PURPOSE: Frequent changes in chronic urticaria (CU) activity over time can cause psychological stress, which also serves as a trigger of CU. To measure the control status of CU, the Urticaria Control Test (UCT) was developed in Germany. This study aimed to investigate the validity, reliability and responsiveness to changes in CU for the Korean version of the UCT (K-UCT) and its relation with salivary cortisol and cortisone levels. METHODS: Linguistic adaptation of the UCT into Korean was conducted. A total of 96 CU patients were enrolled, and 80 of them completed the study. The K-UCT and other outcome scores for CU were measured and repeated after 4 weeks of treatment. Control status was classified by physicians into well-controlled, partly-controlled, and uncontrolled CU. Salivary cortisol and cortisone were measured by liquid chromatography-tandem mass spectrometry. RESULTS: Excellent internal consistency and intra-class reliability were obtained. Strong correlations between the K-UCT and disease severity, reflected in the Urticaria Activity Score (UAS)/global assessment of urticaria control by physicians/patient assessment of symptom severity/CU-specific quality of life were noted. K-UCT scores ≥12 were found to be optimal for determining well-controlled CU (sensitivity, 75.0%; specificity, 758%; area under the curve, 0.824). Perceived stress scale scores were significantly correlated with the UAS and the K-UCT. Salivary cortisone levels were significantly correlated with K-UCT (r = 0.308, P = 0.009) and differed significantly according to control status determined by a K-UCT ≥12. CONCLUSIONS: This study demonstrated that the K-UCT can be a valid instrument with which to gauge CU control status in Korean patients. Further studies are needed to validate salivary cortisone as a biomarker for CU control.
Cortisone* ; Germany ; Humans ; Hydrocortisone ; Korea ; Linguistics ; Mass Spectrometry ; Quality of Life ; Sensitivity and Specificity ; Stress, Psychological ; Urticaria*

BACKGROUND: The purpose of this study was to verify the effects of music therapy on subjective stress response, salivary cortisol and fatigue for nurses working in intensive care unit (ICU). METHODS: This study employed non-equivalent control group pretest–posttest design on quasi experimental basis. Subjects were 52 nurses (26 experimental and control group respectively) who have been working at ICU of Gil Hospital in Incheon, Korea. Data were collected from August 4 to October 6, 2014. Experimental group have listened to their 4-7 favorite musics individually once for 30 minutes after day-work. RESULTS: In experimental group, subjective stress response (t=5.02, P<0.001), salivary cortisol (t=2.08, P=0.042), and fatigue (t=5.66, P<0.001) have decreased significantly comparing to the control group. CONCLUSIONS: This study has confirmed especially through objective physiological index of salivary cortisol that listening the favorite music for nurses in ICU was an effective and objective managerial measure to resolve their job stress and fatigue.
Cortisone ; Critical Care* ; Fatigue* ; Hydrocortisone* ; Incheon ; Intensive Care Units ; Korea ; Music Therapy* ; Music*

