• The Korean Journal of Pain
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• 제27권2호
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• pp.125-132
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• 2014

Background: To improve residual pain management in acute cervical radiculopathy treated with NSAIDs, the feasibility of early and repeated low-dose interscalene brachial plexus block (IS-BPB) needs to be assessed. Methods: This was a prospective study on patients receiving NSAIDs (loxoprofen) for cervical radiculopathy of ${\leq}2$-week onset. Pain was assessed using the visual analogue scale (VAS). A low-dose ultrasonography (USG)-guided IS-BPB (dexamethasone [1.65 mg; 0.5 ml] and mepivacaine [1%; 3.0 ml]) was performed at baseline and weekly thereafter for 4 weeks in an outpatient setting for the intervention group. All patients were evaluated using a visual satisfaction score (VSS) at week 4. Patients with baseline VAS scores < 70 (mild to moderate pain; MM group) and ${\geq}70$ (severe pain; SE group) were compared to the controls receiving NSAIDs. Results: A total of 316 IS-BPBs were performed in the intervention group. There was a significant difference in the decline in the VAS from week 0 to week 3 in the MM and SE groups (P < 0.05); however, from week 3 to week 4, the therapeutic effect exhibited no significant difference. Thirteen patients at week 2 (15.5%; MM: 27.7%; SE: 0%), 43 at week 3 (51.2%; MM: 83.0%; SE: 10.8%), and 47 at week 4 (56.0%; MM: 85.1%; SE: 18.9%) achieved a VAS score of ${\leq}20$. Patient satisfaction was high, and the decrease in VAS scores in both groups was significant (P < 0.05) compared to the controls. Conclusions: Weekly, low-dose, USG-guided IS-BPB can be implemented for early pain relief in acute cervical radiculopathy, with high patient satisfaction.

• Neonatal Medicine
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• 제16권2호
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• pp.146-153
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• 2009

목 적: 고식적인 치료에 반응하지 않는 기관지폐 이형성증에 대한 치료로서 덱사메타손 구제 치료의 사용현황을 조사하기 위해 본 연구를 시행하였다. 방 법: 2004년 3월부터 2008년 8월까지 서울대학교 어린이병원 및 분당서울대학교병원 신생아 중환자실에 입원하여 기관지폐 이형성증으로 치료를 받은 251례의 미숙아를 대상으로 후향적으로 연구하였다. 산모와 신생아들의 인구학적, 임상적 특성을 살펴보았으며, 덱사메타손 구제 치료의 반응성에 따라 반응군 및 비반응군간의 차이점을 비교 분석하였다. 또한 덱사메타손 구제 치료에 따른 합병증을 조사하였다. 결 과: 93례(37.1%)가 중증도의 기관지폐 이형성증으로 분류되었으며, 모든 덱사메타손 구제 치료는 중증도의 기관지폐 이형성증을 가진 사례에서 시행되었다. 덱사메타손은 고식적인 치료가 실패하여 기관 발관이 불가능한 호흡 곤란을 가진 24례(9.6%)에서 투여되었다. 투여된 사례 중 14례(58.3%)에서 덱사메타손 구제 치료에 반응을 나타냈다. 비반응군은 보다 많은 산소 공급을 요구하였으며 폐동맥 고혈압이 동반되는 경우가 많았다. 반응군은 입원 기간의 단축과 사망률의 감소 소견을 보였다. 고용량의 덱사메타손을 투여하는 것이 저용량에 비하여 보다 효과적으로 기계 환기에서 이탈을 유도한다는 근거는 도출되지 않았다. 패혈증은 덱사메타손 구제 치료 이후에 가장 빈번하게 발생하는 합병증이다. 결 론: 중증의 기관지폐 이형성증에서 폐동맥 고혈압이 발생하기 전에 덱사메타손 구제 치료를 시행하는 것이 치료 효과 측면에서 도움이 될 수 있다. 폐동맥 고혈압이 동반된 경우에는 합병증의 발생 가능성으로 인해 덱사메타손 구제 치료를 하지 않는 것이 바람직하다.

