• Korean Journal of Clinical Pharmacy
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• v.14 no.1
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• pp.11-23
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• 2004

Although most children with idiopathic nephrotic syndrome respond to corticosteroid therapy, many responders show steroid dependency and frequent relapse. In these children, one of the major problems is the serious side effects resulting from continuous steroid therapy. Thus, this study was conducted to assess the therapeutic efficacy and safety of six-month cyclosporine treatment with the low-dose deflazacort therapy in children with nephrotic syndrome. Thirty children with steroid dependence (SD), frequent relapse (FR) and steroid resistance (SR) were enrolled in this study. They were treated with 6-month oral cyclosporine $(Cypol-N^{(R)})$ plus the low-dose deflazacort $(Calcort^{(R)})$ therapy at Samsung Medical Center from September 2002. The dosage of cyclosporine was started at 5 mg/kg/day and was monthly adjusted to maintain clinical remission and/or a trough blood level, while deflazacort dosage was reduced gradually. Clinical evaluation and monitoring of cyclosporine toxicity were performed every $2\sim4$ weeks. Outcomes were compared to the latest sir-month period of steroid only therapy before cyclosporine treatment. Student's t-test and ANOVA were used for statistical analysis. Out of 28 children with SD and FR, 23 $(82.1\%)$ sustained remission, and 5 $(17.9\%)$ experienced 1 or 2 relapses during therapy. Out of 2 children with SR, 1 child sustained remission, and 1 child showed no response. The mean duration of remission and occurrence of relapse were significantly improved (p <.0001). In addition, the mean dosage of steroid was significantly reduced (p=.003). Although a number of adverse effects occurred in this study, they were not so serious as to necessitate discontinuation of the therapy. No nephrotoxicity was observed. Twenty out of the 28 children who had been in remission relapsed after withdrawal of cyclosporine. Fifteen of these children showed relapse within a month. These results demonstrated that the combination of cyclosporine with the low-dose deflazacort was efficient and safe in children with SD and FR during the six-month treatment. However, further studies are necessary in order to resolve the problem of high relapse rate after discontinuation of cyclosporine.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.14.1-14
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• 1983

The most common cause of the decannulation difficulty is the trauma. This may be accidental, iatrogenic such as prolonged intubation, high tracheostomy, secondary infection, formation of granulation tissue, improper use of cannula and wide resection of anterior tracheal wall. Another common cause is psychologic dependency. Treatments may be categorized into dilatation with or without injection of steroid, dilatation and prolonged stent, luminal augmentation and resection of the stenosis with primary reanastomosis. Recently authors experienced a case of the decannulation difficulty in a 2 - year - old which was developed after tracheostomy for the removal of bronchial foreign body and was treated with a silicon T -tube stent with good result.

• The Korean Journal of Mycology
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• v.13 no.2
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• pp.83-87
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• 1985

The temperature dependency and the stability of enzyme systems for $11{\alpha}-hydroxyla­tion$ of progesterone were investigated using Aspergillus phoenicis. Though A. phoenicis conserves high enzyme activities for lactose hydrolysis even at high temperatures, the bioconversion reaction of progesterone by this strain was found to be very temperature sensitive. The compositions of reaction mediums of inside and outside of cells were analyzed using sonication technique. At early stage of reaction, the concentration of $11{\alpha}-hydroxyprogesterone$ of cell inside was higher than that of outside. But as the reaction proceeded further, the $11{\alpha}-hydroxyprogesterone$ existing inside of cells being converted into another products, its concentration was lower within the cells that in the bulk medium. Even in the reaction mediums containing organic solvents, A. phoenicis was founded to be able to metabolite, so that $11{\alpha}-hydroxyprogesterone$ can be produced continuously from fixed bed reactions packed with immobilized A phoenicis in vivo.

