• 제목/요약/키워드: Corticosteroid

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Diphenylcyclopropenone (DPCP) 면역요법으로 호전된 전두 탈모증 2 예 (Two Cases of Alopecia Totalis treated with Diphenylcyclopropenone (DPCP) Immunotherapy)

  • 문석기;신영민;김찬우;신동훈;최종수;김기홍
    • Journal of Yeungnam Medical Science
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    • 제23권2호
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    • pp.232-239
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    • 2006
  • Treatments for alopecia areata include topical corticosteroid treatment, corticosteroid intralesional injection, systemic corticosteroid treatment, PUVA(psoralen-UVA) and topical immunotherapy. The therapeutic effects are variable. Alopecia totalis is hard to treat completely. Topical immunotherapy with dinitrochlorobenzene (DNCB), squaric acid dibutyl ester (SADBE) or diphenylcyclopropenone (diphencyprone, DPCP) represents the most accepted therapeutic modality for the treatment of extensive alopecia areata. We report two cases of alopecia totalis treated with DPCP. After DPCP treatment, total scalp hair was completely recovered.

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Steroid-resistant sarcoid myositis that was successfully treated with oral methotrexate

  • Noh, Kyung-Ha;Huh, So-Young;Park, Young-Eun;Shin, Jin-Hong;Kim, Dae-Seong
    • Annals of Clinical Neurophysiology
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    • 제22권1호
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    • pp.41-45
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    • 2020
  • Acute sarcoid myositis is rarely complicated by sarcoidosis, and steroid therapy is considered the standard treatment. We experienced a patient with acute sarcoid myositis who did not respond to aggressive high-dose corticosteroid therapy, but showed a dramatic improvement after the addition of weekly low-dose oral methotrexate (MTX). This intervention allowed the resumption of normal daily activities after 6 months. Our case strongly suggests that MTX should be considered in patients with acute sarcoid myositis that is resistant to corticosteroid therapy.

심낭삼출로 발병하여 스테로이드 단독치료로 호전된 소아 전신성 홍반성 낭창 1례 (A Case of Steroid-responsive Pericardial Effusion as an Initial Manifestation of Childhood Systemic Lupus Erythematosus)

  • 이진석;하태선
    • Childhood Kidney Diseases
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    • 제8권1호
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    • pp.80-85
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    • 2004
  • 저자들은 급성 호흡곤란을 주소로 내원하여 반복적 심낭삼출로 2차례 심막천자술을 시행하였으나 심증상이 지속되다가 이후 발생한 임상적 소견과 혈액검사로 전신성 홍반성 낭창을 진단하여 부신피질호르몬을 투여한 후 심증상의 뚜렷한 호전을 보인 11세 여환아를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

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개에 있어서 면역매개성 용혈성빈혈 일례 (Immune Mediated Hemolytic Anemia in a Dog)

  • 최은화;이창우
    • 한국임상수의학회지
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    • 제18권3호
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    • pp.288-292
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    • 2001
  • A 3-year-old, 4.0 kg, intact male shih-tzu dog with anorexia, depression, pale mucous membranes, tachypnea, tachycardia was referred to the Veterinary Medical Teaching Hospital. Autoagglutination was observed by naked eye when blood was collected in an EDTA-tube and many spherocytes were found on a Diff-Quik stained blood smear. PCV was 6% and indirect bilirubin was increased markedly. So the immune-mediated hemolytic anemia was diagnosed. Autoagglutination was too severe to perform cross-matching test. Blood was not transfused as it might accelerate or precipitate hemolytic crisis, and regeneration of erythrocytes was very good. Thus corticosteroid of immunosuppressive dose and fluid were administered and PCV was monitored. Although blood was not transfused, PCV increased from 6 to 15.9% in a day and to 30% 7 days later. Therapy for liver was concurrently conducted because liver enzyme activities were high. Corticosteroid tappering therapy was conducted for 75 days and PCV was recovered to 46% after 4 months form start of the treatment.

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Reverse shoulder arthroplasty for corticosteroid-induced deltoid myopathy in a patient with systemic lupus erythematosus: a case report

  • Bayram, Serkan;Ersen, Ali
    • Clinics in Shoulder and Elbow
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    • 제24권3호
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    • pp.178-182
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    • 2021
  • A 50-year-old woman who had been previously diagnosed with systemic lupus erythematosus consulted our clinic for pain and weakness in her right shoulder. On examination, she had an atrophied deltoid muscle, a painful right shoulder on movement, and a tender mass in the deltoid area. The patient was diagnosed with corticosteroid-induced deltoid myopathy, shoulder pain, and loss of range of motion that did not resolve with conservative treatment. We decided to perform reverse shoulder arthroplasty. No complications were observed at the last follow-up visit at 3 years postoperative. Unlike deltoid insufficiency that results from axillary nerve injury, deltoid myopathy due to corticosteroid use contains intact fibers,. Therefore, we increased the effectivity of the remaining deltoid fibers by extending the moment arm of the anterior fibers using reverse shoulder arthroplasty and achieved reliable improvements in clinical symptoms and function without increasing the risk of dislocation.

