-induced interstitial pneumonia. Notably, significant clinical and radiological improvement was observed 1 month after the discontinuation of MTX and corticosteroid administration. Although some reports have demonstrated lung toxicity in patients receiving high-dose MTX therapy, cases of adverse pulmonary effects following low-dose treatment in patients with psoriasis are rare.This case report underscores the rarity of interstitial pneumonia in a patient with psoriasis undergoing MTX treatment in Korea.

BACKGROUND AND OBJECTIVES: Facial nerve stimulation (FNS) as a complication of cochlear implantation can produce significant discomfort, limit effective use of cochlear implant, and require extensive reprogramming in some patients. The purpose of this study is to review the clinical features of children with FNS after cochlear implantation and to discuss its possible solutions. SUBJECTS AND METHOD: Thirteen children who had FNS after cochlear implantation were included. Their medical records were reviewed retrospectively regarding the presence of inner ear anomaly (IEA), the programming techniques for cochlear implant, timing and progression of FNS, and the management of it. RESULTS: Ten out of 13 children (76.9%) with FNS had IEA. In those 10 patients with IEA, FNS appeared within 6 months from the operation and showed a tendency of being relevant to all electrodes. Authors used four methods to eliminate FNS. They included (a) turning off the specific electrodes when FNS seems related to some specific electrodes, (b) changing the coding strategy or the programming mode, which proved not to be effective, (c) reducing the C-level, which resulted in severe narrowing of dynamic range as well as a relative control of FNS, and (d) surgical exploration in specific cases. CONCLUSION: FNS after CI is at greater risk for IEA. FNS in those cases can interfere with the progression of speech development. This should be sufficiently informed of the parents of CI candidates with IEA preoperatively. Surgical exploration can be reserved for elimination of FNS in specific cases.
Child* ; Clinical Coding ; Cochlear Implantation* ; Cochlear Implants* ; Ear, Inner ; Electrodes ; Facial Nerve* ; Humans ; Medical Records ; Parents ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Although tonsillectomy is one of the most often performed surgeries in Otorhinolaryngology, there has not been any long-term postoperative follow-up studies until now. The authors aimed to validate once more, in a long-term follow up study, the need for performing tonsillectomy. MATERIALS AND METHODS: Medical records of 180 adult patients who have received tonsillectomy were retrospectively studied, and telephone surveys were made to the patients. The telephone questionnaire was designed to find out the postoperative pain, complications such as bleeding, the time each patient took to return to the normal diet and social life, the degree of improvement in the symptoms and the satisfactory rate. RESULTS: The chief complaints were recurrent sore throat. There was no immediate postoperative bleeding, but secondary bleeding occurred in 12.8% of the patients. The postoperative pain scored 7.4 in a scale of one to ten. The average time in returning to the normal diet and the normal life was 17.9, 21.1 days, respectively. Studies in the symptomatic improvement showed almost no or minimal residual symptom in 99% of the patients and about 95% of the patients answered positively in satisfactory category. CONCLUSION: Tonsillectomy caused great pain postoperatively in most of the patients and returning to the normal diet and life took fairly a long time. However, the positive answers about the symptomatic improvement and the high satisfaction rate validates tonsillectomy as an effective surgical treatment for patients with recurrent tonsillitis.
Adult* ; Diet ; Follow-Up Studies ; Hemorrhage ; Humans ; Medical Records ; Otolaryngology ; Pain, Postoperative ; Palatine Tonsil ; Pharyngitis ; Surveys and Questionnaires ; Retrospective Studies ; Telephone ; Tonsillectomy* ; Tonsillitis

BACKGROUND AND OBJECTIVES: The objective of this study was to evaluate improvement in hearing and changes in the tympanogram according to the types of mastoid pneumatization and the mucosal condition of the Eustachian tube orifice after performing tympanoplasty type 1. MATERIALS AND METHODS: Among the patients with chronic otitis media who had received tympanoplasty type 1 at Asan Medical Center from June 1990 to March 1997, sixty five patients were evaluated with pure tone audiometry and tympanometry for a short-term (<6 months) and long-term (>1 year) follow-up period. RESULTS: Greater improvement in hearing was shown in patients with tympanogram type A as compared to the patients with type B and C in both short-term and long-term follow-ups. Patients who showed normal mastoid pneumatization were found to have type A tympanogram more frequently than patients who showed abnormal mastoid pneumatization. However, the degree of postoperative hearing improvement did not depend on the types of mastoid pneumatization. Mucosal condition of the Eustachian tube orifice had some influence on the outcome of postoperative tympanogram and hearing. Greater improvement in the hearing levels were observed more frequently in the normal mucosa. CONCLUSION: Postoperative improvement in hearing was closely related to the postoperative change in the tympanogram. Postoperative hearing results and tympanograms were mainly influenced by the mucosal condition of the Eustachian tube orifice. Relatively greater improvement in hearing was observed in the long-term follow-up compared to the short-term follow-up. However, in order to reach any conclusion on this matter, a longer follow-up period and closer observation would be required.
Acoustic Impedance Tests ; Audiometry ; Chungcheongnam-do ; Eustachian Tube ; Follow-Up Studies* ; Hearing* ; Humans ; Mastoid ; Mucous Membrane ; Otitis Media ; Tympanoplasty*

Rhabdomyosarcoma is a highly aggressive malignant tumor with an incidence of 1/500,000 children per year. Head and neck is the most common site of the embryonal rhabdomyosarcoma. We experienced four cases of embryonal rhabdomyosarcoma, each case originating from temporalis muscle, nasal cavity, parapharynx and nasopharynx. The median age of four patients was 12.5 years old (range, 3-25 years), and the male and female ratio was 2:2 . Two patients were treated with operation and postoperative chemotherapy and irradiation. One patient was treated with induction chemotherapy before operation, and then received postoperative chemotherapy and irradiation. The remaining one patient was incidentally confirmed by excisional biopsy and treated with chemotherapy and irradiation. The median follow-up period was 24 months (range, 6-56 months). Three patients recovered completely with no further evidence of disease. One patient showed breast metastasis after 3 months later.
Biopsy ; Breast ; Child ; Drug Therapy ; Female ; Follow-Up Studies ; Head* ; Humans ; Incidence ; Induction Chemotherapy ; Male ; Nasal Cavity ; Nasopharynx ; Neck* ; Neoplasm Metastasis ; Rhabdomyosarcoma* ; Rhabdomyosarcoma, Embryonal