• Annals of Clinical Neurophysiology
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• v.9 no.1
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• pp.29-32
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• 2007

Recurrent transverse myelitis is a rare manifestation of systemic lupus erythematosus. Recurrent transverse myelitis presents the biggest diagnostic problem, since it is common manifestation of multiple sclerosis. But it can also be the only feature or first manifestation in systemic lupus erythematosus. Neurological manifestations and magnetic resonance imaging can be indistinguishable, and there are no specific diagnostic tools. Here we describe a 59-year-old female having a systemic lupus erythematosus with recurrent transverse myeltitis. No uniform therapeutic protocol exists for systemic lupus erythematous with transverse myelitis, and the prognosis is usually poor. We suggest that aggressive treatment (usually with pulses of methylprednisolone and cyclophosphamide) might improve the prognosis of systemic lupus erythematosus with transverse myeltis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.1
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• pp.81-85
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• 2009

As panfacial fractures are involved multiple fracture, there are possibility of many pre-operative & postoperative complications. It is necessary to do exact pre-operative evaluation, appropriate operation and care, for preventing and treating these complications, especially related to optic nerve injury. The complication occurs rarely after periorbital facial bone fracture, and indirect injuries may occur as a result of impact shearing force transmitted into the optic nerve axons or to the nutrient vessels of the optic nerve. Also indirect injuries may occur after the force of impact because of vasospasm and swelling of the optic nerve within the confines of the nonexpansile optic canal. It is necessary to active evaluation and treatments involving decompression of the orbit surgically and high dose steroid therapy in relation to panfacial fracture. But sometimes this treatments are limited due to severe swelling of the face and related multiple bone fractures in the body. This case showed the delayed neuropathy, at last visual loss, in spite of megadose methylprednisolone administration. The purpose of this article is to present indirect traumatic optic neuropathy that is one of many complications in panfacial bone fracture.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.538-542
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• 2009

Purpose: The successful wound healing means the scarless wound with adequate strength. It has been shown in vivo and in vitro that steroid retard the collagen synthesis. We studied the effect of steroid on the wound breaking strength in rats. Methods: 40 Sprague - Dawley rats were evenly assigned to two groups. One group was served as control, the other group was experimental. We made dorsal midline incision and closed the wound. In the experimental group, we medicated methylprednisolone (0.15 mg/g/day) for 1 week. Then, we compared the differences of the breaking strength and microscopic histology between control and experimental group at 2, 4, 6 and 8 week. Results: Up to 4 week, the breaking strength of the experimental group was markedly decreased than that of control group, while at 6 week the strength of experimental group attained to that of control group nearly. In histologic findings, control group demonstrated dense organization of collagen to experimental group at 4th week. Conclusion: In this experiment, steroid significantly inhibited the strength gain in wound at early period of the wound healing process. When using steroid after the surgery or the wound formation, it is desirable to administrate carefully and need thorough wound management to prevent delayed wound healing.

• Korean Journal of Veterinary Research
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• v.23 no.1
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• pp.57-67
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• 1983

The present study was carried out to observe the histopathological changes in the mammary gland of lactating rats and rabbits injected with dexamethasone. White rats were intramuscularly injected with 0.25mg, 0.5mg or 1.0mg of dexamethasone sodium phosphate (containing $9{\alpha}$-fluoro-$16{\alpha}$-methylprednisolone, 5.0mg/ml) daily for 3 to 10 days on the 3rd day after parturition and white rabbits were intramammary infused with 4mg or 20mg of dexamethasone daily for 4 days on 7th day after parturition. The histopathological changes of the mammary glands, ovaries and adrenal glands of rats and rabbits were observed with light microscope. In the mammary glands of rats, the microscopic findings encountered were decrease of the milk in the alveolar lumina, necrosis and desquamation of epithelial cells, atrophy of alveoli, proliferation of fibroblasts and thickness of alveolar walls, destruction of alveoli, presence of fat droplets within the glandular epithelial cells, infiltration of mononuclear cells and proliferation of adipose tissue, which were relative to the dose and duration of injection. Especially, in the cases of the administration of large doses or long duration, there were severe fibrosis and focal necrosis of glandular tissue. In the mammary glands of rabbits, the morphological changes were similar to those findings in the rats. The milk in the alveolar lumina was decreased gradually according to the dose and duration of injection, while milk fat concentration regarded to increase. In the histological findings of ovaries, necrosis of granulosa cellos, vacuolization and necrosis of luteal cells, atrophy and necrotic foci in the corpora lutes were observed. In the adrenal glands, hyperemia, hemorrhage, vacuolization of adrenal cortical cells, necrotic foci and atrophy of adrenal cortex were observed.

