• Tuberculosis and Respiratory Diseases
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• v.81 no.1
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• pp.1-5
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• 2018

Asthma, remains symptomatic despite ongoing treatment with high doses of inhaled corticosteroids (ICS) in conjunction with long-acting beta-agonists (LABA), is classified as "severe" asthma. In the course of caring for those patients diagnosed with severe asthma, stepping up from ICS/LABA to more aggressive therapeutic measures would be justified, though several aspects have to be checked in advance (including inhaler technique, adherence to therapy, and possible associated comorbidities). That accomplished, it would be advisable to step up care in accordance with the Global Initiative for Asthma (GINA) recommendations. Possible strategies include the addition of a leukotriene receptor antagonist or tiotropium (to the treatment regimen). The latter has been shown to be effective in the management of several subgroups of asthma. Oral corticosteroids have commonly been used for the treatment of patients with severe asthma in the past; however, the use of oral corticosteroids is commonly associated with corticosteroid-related adverse events and comorbidities. Therefore, according to GINA 2017 these patients should be referred to experts who specialize in the treatment of severe asthma to check further therapeutic options including biologics before starting treatment with oral corticosteroids.

• Annals of Geriatric Medicine and Research
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• v.22 no.4
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• pp.200-203
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• 2018

Strongyloides stercoralis is an intestinal nematode that occurs sporadically in temperate areas like Korea. People who are in the immunosuppressed state, over the age of 65 or under the corticosteroid therapy are at risk for developing Strongyloides hyperinfection syndrome. Acute respiratory distress syndrome (ARDS) with alveolar hemorrhage is a rare presentation of Strongyloides hyperinfection. A 78-year-old man had been irregularly injected corticosteroid on his knees, but did not have any immunosuppressive disease. He was initially diagnosed with ARDS and septic shock. Bronchoalveolar lavage (BAL) fluid was bloody and its cytology revealed helminthic larvae identified as S. stercoralis. Results of Cytomegalovirus polymerase chain reaction (PCR), Pneumocystis jirovecii PCR, and Aspergillus antigen testing of the BAL fluid were positive. The clinical progress quickly deteriorated with multiple organ failure, shock and arrhythmia, so he finally died. This is a rare case of ARDS in an older patient without any known immunosuppressive conditions, with alveolar hemorrhage and S. stercoralis being found via BAL.

• Childhood Kidney Diseases
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• v.12 no.2
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• pp.170-177
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• 2008

Purpose : The aim of this study was to evaluate whether the incidence of relapse or nephritis might be influenced by the duration of corticosteroid therapy in children with Henoch-Schonlein purpura(HSP). Methods : We retrospectively analyzed 186 children with a diagnosis of HSP in two major hospitals in Ilsan, Korea from the years 2000 to 2003. To evaluate whether renal involvement or relapse might be influenced by the duration of corticosteroid therapy in children with HSP, one pediatric nephrologist from hospital A, maintained corticosteroid therapy for at least 2 weeks(Group A, n=94). The other from hospital B used only during the symptomatic period(Group B, n=92). Results : There were no significant differences in age, sex, body weight, white blood cell count, hemoglobin, hematocrit, platelet count, serum protein and albumin levels between the two groups. The incidence of abdominal pain or arthralgia also did not differ between two groups. However, the duration of steroid therapy was significantly longer in Group A than in Group B and the cumulative dose of prednisolone was also higher in Group A than in Group B. The development of nephritis was more frequent in Group A. Conclusion : The longer duration of steroid use was not associated with the decreased rate of nephritis. Therefore, corticosteroids should be used carefully in a selected group of HSP children, and be tapered rapidly after control of the acute symptoms.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.16 no.3
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• pp.185-189
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• 2013

Corticosteroid (budesonide) nebulizer therapy is commonly performed. Its side effects have been considered as being safe or ignorable. The authors present a case of esophageal candidiasis in a healthy female adolescent who was treated with budesonide nebulizer therapy a few times for a cough during the previous winter season. This child presented with dysphagia and epigastric pain for 1 month. Esophageal endoscopy showed a whitish creamy pseudomembrane and erosions on the esophageal mucosa. Pathologic findings showed numerous candidal hyphae. She did not show any evidence of immunodeficiency, clinically and historically. The esophageal lesion did not resolve naturally. The esophageal lesion completely improved with the antifungal therapy for 2 weeks; the symptoms disappeared, and the patient returned to normal health. It is important that frequent esophageal exposure to topical corticosteroids application can cause unexpected side effects.

