Adrenal Cortex Hormones ; pharmacology ; therapeutic use ; Adult ; Female ; Fluorescent Antibody Technique ; Follow-Up Studies ; Glomerulonephritis ; drug therapy ; pathology ; Glycosides ; pharmacology ; therapeutic use ; Humans ; Kidney ; drug effects ; pathology ; ultrastructure ; Tablets ; Tripterygium ; chemistry

Adhesive capsulitis is a common cause of shoulder pain and limited movement. The objectives of this review were to assess the efficacy and safety of corticosteroid injections for adhesive capsulitis and to evaluate the optimum dose and anatomical site of injections. PubMed and CENTRAL databases were searched for randomised trials and a total of ten trials were included. Results revealed that corticosteroid injection is superior to placebo and physiotherapy in the short-term (up to 12 weeks). There was no difference in outcomes between corticosteroid injection and oral nonsteroidal anti-inflammatory drugs at 24 weeks. Dosages of intra-articular triamcinolone 20 mg and 40 mg showed identical outcomes, while subacromial and glenohumeral corticosteroid injections had similar efficacy. The use of corticosteroid injections is also generally safe, with infrequent and minor side effects. Physicians may consider corticosteroid injection to treat adhesive capsulitis, especially in the early stages when pain is the predominant presentation.
Adrenal Cortex Hormones ; pharmacology ; Bursitis ; complications ; drug therapy ; therapy ; Female ; Humans ; Injections ; Male ; Pain ; complications ; Physical Therapy Modalities ; Primary Health Care ; Randomized Controlled Trials as Topic ; Shoulder ; physiopathology ; Shoulder Joint ; physiopathology ; Treatment Outcome ; Visual Analog Scale

The small airways have been neglected for many years, but interest in the topic has been rekindled with recent advances in measurement techniques to assess this region and also the ability to deliver therapeutics to the distal airways. Current levels of disease control in asthmatic patients remain poor and there are several contributory factors including; poor treatment compliance, heterogeneity of asthma phenotypes and associated comorbidities. However, the proposition that we may not be targeting all the inflammation that is present throughout the whole respiratory tree may also be an important factor. Indeed decades ago, pathologists and physiologists clearly identified the importance of small airways dysfunction in asthmatic patients. With improved inhaler technology to deliver drug to target the whole respiratory tree and more sensitive measures to assess the distal airways, we should certainly give greater consideration to treating the small airway region when seeing our asthmatic patients in clinic. The aim of this review is to address the relevance of small airways dysfunction in the daily clinical management of patients with asthma. In particular the role of small particle aerosols in the management of patients with asthma will be explored.
Adrenal Cortex Hormones ; Aerosols ; Asthma* ; Comorbidity ; Compliance ; Humans ; Inflammation ; Inhalation ; Nebulizers and Vaporizers ; Pharmacology ; Phenotype ; Physiology ; Population Characteristics

PURPOSE: Esophageal candidiasis (EC) is the most frequent opportunistic fungal infection in immunocompromised host. However, we have found EC in healthy individuals through esophagogastroduodenoscopy (EGD). The aim of this study was to determine the prevalence and risk factors for EC in healthy individuals. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 281 patients who had been incidentally diagnosed with EC. We also conducted age and sex matched case control study to identify the risk factor for EC. RESULTS: The prevalence of EC was 0.32% (281/88125). The most common coexisting EGD finding was reflux esophagitis (49/281, 17.4%). An antifungal agent was prescribed in about half of EC, 139 cases (49.5%). Follow-up EGD was undertaken in 83 cases (29.5%) and 20 cases of candidiasis was persistently found. Case control study revealed EC were more often found in user of antibiotics (p=0.015), corticosteroids (p=0.002) and herb medication (p=0.006) as well as heavy drinking (p<0.001). CONCLUSION: The prevalence of EC was 0.32% (281/88125) in Korea. Use of antibiotics, corticosteroids and herb as well as heavy drinking were significant risk factors for EC in healthy individuals.
Adrenal Cortex Hormones/therapeutic use ; Adult ; Aged ; Alcohol Drinking ; Anti-Bacterial Agents/therapeutic use ; Antifungal Agents/pharmacology ; Candidiasis/*diagnosis/epidemiology ; Case-Control Studies ; Esophageal Diseases/*diagnosis/epidemiology ; Esophagitis, Peptic/complications/diagnosis ; Female ; Humans ; Immunocompromised Host ; Male ; Middle Aged ; Plant Preparations/therapeutic use ; Prevalence ; Republic of Korea ; Retrospective Studies ; Risk Factors