11β-hydroxysteroid dehydrogenase 1 (11β-HSD1) catalyzes the conversion of inactive cortisone into active cortisol, which has pleiotropic roles in various biological conditions, such as immunological and metabolic homeostasis. Cortisol is mainly produced in the adrenal gland, but can be locally regenerated in the liver, fat, and muscle. Its diverse actions are primarily mediated by binding to the glucocorticoid receptor. SW982, a human synovial cell line, expresses 11β-HSD type 1, but not type 2, that catalyzes the conversion of cortisone to cortisol. In this study, therefore, we investigated the control of lipopolysaccharide (LPS)-induced inflammatory responses by prereceptor regulation-mediated maintenance of cortisol levels. Preliminarily, cell seeding density and incubation period were optimized for analyzing the catalytic activity of SW982. Additionally, cellular 11β-HSD1 still remained active irrespective of monolayer or spheroid culture conditions. Inflammatory stimulants, such as interleukin (IL)-1β, tumor necrosis factor (TNF)α, and LPS, did not affect the catalytic activity of 11β-HSD1, although a high dose of LPS significantly decreased its activity. Additionally, autocrine effects of cortisol on inflammatory responses were investigated in LPS-stimulated SW982 cells. LPS upregulated pro-inflammatory cytokines, including IL-6 and IL-1β, in SW982 cells, while cortisol production, catalyzed by cellular 11β-HSD1, downregulated LPS-stimulated cytokines. Furthermore, suppression of NFκB activation-mediated pro-inflammatory responses by cortisol was revealed. In conclusion, the activity of cellular 11β-HSD1 was closely correlated with suppression of LPS-induced inflammation. Therefore, these results partly support the notion that prereceptor regulation of locally regenerated cortisol could be taken into consideration for treatment of inflammation-associated diseases, including arthritis.
Adrenal Glands ; Arthritis ; Cell Line* ; Cortisone ; Cytokines ; Homeostasis ; Humans ; Hydrocortisone ; Inflammation ; Interleukin-6 ; Interleukins ; Liver ; Oxidoreductases* ; Receptors, Glucocorticoid ; Tumor Necrosis Factor-alpha

Adolescent ; Athletes ; Cortisone ; blood ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Hemoglobins ; analysis ; Humans ; Male ; Medicine, Chinese Traditional ; Phytotherapy ; Testosterone ; blood

BACKGROUND: Mosquito bite is a common dermatological complaint with various treatments but with no gold standard treatment regimen. OBJECTIVE: To compare the safety and efficacy of 0.025% capsaicin cream against 1% hydrocortisone cream and placebo as anti-inflammatory and anti-pruritic preparation for mosquito bites. METHODS: Seventy-five volunteers were enrolled in the placebo-controlled trial and randomized into three treatment groups. They were exposed to laboratory-reared mosquitoes to incur bites and to apply the designated cream. Anti-inflammatory and anti-pruritic effects were determined by mean lesion size, physician's global assessment, pruritus intensity score and 100mm visual analog scale. RESULTS: The mean lesion size and physician's global assessment, pruritus intensity score and visual analog scale showed no significant difference between 0.025% capsaicin and 1% hydrocortisone and they were both found to be superior to placebo (p-value< 0.001 using repeated measures of ANOVA; Kruskal-Wallis test). CONCLUSION: 0.025% capsaicin is comparable to 1% hydrocortisone as an anti-inflammatory and anti-pruritic preparation for mosquito bites.

Human ; Animal ; Male ; Female ; Analysis Of Variance ; Capsaicin ; Cortisone ; Culicidae ; Hydrocortisone ; Insect Bites And Stings ; Pruritus ; Visual Analog Scale ; Volunteers

Cortisone ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Immunoglobulins, Intravenous ; therapeutic use ; Immunomodulation ; Integrative Medicine ; methods ; Phytotherapy ; Sepsis ; drug therapy ; immunology ; Systemic Inflammatory Response Syndrome ; drug therapy ; immunology

OBJECTIVE: To determine the clinical feature of lichen planus in Hunan, and to provide references for correct diagnosis and treatment. METHODS: The clinical data from 124 outpatients with lichen planus attending Dermatology Department of Xiangya Hospital, Central South University from January 2000 to April 2008 were analysed retrospectively, including data on sex, age of visit or onset, course of disease, clinical manifestation, histopathology, and so on. RESULTS: In these 124 patients, male to female ratio was 1:1. Most patients were in 30-60 age group when they first visited the Out-patient Department. There were 2 onset peaks, one in 14-29 age group and the other in 40-60 age group. Most (35.5%) of the lesions were chronic localized subtypes. The limbs were the most common site to be involved, and they were also the most prevalent site for onset of lichen planus(74 cases, 59.7% ). The second common site was the trunk (29 cases, 23.4%). Fifteen patients (12.1%) had genitalia lesions, and 9 (7.3%) accompanied with oral mucosal involvement. Most of the eruptions were half-distributed (44.3%), 64 patients (51.6%) had pruritus,which ranged from mild irritation to severe intolerable itching, 56 (45.2%) had no subjective symptoms, 4 (3.2%) had spontaneous pain or tenderness, and 2 had positive family history of lichen planus. The diagnostic accordance rate was 50.8%. CONCLUSION Some characteristics exist in sex, age, and clinical manifestation of lichen planus in Hunan province. Systemic and/or local treatment should be taken according to the lesion morphology, localization and subtypes of lichen planus.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; China ; Cortisone ; therapeutic use ; Female ; Humans ; Lichen Planus ; diagnosis ; drug therapy ; pathology ; Male ; Retrospective Studies ; Young Adult

