• 한방안이비인후피부과학회지
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• 제26권4호
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• pp.91-100
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• 2013

Background and Objective : Dyshidrotic Eczema is characterized by a pruritic vesicular eruption on the fingers, palms, and soles. It is an acute, chronic, or recurrent dermatosis. The causes of dyshidrosis are unknown. There are many treatments available for dyshidrosis including topical steroids but long term treatment of streoids may have side effects. The purpose of this study is to find out the effect of Fulinggancao-Tang on Dyshidrotic Eczema. Methods : We have diagnosed the patients through the Shanghanlun six meridian patterns diagnostic system and we treated the patients with Fulinggancao-Tang. The severity of Dyshidrotic Eczema was evaluated by visual analogue scale(VAS). Results : After the treatment itching and vesicles of hands and foots were all disappeared in both patients. Conclusions : Fulinggancao-Tang have improved the signs and symptoms of Dyshidrotic Eczema case. It is considered that Fulinggancao-Tang is considerably effective on the treatment of skin disease that especially vulnerable to water.

• Tuberculosis and Respiratory Diseases
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• 제72권1호
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• pp.93-97
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• 2012

Propylthiouracil (PTU) is one of the most common drugs used in the treatment of Graves' disease. There are a number of side effects found with PTU use including fever, rash, arthralgia, and flu-like symptoms. Recently antineutrophil cytoplasmic antibodies (ANCA) positive vasculitis after PTU treatment was reported as a rare side effect, which can cause diffuse alveolar hemorrhage and glomerulonephritis. A 45-year-old woman with Graves' disease had been treated with PTU for five months, complained of hemoptysis due to pulmonary alveolar hemorrhage causing anemia, and also had hematuria. Simple chest X-ray and HRCT showed bilateral consolidation and bronchoalveolar lavage fluid revealed alveolar hemorrhage. A serologic test was positive for ANCA against myeloperoxidase and proteinase-3. Such findings suggested that the presence of PTU induced ANCA positive vasculitis. Cessation of PTU and the administration of high dose steroids improved the clinical manifestation, radiologic and serologic findings. We observed ANCA titer serially for 6 years. During the follow up period, ANCA titer decreased slowly and stayed within the acceptable upper normal limit.

• 한국동물위생학회지
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• 제47권1호
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• pp.19-26
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• 2024

Canine atopic dermatitis (CAD) is an inflammatory and pruritic skin disease with a genetic predisposition, characterized by allergic sensitivity. It is known for its distinctive clinical features, including a high recurrence rate and chronic progression. To manage CAD, medications such as steroids and immunosuppressants are commonly used, but consideration should be given to the potential resistance and side effects associated with long-term use. In order to reduce these risks, various adjunctive factors are currently under consideration. One of these adjunctive agents, probiotics have shown effectiveness in regulating atopic dermatitis by modulating immune responses, as demonstrated in several recent studies. In this study, a substance combining three probiotics-L. plantarum, L. reuteri, and Ped. Acidilactici-was used in patients diagnosed with CAD, and its clinical effects and safety were evaluated. The trial involved four groups: a group receiving conventional treatment for atopic dermatitis (A), a group prescribed low-dose probiotics (B), a group prescribed high-dose probiotics (C), and a group prescribed topical probiotics (D). For assessment, the Canine Atopic Dermatitis Extent and Severity Index (CADESI), Trans-Epidermal Water Loss (TEWL) test, gut microbiome, and serum IgE test were conducted. As a result, the CAD severity index (CADESI-4) significantly decreased in the probiotics groups (B & C). In the serum total IgE test, the groups consuming probiotics showed a significant difference, while the group using topical probiotics (D) did not exhibit a significant change. Also, the TEWL test showed improved scores in the probiotics groups (B & C). Therefore, L. plantarum, L. reuteri, and Ped. Acidilactici probiotic combination could be considered as an effective adjunctive treatment, especially for atopic patients with moderate to severe skin lesions.