OBJECTIVETo study the effect of Jiaweisinisan (JWSNS), a traditional Chinese herbal medicinal recipe, on gastric mucosal ultrastructure and brain-gut axis in rat models of chronic psychological stress and elucidate the mechanism of JWSNS for ameliorating stress-induced gastrointestinal dysfunction.

METHODSSixty rats were randomly assigned into normal control group, model group, 3 JWSNS groups (high, moderate, and small doses), and omeprazole group (n=10). Rat models of chronic psychological stress were established by random stressful stimulations, and following the corresponding interventions, plasma adrenocorticotropic hormone (ACTH) and cortisol (CORT) levels were detected using radioimmunoassay, and the mRNA expressions of gastrin receptor in the gastric tissue (GASR) and vasoactive intestinal peptide II receptor (VIPR2) in the jejunal tissue were examined using RT-PCR. Transmission electron microscopy was employed to examine the ultrastructural changes in the gastric mucosa tissue cells of the glandular stomach area and alterations in the intercellular junctions.

RESULTSElectron microscopy revealed obvious damages in gastric mucosal epithelial cell organelles and nuclei in the model rats. These damages were ameliorated after treatments with JWSNS and omeprazole. Compared with the model group, the 3 JWSNS groups and omeprazole group all showed significantly lowered plasma ACTH and CORT levels, increased gastrin receptor mRNA expression and decreased jejunal VIPR2 mRNA expression (P<0.05 or 0.01).

CONCLUSIONJWSNS can obviously ameliorate the pathologies of the gastric mucosa cells, regulate the state of brain-gut axis, and modulate the gastric gastrin receptor and jejunal VIPR2 mRNA expressions in rats with chronic psychological stress.

Adrenal Cortex Hormones ; blood ; Adrenocorticotropic Hormone ; blood ; Animals ; Drugs, Chinese Herbal ; pharmacology ; Gastric Mucosa ; metabolism ; pathology ; ultrastructure ; Hydrocortisone ; blood ; Jejunum ; metabolism ; Male ; Rats ; Rats, Wistar ; Receptors, Bombesin ; metabolism ; Receptors, Vasoactive Intestinal Peptide, Type II ; metabolism ; Stress, Psychological ; pathology

OBJECTIVETo explore the effect of Yougui Recipe, a kidney-supplementing and yang-activating formula which on the behavioral changes of rat of steroid-induced avascular necrosis of the femoral head (SANFH).

METHODSThirty Wistar rats were involved and were randomly divided into the blank control group (group A), the model group (group B) and the Yougui Recipe group (group C). SANFH models were established by injection of colibacillus endotoxin and prednisolone intramuscularly. Group C was lavaged with Yougui Recipe (10 ml/kg), while group A and group B were lavaged with the same amount of saline. The behavior of catch force, independent activities, the tail suspension, field experiment and water cleans maze experiment were observed after 6 weeks.

RESULTSCompared with Yougui Recipe, rats in model group: catch force and independent activity decreases; the tail suspension activities was less time. In the desert field experiments, the total distance in 10 min movement reduced significantly. In the water maze experiment, incubation period of escape had a long time obviously, total distance of activities reduced.

CONCLUSIONYougui Recipe can relieve the ethologic change of rat model of steroid-induced avascular necrosis of the femoral head.

