• Title/Summary/Keyword: 스테로이드 요법

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The Effect of Methylprednisolone Pulse Therapy against Steroid Resistant Nephrotic Syndrome in Children (스테로이드 저항성 신증후군 환아에서의 Methylprednisolone 충격 요법의 치료 효과)

  • Lee Chang-Youn;Ha Il-Soo;Cheong Hae-Il;Choi Yong
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.123-129
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    • 1997
  • Purpose : The Childhood Steroid Resistant Nephrotic Syndrome (SRNS) has a poor prognosis and there has been no effective therapy against SRNS of children. In 1990, Mendoza have reported that methylprednisolone pulse therapy was effective against SRNS of children. But in 1992, Waldo have reported that methylprednisolone pulse therapy was not as effective as in the report of Mendoza. So, retrospectively, we have studied 20 korean children with SRNS to evaluate the effect of methylprednisolone pulse therapy, Methods : Mothylprednisolone pulse therapy were given to 20 korean children with SRNS who admitted to Seoul National University Hospital from 1990 to 1995 and follow up was done Results : 1) During methylprednisolone pulse therapy, remission of nephrotic syndrome was induced in 45% of patients. 2) during follow up after the end of methylprednisolone pulse therapy, remission of nephrotic syndrome was maintained in 45% of patients. 3) 25% of patients has progressed to chronic renal failure. Conclusion : We think that the methylprednisolone pulse therapy is a effective therapy against SRNS of children with the 45%, remission rate of of SRNS in Korean Children

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Therapeutic Effect of Plasmapheresis in Relapsed Focal Segmental Glomerulosclerosis after Steroid Pulse Therapy (스테로이드 충격요법 후 재발된 국소성 분절성 사구체 경화증에서 혈장반출법의 치료 효과)

  • Kim Lan;Kim Eun-Mi
    • Childhood Kidney Diseases
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    • v.7 no.1
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    • pp.1-8
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    • 2003
  • Purpose : Focal segmental glomerulosclerosis(FSGS) is known to have a poor prognosis and a poor response to treatment. We performed a combination therapy of plasmapheresis, steroid pulse and immunoglobulin in 4 patients with relapsed steroid dependent(SD) or steroid resistant(SR) FSGS after steroid pulse therapy. Materials and Methods : 8 cycles of plasmapheresis were performed in 4 patients with biopsy proven FSGS who had relapsed after steroid pulse therapy from March 1988 to July 2002. Clinical findings and treatment courses were reviewed retrospectively. Results : Among the 4 patients, there were 3 males and 1 female. After 8 cycles of plasmapheresis, clinical remissions were obtained. Two of the four patients had two relapses and received 2 more cycles of plasmapheresis which resulted in remissions. One of these patients had two further relapses and was treated with oral steroid resulting in clinical remission. Three patients have maintained normal serum creatinine level and glomerular filtration rates during the follow-up period of 10 years, and the other 1 patient for 5 months. Conclusion : A combination therapy of plasmapheresis, steroid pulse and immunoglobulin led to a complete remission in patients with FSGS who were SD or SR and was effective in maintaining normal renal function.

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Corticosteroids Add-on Therapy in the Acute Phase of Kawasaki Disease (고위험군 가와사끼병에서 스테로이드 추가 요법의 효과)

  • Kang, Seon-Mi;Moon, Eun-Kyung;In, Su-Mi;Kil, Hong-Ryang
    • Clinical and Experimental Pediatrics
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    • v.45 no.12
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    • pp.1571-1576
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    • 2002
  • Purpose : Recently, clinical trials of steroid add-on therapy were reported with variable results in Kawasaki disease. We analyzed the clinical outcomes of patients at high risk of with Kawasaki disease(${\geq}4$ points of Harada score) treated by three commonly used different treatment regimens, with or without corticosteroids. Methods : Medical records of 96 children with Kawasaki disease treated with one of the threee regimens were reviewed retrospectively. Regimen 1 was aspirin(100 mg/kg/day) plus intravenous gamma globulin 2 g/kg single dose; regimen 2, aspirin(100 mg/kg/day) plus intravenous gamma globulin 1 g/kg single dose; regimen 3, regimen 2 plus prednisolone(2 mg/kg/day), followed by tapering two weeks and pulse therapy of methyl prednisolone performed in cases of retreatment. Also low dose aspirin was given in all three regimens for eight weeks after the acute phase. The cardiovascular and laboratory evaluations were performed on acute phase, immediate after acute phase, and subacute phase, eight weeks after treatment. Results : The frequency of coronary artery lesions and laboratory findings in the three different regimens were similar. The more rapid control of fever after treatment was noted in regimen 3. Furthermore the frequency of retreatment was decreased in regimen 3 compared to the other two regimens. Conclusion : Steroid add-on therapy showed some beneficial outcome compared to conventional treatment regimens. The role of steroid in the treatment of Kawasaki disease should be reassessed in systemic manner.

