• Title/Summary/Keyword: 소염제

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Chronic Recurrent Multifocal Osteomyelitis Associated With Inflammatory Bowel Disease Successfully Treated With Infliximab

  • Kwak, Shinhyeung;Kim, Dongsub;Choi, Joon-sik;Yoon, Yoonsun;Kim, Eun Sil;Kim, Mi Jin;Yoo, So-Young;Shim, Jong Sup;Choe, Yon Ho;Kim, Yae-Jean
    • Pediatric Infection and Vaccine
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    • v.29 no.2
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    • pp.96-104
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    • 2022
  • Chronic recurrent multifocal osteomyelitis (CRMO) is an inflammatory bone disorder presenting with sterile osteomyelitis, most often presenting in childhood. Although the etiology is understood incompletely, its association with other auto-inflammatory diseases including inflammatory bowel disease (IBD); psoriasis; Wegener's disease; arthritis; and synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome suggests that dysregulated innate immunity may play an important role in the pathogenesis. We report a case of a 13-year-old boy with CRMO associated with Crohn's disease (CD) successfully treated with infliximab after failure of non-steroidal anti-inflammatory drug (NSAID) treatment. He initially was diagnosed with CRMO based on symmetric and aseptic bone lesions with no fever, lack of response to antibiotic treatment, vertebral involvement, and normal blood cell counts. Despite five months of NSAID treatment, his musculoskeletal symptoms were aggravated, and he developed gastrointestinal symptoms. Finally, he was diagnosed with CRMO associated with CD. Due to the severity of symptoms, infliximab was initiated and produced symptom improvement. This case supports infliximab as another choice for treatment of bowel symptoms in addition to the bone and joint symptoms of CRMO when other first-line treatments are ineffective.

Effect of Gabapentin for the Treatment of Burning Mouth Syndrome Comorbid with Depression in Postmenopausal Women (폐경 후 여성의 우울증에 수반된 구강 작열감 증후군(Burning Mouth Syndrome)에 대한 Gabapentin의 효과)

  • Kim, Min-Jeong;Kim, Hyun-Seuk;Park, Si-Sung
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.2
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    • pp.138-142
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    • 2014
  • Burning mouth syndrome is characterized by intra-oral burning sensation without any organic abnormalities. This syndrome is associated with various etiological factors such as neuropathy, malnutrition, menopause and depression. Several medications have been tried for the treatment. Those are analgesics, hormones, anticonvulsants and antidepressants. However, optimal effective pharmacologic treatment remains still unknown. The purpose of this case study is to report the clinical effectiveness of gabapentin in the treatment of burning mouth syndrome in postmenopausal women with comorbid depression. We report two menopausal women. Antidepressants were effective for improving depressive symptoms, but it had no effects on intra-oral burning sensation. Gabapentin reduced intra-oral burning sensation effectively for all two patients. One patient reported 55% reduction(a decrease from 9 to 4 on VAS), the other patient reported 35% reduction(from 8 to 5) of the intra-oral burning sensation during 16 weeks. The minimal effective daily dose of gabapentin was 300mg. This study suggests that gabapentin might be a useful, effective therapeutic option for treating burning mouth syndrome in postmenopausal women with comorbid depression. Further prospective clinical studies are needed to investigate the effectiveness of gabapentin in patients with burning mouth syndrome.

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A Case Report of Polyarticular Type Juvenile Idiopathic Arthritis(JIA) Patient Ineffective Response to DMARDs and NSAIDs (항류마티스제(DMARDs)와 비스테로이드성 소염진통제(NSAIDs)에 반응하지 않는 다수관절형 소아기 류마티스 관절염 환아 증례 보고)

  • Yoo, Chang-Kil;Lee, Yun-Ju
    • The Journal of Pediatrics of Korean Medicine
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    • v.24 no.1
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    • pp.57-64
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    • 2010
  • Objectives This study is to examine case that has an significant result on treating Polyarticular Type Juvenile Idiopathic Arthritis(JIA) the patient who did not response to DMARDs and NSAIDs with oriental medicine. JIA is the most common form of persistent arthritis in children before age 16. The symptoms of JIA is pain and edema of joints, fever, lethargy, reduced physical activity, and poor appetite. But the symptoms vary. Methods The patient felt pain and had limitation of mobility on his joints, but the DMARDs and NSAIDs were not effective. Therefore, he was treated with oriental medicine and withdrew from DMARDs and NSAIDs. The patient took DMARDs and NSAIDs from May 2007 to November 2008(He did not took DMARDs and NSAIDs from December 2007 to June 2008), and took oriental medicine from November 2008 until now. Results The patient's pain and limited mobility on his joints, edema, morning stiffness, fatigue was gone, and could maintain the condition. He doesn't have DMARDs or any other western medicine anymore. Conclusions This study shows that a Polyarticular Type Juvenile Idiopathic Arthritis patient who had ineffective response to DMARDs and NSAIDs can reach to the clinical remission by oriental medicine treatment. His morning stiffness, fatigue, pain of joints, edema was gone and ESR was in normal range with Oriental medicine treatment.

