• 제목/요약/키워드: Steroid treatment

검색결과 701건 처리시간 0.038초

석회화 건염의 보존적 치료와 조기 관절경적 치료 결과 (Conservative and Early Arthroscopic Treatment of Calcific Tendinitis)

  • 김명구;배주한;전윤상
    • 대한관절경학회지
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    • 제13권2호
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    • pp.149-154
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    • 2009
  • 목적: 석회화 건염에 대하여 보존적 치료 및 조기 관절경을 이용한 수술적 치료 후 통증과 임상경과를 비교 관찰하였다. 대상 및 방법: 2002년 2월부터 2008년 5월까지 석회화 건염으로 진단받은 30예 중 6개월 이상 추시관찰이 가능하였던 스테로이드 주사치료 15예 및 수술 치료 15예를 대상으로 하여 석회질의 통증과 운동 범위의 호전을 2주, 12주, 24주째 각각 비교 관찰하여, Constant-Murley score를 이용하여 평가하였다. 결과: 통증 정도는 Constant-Murley score상 보존적 치료군의 경우 수술 전 평균 3.2에서 치료 이후 2주, 12주, 24주째 각각 13.6점, 14.5점, 14.7점이었으며, 수술적 치료군은 수술 전 평균 3.3에서 수술후 2주, 12주, 24주째 각각 10.2점, 13.0점, 14.3점이었다. 운동 범위는 보존적 치료군의 경우 수술 전 평균 14.3에서 치료 이후 2주, 12주, 24주째 각각 21.7점, 31.3점, 35.7점이었으며, 수술적 치료군은 수술 전 평균 14.4에서 수술후 2주, 12주, 24주째 각각 33.1점, 35.8점, 36.4점이었다. 치료 2주째 및 12주째 두 간의 비교에서는 수술적 치료 군이 유의하게 우수하였으나, 최종 추시시는 통계학적인 차이가 없었다. 결론: 석회화 건염의 조기 관절경적 치료는 환자의 만족도를 높이고 조기에 일상 생활로 복귀할 수 있는 효과적인 치료법으로 사료된다.

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덱사메타손 처치에 따른 폐 표면 활성 단백질-A 유전자 변이의 반응의 차이점에 관한 연구 (Differential Response of Surfactant Protein-A Genetic Variants to Dexamethasone Treatment)

  • 김을순;이인규;오명호;배종우
    • Clinical and Experimental Pediatrics
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    • 제46권4호
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    • pp.335-339
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    • 2003
  • 목 적 : 폐 표면 활성제 단백질-A는 폐 표면 활성제의 생리작용과 구조에 관여하며, 폐의 숙주방어와 염증반응에 주된 역할을 하고 있다. 스테로이드 치료는 미숙아의 분만이 예측되는 산모에 대해서 미숙아의 급성 호흡곤란 증후군 등을 예방할 목적으로, 또는 미숙아의 만성 폐질환을 예방하기 위하여 널리 사용되고 있다. 현재까지 인간에서 두 가지의 SP-A 유전자 및 여러 종류의 대립형질이 밝혀져 있고, 덱사메타손 치료에 서로 다른 반응을 보이고 있으며, SP-A 3'UTR이 관여 할 가능성이 있다는 연구가 발표되었다. 저자들은 가장 많은 빈도를 보이는 8가지 SP-A 대립형질에서 덱사메타손 처치에 대하여 서로 다른 반응이 3'UTR에 의하여 이루어지는지를 규명하고자 연구를 하였다. 방 법 : 리포터 유전자로서 luciferase를 사용하여 8종류의 SP-A 대립형질의 3'UTR을 포함하는 구성체를 만들었다. 이 구성체들은 SV40 promotor에 의하여 조절되었으며, SP-A를 생산하는 H441 세포내로 형질도입 되었다. 덱사메타손 처치 후 리포터 유전자의 활성도를 측정하였으며, 대조군에 따라 표준화되었다. 결 과 : 덱사메타손 처치 시 $6A^3$, 6A, 1A 대립 유전자에서 리포터 유전자의 활성 반응이 유의하게 감소하였다. 결 론 : SP-A 유전자 변이 중 덱사메타손 처치에 대한 유전자 표현 반응이 서로 다르다는 사실은 스테로이드 치료 시 미숙아의 개개인의 SP-A 유전자 변이에 따라 고려하여 사용해야함이 타당할 것으로 생각된다.

