• 한국임상약학회지
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• 제30권2호
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• pp.102-112
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• 2020

Objective: To analyze the prescription patterns for the treatment of ulcerative colitis (UC) and to investigate factors co-occurring with systemic corticosteroid use. Methods: We used patient-level data from Korean National Health Insurance claims database to identify patients diagnosed with UC (ICD-10 code : K51) and their medications prescribed for UC between January 1 and Decemeber 31, 2017. We found that medications for UC treatment were 5-aminosalicylic acid (5-ASA), immunomodulators, biologics, and corticosteroids. We presented the prescription pattern according to the sex, age group, type of health insurance, site of UC, type of medical institution, and concomitant medication. To evaluate factors associated with prescription of systemic corticosteroids for UC, we used a multivariate logistic regression model to estimate adjusted odds ratios (aORs) and their 95% confidence intervals (CIs). Results: Of 1,469 UC patients, 74.5% used 5-ASA and 15.2% used systemic corticosteroids. 5-ASA constituted 77.5% of all prescriptions and systemic corticosteroids accounted for 13.1%. The most widely used therapy was 5-ASA monotherapy (54.8%), followed by a double therapy with 5-ASA and immunomodulators (8.2%) or 5-ASA and systemic corticosteroids (7.2%). Systemic corticosteroids were more likely to be prescribed with immunomodulators (aOR=1.88, 95% CI=1.54-2.28) and biologics (aOR=2.82, 95% CI=2.28-3.50) than without them. Conclusions: We found that 15.2% of UC patients were prescribed with a systemic corticosteroid, which is less than reported previously. Systemic corticosteroids were more likely to be prescribed with immunomodulators and biologics.

• 한방안이비인후피부과학회지
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• 제21권2호
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• pp.19-27
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• 2008

Objective : The side effect of prolonged use of topical corticosteroids to skin is well-known. Moreover, resent studies have shown that prolonged use of systemic corticosteroids also negatively impacts skin barrier function. Corticosteroids have a major role in the practical management of many variable conditions. So, it is important to find the drug or the method which could protect the skin from the damage caused by corticosteroids. At former study, we investigated that Insamyangyoung-tang has some effect on skin barrier function of DNCB induced contact dermatitis hairless mice. So, this study was performed to research the effect of Insamyangyoung-tang on the TEWL with high dose steroid injected hairless mice. Method : Hairless mice were divided into 4 groups ; Control group, Group A, Group B and Group C. All groups were injected triamcinolone O.4mg for 10 times. Control group was medicated distilled water during the experimental period. Group A was medicated distilled water for 5 days before the $1^{st}$ injection day, and then medicated Insamyangyoung-tang extract during the experimental period. Group B was medicated Insamyangyoung-tang extract for 5 days before the $1^{st}$ injection day, and then medicated distilled water during the experimental period. Group C was medicated Insamyangyoung-tang extract for 5 days before the $1^{st}$ injection day, and then medicated Insamyangyoung-tang extract during the experimental period. TEWL of each group was measured for 5 times. After the $10^{th}$ injection, the tissue sample was made and the damage of epithelial cell was examined. Statistical significance was set at p<0.05 by using non parametric methods and repeated-anova.. Results : Group C showed significant effect on TEWL change of hairless mice evoked by triamcinolone injection. Group A and Group B also showed some effect, but there was no statistical significance.

• Tuberculosis and Respiratory Diseases
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• 제78권1호
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• pp.27-30
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• 2015

The drug reaction with eosinophilia and systemic symptom (DRESS) syndrome is a severe adverse drug-induced reaction which includes a severe skin eruption, fever, hematologic abnormalities (eosinophilia or atypical lymphocytes) and internal organ involvement. The most frequently reported drug was anticonvulsants. The diagnosis of DRESS syndrome is challenging because the pattern of cutaneous eruption and the types of organs involved are various. The treatments for DRESS syndrome are culprit drug withdrawal and corticosteroids. Here we report a 71-year-old man with skin eruption with eosinophilia and hepatic and renal involvement that appeared 4 weeks after he had taken anti-tuberculosis drugs (isoniazid, ethambutol, rifampicin, and pyrazinamide), and resolved after stopping anti-tuberculosis drugs and the administration of systemic corticosteroids. DRESS recurred after re-challenging isoniazid, we identified isoniazid was causative drug.