• 대한수의학회지
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• 제37권3호
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• pp.569-576
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• 1997

Fowl typhoid(FT) caused by Salmonella gallinarum is an infectious, egg-transmitted disease and characterized by swollen bronze liver, greenish-yellow diarrhea and high mortality in growing and adult chickens. Since 1992 the outbreak of FT has been increased. Several problems have been occurred such as absence of appropriate vaccines and lack of useful therapeutic methods. In these studies we investigated the pathogenicity of S gallinarum isolated in chickens. To compare the pathogenicity among the species of chickens, all chickens were challenged intramuscularly or orally with $1{\times}10^7$ CFU of S gallinarum. The brown-colored layers were more susceptible and white leghone chickens were more resistant than other species. In the brown layer chickens orally challenged, lethal doses ($LD_{50}$) of the isolates were inoculated at 1 day, 2 weeks, 4 weeks and 8 weeks old chickens with amount of $10^{4.2}$, $10^{4.7}$, $10^{7.0}$ and $10^{7.6}$ CFU, respectively. The chickens which were intramuscularly challenged with the less amount than $10^2$ CFU showed higher mortality than that of the chickens orally inoculated with same dose. Also, we investigated the recovery rates of bacteria from various organs of survival chickens which were challenged orally with $5{\times}l0^7$ CFU of S gallinarum. The bacteria was more frequently and isolated earlier from the liver and spleen than from any other ogans. In the pathogenicity test, the white-leghorn chickens which were known as resistant-strain against Salmonella were artificially immunosuppressed using bursectomy and/or dexamethasone treatment. Mortality of chickens with both bursectomized and treated with dexamethasone was higher(90%) than that of the control group(10%), the bursectomized chickens(10%) and the dexamethasone only treated group(20%). It was suggested that the protective mechanism in chickens against S gallinarum may be required both the functions of B-cells and T-cells.

• 한국임상수의학회지
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• 제23권2호
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• pp.202-206
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• 2006

A 7-year-old, spayed female, Yorkshire terrier dog with polyuria/polydipsia (PU/PD), interdigital edema, pruritus and abdominal enlargement was referred to the Veterinary Medical Teaching Hospital of the present university. Pituitary-dependent hyperadrenocortisim (PDH) was diagnosed by clinical signs, physical examination, laboratory examination (complete blood count, serum chemistry, urinalysis, ACTH stimulation test and high dose dexamethasone suppression test) and diagnostic imaging (radiography, ultrasonography and computed tomography). Clinical signs were improved after trilostane treatment, and maintenance therapy with trilostane still continued after successful induction therapy. Trilostane can be used as an alternative to mitotane therapy in hyperadrenocortisim in dogs.

• Asian Pacific Journal of Cancer Prevention
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• 제13권9호
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• pp.4777-4781
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• 2012

Objective: To investigate the relationship between the efficacy and safety of different doses of thalidomide (Thal) plus dexamethasone (Dex) as the initial therapy in elderly patients with newly diagnosed multiple myeloma (MM). Methods: Clinical data of 28 elderly patients with newly diagnosed MM who underwent the TD regimen as the initial therapy were analyzed retrospectively. The patients were divided into two groups according to the maximal sustained dose of Thal: lower dose (group A) and higher dose (group B). The overall response rate (ORR), progression free survival (PFS), overall survival (OS), and adverse events (AES) were compared between the two groups. Results: A total of 28 patients were followed up with a median of 18 months. The ORR was 60.1%. The median response time and PFS were 2.0 and 17.0 months, respectively. The mean sustained dose of Thal in group B was significantly higher than group A (292.9 mg v 180.4 mg, P=0.01). There was no significantly difference in ORR (57.1% v 64.3%, P=1.00) and PFS (9.63months v 17.66 months, P=0.73) between groups A and B. During the follow up, only five patients died (<40%) and, therefore, median OS values were not available. It is estimated, however, that the mean survival time in the two groups was 35.6 and 33.4 months (P>0.05), respectively. All of the patients tolerated the treatment well. The incidence of AES in patients with a grading above 3 in group B was significantly higher than in group A (P=0.033). Conclusions: The TD regimen results in a high response rate and manageable AES as the initial therapy in elderly patients with MM. TD should be considered as the front line regimen for the treatment of elderly patients with MM in areas with financial constraints. The clinical response can be achieved at a low dose Thal with minimal toxicity.

