• 대한통합의학회지
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• 제9권4호
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• pp.237-249
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• 2021

Purpose : This study was to compare the effect changes after physical therapy (extracorporeal shock wave therapy + high-load strengthening exercise) or corticosteroid injection in patients diagnosed with chronic plantar fasciitis. Methods : A total of 40 patients were randomly assigned to each group of 20. According to the intervention method, "Group 1. Physiotherapy" was performed for 12 weeks, and "Group 2. Corticosteroid injection" was performed only once. As a pre-intervention test, plantar fascia thickness, pain intensity I, II (What is the most painful moment of the day?, How painful is the first step in the morning?), and functional performance were measured. To compare the effects of each group, the tests 3, 6, and 12 weeks after were also performed using the same measurement method. Also, after 12 weeks, patient satisfaction was also compared. Results : There was no significant difference between the groups in the change in the thickness of the plantar fascia during all periods. However, pain intensity I, II was significantly lower in Group 1 than in Group 2 at only 12 weeks and functional performance was also significantly increased in Group 1 compared to Group 2 at only 12 weeks. Also, there was no significant difference between groups in patient satisfaction. Conclusion : The physiotherapy protocol, which consisted of extracorporeal shock wave therapy and high-load strengthening exercise, showed excellent results, especially after 12 weeks, compared to corticosteroid injection. It is recommended as a more effective treatment method as it is possible to safely return to daily life by reducing pain and improving functional performance.

• 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.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권3호
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• pp.175-186
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• 2022

This study aimed to systematically review the effectiveness of methylene blue (MB) photosensitizers in the management of symptomatic oral lichen planus (OLP). Electronic online databases and manual searches were performed for randomized controlled trials (RCTs) published in English between January 2010 and February 2022. RCTs comparing photodynamic therapy (PDT) and corticosteroid therapy at baseline and follow-up period were identified. The Cochrane risk of bias tool was used to assess the quality of the included studies. A meta-analysis was performed regarding visual analog scale (VAS) scores, Thongprasom sign scores, lesion size, response to treatment, and exacerbation of lesions after therapy. The clinical severity was analyzed qualitatively. Five RCTs consisting of 180 samples fulfilled the inclusion and exclusion criteria. All parameters of VAS score, Thongprasom sign score, lesion size, and response to treatment were statistically non-significant. Our results indicate that both MB-PDT and corticosteroid therapy are effective for the management of OLP. Moreover, MB-PDT is an effective alternative treatment option for OLP when corticosteroids are contraindicated. However, conclusive evidence cannot be ascertained owing to the heterogeneity among the studies.

• Clinical and Experimental Pediatrics
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• 제51권9호
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• pp.1018-1022
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• 2008

선천 부신 과다형성 환자에서 고환 부신 잔류 종양은 흔하게 발생한다. 대개 이 종양은 적절한 corticosteroid 억제 치료로 호전될 수 있다. 저자들은 양측성 고환 부신 잔류 종양을 보인 21-hydroxylase 결핍증 환아에게서 corticosteroid를 투여하였으나 반응하지 않아 고환 적출술을 시행한 사례를 경험하였기에 보고하는 바이다.

• 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.

• Journal of Oral Medicine and Pain
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• 제43권1호
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• pp.16-20
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• 2018

Graft-versus-host disease (GVHD) is frequent complications of hematopoietic stem cell transplantation. In the chronic GVHD (cGVHD), the oral cavity is the most commonly affected region. The clinical manifestations include erythema, ulceration, lichenoid-hyperkeratotic change in oral mucosa, dry mouth, and limitation of mouth opening. The initial treatment strategy of oral cGVHD patients is topical corticosteroid therapy in various formulation. However, corticosteroid resistance appears in some patients. We report a case of a 25-year-old male patient with oral cGVHD, who has resistance to topical corticosteroid medication, treated with 0.03% tacrolimus ointment and low-dose doxycycline. The patient showed subjective and objective improvement without side effect.

• 한국임상수의학회지
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• 제22권3호
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• pp.264-267
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• 2005

