• The Journal of Korean Orthopaedic Ultrasound Society
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• v.1 no.2
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• pp.91-93
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• 2008

De Quervain's disease is a stenosing tenosynovitis that affects the synovial sheath of the tendons of the abductor pollicis longus and extensor pollicis brevis; it can be considered a work-related disease, since it frequently is associated with highly repetitive movements in jobs using the hands. The usual sign and symptom of de Quervain's diseases are positive Finkelstein's sign and pain and tenderness around the radial styloid process. The majority of de Quervain's disease has a good results to conservative treatment, but surgery can be performed in case of recurrence or pain last more than 6 months without improvement in spite of conservative treatment. We diagnosed a patient with atypical de Quervain's disease by ultrasonography, treated by local steroid injection and pain was relieved. We report a case of atypical de Quervain's disease evaluated by ultrasonography with brief of literatures.

• Tuberculosis and Respiratory Diseases
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• v.78 no.4
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• pp.390-395
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• 2015

Primary anaplastic large cell lymphoma (ALCL) of the lung is highly aggressive and quite rare. We report here a case of anaplastic lymphoma kinase-positive endobronchial ALCL, that was initially thought to be primary lung cancer. A 68-year-old woman presented with hemoptysis, dyspnea, and upper respiratory symptoms persisting since 1 month. The hemoptysis and and bronchial obstruction lead to respiratory failure, prompting emergency radiotherapy and steroid treatment based on the probable diagnosis of lung cancer, although a biopsy did not confirm malignancy. Following treatment, her symptoms resolved completely. Chest computed tomography scan performed 8 months later showed increased and enlarged intra-abdominal lymph nodes, suggesting lymphoma. At that time, a lymph node biopsy was recommended, but the patient refused and was lost to follow up. Sixteen months later, the patient revisited the emergency department, complaining of persistent abdominal pain since several months. A laparoscopic intra-abdominal lymph node biopsy confirmed a diagnosis of ALCL.

• Tuberculosis and Respiratory Diseases
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• v.67 no.3
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• pp.234-238
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• 2009

Henoch-$Sch\ddot{o}nlein$ Purpura (HSP) is a systemic vasculitis involving small vessels with the deposition of immune complexes containing IgA and C3, which is characterized by associated skin, joint, renal, and gastrointestinal manifestations. Although there were several causes such as autoimmunity, infection, and drugs, it also can be presented as a form of vasculitidies associated with malignancies. We report a case of HSP developed during treatment for non-small cell lung cancer in a 66-year-old man. Multiple purpuric skin lesions occurred in both legs after the first cycle of chemotherapy, which was diagnosed as HSP by clinical and pathologic examinations. Due to the itching sensation, topical steroid was applied and the patient was improved 3 weeks later without a scheduled change in chemotherapy.

• The Korean Journal of Physiology and Pharmacology
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• v.10 no.2
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• pp.79-83
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• 2006

We evaluated therapeutic and preventive properties of dehydroepiandrosterone (DHEA), a weak androgenic steroid, against isoproterenol-induced cardiomyopathy. The cardiomyopathy was induced by daily i.p. administration of isoproterenol to rats for five days. One group of rats were given with daily s.c. for 5 days during isoproterenol and the other group with daily s.c. DHEA for total 10 days, including 5 days before and during isoproterenol. The animals were killed after each treatment, and cardiac muscle failure was evaluated using histopathologic examination and biochemical indices. DHEA was found to reduce the damaged area and inhibit the elevation in the serum levels of glutamic oxaloacetic transaminase (SGOT), lactate dehydrogenase (LDH), skeletal muscle creatine kinase (CK) and heart creatine kinase (CK-MB) induced by isoproterenol. We also assayed widely used oxidative stress parameters, including thiobarbituric acid reactive substances (TBARS), superoxide dismutase (SOD), catalase and glutathion peroxidase (GPx). DHEA decreased the escalated level of TBARS and enhanced the anti oxidant defense reaction with an increase in Mn-SOD and Cu/Zn-SOD. On the other hand, the treatment with DHEA did not affect catalase and GPx activity. The present study indicates that DHEA has a therapeutic and preventive effect against isoproterenol-induced cardiomyopathy and its effects may depend largely on the increase in SOD activity.

