No abstract available.
Betamethasone* ; Butyrates* ; Diethylpropion* ; Humans* ; Keratinocytes*

BACKGROUND: Corticosteroid is most potent and effective anti-inflammatory medication currently available and inhaled form has been used in the long-term control of asthma. Fluticasone propionate(Flixotide/Flovent : FP) is highly potent and topically active inhaled corticosteroid and has at least twice the potency of beclomethasone dipropionate(BDP) in the control of asthma. The aim of this study was to compare the efficacy of FP and BDP in several aspects. METHOD: Fifty patients with asthma were treated in a randomized, parallel group study of 4 weeks duration. During 2-week run-in period beta2-agonist was administered. After run-in period, FP 500 micro gram/day was administered via Diskhaler or BDP 800 micro gram/day via reservoir dry-power device. During the run-in and treatment period, morning and evening peak expiratory flow rate(PEFR) were measured daily. Daytime and night-time asthma symptoms, daytime and night-time rescue bronchodilator use were checked daily. FEV1.0 and FVC were measured biweekly in both groups. RESULTS: Three patients treated with FP and seven patient treated with BDP were dropped out. Therefore forty patients completed the study. Morning and evening PEFR was increased and diurnal variation of PEFR decreased significantly in both groups. FEV1.0 increased significantly in FP treatment group but not in BDP group. There were also improvements in daytime and night-time asthma symptoms, daytime and night-time rescue bronchodilator use in both groups after treatment. there were no significant difference between groups in any of the efficacy parameters. Therapeutic effects were dimonstrated earlier in patient treated with FP than BDP. CONCLUSION: In this study, 500 micro gram/day fluticasone propionate was as effective as 800 micro gram/day beclomethasone dipropionate in the control of asthma. Therapeutic effects were demonstrated earlier in patient treated with FP than BDP without adverse effect.
Asthma ; Beclomethasone* ; Diethylpropion* ; Humans ; Peak Expiratory Flow Rate ; Fluticasone

Ketoprofen is an nonsteroidal anti-inflammatory drug derived from propionic acid. It has been widely used as topical preparations, as gel or patch. It has been reported that topical ketoprofen can cause contact dermatitis and photocontact dermatitis. We experienced five cases of contact dermatitis, developed after applying ketoprofen patch(Ketotop(R), Pacific pharmaceutical Co., Korea) for the control of oste omuscular or joint pain. While one patient had generalized urticarial eruption, the rest of patents showed localized erythematous pruritic eczematous skin eruptions. It was verified through intradermal skin test and pin prick test that ketoprofen itself was not the causative drug for the skin eruption. Patch test excluded the possibility of allergic skin reaction to rubber compounds. It should be elucidated which compounds are allergic or toxic to the skin, contained in woven fabrics.
Arthralgia ; Dermatitis, Contact* ; Dermatitis, Photoallergic ; Diethylpropion ; Humans ; Ketoprofen* ; Patch Tests ; Rubber ; Skin ; Skin Tests

PURPOSE: We aim to compare the effectiveness and safety of fluticasone propionate (Flt) plus tulobuterol (Hk) versus high-dose Flt alone in controlling asthma in children. METHODS: Fifty three children aged 4 to 8 years, who were diagnosed with mild persistent asthma and underwent maintenance therapy with a low dose of inhaled corticosteroid (Flt) of 50-100 microgram/day were randomized to receive Flt plus Hk (Hokunalin(R) patch 1 mg, Abbott Japan, Tokyo, Japan), or Flt alone at twice the dosage. Patients underwent new treatment for 4 weeks. Asthma symptom scores, mean changes in morning and evening peak expiratory flow (PEF), the frequency of night awakenings, the use of reliever medication, caregiver's overall satisfaction and safety were evaluated and compared in each group. And they were followed-up again 4 week after treatment course for the evaluation of treatment-emergent adverse event (TEAE). RESULTS: No significant difference was found between the groups in terms of mean changes in the morning and evening PEF, the frequency of night awakening, the use of rescue medication and caregiver's overall satisfaction (P=0.83, P=0.83, P=0.17, P=0.32 and P=0.63). Furthermore, no statistically significant difference was observed between 2 groups in the incidence of any TEAE (P=1.00). CONCLUSION: This study demonstrated that a combination of Flt and Hk was as effective as a high-dose Flt therapy in the management of mild persistent asthma in children. The results of this study suggest that tulobuterol add-on therapy can be considered as a reasonable substitute to an increase in the dosage of steroid in the patients with steroid-phobia and it might be used to reduce the risk of high dose steroid therapy.
Aged ; Androstadienes ; Asthma ; Child ; Diethylpropion ; Humans ; Incidence ; Japan ; Terbutaline ; Tokyo ; Fluticasone