Adrenal Cortex Hormones ; toxicity ; Animals ; Drugs, Chinese Herbal ; pharmacology ; Femur Head Necrosis ; chemically induced ; psychology ; Hindlimb Suspension ; Male ; Maze Learning ; drug effects ; Motor Activity ; drug effects ; Rats ; Rats, Wistar

INTRODUCTIONGlucocorticoids cause osteoporosis by decreasing bone formation and increasing bone resorption activity. Glucocorticoid action in bones depends on the activity of 11-beta-hydroxysteroid dehydrogenase type 1 (11β-HSD1) enzyme, which plays an important role in regulating corticosteroids. 11β-HSD1 is expressed by human and rat osteoblasts. We aimed to investigate the relationship between 11β-HSD1 dehydrogenase activity and bone histomorphometric changes in glucocorticoid-induced osteoporotic bone in rats.

METHODSA total of 30 male Sprague-Dawley rats (aged three months, weighing 200-250 g) were divided into three groups of ten each. Group 1 rats were the baseline control, which were sacrificed untreated at the beginning of the study. Group 2 rats underwent sham operation and were administered with vehicle olive oil intramuscularly at 0.05 ml/kg. Group 3 rats were adrenalectomised and administered with an intramuscular injection of dexamethasone 120 μg/kg body weight/day. The treatment was started two weeks after the operation, for a duration of two months. Plasma osteocalcin, plasma pyrodinoline, plasma corticosterone and 11β-HSD1 were measured, and bone histomorphometry analysis was performed.

RESULTSDexamethasone treatment caused an increase in plasma corticosterone level, together with a significant reduction in 11β-HSD1 dehydrogenase activity of the bone, along with a higher plasma level of the bone resorption marker, pyridinoline. Dexamethasone treatment also caused a reduction in trabecular volume, number and thickness, and an increase in trabecular separation.

CONCLUSIONLong-term glucocorticoid treatment reduces the 11β-HSD1 dehydrogenase activity in the bone, which can otherwise lead to bone loss due to the increased level of active glucocorticoids.

11-beta-Hydroxysteroid Dehydrogenase Type 1 ; metabolism ; Adrenal Cortex Hormones ; metabolism ; Amino Acids ; pharmacology ; Animals ; Body Weight ; Bone and Bones ; metabolism ; Corticosterone ; blood ; Dexamethasone ; pharmacology ; Enzyme-Linked Immunosorbent Assay ; methods ; Gene Expression Regulation, Enzymologic ; Glucocorticoids ; metabolism ; Humans ; Male ; Osteoporosis ; metabolism ; Rats ; Rats, Sprague-Dawley

OBJECTIVE: To study the expression of Eotaxin and Eotaxin-2 in nasal polyp and observe the effects of steroids on Eotaxin and Eotaxin-2 in nasal polyps. METHOD: The SP immunohistochemical method was applied to explore the expression of Eotaxin and Eotaxin-2 in nasal polyps before and after systemic corticosteroids therapy; the optical density of positive cells were measured by using HPIAL-2000 image-conduct system. RESULT: The expression of Eotaxin and Eotaxin 2 were positive in mucosal epithelia, vascular endothelial, glandular epithelium, and inflammatory cells. After corticosteroids use, the number of eosinophils, the expression of Eotaxin in mucosal epithelia, inflammatory cells and vascular endothelial, and the expression of Eotaxin-2 in mucosal epithelia were significantly decreased (P<0.05). The steroids affected the expression of on Eotaxin-2 in mucosal epithelia of nasal polyps mostly. CONCLUSION 1) The expression of Eotaxin and Eotaxin-2 in nasal polyp are positive. 2) The effects of steroid on the nasal polyps may depend on decreasing the infiltration of eosinophils and the expression of Eotaxin and Eotaxin-2.
Adrenal Cortex Hormones ; pharmacology ; Adult ; Chemokine CCL11 ; metabolism ; Chemokine CCL24 ; metabolism ; Female ; Humans ; Male ; Middle Aged ; Nasal Mucosa ; drug effects ; metabolism ; Nasal Polyps ; drug therapy ; metabolism ; Young Adult

