• Title/Summary/Keyword: Steroid.

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A Case of Atypical Thrombotic Microangiopathy (비전형적 혈전성 미세병증 1례)

  • Oh, Ji Young;Park, Se Jin;Kim, Ki Hwan;Lim, Beom Jin;Jeong, Hyeon Joo;Ki, Jung Hye;Kim, Kee Hyuck;Shin, Jae Il
    • Childhood Kidney Diseases
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    • v.17 no.2
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    • pp.149-153
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    • 2013
  • We report the case of a 14-year-old girl, diagnosed with atypical thrombotic microangiopathy (TMA). The patient presented with persistent fever, nausea, and newly developed peripheral edema. Her laboratory findings indicated chronic anemia with no evidence of hemolysis, thrombocytopenia, or elevated serum creatinine level. A few days after hospitalization, acute renal failure and fever worsened, and proteinuria developed. On day 40 of hospitalization, she experienced a generalized tonic seizure for 5 min, accompanied by renal hypertension. Brain magnetic resonance imaging revealed posterior reversible leukoencephalopathy syndrome. After steroid pulse therapy, a renal biopsy was performed because of delayed recovery from thrombocytopenia. The biopsy findings showed features of thrombotic microangiopathic hemolysis with fibrinoid change restricted. Current diagnostic criteria for TMA have focused on thrombotic thrombocytopenic purpura and hemolytic uremic syndrome, and diagnosis is based on the clinical presentation and etiology, with the consequence that idiopathic and atypical forms of TMA can be overlooked. Developing effective tools to diagnose TMA, such as studying levels of ADAMTS13 or testing for abnormalities in the complement system, will be the first step to improving patient outcomes.

Update on Phosphorylation-Mediated Brassinosteroid Signaling Pathways (단백질 인산화에 의해 매개되는 브라시노스테로이드 신호전달 연구의 최근 상황)

  • Lee, Yew;Kim, Soo-Hwan
    • Journal of Life Science
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    • v.22 no.3
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    • pp.428-436
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    • 2012
  • Protein phosphorylation is a universal mechanism that regulates cellular activities. The brassinosteroid (BR) signal transduction pathway is a relay of phosphorylation and dephosphorylation cascades. It starts with the BR-induced activation of the membrane receptor kinase brassinosteroid insensitive 1 (BRI1), resulting in the dephosphorylation of transcription factors such as BZR1/BES2 and BZR2/BES1 followed by BR-induced gene expression. Brassinosteroid signal transduction research has progressed rapidly by identifying the phosphorylation/dephosphorylation site(s) of the BR-regulated kinase and phosphatase substrates with a simultaneous pursuit of mutant phenotypes. Autophosphorylation, transphosphorylation, and serine/threonine and tyrosine phosphorylation of the receptor protein kinases BRI1 and BRI1-associated kinase (BAK1) have increased the understanding of the regulatory role of those kinases during physiological and developmental processes in plants. The phosphorylation event initiated by BR is also found in the regulation of receptor-mediated endocytosis and the subsequent degradation of the receptor. However, the basic molecular links of the BR signal transduction pathway are not well understood regarding this phosphorylation/dephosphorylation event. This review summarizes the current state of BR signal transduction research to uncover the phosphorylation/dephosphorylation networks and suggests directions for future research on steroid signal transduction to gain a more comprehensive understanding of the process.

Evaluation of the Postoperative Motor Function for Metastatic Brain Tumors Around the Motor Cortex (운동중추 주변에 위치한 전이성 뇌종양의 수술 후 운동 기능에 대한 평가)

  • Kim, Sang Hyo;Jung, Shin;Kang, Sam Suk;Lee, Jung Kil;Kim, Tae Sun;Kim, Jae Hyoo;Kim, Soo Han;Lee, Je Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup1
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    • pp.25-29
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    • 2001
  • Objective : Intracranial metastasis is responsible for nearly 50% of mortalities of systemic cancers. Although its frequency is increasing and there is little doubt that improving the quality and expectancy of life is the final goal, the mode of treatment is still disputed. The authors report the postoperative motor function after surgery in patients with metastatic tumors around the motor cortex. Materials and Methods : We studied 24 patients with metastatic tumors around the central sulcus during the last 22 months. Motor function was assessed pre- and post-operatively as well as its response to corticosteroids. MRI, neuronavigation system and intraoperative ultrasonography were used for tumor localization and functional MRI and cortical stimulator were used to define the motor cortex. Results : Single metastasis was found in 13 cases(54%) and 11 cases(44%) had multiple foci. Thirteen cases were located in precentral, 7 in postcentral, and 4 in superior or middle-frontal lobe. The most common primary focus was the lung(16 cases). There was no difference in postoperative motor function improvement between the steroid responsive group and non-responsive group(92% versus 90%). Ninty-two percent of the patients showed significant improvement of motor function and lived independently but there was worsening in the upper extremity in one and in another no improvement. Whole brain radiation of 3000cGy was given in all cases and 4 patients died of recurrence in primary or intracranial focus during mean follow-up periods of 14 monthes. Conclusion : Surgery may provide substantial improvement of the motor function and quality of life of the patients with metastatic tumors around the motor cortex.