Effect of Other Medications on the Stability of Omeprazole in Aqueous Solution for the Peptic Ulcer Disease (소화성궤양시 병용약물이 수용액 중의 오메프라졸 안정성에 미치는 영향)

  • Lee, Young-Jae;Whang, Wan-Kyunn;Cho, Seong-Wan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.11
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    • pp.3494-3499
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    • 2009
  • The stability of omeprazole in the aqueous solutions containing loxoprofen or Sodium bicarbonate was examined at room temperature. Loxoprofen or Sodium bicarbonate (60 mg) was added to omeprazole (600 ${\mu}g$/ml) solution to check the stability profile. Then, the solution was kept at room temperature for 80 hours. The concentration was assayed at each concentration by stability-indicating High performance liquid chromatography (HPLC) method. Aliquots of the solution were withdrawn at specified time intervals and assayed by chromatographic analysis for intact omeprazole. The relation between omeprazole concentration and peak area was linear from 5 to 160 ${\mu}g$/ml. The analysis method was precise with relative standard deviation (% RSD) no greater than 3.05 %. The remaining percentage-time curves revealed that omeprazole was degraded rapidly as functions of time and temperature following pseudo first-order kinetics. In conclusion, the stability of omeprazole was significantly affected by liquid solutions mixed with alkalizer (Sodium carbonate) or the NSAIDs (loxoprofen).

Comparative Analysis of Delivery Management in Various Medical Facilities (의료기관별 분만관리 양상의 비교 분석)

  • Park, Jung-Han;You, Young-Sook;Kim, Jang-Rak
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.4 s.28
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    • pp.555-577
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    • 1989
  • This study was conducted to compare the delivery management including laboratory tests, medication and surgical procedures for the delivery in various medical facilities. Two university hospitals, two general hospitals, three hospitals, two private obstetric clinics, and two midwifery clinics in a large city were selected as they permitted the investigators to abstract the required data from the medical and accounting records. The total number of deliveries occurred at these 11 facilities between 15 January and 15 February, 1989 was 789 among which 606(76.8%) were vaginal deliveries and 183 (23.3%) were C-sections. For the normal vaginal deliveries, CBC, Hb/Hct level, blood typing, VDRL, hepatitis B antigen and antibody, and urinalysis were routinely done except the private clinics and midwifery clinics which did not test for hepatitis B and Hb/Hct level at all. In one university hospital ultrasonography was performed in 71.4% of the mothers and in one general hospital liver function test was done in 76.7% of the mothers. For the C-section, chest X-ray, bleeding/clotting time and liver function test were routinely done in addition to the routine tests for the normal vaginal deliveries. Episiotomy was performed in 97.2% of the vaginal deliveries. The type and duration of fluid infused and antibiotics administered showed a wide variation among the medical facilities. In one university hospital antibiotics was not administered after C-section at all while in the general hospitals and hospitals one or two antibiotics were administered for one week on the average. In one private clinic one pint of whole blood was transfused routinely. A wide variation was observed among the medical facilities in the use of vitamin, hemostatics, oxytocics, antipyreptics, analgesics, anti-inflammatory agents. sedatives. digestives. stool softeners. antihistamines. and diuretics. Mean hospital day for the normal vaginal deliveries of primipara was 2.6 days with little variation except one hospital with 3.5 days. Mean hospital day for the C-section of primipara was 7.5 days and that of multipara was 7.6 days and it ranged between 6.5 days and 9.4 days. Average hospital fee for a normal vaginal delivery without the medical insurance coverage was 182,100 Won for the primipara and 167,300 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 82,400 Won and a multiparous mother paid 75,600 Won. Average hospital fee for a C-section without the medical insurance was 946,500 Won for the primipara and 753,800 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 256,200 Won and a multiparous mother paid 253,700 Won. Average hospital fee for a normal vaginal delivery in the university hospitals showed a remarkable difference, 268,000 Won vs 350,000 Won, as well as for the C-section. A wide variation in the laboratory tests performed for a normal vaginal delivery and a C-section as well as in the medication and hospital days brought about a big difference in the hospital fee and some hospitals were practicing the case payment system. Thus, standardization of the medical care to a certain level is warranted for the provision of adequate medical care for delivery.

