PURPOSE: To compare the surgical outcomes and intraocular pressure (IOP) reduction after trabeculectomy in patients with primary open-angle glaucoma (POAG) according to treatment with three different postoperative topical steroids. METHODS: A total of 84 eyes of 84 patients who had undergone trabeculectomy for POAG and were followed-up at least 1 year were included in this study. According to the postoperative topical steroid treatment, the patients were divided into three groups involving 0.5% loteprednol etabonate (LE), 1% rimexolone (RMX), and 1% prednisolone acetate (PDA). The mean IOP change, mean number of topical anti-glaucoma medication changes, 1-year success rate, and complication percentage were compared among the three groups. RESULTS: There were significant reductions in the IOP and number of anti-glaucoma medications during the postoperative 1-year follow-up in all of the groups (all, p < 0.05), but there were no differences among the three groups. Postoperative 1-year success rates (68.2% in the LE group, 67.0% in the RMX group, and 65.9% in the PDA group; p = 0.88) and complication percentages of trabeculectomy were not significantly different among the three groups. CONCLUSIONS: There were no statistical differences in the 1-year success rate, complication percentage, visual acuity, IOP, and number of anti-glaucoma medications among treatment regimens. LE and RMX were as effective and safe as PDA after trabeculectomy in patients with POAG.
Follow-Up Studies ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Loteprednol Etabonate ; Prednisolone ; Steroids ; Trabeculectomy ; Visual Acuity

BACKGROUND AND OBJECTIVES: The epithelial rupture theory for the polyp formation has been well approved. According to Norlander et al., the polyp formation initiated by multifactorial pathophysiological events (infection/inflammation) appears to be a series of the consecutive events involving the rupture of epithelium, prolapse of lamina propria, epithelial ingrowth, microcavity formation, and finally the polyp formation. The purpose of this study is to determine the effects of steroid and steroid receptor blocker at the early stage of the polyp formation in a rabbit model. MATERIALS AND METHODS: In 20 New Zealand white rabbits, polyps were induced by epithelial damage with ostial occlusion. The mometasone and RU 486, given by the biodegradable film (polylactic acid), were used to investigate the possible effects of steroid and steroid receptor blockers. After one and three weeks, macroscopic polyps were counted postmortem and on histological slides after serial sectioning. RESULT: The polyp formation was significantly increased in the RU 486-treated group, whereas it was reduced in the mometasone-treated group. According to the alpha-actin immunohistochemistry, neovascularization at the margin of the initial polyp in the RU 486-treated group markedly increased compared with the mometasone-treated group. CONCLUSION: Steroid is thought to inhibit the initial polyp formation by reducing neovascularization particularly at the margin of initial polyp.
Actins ; Epithelium ; Immunohistochemistry ; Mifepristone ; Mucous Membrane ; Nasal Polyps ; Polyps* ; Prolapse ; Rabbits ; Receptors, Steroid* ; Rupture ; Steroids ; Mometasone Furoate

Administration, Intranasal ; Adult ; Aerosols ; Androstadienes ; therapeutic use ; Anti-Inflammatory Agents ; administration & dosage ; therapeutic use ; Budesonide ; therapeutic use ; Child ; Female ; Fluticasone ; Humans ; Male ; Mometasone Furoate ; Nasal Polyps ; drug therapy ; Pregnadienediols ; therapeutic use ; Rhinitis, Allergic, Perennial ; drug therapy ; epidemiology ; pathology ; Rhinitis, Allergic, Seasonal ; drug therapy ; Singapore ; epidemiology ; Sinusitis ; drug therapy ; Triamcinolone Acetonide ; therapeutic use

PURPOSE: To compare the effect of loteprednol etabonate (LE) with prednisolone acetate (PDA) drops on the proliferation of human Tenon's capsule fibroblasts (HTFBs). METHODS: Primarily cultured HTFBs were treated with serially diluted PDA and LE for 3 days. Cellular survival was determined by a rapid colorimetric assay using MTT. RT-PCR was performed to determine the relative expression of TGF-beta mRNA in response to LE and PDA. RESULTS: PDA inhibited proliferation of HTCF in a dose-dependent manner and LE inhibited significantly the proliferation of HTCF at the higher concentration of 50 microg/ml (p < 0.05). Compared to LE, PDA inhibited proliferation of HTCF significantly at each diluted concentration (p < 0.05). Expressions of TGF-beta were decreased as the concentration of both PDA and LE increased. PDA decreased expression of TGF-beta more significantly compared to LE at each concentration (p < 0.05). CONCLUSIONS: Although LE has offered promising anti-inflammatory efficacy with decreased impact on intraocular pressure, LE may be less effective than PDA in inhibiting fibroblast proliferation and may be not comparable to PDA in preventing excessive scarring after glaucoma filtering surgery.
Androstadienes ; Cicatrix ; Fibroblasts ; Filtering Surgery ; Glaucoma ; Humans ; Intraocular Pressure ; Ophthalmic Solutions ; Prednisolone ; RNA, Messenger ; Tenon Capsule ; Transforming Growth Factor beta ; Loteprednol Etabonate