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Changes in Plasma Sex Steroid Hormone and Vitellogenin Levels during Gonadal Development of the Spotted Flounder, Verasper variegatus (범가자미, Verasper variegatus의 생식소 발달단계에 따른 혈중 난황단백전구체 (vitellogenin)와 성 스테로이드 호르몬 변화)

  • KIM Yoon;BAEK Hea-Ja;HAN Chang-Hee;AIDA Katsumi;KOBAYASHI Makito
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.32 no.5
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    • pp.624-628
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    • 1999
  • Annual plasma levels of vitellogenin and sex steroids were investigated in relation to the gonadal development for understanding the endocrine control of reproduction in spotted flounder, Verasper variegatus. The plasma vitellogenin level was highest, 6.36 mg/ml, in November when vitellogenesis was most active. The level, thereafter, decreased to 3.81 mg/ml in December with the initiation of spawning. On the other hand, estradiol-17 $\beta$ was highest, 2.7 ng/ml, in December, and rapidly decreased in January when spawning occurred. The decreased level of estradiol-17$\beta$, around 0.2 ng/ml, remained unchanged until May. The profiles of plasma testosterone were similar to those of estradiol-17$\beta$ in the fish, The plasma 17 $\alpha$-hydroxyprogesterone level was relatively low throughout the spawning period, but increased slightly with the initiation of ovarian development, In males, the plasma testosterone and 11-ketotestosterone were highest in December when spermiation actively proceeded, but rapidly decreased during the spawning period (January).

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Gender-independent efficacy of mesenchymal stem cell therapy in sex hormone-deficient bone loss via immunosuppression and resident stem cell recovery

  • Sui, Bing-Dong;Chen, Ji;Zhang, Xin-Yi;He, Tao;Zhao, Pan;Zheng, Chen-Xi;Li, Meng;Hu, Cheng-Hu;Jin, Yan
    • Experimental and Molecular Medicine
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    • v.50 no.12
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    • pp.12.1-12.14
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    • 2018
  • Osteoporosis develops with high prevalence in both postmenopausal women and hypogonadal men. Osteoporosis results in significant morbidity, but no cure has been established. Mesenchymal stem cells (MSCs) critically contribute to bone homeostasis and possess potent immunomodulatory/anti-inflammatory capability. Here, we investigated the therapeutic efficacy of using an infusion of MSCs to treat sex hormone-deficient bone loss and its underlying mechanisms. In particular, we compared the impacts of MSC cytotherapy in the two genders with the aim of examining potential gender differences. Using the gonadectomy (GNX) model, we confirmed that the osteoporotic phenotypes were substantially consistent between female and male mice. Importantly, systemic MSC transplantation (MSCT) not only rescued trabecular bone loss in GNX mice but also restored cortical bone mass and bone quality. Unexpectedly, no differences were detected between the genders. Furthermore, MSCT demonstrated an equal efficiency in rectifying the bone remodeling balance in both genders of GNX animals, as proven by the comparable recovery of bone formation and parallel normalization of bone resorption. Mechanistically, using green fluorescent protein (GFP)-based cell-tracing, we demonstrated rapid engraftment but poor inhabitation of donor MSCs in the GNX recipient bone marrow of each gender. Alternatively, MSCT uniformly reduced the $CD3^+T$-cell population and suppressed the serum levels of inflammatory cytokines in reversing female and male GNX osteoporosis, which was attributed to the ability of the MSC to induce T-cell apoptosis. Immunosuppression in the microenvironment eventually led to functional recovery of endogenous MSCs, which resulted in restored osteogenesis and normalized behavior to modulate osteoclastogenesis. Collectively, these data revealed recipient sexually monomorphic responses to MSC therapy in gonadal steroid deficiency-induced osteoporosis via immunosuppression/anti-inflammation and resident stem cell recovery.

