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Objective@#Burr hole trephination is a common treatment for chronic subdural hematoma, intracranial hematoma, and intraventricular hematoma due to its effective drainage of hematoma, minimal invasiveness and short operation time. However, cosmetic complications such as scalp depression can occur. The aim of this study was to evaluate the usefulness of an allogenic acellular dermal matrix (ADM) to prevent scalp depression at the burr hole site. @*Methods@#A retrospective analysis was performed with 75 cases in 66 patients who were treated with burr hole trephination from January 2018 to December 2019. These cases divided into 2 groups; based on the method used to cover the burr hole site: Gelfoam packing only (GPO) and ADM. The degree of the scalp depression was measured from the more recent follow-up brain computed tomography scan. @*Results@#There was a significant difference in the degree of scalp depression between GPO and ADM groups (p=0.003). No significant correlation between patient's age and the degree of scalp depression (GPO: p=0.419, ADM: p=0.790). There were no wound infection complication in either group. @*Conclusion@#ADM is a suitable material to prevent scalp depression after burr hole trephination.
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BACKGROUND: Psoriatic arthritis (PsA) is a seronegative inflammatory arthritis associated with psoriasis. The prevalence of PsA varies across different countries, and a few previous studies have reported that 9~17% of Korean patients with psoriasis present with PsA. However, limited data are available regarding the clinical features and treatment of Korean patients with PsA. OBJECTIVE: To evaluate the clinical features of Korean patients with PsA and the treatment modalities used in the real-world setting. METHODS: This study was a retrospective single-center study. We analyzed 101 Korean patients who had been diagnosed with PsA based on the Classification Criteria for Psoriatic Arthritis (CASPAR). We reviewed the patients' medical records, Psoriasis Area and Severity Index (PASI) score, body surface area (BSA), manifestation pattern of PsA, and treatment course. RESULTS: Our study included 101 patients. The mean age was 50.7 years. The mean PASI score was 8.6, and the mean BSA was 11.5%. Spondylitis was the most common manifestation (40.6%). In most patients, psoriatic lesions preceded the onset of PsA (57.4%). Psoriasis and PsA occurred simultaneously in 32.7%, and PsA developed prior to psoriasis in 9.9% of patients. The administration of nonsteroidal anti-inflammatory drugs (NSAIDs) was the most commonly utilized treatment strategy (82.2%), followed by the use of methotrexate and sulfasalazine. Twenty-two patients were treated with biologics with favorable efficacy. CONCLUSION: Spondylitis was the most common manifestation in patients. NSAIDs, methotrexate and sulfasalazine were the drugs most commonly used to treat Korean patients with PsA. Dermatologists should be mindful of this entity, and during history taking at the patient's initial visit, those with psoriasis should be asked, "Do you have any pain or swelling of joints?" to ensure early diagnosis of PsA.
Тема - темы
Humans , Anti-Inflammatory Agents, Non-Steroidal , Arthritis , Arthritis, Psoriatic , Biological Products , Body Surface Area , Classification , Early Diagnosis , Medical Records , Methotrexate , Prevalence , Psoriasis , Retrospective Studies , Spondylitis , SulfasalazineРеферат
BACKGROUND: Thiopurine S-methyltransferase (TPMT) is an important enzyme in the metabolism of thiopurines including azathioprine (AZA), 6-mercaptopurine, and 6-thioguanine. TPMT genotyping is widely used for screening of AZA-related toxicity during routine clinical practice in Korea. However, the data of TPMT genotypes and its AZA-related toxicity have not been studied in the field of dermatology. OBJECTIVE: The aim of this study was to evaluate the genetic basis of TPMT polymorphism in Korean dermatologic patients and subsequently to investigate the relationship between mutant TPMT and adverse responses to AZA treatment. METHODS: This study was retrospective, single-center study. One hundred forty-nine Korean dermatologic patients who underwent TPMT screening test were included. Each patient's medical records, the result of TPMT screening test, dose and treatment period of AZA, and side effects, were reviewed. Laboratory tests were assessed at each visit in order to monitor adverse drug reactions. Leukopenia grading was used in accordance with the common terminology criteria for adverse events (CTCAE) ver. 4.03. RESULTS: Behçet's disease was the leading disorder among the patients. The frequency of TPMT mutation was 4.0% (6/149) among the participants in this study. Four of the six patients with genetic alterations were treated with a low-dose AZA regimen, but no AZA-related adverse events were observed. CONCLUSION: Our results suggest that 1) TPMT polymorphisms in Korean dermatologic patients are similar to those previously reported in Asian patients with the most common mutant allele being TPMT*3C and 2) AZA can be used in the patients with these polymorphisms under a careful dosing regimen.