Review of Sarcoidosis in a Province of South Korea from 1996 to 2014

  • Kim, Min-Seok;Park, Cheol-Kyu;Shin, Hong-Joon;Seo, Hyeong-Won;Chang, Jinsun;Ahn, Seong;Kim, Tae-Ok;Lim, Jung-Hwan;Oh, In-Jae;Kwon, Yong-Soo;Kim, Yu-Il;Lim, Sung-Chul;Kim, Young-Chul
    • Tuberculosis and Respiratory Diseases
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    • 제80권3호
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    • pp.291-295
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    • 2017
  • Background: Since the introduction of endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) of mediastinal lymph nodes, the incidence of histopathologically-confirmed sarcoidosis has increased. Methods: The electronic medical records of Chonnam National University (CNU) Hospital and CNU Hwasun Hospital (CNUHH) were searched for confirmed cases of sarcoidosis diagnosed between 1996 and 2014. Cases were selected using a combination of clinical, radiological, and pathological evidence. Of 115 cases with the relevant disease codes, 16 cases were excluded, as they had not been confirmed pathologically or had no definitive clinical features of sarcoidosis. Results: Among 99 cases of confirmed sarcoidosis, only nine patients were diagnosed with sarcoidosis before 2008; the rest were diagnosed from 2008 onward, after the introduction of EBUS-TBNA. EBUS-TBNA was used in 75.8% of patients, open surgical biopsy in 13.2%, and mediastinoscopic biopsy in 5.1%. At the time of diagnosis, 42.4% of sarcoidosis cases were at stage I, 55.6% at stage II, and 2% at stage III. Spontaneous remission of sarcoidosis was observed in 33.3% of cases, and stable disease in 37.4%; systemic steroid treatment was initiated in 23.2% of cases. Of the patients treated with systemic steroids, 69.6% showed improvement. The median duration of steroid treatment was 5 months. Conclusion: Following the introduction of EBUS-TBNA, the number of newly diagnosed sarcoidosis patients has increased. Clinical features of sarcoidosis were similar to those previously reported. Spontaneous remission occurred in about one-third of patients, while one-fourth of patients required systemic steroid treatment.

The inhibitory effects of gonadotropin-releasing hormone(GnRH) agonist on ovarian functions in immature rats pretreated with pregnant mare serum gonadotropin(PMSG)

  • Yun, Young-won;Yun, Sang-keun;Yu, Wook-joon
    • 대한수의학회지
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    • 제39권2호
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    • pp.276-286
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    • 1999
  • In the present study, to understand how gonadotropin-releasing hormone (GnRH) affects ovarian functions in superovulated rats, we examined the effects of GnRH agonist on the ovulatory response, the morphological normality and nuclear maturation of ovulated oocytes, the ovarian weight, the ovarian histology, and the circulating steroid hormone ($17{\beta}$-estradiol, progesterone and testosterone) levels in immature rats pretreated with 30IU pregnant mare serum gonadotropin (PMSG) and supplemented with 10IU human chorionic gonadotropin(hCG). GnRH agonist was intravenously injected via jugular vein catheter every 20min for 4hrs in early follicular phase (from 6hr after PMSG) of superovulated rats. In addition, GnRH antagonist, Antide, was intravenously injected in combination with GnRH agonist to verify the effects of GnRH agonist on ovarian functions. All animals were sacrificed at 72hr after PMSG administration. The administration with GnRH agonist in early follicular phase of superovulated rats caused inhibition of ovulatory response, increased the proportion of abnormal appearing oocytes(especially, in the rats of the group treated with 500ng GnRH agonist), decreased ovarian weight and promote follicular atresia, compared to those from the rats of control regimen that were not treated with GnRH agonist. In addition, the treatment with GnRH agonist in the superovulated rat distinctly decreased serum steroid hormone ($17{\beta}$-estradiol, progesterone and testosterone) levels in preovulatory phase. On the other hand, the inhibitory effects of GnRH agonist treatment in superovulation-pretreated rats on ovarian functions were totally reversed by the combination with GnRH antagonist, Antide. The nuclear maturation of oocytes recovered from the oviducts in immature rats treated with GnRH agonist and/or GnRH antagonist was characterized by prematurity and asynchronization in early follicular phase, which was similar to control group. The overall results of this study indicate that GnRH agonist disturbs directly ovarian function in early follicular phase of superovulated immature rats in terms of ovulatory response and morphological normality of ovulated oocytes. This concept has been further evidenced by the findings of a great decrease in ovarian weight, a marked increase in follicular and a distinct decrease circulating steroid hormone ($17{\beta}$-estradiol, progesterone and testosterone) levels in GnRH agonist treatment regimen in early follicular phase.