Toxic Optic Neuropathy Caused by Chlorfenapyr Poisoning (클로르페나피르 음독 후 발생한 독성 시신경병증 1예)

  • Park, Su Jin;Jung, Jae Uk;Kang, Yong Koo;Chun, Bo Young;Son, Byeong Jae
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.11
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    • pp.1097-1102
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    • 2018
  • Purpose: To report a case of toxic optic neuropathy caused by chlorfenapyr ingestion accompanied by central nervous system involvement. Case summary: A 44-year-old female visited our clinic complaining of reduced visual acuity in both eyes for 7 days. She had ingested a mouthful of chlorfenapyr for a suicide attempt 2 weeks prior to the visit. Gastric lavage was performed immediately after ingestion at the other hospital. Her best-corrected visual acuity was finger count 30 cm in the right eye and hand motion in the left eye. Both pupils were dilated by 5.0 mm and the response to light was sluggish in both eyes. A relative afferent pupillary defect was detected in her left eye. Funduscopy revealed optic disc swelling in both eyes. Magnetic resonance imaging of the brain showed a symmetric hyper-intense signal in the white matter tract including the internal capsule, corpus callosum, middle cerebellar peduncle, and brainstem. The patient was diagnosed with toxic optic neuropathy induced by chlorfenapyr ingestion, and underwent high-dose intravenous corticosteroid pulse therapy. Three days later, the best-corrected visual acuity was no light perception in both eyes. Three months later, optic atrophy was observed in both eyes. Optical coherence tomography revealed a reduction in the thicknesses of the retinal nerve fiber layer and ganglion cell and inner plexiform layer in the macular area. Conclusions: Ingestion of even a small amount of chlorfenapyr can cause severe optic nerve damage through the latent period, despite prompt lavage and high-dose steroid treatment.

Case of Anterior Segment Ischemia after Two Vertical Rectus Muscles Surgery (두 개의 수직근수술 후 발생한 전안부허혈 1예)

  • Ahn, Jayoung;Kim, Gyu Nam;Kim, Seong Jae;Chung, In Young;Seo, Seong Wook;Yoo, Ji Myong
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.12
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    • pp.1195-1200
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    • 2018
  • Purpose: To report a case of anterior segment ischemia after superior and inferior rectus muscle surgery in a patient with superior rectus muscle enlargement. This is the first report in the Republic of Korea of anterior segment ischemia after two rectus muscles surgery. Case summary: An 80-year-old male was referred to our clinic with a 3 years history of diplopia. The patient had 30 prism diopters right eye hypertropia in the primary position and downgaze limitation. The orbital computed tomography scan revealed enlargement of the right superior rectus muscle. He underwent right superior rectus recession and inferior rectus resection. On postoperative day 2, slit lamp examination revealed diffuse corneal edema, Descemet's membrane folding, an aqueous flare and a dilated pupil. Treatment with 45 mg oral steroid was initiated, and 1% prednisolone acetate and 0.5% Levofloxacin eye drops were administered. At postoperative 1 month, the patient was orthophoric in the primary position, and there was no corneal edema, pupil abnormality or aqueous flare. Conclusions: Base on the present case, the possibility of anterior segment ischemia should be considered after even two muscles surgery, and older patients with vertical muscle surgery should be considered more carefully.

Acute postoperative myelopathy caused by spontaneous developed cervical disc herniation: Case report & literature review (수술후 자연발생 경추간판탈출에 의한 척수병증: 증례보고 및 문헌고찰)