Paraquat에 의한 급성 폐손상에 대한 Corticosteroid의 영향 (Effects of Corticosteroid on the Paraquat Induced Lung Injury)

  • 장근;김안명;강정성;정병학;정은택;문형배
    • Tuberculosis and Respiratory Diseases
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    • 제39권4호
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    • pp.325-333
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    • 1992
  • 연구배경 : 간질성 폐질환의 병리학적 과정은 초기의 조직 파괴과정인 급성 폐포염과 이어서 진행되는 폐 섬유화로 이루어진다. 제초제로서 널리 사용되는 Paraquat에 의한 백서의 폐 손상은 간질성 폐질환의 폐포염의 model로 하여 급성 폐포염에 Corticosteroid가 미치는 영향을 기관지 폐포 세정술과 폐 조직 생검의 시간적 변화로서 관찰하였다. 방법 : 체중 200 gm 이상되는 백서의 복강내로 Paraquat 20 mg/kg 투여하여 6시간, 1일, 2일, 3일째에 기관지 폐포 세정에 의한 세포분석, 그리고 폐 조직 생검을 실시하여 시간적 변화를 정상 대조군과 비교하였고, 이어서 Paraquat와 Corticosteroid 동시 투여군에서 관찰하여 Paraquat단독 투여군과 비교 하였다. 결과 : 1) 기관지 폐포 세정액의 세포분석소견 : Paraquat 단독 투여군은 투여후 1일, 2일째에 걸쳐 유의한 세포수의 증가를 보였는데, 증가의 주 요인은 호중구의 증가에 의하며, 대식구의 절대수는 변화가 없었다. 3일째부터는 염증반응이 감소하기 시작했다. Paraquat, Corticosteroid 동시 투여군에 있어서는 전반적으로 Paraquat 단독 투여군에 비해 호중구의 유의한 감소에 의한 총 세포수의 감소를 확인하였다. 2) 폐 조직 생검 소견 : Paraquat 투여 후 1일째부터 폐포벽의 부종, 출혈, 호중구를 주로하는 염증세포의 폐포내 침윤이 나타났으며, 3일째에는 염증반응은 감소하나 폐포내에 초자양막이 형성되기 시작하였다. Paraquat, Corticosteroid 동시 투여군에서는, 1일째까지는 현저하게 전반적인 병리소견 특히 호중구의 침윤이 억제되어 있으며 2일째부터는 염증반응의 억제가 완화되어 있다. 결론 : Paraquat 투여 백서의 폐 손상에 있어서 Corticosteroid는 폐포염의 염증성 반응, 특히 호중구의 침윤을 유의하게 억제시킴을 기관지 폐포 세정술과 폐 생검으로 확인하였다.

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Lithium 이온의 배설에 미치는 Corticosteroid의 영향 (Effect of Corticosteroids on Renal Excretion of Lithium)

  • 오신열;하정희;이광윤;김원준
    • Journal of Yeungnam Medical Science
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    • 제3권1호
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    • pp.229-235
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    • 1986
  • rat에 주사된 lithium 이온의 배설에 미치는 수종의 corticosteroid의 영향을 검색한 결과 다음과 같은 결론을 얻었다. 1. fludrocortisone을 10mg/kg 투여하여 혈청내 lithium 농도를 줄일 수 있었고, lithium의 뇨중 배설량도 증가시켰다. 2. dexamethasone을 0.1mg/kg 투여하여 혈청내 lithium 농도를 줄일 수 있었고, 1mg/kg을 투여하여 lithium의 뇨중 배설량도 증가시켰다. 3. dexamethasone에 의하여서는 혈중 $Na^+$$K^+$에 대한 농도비가 감소하였고, 반대로 뇨중 $Na^+$$K^+$에 대한 농도비가 감소하였다. 이상의 실험 결과를 미루어 corticosteroid는 lithium의 뇨중 배설량을 증가시키고 그 혈중 농도를 감소시킬 수 있으나, 이러한 작용은 신장을 통한 $Na^+$ 이나 $K^+$의 이동과는 전혀 상관이 없다고 생각된다.

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중등도-중증 궤양성 대장염 환자에서 infliximab의 치료효과에 대한 메타분석 (Meta-analysis of the Efficacy of Infliximab in Patients with Moderate-Severe Ulcerative Colitis)

