• Microbiology and Biotechnology Letters
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• v.18 no.1
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• pp.66-70
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• 1990

A study on 11 $\alpha$-hydroxylation of progesterone by using Rhizopus nigricans was carried out to produce efficiently 11 $\alpha$-hydroxyprogesterone which is an essential intermediate of corticosteroids synthesis. Firstly, medium was optimized in view of bioconversion yield and cell growth. Glucose and casamino acid were selected as carbon and nitrogen source and the ratio of carbon to nitrogen which maximize bioconversion yield was determined to be 2:1. Secondly, the addition time of progesterone and dispersion method were studied. When progesterone dispersed with 0.01% (v/v) Tween 80 was added at 12-14 hr of cultivation, higher bioconversion yield was obtained. When 20g/$\ell$ of progesterone was added, the yield reached 70% under optimized conditions.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.14 no.2
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• pp.271-277
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• 2001

Erythema nodosum is a nodular erythematous eruption predominently limited to the pretibial area but occasionally involving the arms or other areas. That is clinical entity defined easily but there are many different opinions about histopathologic findings, Recently erythema nodosum is characterized histopathologically by a septal panniculitis in which the fibrous septa of subcutaneous fat become inflamed. Erythema nodosum has been known to be frequently associated with some kinds of drugs, infections with streptococci, mycobacteria but in $60\%$, no cause is found, Treatment of erythema nodosum consists of supportive care and elimination of underlying causes. Because spontaneous resolution of the lesions can occur in 3 to 6 weeks. Although there are trial treatments are applied to erythema nodosum, ego corticosteroids, NSAIDs, potassium iodine, there isn't any definite. So We report a case of erythema nodosum which was not relieved by NSAIDS but by experimental acupuncture treatment.

• Archives of Plastic Surgery
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• v.32 no.5
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• pp.648-652
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• 2005

In 1940, Kasabach and Merritt first described the association of a large vascular tumor and thrombocytopenia and termed this Kasabach-Merritt(KM) syndrome. It is characterized by a rapidly enlarging vascular anomaly and consumptive coagulopathy with thrombocytopenia, prolonged prothrombin time and partial thromboplastin time, hypofibrinogenemia, and the presence of D-dimer and fibrin split product, with or without microangiopathic hemolytic anemia. This is a potentially life-threatening condition with mortality rates from 20 to 30% as a result of severe sepsis, coagulopathy, or invasion of vital organs. Treatment modalities are corticosteroids, interferon alfa-2a or 2b, chemotherapy(vincristine, cyclophosphamide, etc.), aspirin, dipyridamole, com- pression, radiation therapy, embolization of feeding vessels and surgical excision. A standard treatment regimen for KM syndrome has not been established and most reports on definitive management of these complex vascular lesions have been anecdotal, involving small numbers of patients. The authors have successfully treated a patient of KM syndrome with actively bleeding huge hemangioma by surgical excision. They present it with the review of articles.

• Clinical and Experimental Pediatrics
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• v.62 no.6
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• pp.199-205
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• 2019

Although Mycoplasma pneumoniae pneumonia (MPP) has been generally susceptible to macrolides, the emergence of macrolide-resistant MPP (MRMP) has made its treatment challenging. MRMP rapidly spread after the 2000s, especially in East Asia. MRMP is more common in children and adolescents than in adults, which is likely related to the frequent use of macrolides for treating M. pneumoniae infections in children. MRMP is unlikely to be related to clinical, laboratory, or radiological severity, although it likely prolongs the persistence of symptoms and the length of hospital stay. Thereby, it causes an increased burden of the disease and poor quality of life for the patient as well as a societal socioeconomic burden. To date, the only alternative treatments for MRMP are secondary antimicrobials such as tetracyclines (TCs) or fluoroquinolones (FQs) or systemic corticosteroids; however, the former are contraindicated in children because of concerns about potential adverse events (i.e., tooth discoloration or tendinopathy). A few guidelines recommended TCs or FQs as the second-line drug of choice for treating MRMP. However, there have been no evidence-based guidelines. Furthermore, safety issues have not yet been resolved. Therefore, this article aimed to review the benefits and risks of therapeutic alternatives for treating MRMP in children and review the recommendations of international or regional guidelines and specific considerations for their practical application.

• Journal of Medicine and Life Science
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• v.16 no.1
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• pp.17-22
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• 2019

Epstein-Barr virus(EBV) infection is common and usually asymptomatic in young infants and children. However, EBV infections in transplant recipients and other immunosuppressed patients can be fatal. EBV-related neurological complications in immunocompetent adults are extremely rare and self-limited. Acute disseminated encephalomyelitis(ADEM) may also follow EBV infection; ADEM is characterized by abrupt onset and rapid progression. We report an immunocompetent adult patient who developed diffuse meningoencephalitis with ADEM-like features caused by EBV infection. A 35-year-old Vietnamese woman was admitted presenting with urinary retention, altered mental status, and paraplegia. PCR of the patient's cerebrospinal fluid showed positive results for EBV. Brain and spine magnetic resonance imaging showed ADEM-like features. She was treated with acyclovir, steroid, and immunoglobulins. We report the case of an immunocompetent adult Vietnamese woman who presented with rapidly progressive diffuse meningoencephalitis associated with EBV infection and was treated with antivirals, corticosteroids, and immunoglobulins.