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Effects of Steroid Hormones on $In$ $Vitro$ GVBD and Oocyte Steroidogenesis in Blacktip Grouper, $Epinephelus$ $fasciatus$

  • Hwang, In-Joon;Kim, Seol-Ki;Choi, Sang-Jun;Lee, Chi-Hoon;Lee, Young-Don;Kim, Hyung-Bae;Baek, Hea-Ja
    • 한국발생생물학회지:발생과생식
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    • 제16권1호
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    • pp.39-45
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    • 2012
  • To verify the sex steroids which are involved in oocyte maturation of the blacktip grouper, $Epinephelus$ $fasciatus$, we incubated vitellogenic oocytes (0.41 and 0.50 mm in average diameter) in the presence of exogenous steroid precursor ($[^3H]17{\alpha}$-hydroxyprogesterone). Steroids were extracted, separated and identified by thin layer chromatography. The major metabolites produced were androstenedione, estradiol-$17{\beta}$, estrone and progestogens. Progestogen metabolites in the oocytes of 0.50 mm were more abundant than those of 0.41 mm. Also, we investigated the $in$ $vitro$ effects of human chorionic gonadotropin (HCG; 5, 50 and 500 $IU/m{\ell}$), $17{\alpha},20{\beta}$-dihydroxy-4-pregnen-3-one ($17{\alpha}20{\beta}P$) and $17{\alpha},20{\beta}$-trihydroxy-4-pregnen-3-one ($17{\alpha}20{\beta}21P$; 5, 50 and 500 $ng/m{\ell}$, respectively) on oocyte maturation. In the oocytes of 0.41 mm, treatment with 50 IU HCG stimulated GVBD ($55.30{\pm}1.20%$) compared with controls ($32.41{\pm}3.13%$, $p$<0.05). In the oocytes of 0.50 mm, treatment of $17{\alpha}20{\beta}P$ (50 and 500 $ng/m{\ell}$) stimulated GVBD ($50.13{\pm}2.52$ and $51.77{\pm}5.91%$, respectively) compared with controls ($36.81{\pm}2.89%$, $p$<0.05). Treatment with 500 IU HCG also stimulated GVBD ($49.59{\pm}5.15%$) compared with controls ($p$<0.05). Taken together, these results suggested that both HCG and $17{\alpha}20{\beta}P$ were effective on in vitro oocyte maturation and $17{\alpha}20{\beta}P$ may act as a maturation inducing hormone in blacktip grouper.

Acupuncture in Patients with a Vertebral Compression Fracture: A Protocol for a Randomized, Controlled, Pilot Clinical Trial

  • Lee, Hyun-Jong;Seo, Jung-Chul;Park, Sung-Hoon;Kwak, Min-Ah;Shin, Im Hee;Min, Bo-Mi;Cho, Min-Su;Roh, Woon-Seok;Jung, Jin-Yong
    • 대한약침학회지
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    • 제18권1호
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    • pp.79-85
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    • 2015
  • Objectives: A vertebral compression fracture (VCF) is characterized by back pain and fracture of a vertebral body on spinal radiography. VCFs of the thoraco lumbar spine are common in the elderly. In general, appropriate analgesics should be prescribed to reduce pain and, thus, promote early mobilization. The ideal treatment approach for VCFs has not been determined. In Korea, acupuncture and herbal medication have been used to treat VCFs for many years. There is empirical evidence that acupuncture might benefit patients with a VCF. However, no randomized, controlled, clinical trials evaluating the efficacy and the safety of acupuncture for treating a VCF have been published. Therefore, we designed a randomized, controlled, pilot, clinical trial to obtain information for the design of a further full scale trial. Methods: A five week protocol for a randomized, controlled, pilot, clinical trial is presented. Fourteen patients will be recruited and randomly allocated to two groups: a control group receiving interlaminar epidural steroid injections once a week for three weeks, and an experimental group receiving interlaminar epidural steroid injections plus acupuncture treatment (three acupuncture sessions per week for three weeks, nine sessions in total). The primary outcomes will be the pain intensity (visual analogue scale and PainVision$^{TM}$ system). The secondary outcome measurements will be the answers on the short form McGill pain questionnaire and the oswestry disability index. Assessments will be made at baseline and at one, three, and five weeks. The last assessment (week five) will take place two weeks after treatment cessation. This study will provide both an indication of feasibility and a clinical foundation for a future large scale trial. The outcomes will provide additional resources for incorporating acupuncture into existing treatments, such as nonsteroidal anti-inflammatory medications, narcotics and vertebral augmentation. This article describes the protocol.