• Clinical and Experimental Pediatrics
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• v.51 no.3
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• pp.293-298
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• 2008

Purpose : The aim of our study was to evaluate the therapeutic response to cyclosporine, time to remission and side effects in steroid resistant nephrotic syndrome (SRNS). Methods : This study included 22 children with idiopathic SRNS who were treated with cyclosporine between June 1989 and August 2006. Medical records were reviewed retrospectively. Results : The mean age of patients at diagnosis was $5.2{\pm}3.3\;years$. The male to female ratio was 1.2:1. Pre-treatment renal biopsies showed minimal change (MCD) in 12 (54.5%), focal segmental glomerulosclerosis (FSGS) in 8 (36.4%), membranous nephropathy (MGN) in one (4.5%) and mesangioproliferative glomerulonephritis in one (4.5%). 15 (68.2%) patients responded to cyclosporine, of whom 11 (91.6%) patients were MCD, 3 (37.5%) patients FSGS, and 1 patient MGN (MCD vs FSGS, P<0.05). The time to remission in patients who responded to cyclosporine was $31.5{\pm}15.2\;days$. Four of the 15 cyclosporine responders maintained complete remission even after cessation of the medication Seven still received cyclosporine, 2 were intermittently treated with steroids after discontinuation of cyclosporine, and two were treated with cyclosporine and steroids. The mean duration of cyclosporine therapy was $546.5{\pm}346.2$, $1,392.9{\pm}439.7$, $439.5{\pm}84.1$, and $433.5{\pm}74.2$ days, respectively. We performed post-treatment biopsies in 8 patients and partial interstitial fibrosis and tubular atrophy were found in two. Conclusion : The thrapeutic response of cyclosporine is good in steroid resistant nephrotic syndrome, especially in minimal change. But, there is a problem of long term cyclosporine dependency.

• Journal of Embryo Transfer
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• v.20 no.1
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• pp.71-77
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• 2005

To investigate the influence of relaxin and insulin on the ovarian steroid secretion of porcine granulosa cells, we used porcine granulosa cells partially luteinized in a primary culture and examined the production of progesterone and $17{\beta}-estradiol$. Porcine granulosa cells were cultured in the presence of serum for 48 h after attachment and subsequently in the absence of serum fur 24 h. To confirm the dose dependency of relaxin or insulin, various concentrations (10, 100, 1000 ng/ml) of relaxin or insulin were added in the medium for the last 24 h, respectively. To investigate the combinational effect of relaxin and insulin, 100 ng/ml relaxin and/or 100 ng/ml insulin were added in the medium for the last 24 h in the presence or absence of luteinizing hormone (100 ng/ml). The medium was collected and used for radioimmunoassay to measure the production of progesterone and $17{\beta}-estradiol$. Relaxin or insulin increased the production of progesterone by dose dependency, respectively while they had no effect of the production of $17{\beta}-estradiol$. Relaxin (100 ng/ml) and/or insulin (100 ng/ml) significantly increased the production of progesterone in the presence of luteinizing hormone while they had no effect of the production of $17{\beta}-estradiol$. In conclusion, relaxin and/or insulin increased the progesterone secretion of porcine granulosa-lutein cells in vitro while had no effect on the production of $17{\beta}-estradiol$ and had no synergism on the effects. The effects of relaxin and/or insulin on the production of progesterone were augmented by the presence of luteinizing hormone.

• Archives of Pharmacal Research
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• v.15 no.2
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• pp.169-175
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• 1992

Anti-inflammatory glucocorticoid (GC) derivatives have been clinically used in immune-malfunctional diseases for their immunosuppressive activity. However, there is still a lack of knowledge on the relationship between anti-inflammatory and immunosuppressive activities. In order to compare immunosuppressive activities with the known anti-inflammatory activities of the GC derivatives, eight clinically used GC derivatives including hydrocortisone, prednislone, 6$\alpha$-methyl prednisolone, triamcinolone, dexamethasone, betamethasone, triamcinolone acetonide and fluocinolone acetonide were selected, and lymphoblastosis inhibition and plaque-forming cell (PFC) response in mice were studied as immunological parameters. In Con A-induced lymphoblatosis inhibition invitro, all derivatives showed potent inhibition $IC_{50}$ values of the derivaties except methyl prednisolone and triamcinolone were less than $10^{-7}$M and good dose dependency was obtained. This result was well correlated with that of their anti-inflammatory potencies obtained. This result was well correlated with that of their anti-inflammatory potencies and their receptor binding affinities. However, in PFC response, consistent result were not obtained. Total numbers of PFCs per spleen were decreased by some derivatives, but numbers of PFCs per $10^6$ cells were not decreased by systemic administration of but numbers of PFCs per $10^6$ cells were not decreased by systemic administration of GC at the dose of 0.05 mg/mouse. Furthermore, at the dose of 0.1 mg/mouse, numbers of PFCs per $10^6$ cells were found to be increased, although total PFCs per spleen were decreased.