• Journal of Yeungnam Medical Science
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• 제32권2호
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• pp.132-137
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• 2015

Adrenocorticotropic hormone (ACTH)-producing pheochromocytoma has been rarely reported, whereas only a few cases of Cushing syndrome accompanied by opportunistic infections have been reported. We experienced a patient with pheochromocytoma with ectopic Cushing syndrome complicated by invasive aspergillosis. A 35-year-old woman presented with typical Cushingoid features. Her basal plasma cortisol, ACTH, and 24-hour urine free cortisol levels were significantly high, and 24-hour urine metanephrine and catecholamine levels were slightly elevated. The endogeneous cortisol secretion was not suppressed by either low- or high-dose dexamethasone. Abdominal computed tomography (CT) revealed a heterogeneous enhancing mass measuring approximately 2.5 cm in size in the left adrenal gland. No definitive mass lesion was observed on sellar magnetic resonance imaging. On fluorine-18 fluorodeoxyglucose positron emission tomography/CT, a hypermetabolic nodule was observed in the left upper lung. Thus, we performed a percutaneous needle biopsy, which revealed inflammation, not malignancy. Thereafter, we performed a laparoscopic left adrenalectomy, and its pathologic finding was a pheochromocytoma with positive immunohistostaining for ACTH. After surgery, the biochemistry was normalized, but the clinical course was fatal despite intensive care because of the invasive aspergillosis that included the lungs, retina, and central nervous system.

• Asian-Australasian Journal of Animal Sciences
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• 제22권12호
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• pp.1686-1692
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• 2009

Garlic oil (GAR, Allium sativum L.) has been studied as a feed additive to improve animal production performance and decrease methane emission in ruminants. The present study was designed to determine the possible effect of GAR on fatty acid composition and accumulation in animal fat tissue using a cell model. 3T3-L1 preadipocytes at $2{\times}10^{4}\;mL^{-1}$ were seeded to 24-well plates and allowed to proliferate to reach confluence. The cells were then treated with media containing 0, 2.5, 5, 10, 20 and 40 $\mu{g}$ $mL^{-1}$ of GAR during the differentiation period for 8 days. Media containing dexamethasone, methyl-isobutylxanthine and insulin was applied during the first 2 days of the early differentiation period. On day 8 sub-sets of the wells were stained with oil red-O and the remaining cells were harvested for determination of glycerol-3-phosphate dehydrogenase [EC 1.1.1.8] (GPDH) activity (n = 6) and cellular fatty acid concentration (n = 6). It was found that supplementation of GAR increased (p<0.05) the ratio of monounsaturated fatty acids/saturated fatty acids in the adipocytes and showed inhibitory effect (p<0.05) on the post-confluent proliferation. With relative low dosage, GAR (5-20 $\mu{g}$ $mL^{-1}$) increased (p<0.05) the GPDH activity without affecting the cellular fatty acid concentration, while a high dosage (40 $\mu{g}$ $mL^{-1}$) inhibited (p<0.05) fatty acid accumulation and decreased GPDH activity. Supplementation of GAR had an effect on cell post-confluent proliferation, differentiation and fatty acid accumulation. However, the effect may be diverse and depends on the dose applied.

