• Childhood Kidney Diseases
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• 제1권2호
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• pp.123-129
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• 1997

목적 : 소아의 스테로이드 저항성 신증후군은 예후가 불량함에도 불구하고 지금까지 효과적인 치료방법이 없는 병이었으나 1990년 Mendoza등이 Methylprednisolone 충격 요법이 스테로이드 저항성 신증후군에서 효과적이라는 것을 보고하였다. 하지만 2년 뒤 Waldo 등은 Methylprednisolone 충격 요법이 Mendoza 등의 보고와는 다르게 스테로이드 저항성 신증후군에 효과가 적었다고 보고하여 이에 저자는 한국 소아에서 스테로이드 저항성 신증후군이 발생한 경우 Methylprednisolone 충격 요법의 효과를 알아보고 위의 보고의 서로 다른 결과를 확인하고자 본 연구를 시행하였다. 방법 : 1990년부터 1995년까지 만 5년간 서울대병원 소아과에 스테로이드 저항성 신증후군으로 입원한 소아를 대상으로 Methylprednisolone 충격 요법을 시행하여 $30{\pm}11$개월동안 추적 관찰하였다. 결과 : 1) Methylprednisolone 충격 요법 치료로 신증후군이 완해가 유도된 환아는 20명중 9명으로 45%이었다. 2) Methylprednisolone 충격 요법 치료후 신증후군의 완해가 유지된 환아는 20명중 9명으로 45%이었다. 3) Methylprednisolone 충격 요법에 반응이 없었던 환아중 만성 신부전으로 이행된 경우는 5례로서 25%이었다. 결론 : Methylprednisolone 충격 요법은 스테로이드 저항성 신증후군 소아의 45%에서 신증후군의 완해를 유도하고 유지시키는 효과적인 치료 방법이었다.

• 대한의생명과학회지
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• 제15권3호
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• pp.261-263
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• 2009

Methylprednisolone is a synthetic glucocorticoid which is usually taken intravenously for many neurosurgical diseases which cause edema including brain tumor, and trauma including spinal cord injury. Methylprednisolone reduces swelling and decreases the body's immune response. It is also used to treat many immune and allergic disorders, such as arthritis, lupus, psoriasis, asthma, ulcerative colitis, and Crohn's disease. To identify genes expressed during methylprednisolone treatment against neurons of rats (PC12 cells), DNA microarray method was used. We have isolated 2 gene groups (up- or down-regulated genes) which are methylprednisolone differentially expressed in neurons. Lipocalin 3 is the gene most significantly increased among 772 up-regulated genes (more than 2 fold over-expression) and Aristaless 3 is the gene most dramatically decreased among 959 down-regulated genes (more than 2 fold down-expression). The gene increased expression of Fgb, Thbd, Cfi, F3, Kngl, Serpinel, C3, Tnfrsf4 and Il8rb are involved stress-response gene, and Nfkbia, Casp7, Pik3rl, I11b, Unc5a, Tgfb2, Kitl and Fgf15 are strongly associated with development. Cell cycle associated genes (Mcm6, Ccnb2, Plk1, Ccnd1, E2f1, Cdc2a, Tgfa, Dusp6, Id3) and cell proliferation associated genes (Ccl2, Tnfsf13, Csf2, Kit, Pim1, Nr3c1, Chrm4, Fosl1, Spp1) are down-regulated more than 2 times by methylprednisolone treatment. Among the genes described above, 4 up-regulated genes are confirmed those expression by RT-PCR. We found that methylprednisolone is related to expression of many genes associated with stress response, development, cell cycle, and cell proliferation by DNA microarray analysis. However, We think further experimental molecular studies will be needed to figure out the exact biological function of various genes described above and the physiological change of neuronal cells by methylprednisolone. The resulting data will give the one of the good clues for understanding of methylprednisolone under molecular level in the neurons.

• Journal of Chest Surgery
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• 제17권4호
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• pp.574-586
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• 1984

Although corticosteroid have been shown to stabilize lysosomal membranes and prevent release of hydrolytic enzymes, the mechanism of membrane stabilization remains obscure. This study described functional assessment of efficiency of methylprednisolone in GIK solution by using a isolated Rat Heart Model. Isolated rat heart were subjected to a 2-minute period of coronary infusion with a cold GIK or methylprednisolone mixed cold GIK solution immediately before and also at the midpoint of a 60-minute period of hypothermic [$10{\pm}1^{\circ}C$] ischemic arrest. The result of this were as follow: 1.Spontaneous heart beat after ischemic arrest occurred 11 second later after Langendorffs reperfusion in the methylprednisolone mixed GIK group and 14 second later in the control group. 2.The percentage of recoveries of heart rate at 30 minute after postischemic working heart perfusion was 88.6\ulcorner.6% in the methylprednisolone mixed GIK group. This percentage of recovery was not significantly greater than the control group. 3.The percentage of heart function at 30 minute after postischemic working heart perfusion were; peak aortic pressure $90.8{\pm}4.5%$ coronary flow $87.5{\pm}1.45$ and aortic flow $74.9{\pm}11.8%$ in the methylprednisolone mixed GIK group. This percentage of recovery was significantly greater than the control group. [p<0.05]

