• Title/Summary/Keyword: 스테로이드 요법

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The Effect of Steroid on the Treatment of Endobronchial Tuberculosis (기관지 결핵 치료에 있어서 스테로이드의 효과)

  • Sung, Yun-Up;Kim, Sang-Hoon;Shin, Jong-Wook;Lim, Seong-Yong;Kang, Yun-Jung;Koh, Hyung-Gee;Park, In-Won;Choi, Byoung-Whui;Hue, Sung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.2
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    • pp.130-141
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    • 1995
  • Background: Endobronchial tuberculosis is one of the serious complications of pulmonary tuberculosis. Without early diagnosis and proper treatment of endobronchial tuberculosis, bronchostenosis can leave and lead to the collapse of distal lung parenchyme, bronchiectasis, and secondary pneumonia accompanied with moderate to severe dyspnea, cough, hemoptysis, and localized wheezing. Therefore steroid therapy has been tried to prevent bronchostenosis. But the effect of steroid therapy on the endobronchial tuberculosis is not definite at present. We tried to elucidate the effect of steroid on the treatment of endobronchial tuberculosis for prevention of bronchostenosis. Methods: We observed the initial and sequential bronchoscopic findings, pulmonary function tests and simple chest roentgenograms in 58 patients diagnosed as endobronchial tuberculosis and admitted to Chung-Ang university hospital from 1988 to 1992. The patients in nonsteroid group (n=39) were treated with anti-tuberculosis chemotherapy only and steroid group(n=17) with combined steroid therapy. Sequential bronchoscopic findings, pulmonary function tests, and chest roentgenograms were comparatively analyzed between the two groups. Results: 1) The endobronchial tuberculosis was highly prevalent in young females especially in third decade. 2) Both actively caseating type and the stenotic type without fibrosis was the most common in the bronchoscopic classification. 3) The sequential bronchoscopic findings in steroid group 2 months after treatment showed no significant improvements compared with nonsteroid group. 4) There was no significant difference between the two groups in the sequential bronchoscopic improvements according to bronchoscopic types. 5) We did not find any significant difference in improvements on follow-up pulmonary function tests and simple chest roentgenograms between the two groups 2 month after treatment. 6) There was no significant adverse effect of steroid during the treatment. Conclusion: Combined steroid therapy provably would not influence outcome of the treatment of endobronchial tuberculosis.

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The Prognosis of Focal Segmental Glomerulosclerosis Patients with Methylprednisolone Pulse Therapy Alone (Methylprednisolone 충격 요법만 받은 국소성 분절성 사구체 경화증 환아의 예후)

  • Kim, Joung-A;Park, Kwang-Sik;Shin, Jae-Il;Jeong, Il-Cheon;Kim, Ji-Hong;Kim, Pyung-Kil;Jeong, Hyun-Joo;Lee, Jae-Seung
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.178-184
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    • 2007
  • Purpose : Since the first report by Mendoza in 1990, there have been several studies reporting that long-term intravenous methylprednisolone(MP) pulse therapy combined with cyclosporin A(CsA) or cyclophosphamide might be beneficial for the treatment of steroid resistant focal segmental glometulosclerosis(FSGS). We investigated the therapeutic effect of long-term MP pulse therapy without CsA or cyclophosphamide on steroid resistant FSGS. Methods : The medical records of the 10 steroid resistant FSGS patients who were treated with MP pulse therapy by the Mendoza protocol without CsA or cyclophosphamide in our hospital were retrospectively reviewed. Results : The median age at onset was 2.6 years(range 1.1-10.6 years) and the median age at the initiation of therapy was 5.7 years(range 1.8-20 years). The median duration of follow-up was 35 months(range 4-132 months). At the end of therapy, 5 patients achieved complete remission(50%) and 2 partial remission(20%), one of whom relapsed after the therapy. Three patients did not respond to the therapy, two of whom progressed to end-stage renal failure during the therapy eventually requiring kidney transplantation. Conclusion : Intravenous long-term MP pulse therapy without CsA or cyclophosphamide by the Mendoza protocol may be effective in a subset of patients with steroid-resistant FSGS.

