Factors Associated With Subdural Hygroma Following Mild Traumatic Brain Injury / 대한신경손상학회지

Objective@#Subdural hygroma (SDG) is a complication of traumatic brain injury (TBI). In particular, the outcome and outpatient treatment period may vary depending on the occurrence of SDG. However, the pathogenesis of SDG has not been fully elucidated. Therefore, this study aimed to identify the risk factors associated with the occurrence of SDG after mild TBI. @*Methods@#We retrospectively analyzed 250 patients with mild TBI admitted to a single institution between January 2021 and December 2021. The SDG occurrence and control groups were analyzed according to the risk factors of SDG, such as age, history, initial computed tomography (CT) findings, and initial laboratory findings. @*Results@#The overall occurrence rate of SDG was 31.6% (n=79). A statistically significant association was found between preoperative diagnoses and the occurrence of SDG, such as subarachnoid hemorrhage (odds ratio [OR], 2.36; 95% confidence interval [CI], 1.26–4.39) and basal skull fracture (OR, 0.32; 95% CI, 0.12–0.83). Additionally, age ≥70 years (OR, 3.20; 95% CI, 1.74–5.87) and the use of tranexamic acid (OR, 2.12; 95% CI, 1.05–4.54) were statistically significant factors. The prognostic evaluation of patients using the Glasgow Outcome Scale (GOS) did not show any statistical differences between patients with and without SDG. @*Conclusion@#SDG was not associated with the prognosis of patients assessed using the GOS. However, depending on the occurrence of SDG, differences in patient symptoms may occur after mild TBI. Therefore, the early evaluation of patients with mild TBI and determination of the probability of developing SDG are important.

Spinal Cord Infarction After Transarterial Chemoembolization for Hepatocellular Carcinoma / 대한신경손상학회지

Transarterial chemoembolization (TACE) is an effective treatment for unresectable hepatocellular carcinoma (HCC). It is considered relatively safe. However, fatal complications such as pulmonary edema and liver abscesses can occur. Spinal infarction due to local embolism of the central nervous system after TACE is a very rare, but fatal complication. Here, we report a case of spinal cord infarction after TACE for ruptured HCC. Paraplegia occurred at the T10 sensory level 6 hours after the procedure. The patient received steroid megadose therapy but died 5 days later due to exacerbation of metabolic acidosis and blood loss. This case demonstrates the need for a comprehensive and extensive study of arterial blood flow prior to angiography.

Minimally Invasive Surgery for Axillary Osmidrosis Using a Combination of Subcutaneous Tissue Removal and a 1,444-nm Nd:YAG Laser

Many treatment modalities have been developed for axillary osmidrosis. It is well known that the surgical treatment has the best results. However, there is a high possibility of side effects. The 1,444-nm lipolysis laser has been recently introduced to remove the apocrine glands. So far, subdermal coagulation treatment with a 1,444-nm Nd:YAG laser may be the least invasive and most effective therapy for axillary osmidrosis. However, according to our previous experience, the recurrence rate was 20%~30%. This emphasizes the need for combination of surgical method and non-surgical method and we combined subcutaneous tissue removal and photothermocoagulation with a 1,444-nm Nd:YAG laser. Three patients for bilateral axillary osmidrosis were enrolled. After an incision of about one-third the length of the widest transverse diameter, the apocrine glands were separated from the skin. And then apocrine glands within the marked area were destroyed by irradiation with a 1,444-nm Nd:YAG laser thereafter. All patients exhibited no relapse of axillary osmidrosis and were satisfied with the treatment results. A combination of subcutaneous tissue removal and Interstitial laser photothermocoagulation with a 1,444-nm Nd:YAG laser could be an effective treatment for mild to moderate axillary osmidrosis.

