• 제목/요약/키워드: Steroid treatment

검색결과 690건 처리시간 0.024초

안와골절 수술 후 발생한 신경손상 (Nerve Injuries after the Operations of Orbital Blow-out Fracture)

  • 최재일;이성표;지소영;양완석
    • 대한두개안면성형외과학회지
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    • 제11권1호
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    • pp.28-32
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    • 2010
  • Purpose: In accordance with the increasing number of accidents caused by various reasons and recently developed fine diagnostic skills, the incidence of orbital blow-out fracture cases is increasing. As it causes complications, such as diplopia and enophthalmos, surgical reduction is commonly required. This article reports a retrospective series of 5 blow-out fracture cases that had unusual nerve injuries after reduction operations. We represents the clinical experiences about treatment process and follow-up. Methods: From January 2000 to August 2009, we treated total 705 blow-out fracture patients. Among them, there were 5 patients (0.71%) who suffered from postoperative neurologic complications. In all patients, the surgery was performed with open reduction with insertion of $Medpor^{(R)}$. Clinical symptoms and signs were a little different from each other. Results: In case 1, the diagnosis was oculomotor nerve palsy. The diagnosis of the case 2 was superior orbital fissure syndrome, case 3 was abducens nerve palsy, and case 4 was idiopathic supraorbital nerve injury. The last case 5 was diagnosed as optic neuropathy. Most of the causes were extended fracture, especially accompanied with medial and inferomedial orbital blow-out fracture. Extensive dissection and eyeball swelling, and over-retraction by assistants were also one of the causes. Immediately, we performed reexploration procedure to remove hematomas, decompress and check the incarceration. After that, we checked VEP (visual evoked potential), visual field test, electromyogram. With ophthalmologic test and followup CT, we can rule out the orbital apex syndrome. We gave $Salon^{(R)}$ (methylprednisolone, Hanlim pharmaceuticals) 500 mg twice a day for 3 days and let them bed rest. After that, we were tapering the high dose steroid with $Methylon^{(R)}$ (methylprednisolon 4 mg, Kunwha pharmaceuticals) 20 mg three times a day. Usually, it takes 1.2 months to recover from the nerve injury. Conclusion: According to the extent of nerve injury after the surgery of orbital blow-out fracture, the clinical symptoms were different. The most important point is to decide quickly whether the optic nerve injury occurred or not. Therefore, it is necess is to diagnose the nerve injury immediately, perform reexploration for decompression and use corticosteroid adequately. In other words, the early diagnosis and treatment is most important.

Effect of Soyabean Isoflavones Exposure on Onset of Puberty, Serum Hormone Concentration and Gene Expression in Hypothalamus, Pituitary Gland and Ovary of Female Bama Miniature Pigs

  • Fan, Juexin;Zhang, Bin;Li, Lili;Xiao, Chaowu;Oladele, Oso Abimbola;Jiang, Guoli;Ding, Hao;Wang, Shengping;Xing, Yueteng;Xiao, Dingfu;Yin, Yulong
    • Asian-Australasian Journal of Animal Sciences
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    • 제28권11호
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    • pp.1573-1582
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    • 2015
  • This study was to investigate the effect of soyabean isoflavones (SIF) on onset of puberty, serum hormone concentration, and gene expression in hypothalamus, pituitary and ovary of female Bama miniature pigs. Fifty five, 35-days old pigs were randomly assigned into 5 treatment groups consisting of 11 pigs per treatment. Results showed that dietary supplementation of varying dosage (0, 250, 500, and 1,250 mg/kg) of SIF induced puberty delay of the pigs with the age of puberty of pigs fed basal diet supplemented with 1,250 mg/kg SIF was significantly higher (p<0.05) compared to control. Supplementation of SIF or estradiol valerate (EV) reduced (p<0.05) serum gonadotrophin releasing hormone and luteinizing hormone concentration, but increased follicle-stimulating hormone concentration in pigs at 4 months of age. The expression of KiSS-1 metastasis-suppressor (KISS1), steroidogenic acute regulatory protein (StAR) and 3-beta-hydroxysteroid dehydrogenase/delta-5-delta-4 isomerase ($3{\beta}-HSD$) was reduced (p<0.01) in SIF-supplemented groups. Expression of gonadotropin-releasing hormone receptor in the pituitary of miniature pigs was reduced (p<0.05) compared to the control when exposed to 250, 1,250 mg/kg SIF and EV. Pigs on 250 mg/kg SIF and EV also showed reduced (p<0.05) expression of cytochrome P450 19A1 compared to the control. Our results indicated that dietary supplementation of SIF induced puberty delay, which may be due to down-regulation of key genes that play vital roles in the synthesis of steroid hormones.