• The Korean Journal of Pain
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• 제27권3호
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• pp.278-284
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• 2014

Background: Establishment of laparoscopic cholecystectomy as an outpatient procedure has accentuated the clinical importance of reducing early postoperative pain, as well as postoperative nausea and vomiting (PONV). We therefore planned to evaluate the role of a multimodal approach in attenuating these problems. Methods: One hundred and twenty adult patients of ASA physical status I and II and undergoing elective laparoscopic cholecystectomy were included in this prospective, randomized, placebo-controlled study. Patients were divided into four groups of 30 each to receive methylprednisolone 125 mg intravenously or etoricoxib 120 mg orally or a combination of methylprednisolone 125 mg intravenously and etoricoxib 120 mg orally or a placebo 1 hr prior to surgery. Patients were observed for postoperative pain, fentanyl consumption, PONV, fatigue and sedation, and respiratory depression. Results were analyzed by the ANOVA, a Chi square test, the Mann Whitney U test and by Fisher's exact test. P values of less than 0.05 were considered to be significant. Results: Postoperative pain and fentanyl consumption were significantly reduced by methylprednisolone, etoricoxib and their combination when compared with placebo (P<0.05). The methylprednisolone + etoricoxib combination caused a significant reduction in postoperative pain and fentanyl consumption as compared to methylprednisolone or etoricoxib alone (P<0.05); however, there was no significant difference between the methylprednisolone and etoricoxib groups (P>0.05). The methylprednisolone and methylprednisolone + etoricoxib combination significantly reduced the incidence and severity of PONV and fatigue as well as the total number of patients requiring an antiemetic treatment compared to the placebo and etoricoxib (P<0.05). Conclusions: A preoperative single-dose administration of a combination of methylprednisolone and etoricoxib reduces postoperative pain along with fentanyl consumption, PONV, antiemetic requirements and fatigue more effectively than methylprednisolone or etoricoxib alone or a placebo.

• Clinical and Experimental Pediatrics
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• 제48권8호
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• pp.886-893
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• 2005

목 적 : 가와사키병은 어린 소아에서 전신성 혈관염을 일으키는 가장 흔한 원인이다. 가와사키병이 발병한 경우 여러 혈관 성장인자들의 분비가 촉진되어 내막층의 증식과 신생 혈관 생성작용이 진행되면서 관상동맥이 재구성된다. 수년간 가와사키병의 치료제로 IVIG와 코르티코스테로이드가 사용되었으나 그 치료기전이 명확히 밝혀진 바는 없다. 이런 IVIG와 코르티코스테로이드가 가와사키병의 관상동맥합병증을 감소시키는데 어떠한 기전으로 작용하는지 알아보고자 본 연구에서는 Matrigel을 이용하여 in vitro에서 VEGF에 의해 유도된 내막세포 분화에 대한 IVIG와 methylprednisolone의 효과를 보고자 하였다. 방 법 : Matrigel을 이용하여 in vitro에서 VEGF에 의해 유도된 내막세포 분화에 대한 IVIG와 methylprednisolone의 효과를 보고자 VEGF, VEGF와 IVIG, VEGF와 VEGF antibody, VEGF와 methylprednisolone, VEGF, IVIG와 methylprednisolone을 각각 넣어주고, HUVECs를 18시간 동안 배양 후 튜브의 총 길이를 측정하였다. 결 과 : 1) IVIG의 농도를 25 mg/mL, 그리고 40 mg/mL로 증량하였을 경우 IVIG를 투여하지 않은 대조군에 비하여 통계학적으로 각각 유의한 세포수(HUVECs) 감소 효과를 관찰할 수 있었으며(P<0.001), 40 mg/mL를 처리한 경우가 25 mg/mL를 처리한 경우보다 세포수 감소 효과가 더 뚜렷하였다(P<0.05). 세포배양 시간에 따른 억제 효과는 25 mg/mL과 40 mg/mL에서 배양 후 24시간과 48시간 모두에서 대조군과 비교하여 통계학적으로 유의한 효과를 보였다(P<0.001). 2) VEGF 20 ng/mL를 처리한 군에 IVIG 40 mg/mL 또는 여러 농도의 methylprednisolone($10^{-12}M$, $10^{-9}M$ or $10^{-6}M$)을 처치해 주었을 때 튜브 형성이 유의하게 억제되었으며(P<0.05), methylprednisolone의 경우 그 억제 정도가 농도에 비례하여 일어났으나 IVIG 투여시 보다는 억제 효과가 약하였다. 한편, IVIG와 methylprednisolone와 병합투여한 경우는 methylprednisolone 농도에 상관없이 모두 튜브 형성을 잘 억제하였으며(P<0.001), IVIG만 단독 투여한 것과 통계적 차이는 없었다. 결 론 : 본 연구에서는 in vitro에서 VEGF가 HUVECs의 분화를 유도하고 분화된 내막세포의 맥관 형성이 IVIG와 methylprednisolone에 의해 저해된다는 것을 보여주었다. 이는 가와사키병의 관상동맥합병증이 생기는 기전 중 VEGF와 내막세포의 분화로 인해 일어나는 관상동맥의 재구성을 IVIG와 methylprednisolone이 억제한다는 것을 시사하며 치료 기전 중 하나로 제시될 수 있다.