스테로이드에 반응을 보인 신증후군 환아에서 재발 예측인자로서 고지혈증의 중요성 (The Significance of Hyperlipidemia as a Predictive Factor of Relapse in Corticosensitive Nephrotic Syndrome)

  • 정순필;홍순철;임성준;임인석;최응상
    • Childhood Kidney Diseases
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    • 제5권2호
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    • pp.136-146
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    • 2001
  • 목 적 : 신증후군 환아의 궁극적인 예후는 양호하지만 치료시의 어려움은 빈번한 재발이다. 스테로이드에 반응을 보였던 신증후군 환아의 재발 가능성의 예측인자에 대한 여러 보고가 있었는데 최근에는 스테로이드에 반응을 보이는 신증후군 환아에서 관해기까지의 기간이 짧을수록 재발의 빈도가 의미 있게 적음이 보고되었다. 본 연구에서는 신증후군으로 처음 진단 후 스테로이드에 반응을 보였던 환아들을 대상으로 스테로이드를 사용하기 전의 고지혈증의 정도와 환아의 신기능 및 관해 유도기간과의 연관성을 검증하여, 고지혈증이 관해유도의 지연 혹은 빈발 재발 환자를 조기에 선별하여 예측지표로 사용될 수 있는지 알아보고자 시행하였다. 대상 및 방법 : 1994년 10월부터 2000넌 8월까지 본원 소아과에서 입원했던 환아들 중 처음으로 신증후군으로 진단된 후 스테로이드 치료에 반응을 보였던 33명을 대상으로 이들의 입원 및 외래 기록지를 중심으로 후향적으로 분석하였다. 결 과 : 모든 대상 환아에서 고지혈증 소견이 관찰되었으며 이중 triglyceride, total cholesterol, LDL cholesterol, apoB, Lp(a), total cholesterol/HDL cholesterol은 증가하였으나 HDL cholesteol은 증가하지 않았다. 스테로이드를 사용하기 전의 혈청 알부민은 $1.7{\pm}0.8\;g/dL$의 감소되었고 단백뇨는 $3.8{\pm}3.2\;g/24hr$로 증가보이나 크레아티닌 청소율은 $121.7{\pm}47.7\;mL/min/1.73m^2$로 감소되지 않았으며 스테로이드 사용 후 관해 유도기간은 $15.6{\pm}11.0일$이 필요했다. 혈청 알부민은 total cholesterol (r = -0.5157, P<0.005), LDL cholesterol (r = -0.5543, P<0.005), total cholesterol/HDL cholesterol (r = -0.4506, P<0.01), Lp(a) (r = -0.4570, P<0.025), apoB (r = -0.5297, P<0.025), apoB/apoAl (r = -0.5851, P<0.01), apoB/HDL cholesterol (r = -0.4961, P<0.05)등과 음의 상관관계가 있었다. 단백뇨와 크레아티닌 청소율은 스테로이드를 사용하기 전 혈청지질, 지단백과 상관관계를 보이지 않았다. 관해 유도기간은 스테로이드를 사용하기 전 HDL cholesterol (r = +0.4511, P<0.05), apoB (r = +0.5190, P<0.05), apoB/HDL cholesterol (r = +0.7169, P<0.005)과 양의 상관관계가 있었다. 결 론 : 본 연구를 통해 신증후군의 특징인 고지혈증은 서로 다른 경과의 신증후군, 서로 다른 병리조직학적 소견과 지질대사 과정에 다양한 영향을 끼치는 요인에 의해 각각의 지질 및 지단백의 상승에 차이가 있을 수 있고 이런 지질 및 지단백의 상승은 주로 간에서 생성의 증가의 발생함을 알 수 있었다. 또한 지단백중 스테로이드를 사용하기전의 HDL cholesterol, apoB, apoB/HDL cholesterol등은 관해 유도기간과 의미 있는 양의 상관관계를 보여서 신증후군 환아의 재발을 예측 할 수 있는 지표로서 임상적인 의미를 부여할 수 있을 것이다.

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인삼 총 사포닌의 에스트로젠, 안드로젠, 레티노익산 호르몬 수용체에 대한 활성 (Estrogen, Androgen, and Retinoic Acid Hormone Activity of Ginseng Total Saponin)

