• Title/Summary/Keyword: corticosteroid therapy

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Association between Asymptomatic Urinary Tract Infection and Postoperative Spine Infection in Elderly Women : A Retrospective Analysis Study

  • Lee, Seung-Eun;Kim, Kyoung-Tae;Park, Yong-Sook;Kim, Young-Baeg
    • Journal of Korean Neurosurgical Society
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    • v.47 no.4
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    • pp.265-270
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    • 2010
  • Objective : The purpose of this study is to identify the relationship between asymptomatic urinary tract infection (aUTI) and postoperative spine infection. Methods : A retrospective review was done in 355 women more than 65 years old who had undergone laminectomy and/or discectomy, and spinal fusion, between January 2004 and December 2008. Previously postulated risk factors (i.e., instrumentation, diabetes, prior corticosteroid therapy, previous spinal surgery, and smoking) were investigated. Furthermore, we added aUTI that was not previously considered. Results : Among 355 patients, 42 met the criteria for aUTI (Bacteriuria ${\geq}\;10^5\;CFU/mL$ and no associated symptoms). A postoperative spine infection was evident in 15 of 355 patients. Of the previously described risk factors, multi-levels (p<0.05), instrumentation (p<0.05) and diabetes (p<0.05) were proven risk factors, whereas aUTI (p>0.05) was not statistically significant. However, aUTI with Foley catheterization was statistically significant when Foley catheterization was added as a variable to the all existing risk factors. Conclusion : aUTI is not rare in elderly women admitted to the hospital for lumbar spine surgery. The results of this study suggest that aUTI with Foley catheterization may be considered a risk factor for postoperative spine infection in elderly women. Therefore, we would consider treating aUTI before operating on elderly women who will need Foley catheterization.

A Case of Pneumocystis carinii Pneumonia in an Infant with Failure to Thrive (성장 장애를 보인 영아에서 발현된 주폐포자충 폐렴 1례)

  • Kong, Sun Hui;Lee, Ho Jun;Kim, Soo Yeon;Kim, Hak Sung;Lee, Dong Woo;Kim, Jae Yoon
    • Pediatric Infection and Vaccine
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    • v.12 no.1
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    • pp.95-99
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    • 2005
  • Pneumocystis carinii pneumonia is an infectious disease which is highly prevalent in the group of immunosuppressed patients, particularly with hematologic tumors as lymphomas and acquired immune deficiency syndrome(AIDS), severe malnutrition, organ transplantations, high dose corticosteroid therapy. Some cases of Pneumocystis carinii pneumonia in infants with primary immune deficiency were already reported. The authors present a case of Pneumocystis carinii pneumonia developed in an infant who suffered from 10 days of poor feeding and failure to thrive and not included in the risk groups listed above. He had bilateral interstitial infiltrations on the chest radiography, diagnosed as Pneumocystis carinii pneumonia after Gomori-methenamine silver staining of his sputum that was taken through tracheal intubation. He improved after administering Trimethoprim-sulfamethoxazole for 14 days.

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Three-Phase Bone Scintigraphy in Reflex Sympathetic Dystrophy Syndrome of the Hand (반사성 교감신경계 기능장애 증후군(RSDS)의 손 3상 골스캔 소견)

  • Ahn, Myeong-Im;Park, Jeong-Mi;Park, Young-Ha;Kim, Sung-Hoon;Chung, Soo-Kyo;Shinn, Kyung-Sub;Bahk, Yong-Whee
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.1
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    • pp.81-86
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    • 1991
  • Reflex sympathetic dystrophy syndrome (RSDS), known also as Sudeck's atrophy, is an uncommon disorder recognized by its distinctive symptom complex consisting of pain and tenderness, vasomotor instability, swelling, and dystrophic skin changes and radiologic changes. The present study has been carried out to prospectively establish scintigraphic diagnostic criteria for RSDS using three-phase radionuclide bone scintigraphy (TPBS). In addition, the usefulness in the evaluation of treatment of RSDS was assessed. Patients included were 6 men and 7 women with the age ranging from 25 to 63 years (average 47 years). Diagnosis was based on typical clinical symptoms and signs as described above. Associated clinical conditions in these patients were cerebral infarction (4 patients), lung cancer (2 patients), trauma (1 patient), lymphoma (1 patient), and unknown cause (5 patients). All patients showed diffuse radionuclide accumulation in juxtaarticular region on the delayed static image and 11 patients showed diffusely increased activities also on scintiangiogram and blood-pool image. Fillow-up TPBS after corticosteroid therapy in 4 patients revealed near normal return of abnormal radionuclide accumulations in the affected hand. TPBS is an useful test for the diagnosis of as well as the evaluation of the therapeutic effects of RSDS.