Hydrocortisone 정주후 기관지수축이 발생한 기관지 천식 1예 (A Case of Bronchospasm after Intravenous Hydrocortisone Succinate injection in an Asthmatics)

  • 이영수;주용진;김광호;한병근;이상철;용석중;신계철
    • Tuberculosis and Respiratory Diseases
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    • 제41권5호
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    • pp.568-573
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    • 1994
  • 저자들은 급성 기관지 천식환자에서 치료제로 사용하는 hydrocortisone을 투여 후 유발된 기관지 수축이 발생한 예를 경험 하였기에 문헌고찰과 함께 보고하는 바이다.

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기관지결핵에 의한 기도협착에서 풍선카테터를 이용한 기도확장요법 (Balloon Dilatation of Bronchial Stenosis in Endobronchial Tuberculosis)

  • 정희순;한성구;심영수;김건열;한용철;김우성;임정기
    • Tuberculosis and Respiratory Diseases
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    • 제38권3호
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    • pp.236-244
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    • 1991
  • The prevalence rate of pulmonary tuberculosis is 1.8% in 1990, and endobronchial tuberculosis may exist in 10 to 40% of active disease. Endobronchial tuberculosis usually leaves bronchial stenosis as the complication despite of modern chemotherapy, and it is often misdiagnosed as bronchial asthma. When bronchial stenosis involves major airway, its treatment needs such special measures as steroid therapy, surgical intervention and/or laser therapy, but the therapeutic result is often disappointing. To exploit a new treatment modality for bronchial stenosis, balloon dilatation was carried out in 12 patients with endobronchial tuberculosis. Under local anesthesia, 4F-Fogarty balloon was inserted via bronchofiberscope in ten cases and 10F-Gruentzig balloon was introduced under fluoroscopic guide in two others. Endobronchial tuberculoses were subdivided into two(16.7%) with actively caseating type, seven (58.3%) with fibrostenotic type, and three (25.0%) with stenotic type without fibrosis, according to the bronchoscopic findings. In 7 healed cases which were all stenotic with fibrosis, three (42.9%) took favorable turn in clinical status but four (57.1%) were not improved with balloon dilatation. In 5 active cases, all (two with actively-caseating type and three with stenotic type without fibrosis) were improved with this method. $FEV_{1.0}$ or FVC increased 10% or more after procedure in seven (70.0%) of ten and bronchial lumen remained enlarged in eight (66.7%) of twelve, in whom follow-up examination was done after the procedure. Balloon dilatation of bronchial stenosis is more effective, when endobronchial tuberculosis is in active stage than in healed fibrotic stage. It is suggested that bronchial stenosis can be minimized by early diagnosis and early application of balloon dilatation in the course of disease.