• Tuberculosis and Respiratory Diseases
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• 제79권3호
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• pp.188-192
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• 2016

Antisynthetase syndrome has been recognized as an important cause of autoimmune inflammatory myopathy in a subset of patients with polymyositis and dermatomyositis. It is associated with serum antibody to aminoacyl-transfer RNA synthetases and is characterized by a constellation of manifestations, including fever, myositis, interstitial lung disease, mechanic's hand-like cutaneous involvement, Raynaud phenomenon, and polyarthritis. Lung disease is the presenting feature in 50% of the cases. We report a case of a 60-year-old female with acute respiratory distress syndrome (ARDS), which later proved to be an unexpected and initial manifestation of anti-Jo-1 antibody-positive antisynthetase syndrome. The present case showed resolution of ARDS after treatment with high-dose corticosteroids. Given that steroids are not greatly beneficial in the treatment of ARDS, it is likely that the improvement of the respiratory symptoms in this patient also resulted from the prompt suppression of the inflammatory systemic response by corticosteroids.

• Intestinal research
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• 제11권3호
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• pp.155-160
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• 2013

Behçet's disease (BD) is a systemic immunological disorder characterized by recurrent mucosal ulcerative lesions including oral and genital ulcerations in association with skin and ocular involvements. BD also can involve the gastrointestinal tract. Gastrointestinal involvement of BD is one of the major causes of morbidity and mortality for this disease. However, clinical data are quite limited because of the rarity of intestinal BD. Therefore, the management of intestinal BD is heavily dependent on expert opinions and standardized medical treatments of intestinal BD are yet to be established. In this brief review, the authors summarized the currently available medical treatments such as 5-aminosalicylic acids, corticosteroids, immuno-modulators, and anti-TNF agents. Moreover, we sought to suggest a treatment algorithm for intestinal BD based on the recently published and updated data.

• Journal of Oral Medicine and Pain
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• 제46권2호
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• pp.63-68
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• 2021

Mucous membrane pemphigoid (MMP) is a heterogeneous group of chronic, autoimmune subepithelial blistering diseases, predominantly involving oral mucosal membrane. Because of its pathophysiology of autoimmune reaction, MMP-related gingivitis would not respond to conventional periodontal treatments. We present a case of a 65-year-old female with a chief complaint of chronic generalized buccal gingivitis, unimproved after periodontal treatment for four months. Based on the clinical findings, histological examination, and direct immunofluorescence microscopy, it was diagnosed as MMP. The symptoms were relieved with immunomodulatory therapy using corticosteroids and the supportive management of professional plaque control. MMP can cause pathological involvement throughout the oral and other mucosae of the body, thus leading to functional impairment through repeated inflammatory cascades. Therefore, accurate diagnosis is essential to properly manage local and possible systemic complications of MMP.

• 한방안이비인후피부과학회지
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• 제21권3호
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• pp.1-9
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• 2008

Objective : Prolonged use of systemic corticosteroids negatively impacts skin barrier function. Corticosteroids have a major role in the practical management of many diseases, so it is necessary to find the drug or supplement which could keep the skin healthy during the systemic corticosteroids therapy. Seed of Trichossnthcs kiiilowii was commonly used for pulmonary disease in traditional Chinese medicine. Many studies have investigated and found that seed of Trichosanthes kirilowii has anti-bacterial, anti-HIV, anti-tumor and immunoregulatory functions. This study was performed to investigate the effect of seed of Trichosmthes kirilowii on the Skin Barrier Method : Triamcinolone 0.4mg was injected male hairless mice for 5 weeks ( 2 times a week, totally 10 times), Just before the first injection, hairless mice were divided into 3 groups; Control ( normal saline medicated group ), GroupA( seed of Trichosuuhes kirilowii qd/day medicated group ) and GroupB( seed of Trichosuuhes kiiilowii bid/day medicated group ), Body weight of all the groups were checked during the experiment, After $10^{th}$ injection, TEWL (Transeidermal water loss) of 3 groups were artificially increased by 9 times tape stripping and the changes of TEWL were checked at before stripping, right after, 2h, 4h, 6h, 24h, 48 and 72h later after stripping, AST, ALT and CBC were also checked. Indeed, stratum corneum of 3 groups were also examined and compared with that of normal hairless mouse. Results : 1. GroupB showed significantly lower body weight among three groups 2, There was no statistical difference at AST, ALT and CBC among three groups 3. GroupB was showed significantly lower TEWL than TEWL of Control at 48h later. 4 GroupB recovered it's TEWL of before tape stripping at 24h later, GroupA recovered that at 48h and Control recovered that at 72h later at the same condition 5. Stratum corneum of GroupA and GroupB were looked almost normal and healthy. On the contrary, stratum corneum of Control was looked thin and unhealthy. Conclusions : Seed of Ttichossnthes kirilowii has some effects on skin barrier function, especially TEWL of high dose corticosteroids injected hairless mouse and the efficacy seemed to be related with the dosage.