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Conservative Management in Simple Bone Cyst (단순 골 낭종의 보존적 치료)

  • Kim, Ji-Youn;Cho, Yong-Jin;Shin, Kyoo-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.2
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    • pp.51-57
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    • 2011
  • Purpose: This study evaluated the results of conservative treatment for simple bone cyst. Materials and Methods: We studied 126 cases of simple bone cyst, which were treated by observation or steroid injection from February 1990 to May 2010. Their mean age at diagnosis was 14 years (${\pm}9$ years, 2-60 years) and the mean follow-up duration for this study were 41 months (${\pm}37$ months, 12-159 months). Observation and steroid injection was applied for conservative management of simple bone cyst and results was scored by modified Neer classification. Results: 31 cases (24.6%) were treated by observation and 95 cases (75.4%) were treated by steroid injection. The 95 patients were treated by a mean of 1.1 (${\pm}0.9$, 0-4) steroid injections and a single steroid injection was given in 65 cases (51.6%). The 102 cases (80.9%) were resulted in modified Neer classification I and II which could be considered as healing of simple bone cyst. Conclusion: Conservative management can be considered as an initial treatment for simple bone cyst with good result.

The Efficacy of Added Montelukast in Persistent Asthmatics Who Were Not Completely Controlled on Inhaled Corticosteroids and Inhaled Long-acting β2-agonists (흡입 스테로이드와 지속성 베타2 항진제의 병용요법으로 완전히 조절되지 않는 천식 환자에서 추가 montelukast의 효과)

  • Choi, Jeong-Hee;Park, Hae-Sim;Lee, Kwan-Ho;Shim, Jae-Jeong;Uh, Soo-Taek;Lee, Sang-Pyo;Lee, Yong-Chul;Choi, Won-Il;Lee, Jae-Ho;Kim, Joo-In;Lee, Myung-Goo;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.4
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    • pp.337-345
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    • 2007
  • Backgrounds: Although glucocorticoids are one of the most potent anti-inflammatory agents, they have limited effect on cysteinyl leukotriene biosynthesis. In addition, the response to inhaled corticosteroids (ICS) and inhaled long-acting ${\beta}_2-agonists$ (LABA) combination therapy in moderate to severe persistent asthmatics varies. Additional therapy with leukotriene receptor antagonists (LTRA) in patients with moderate to severe asthma suboptimally controlled with ICS and LABA combination therapy would be complementary to asthma control. Methods: One hundred and ninety eight asthmatics entered a 2 month, open-label descriptive study. Patients suffering from persistent asthma and suboptimally controlled on a combination therapy of fluticasone/salmeterol or budesonide/formoterol were given montelukast 10 mg daily as an add-on therapy. The level of asthma control was assessed using the Asthma Control Questionnaire (ACQ) including $FEV_1%$ predicted at the baseline and after a 2-month treatment with montelukast. A global evaluation of the treatment was also made by the patients and physicians. Results: The mean ACQ score decreased significantly on montelukast ($11.5{\pm}5.4$ at baseline vs. $6.7{\pm}5.0$), with a significant improvement in all individual symptom scores (p<0.01). The $FEV_1%$ predicted values did not show any significant change. 59.9% of patients and 59.4% of physicians reported global improvement in their asthma (${\kappa}=0.85$). Conclusion: These results suggest that the addition of montelukast in patients with persistent asthma that is suboptimally contolled by combination therapy of ICS and LABA might confer complementary effects on asthma control.

Comparison of Efficacy of Steroid Oint with Different Potency in Phimosis (생리적 포경 치료를 위한 역가가 다른 스테로이드 연고의 효과 비교)