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소아 피부 경화증 환자의 치험례 (LOCALIZED SCLERODERMA IN A CHILD : CASE REPORT)

  • 김은영;유승훈;김종수
    • 대한소아치과학회지
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    • 제32권2호
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    • pp.256-261
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    • 2005
  • 피부 경화증(scleroderma)은 만성 결체조직 질환으로 정확한 원인은 밝혀지지 않았으나 자가 면역 질환으로 알려져 있다. 대개 $30{\sim}50$세의 여성에서 호발하며 소아에서는 매우 드물다. 장기의 이환여부에 따라 국소성과 전신성 피부 경화증으로 분류할 수 있다. 국소적 형태는 예후가 양호하고 피부에만, 또는 피하 근육까지 이환되며, 내부 장기에는 이환되지 않는다. 전신적인 형태는 피부와 구강점막 및 위장계, 호흡계, 심혈관계 등을 포함하늘 전신 다발적 발생 (multisystemic involvement)이 특징적이다. 안면피부 이환시 작고 예리한 코, 무표정한 응시 (expressionless stare), 좁아진 입모양(narrow oral aperture) 등이 특징적이다. 대개 레이노 현상(Raynaud's phenomenon)이 존재하며 질환이 진행되면서 개구장애와 혀, 치은의 경화가 나타나게 된다. 피부 석회증(calcinosis cutis), 레이노현상(Raynaud's phenomenon). 식도 기능부전(esophageal dysfunction), 공지증(sclerodactyly), 모세혈관 확장증(telangioectasia)이 복합된 질환을 크레스트 증후군(CREST syndrome)이라 부른다. 피부 경화증의 치료는 국소적 및 전신적 스테로이드 치료, collagen cross-link inhibitor (D-penicillamine), 면역억제제 등을 사용한다. 개구제한의 치료는 설압자를 이용한 mouth stretching exercise를 통해 개선될 수 있다. 본 증례에서는 국소성 피부 경화증으로 진단되고 개구제한이 있는 6세 남아에게 아산화질소와 enflurane을 이용한 깊은 진정요법을 이용하여 상하악 제 1, 2 유구치의 우식치료 치험례를 보고한다.

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구강내 발생한 다발성 정맥기형 병소에의 Ethanolamine Oleate 경화제 주사 후 치험례 (Sclerotherapy of Multiple Intraoral Venous Malformations with Use of Ethanolamine Oleate: A Case Report)

  • 김태광;양재영;최석태;전희경;임대호;백진아;신효근;고승오
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제34권6호
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    • pp.488-493
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    • 2012
  • Hemangioma and vascular malformation are the most common benign tumors that are caused by congenitally or traumatic events. Theses tumors represent approximately 1/3~1/4 of all hemangiomas and vascular malformations in the head and neck. There are many forms of treatment for hemangioma and vascular malformation including closed observation, surgery, radiotherapy, laser therapy, steroid therapy, compression, embolization, and sclerotherapy. Ethanolamine oleate is an unsaturated fatty acid salt that has been used as a sclerosing agent because of its excellent thrombosing properties. This paper presents 1 case of intraoral multiple venous malformations treatment with 1.25% ethanolamine oleate (3.6~9.6 mg dose) intralesionally injected for 6 to 14 weeks over 2 week intervals. After the sclerotherapy, lesions almost completely disappeared without side effects. In conclusion, sclerotherapy using ethanolamine oleate is very effective against venous malformations, and sufficiently provides alternative support for surgical and other methods.

구강 작열감 증후군에서 클로나제팜의 국소적 적용 (Topical Application of Clonazepam to Burning Mouth Syndrome)

