• Title/Summary/Keyword: Corticosteroid

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Respiratory Review of 2014: Asthma

  • Yoon, Ho Il
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.6
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    • pp.237-242
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    • 2014
  • Asthma is a chronic inflammatory disease of the airway that comprises a variety of etiologies and inflammatory phenotypes. Clinically, there is a wide range of patients with varying severities and responses to individual drugs. The introduction of inhaled corticosteroid therapy has dramatically changed the treatment of asthma. Recent development of new therapies suggests the possibility of another breakthrough. These can be categorized as follows: anti-cytokine therapies that usually target eosinophilic inflammation, sublingual immunotherapy, and bronchial thermoplasty. In this paper, we will review the major articles related to asthma treatment that were published in 2013.

Sacral Intradural Cysticercosis Misdiagnosed as Brain Tumor Metastasis

  • Kim, Seok-Won;Lee, Seung-Myung
    • Journal of Korean Neurosurgical Society
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    • v.37 no.1
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    • pp.67-69
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    • 2005
  • Spinal intradural cysticercosis is a rare manifestation of neurocysticercosis that may present as an isolated lesion. We report a case of sacral intradural cysticercosis misdiagnosed as a metastasis through cerebrospinal fluid seeding in a 48-year-old patient who underwent ependymoma surgery 3 months ago. We performed S1-2 laminectomy with the total removal of intradural lesion. The cysticercosis was confirmed histologically. The patient was given albendazole with corticosteroid.

A Case Report of Hypopituitary Patient (뇌하수체 호르몬 기능부전증의 일례)

  • Kim, Kwang-Hyun;Lee, Bong-Won
    • The Journal of the Korean dental association
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    • v.11 no.3
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    • pp.191-194
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    • 1973
  • The Authors have observed a case of hypopituitary patient in 15 year-old Korean child for 10 months. Since he was discharged, he was taken the hormonal therapy with corticosteroid and T₃. As the result of it, his body weight increased by 1.2kg and height grew by 3cm. However it is not clear whether this growth is due to the child's natural growth or due to the above hormonal therapy.

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Fat Embolism Syndrome Which Induced Significant Cerebral Manifestation Without Respiratory Distress (호흡기 증상 없이 발생한 뇌 지방색전증 1례)

  • Kim, Hyung Geun;Lee, Kyung Mi;Kim, Ji Hye;Kim, Jun Sig;Han, Seung Baik
    • Journal of Trauma and Injury
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    • v.18 no.2
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    • pp.175-178
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    • 2005
  • Fat embolism syndrome is a collection of respiratory, neurological and cutaneous symptoms and signs associated with trauma and other disparate surgical and medical conditions. The incidence of clinical syndrome is low while the embolization of marrow fat appears to be an almost inevitable consequence of long bone fractures. The pathogenesis is a subject of conjecture and controversy. There are two theories which have gained acceptance(mechanical theory, biochemical theory). Onset of symptom is usually within 12 to 72 hours, but may manifest as early as 6 hours to as late as 10 days. The classic triad of fat embolism syndrome involves pulmonary changes, cerebral dysfunction and petechial rash. The cornerstone of treatment is preventing the stress response, hypovolemia and hypoxia and operative stabilization of fractures. Corticosteroid are the only drugs which have repeatedly shown a positive effect on the prevention and treatment of fat embolism syndrome. We report a case of post-traumatic fat embolism syndrome with severe cerebral involvement without respiratory distress. A 55 years old female had a traffic accident. She sustained pelvic bone fracture and both humerus fracture. Approximately 4 hours after the accident, mental status change developed without a focal neurologic deficits. She had no respiratory symptom and sign. Her brain MRI showed multiple cerebral fat embolism lesion. The patients received supportive treatment with corticosteroid, albumin. Her neurologic status stabilized over several days. After orthopedic surgery, she was discharged 62 days after admission.

A Case of Pyoderma Gangrenosum in Rheumotoid Arthritis Patient (류마티스 관절염 환자에서 발생한 괴저성 농피증 1예)

  • Ryu, Dong-Hwan;Kwon, Chang-Mo;Lee, Jung-Hun;Hong, Young-Hun;Lee, Choong-Ki
    • Journal of Yeungnam Medical Science
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    • v.20 no.1
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    • pp.79-84
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    • 2003
  • Pyoderma gangrenosum is uncommon neutrophilic dermatosis characterized by richness of the mature neutrophilic polynuclear dermal infiltrate. Pyoderma gangrenosum is associated with variable diseases, most commonly inflammatory bowel disease, hematological diseases, malignancies, but it is reported rarely in rheumatoid arthritis. We report a case of pyoderma gangrenosum in rheumoid arthritis patient. A 50-year-old woman admitted to our hospital due to painful pretibial ulcerative skin lesions. She had been treated as rheumatoid arthritis for 8 years. At admission, body temperature was $36.5^{\circ}C$ and other vital sign was unremarkable. Physical examination revealed right pretibial ulceration, multiple pustules on left pretibial area and both palms. Laboratory studies revealed WBC count 7,600/uL (neutrophils 60.3%, eosinophil 3.2%), hemoglobin 11.4 g/dL, platelet count 319,000/uL, ESR 65 mm/hour. Other lab findings were also unremarkable. Skin biopsy was done, which showed dense dermal infiltrate of neutrophils and wound culture were negative. By 8 weeks after systemic high dose corticosteroid (1 mg/kg/day), cyclosporine A (5 mg/kg/day), sulfasalazine 2 g therapy, symptoms and skin ulceration were being improved. Without skin relapse, she is followed up our hospital with low dose corticosteroid and sulfasalazine.