PURPOSE: To compare the effects of anti-inflammatory agents, specifically bromfenac, loteprednol, and prednisolone, on the permeability of cultured human trabecular meshwork cell (HTMC) monolayers. METHODS: HTMCs were cultured until confluency in the inner chamber of Transwell, then exposed to 1/1,000 or 1/500 diluted commercial 0.1% bromfenac, 0.5% loteprednol, and 1% prednisolone for 24 hours. The permeabilities of carboxyfluorescein through the HTMC monolayer were measured with a spectrofluorometer after 2 hours in the outer chamber. Cellular viabilities were assessed with an 3-[4,5–dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) assay. RESULTS: Bromfenac and loteprednol diluted at 1/1,000 or 1/500 did not significantly affect the cellular survival (p > 0.05). Bromfenac did not affect the permeability via the HTMC monolayer (p > 0.05) and loteprednol decreased the permeability (p < 0.05). In addition, 1/2,000 prednisolone also decreased the permeability (p < 0.05). CONCLUSIONS: Among the anti-inflammatory agents, the non-steroidal anti-inflammatory agent bromfenac did not affect the permeability, while loteprednol and prednisolone decreased the permeability through the HTMC monolayer. Thus, loteprednol and prednisolone may decrease the trabecular outflow.
Anti-Inflammatory Agents* ; Humans ; Loteprednol Etabonate ; Permeability* ; Prednisolone ; Trabecular Meshwork*

PURPOSE: To compare the effects of anti-inflammatory agents, specifically bromfenac, loteprednol, and prednisolone, on the permeability of cultured human trabecular meshwork cell (HTMC) monolayers. METHODS: HTMCs were cultured until confluency in the inner chamber of Transwell, then exposed to 1/1,000 or 1/500 diluted commercial 0.1% bromfenac, 0.5% loteprednol, and 1% prednisolone for 24 hours. The permeabilities of carboxyfluorescein through the HTMC monolayer were measured with a spectrofluorometer after 2 hours in the outer chamber. Cellular viabilities were assessed with an 3-[4,5–dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) assay. RESULTS: Bromfenac and loteprednol diluted at 1/1,000 or 1/500 did not significantly affect the cellular survival (p > 0.05). Bromfenac did not affect the permeability via the HTMC monolayer (p > 0.05) and loteprednol decreased the permeability (p < 0.05). In addition, 1/2,000 prednisolone also decreased the permeability (p < 0.05). CONCLUSIONS: Among the anti-inflammatory agents, the non-steroidal anti-inflammatory agent bromfenac did not affect the permeability, while loteprednol and prednisolone decreased the permeability through the HTMC monolayer. Thus, loteprednol and prednisolone may decrease the trabecular outflow.
Anti-Inflammatory Agents* ; Humans ; Loteprednol Etabonate ; Permeability* ; Prednisolone ; Trabecular Meshwork*

INTRODUCTION: Norwegian or crusted scabies is a rare and highly contagious form of skin parasitosis caused by Sarcoptes scabiei var. hominis. Individuals maffffinly affected are considered to be immunocompromised such as those on prolonged glucocorticosteroid therapy, with AIDS or organ transplant patients. This disease presents as a hyperkeratotic dermatosis with an acral distribution. CASE REPORT: This is a case of a 2-month-old healthy Filipino male, who was previously managed as a case of miliaria rubra and treated with clobetasol 0.05% – ketoconazole 2% cream for 1 week. The papules and plaques became widespread. Consult with a pediatrician revealed widespread scabies and for which patient was prescribed topical permethrin with no improvement. On examination, patient presented with multiple erythematous papules and plaques with crusts on the face, trunk, extremities, palms and soles. Thickened yellowish plaques were observed on the palms and soles. Both parents also presented with widespread papules most prominent on the flexural areas accompanied by nocturnal pruritus. On dermoscopy, numerous mites and burrows were seen in a “jet with contrail pattern.” Prominent yellowish scales were also noted. Patient was admitted due to fever and superimposed bacterial infection and was given IV oxacillin, paracetamol, 8% precipitated sulfur in a hypoallergenic lotion applied twice daily and sodium fusidate ointment. On the 4th hospital day, the patient was afebrile and the lesions were noted to decrease in both erythema and crusting. Follow-up dermoscopy revealed absence scales, burrows and mites. CONCLUSION: Prolonged, unsupervised use of topical corticosteroids in our case most likely induced an immunocompromised state thus predisposing the patient to develop Norwegian scabies. In countries were cases of Norwegian scabies have been unresponsive to permethrin and when ivermectin is not available, the use of precipitated sulfur may still be the best therapeutic and safest option for infants.
Infant ; Scabies ; Mometasone Furoate ; Anti-Allergic Agents ; Adrenal Cortex Hormones