• Journal of Yeungnam Medical Science
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• v.31 no.2
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• pp.148-151
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• 2014

Radioactive iodine (RAI) therapy is widely used for the treatment of Graves disease. After RAI therapy, 44% become hypothyroid and up to 28% remain hyperthyroid. The development of thyrotoxicosis after RAI therapy is believed to be mediated by 2 different mechanisms: a transient increased release of thyroid hormone due to radiation thyroiditis and the rare development of Graves disease due to the formation of antibodies to the thyroid-associated antigens released from the damaged follicular cells. A 55-year-old woman was hospitalized with severe headache, weight loss, and palpitation. She received a dose of 7 mCi of RAI (I-131) about 6 weeks earlier. Thyroid function test showed 7.98 ng/dL free T4, >8 ng/mL T3, < $0.08{\mu}IU/L$ thyroid stimulating hormone, and high titer thyroid stimulating immunoglobulin (TSI) (85.8 IU/L). She improved with propylthiouracil, propranolol, and steroid treatment. The TSI, however, was persistently elevated for 11 months.

• Korean Journal of Clinical Pharmacy
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• v.31 no.3
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• pp.237-246
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• 2021

Background: Pembrolizumab, an anti-cancer drug, is known to increase the activity of the immune system, leading to side effects called immune-related adverse events (irAE), including type 1 diabetes. This study analyzed the correlation between blood glucose level and pembrolizumab administration and investigated the covariates that affect those changes in cancer treatment. Methods: The information of 133 adult cancer patients was obtained from the electronic medical record (EMR) to identify the changes in random blood glucose (RBG) levels during the pembrolizumab treatment. Subjects were classified into subgroups according to their baseline RBG level, history of diabetes, and the use of steroids, and linear regression analysis was conducted. In addition, a secondary analysis was performed within the group of subjects having a strong correlation to glycemic change, which was based on the Pearson correlation coefficient being less than -0.7 or greater than +0.7. Univariate and multivariate logistic regressions were conducted to identify the risk factors to glycemic increase. Results: The RBG level tended to descend without significant differences in total patients during the administration period of pembrolizumab. Despite the insignificance, the logistic regression analysis presents that the odds ratios of baseline RBG less than 130 mg/dL, prophylactic steroid use, and higher dose of pembrolizumab per cycle (mg/kg/cycle) were greater than 1. Conclusions: Prophylactic administration of steroids and a higher dose of pembrolizumab per cycle may increase the blood glucose level as irAE in cancer patients with a strong tendency to glycemic change.

• Tuberculosis and Respiratory Diseases
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• v.82 no.4
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• pp.285-297
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• 2019

Connective tissue disease (CTD) is a collection of disorders characterized by various signs and symptoms such as circulation of autoantibodies in the entire system causing damage to internal organs. Interstitial lung disease (ILD) which is associated with CTD is referred to as CTD-ILD. Patients diagnosed with ILD should be thoroughly examined for the cooccurrence of CTD, since the treatment procedures and prognosis of CTD-ILD are vary from those of idiopathic interstitial pneumonia. The representative types of CTD which may accompany ILD include rheumatoid arthritis, systemic sclerosis (SSc), Sjogren's syndrome, mixed CTD, idiopathic inflammatory myopathies, and systemic lupus erythematous. Of these, ILD most frequently co-exists with SSc. If an ILD is observed in the chest, high resolution computed tomography and specific diagnostic criteria for any type of CTD are met, then a diagnosis of CTD-ILD is made. It is challenging to conduct a properly designed randomized study on CTD-ILD, due to low incidence. Therefore, CTD-ILD treatment approach is yet to been established in absence of randomized controlled clinical trials, with the exception of SSc-ILD. When a patient is presented with acute CTD-ILD or if symptoms occur due to progression of the disease, steroid and immunosuppressive therapy are generally considered.