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Treatment of the Headache (두통의 치료)

  • Chung, Kyung-Cheon
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.263-273
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    • 1999
  • Headache is a symptom with varied etiologies and extraordinarily frequent. Headaches can be a symptom of another diseases, such as meningitis, subarachnoid hemorrhage or brain tumor, may represent the disease entity itself as the case in migraine. The international Headache Society criteria were the first to distinguish between primary and secondary headache disorders. When evaluating a patient who presents with headache, the physician abviously needs to identify or exclude the myriad conditions that can cause secondary headache and initial diagnostic workup should be considered. If patient meets the criteria for a primary headache disorder, treatment commonly initiated without additional neurodiagnostic tests. The headache type, its associated feature, and the duration and the intensity of the pain attack all can influence the choice of acute therapy in migraine. Pharmacologically, such as NSAIDs, combination analgesics, vasoactive antimigraineous drugs, neuroleptics, antidepressants, or corticosteroids. Other approches to managing headache include a headache diary to identify triggers, biofeedback, relaxation technique and behavioral modification. Daily preventive medication should be considered by his attack frequency and intensity, and maintained for 4 to 6 months. Tension-type headaches are distinguished between episodic and chronic tension-type headache, but physician must make sure that patient is not drug-overuse or independent during symptomatic abortive therapy or preventive medication. The most difficult headache patients to treat are those with chronic daily headache. They often have physical dependency, low frustration tolerance, sleep problems, and depression. So discontinuation of overused medication is crucial. New developments in migraine therapy are broadening the scope of abortive and prophylactic treatment choices available to the physician. The enhanced ease of the use of sumatriptan and DHE will likely increase patient compliance and satisfaction.

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In Vitro Skin Irritation Test of Anti-Inflammatory Drugs (소염진통제 약물에 대한 In vitro 피부자극 시험연구)

  • Lee, Jong-Kwon;Kim, Dai-Byung;Lee, Eun-Hee;Lee, Sun-Hee;Ryu, Seung-Rel;Choi, Ki-Hwan;Kim, Yoon-Jeong;Kim, Pu-Young
    • Toxicological Research
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    • v.14 no.3
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    • pp.315-320
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    • 1998
  • In vitro skin iritation of anti-inflammatory drugs was investigated in terms of the cytotoxicity method to human skin fibroblast cells. Five anti-inflammatory drugs (Diclofenac, Naproxen, Meclofenamic acid, Ibuprofen and Fnoprofen) which are commercially available as oral preparations or injections were tested. The cytotoxicity of 5 chemicals was evaluated by using MTT[tetrazolium salt 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide] assay. NRU (neutral red uptake) assay and Alamar Blue assay after fibroblast cells had been exposed to the chemicals for 24 hours or 489 hours. The $IC_{50}$ values of the chemicals showed the comparative strength of cytotoxicity as following order of Meclofenamic acid>Diclofenac>Fenoprofen>Ibuprofen>Naproxen. The values of $IC_{50}$ determined by Alamar Blue assay were lower than those of MTT and NRU assay. These data suggest Alamar Blue assay can be useful method for assessing in vitro skin irritation potential of anti-inflammatory drugs.

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Nonsteroidal Anti-inflammatory Drugs Utilization Patterns among the Elderly with Osteoarthritis at Primary Ambulatory Care Units in Busan Metropolitan City, Korea (부산지역 의원급 외래 노인 골관절염환자의 비스테로이드소염제 사용양상평가)