  • Hwang, In Ok;Lee, Eun Sil;Park, Yong Hoon
    • Clinical and Experimental Pediatrics
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    • v.48 no.6
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    • pp.594-598
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    • 2005
  • Purpose : Phimosis is the inability to retract the foreskin of the penis over the glans of the penis. Even though phimosis is not pathogenic, the presence of phimosis is known to increase the risk of urinary tract infection in infancy. The use of topical steroids has been advocated as a safe and economical alternative to surgical intervention. The purpose of the study was to assess the effectiveness of topical steroids for the treatment of phimosis in young boys. Methods : A total of 53 boys with phimosis were divided into two groups to distinguish between the efficacy of low-potency topical steroid(group 1, 27 cases) and of high-potency topical steroid (group 2, 26 cases). Results : The success rate increased in the process of time. After 6 weeks, the success rate was 21 cases in group 1 and 22 cases in group 2. There was no significant differences in treatment outcomes between the two groups. The age of the boys, the appearance of prepuce prior to treatment, and the presence of previous symptoms, including symptoms of UTI, and ballooning of the prepuce at micturation had no significant difference on treatment outcomes. Conclusion : Topical steroid was effective in treatment of phimosis in boys younger than 4 years old. Although treatment outcomes between low- and high-potency topical steroids were not significantly different, those treated with a high-potency steroid cream showed more fast improvement. Further studies are necessary to assess systemic side effects of steroid treatment, duration of treatment and prevention of genitourinary tract infection in male infants.

The Effect of Steroid Injection of Simple Bone Cyst in Adults (성인에서 발생한 단순성 골 낭종에 대한 스테로이드 주입의 효과)

  • Yang, Jun-Young;Lee, June-Kyu;Kim, Dong-Hee;Kim, Tae-Hoon
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.1
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    • pp.23-29
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    • 2006
  • Purpose: To evaluate the effectiveness of steroid injection for treatment of simple bone cyst in adults. Materials and Methods: 11 patients who were able to be followed up from February 1998 to February 2003. These lesions were attained by needle aspiration or trepanation and 80 mg to 200 mg of Depo-medrol (methylprednisolone acetate, Shin Poong Pharm. Co., Korea) was injected. The follow-up roentgenograms were done every 2 weeks, and if there were no evidence of recovery, re-injection was done 8 weeks later. Injection has done maximally 5 times, and we evaluated the result with modified Neer, Pentimalli, Scaglietti and Sandra classification. Results: There were no cases in which one Injection was enough for full recovery, and 3 cases after 2 injections, 3 cases after 3 injections, 2 case after 5 injections had good result. but 2 cases after more than 5 injections did not show improvements and are currently under observation. One case showed a increase in size of the bone cyst after 2 injections of steroid and underwent curettage and autogenous bone graft. Overall outcomes by Pentimalli classification were good in One case, fair in 7 cases and poor in 3 cases at final follow-up. Conclusion: Local injection of steroids is effective method in adults and can be considered as a first line treatment modality.

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No Effect of IV cyclophosphamide in Children with Steroid Resistant Nephrotic Syndrome (스테로이드 저항성 신증후군 소아 3례에서 Cyclophosphamide 정맥투여요법의 치료실패)

  • Min, Su-Jeen;Lee, Chang-Yeun
    • Childhood Kidney Diseases
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    • v.2 no.2
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    • pp.183-186
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    • 1998
  • Steroid Resistant Nephrotic Syndrome(SRNS) in children has poor prognosis and no effective therapy. In 1994, Ravi Elhence have reported that IV cyclophosphamide therapy was effective against SRNS of children. So, we evaluated the efficacy of IV cyclophosphamide in 3 children with biopsy proven steroid-resistant MCNS. And the result was the rapeutic failure. In conclusion, IV cyclophosphamide therapy wass not effective against SRNS of children.

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영구 기공협착(tracheal stenosis)의 치료

  • 최종욱;김혜정;석윤식;박호정
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1995.04a
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    • pp.91.1-91
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    • 1995
  • 후두 또는 하인두 암종에 대한 광범위 절제 후 효율적인 호흡을 위하여 영구기공(permanant tracheostome)을 만들어 주게 되는데, 여러 가지 원인에 의하여 기공 협착이 발생하면 가피형성, 혈담, 호흡곤란 등을 초래하게 된다. 현재까지 기공협착의 치료는 Z형 성형술, 국소 스테로이드요법, 스텐트 삽입법 등 다양하게 이용되고 있으나 만족할 만한 결과를 얻는데 한계가 많았다. 이러한 기공협착의 치료에 도움을 얻고자, 저자들이 경험한 12례의 기공협착 환자에 대하여 기관전진점막피판(tracheal advancement flap)을 이용하여 성공적으로 치료하였기에 요약 보고하고자 한다.