• 대한약리학회지
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• 제32권2호
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• pp.233-241
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• 1996

Previous studies have shown that glucocorticoid suppresses microsomal epoxide hydrolase(EH) gene expression and that EH expression is altered during pregnancy. The effects of progesterone on the expression of rat EH and certain glutathione S-transferase(GST) genes were examined in this study. Northern RNA blot analysis revealed that progesterone was effective in increasing hepatic EH mRNA levels at 12 h to 48 h after treatment with a maximal 9-fold increase being noted at 12 h time point. Nonetheless, multiple daily treatment with progesterone rather caused minimal relative increases in EH mRNA levels. GST Ya and Yb1/2 mRNA levels were also transiently elevated at 12 h after progesterone treatment, followed by gradual decreases from the maximal Increases at day 1, 2 and 5 post-treatment. These changes in EH and GST mRNA levels were noted only at a relatively high dose of progesterone. Furthermore, immunoblot analyses showed that rats treated with progesterone for 5 days failed to show EH or GST induction, indicating that progesterone-induced alterations in EH and GST mRNA levels do not reflect bona fide induction of the detoxifying enzymes. Concomitant progesterone treatment of rats with the known EH inducers including ketoconazole and clotrimazole failed to additively nor antagonistically alter EH mRNA levels. In contrast, dexamethasone substantially reduced ketoconazole- or clotrimazole-inducible EH expression. These results showed that progesterone stimulates the EH, GST Ya and Yb1/2 gene expression at early times followed by marked reduction in the RNA levels from the maximum after multiple treatment and that the changes in mRNA do not necessarily reflect induction of the proteins.

• Clinical and Experimental Pediatrics
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• 제53권3호
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• pp.437-441
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• 2010

독성표피괴사용해(TEN)와 스티븐-존슨 증후군(SJS)은 약물이나 감염에 의해 발생하는 피부점막을 침범하는 드물지만 치명적인 질병이다. 스테로이드는 TEN의 치료에 많이 이용되어왔지만, 아직까지도 논쟁중이다. 스테로이드에 의한 정신과적 영향은 두통, 불면증, 우울증, 심리질환 등이 있다. 스테로이드에 의한 정신질환에서 치료는 스테로이드의 감량 또는 중단이고, 항정신성 약물을 투여한다. 신증후군으로 진단된 11세 남아에서 스테로이드 치료 후 관해상태에서 유지치료를 시행하고 있던 중에 TEN이 발생하였다. 저자들은 이 환아에서 치료목적으로 투여한 고용량 스테로이드 정맥주사로 인해 정신질환이 동반되었고, 이후 스테로이드 감량과 항정신성 약물과 면역글로불린으로 증상이 호전되는 것을 경험하여 이를 보고하는 바이다.

• Natural Product Sciences
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• 제22권1호
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• pp.70-75
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• 2016

A phytoformula containing the root barks of Morus alba, the fructus of Schizandra sinensis and the roots of Asparagus cochinchinensis (MSA) was prepared as a potential new herbal remedy, and its therapeutic potential for alleviating inflammatory lung conditions was examined. For in vivo evaluation, an animal model of lipopolysaccharide (LPS)-induced acute lung injury (ALI) in mice was used. With oral administration of 6 - 60 mg/kg, MSA potently and dose-dependently inhibited bronchitis-like symptoms in acute lung injury induced by intranasal treatment of LPS as judged by the number of cells in the bronchoalveolar lavage fluid (BALF) and histological observation. The inhibitory potency was comparable with that of dexamethasone. For in vitro assay, the effects on the production of proinflammatory molecules in lung epithelial cells and alveolar macrophages were examined. Although MSA inhibited IL-6 production in IL-$1{\beta}$-treated lung epithelial cells (A549) only at a high concentration ($300{\mu}g/ml$), the formula strongly and concentration-dependently inhibited NO production in LPS-treated alveolar macrophages (MH-S) at $20-300{\mu}g/ml$. Based on all of these findings, the new phytoformula MSA is suggested to have the potential to control inflammatory lung diseases including bronchitis, at least in part, by inhibiting inducible nitric oxide synthase-catalyzed NO production.