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Treatment of Atopic Dermatitis Associated with Malassezia sympodialis by Green Tea Extracts Bath Therapy: A Pilot Study

  • Kim, Hyun-Kyu;Chang, Hui-Kyoung;Baek, Seok-Yun;Chung, Jin-Oh;Rha, Chan-Su;Kim, So-Young;Kim, Beom-Joon;Kim, Myeung-Nam
    • Mycobiology
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    • v.40 no.2
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    • pp.124-128
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    • 2012
  • Multiple treatment modalities, including topical and systemic corticosteroid and phototherapy, have been used in treatment of patients with atopic dermatitis. However, long-term corticosteroid therapy may have various adverse effects. The purpose of this study was to investigate the therapeutic efficacy and safety of bath therapy using green tea extracts for treatment of patients with atopic dermatitis. A total of four patients with atopic dermatitis were enrolled in this study. A Malassezia multiplex detection kit was used in performance of multiplex PCR on clinical isolates, which confirmed Malassezia sympodialis. Subjects underwent treatment with bath therapy using green tea extracts three times per wk for a period of 4 wk. Assessment using the scoring atopic dermatitis (SCORAD) index, the visual analogue scale for pruritus, and transepidermal water loss was performed weekly. Laboratory tests were performed before and after treatment. All patients showed marked improvement on the mean SCORAD and visual analogue scale, and a significant decrease in the mean values of serum eosinophil counts was observed after treatment. Bath therapy with green tea extract is an effective, safe, and nonsteroidal therapy for treatment of patients with atopic dermatitis associated with Malassezia sympodialis.

Critical Illness-Related Corticosteroid Insufficiency in Patients with Low Cardiac Output Syndrome after Cardiac Surgery

  • Ok, You Jung;Lim, Ju Yong;Jung, Sung-Ho
    • Journal of Chest Surgery
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    • v.51 no.2
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    • pp.109-113
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    • 2018
  • Background: Low cardiac output syndrome (LCOS) after cardiac surgery usually requires inotropes. In this setting, critical illness-related corticosteroid insufficiency (CIRCI) may develop. We aimed to investigate the clinical features of CIRCI in the presence of LCOS and to assess the efficacy of steroid treatment. Methods: We reviewed 28 patients who underwent a rapid adrenocorticotropic hormone (ACTH) test due to the suspicion of CIRCI between February 2010 and September 2014. CIRCI was diagnosed by a change in serum cortisol of <$9{\mu}g/dL$ after the ACTH test or a random cortisol level of <$10{\mu}g/dL$. Results: Twenty of the 28 patients met the diagnostic criteria. The patients with CIRCI showed higher Sequential Organ Failure Assessment (SOFA) scores than those without CIRCI ($16.1{\pm}2.3$ vs. $11.4{\pm}3.5$, p=0.001). Six of the patients with CIRCI (30%) received glucocorticoids. With an average elevation of the mean blood pressure by $22.2{\pm}8.7mm\;Hg$ after steroid therapy, the duration of inotropic support was shorter in the steroid group than in the non-steroid group ($14.1{\pm}2.3days$ versus $30{\pm}22.8days$, p=0.001). Three infections (15%) developed in the non-steroid group, but this was not a significant between-group difference. Conclusion: CIRCI should be suspected in patients with LCOS after cardiac surgery, especially in patients with a high SOFA score. Glucocorticoid replacement therapy may be considered to reduce the use of inotropes without posing an additional risk of infection.

A Case of Secondary Organizing Pneumonia Associated with Endobronchial Actinomycosis (기관지 방선균증과 동반된 이차성 기질화 폐렴 1예)

  • Lee, Byoung Hoon;Lee, Ki-Deok;Kim, Sang Hoon;Woo, Jeong Joo
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.3
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    • pp.227-231
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    • 2007
  • Several types of infection can cause organizing pneumonia when the inflammatory process remains active with the further organization of the intra-alveolar fibrinous exudates, despite the control of the infectious organism by antibiotics. We report a case of 37-year-old male with secondary organizing pneumonia associated with an endobronchial actinomycosis. The patient presented with a subacute cough, sputum and fever. Bronchial biopsy revealed sulfur granule to be consistent with the actinomycosis, and percutaneous needle biopsy revealed typical pattern of organizing pneumonia. The patient was treated with the appropriate antibiotics and corticosteroid. There was rapid improvement in the symptoms and radiological findings, and after six months of treatment, the corticosteroid dose was tapered off without a recurrence of the organizing pneumonia.

Thymoma accompanying Autoimmune Hemolytic Anemia (자가 용혈성 빈혈을 동반한 흉선종 1예)

  • Lee, Sin-Hwa;Park, Neung-Hwa;Lee, Keum-Hee;Kim, Young-Woo;Jang, Tai-Weon;Jung, Maan-Hong;Jung, Gyoo-Sik;Cho, Sung-Rae
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.3
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    • pp.381-386
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    • 1995
  • Severe autoimmune hemolytic anemia was developed in the 45-year-old man whose anterior mediastinal growing mass, which was proved later as the invasive thymoma, had been found 4 years ago. The hemoglobin level was 6.2g/dl and both the direct and indirect Coombs' tests were positive. Prompt remission of the hemolytic anemia was achieved by thymectomy combined with corticosteroid therapy. Two months after the discontinuation of corticosteroid therapy his hemolytic anemia was recurred. The patient currently has been followed up for 8 months with no signs of local recurrence or hemolytic anemia and he is still receiving 15 mg of prednisolone daily.

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