• Tuberculosis and Respiratory Diseases
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• 제39권3호
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• pp.219-227
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• 1992

연구배경 : 기관지 천식의 병인에 염증반응이 중요한 역할을 한다고 알려져 있고 염증을 억제하기 위해 스테로이드제제가 치료제로서 가장 많이 사용되고 있다. 흡입용 스테로이드는 전신적 부작용이 적어 경구용 스테로이드보다 비교적 안전하게 사용되고 있으나 효과와 부작용에 대하여는 아직 논란이 많다. 이에 저자들은 기관지 천식환자에서 흡입용 스테로이드인 budesonide의 효과와 전신적 부작용의 지표로서 부신피질-뇌하수체축에 대한 영향을 알고자 본 실험을 했다. 방법 : 강남성모병원에 내원한 기관지 천식환자 23명에서 내원당시, placebo투여 2주후, budesonide투여후 3주와 6주에 임상증상, 폐기능 검사, 히스타민 기도 유발검사, 오전 8시와 오후 4시의 ACTH 및 cortisol을 측정하여 비교하였다. 결과 : 1) 폐기능의 변화 : PEFR, FEV1, FVC가 budesonide 치료 3주일부터 증가하기 시작하여 치료전보다 의미있는 개선효과가 있었다. 2) 증상의 변화 : 호흡곤란 치료후 3주일과 6주일후에 의미있는 증상의 개선이 있었다. 객담 : 치료후 3주일과 6주일에 치료전보다 의미있는 증상의 개선이 있었다. 수포음 : 치료후 3주일과 6주일에 의미있는 차이가 있었다. 3) 히스타민 기도 유발 시험 : 치료 3주일에는 의미있는 차이는 없었으나, 치료 6주일에 의미있는 차이가 있었다(p<0.05). 4) 혈중 Cortisol의 변화 : Budesonide 6주일 치료후에 오전 8시와 4시의 cortisol에는 의미있는 차이가 없었다. 5) 혈중 ACTH의 변화 : Budesonide 6주 치료 전후의 혈중 ACTH에는 영향이 없었다. 결론 : 이상의 결과로 기관지 천식의 치료에 흡입용 스테로이드인 budesonide는 하루 $800{\mu}g$씩 투여할 경우 치료후 3주일부터 유의한 증상의 개선효과가 나타나기 시작하여 6주일후에는 3주일보다 임상증상이 더욱 개선되고, 부신피질-뇌하수체축에는 뚜렷한 억제능이 없는 것으로 사료된다.

• 한국임상약학회지
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• 제24권1호
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• pp.15-25
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• 2014

Background: Elderly patients with gastrointestinal (GI) and cardiovascular (CV) risk factors may be more easily exposed to NSAID-related side effects (SEs). Based on the ACG guideline of year 2009, the aim of the study is to evaluate proper use of NSAIDs and gastroprotective drugs according to the degree of GI and CV risk strengths in the patients. Methods: Retrospectively surveyed 410 elderly patients with NSAIDs for more than 30 days at a general hospital in Korea. GI risk factor includes age, ulcer history, high-dose NSIADs, concurrent aspirin use, steroids or anticoagulants. CV risk factor includes angina, myocardial infarction, cerebral infarction, atrial fibrillation or coronary intervention requiring low-dose aspirin. These factors were classified as high/low cardiovascular groups and high/moderate/low GI groups. Results: There were 14 patients in high CV risk group and high GI risk group. The group was recommended not to use NSAIDs as it is not adequate. There were 101 patients in high CV risk group and moderate GI risk group. This group was recommended to use naproxen and PPI/misoprostol. But all patients except one were not adequate. There were 9 patients in low CV risk group and high GI risk group. This group was recommended to use selective COX-2 inhibitor and PPI/misoprostol. 5 cases were proper while 4 cases did not. There were 285 patients in low CV risk and moderate GI risk group who were recommended to use non selective NSAIDs and PPI/misoprostol or selective COX-2 inhibitor only. 103 patients were proper while 182 patients not adequate. Overall, the SEs were higher in those cases for inadequate use of drugs comparing to the adequate. CV SEs were statistically significant. However, SEs for each risk groups were different. For the case of low CV risk group and high/moderate GI risk group, the inadequate use of drugs makes the SE high and the other groups are not. Also, it was not statistically significant. Conclusions: In elderly patients, the inappropriate use of NSAIDs can increase the risk of the disease. Therefore, GI and CV risk must be considered simultaneously, and the proper use of NSAIDs and gastroprotective drugs for each risk groups should be reconsidered.