The aim of this study was to investigate relationships between acute exacerbation and Forced Expiratory Volume 1 second (FEV1) improvement after treatment with combined long-acting beta-agonist (LABA) and inhaled corticosteroid (ICS) in patients with chronic obstructive pulmonary disease (COPD). A total of 137 COPD patients were classified as responders or nonresponders according to FEV1 improvement after 3 months of LABA/ICS treatment in fourteen referral hospitals in Korea. Exacerbation occurrence in these two subgroups was compared over a period of 1 yr. Eighty of the 137 COPD patients (58.4%) were classified as responders and 57 (41.6%) as nonresponders. Acute exacerbations occurred in 25 patients (31.3%) in the responder group and in 26 patients (45.6%) in the nonresponder group (P=0.086). FEV1 improvement after LABA/ICS treatment was a significant prognostic factor for fewer acute exacerbations in a multivariate Cox proportional hazard model adjusted for age, sex, FEV1, smoking history, 6 min walk distance, body mass index, exacerbation history in the previous year, and dyspnea scale.Three-month treatment response to LABA/ICS might be a prognostic factor for the occurrence of acute exacerbation in COPD patients.
Adrenal Cortex Hormones/*therapeutic use ; Adrenergic beta-2 Receptor Agonists/*therapeutic use ; Bronchodilator Agents/*therapeutic use ; Budesonide/therapeutic use ; Drug Therapy, Combination ; Female ; Fluticasone/therapeutic use ; Forced Expiratory Volume/drug effects/*physiology ; Formoterol Fumarate/therapeutic use ; Humans ; Male ; Pulmonary Disease, Chronic Obstructive/*drug therapy/physiopathology ; Recurrence ; Republic of Korea ; Salmeterol Xinafoate/therapeutic use ; Smoking ; Spirometry ; Treatment Outcome

Abiraterone Acetate/therapeutic use* ; Androstenes/therapeutic use* ; Dexamethasone/therapeutic use* ; Humans ; Male ; Prostatic Neoplasms, Castration-Resistant/pathology*

OBJECTIVETo explore the treatment methods of pediatric obstructive sleep apnea hypopnea syndrome (OSAHS).

METHODSA total of 386 children with OSAHS were enrolled from June 2008 to April 2011.Ninety children with adenoid and tonsil ≤ degree III (group A) were randomly divided into A1 subgroup and A2 subgroup, while 22 of 296 (group B) children aged less than 3 years old with degree IV adenoid and(or) tonsil were divided into B1 subgroup, and the other 274 of 296 children with degree IV adenoid and (or) tonsil were divided into B1 subgroup, B2 subgroup and B3 subgroup. The adenoid, tonsil size examination and nasal endoscopic examination scores were performed before treatment, 3 months and 6 months after treatment. Drug therapy included oral antibiotics, mometasone furoate as a nasal spray, leukotriene receptor antagonist (LTRAs), mucoactive medications. Conservative treatment meant drug therapy plus negative pressure of sputum aspiration.Surgical treatment meant coblation adenotonsillectomy. A1 subgroup received drug therapy for 3 months; A2 and B1 subgroup received conservative treatment for 3 months; B2 subgroup received coblation adenotonsillectomy after 3 days conservative treatment and postoperative drug therapy for 2 weeks; B3 subgroup received coblation adenotonsillectomy after 2 weeks conservative treatment and postoperative drug therapy for 3 months.

RESULTSThe adenoid and tonsil size of A2 subgroup decreased at 3 months after treatment (Wald χ² were 10.584 and 8.366, respectively, P < 0.05), no significant re-increase was found at 6 months, and no decrease was found in the A1 subgroup (P > 0.05). The nasal endoscopic examination scores decreased in both A1 and A2 subgroup at 3 months after the treatment (F = 403.420, P < 0.05), but it was found re-increase in A1 subgroup at the 6 months (P < 0.05), no significant re-increase was found in the A2 subgroup. The polysomnography (PSG) monitor of A2 subgroup was 100.0% normal at 3 months after treatment, while the A1 subgroup was only 43.2% (χ² = 36.189, P < 0.05). B2 and B3 subgroups cured after coblation adenotonsillectomy, but no decrease of the adenoid and tonsil size was found in B1 subgroup (P > 0.05). The nasal endoscopic examination scores of B1, B2 and B3 subgroups showed significant decrease after the treatment, but re-increase was found in both B1 and B2 subgroups at the 6 months (F = 1 614.244, P < 0.05), no significant re-increase was found in the B3 subgroup. The PSG monitor of B3 subgroup was 100.0% normal at 3 months after treatment, B2 subgroup 73.4%, and B1 subgroup only 57.4% (χ² = 90.846, P < 0.05).

CONCLUSIONSThe treatment method of children with OSAHS should be selected according to the age, condition of disease, and size of the adenoid and tonsil. Adenoid and tonsil ≤ degree III should select conservative treatment; while for degree IV adenoid and (or) tonsil, surgical treatment should be primary choice. Conservative treatment can reduce the risk of perioperative and adequate postoperative drug therapy can help prevent recurrence after surgery.

Adenoidectomy ; Adenoids ; Child ; Humans ; Mometasone Furoate ; Palatine Tonsil ; Polysomnography ; Pregnadienediols ; Recurrence ; Sleep Apnea, Obstructive ; therapy ; Tonsillectomy