• Parasites, Hosts and Diseases
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• v.49 no.3
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• pp.303-308
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• 2011

This study investigated whether elevated host immune capacity can inhibit T. gondii infection. For this purpose, we used silk protein extracted from Bombyx mori cocoons as a natural supplement to augment immune capacity. After silk protein administration to BALB/c mice for 6 weeks, ratios of T lymphocytes ($CD4^+$ and $CD8^+$ T-cells) and splenocyte proliferative capacities in response to Con A or T. gondii lysate antigen (TLA) were increased. Of various cytokines, which regulate immune systems, Th1 cytokines, such as IFN-${\gamma}$, IL-2, and IL-12, were obviously increased in splenocyte primary cell cultures. Furthermore, the survival of T. gondii (RH strain)-infected mice increased from 2 days to 5 or more days. In a state of immunosuppression induced by methylprednisolone acetate, silk protein-administered mice were resistant to reduction in T-lymphocyte ($CD4^+$ and $CD8^+$ T-cells) numbers and the splenocyte proliferative capacity induced by Con A or TLA with a statistical significance. Taken together, our results suggest that silk protein augments immune capacity in mice and the increased cellular immunity by silk protein administration increases host protection against acute T. gondii infection.

• Childhood Kidney Diseases
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• v.9 no.1
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• pp.83-90
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• 2005

Focal segmental glomerulosclerosis(FSGS) has been detected in approximately 10% of cases of Idiopathic nephrotic syndrome in children, and exhibits a poor response to initial steroid therapy, as well as a higher rate of progression to chronic renal failure and relapse after kidney transplantation. We describe a case of an eleven year-old boy with steroid-resistant FSGS who exhibited a response to a second trial of cyclosporin h(CsA) therapy. At the age of 26 months, this patient was diagnosed with steroid-resistant FSGS. For 9 years, he had undergone a gauntlet of therapies to induce remission; oral steroids, cyclophosphamide, methylprednisolone(mehyIPd) pulse therapy, CsA, and ibuprofen therapy. Although these therapies failed to induce remission, the patient's renal function remained In the normal range during the nine years of treatment. At the age of ten years, the patient's proteinuria decreased, and complete remission was attained with a second administration of CsA, coupled with a low dose of oral steroids. This patient continues to receive CsA without relapse. Therefore, our major concern involves the possibility of relapse after the discontinuation of CsA therapy Our findings in this case suggest that, in cases of refractory FSGS, if renal insufficiency does not emerge, aggressive therapy for the amelioration of proteinuria should be continuously pursued.

• Korean Journal of Transplantation
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• v.32 no.4
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• pp.75-83
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• 2018

Background: This study was designed to analyze the clinical usefulness of mycophenolic acid trough concentration monitoring in kidney transplantation patients who were maintained with cyclosporine. Methods: The data of patients who underwent mycophenolic acid trough concentration monitoring after their first kidney transplant between November 2006 and August 2013 and were prescribed with cyclosporine, mycophenolate, and methylprednisolone were reviewed retrospectively. Cox analysis was used to analyze the risk factors for acute rejection within 1 year post-transplantation. Results: Among 90 patients, 41 (45.6%) achieved both the target levels of cyclosporine and mycophenolic acid, while three patients (3.3%) failed to achieve the target level of either cyclosporine or mycophenolic acid. Nine patients (10.0%) only achieved the mycophenolic acid target level and 37 patients (41.1%) only achieved the cyclosporine target level. While patients who achieved only the mycophenolic acid target concentration had no statistically increased risk compared to patients who achieved both target levels (hazard ratio [HR], 1.569; 95% confidence interval [CI], 0.316 to 7.778; P=0.581), patients who only achieved the cyclosporine target concentration showed an increased risk of rejection compared to the both achievement group (HR, 4.112; 95% CI, 1.583 to 10.683; P=0.004). Patients who had no achievement in the target levels showed significantly increased rejection risk compared to the patients who achieved both target levels (HR, 17.811; 95% CI, 3.072 to 103.28; P=0.001). Conclusions: Mycophenolic acid trough concentration monitoring combined with cyclosporine trough concentration monitoring is useful for avoiding acute cellular rejection if the first 1 year post-transplantation.