• The Korean Journal of Pain
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• v.5 no.1
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• pp.117-120
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• 1992

Non traumatic aseptic necrosis of the head of the femur is well documented with respect to its clinical roentgenographic and pathological aspect, but not with respect to etiology. A number of reports have associated various diseases and conditions with necrosis of the femoral head. Prominent among these are alcoholism, steroid therapy and hemostatic disorder. The increased incidence of avascular necrosis of bone associated with long-term corticosteroid therapy has aroused much interest. The pathogenesis of cortisone-induced avascular necrosis is as yet unproved. But cortisone-induced fatty liver with hyperlipidemia, leading to systemic embolization of fat and avascular necrosis of bone has much experimental support. We present a case of bilateral avascular necrosis of the femur head following several epidural steroid injections in a 30 year old male patient who had low back pain with radiation to both legs for 1 year and who had Cushinoid appearance for several months. One week later, he had a total replacement of both hip operation.

• The Korean Journal of Rehabilitation Nursing
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• v.2 no.2
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• pp.193-205
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• 1999

This study was carried out to identify the important risk factors for reduced bone mass of postmenopausal RA patients and to develop discriminant function which can classify postmenopausal RA patients with either reduced or normal bone mass. Through the literature review, individual characteristics such as age, body weight, height, age of menarche, duration of menopause, gravity, parity, and breast feeding period and factors of life style such as milk consumption exercise habit, alcohol intake, cigarette smoking, coffee consumpt ion , disease activity, corticosteroid therapy were identified as influencing factors of reduced bone mass in RA patients Sixty eight postmenopausal women with rheumatoid arthritis aged between 42 and 76 were selected among those who checked bone mineral density in lumbar spine and femur from october, 1998 to Apr il, 1999 at Dong-a university hospital in Pusan. Assessment of disease activity, duration of disease and corticosteroid therapy were made by the same rheumatologist and included Ritchie articular index, erythrocyte sedimentation rate, and C-reactive protein on measuring bone mineral density. Cumulative steroid dosage was calculated from the daily dosage multiplied by t h e number of days received. The information of other risk factor including health assessment score, individual characteristics and life style factors were collected by questionnaire. Bone mineral density(BMD) was measured using DXA at lumbar spine and femoral Ward's triangle. Discriminant function(regression equation) was developed for estimating the likelihood of the presence or absence of reduced bone mass. The results are as follows: Among the subjects, thirteen(19.1%) exhibited osteoporosis in lumbar spine and twenty four(35.3%) exhibited osteoporosis in femoral Ward's triangle. For lumbar spine, the variables significant were age, body weight, health assessment score, while for femoral Ward's triangle, age, body weight, duration of disease. But disease activity and corticosteroid therapy were not signigicant to distinguish reduced bone mass from normal bone mass. When the discriminant function was evaluated by comparing the observed out come with predicted out come, the discriminant function correctly classified 85.4% of patients with reduce bone mass and 63.0% of patients with normal bone mass in the lumbar spine and 100% of patients with reduced bone mass and 9.1% of patients with normal bone mass in the femoral Ward's triangle. In summary, we found that osteoporosis in postmenopausal women with RA is more evident at the femur than the lumbar spine. Also the important discriminant factors of reduced bone mass postmenopausal women with RA were age, body weight , duration of disease and health disability. In nursing situation, the efforts to improve of functional capacity of postmenopausal women with rheumatoid arthritis should be considered to prevent osteoporosis and fractures. Also we recommend those postmenopausal women with RA who are classified as a group of the reduced bone mass in the discriminant function should examine the bone mineral density to further examine the usefulness of this discriminant function.