Chronic pelvic pain is difficult to diagnose and usually has a poor outcome. However, if it was identified early it might have a better prognosis. We treated three patients whose trigger points in obturator internus were diagnosed as origin of myofascial pain. The first patient complained of coccygodynia with pain that radiated up his left leg when walking. The second patient had coccygeal pain that radiated to the left thigh area. The last patient was troubled with coccygeal and pelvic pain at anytime. In all of the cases MRI studies of the lumbar spine and pelvis were unrevealing. Electrodiagnostic studies were normal. The impression was that the patients had the myofascial pain syndrome, therefore injections with local anesthetics and cortisone at the myofascial pain originated in obturator internus. Although each of the patients had different symptoms, they all had a good response to treatment.
Anesthetics, Local ; Cortisone ; Humans ; Leg ; Myofascial Pain Syndromes ; Pelvic Pain ; Pelvis ; Prognosis ; Spine ; Thigh ; Trigger Points ; Walking

OBJECTIVE: To retrospectively explore the diagnosis and treatment of postoperative lumbar intervertebral disc infection. METHODS: Twelve patients who suffered from postoperative lumbar intervertebral disc infection between April 1995 and September 2004 were confirmed doubtlessly by the diagnosis. They were treated with early immobilization combined with early and sufficient antibiotics and adequate corticosteroid. Patients with severe symptoms were managed by percutaneous puncture and washing discectomy such as rising temperature and perivertebral muscle spasm besides nostalgia, and early debridement of all necrotic tissue was done. RESULTS: Six were healed by non-operation and operation in the other 6. All had gotten locomotion with corset after the operation for 6-8 weeks and were followed-up from 6 months to 3 years. They have achieved excellent outcomes. CONCLUSION When a postoperative disc space infection occurs, early diagnosis and treatment should be undertaken to achieve excellent outcomes.
Adult ; Anti-Bacterial Agents ; administration & dosage ; Cortisone ; administration & dosage ; Diskectomy ; Female ; Humans ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; Male ; Middle Aged ; Retrospective Studies ; Surgical Wound Infection ; diagnosis ; drug therapy

Addisonian crisis, also commonly referred to as adrenal crisis, occurs when the cortisol produced by the adrenal gland is insufficient to meet the body's needs. Pituitary apoplexy usually occurs as hemorrhagic and ischemic necrosis in the presence of a pre-existing pituitary adenoma, and is a rare sequela of cardiovascular surgery. Most pituitary apoplexy that happens in cardiovascular surgery has been known to be related to harmful effects of the cardiopulmonary bypass. The case presented herein illustrates occult pituitary apoplexy that occurred after off-pump coronary artery bypass grafting. In this patient, the initial signs of addisonian crisis was similar to those of septic shock, and were overlooked. However, once recognized, they were reduced dramatically with standard stress-dose cortisone.
Adrenal Glands ; Adrenal Insufficiency ; Cardiopulmonary Bypass ; Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump* ; Cortisone ; Humans ; Hydrocortisone ; Necrosis ; Pituitary Apoplexy ; Pituitary Gland ; Pituitary Neoplasms ; Shock, Septic ; Transplants