• Journal of Oral Medicine and Pain
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• 제35권4호
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• pp.259-264
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• 2010

만성 궤양성 치은 병소는 편평태선, 양성점막유천포창, 심상성 천포창 등과 같은 다양한 질환에 의해 유발될 수 있으며 코티코스테로이드 약물요법이 주된 치료로 이용된다. 코티코스테로이드를 복용하는 경우 위장장애, 체중증가 등의 부작뿐만 아니라 장기 복용 시 골다공증, 당뇨 및 고혈압 발생 또는 악화, 부신기능 저하, 쿠싱증후군 등의 심각한 부작용이 발생 할 수 있어 병소가 국소 부위에 제한되어 발생하거나 전신증상을 동반하지 않는 경우 스테로이드 약물의 국소 도포가 만성 궤양성 치은 병소의 주된 치료로 이용되고 있다. 하지만 국소 스테로이드 치료를 구강 내에 사용하는 경우 타액 분비, 혀, 입술, 협점막 등의 움직임에 의해 도포한 약제가 소실되어 효과가 감소되고 병소가 넓은 부위에 분포하거나 구강 내 깊숙한 부위에 발생하는 경우 환자 스스로 약물을 도포하기가 용이하지 않으며, 질병에 이환 되지 않은 정상 점막에도 약제가 도포 되는 등의 단점이 있다. 국소 스테로이드 적용 방법의 단점을 극복하고 효과를 최대화함으로써 스테로이드 복용을 최소화할 수 있는 방법으로 스텐트를 이용한 스테로이드 밀폐 요법이 보고된 바 있으나 실제 임상에서 적극적으로 활용되지는 않고 있다. 따라서 만성 궤양성 치은 병소가 발생한 환자에게 스텐트를 이용한 국소스테로이드 치료를 시행하여 양호한 치료 효과를 보인 증례를 통해 그 효용성과 임상적 활용 방안을 알아보고자 한다.

• Annals of Clinical Neurophysiology
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• 제4권2호
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• pp.91-97
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• 2002

The field of critical care medicine has flourished, but an unfortunate result of improved patient survival in the intensive care unit is the occurrence of certain acquired neuromuscular disorders. During the last two decades, various neuromuscular disorders were recognized as common causes of weakness occurring in critically ill patients. The two most common disorders are an acute quadriplegic myopathy predominantly associated with the use of intravenous corticosteroids and neuromuscular junction blocking agents and severe systemic illness termed critical illness myopathy(CIM), and an axonal sensorimotor polyneuropathy termed critical illness polyneuropathy. I will review briefly about general components of the CIM.

• Tuberculosis and Respiratory Diseases
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• 제74권4호
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• pp.151-162
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• 2013

Diffuse alveolar hemorrhage (DAH) is a life-threatening and medical emergency that can be caused by numerous disorders and presents with hemoptysis, anemia, and diffuse alveolar infiltrates. Early bronchoscopy with bronchoalveolar lavage is usually required to confirm the diagnosis and rule out infection. Most cases of DAH are caused by capillaritis associated with systemic autoimmune diseases such as anti-neutrophil cytoplasmic antibody-associated vasculitis, anti-glomerular basement membrane disease, and systemic lupus erythematosus, but DAH may also result from coagulation disorders, drugs, inhaled toxins, or transplantation. The diagnosis of DAH relies on clinical suspicion combined with laboratory, radiologic, and pathologic findings. Early recognition is crucial, because prompt diagnosis and treatment is necessary for survival. Corticosteroids and immunosuppressive agents remain the gold standard. In patients with DAH, biopsy of involved sites can help to identify the cause and to direct therapy. This article aims to provide a general review of the causes and clinical presentation of DAH and to recommend a diagnostic approach and a management plan for the most common causes.