• Journal of Veterinary Clinics
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• v.38 no.3
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• pp.143-146
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• 2021

A 2-year-old intact female Maltese dog was presented with generalized involuntary tremors and nystagmus without regular direction. The dog was conscious the whole time while it was trembling. Its involuntary tremors were alleviated at rest or during sleep. Magnetic resonance imaging (MRI) revealed asymmetric hydrocephalus and caudal occipital malformation. In cerebrospinal fluid (CSF) analysis, a trace of protein was found and total nucleated cell count (TNCC) was slightly increased. However, infectious pathogens were not found. In complete blood count, there was a mild leukocytosis. After the patient received anticonvulsants (midazolam, phenobarbital, KBr), diuretics (furosemide) with an anti-inflammatory drug (prednisolone, 0.5 mg/kg PO bid), and a proton-pump inhibitor (omeprazole), it showed no improvement. The patient was tentatively diagnosed with corticosteroid responsive tremor syndrome. So the anticonvulsants and diuretics were discontinued and the dose of prednisolone was increased to an immunosuppressive dose (1 mg/kg PO bid). After administering the immunosuppressive dose of prednisolone, the patient did not show nystagmus. Its tremors were much alleviated. However, they did not disappear. Five weeks later, the patient showed gradual improvement but still was trembling when moving around. Nine weeks later, its tremors were similar to before. So diazepam (0.3 mg/kg PO sid) was added to the treatment. After that, its tremors were alleviated more. Prednisolone and diazepam were maintained for about five months, with tapering of the dose of prednisolone (until 0.5 mg/kg PO sid). About 7 months later after the treatment was started, the dog was trembling rarely except when it was excited. Therefore, diazepam was discontinued. This case describes a refractory white dog shaker syndrome successfully managed with long-term administration of a steroid and diazepam.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.35 no.4
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• pp.209-218
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• 2022

Objective : This study assessed the effect of a combination of Korean medicine on a chronic nipple eczema patient complaining of stress and immunodeficiency due to long-term steroid use. Methods : Herbal medicine, moxibustion and acupuncture were performed for a year. Treatment outcomes were evaluated with DLQI(Dermatology Life Quality Index), EQ-5D-5L(The 5 level of EuroQol 5 Dimensio scale), EQ-VAS(EuroQol-Visual Analog Scale), ADSI(Atopic Dermatitis Severity Index), pruritus NRS(Numeral Rating Scale), pictures and patient's statements. Results : After the treatment, symptoms have been alleviated, the quality of life has increased, and it has been maintained without further nipple eczema for three months. Conclusion : We suggest that Korean medicine is effective for chronic nipple eczema patient.

• The Korean Journal of Pain
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• v.36 no.2
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• pp.195-207
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• 2023

Background: This study aimed to compare the effectiveness of the pericapsular nerve group (PENG) block and intra-articular injection (IAI) of steroid-bupivacaine in the treatment of hip osteoarthritis (OA). Methods: After randomization, patients received either a PENG block or IAI under ultrasound-guidance. Clinical evaluations were recorded at baseline, day 1, and weeks 1, 4, and 8 post-intervention. The numerical rating scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Harris Hip Scale (HHS) scores, pain medication use determined by a quantitative analgesic questionnaire, and patient satisfaction were evaluated. Results: Sixty patients were included in this study. NRS scores improved significantly for both groups during the follow-up compared to pretreatment (P < 0.001), with better pain scores for the PENG group (P < 0.001) at day 1 with larger effect size (Cohen's d = 4.62), and IAI group at 4 (Cohen's d = 5.15) and 8 (Cohen's d = 4.33) weeks (P < 0.001). There was no significant difference in pain medication consumption (P = 0.499) and patient satisfaction (P = 0.138) between groups. Patients in the IAI group experienced significant improvement in HHS (Cohen's d = 2.16, P = 0.007) and WOMAC (Cohen's d = 1.02, P = 0.036) scores at 8 weeks compared to the PENG group. Conclusions: The ultrasound-guided PENG block provides effective pain relief which improves functionality and quality of life in hip OA patients up to 2 months. The PENG block can be considered an easy, safe, and useful alternative treatment modality for hip OA.