• Archives of Plastic Surgery
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• 제33권1호
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• pp.120-123
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• 2006

Spontaneous extensor pollicis longus tendon rupture is commonly caused by attrition of the tendon from trauma or inflammatory processes. We experienced a patient with extensor pollicis longus tendon rupture after steroid injection, in which the rupture may have been caused by the effects of steroid itself as well as direct damage from the needle. A 51-year-old woman complained of inability to extend her right thumb at the first metacarpophalangal & interphalangeal joint level. The patient had a history of local steroid injection into the dorsal & radial side of wrist on two occations, and had no history of trauma or rheumatologic disease. After a physical examination of the patient, we decided to explore the wrist. The patient agreed with operation. Intraoperatively, an incision was made into the wrist and the proximal and distal ends of the ruptured extensor pollicis longus tendon were identified. The defect between the proximal and the distal end was measured to approach 8cm, and a palmaris longus tendon graft was performed. After three months of rehabilitation, the first metacarpophalangal & interphalangeal joint recovered the normal range of motion. Steroid injection has been widely used in various musculoskeletal disorders such as rheumatoid arthritis and osteoarthritis. However, inadvertent steroid injection into the extra or intra articular spaces may lead to tendon rupture. Steroids reduce tensile strength by decreasing tenocyte activity and collagen synthesis. Also, the physical effect of direct needle-stick injury into the mesotenon and blood vessels around the tendon may cause damage. In addition, hematoma and edema may increase pressure around the tendon and compromise blood supply, leading to tendon degeneration and subsequent rupture. When injecting steroid into an articular area, all physicians should have a complete understanding of the surrounding anatomy and always keep in mind the hazards of such procedures.

• Clinical and Experimental Pediatrics
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• 제53권3호
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• pp.437-441
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• 2010

독성표피괴사용해(TEN)와 스티븐-존슨 증후군(SJS)은 약물이나 감염에 의해 발생하는 피부점막을 침범하는 드물지만 치명적인 질병이다. 스테로이드는 TEN의 치료에 많이 이용되어왔지만, 아직까지도 논쟁중이다. 스테로이드에 의한 정신과적 영향은 두통, 불면증, 우울증, 심리질환 등이 있다. 스테로이드에 의한 정신질환에서 치료는 스테로이드의 감량 또는 중단이고, 항정신성 약물을 투여한다. 신증후군으로 진단된 11세 남아에서 스테로이드 치료 후 관해상태에서 유지치료를 시행하고 있던 중에 TEN이 발생하였다. 저자들은 이 환아에서 치료목적으로 투여한 고용량 스테로이드 정맥주사로 인해 정신질환이 동반되었고, 이후 스테로이드 감량과 항정신성 약물과 면역글로불린으로 증상이 호전되는 것을 경험하여 이를 보고하는 바이다.

• The Korean Journal of Pain
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• 제35권2호
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• pp.191-201
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• 2022

Background: This study aimed to assess the efficacy of the adductor canal block (ACB) in comparison to intra-articular steroid-lidocaine injection (IASLI) to control chronic knee osteoarthritis (KOA) pain. Methods: A randomized, single-blinded trial in an outpatient rehabilitation clinic recruiting chronic KOA with pain ≥ 6 months over one year. Following randomization, subjects received either a single ACB or IASLI under ultrasound guidance. Numerical rating scale (NRS) scores for pain, and Knee Injury and Osteoarthritis Outcome Scores (KOOS) were recorded at baseline, 1 hour, 1 month, and 3 months postinjection. Results: Sixty-six knees were recruited; 2 were lost to follow-up. Age was normally distributed (P = 0.463), with more female subjects in both arms (P = 0.564). NRS scores improved significantly for both arms at 1 hour, with better pain scores for the IASLI arm (P = 0.416) at 1st month and ACB arm at 3rd month (P = 0.077) with larger effect size (Cohen's d = 1.085). Lower limb function improved significantly in the IASLI arm at 1 month; the ACB subjects showed greater functional improvement at 3 months (Cohen's d = 0.3, P = 0.346). Quality of life (QoL) improvement mirrored the functional scores whereby the IASLI group fared better at the 1st month (P = 0.071) but at the 3rd month the ACB group scored better (Cohen's d = 0.08, P = 0.710). Conclusions: ACB provides longer lasting analgesia which improves function and QoL in chronic KOA patients up to 3 months without any significant side effects.