A Case Report on Bee Venom Acupuncture for Patient with Osteo-Arthritis of Knee Joint, Diabetic Mellitus, and No Response for Steroid Injection (관절강내 Steroid injection에 호전되지 않은 DM을 가진 OA환자에 대한 봉독요법 치험1례)

  • Han, Soon-Hyun;Youn, You-Suk;Kim, Sung-Soo;Chung, Won-Suk
    • The Journal of Korea CHUNA Manual Medicine
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    • v.4 no.1
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    • pp.17-28
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    • 2003
  • We experienced a patient(53-year-old female) with knee joint effusion, pain and stiffness who had not responded to steroid injection therapy, significantly improved by bee venom acupuncture in clinical symptom. And for a opinion that prohibited bee venom acupuncture on DM because of increasing serum glucose level by increasing serum cortisol level, we also experienced that serum glucose level of DM patient stabilized by bee Venom acupuncture treatments, so we report this case with literature review of articles.

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Sarcoptic Mange and latrogenic Hyperadrenocorticoidism in a Dog Undergoing Hyposensitisation for Atopy based on RAST Testing (방사선 알레르기 흡착 시험법(Radioallergosorbent testing, RAST)에 기반을 둔 아토피에 대한 저감작을 경험 중인 개에서의 천공개선충과 임상수의사에 의해 야기되는 고부신피질양증)

  • Burton Greg
    • Journal of the korean veterinary medical association
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    • v.38 no.6
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    • pp.549-558
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    • 2002
  • 3.5살짜리 래브라도 리트리버(Labrador Retriever)는 매일 처방되는 피질스테로이드제에 무반응으로 비계절적, 심한 소양증을 2년간 앓고 있는 병력을 갖고 있었다. 공기유래 알레르겐(알러젠; Allergens)들에 대한 시험관내 RAST1(Radioallergosorbent testing; 방사선 알레르기 흡착 시험법)에 양성으로 나타난 것을 기초로 한 면역요법(Immunotherapy)을 18개월 동안 시행했으나 성공적이지 않았다. 부신피질호르몬(Adrenocorticotropic Hormone, ACTH)자극 시험법은 이것이 본래 임상수의사에 의해 발생(Iatrogenic)된 것임을 예시하여준다. 피부 찰과물(Skin scrapings)을 검사한 결과 개 천공개선충(Sarcoptic mange)이라는 진단이 내려졌다. 이버맥틴(Ivermectin)치료효과와 피질스테로이드(Corticosteroid)의 투약중지에 대한 반응이 극적으로 나타났다. 10개월 추적기간(10-month follow-up period)동안에 이 질병은 재발되지 않았다. 이것은 비록 계절적인 알레르겐을 배제하기 위해 긴 기간동안 추적이 필요하였으나 개 천공개선충이 오히려 피질스테로이드요법에 대한 2차적인 것보다는 1차적인 질병이라는 것을 말해준다. 아토피의 진단을 위해 혈청학적 시험법의 이용이 논의되었다.

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Efficacy of Nutritional Therapy in Children with Crohn Disease (소아 크론병에서 영양 치료의 효과)

  • Suh, Hyun Ah;Kim, Sung Eun;Jang, Joo Young;Kim, Bong Jin;Kim, Joon Sung;Lee, Sun Youn;Chang, Soo Hee;Kim, Kyung Mo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.2
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    • pp.210-217
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    • 2006
  • Purpose: Crohn disease (CD) in children is frequently complicated by malnutrition and growth retardation. Conventional treatment with corticosteroid may also affect the growth of children, which may be alleviated by nutritional therapy. Therefore, we performed this study to evaluate the role of nutritional therapy in the treatment of CD in children. Methods: The study cohort consisted of thirty children under the age of 17 years, admitted to the Asan Medical Center from 2001 to 2005. While 11 children received nutritional therapy (NT) with an elemental diet, 19 received conventional corticosteroid therapy (ST). Comparative analysis was performed for the rate of the induction of remission, recurrence, disease activity index of pre and post-treatment, and changes of the growth using mean standard deviation score for weight (zW) and height (zH). Results: Ten of 11 children with NT and 18 of 19 children with ST completed the therapy. Two of them were lost to follow-up during the treatment. All 10 children with NT and 15 of 18 children with ST achieved remission. While there was no recurrence in children with NT, 7 with ST showed recurrence within 1 year. Pre- and post treatment Pediatric Crohn disease Activity Index (PCDAI) did not show a difference between the two groups. There were no differences in zW and zH between the two groups after 1 year of follow-up. Conclusion: This study showed that nutritional therapy could be considered instead of steroid therapy for treatment of children with CD. However, a long-term study will be needed to determine the long-term efficacy.