  • 김종윤;이숙향;유기연
    • 한국임상약학회지
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    • 제22권3호
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    • pp.251-259
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    • 2012
  • Ulcerative colitis (UC) is characterized by a life-long chronic course with remissions and exacerbations. Use of biological therapies may reduce or delay the surgical procedures in patients with UC. The aim of this study was to determine the impact of infliximab (IFX) use on the rate of remission, surgical interventions, and the effect on quality of life in patients with moderate to severe UC. Literature was searched for studies that investigated the efficacy of IFX on the rate of remission, colectomy and quality of life (QoL) between January 1990 and June 2012 at MEDLINE, January 1988 and June 2012 at EMbase and others. Eleven trials were included in the meta-analysis; divided into placebo controlled 8 trials and intravenous corticosteroid controlled group 3 trials. In comparison to placebo control groups, patients who received IFX had an odds ratio (OR) of 3.712 (95% CI: 2.714, 5.079) for the short-term clinical remission, and 3.053 (95% CI: 2.044, 4.559) for the rate of long-term remission. In colectomy rate and quality of life (QoL), odds ratio were 0.566(95% CI: 0.387, 0.827) and 0.658 (0.505, 0.811) respectively. Any adverse reactions including infections, infusion reaction, rash and arthralgia were equivalent in both groups. Compared with intravenous corticosteroid controlled group, patients who received IFX had lower remission rate with short-term odds ratio 0.227 (95% CI: 0.033, 1.556) and long-term odds ratio 1.054 (95% CI: 0.317, 3.502) respectively. However, statistical significance was not showed with both two analyses. The higher adverse drug reaction (ADR) rates were occurred in the corticosteroid controlled groups. 73.3% of patients treated corticosteroid reported Cushing-like syndrome with moon face. In conclusion, IFX does increase remission rate and decrease the rate of colectomy in patients with UC without elevating any adverse reactions significantly. IFX also improves QoL in moderate to severe UC patients. It would not exceed the efficacy of intravenous corticosteroid, whereas intravenous corticosteroid also reported high rate of adverse reactions.

Comparison of ultrasound-guided subacromial corticosteroid and ozone (O2-O3) injections in the treatment of chronic rotator cuff tendinopathy: a randomized clinical trial

  • Merve Orucu Atar;Nurdan Korkmaz;Sefa Gumruk Aslan;Ozge Tezen;Sinem Uyar Koylu;Yasin Demir;Serdar Kesikburun
    • The Korean Journal of Pain
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    • 제36권1호
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    • pp.128-136
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    • 2023
  • Background: The authors aimed to compare the effects of a one-time ultrasound (US)-guided subacromial corticosteroid injection and three-time ozone (O2-O3) injection in patients with chronic supraspinatus tendinopathy. Methods: Participants were randomly assigned to the corticosteroid group (n = 22) or ozone group (n = 22). Injections in both groups were administered into subacromial bursa with an US-guided in-plane posterolateral approach. Primary outcome measure was the change in the Western Ontario Rotator Cuff Index (WORC) score between baseline and 12-weeks post-injection. Secondary outcome measures included visual analog scale and Shoulder Pain and Disability Index scores. Assessments were recorded at baseline, and 4-weeks and 12-weeks post-injection. Results: Forty participants completed this study. Based on repeated measurement analysis of variance, a significant effect of time was found for all outcome measures in both groups. Both the groups showed clinically significant improvements in shoulder pain, quality of life, and function. Baseline, 4-week post-injection, and 12-week post-injection WORC scores (mean ± standard deviation) were 57.91 ± 18.97, 39.10 ± 20.50 and 37.22 ± 27.31 in the corticosteroid group, respectively and 69.03 ± 15.89, 39.11 ± 24.36, and 32.26 ± 24.58 in the ozone group, respectively. However, no significant group × time interaction was identified regarding all outcome measures. Conclusions: Three-time ozone injection was not superior to a one-time corticosteroid injection in patients with chronic supraspinatus tendinopathy. It might be as effective as corticosteroid injection at 4-weeks and 12-weeks post-injection in terms of relieving pain and improving quality of life and function.

Henoch-Sc$\ddot{o}$lein 자반증에서 출혈성 물집을 동반한 9세 소아 1례 (Hemorrhagic Bullous Lesions in a 9-year-old Girl with Henoch-Sch$\ddot{o}$lein Purpura)

  • 김문규;박성은;이준호
    • Childhood Kidney Diseases
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    • 제16권1호
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    • pp.51-53
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    • 2012
  • 헤노흐-쇤라인 자반증(HSP)은 소아에서 가장 흔한 혈관염으로 피부 자반증, 관절염, 복통, 그리고 신염 등을 특징으로 한다. HSP 소아에서 물집을 동반하는 경우는 매우 드물다. 관절염을 동반한 HSP를 보인 9세 여아에서 경구용 스테로이드 치료를 시작했음에도 불구하고 피부 자반이 빠르게 출혈성 물집 병변으로 진행되었다. 치료 7일 후 몇몇 궤양성 병변은 경미한 흉터로 남았으나 관찰 6개월 후 흉터는 완전히 소멸되었다. 현미경적 혈뇨는 관찰 6개월간 지속되었으나 단백뇨는 관찰되지 않았다. HSP 소아에서 물집이 동반되었을 경우, 신장의 예후에는 직접적인 연관은 없었다. 임상적으로 HSP 진단기준을 만족한다면 HSP 진단을 위해 피부조직검사는 필요 없을 것으로 보이며, 더 많은 증례가 모이면 정확한 결론을 내릴 수 있을 것으로 사료된다. 관절염을 동반한 HSP 9세 여자 소아에서 경구용 스테로이드 치료를 시작했음에도 불구하고 피부 자반이 빠르게 출혈성 물집 병변으로 진행되는 HSP 증례를 경험하였기에 보고하는 바이다.