The treatment consensus of anorexia nervosa in the last century was to remove the patient from her family and home surroundings. A great range of treatment from prescribing hormonal extracts to prefrontal leucotomy has been tried. Although in former decades many quite different forms of treatment have been described and advocated for anorexia nervosa, there is today consensus concerning the overall management of the disorder. But there still remains a widespread clinical opinion that inpatient treatment is necessary for some as a means of reliably increasing weight. Over the last hundred years the management of anorexia nervosa has changed. Treatment has shifted from medical wards, through to psychiatric wards and now, following the trends in all of medicine, towards community care in Western society. In Korea, case reports of anorexia nervosa and related articles have been published since the late seventies. Recently several epidemiological studies and clinical reports suggested increasing rate of eating disorders including anorexia nervosa in Korea. However, systematic approaches for these patients have not been tried in Korea. The author introduces the treatment model for inpatients with anorexia nervosa of Johns Hopkin's Hospital, Maudsley Hospital, and St. John's Mercy Medical Center. The author also introduces treatment experience with anorexic inpatient at Seoul Paik Hospital.
Anorexia Nervosa* ; Anorexia* ; Consensus ; Diethylpropion ; Feeding and Eating Disorders ; Humans ; Inpatients* ; Korea ; Psychosurgery ; Seoul

Nasal polyp is an intractable condition usually associated with chronic hyperplastic sinusitis with allergic rhinitis. IL-4 is known to contribute to the inflammatory reaction by enhancing binding of inflammatory cells in the nasal polyp. The objectives of this study were to evaluate the effect of roxithromycin (300 mg daily) and intranasal fluticasone spray (200 microgram daily ) in reducing symptoms of chronic sinusitis and polyp size and to compare pre - and post-treatment secretion of IL-4. Twenty-four patients with chronic sinusitis with nasal polyp and allergic rhinitis were selected and allocated into 3 groups ; roxythromycin, fluticasone propionate and combined use group. Statistically significant decrease in symptoms was observed in both the roxythromycin and fluticasone propionate groups. Significant improvement of rhinorrhea and postnasal drip was observed in the combined use group. The polyp size decreased significantly in all three groups. IL-4 secretion decreased significantly in the combined use group after treatment. Long term medication of roxithromycin and intranasal fluticasone spray were effective in reducing symptoms and polyp size in chronic sinusitis with allergic rhinitis. They were also effective in reducing IL-4.
Diethylpropion ; Humans ; Interleukin-4* ; Nasal Polyps ; Polyps* ; Rhinitis ; Roxithromycin* ; Sinusitis* ; Fluticasone

PURPOSE: The efficacy of intranasal corticosteroids for the treatment of allergic rhinitis has been reported. But the efficacy of intranasal corticosteroids has not been compared between perennial nonallergic rhinitis (PNAR) and perennial allergic rhinitis (PAR). METHODS: Twenty-three patients with PNAR and 19 patients with PAR were enrolled in this study. Every patient received fluticasone propionate (FP) 200 g (100 g, bid) daily for 4weeks. Control group (n=16) was received only anti-histamine (hydroxyzine 0.6 mg/kg/dose) intermittently. Efficacy of FP was evaluated by the mean change in nasal congestion, rhinorrhea, nasal itching, sneezing and total nasal symptom score (a sum of patient ratings of nasal congestion, rhinorrhea, nasal itching, and sneezing). RESULTS: Both groups (PNAR and PAR) showed similar improvement of nasal symptom with FP 200 g compared with control. (P< 0.05) In the total population, both groups showed significant improvements from baseline in TNSS compared with control during each week of treatment. (P< 0.05) In PNAR and PAR, nasal congestion was significantly improved more than in control. (P< 0.01, P< 0.01) Rhinorrhea and itching in PAR were improved more than in control. (P=0.02, P=0.03) In sneezing, all three groups showed no differences. (P=1.00, P=0.31, P= 0.29) CONCLUSION: Intranasal FP is an effective treatment for perennial nonallergic rhinitis as same as perennial allergic rhinitis.
Adrenal Cortex Hormones ; Diethylpropion ; Estrogens, Conjugated (USP) ; Humans ; Pruritus ; Rhinitis* ; Sneezing ; Fluticasone