  • Lee, Jeong-Woo;Lee, Keun Hyeong;Lee, Ju-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.10
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    • pp.303-308
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    • 2019
  • Non-traumatic acute myelopathy caused by cervical disc herniation is rare. To date, no case has been reported to be caused by extrusion cervical disc herniation, unrelated to patient posture during surgery. Here, we report the case of a 65-year-old male patient with cervical myelopathy who underwent subsequent arthroscopic rotator cuff surgery under general anesthesia; non-cervical spine surgery. Ed. Notes: I am unable to understand the insertion of the highlighted phrase. Please delete if not required, or revise the sentence appropriately. Patient showed acute postoperative tetraplegia in spite of optimal anesthetic management. He showed no limitation of neck movement at pre-operative airway evaluation, and had no history of trauma to the cervical spine. During surgery, there had been no overextension or twisting of the neck, including at the time of anesthetic induction by tracheal intubation. However, cervical disc herniation causing spinal canal cord compression was detected in the postoperative magnetic resonance imaging, which probably resulted in tetraplegia of the patient. Motor and sensory functions were recovered after 21 days of conservative treatment, including steroid pulse intravenous therapy without any surgical intervention. In this report, the disease is described after reviewing other reported cases; furthermore, we also discuss the pathophysiology of the disease. Based on our report, we propose that under general anesthesia, clinicians should pay attention to the possibility of pre-existing cervical disease, even in non-cervical spine surgeries of geriatric patients.

Chronic Low-Dose Nonylphenol or Di-(2-ethylhexyl) Phthalate has a Different Estrogen-like Response in Mouse Uterus

  • Kim, Juhye;Cha, Sunyeong;Lee, Min Young;Hwang, Yeon Jeong;Yang, Eunhyeok;Ryou, Chongsuk;Jung, Hyo-Il;Cheon, Yong-Pil
    • Development and Reproduction
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    • v.22 no.4
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    • pp.379-391
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    • 2018
  • Through the development of organic synthetic skill, chemicals that mimic signaling mediators such as steroid hormones have been exposed to the environment. Recently, it has become apparent that this circumstance should be further studied in the field of physiology. Estrogenic action of chronic low-dose nonylphenol (NP) and di-(2-ethylhexyl) phthalate (DEHP) in mouse uterus was assessed in this study. Ten to twelve-week-old female mice (CD-1) were fed drinking water containing NP (50 or $500{\mu}g/L$) or DEHP (133 or $1,330{\mu}g/L$) for 10 weeks. Uterine diameter, the thickness of myometrium and endometrium, and the height of luminal epithelial cells were measured and the number of glands were counted. The expression levels of the known $17{\beta}$-estradiol ($E_2$)-regulated genes were evaluated with real-time RT-PCR methodology. The ration of uterine weight to body weight increased in $133{\mu}g/L$ DEHP. Endometrial and myometrial thickness increased in 133 and $1,330{\mu}g/L$ DEHP treated groups, and in 50, $500{\mu}g/L$ NP and $133{\mu}g/L$ DEHP, respectively. The height of luminal epithelial cell decreased in NP groups. The numbers of luminal epithelial gland were decreased in NP groups but increased in $50{\mu}g/L$ DEHP group. The histological characters of glands were not different between groups. The mRNA expression profiles of the known $17{\beta}$-estradiol ($E_2$) downstream genes, Esr1, Esr2, Pgr, Lox, and Muc1, were also different between NP and DEHP groups. The expression levels dramatically increased in some genes by the NP or DEHP. Based on these results, it is suggested that the chronic low-dose NP or DEHP works as estrogen-like messengers in uterus with their own specific gene expression-regulation patterns.

Relievable Effect of Alpinetin on Dexamethasone-Induced Skin Aging (Alpinetin의 Dexamethasone으로 유도한 피부 노화 완화 효과)

  • Nam, Jin-Ju;Kim, Youn Joon;Kang, Seunghyun
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.42 no.2
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    • pp.163-171
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    • 2016
  • Steroid hormone, glucocorticoid (GC) has strong anti-inflammatory effects by binding to glucocorticoid receptor (GR) inhibiting the expression of inflammatory genes. Therefore, agents that activate the GR have been used for the treatment of dermatitis. However, the agents have side effects such as skin barrier dysfunction and dermal atrophy, inducing skin damage as well as skin aging. It has been reported that GC is activated by 11 beta-hydroxysteroid dehydrogenase type 1 ($11{\beta}$-HSD1) to increase the activity of the GR. This study aimed to identify natural materials that can effectively inhibit dexamethasone. We found that alpinetin isolated from Alpinia katsumadai extract has a significant effect on this. Alpinetin not only inhibited $11{\beta}$-HSD1 expression, but also suppressed the increase of phosphorylated GR and cortisol concentration. Alpinetin also recovered collagen expression in dexamethasone-treated dermal fibroblasts, and the reduction of dermal thickness in dexamethasnone-treated 3D skin model. These results suggest that alpinetin prevents skin aging induced by the increase of $11{\beta}$-HSD1 expression.