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Comparison of the Therapeutic Efficacy of Methylprednisolone Pulse Therapy and Oral Steroid Therapy in Children with IgA Nephropathy and HSP Nephritis Combined with Proteinuria (단백뇨를 동반한 IgA 신병증 및 HSP 신염을 가진 소아에서 메틸프레드니솔론 충격요법과 경구 스테로이드 요법의 비교)

  • Ahn, Ji Young;Moon, Jung Eun;Hwang, Young Ju;Choi, Bong Seok;Ko, Cheol Woo;Cho, Min Hyun
    • Childhood Kidney Diseases
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    • v.18 no.1
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    • pp.24-28
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    • 2014
  • Purpose: The purpose of this study was to assess the therapeutic efficacy of methylprednisolone pulse therapy in children with IgA nephropathy and Henoch- Sch$\ddot{o}$nlein Purpura (HSP) nephritis combined with proteinuria. Methods: We retrospectively reviewed the clinical records of 21 patients who were diagnosed with IgA nephropathy and HSP nephritis based on percutaneous renal biopsy. Of the 21 patients, 15 were diagnosed with IgA nephropathy and 6 were diagnosed with HSP nephritis. They had mild to severe proteinuria at the time of diagnosis or during follow-up. Group 1 (n=7) received methylprednisolone pulse therapy three times every couple of months, and Group 2 (n=14) received oral steroid therapy. The follow-up periods for Group 1 and 2 were 14.0 (9-54) months and 26.5 (14-34) months, respectively. There was no significant difference in the follow-up duration between the two groups. Results: The average age at diagnosis and biopsy was lower in Group 1 compared to Group 2, but it was not significantly different. At admission, all patients in both groups had hematuria and 5 patients (71.4%) of Group 1 and 14 patients (100 %) of Group 2 had proteinuria. Before treatment, there was no significant difference of spot urine protein/creatinine ratio between the two groups. During followup, 7 patients of Group 1 (100%) and 10 patients of Group 2 (71.4%) showed complete improvement of proteinuria and the spot urine protein/creatinine ratio in Group 1 was significantly lower than Group 2. Conclusion: In patients with IgA nephropathy and HSP nephritis with proteinuria, methylprednisolone pulse therapy was more effective than oral steroid therapy in the reduction of proteinuria. To investigate the effects on long-term prognosis, large-scale prospective studies are needed.

Effects of host modulation by nonsteroidal anti-inflammatory drugs on periodontal disease: a systematic review and meta-analysis (비스테로이드성 항염증제를 이용한 숙주조절이 치주질환에 미치는 영향: 체계적 고찰 및 메타 분석)

  • Kang, Dae-Young;Cho, In-Woo;Shin, Hyun-Seung;Ahn, Hyeong-Sik;Kim, Hyun-Jung;Park, Jung-Chul
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.1
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    • pp.7-18
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    • 2017
  • Purpose: Nonsteroidal anti-inflammatory drugs that prohibit biosynthesis of arachidonic acid metabolites have been considered potent host modulation agents. The aim of this review was to determine the effect of nonsteroidal anti-inflammatory drugs adjunctive with nonsurgical periodontal treatment in patients with periodontal disease. Materials and Methods: Three electronic databases were searched to identify relevant studies. The methodological quality and mean differences of the change in clinical attachment level and probing depth were analyzed according to Cochrane review methods. Results: Twelve studies were included in the methodological assessment and nine studies were suitable for inclusion in the meta-analysis. The mean difference in the clinical attachment level gain did not differ significantly between the nonsteroidal anti-inflammatory drugs and control groups at any observation time. The highest mean difference in clinical attachment level gain was 0.30 mm at 4 weeks (95% confidence interval = -0.37 to 0.97). There was a significant mean difference in the probing depth reduction, of 0.34 mm (95% confidence interval = 0.29 to 0.40) at 6 weeks. Conclusion: Therefore, nonsteroidal anti-inflammatory drugs have additional therapeutic effect when administrated with nonsurgical periodontal treatment.