• The Korean Journal of Pain
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• 제36권2호
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• pp.216-229
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• 2023

Background: The role of the sympathetic nervous system appears to be central in causing pain in complex regional pain syndrome (CRPS). The stellate ganglion block (SGB) using additives with local anesthetics is an established treatment modality. However, literature is sparse in support of selective benefits of different additives for SGB. Hence, the authors aimed to compare the efficacy and safety of clonidine with methylprednisolone as additives to ropivacaine in the SGB for treatment of CRPS. Methods: A prospective randomized single blinded study (the investigator blinded to the study groups) was conducted among patients with CRPS-I of the upper limb, aged 18-70 years with American Society of Anaesthesiologists physical status I-III. Clonidine (15 ㎍) and methylprednisolone (40 mg) were compared as additives to 0.25% ropivacaine (5 mL) for SGB. After medical treatment for two weeks, patients in each of the two groups were given seven ultrasound guided SGBs on alternate days. Results: There was no significant difference between the two groups with respect to visual analogue scale score, edema, or overall patient satisfaction. After 1.5 months follow-up, however, the group that received methylprednisolone had better improvement in range of motion. No significant side effects were seen with either drug. Conclusions: The use of additives, both methylprednisolone and clonidine, is safe and effective for the SGB in CRPS. The significantly better improvement in joint mobility with methylprednisolone suggests that it should be considered promising as an additive to local anaesthetics when joint mobility is the concern.

• Clinical and Experimental Pediatrics
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• 제48권6호
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• pp.594-598
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• 2005

목 적 : 포경이라 함은 포피가 귀두부가 완전히 노출되도록 뒤로 당겨지지 않은 상태를 말한다. 포경은 영 유아 시기에 남아에 있어 요로 감염의 빈도를 증가시키는 위험 요인으로 알려져 있어 영 유아에 있어서 포경에 대한 일차적인 치료로 포경 수술이 행해져 왔다. 그러나 최근 포경 수술의 필요성과 안전성에 대한 논란이 있어왔고 그 대안으로 스테로이드 연고의 국소 치료가 대두되고 있다. 포경 수술의 대안으로서 스테로이드 국소 치료의 효과와 스테로이드 역가가 치료 효과와 부작용과 상관관계가 있는지 알아보고자 한다. 방 법 : 생리적 포경이 심한 4세 이하 남아 53명을 대상으로 저역가 스테로이드 연고 치료군(이하 1군) 27명과 고역가 스테로이드 연고 치료군(이하 2군) 26명으로 나누어 연고를 포피에 도포하고 물리치료를 병행하여 나타나는 치료 효과를 전향적으로 조사, 비교하였고 치료 성공 환아는 치료 종료 한달 후 포경 재발과 요로 감염 발생 여부를 확인하였다. 결 과 : 스테로이드 역가에 따른 각 주별 치료 효과를 비교한 결과 치료 시작 1주 후 치료가 성공된 경우는 1군에서는 2명(7.7%), 2군에서는 2명(7.7%)이었으며 그 이후 성공률은 점점 증가하여 치료 시작 후 6주에는 1군에서는 21명(80.8%), 2군에서는 22명(84.6%)이었다. 각 주별로 두 군간에 치료 성공률에는 유의있는 차이가 없었다. 대상아의 나이, 치료 시작 전 포피 상태, 기왕력의 유무에 따른 성공률의 차이는 없었다. 스테로이드로 인한 부작용으로는 처음 치료 물리 치료 시작시 보챔(5명)과 경미한 소양감(1명)을 보였으나 치료 일수 경과에 따라 증상이 소실되었고 소량의 혈성 분비물(1명)을 보인 환아는 치료를 중단하였다. 치료 종료 한달 후 추적 관찰 시 3명의 환아에서 포경이 재발하였으며 모두 스테로이드 연고 국소 도포 종료 후 지속적인 물리 치료가 이루어지지 않았던 경우였다. 결 론 : 저역가와 고역가 국소 스테로이드 연고를 포경이 있는 영 유아에게 국소 도포하고 물리치료를 병행한 것은 포경 치료에 효과적이었으며, 저역가 스테로이드 연고가 고역가 스테로이드로 치료하는 경우보다 치료 기간이 더 많이 필요하였으나 통계적으로 의미있는 차이는 아니었다. 그리고 치료 종료 후 요로 감염이 발생한 예는 없었다. 포경에 국소 스테로이드 연고를 도포한 치료를 한 경우 치료가 성공한 이후에도 지속적인 물리 치료는 필요하며, 적절한 물리 치료의 기간이나 국소 스테로이드 연고의 도포에 따른 전신적 부작용에 대한 조사는 향후 필요할 것으로 생각된다. 그리고 스테로이드 국소 요법이 포경을 가진 영 유아에서 비뇨생식기계 감염의 재발 또는 발생을 예방할 수 있는지에 대한 연구는 좀 더 큰 규모로 이루어져야 할 것으로 생각된다.