2.Management strategy for idiopathic nehprotic syndrome in children.
Journal of Central South University(Medical Sciences) 2008;33(1):1-7
Corticosteroid, alkylating agents, like cyclophosphamide and chlorambucil, have been used to treat idiopathic nephrotic syndrome for more than fifty years, changing the outcome of these children. However, with long-term use of steroid, especially high dosages, they have unbearable side effects. Newer agents like cyclosporine A, levamisole, tacrolimus, mycophenolate mofetil, have been used to spare those unwanted side effects. In the choice of drugs, the benefits obtained will have to be evaluated against possible side effects, with drug cost also taken into consideration. Though most steroid sensitive nephrotic children may run a relapsing course, have a good prognosis with many becoming non-relapsers or infrequent relapsers in adulthood, the treatment approach should aim at using the minimal amount of drug required to keep patient in remission to tie them over childhood. As for steroid resistant nephrotic syndrome children, especially for focal segmental glomerulosclerosis (FSGS), because of possible grave prognosis of going into end-stage renal failure, more aggressive approach should be adopted, including the use of strong immunosuppressants, such as, cyclosporine, tacrolimus, or mycophenolate mofetil if necessary. The long-term goals of treatment, other than those of physical and medical conditions, should also consider the growth, education, and psychological impact of the disease and side effects of drugs on the child, especially during an adolescent period, so as to allow them having normal development into adulthood.
Child
;
Cyclosporine
;
therapeutic use
;
Drug Therapy, Combination
;
Female
;
Humans
;
Levamisole
;
therapeutic use
;
Male
;
Nephrotic Syndrome
;
drug therapy
;
Prednisolone
;
therapeutic use
;
Tacrolimus
;
therapeutic use
4.Therapy for Graves' ophthalmopathy.
Jianguo ZHENG ; Xia ZHANG ; Rixiang GONG ; Ji WANG ; Tianzhi TAN
Journal of Biomedical Engineering 2004;21(5):876-879
Graves' ophthalmopathy (GO) is also called thyroid-related eye disease, infiltrative ophthalmopathy, which is related with the autoimmunity of thyroid, especially hyperthyroidism. Its morbidity ragnes from five percent to ten percent of hyperthyroidism, and the morbidity of male patients is higher than that of the female patients. The treatment of severe GO is a difficult task for doctors. The therapeutic effect is not always satisfactory. In order to solve this knotty problem, researchers have been devoting themselves to the development of new therapeutic methods. Here, the development of the therapies for GO is introduced, and the trends of treatments are prospected.
Combined Modality Therapy
;
Exophthalmos
;
etiology
;
radiotherapy
;
therapy
;
Graves Disease
;
complications
;
radiotherapy
;
therapy
;
Humans
;
Immunoglobulins
;
therapeutic use
;
Prednisolone
;
therapeutic use
5.Pyoderma gangrenosum with oral involvement - case report and review of the literature.
Geetha PARAMKUSAM ; Venkateswarlu MEDURI ; Naresh GANGESHETTY
International Journal of Oral Science 2010;2(2):111-116
Pyoderma gangrenosum (PG) is a rare, noninfectious neutrophilic dermatosis. Clinically, it begins with sterile pustules that rapidly progress into painful ulcers of variable depth and size with undermined violaceous borders. The diagnosis of PG is based on the history of an underlying disease, a typical clinical presentation, histopathology, and exclusion of other diseases. The peak incidence occurs between the ages of 20 to 50 years with women being more often affected than men. There have been very few reports of pyoderma gangrenosum with oral mucosal involvement. Oral lesions in previously reported cases have included ulcers of varying sizes from a few mm to several cm and have been reported to have been found on the tongue, soft and hard palate, buccal mucosa, and gingiva. Some of these oral lesions have been associated with ulcerative colitis, inflammatory bowel disease, and polycythemia rubra vera. A few cases were reported with biopsy findings, the histological picture being nonspecific, showing ulceration, and necrosis with inflammatory cell infiltrate. A peculiar case of pyoderma gangrenosum with an oral lesion is presented here, and the differential diagnosis is discussed.