PURPOSE: This study assessed the association between the ratio of leukotriene E4 (LTE4) to fractional exhaled nitric oxide (FENO) in the response of children with exercise-induced bronchoconstriction (EIB) enrolled in a therapeutic trial with montelukast or inhaled corticosteroid (fluticasone propionate [FP]). METHODS: Children aged 6 to 18 years with EIB were randomized in a 4-week, placebo-controlled, double-blinded trial with montelukast or FP. Before and after treatment, treadmill exercise challenges were performed. The LTE4 levels in the induced sputum and urine and the FENO levels were measured in subjects before and 30 minutes after the exercise challenges. The same tests were conducted after treatment. RESULTS: A total of 24 patients completed the study: 12 in the montelukast group and 12 in FP group. Both study groups displayed a similar postexercise maximum decrease in forced expiratory volume in one second (FEV1) before treatment as well as after treatment. However, there were significant differences in the magnitude of change between the two (Delta; -18.38+/-14.53% vs. -4.67+/-8.12% for the montelukast and FP groups, respectively; P=0.021). The Delta logarithmic sputum baseline and postexercise LTE4/FENO ratio were significantly lower in the montelukast group than in the FP group (baseline; -0.09+/-0.21 vs. -0.024+/-0.03, P=0.045; postexercise, -0.61+/-0.33 vs. -0.11+/-0.28, P=0.023). CONCLUSIONS: These data indicate that the efficacy of montelukast for preventing a maximum decrease in FEV1 after exercise is significantly higher than that of FP, and the high LTE4/FENO ratio is associated with a greater response to montelukast than to FP for EIB therapy. These results suggest that LTE4 may play an important role in EIB.
Acetates ; Aged ; Bronchoconstriction ; Child ; Diethylpropion ; Forced Expiratory Volume ; Humans ; Leukotriene E4 ; Nitric Oxide ; Quinolines ; Sputum

Spontaneous pneumomediastinum (PM) is an uncommon condition in which free air enters the mediastinum. This usually occurs either through esophageal tears after vigorous vomiting, or after alveolar rupture subsequent to a rapid increase in intra-alveolar pressure. Spontaneous PM is a rare entity in anorexia nervosa (AN) and self-induced vomiting is often the cause of PM in patients with AN. We experienced a case of spontaneous PM in an anorexic adolescent, in whom vomiting was not the cause of PM.
Adolescent ; Anorexia Nervosa* ; Anorexia* ; Diethylpropion ; Humans ; Mediastinal Emphysema* ; Mediastinum ; Rupture ; Subcutaneous Emphysema ; Tears ; Vomiting

PURPOSE: No studies have been conducted to investigate the acute toxicity of aryloxyphenoxypropionate herbicides in humans following ingestion. Therefore, this study was conducted to investigate the clinical characteristics of aryloxyphenoxypropionate herbicide poisoning and provide guidance for physicians treating patients who have ingested these types of herbicides. METHODS: A retrospective observational case series was conducted using ten patients with history of aryloxyphenoxy propionate herbicide. Data were collected for clinical manifestation, management and final outcome. RESULTS: The most common symptoms were gastrointestinal irritation and an altered mental state (Glasgow Coma Scale<15). An elevated lactate level was a common laboratory abnormality, and prolonged QTc interval was commonly observed. These clinical features normalized within one day of supportive treatment. CONCLUSION: The acute toxicity of aryloxyphenoxypropionate herbicides in humans is manageable with supportive treatment. However, physicians should take into account depressed consciousness, the possibility of arrhythmia, and an elevated lactate level when planning their treatment strategy.
Acetyl-CoA Carboxylase ; Arrhythmias, Cardiac ; Coma ; Consciousness ; Diethylpropion* ; Eating* ; Herbicides ; Humans ; Lactic Acid ; Poisoning ; Retrospective Studies