• Clinical and Experimental Pediatrics
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• v.63 no.12
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• pp.469-476
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• 2020

The major pathogens that cause atypical pneumonia are Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila. Community-acquired pneumonia (CAP) caused by M. pneumoniae or C. pneumoniae is common in children and presents as a relatively mild and self-limiting disease. CAP due to L. pneumophila is very rare in children and progresses rapidly, with fatal outcomes if not treated early. M. pneumoniae, C. pneumoniae, and L. pneumophila have no cell walls; therefore, they do not respond to β-lactam antibiotics. Accordingly, macrolides, tetracyclines, and fluoroquinolones are the treatments of choice for atypical pneumonia. Macrolides are the first-line antibiotics used in children because of their low minimum inhibitory concentrations and high safety. The incidence of pneumonia caused by macrolide-resistant M. pneumoniae that harbors point mutations has been increasing since 2000, particularly in Korea, Japan, and China. The marked increase in macrolide-resistant M. pneumoniae pneumonia (MRMP) is partly attributed to the excessive use of macrolides. MRMP does not always lead to clinical nonresponsiveness to macrolides. Furthermore, severe complicated MRMP responds to corticosteroids without requiring a change in antibiotic. This implies that the hyper-inflammatory status of the host can induce clinically refractory pneumonia regardless of mutation. Empirical macrolide therapy in children with mild to moderate CAP, particularly during periods without M. pneumoniae epidemics, may not provide additional benefits over β-lactam monotherapy and can increase the risk of MRMP.

• Tuberculosis and Respiratory Diseases
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• v.84 no.1
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• pp.22-34
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• 2021

The coronavirus pandemic, known as coronavirus disease 2019 (COVID-19), is an infectious respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus first identified in patients from Wuhan, China. Since December 2019, SARS-CoV-2 has spread swiftly around the world, infected more than 25 million people, and caused more than 800,000 deaths in 188 countries. Chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD) appear to be risk factors for COVID-19, however, their prevalence remains controversial. In fact, studies in China reported lower rates of chronic respiratory conditions in patients with COVID-19 than in the general population, while the trend is reversed in the United States and Europe. Although the underlying molecular mechanisms of a possible interaction between COVID-19 and chronic respiratory diseases remain unknown, some observations can help to elucidate them. Indeed, physiological changes, immune response, or medications used against SARS-CoV-2 may have a greater impact on patients with chronic respiratory conditions already debilitated by chronic inflammation, dyspnea, and the use of immunosuppressant drugs like corticosteroids. In this review, we discuss importance and the impact of COVID-19 on asthma and COPD patients, the possible available treatments, and patient management during the pandemic.

• Journal of Yeungnam Medical Science
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• v.38 no.2
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• pp.148-151
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• 2021

Pudendal nerve entrapment (PNE) syndrome refers to the condition in which the pudendal nerve is entrapped or compressed. Reported cases of PNE associated with ganglion cysts are rare. Deep gluteal syndrome (DGS) is defined as compression of the sciatic or pudendal nerve due to a non-discogenic pelvic lesion. We report a case of PNE caused by compression from ganglion cysts and treated with steroid injection; we discuss this case in the context of DGS. A 77-year-old woman presented with a 3-month history of tingling and burning sensations in the left buttock and perineal area. Ultrasonography showed ganglion cystic lesions at the subgluteal space. Magnetic resonance imaging revealed cystic lesions along the pudendal nerve from below the piriformis to the Alcock's canal and a full-thickness tear of the proximal hamstring tendon. Aspiration of the cysts did not yield any material. We then injected steroid into the cysts, which resolved her symptoms. Steroid injection into a ganglion cyst should be considered as a treatment option for PNE caused by ganglion cysts.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.34 no.1
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• pp.56-65
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• 2021

Objectives : The purpose of this study is to report the effectiveness of Korean medical treatment on ptosis in myasthenia gravis. Methods : We treated the patient who had suffered from rt. ptosis and was diagnosed with myasthenia gravis with acupuncture, electropuncture, herbal acupuncture, cupping therapy, herbal medicines and western medicine such as corticosteroids and acetylcholinesterase inhibitors. The effectiveness of treatment was evaluated through Relative Interpalpebral Fissure(IPF) and photography. Results : After the treatments, relative Interpalpebral Fissure(IPF) was increased and improvement remained for three months after the treatment was finished. Conclusions : The result indicates that combination therapy of Korean medical treatment and western medicine had an effect on treatment of ptosis with myasthenia gravis.

• Journal of Yeungnam Medical Science
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• v.39 no.3
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• pp.200-205
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• 2022

Pain from nervous or musculoskeletal disorders is one of the most common complaints in clinical practice. Corticosteroids have a high pain-reducing effect, and their injection is generally used to control various types of pain. However, they have various adverse effects including flushing, hyperglycemia, allergic reactions, menstrual changes, immunosuppression, and adrenal suppression. Pulsed radiofrequency (PRF) is known to have a pain-reducing effect similar to that of corticosteroid injection, with nearly no major side effects. Therefore, it has been widely used to treat various types of pain, such as neuropathic, joint, discogenic, and muscle pain. In the current review, we outlined the pain-reducing mechanisms of PRF by reviewing previous studies. When PRF was first introduced, it was supposed to reduce pain by long-term depression of pain signaling from the peripheral nerve to the central nervous system. In addition, deactivation of microglia at the level of the spinal dorsal horn, reduction of proinflammatory cytokines, increased endogenous opioid precursor messenger ribonucleic acid, enhancement of noradrenergic and serotonergic descending pain inhibitory pathways, suppression of excitation of C-afferent fibers, and microscopic damage of nociceptive C- and A-delta fibers have been found to contribute to pain reduction after PRF application. However, the pain-reducing mechanism of PRF has not been clearly and definitely elucidated. Further studies are warranted to clarify the pain-reducing mechanism of PRF.