A Prospective, Long-Term Follow-Up Study of 1,444 nm Nd:YAG Laser: A New Modality for Treating Axillary Bromhidrosis

BACKGROUND: Surgery for bromhidrosis has a high risk of complications such as hematoma and necrosis. New nonsurgical methods may reduce the burden on surgery and the risks for the patient. OBJECTIVE: This study was performed to evaluate the efficacy and side-effects of the 1,444 nm Nd:YAG interstitial laser for treating axillary bromhidrosis. METHODS: Eighteen bromhidrosis patients were treated with a 1,444 nm Nd:YAG laser at Korea University Ansan Hospital. The post-treatment follow-up was 6 months. After the procedure, we confirmed apocrine gland destruction through histopathological examination. At each follow-up, we measured the severity of the remaining odor, postoperative pain, degree of mobility restriction, and overall satisfaction. RESULTS: After 180 days of follow-up, malodor elimination was good in 20 axillae, fair in 12 axillae, and poor in four axillae. At the end point of the study, 14 patients were totally satisfied with the laser treatment, three patients were partially satisfied, and one patient was disatisfied. Pain and limitation of mobility were significantly reduced within 1 week post-operatively, and were almost resolved within 4 weeks post-operatively. A histopathological examination revealed decreased density and significant alterations to the apocrine glands. CONCLUSION: Subdermal coagulation treatment with a 1,444 nm Nd:YAG interstitial laser may be a less invasive and effective therapy for axillary bromhidrosis.

Clinical Value of Hepatitis Screening and Liver Function Test in Korean Patients with Lichen Planus / 대한피부과학회지

BACKGROUND: The relationship between viral hepatitis and lichen planus (LP) remains as a matter of controversy. Geographical variations are suggested to be a major factor influencing such association. Reliable figures from Korean patients are still lacking. OBJECTIVE: The aim of this study is to determine the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in Korean patients with lichen planus (LP) and to compare it with patients without LP. METHODS: The retrospective study was performed on 45 LP patients and 45 controls with matching age and gender. We examined for serological evidences of hepatic disease, hepatitis B surface antigen (HBsAg), and anti-HCV seropositivity. Statistical analysis was calculated by using an unpaired t-test and Fisher's exact test. RESULTS: No significant differences between the serum levels of alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were observed between the two groups. The prevalence of HBsAg in LP patients (4.4%) was not significantly higher (p>0.05) than those of the control subjects (2.2%). None of the patients with LP nor the control subjects had Anti-HCV. CONCLUSION: Korean patients with LP did not have any significant associations with liver diseases or HBV, and HCV infections. Although a large-scale multicenter study is needed to support our results, it is not advisable for Korean patients with LP to be tested for liver functions or HBV, and HCV infections as part of a routine screening test.

New Alternative Combination Therapy for Recalcitrant Common Warts: The Efficacy of Imiquimod 5% Cream and Duct Tape Combination Therapy

No abstract available.

Prognostic Significance of Thyroid Autoantibodies in Urticaria / 대한피부과학회지

BACKGROUND: The association between chronic urticaria and thyroid autoantibodies is now generally accepted, and some authors recommend screening for thyroid autoimmunity and function in all patients with chronic urticaria for early identification of patients who might require treatment of underlying thyroid dysfunction or follow-up. However, the prognostic significance of thyroid autoantibodies in urticaria patients is still unclear. OBJECTIVE: To evaluate antibody reactivity as a prognostic factor, the association between antibody positivity and disease duration were analyzed. METHODS: Medical records from March 2002 to October 2010 of urticaria patients (M: 41, F: 125), who were tested for thyroid auto-antibodies at their first visit, were collected and reviewed for the duration of urticaria. Patients with a 6-week or longer history of urticaria were categorized into the chronic urticaria group; patients whose urticaria resolved within 6 weeks were categorized into the acute urticaria group. RESULTS: A positive result to the thyroid autoantibody was shown by 28.9% of chronic urticaria patients and 10.7% of acute urticaria patients. Average duration of urticaria in patients who were thyroid autoantibody positive was 33.9 weeks, while patients with thyroid autoantibody negative tests had urticaria for 6.9 weeks on average. The frequency of a positive result to only the thyroid peroxidase antibody was different between the chronic urticaria group (15.6%) and the acute urticaria group (2.5%). CONCLUSION: According to our results, the average duration of urticaria in patients with thyroid autoantibodies was significantly longer than in urticaria patients without thyroid autoantibodies. Thyroid autoantibodies were statistically meaningful prognostic factors predicting the duration of urticaria.