구토와 식용부진을 3일전부터 나타내고, 2년전부터 좌측 후지 상부에 종괴를 갖고 있는 12년령, 8.0kg, 난소 제거 잡종 암캐 1두가 충남대학교 부속동물병원에 내원하였다. 환자는 fine-needle aspiration (FNA) 세포진단학 검사에 의하여 mast cell tumor로 진단하였다. Mast cell tumor 진단을 위한 WHO clinical staging system에 의하여 stage IIIa로 분류하였다. 환자는 adjuvant corticosteroid 요법에 의하여 투약되었으며, 축주의 요구에 의하여 완전 외과 절제는 실시하지 아니 하였다. 초기에 adjuvant corticosteroid 단독 요법에 의하여 종괴의 크기가 점차 감소하였으며, 환자의 전신상태는 호전되었다. 그러나 그 후에는 더 이상 glucocorticoid에 반응을 하지 아니 하였으며, 종괴의 크기가 증가하였고, 2개월 후에 간헐적 구토와 심한 호흡곤란 때문에 안락사 하였다. 비장 종괴, 십이지장 궤양, 간 종괴와 후지 상부 근육부위에 침윤된 mast cell tumor가 부검 시에 발견되었다. Mast cell tumor는 grade I 또는 II에서 그리고 .조직학적으로 well-differentiated된 상태에서 외과적 완전절제, 방사선요법, adjuvant corticosteroid 요법, 화학요법을 병용 하여야 양호한 예후를 나타낼 것으로 기대된다.

• 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.

• Clinical and Experimental Pediatrics
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• 제49권7호
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• pp.784-789
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• 2006

목 적 : HSP는 피부, 관절, 위장관, 신장을 포함한 전신의 소혈관을 침범하는 혈관염이다. HSP의 위장관 증상은 때로 다량의 위장관 출혈, 장천공, 장중첩 등의 위중한 형태로 나타날 수 있는데, 이 중 일부 환자는 corticosteroid 치료에도 불구하고 증상이 호전되지 않는 경우가 있다. 저자들은 심한 위장관 증세를 보이면서 스테로이드에 반응하지 않는 HSP 환아에서 IVIG 치료의 효과를 알아보고자 하였다. 방 법 : 1999년 4월부터 2005년 1월까지 심각한 위장관 증상으로 입원한 22명의 HSP 환아들의 의무기록을 조사하였다. 이들 모두에서 처음엔 methylprednisolone(2 mg/kg)을 정맥 투여하였으며, 스테로이드 치료에 반응이 없는 환아들을 대상으로 하여 IVIG(2 g/kg)을 투여하였다. 결 과 : 대량의 위장관 출혈과 복통 등이 동반된 심한 위장관 증상을 나타낸 22명의 환아(연령 : 2.3-15세, 성별 M : F=12 : 10)중에 12명이 스테로이드 치료에도 불구하고 증상이 호전되지 않아 고용량 IVIG 치료를 받았다. IVIG 투여 전, methylprednisolone 정맥주사의 평균 투여기간은 $5.6{\pm}4.9$일이었으며 12명 중 11명에서 IVIG 투여 후 1시간에서 5일 사이에 위장관 증상이 호전되었다. 나머지 1명은 IVIG 투여 후에도 복통이 있었으나, 혈변은 소실되었다. IVIG을 투여받은 환아들과 corticosteroid만을 투여받은 환아들간에 입원기간의 차이는 없었다($12.8{\pm}7.6$일 vs. $13.2{\pm}7.8$일, P=0.777). 복통이 지속되었던 총기간은 IVIG 투여군이 짧았으나 통계적으로는 유의하지 않았다($8.8{\pm}8.1$일 vs. $14.8{\pm}16.9$일, P=0.306). Methylprednisolone 정맥주사만을 단독으로 치료받은 10명 중 2명(20%)은 장천공으로 수술을 받았으나, IVIG 투여군 12명에서는 장천공이 전혀 발생하지 않았다. 결 론 : 심한 위장관 침범이 있는 HSP 환아의 복부증상이 기존의 스테로이드 치료에도 불구하고 호전되지 않을 때에는 고용량 정맥 면역글로불린 투여를 고려해 볼 수 있을 것이다.

• Clinical and Experimental Pediatrics
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• 제59권4호
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• pp.196-201
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• 2016

Chronic granulomatous disease (CGD) is a rare inherited disorder caused by defective nicotinamide adenine dinucleotide phosphate oxidase enzyme and characterized by recurrent bacterial and fungal infections. Although liver abscess is a common manifestation of CGD, its management in CGD patients is not well-defined. In addition, the generalized guidelines for treating liver abscesses do not necessarily apply to CGD patients. Corticosteroids are commonly used to control granulomatous complications, such as inflammatory gastrointestinal and genitourinary lesions, in patients with CGD, Corticosteroids have also been used in combination with antimicrobials to treat refractory infections in patients with CGD. Because corticosteroids are capable of suppressing symptomatic inflammation, all potential infections must be adequately controlled prior to corticosteroid initiation. We report 3 typical CGD cases with liver abscesses refractory to conventional treatments that were successfully treated with the concomitant use of corticosteroid and antimicrobials. It remains unclear whether corticosteroid therapy is required for liver abscesses in CGD refractory to conventional treatments. However, based on our observations, use of corticosteroids in combination with optimal antimicrobials should be considered for refractory liver abscesses in CGD.