  • 지상미;이영주
    • Journal of Ginseng Research
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    • 제27권3호
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    • pp.93-97
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    • 2003
  • Alternative or complementary medicine plays an important role in health care system. Ginseng, being one of the most popular oriental herbs, is believed to contain various steroid hormone activity. Ginseng has been demonstrated pharmacological effect in the cardiovascular, endocrine, central nervous, and immune system. Our objective was to study that total saponin might mediate some of their actions by binding to the steroid hormone receptor, as they share many of the actions of steroid hormone in various physiological system. Using total saponin from Panax Ginseng, we have studied the possibility of total saponin being a potential estrogen receptor, androgen receptor, and retinoic acid receptor ligand. Total saponin activated the transcription of both the estrogen and androgen responsive luciferase reporter plasmids at a concentration of 100$\mu\textrm{g}$/ml in COS cells transiently transfected with the corresponding receptor and hormone responsive receptor plasmids. And total saponin caused a concentration-dependent stimulation of estrogen receptor. Total saponin increased the expression of estrogen responsive c-fos proto-oncogene at the protein level in MCF7 cells at 24 h treatment as examined by Western analysis. The c-fos induction was used as a specific marker of estrogen responsiveness. This activation was inhibited by the specific estrogen receptor antagonist, ICI 182,780. However, total saponin failed to activate the retinoic acid receptor in COS cells transiently transfected with the corresponding receptor and retinoic acid responsive reporter plasmids. These results show that total saponin is capable of activating estrogen and androgen receptors.

The Effects of a Forceful Transforaminal Epidural Steroid Injection on Radicular Pain: A Preliminary Study

  • Byun, Jong Min;Park, Hahck Soo;Woo, Jae Hee;Kim, Jin
    • The Korean Journal of Pain
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    • 제27권4호
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    • pp.334-338
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    • 2014
  • Background: Lumbar transforaminal epidural steroid injections (TFESIs) are performed to provide symptom relief in patients with radicular pain. Recent articles suggested that injected volume itself have analgesic effects and higher volumes are associated with better outcomes. To date, few studies have been conducted to investigate the effects of volume. Therefore, well-designed controlled studies were necessary to confirm the effect of volume itself on pain relief. The purpose of this study was to examine the effectiveness of a forceful saline injection on lumbar TFESI using non-particulate steroids. Methods: Fifty consecutive patients with lumbar radicular pain were enrolled. The participants were allocated into one of two groups: dexamethasone with volume (Group DV) and dexamethasone alone (Group DO). The volume was delivered by a forceful injection of 5ml of normal saline. The primary end-point for this study was a VAS pain score and modified MacNab score indicating the rate of effectiveness at the four-week follow-up. Results: There were no significant post-procedural VAS differences between two groups (P = .252). The effectiveness rate among the patients was 47.8% in DV group, 34.8% in DO group, measured by modified MacNab score. The difference was not statistically significant (P = .117). Conclusions: A forceful saline injection did not have a significant effect during the treatment of radicular pain. Further studies with greater volumes and with additional techniques would offer a more conclusive perspective.

성선자극 호르몬 투여가 토끼의 혈중 난소 스테로이드호르몬 수준에 미치는 영향 (Effect of Gonadotropin Administration on Blood Ovarian Steroid Hormone Level in Rabbit)

  • 김병기
    • 한국가축번식학회지
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    • 제21권4호
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    • pp.363-371
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    • 1997
  • The present study was carried out to investigate the effect of gonadotropin administration on blood ovarian steroid hormone in angora rabbit. Mature angora rabbits were primed for superovulation with PMSG 100IU. Eighty hours later, the rabbit were induced to ovulate with HCG 100IU. In exp 1, blood progesterone and estradiol of superovulated does were measured by radiommunoassay. Blood progesterone concentration at 93, 99, 102 and 114 hours after HCG injection were 12.9$\pm$0.5, 34.8$\pm$5.1, 12.2$\pm$2.7 and 43.4$\pm$5.8ng/ml, respectively. Mean progesterone concentration of blood collected at 99 and 114 hours after HCG injection(p<0.05). However, mean blood estradiol concentration was not changed. In exp 2, superovulated does were unilaterally ovariectomized at 96 hours after HCG injection. Blood progesterone concentration was tend to be decreased after ovariectomy. Nosignificant changes in blood estradiol concentration was observed after ovariectomy. In exp 3, superovulated does were bilaterally ovariectomized at 96 hours after HCG injection Ovariectomized does were treated with progesterone. Blood progesterone level in the rabbits treated, twice daily, with 5mg progesterone after ovariectomy was similiar to that in the superovulated intact rabbits. Blood estradiol concentration of the rabbits after bilateral ovariectomy was beyond detection range. Blood progesterone concentration was significantly decreased to 7.6$\pm$3.0ng/ml wi thin 3 hours after ovriectomy(p<0.05). However, that value was increased to 34.8$\pm$8.2ng/ml by 5 mg progesterone treatment and this elevated level was significatnly decreased to 7.3$\pm$2.4ng/ml at 12 hours after progesterone administration(p<0.05).

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