OBJECTIVE: To observe histopathologic changes of irradiated guinea pigs' nasal mucosa treated with intranasal corticosteroids and to study the radioprotective effect of intranasal corticosteroids. METHOD: Fifty health guinea pigs nasal parts were performed irradiation by the WDVE-6MeV linear accelerator. They had accepted 5 Gy one time per week for three weeks through X-ray irradiating to establish the animal irradiation injury model. After that, they were divided into 2 groups randomly: the control group and the administration group and each group had 25 guinea pigs. The administration group received intranasal corticosteroids on the second day after three weeks irradiation, 5 animals per one group were sacrificed randomly at 1 W, 1 M, 2 M, 3 M, 4 M after administration, the histopathologic changes were observed under optical, scanning electron and transmission electron microscope respectively. RESULT: Using intranasal corticosteroids after irradiation, the early inflammatory reaction of the administration group was milder than the control group. With the drug being given constantly, the recovery of epithelial cell with irradiated damage was accelerated and the coverage rate of cilia went up obviously; After four months, the coverage rate of cilia had risen to 72.9%; But, for the control group, the coverage rate of cilia is only 50.2%. The atrophy of submucosal glandular organ was lessened and they displayed some extent secretory function. The reparation was accelerated as time went by. CONCLUSION Irradiation brought about serious injury on guinea pigs' nasal mucosa. But, the injury was lessen after using intranasal corticosteroids. Intranasal corticosteroids play the role of radioprotection for the irradiated nasal mucosa.
Adrenal Cortex Hormones ; pharmacology ; Animals ; Guinea Pigs ; Nasal Mucosa ; drug effects ; pathology ; radiation effects ; Radiation Injuries, Experimental ; prevention & control

BACKGROUNDCD4(+)CD25(+) regulatory T cells (Tregs) mediate immune suppression through cell-cell contact with surface molecules, particularly cytotoxic T lymphocyte-associated antigen 4 (CTLA-4), glucocorticoid-induced tumor necrosis factor receptor family-related protein (GITR), and transforming growth factor beta (TGF-beta), but little is known about the exact role of Tregs in the pathogenesis of asthma. This study sought to characterize the expression of surface markers on peripheral blood mononuclear cells-derived Tregs in patients with atopic asthma and healthy subjects, and to investigate the effect of inhaled corticosteroid on them.

METHODSThe expression of surface molecules on CD4(+)CD25(high) Tregs was detected by flow cytometry. The effect of inhaled corticosteroid on expression of the surface molecules on Tregs was determined in vivo and in vitro. Total serum immunoglobulin E (IgE) and high-sensitivity C-reactive protein were measured by enzyme linked immunosorbent assay and latex enhanced immunoturbidimetric assay, respectively.

RESULTSEquivalent numbers of peripheral Tregs were found in patients with atopic asthma (stable and acute) and healthy subjects. Tregs preferentially expressed CTLA-4, GITR, toll-like receptor 4 (TLR4), latency-associated peptide (LAP/TGF-beta1), and forkhead box P3 (FOXP3). Patients with acute asthma had decreased numbers of CD4(+)CD25(high)LAP(+) T cells compared to healthy subjects and stable asthmatics. Inhaled corticosteroid enhanced the percentage of Tregs expressing LAP in vivo and in vitro dose-dependently. Furthermore, the percentages of Tregs expressing LAP were negatively correlated with total serum IgE levels and severity of asthma, but positively correlated with forced expiratory volume in one second percentage of the predicted value in patients with asthma.

CONCLUSIONSThe results suggest that membrane-bound TGF-beta1 is a potential candidate for predicting the severity of asthma, and may contribute to the sustained remission of asthma. Strategies targeting Tregs on their surface markers, especially TGF-beta1, are promising for future therapy of asthma.

Administration, Inhalation ; Adrenal Cortex Hormones ; administration & dosage ; Adult ; Antigens, CD ; blood ; Antigens, Differentiation ; blood ; Asthma ; drug therapy ; immunology ; Budesonide ; pharmacology ; CTLA-4 Antigen ; Female ; Forkhead Transcription Factors ; blood ; Glucocorticoid-Induced TNFR-Related Protein ; Humans ; Male ; Middle Aged ; Receptors, Nerve Growth Factor ; blood ; Receptors, Tumor Necrosis Factor ; blood ; T-Lymphocytes, Regulatory ; drug effects ; immunology ; Toll-Like Receptor 4 ; blood ; Transforming Growth Factor beta1 ; blood