• Childhood Kidney Diseases
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• v.25 no.1
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• pp.29-34
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• 2021

C3 glomerulonephritis (C3GN), a rare condition associated with dysregulation of the alternative pathway of the complement system, is histopathologically characterized by isolated or dominant C3 deposition in the renal glomeruli. We report a case of C3GN associated with anti-complement factor H (CFH) autoantibodies and CHF-related protein deficiency in an adolescent male. A 16-year-old adolescent male was admitted to a hospital with a 1-month history of generalized edema prior to presentation. Persistent microscopic hematuria and low serum C3 levels were incidentally detected at 7 and 10 years of age, respectively. Laboratory test results revealed hypoalbuminemia, nephrotic-range proteinuria, microscopic hematuria, and normal serum creatinine levels. The serum C3 and C4 levels were 17 mg/dL (normal 80-150 mg/dL) and 22 mg/mL (17-40 mg/mL), respectively. Renal biopsy showed typical features of C3GN. Further investigations revealed positive results on plasma anti-CFH autoantibody testing and a homozygous deletion of CFHR1 and CFHR3, which encode CFH-related proteins 1 and 3, respectively. Proteinuria persisted despite treatment with intravenous methylprednisolone, mycophenolate mofetil, and angiotensin-receptor blocker; however, his renal function remained stable. In conclusion, anti-CFH autoantibodies serve as important contributors to C3GN. This is the first case report that describes C3GN in an adolescent Korean male with anti-CFH autoantibodies and homozygous CFHR1 and CFHR3 deletion.

• The Korean Journal of Pain
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• v.35 no.2
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• pp.183-190
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• 2022

Background: To compare ultrasound-guided pulsed radiofrequency (PRF) of the genicular nerve with the genicular nerve block using local anesthetic and steroid for management of osteoarthritis (OA) knee pain. Methods: Thirty patients with OA knee were randomly allocated to receive either ultrasound-guided PRF of the genicular nerve (PRF group) or nerve block with bupivacaine and methylprednisolone acetate (local anesthetic steroid [LAS] group). Verbal numeric rating scale (VNRS) and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) scores were measured at pre-procedure and 1-, 4-, and 12-weeks post-procedure. Results: VNRS scores decreased significantly (P < 0.001) in both the groups at 12 weeks and other follow up times compared to baseline. Seventy-three percent of patients in the PRF group and 66% in the LAS group achieved effective pain relief (≥ 50% pain reduction) at 12 weeks (P > 0.999). There was also a statistically significant (P < 0.001) improvement in WOMAC scores in both groups at all follow up times. However, there was no intergroup difference in VNRS (P = 0.893) and WOMAC scores (P = 0.983). No complications were reported. Conclusions: Both ultrasound-guided PRF of the genicular nerve and blocks of genicular nerve with local anesthetic and a steroid provided comparable pain relief without any complications. However, PRF of the genicular nerve is a procedure that takes much more time and equipment than the genicular nerve block.

• Clinics in Shoulder and Elbow
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• v.25 no.2
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• pp.129-139
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• 2022

Background: Several therapeutic methods have been proposed for frozen shoulder syndrome. These include suprascapular nerve block, a simple and cost-effective technique that eliminates the need for nonsteroidal anti-inflammatory drug therapy. Methods: This was a clinical trial that included patients with unilateral shoulder joint stiffness. Patients were divided into three groups: those treated with isolated physiotherapy for 12 weeks (PT group), those treated with a single dose intra-articular injection of corticosteroid together with physiotherapy (IACI group), and those treated with a suprascapular nerve block performed with a single indirect injection of 8-mL lidocaine HCL 1% and 2 mL (80 mg) methylprednisolone acetate together with physiotherapy (SSNB group). The variables assessed were age, sex, side of involvement, dominant limb, presence of diabetes, physical examination findings including erythema, swelling, and muscle wasting; palpation and movement findings; shoulder pain and disability index (SPADI) score; and the visual analog scale (VAS) score pre-intervention and at 2-, 4-, 6-, and 12-week post-intervention. Results: Ninety-seven patients were included in this survey (34 cases in the PT group, 32 cases in the IACI group, and 31 cases in the SSNB group). Mean age was 48.55±11.06 years. Fifty-seven cases were female (58.8%) and 40 were male (41.2%). Sixty-eight patients had a history of diabetes (70.1%). VAS and SPADI scores and range of mototion degrees dramatically improved in all cases (p<0.001). Results were best in the SSNB group (p<0.001), and the IACI group showed better results than the PT group (p<0.001). Conclusions: Suprascapular nerve block is an effective therapy with long-term pain relief and increased mobility of the shoulder joint in patients with adhesive capsulitis.