  • Choi, Nam-Kyong;Kim, Yoon-I;Lee, Seung-Mi;Park, Byung-Joo
    • Journal of Preventive Medicine and Public Health
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    • v.37 no.2
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    • pp.150-156
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    • 2004
  • Objectives : To investigate the utilization patterns of non-steroidal anti-inflammatory drugs (NSAIDs) among the elderly with osteoarthritis (OA) undergoing primary ambulatory care in Busan metropolitan city, Korea. Methods : OA patients, aged 65 years and over, were identified from the Korean National Health Insurance Review Agency drug prescription database. The subjects had at least one episode of claim for OA (ICD-10-CM: M15-M19) between August 1, 2000 and February 28, 2002. Trends in the determinations of NSAIDs utilization were identified using chi-squared tests for trend. Results : There were 47,711 osteoarthritic patients. The total number of visits by these patients was 177,443, with a total frequency for NSAID prescriptions of 214,952. Seventy-nine percent of the OA patients were female. NSAIDs were prescribed on 133,284 visits (75.1%) and the proportion of prescriptions was significantly increased with age. Only the proportion of visit when NSAIDs were prescribed decreased, from 65.1 to 43.5%, during the study period (p<0.001). However, the proportion of combined treatments with anti-ulcer drugs was increased. The use of NSAIDs injections was decreased. Of the individual NSAIDs, diclofenac (28.7% of total frequency of NSAID prescriptions), piroxicam (15.0%) and talniflumate (8.7%), were the most frequently prescribed. Among the NSAIDs prescribed OA visits, 45.7% used two or more NSAIDs. Conclusion : The total proportion of NSAIDs prescribed to the osteoarthritic patients was higher than in other studies. The decline in the use of NSAIDs during the study period, and the frequent selection of safer medications, such as combination therapy with anti-ulcer drug, may reflect the risk awareness of the use of NSAIDs.

Treatment of Malignant Effusion with Intracavitary OK-432 Chemical Pleurodesis (악성흡수에 OK-432를 이용한 흉막유착술)

  • 김맹호;이헌재
    • Journal of Chest Surgery
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    • v.29 no.4
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    • pp.414-419
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    • 1996
  • To determine the efficacy of OK-432 as pleural sclerosant, we examined the outcomes in 81 patients (age : 27 to 82 years) with malignant pleural effusion and the outcomes in 64 patients ecieving OK-432 3-10KE(1 Klinische Einheit unit) through a chest tube for malignant pleural effusions. Of 81 patients with malignant pleural effusion, 40 patients had lung cancer. Lung cancer is the most frequent cause of malignant pleural effusion in men and women, in which 57 oyo of it was adenocarcinoma. Eighty seven percent of patient had respiratory symptom. Of the 64 patients with intracavitary injection of OK-432 for malignant pleural effusion, 59 patients had a complete short-term response (no fluid reaccumulation during 1 month after intracavitary injection of OK-432). Five patiens of the non-responders had partial control of effusion, with improvement in respiratory symptoms and these patients underwent thoracentesis. Of the 51 patients who survived longer than 1 month, 48 patients did not have re- accumulation of the fluid during follow up. Fever after intracavitary injection of OK-432 was a majors side effect although but that was easily controlled with non-steroidal anti inflammatory drug therapy, Thus the efficacy of intracavitary OK-4)2 injection for malignant pleural effusion was very helpful.

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DRESS syndrome with acute interstitial nephritis caused by quinolone and non-steroidal anti-inflammatory drugs (퀴놀론과 비스테로이드소염제 투여 후 발생한 급성 간질성 신염이 동반된 DRESS 증후군)

  • Kim, Soo Jin;Nam, Young-Hee;Juong, Ji Young;Kim, Eun Young;Lee, Su Mi;Son, Young Ki;Nam, Hee-Joo;Kim, Ki-Ho;Lee, Soo-Keol
    • Journal of Yeungnam Medical Science
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    • v.33 no.1
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    • pp.59-63
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    • 2016
  • Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and severe drug-induced hypersensitivity syndrome characterized by hematological abnormalities and multiorgan involvement. Liver involvement is the most common visceral manifestation. However, renal failure has been rarely described. The common culprit drugs are anticonvulsants and allopurinol. We experienced a patient with DRESS syndrome with acute interstitial nephritis caused by concomitant administration of quinolone and non-steroidal anti-inflammatory drugs (NSAIDs). A 41-year-old man presented with a diffuse erythematous rash and fever which developed after administration of quinolone and NSAIDs for a month due to prostatitis. He was diagnosed with DRESS syndrome. Skin rash, fever, eosinophilia, and elevations of liver enzymes improved with conservative treatment and discontinuation of the causative drugs. However, deterioration of his renal function occurred on day 8 of admission. The levels of blood urea nitrogen and serum creatinine increased and oliguria, proteinuria and urinary eosinophils were observed. Ultrasonography showed diffuse renal enlargement. The clinical features were compatible with acute interstitial nephritis. Despite intravenous rehydration and diuretics, renal function did not improve. After hemodialysis, his renal function recovered completely within 2 weeks without administration of systemic corticosteroid.