Adult
;
Anti-Infective Agents
;
therapeutic use
;
Chlorhexidine
;
therapeutic use
;
Dapsone
;
therapeutic use
;
Drug Therapy, Combination
;
Female
;
Glucocorticoids
;
therapeutic use
;
Humans
;
Metronidazole
;
therapeutic use
;
Oral Ulcer
;
drug therapy
;
etiology
;
pathology
;
Prednisolone
;
therapeutic use
;
Pyoderma Gangrenosum
;
complications
;
Tooth Mobility
;
etiology
6.Doxorubicin Hydrochloride Liposome-Based CHOP Regimen in the Initial Treatment of Elderly Patients with Diffuse Large B-Cell Lymphoma: A Retrospective Study.
Xiang-Dong WANG ; Bo GUO ; Bing ZHAI ; Bo YANG ; Hui FAN ; Xue-Chun LU ; Su-Xia LI ; Hong-Li ZHU
Journal of Experimental Hematology 2021;29(4):1136-1140
OBJECTIVE:
To evaluate the efficacy and safety of CHOP regimen based on doxorubicin hydrochloride liposome in the initial treatment of elderly patients with diffuse large B-cell lymphoma (DLBCL).
METHODS:
Thirty-one patients with DLBCL treated from January 1, 2012 to December 31, 2019 were analyzed retrospectively, their median age was 83 (71-95) years old, and all of them were in Ⅲ-Ⅳ stage, including 17 cases who had international prognostic index (IPI) ≥ 3. The patients were treated with R-CHOP and CHOP regimens based on doxorubicin hydrochloride liposome. The efficacy and safety were evaluated during and after treatment.
RESULTS:
A total of 219 chemotherapy cycles and 7 median cycles were performed in 31 patients. The overall response (OR) rate and complete remission (CR) rate was 80.7% (25/31) and 61.3% (19/31), respectively, as well as 2 cases (6.5%) stable, 4 cases (12.9%) progressive. The main toxicities were as follows: the incidence of grade Ⅲ -Ⅳ neutropenia was 29% (9/31); two patients (6.5%) developed degree Ⅰ-Ⅱ cardiac events, which were characterized by new degree Ⅰ atrioventricular block; there were no cardiac events requiring emergency treatment and discontinuation of chemotherapy. The 1-year, 2-year and 3-year overall survival rate was 83.9%, 77.4% and 61.3%, respectively. The 1-year, 2-year and 3-year progression-free survival rate was 77.4%, 64.5% and 61.3%, respectively.
CONCLUSION
The chemotherapy regimen based on doxorubicin hydrochloride liposome has better efficacy and higher cardiac safety for elderly patients with DLBCL.
Aged
;
Aged, 80 and over
;
Antineoplastic Combined Chemotherapy Protocols
;
Cyclophosphamide/therapeutic use*
;
Doxorubicin/therapeutic use*
;
Humans
;
Liposomes/therapeutic use*
;
Lymphoma, Large B-Cell, Diffuse/drug therapy*
;
Prednisolone
;
Prednisone/therapeutic use*
;
Retrospective Studies
;
Rituximab/therapeutic use*
;
Vincristine/therapeutic use*
7.Clinical Review of Miliary Tuberculosis in Korean Children: 84 Cases and Review of the Literature.