  • 심영주;최종훈;안형준;권정승
    • Journal of Oral Medicine and Pain
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    • 제34권4호
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    • pp.429-433
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    • 2009
  • 구강 작열감 증후군은 혀나 구강점막에 객관적인 이상징후(abnormal sign)를 보이지 않으면서 혀 및 구강점막의 지속적인 통증을 보이는 만성 질환이다. 연관된 것으로 추정되는 요인이 다양하고 환자마다 통증 양상이 다소 다르게 나타날 수 있어 적절한 진단 및 효과적인 치료를 제공하기 어려운 경우가 많다. 혀나 구강점막의 작열감은 알러지, 캔디다감염, 부기능습관, 타액선 기능저하 등과 같은 국소요인과 당뇨병, 갑상선기능저하증, 영양결핍 등과 같은 전신적 요인, 그리고 우울증, 걱정, 암공포증 등과 같은 심인성 요인과 연관되어 발생할 수 있다. 그러므로, 임상가들은 작열감을 유발할 수 있는 원인들에 대하여 숙지하고 있어야 하며, 혈액검사 등의 관련 검사를 통한 적절한 평가를 정확하고 세심하게 시행하여 효과적인 치료를 제공할 수 있어야 한다. 이러한 구강 작열감 증후군의 치료에는 약물요법, 인지행동요법, 심리치료 등 다양한 치료들이 시도되어지고 있다. 현재 구강작열감 증후군의 치료에 이용되고 있는 약물에는 클로나제팜(clonazepam), 가바펜틴(gabapentin), 삼환성항우울제(amitriptyline), 알파리포산(alpha-lipoic acid), 캡사이신(capsaicin) 등이 보고되고 있으며, 이 중 클로나제팜을 국소적으로 적용하는 것이 전신 투여하는 다른 약물에 비해 부작용이 적으면서 효과도 상당히 좋은 것으로 보고되고 있다. 이에 구강 작열감 증후군 환자에게 클로나제팜을 국소적으로 적용한 증례를 통해 그 효과를 확인하고자 하였다.

Lidocaine과 dexamethasone 혼합용액의 근육내 주사 후 조직학적 변화 (Microstructural Changes after Intramuscular Injection of Lidocaine and Dexamethasone)

  • 장성민;이경은
    • Journal of Oral Medicine and Pain
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    • 제30권1호
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    • pp.25-34
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    • 2005
  • 측두하악장애 및 구강안면통증 환자들 중 근막통증에 의한 기능제한이나 통증을 호소하는 경우를 흔히 볼 수 있다. 근막통증환자를 치료할 때 여러 가지 물리치료가 유용하지만, 즉각적인 통증완화효과를 나타내는 발통점주사요법이 근막통증의 치료로서 널리 적용되고 있다. 발통점주사요법에 흔히 사용하는 화학약제로 생리식염수, 국소마취제, 스테로이드 등이 있으며, 국소마취제는 근육에 대한 부작용이 보고되어 있어 사용상 주의가 필요하다. 이 연구는 상품화된 lidocaine과, dexamethasone 주사제의 혼합용액을 근육내 주사한 후 조직학적 변화를 관찰함으로써 근육에 대한 위해성 여부를 평가하고자 하였다. 또한 용액의 농도에 따라 각각 조직학적 변화를 관찰함으로써 위해성이 없는 적정한 농도를 제시하고자 하였다. 이 연구에서는 생후 9주된 BALB/c 생쥐 (자성) 63마리를 7군으로 분류하여, 앞정강근 (전경골근, tibialis cranialis) 에 각각 생리식염수, dexamethasone, 2.0% lidocaine, 생리식염수와 혼합한 1.0% lidocaine, 생리식염수와 혼합한 1.5% lidocaine, dexamethasone과 혼합한 1.0% lidocaine, dexamethasone과 혼합한 1.5% lidocaine을 주사하였다. 그 후 1일, 7일, 14일째에 희생시켜 실험부위를 절취한 후 조직절편을 만들어 HE염색과 Van-Gieson염색을 거쳐 광학현미경으로 관찰하여 다음의 결론을 얻었다. Lidocaine과 dexamethasone의 혼합용액을 근육내 주사하였을 때, lidocaine의 농도가 1.5% 이하인 경우 조직학적으로 유해하지 않았으며, 통증완화효과와 항염증작용을 동시에 기대할 수 있을 것으로 생각된다. 향후 상기 혼합용액을 발통점주사요법의 약제로 사용할 경우, 인체에서도 동일한 결과가 나올 것인가에 대해서는 추가적인 연구가 필요하다.