• 분석과학
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• 제8권2호
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• pp.139-159
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• 1995

몇 가지 종류의 corticosteroid에 대하여 액체 크로마토그래피-질량분석법으로 양이온 질량 스펙트럼을 얻었다. 화학구조에 따라 수소 첨가된 분자이온 [$MH^+$], 암모늄 첨가이온 [${MNH_4}^+$], 또는 ($MH^+-60$) 이온이 base peak였고 [$MH^+-18$] 또는 [${MNH_4}^+-18$] 이온 등이 특성적으로 나타났다. Methylprednisolone acetate를 male Sprague-Dawley rat에 경구투여한 다음 24시간 동안 배설된 뇨로부터 유리상태 또는 접합상태의 대사물질들을 가수분해, 추출 및 농축하고, thermospray LC/MS를 사용하여 양이온과 음이온 질량토막이온을 분석하였다. Methylprednisolone acetate의 C-21 위치에서의 탈아세틸화(deacetylation), C-20 위치에서 C=0의 -CHOH로의 환원, C-11 위치에서 CHOH의 C=0로의 산화 또는 C-17과 C-20 사이의 bond cleavage등에 의해 생성되는 것으로 추정되는 10여종의 대사물질을 검출하였다. 그 중에 20-hydroxymethylprednisolone(20-HMP), methylprednisolone(MP), methylprednisone(11-KMP)등은 표준물질과 비교 확인하였다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권2호
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• pp.142-154
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• 2000

The purpose of this study is to evaluate the difference in healing of $Medpor^{(R)}$ implants of two different thickness (1.5mm and 4.5mm) and the effects of methylprednisolone on the healing process. Light microscopic and scanning electron microscopic examinations, and hardness measurement were made in 100 rats 2, 4, or 8 weeks postoperatively. The 1.5mm thin implants were taken better than the 4.5mm thick implants. The inflammatory responses were reduced after application of methylprednisolone with arrangement and amount of bone matrix deposited being more irregular and reduced in bulk than in the control group. To hasten postoperative healing after $Medpor^{(R)}$ implantation, the thinner material should be used and steroid injection should be avoided.

• 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.

• 대한의생명과학회지
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• 제11권3호
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• pp.407-416
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• 2005

Cardiopulmonary bypass (CPB) for cardiac surgery induces the production and release of numerous chemotactic substances and cytokines, ensuing systemic inflammatory response that causes postoperative major organ dysfunctions. We performed a randomized, prospective study to investigate clinical effects of preoperative treated-methylprednisolone for preventing inflammation in pediatric cardiac surgery with CPB. Thirty pediatric patients scheduled for elective cardiac surgery were randomized to either control(n=15) or steroid group (n=15, 10 mg/kg of methylprednisolone). Arterial blood samples were taken before and after the operations for measuring total leukocyte (T-WBC) and differential counts, platelet counts, interleukin-6 (IL-6), myeloperoxidase (MPO), neuron specific enolase (NSE), troponin-I (TNI), aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), and creatinine levels. Postoperative parameters such as pulmonary index (PI, $PaO_2/FiO_2$), 24 hrs and total bleeding volumes, mechanical ventilating (MVP) and intensive care unit (ICU)-staying periods, and hospitalization were assessed. T-WBC, neutrophil fraction, IL-6, MPO, NSE, TNI, AST and creatinine levels, bleeding volumes, PI, and MVP at the postoperative periods were lower or shorter in steroid group than in control group (P<0.05). These findings indicated that preoperative administration of methylprednisolone attenuated CPB-induced inflammatory reactions, contributing to postoperative recovery of patients underwent cardiac surgery.

• Annals of Clinical Neurophysiology
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• 제10권1호
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• pp.79-82
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• 2008

The etiology of intractable hiccups is most commonly idiopathic. However, they are occasionally associated with some underlying disorders including gastro-esophageal reflux disease. There are a few previous reports describing the association of intractable hiccups with high dose corticosteroid. We experienced an unusual case of intractable hiccups following a high dose intravenous methylprednisolone therapy in a patient with right third nerve palsy. Since methylprednisolone is commonly used in various neurological problems, physicians should be aware of its possible side effect including intractable hiccups.