• Clinical and Experimental Pediatrics
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• v.61 no.10
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• pp.332-337
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• 2018

Purpose: Bell's palsy is characterized by sudden onset of unilateral facial weakness. The use of corticosteroids for childhood Bell's palsy is controversial. This study aimed to identify clinical characteristics, etiology, and laboratory findings in childhood Bell's palsy, and to evaluate the efficacy of corticosteroid treatment. Methods: We conducted a retrospective analysis of children under 19 years of age treated for Bell's palsy between January 2009 and June 2017, and followed up for over 1 month. Clinical characteristics, neuroimaging data, laboratory findings, treatments, and outcomes were reviewed. Patients with Bell's palsy were divided into groups with (group 1) and without (group 2) corticosteroid treatment. Differences in onset age, sex, laterality, infection and vaccination history, degree of facial nerve palsy, and prognosis after treatment between the groups were analyzed. Results: One hundred patients were included. Mean age at presentation was $7.4{\pm}5.62years$. A total of 73 patients (73%) received corticosteroids with or without intravenous antiviral agents, and 27 (27%) received only supportive treatment. There was no significant difference in the severity, laboratory findings, or neuroimaging findings between the groups. Significant improvement was observed in 68 (93.2%) and 26 patients (96.3%) in groups 1 and 2, respectively; this rate was not significantly different between the groups (P=0.48). Conclusion: Childhood Bell's palsy showed good prognosis with or without corticosteroid treatment; there was no difference in prognosis between treated and untreated groups. Steroid therapy in childhood Bell's palsy may not significantly improve outcomes.

• Korean Journal of Bronchoesophagology
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• v.9 no.1
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• pp.83-86
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• 2003

Background and Objectives : Paradoxical vocal cord movement is a series of paroxysmal adduction of the anterior two-thirds of the vocal cords during respiration or during phonation. The choking, stridor, and wheezing in this condition occur primarily on inhalation, rather than on exhalation. The two pathognomonic diagnostic criterias that need to be assessed during an acute presentation are laryngoscopy with direct visualization of paradoxical adduction of the vocal cords and pulmonary function testing. Materials and Methods : A retrospective review of 3 patients who were referred to otolaryngologist from pulmonology department, and were confirmed by typical laryngoscopic findings with paradoxical adduction of the vocal cords was conducted. Results The patients were misdiagnosed as exercised-induced asthma, and unresponsive to corticosteroid and bronchodilators. Improvement was achieved only by diagnosis with paradoxial vocal cord movement. Biofeed back therapy, voice therapy, treatment for reflux laryngitis improved symptoms. Conclusion The etiology of paradoxical vocal cord movement is unknown. It may be functional or emotional. The functional factors that were proposed are neurologic deficit and gastroesophageal reflux. Management methods of this condition consist of psychological counselling, voice therapy, and antireflux medication.

• The Korean Journal of Nuclear Medicine
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• v.11 no.1
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• pp.71-75
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• 1977

A case is reported of aplastic anemia occuring during Methimazole therapy. Since this seems to be a kind of self-limiting disease having considerably rapid recovery, much more detailed supportive therapy is considered to be crucial rather than any other corticosteroid or the androgen therapy.

• International Journal of Advanced Culture Technology
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• v.12 no.2
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• pp.90-97
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• 2024

Shoulder impingement syndrome (SIS) is a common musculoskeletal condition characterized by pain and functional limitation due to the impingement of subacromial structures. This comprehensive review elucidates the complex nature of SIS, covering its pathophysiology, diagnostic methodologies, treatment options, and preventive measures. Through an exhaustive examination of current literature and clinical practices, the review highlights the importance of a multifaceted approach to SIS management. Physical therapy plays a pivotal role, focusing on exercises to strengthen shoulder musculature, enhance scapular stability, and improve range of motion. The review also discusses the strategic use of medications such as NSAIDs and corticosteroid injections, emphasizing their effectiveness in pain and inflammation management. Additionally, it advocates for structured rehabilitation programs post-treatment to restore function and prevent recurrence, recommending preventive strategies like ergonomic adjustments, targeted exercises, and proper technique training. This paper underscores the need for personalized and evidence-based treatment strategies, integrating physical therapy and pharmacological management when necessary.