1,721,450 research outputs found

    한국인 중증 건선 환자에서 생물학적 제제 치료 전환에 대한 임상적 특징과 치료 방향에 대한 후향적 단일기관 연구

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    Background: Since the advent of biologics, they have been an efficient treatment for severe psoriasis vulgaris. Psoriasis that is refractory to biologics is associated with factors, such as old age, a high initial psoriasis area and severity index, a high body mass index (BMI), and nail involvement. Objective: We evaluated the clinical characteristics and differences in laboratory parameters in patients witfi severe psoriasis who switched biologics at least once. Methods: We analyzed the demographics, medical records, and laboratory data of 29 Korean patients who had switched biologics. Patients were classified into two groups based on the number of times they switched to biologics. Results: The reasons for switching biologics in the 29 patients were primary failure (37.9%), secondary failure (58.6%), and occurrence of adverse events (3.5%). The multiple switching group showed higher mean values than the single switching group for the factors associated with low efficacy of biologics, such as age at initial presentation (43.4±9.6 years vs. 42.1 ±12.1 years), an initial psoriasis area severity index (15.3±6.3 vs. 12.9±4.4), and a BMI (27.4±4.0 kg/m2and 26.3±3.4 kg/m2), respectively. Conclusion: In this single-centered study, secondary failure was the most common reason for switching biologics. Higher mean values for factors affecting the efficacy of biologics were noted in the multiple switching group; however, the difference was not statistically significant. When choosing biologics for patients, dermatologists should be mindful of this as they select the second-line biologics

    Simulation of cylindrical plunge grinding based on the behaviour of cutting edge wear

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    In cylindrical plunge grinding, a series of workpieces are ground successively without intermediate dressing of the wheel. Through the grinding, the wheel characteristic is continuously changed by the wear, fracture and new exposure of abrasive grains, having a profound effect on the grains on wheel surfaces in the cylindrical grinding process are developed to make it possible to describe the time dependent results of grinding and to establish the grinding operation standards capable of estimating grinding wheel performance and selecting grinding conditions, in which many parameters in actual grinding operations are considered. This simulation system can display its results in graphical form including the time dependent results and the effects of various parameters as well as optimization capabilities. This simulation has the same effects as many grinding experiments, and capable of selecting the optimum grinding wheels and conditions

    중등도 및 중증 판상 건선에서 인터루킨-17 억제제와 인터루킨-23 억제제의 장단기 효과 비교: 단일 기관의 경험

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    Background: Interleukin (IL)-17 and IL-23 inhibitors have helped achieve clear skin in many patients with psoriasis. However, real-world data to compare short- and long-term efficacy of these biologies in Korean patients are lacking. Objective: To compare short- and long-term efficacy of IL-17A and IL-23 inhibitors in patients with moderate-to-severe psoriasis.Methods: We retrospectively evaluated efficacy of IL-17A and IL-23 inhibitors among patients treated at Ajou University Hospital from 2017 to 2022. The specific agents studied were as follows: secukinumab, 32 patients; ixekizumab, four patients; guselkumab, 13 patients; and risankizumab, 31 patients. Patients who were followed up for less than a year or changed biologies were excluded.Results: The rates of psoriasis area and severity index (PASI) 90 achievement of secukinumab were 62.5%, 86.7%, 89.3%, 80.8%, and 70.8% at weeks 16, 40, 88, 112, and 136, respectively. For ixekizumab, the PASI90 achievement rates were 75%, 100%, 75%, and 100% at weeks 16, 40, 64, and 88, respectively. The PASI90 achievement rates of guselkumab were 53.8%, 76.9%, 72.7%, and 77.8% at weeks 20, 44, 68, and 92, respectively. For risankizumab, PASI90 achievement rates were 69.7%, 90.0%, 93.7%, and 100% at weeks 28, 52, 76, and 100, respectively. Before 52 weeks, PASI90 achievement was significantly lower with guselkumab than with secukinumab (hazardratio=0.22). After 52 weeks, PASI90 achievement was significantly higher with risankizumab than with secukinumab (hazard ratio=2.00).Conclusion: PASI90 was achieved faster with IL-17A inhibitors than with IL-23 inhibitors. However, IL-23 inhibitors afforded the maintenance of a higher PASI score after 52 weeks
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