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/Aims: The optimal systolic blood pressure (SBP) goal for elderly patients with hypertension, especially to reduce cardiovascular disease (CVD) incidence and improve outcome, is unclear. This study aimed to evaluate the beneficial effects of intensive treatment for hypertension on the incidence of CVD in elderly Korean patients. Methods: The HOW to Optimize eLDerly systolic Blood Pressure (HOWOLD-BP) trial is a multicenter, parallel-design, open-label, randomized controlled trial designed to evaluate whether intensive treatment (SBP ≤ 130 mmHg) will provide more benefits in lowering the incidence and mortality associated with CVD than standard treatment (SBP ≤ 140 mmHg) in elderly patients with hypertension aged ≥ 65 years. For this study, eleven university hospitals in Korea will enroll approximately 3,176 elderly patients with hypertension between 2019 and 2022. Patients will be requested to visit the clinic every 4 months for the first year and every 6 months thereafter for 36 months. Parameters, including clinic and home blood pressure, anthropometric and laboratory findings, and frailty assessments, will be collected according to the standardized protocol. The primary outcome is a composite of CVD (acute coronary syndrome, stroke, and heart failure) incidence and cardiovascular deaths. Results: As of December 2021, 1,655 participants had been enrolled in the study, including 831 patients in the standard group and 824 patients in the intensive group. Conclusions The HOWOLD-BP trial is the first study performed in Korea to evaluate the beneficial effects of intensive blood pressure treatment on CVD in elderly patients with hypertension. The results of this study will help clarify the appropriate target SBP for this population.

OBJECTIVE: To investigate the function of sympathetic nervous system in patients with first-ever unilateral stroke by measuring hand sympathetic skin response (SSR) and the relationship between sympathetic dysfunction and motor function. METHOD: Eighteen patients with first-ever unilateral stroke and eighteen normal controls were recruited. The differences of hand SSR amplitude and latency between affected and unaffected side were investigated. Motor function was classified according to the Brunnstrom stage and activities of daily living were evaluated by modified Barthel Index (MBI) and Functional Independence Measure (FIM). Orthoestatic hypotension (OH) was evaluated and graded. RESULTS: The difference of the amplitude of hand SSR between affected and unaffected side was increased in stroke patient group (p<0.05). There was significant correlation between Brunnstrom stage and the difference of hand SSR amplitude (p<0.05). There were significant correlations between MBI, FIM and the difference of hand SSR amplitude (p<0.05). There was significant correlation between OH and the difference of hand SSR amplitude (p<0.05). CONCLUSION: Evaluation of hand SSR could be useful methods to evaluate central autonomic dysfunction and motor dysfunction.
Activities of Daily Living ; Hand ; Humans ; Hypotension ; Skin ; Stroke* ; Sympathetic Nervous System*

BACKGROUND: Controlling postoperative pain after knee replacement while reducing opioid-induced adverse effects and improving outcomes remains an important challenge. To assess the effect of combined capsicum plaster at the Korean hand acupuncture point on opioid consumption and outcomes after total knee replacement. METHODS: One hundred and two patients, received total knee replacement, were included in a randomized, double-blinded study: 51 patients were in the placebo group, and 51 patients were in K-M26 group. Capsicum plaster was applied at the K-M26 point in K-M26 group, whereas in the placebo group, an inactive tape was fixed at K-M26 point of both hands. The capsicum plaster was applied before induction of anesthesia for 8 h, and attached during 3 days postoperatively. They received postoperative pain treatment with intravenous patient-controlled analgesia (PCA) during the first postoperative 48 h. Visual analog scale (VAS) scores at rest were used to assess pain. Total PCA volume delivered, number of PCA requests, supplemental analgesics, overall satisfaction score and adverse events were evaluated. RESULTS: K-M26 group reported significant lower VAS and supplemental analgesic doses at 3 days postoperatively compared with placebo group. No significant differences were found in delivered doses and requested number of PCA, and satisfaction score between two groups. There was a tendency of decrease in postoperative nausea and vomiting in K-M26 group, but no significant differences. CONCLUSIONS: PCA with capsicum plaster at in K-M26 point is thought to be potent and safe for postoperative pain relief after total knee replacement with the lesser adverse events.
Acupuncture Points* ; Acupuncture* ; Analgesia, Patient-Controlled ; Analgesics ; Anesthesia ; Arthroplasty, Replacement, Knee ; Capsicum* ; Hand* ; Humans ; Knee* ; Pain Management* ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Visual Analog Scale

It is well known that the brain-injured patients with tracheostomy is prone to frequent tracheopulmonary aspiration and dysphagia problems. We experienced two brain-injured patients with dysphagia, who revealed the improvement of clinical and videofluoroscopic parameters after application of Passy-Muir speaking valve (PMV 2000(R), Passy-Muir Inc., USA). Two brain-injured patients had kept on nasogastiric and tracheostomy tubes. After PMV application for 2 weeks, the frequency of aspiration decreased, sleep hygiene and emotional lability improved, and also videofluoroscopic parameters such as pharyngeal delay time, pharyngeal transit time, and epiglottic closure were improved. Eventually, they could be free from tracheostomy tubes within 1 month after PMV application.
Brain Injuries ; Deglutition Disorders* ; Humans ; Hygiene ; Tracheostomy