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Analysis and Management of Complications of Open Reduction and Medpor Insertion through Transconjunctival Incision in Blowout Fractures (안와골절에서 결막절개를 통한 Medpor 내고정술의 합병증 분석과 치료)

  • Lee, Ji Won;Choi, Jae Il;Ha, Won;Yang, Wan Suk
    • Archives of Craniofacial Surgery
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    • v.13 no.1
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    • pp.22-28
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    • 2012
  • Purpose: In accordance to an increased interest in facial appearance and the popularization of computed tomography scanning, the number of diagnosis and treatment of blowout fractures has been increased. The purpose of this article is to review pure blowout fracture surgery through transconjunctival incision focusing on complications and their management. Methods: In this retrospective study, 583 patients, who had been treated for pure blowout fracture through transconjunctival incision from 2000 to 2009, were evaluated. Their hospital records were reviewed according to their sex, age, fracture site, preoperative presentations, time interval between trauma and surgery, and postoperative complications. Results: According to postoperative follow-up results, there were early complications that included wound dehiscence and infection (0.2%), hematoma (insomuch as extraocular movement is limited) (0.7%), lacriminal duct injury (0.5%), and periorbital nerve injury (0.7%). In addition, there were late complications that lasted more than 6 months, that included persistent diplopia (1.7%), extraocular movement limitation (0.9%), enophthalmos (1.0%), periorbital sensation abnormalities (1.0%), and entropion (0.5%). Conclusion: We propose the following guidelines for prevention of postoperative complications: layer by layer closure; bleeding control with the epinephrine gauzes, Tachocomb, and Tisseel; conjunctival incision 2 to 3 mm away from punctum; avoidance of excessive traction; performing surgical decompression and high dose corticosteroid therapy upon confirmation of nerve injury; atraumatic dissection and insertion of Medpor Barrier implant after securing a clear view of posterior ledge; using Medpor block stacking technique and BioSorb FX screw fixation; performing a complete resection of the anterior ethmoidal nerve during medial wall dissection; and making an incision 2 to 3 mm below the tarsal plate.

A Case of Hantavirus Pulmonary Syndrome (한타바이러스 폐 증후군)

  • Lee, Kye-Young;Kim, Yun-Seup;Jee, Young-Koo;Bai, Hyun-Ju;Yun, Sung-Cheul;Kim, Keun-Youl
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1382-1389
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    • 1997
  • Hantavirus pulmonary syndrome(HPS) is a systemic disease that is caused by a newly discorved and characterized virus of the Hantavirus genus, which is most frequently referred to as the sin nombre virus. The clinical syndrome resembles other hantavirus syndromes worldwide, except that it is characterized by a brief prodromal illness followed by rapidly progressive, noncardiogenic edema, and that it is more deadly than any previously recognized hantavirus infection. The clinical manifestations of HPS are characterized by four clinical phases : prodrome, pulmonary edema and shock, diuresis, and convalescence. Mortality is greatest in the first 24 hours of the pulmonary edema and shock phase of the illness. These phases are strikingly similar to the clinical phases of Hemorrhagic fever with renal syndrome(HFRS) induced by Hantaan virus, except that HPS has not been associated with renal failure and Disseminated intravascular coagulation(DIC). We here report a case of hantavirus pulmonary syndrome developed in a 58 year-old man. He had a flu-like illness followed by the rapid onset of respiratory failure due to noncardiogenic pulmonary edema. HPS was diagnosed by clinical manifestations, identification of high titer antibody to Hantaan virus antigen and histologic finding of transbronchial lung biopsy (TBLB) specimen. The patient was treated with mechanical ventilation and initial corticosteroid pulse therapy resulting in successful outcome.

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A Case of Chronic Eosinophilic Pneumonia after Ingestion of Wild Rats (들쥐 생식 후에 발생한 만성 호산구성폐렴 1예)

  • Choi, Hyung-Seok;Kim, Ho-Jung;Lee, Hyuk-Pyo;Shim, Tae-Sun;Cho, Sang-Heon;Kim, Young-Whan;Shim, Young-Soo;Kim, You-Young;Kim, Tae-Jin;Kim, Young-Il
    • Tuberculosis and Respiratory Diseases
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    • v.38 no.2
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    • pp.194-201
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    • 1991
  • The Pulmonary Infiltration and Eosinophilia Syndrome (PIE Syndrome) includes a wide spectrum of clinical disorders with pulmonary infiltrates and peripheral eosiophilia. It is poorly understood and ill-defined group of disorders. Often its etiology is poorly delineated. There may exist an eosinophilic type of alveolitis in the category of PIE syndrome. It shows characteristic clinical picture, peripheral eosinophilia and especially dramatic improvement following therapy with corticosteroids. We report a case of the syndrome in 43-year-old man with brief review of contemporary literature. In this case, the diagnosis was confirmed by open lung biopy which showed characteristic eosinophilic alveolitis accompanied by periphiral eosinophilia. Corticosteroid was administered with rapid clinical improvement in this case.