Pyung Kil KIM ; Jae Seung LEE ; Duk Jin YUN
Yonsei Medical Journal 1969;10(2):146-152
Tuberculosis is still one of the most serious infectious diseases in Korea. Tuberculosis in childhood is a serious prablem to Korean pediatricians. Miliary tuberculosis, a form of extrapulmonary tubercubsis, has been frequently observed in outpatient dispensaries or in-patient wards in Korea. Only one clinical review by Mm et al (1969) was reported. We have summarized another eighty four psdiatric patients who were observed during a nine years and three months period from Jan. 1960 to March of 1969, at Wonju Union Christian Hospital, Wonju, Kang Won Do, a branch hospital of our Saverance. The following results were obtained; 1). During nine years and three months from Jan. 1960 to March of 1969, eighty four cases of miliary tuberculosis were observed which was 1.7 per cent of the total admission of pediatric patients (4,991) during the above period. 2). The youngest one was a five month old female infant and the oldest was a thirteen year old boy. The age group of three to six years included 40.5 per cent while 10.7 per cent were under one year. 3). Only eighteen per cent of the patients had a definite contact history with tuberculosis in the family. 4). Their chief complaints on admission were fever, cough, vomiting, loss of appetite, abdominal pain, fatigue, in order. All eight convulsive patients had complication of meningitis. 5). Negative tuberculin responses were found in more than fifty per cent of patients. 6). Tuberculous meningitis was the most frequent complication (28.5 per cent)in miliary tuberculosis. Tuberculous complications were found in fifty per cent of all patients. 7). Death rate was twelve per cent. Six out of ten deaths occurred within three days after admission. Eight out of ten deaths were complicated cases of tuberculous meningitis. Seven out of ten deaths were male patients. 8). In improved cases, improvement on X-ray and by clinical symptoms appeared after two weeks or several months. 9). The Patients were treated by triple chemotherapy and addition of corticosteroid, but we did not find a remarkable effect of steroid. 10). The prevention must precede treatment and doctor's and patient's attention to miliary tuberculosis must be emphasized.
Adolescent
;
Child
;
Child, Preschool
;
Human
;
Infant
;
Prednisolone/therapeutic use
;
Tuberculosis, Miliary/drug therapy/*epidemiology
8.Sarcoidosis with cardiac involvement.
Hyeong Cheon PARK ; Se Kyu KIM ; Yong Sam KIM ; Joon CHANG ; Kyung Young CHUNG ; Dong Hwan SHIN ; Sung Kyu KIM ; Won Young LEE ; Sung Soon KIM
Yonsei Medical Journal 1995;36(6):538-545
Patients with significant cardiac sarcoidosis are at increased risk of sudden death from ventricular dysrhythmias or conduction disturbances. We report a patient in whom there was radiographic and histologic evidence of systemic sarcoidosis; though histologic confirmation of involvement of heart by sarcoidosis is lacking, the clinical manifestations, radionuclide image findings, rhythm disturbances, and the response to steroid therapy are strong evidence in favor of myocardial involvement by the granulomatous process.
Case Report
;
Female
;
Human
;
Middle Age
;
Myocardial Diseases/*drug therapy
;
Prednisolone/therapeutic use
;
Sarcoidosis/*drug therapy
10.Sympathetic ophthalmia in an infected post-scleral buckling eye.
Jona M B SY-ONGKEKO ; Archimedes L D AGAHAN ; Juan S LOPEZ ; Jacinto U DY-LIACCO
Annals of the Academy of Medicine, Singapore 2011;40(3):147-148
Adrenal Cortex Hormones
;
therapeutic use
;
Aged
;
Anti-Infective Agents
;
therapeutic use
;
Anti-Inflammatory Agents
;
therapeutic use
;
Atropine
;
therapeutic use
;
Dexamethasone
;
therapeutic use
;
Eye Infections
;
complications
;
drug therapy
;
Female
;
Fluoroquinolones
;
therapeutic use
;
Glucocorticoids
;
therapeutic use
;
Humans
;
Mydriatics
;
therapeutic use
;
Ophthalmia, Sympathetic
;
drug therapy
;
etiology
;
Prednisolone
;
therapeutic use
;
Scleral Buckling
;
adverse effects
;
Triamcinolone
;
therapeutic use