난소를 제거한 생쥐 자궁조직에서의 ADAM-8, 9, 10, 12, 15, 17 그리고 ADAMTS-1의 유전자 발현 (Gene Expression of ADAM-8, 9, 10, 12, 15, 17 and ADAMTS-1 in Ovariectomized Mice Uteri)

  • 김지영;허주영;김해권
    • 한국발생생물학회지:발생과생식
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    • 제8권2호
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    • pp.99-111
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    • 2004
  • 난소가 제거된 생쥐를 이용하여 자궁조직에서의 ADAM-8, 9, 10, 12, 15, 17, 그리고 ADAMTS-1의 유전자의 발현이 생식호르몬에 의하여 조절되는 지를 알아보았다. 암컷 생쥐의 난소를 제거하고, 2주후에 sesame oil, 17 ${\beta}$-estradiol ($E_2$), progesterone ($P_4$ 혹은 이 둘 혼합액 ($E_2+P_4$)을 피하 주사하였다. RT-PCR 방법을 이용하여 유전자 전사체의 발현을 조사한 결과 ADAM-8, 12, 그리고 17은 oil을 주사하거나 $P_4$만을 주사한 군보다 $E_2$를 주사한 군에서 자궁조직에서의 mRNA의 양이 현저하게 증가하였다. 반면 ADAM-9, 10, 15, 그리고 ADAMTS-1은 oil을 주사하거나 $E_2$만을 주사한 군보다 $P_4$를 주사한 군에서 mRNA의 양이 현저하게 증가하였다. 또한 단백질의 발현양상의 결과도 RT-PCR의 결과와 동일하게 관찰되었다. 이러한 결과로 미루어 ADAM-8, 12, 그리고 17은 17 ${\beta}$-estradiol에 의하여, ADAM-9, 10, 15, 그리고 ADAMTS-1은 progesterone에 의하여 유전자의 발현이 upregulation 되는 것으로 생각되어진다.

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Assessment of testicular steroidogenic enzymes expression in experimental animal model following withdrawal of nandrolone decanoate

  • Min, TaeSun;Karthikeyan, Adhimoolam;Lee, Ki-Ho
    • Journal of Animal Science and Technology
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    • 제63권6호
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    • pp.1247-1264
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    • 2021
  • Anabolic steroids are frequently used to increase the growth rate of meat-producing animals. Exposure to an anabolic-androgenic steroid, nandrolone decanoate (ND), is associated with expressional reduction of testicular steroidogenic enzymes. However, the effect of withdrawal of ND exposure on the expression of these testicular molecules has not been thoroughly explored. The current research investigated expression changes of testicular steroidogenic enzymes in rats at several recovery periods (2, 6, and 12 weeks) after the stop of ND treatment with different doses (2 and 10 mg/kg body weight) for 12 weeks. Body and testis weights were recorded, and transcript levels of molecules were determined by quantitative real-time polymerase chain reaction (PCR). The immunohistochemistry was used to examine the changes of immuno-intensities of molecules. At 6 and 12 weeks of the recovery period, the 10 mg/kg ND-treated rats were lighter than other experimental groups. The interstitial compartment vanished by ND treatment filled up as the recovery period became longer. The expression of steroidogenic acute regulatory protein was returned to the control level at 12 weeks of the recovery period. Expression levels of cytochrome P450 side-chain cleavage and 17a-hydroxylase were increased in 2 mg/kg ND-treated group at 6 weeks of the recovery period, and transcript levels of these molecules in 2 and 10 mg/kg ND-treated groups at 12 weeks of the recovery period were significantly lower than the control. Expression levels of 3β-hydroxysteroid dehydrogenase (HSD) type I and 17β-HSD type 3 in 2 mg/kg ND-treated group were comparable with those of control at 12 weeks of the recovery period, but not in 10 mg/kg ND-treated group. Expression of cytochrome P450 aromatase (Cyp19) was reverted to the control level at 2 weeks of the recovery period. Except for Cyp19, there was a visible increase of immuno-staining intensity of other testicular steroidogenic enzymes in the Leydig cells as the recovery period progressed. This research has demonstrated that the cease of ND administration could restore the expression of testicular steroidogenic enzymes close to the normal level. Nevertheless, a relatively long recovery period, compared to the ND-exposure period would be required to retrieve normal expression levels of testicular steroidogenic enzymes.