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Effect of supportive periodontal treatment in the oral lichen planus patients (구강편평태선 환자에서 보조적 치주치료의 효과)

  • Kwon, Eun-Young;Choi, Jeomil;Lee, Ju-Youn
    • Journal of Dental Rehabilitation and Applied Science
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    • v.31 no.2
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    • pp.134-142
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    • 2015
  • Lichen planus is an immune-mediated mucocutaneous disease, affects more frequently middle-aged Caucasian women and makes signs and symptoms in the oral mucosa. Cutaneous lichen planus lesions cause itching but they are self-limiting, oral lichen planus lesions are usually chronic, recalcitrant to treatment and potentially premalignant in some cases. Although, oral lichen planus is non-plaque related disease, they possess particular problems because plaque control is complicated by pain and bleeding and might cause plaque-related disease. The resulting condition comprises accumulations of plaque, which again can influence the progress of oral lichen planus with burning sensation, spontaneous gingival bleeding. Thus, it should be noted that both medication and supportive periodontal treatment are essential for the remission of the lesions. This case report introduces topical corticosteroid therapy and supportive periodontal treatment including intensive oral hygiene procedures to obtain an improvement of subjective symptoms and objective changes and to prevent relapse the lesions.

A Case of Drug Induced Interstitial Pneumonitis by Gemcitabine (Gemcitabine에 의한 약물 유발성 간질성 폐렴 1예)

  • Lee, Sung Soon;Ham, Cho Rom;Chin, Jae-Yong;Lee, Hye Ran;Kim, Su Young;Kim, Mi-young;Lee, Hyun-Kyung;Lee, Hyuk Pyo;Yum, Ho-Kee;Choi, Soo Jeon
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.3
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    • pp.315-320
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    • 2004
  • Gemcitabine is an effective newly developed chemotherapeutic agent, which is increasingly being used to treat non-small cell lung, ovarian and breast cancers. Pulmonary toxicity is usually self-limiting mild dyspnea, bronchospasm, but severe pulmonary toxicity is rarely reported. Herein, we report drug induced interstitial lung disease associated with gemcitabine treatment. High resolution computerized tomogram (HRCT) showed an increased ground glass opacity and thickened septal lines. The patient showed a rapid good response with prednisolone treatment.

Fibrosing Mediastinits Causing Obstruction of Left Lower Lobar Bronchus: A Pediatric Case Report (좌하엽 기관지 폐쇄를 유발한 섬유성 종격동염: 소아 증례 보고)

  • Young Woo Sim;Young Seon Kim;Seung Eun Lee;Min Hye Jang
    • Journal of the Korean Society of Radiology
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    • v.83 no.3
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    • pp.744-749
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    • 2022
  • Fibrosing mediastinitis is a rare benign disorder characterized by the proliferation of dense fibrous tissue within the mediastinum. It typically manifests as localized or infiltrative soft-tissue masses in the middle mediastinum or hilar area, which cause compression and encasement of adjacent mediastinal structures, such as the vessels or airway. Here, we report a rare case of fibrosing mediastinitis in a 13-year-old girl that presented as a middle mediastinal mass lesion on CT scan with obliterating left lower lobar bronchus. The patient's symptoms and follow-up chest CT showed significant improvement following systemic corticosteroid treatment. As fibrosing mediastinitis can improve with systemic steroid therapy, radiologists must be aware of its radiologic findings when discriminating between infiltrating soft tissue lesions in the mediastinum.

The Correlation of TUNEL Apoptotic Index with Clinicoradiologicopathologic Scores in Interstitial Lung Disease (간질성 폐질환에서 TUNEL 아포프토시스 지수와 임상적, 방사선학적, 및 병리학적 지표와의 상관관계)

  • Kim, Youn-Seup;Myung, Na-Hye;Park, Jae-Seuk;Jee, Young-Koo;Lee, Kye-Young
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.2
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    • pp.136-147
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    • 2002
  • Background : Interstitial lung disease has various manifestations that are differentiated by their pathology, progress and treatment. However, all manifestations eventually progresses to pulmonary fibrosis. Recent studies have shown that apoptosis of pulmonary epithelial cells might be related to pulmonary fibrosis. The correlation of the apoptotic index with the clinical manifestations, pathological findings, HRCT findings and the response to treatment were examined. Materials and Methods : Twenty subjects (14 men, 16 women), who had been diagnosed with interstitial lung disease through an open lung biopsy, were enrolled in this study. The subtypes were one AIP, two NIP, eight BOOP, and seven UIP cases. The apoptotic index was scaled from 0-2 depending on the fraction of positive staining cells by TUNEL method. The clinical severity was assessed by a modification of a previously developed CRP scoring system. The pathologic scores were based on 4 components: fibrosis, cellularity, desquamation, and granulation. In the HRCT study, each lobe was scored by the radiologists on a scale for both fibrosis and ground-glass attenuation. The treatment response was assessed by an increase in more than 10% of the CRP score, and comparing the results 3 months before and after treatment. Results : The apoptotic index showed no correlation with the CRP and HRCT scoring system. The apoptotic index correlated with the pathologic elements including fibrosis, cellularity and the desquamation score (p<0.05). Of the 16 patients who received corticosteroid therapy, 9 patients (56.3%) responded to therapy. There was no correlation between the response to corticosteroid and the apoptotic index. In the case of patients with acute and subacute ILD, the apoptotic index showed a correlation with the cellularity, desquamation, and the total histological score (p<0.05). In the case of patients with chronic ILD, the apoptotic index correlated with the fibrosis and cellularity score (p<0.05). Conclusion : Apoptosis of the pulmonary epithelial cells is implicated in the pathogenesis of interstitial lung disease particularly on a pathological basis.