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The Effects of Intravenous Methylprednisolone Pulse Therapy by Mendoza Protocol in Primary and Secondary Nephrotic Syndrome (일차성 및 이차성 신증후군에서 Mendoza Protocol에 의한 Intravenous Methylprednisolone Pulse Therapy의 효과)

  • Lee Kyoung-Jae;Han Jae-Hyuk;Lee Young-Mock;Kim Ji-Hong;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.117-124
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    • 2001
  • Purpose : Since Mendoza(1990)'s report that long term methylprednisolone pulse therapy by Mendoza protocol (MP therapy) is a good treatment option in focal segmental glomerulosclerosis(FSGS), there have been reports of the effects of this therapy in steroid-resistant nephrotic syndrome. However, no studies have been performed on the effects of MP therapy in steroid- dependent nephrotic syndrome and secondary nephrotic syndrome. In this study, we investigated the effects of long term MP therapy in primary and secondary nephrotic syndrome in which previous treatment options were not effective. Methods : We chose 10 children who were diagnosed with steroid-dependent minimal change nephrotic syndrome(SD-MCNS), who had shown frequent relapse during the immunocompromised or cytotoxic therapy Period, and 6 children with FSGS and 5 children with secondary nephrotic syndrome children, who had shown no response during the previous therapy period. We treated these patients according to Mendoza protocol involving infusions of high doses of methylprednisolone, often in combination with oral cyclophosphamide for 82 weeks. Results : In all the 10 children with SD-MCNS, complete remission was visible on average of $18{\pm}9$ days after MP therapy was started. However, all these children relapsed during or after MP therapy. In these children, the mean relapse rate prior to MP therapy was $2.1{\pm}1.0$ relpases/year, which was reduced to $1.4{\pm}0.9$ relapses/year during MP therapy(P>0.05) and rose to $2.7{\pm}1.0$ relapse/year after MP therapy. Of the 6 children with FSGS, 4 children($67\%$) showed complete remission, of whom 3 children($50\%$) remained in the remission status during the follow up period, $1.2{\pm}0.7$ years, after the end of MP therapy. 2 children($33\%$) showed no response. All of the 5 children with secondary nephrotic syndrome showed remission and remained in the remissiom status during the follow up period, $1.7{\pm}0.6$ years The only side effect of MP therapy was transient hypertension in 10 children of ail subjects during the intravenous infusion of methylprednisolone. Conclusion : We conclude that although long term MP therapy is not effective in the treatment of SD-MCNS, it is an effective therapy against intractable FSGS and secondary nephrotic syndrome. (J Korean Soc Pediatr Nephrol 2001 ; 5 : 117-24)

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Topical Steroid Therapy using Stent on Chronic Ulcerative Gingival Lesions (스텐트를 이용한 만성 궤양성 치은 병소의 국소 스테로이드 치료)

  • Park, Hyung-Uk;Ahn, Hyung-Joon;Choi, Jong-Hoon;Kwon, Jeong-Seung
    • Journal of Oral Medicine and Pain
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    • v.35 no.4
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    • pp.259-264
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    • 2010
  • The majority of chronic gingival ulcerative lesions are known to be due to autoimmune disease such as oral lichen planus, benign mucous membrane pemphigoid or pemphigus vulgaris. Topical or systemic corticosteroids are mainly used and adjuvant drugs like immunosuppressant, anti-inflammatory drugs, antimalarials or antimetabolites can also be prescribed. Because systemic corticosteroids causes various side effects, such as gastrointestinal disturbance, osteoporosis, diabetes or adrenal suppression. So, topical steroid therapy is main treatment for chronic gingival ulcerative lesion confined to small area. However, there's also limitation of topical corticosteroids. The effect of the corticosteroids decreases due to salivary flow and the movement of the tongue, lips, or buccal mucosa. When the lesions are widely distributed or positioned deeply in oral cavity, it is hard to apply the medication on patients' own. Moreover, it can be applied to unaffected mucosa. Although occlusive steroid therapy using stent was reported to minimize taking steroid and overcome the faults of applying topical steroids, it has been used less frequently in the clinical field. Therefore, this report is going to find out the usefulness and the way to utilize clinically through the case which acted satisfactorily by performing topical steroid therapy using stent on chronic ulcerative gingival lesions.

A Case of Prurigo Nodularis (결절성 양진 치험 1례)

  • Weon, Young-Ho;Cho, Young-Chun
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.29 no.4
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    • pp.232-238
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    • 2016
  • Objectives : The purpose of this study is to know the effect of Korean medical treatments on prurigo nodularis. Methods : We treated a 9-years-old boy patient with prurigo nodularis with Korean Medicine. After Korean medical treatment for 6 months, we measured the change of nodule and itching. Results & Conclusions : Symptoms of prurigo nodularis were improved remarkably. Nodule was reduced and itching was removed. Thus Korean medical treatments are effective on prurigo nodularis.