BACKGROUND Intramuscular corticosteroid injection may cause adverse effects such as dermal and/or subcutaneous atrophy,alopecia,hypopigmentation,and hyperpigmentation.Although cutaneous atrophy can spontaneously resol...BACKGROUND Intramuscular corticosteroid injection may cause adverse effects such as dermal and/or subcutaneous atrophy,alopecia,hypopigmentation,and hyperpigmentation.Although cutaneous atrophy can spontaneously resolve,several treatment options have been suggested for this condition.CASE SUMMARY In this paper,we report a case of corticosteroid injection induced lipoatrophy treated with autologous whole blood(AWB)injection,as the condition had been unresponsive to fractional laser therapy.A 29-year-old female patient visited the dermatology clinic complaining of skin depression on her right buttock area,which had appeared six months earlier.There had been only subtle improvement at the margins after fractional CO_(2) laser treatment;therefore,after obtaining informed consent from the patient,AWB treatment was initiated.One month after the first AWB injection,the size and depth of the lesion had noticeably improved,and a slight improvement was also observed in discoloration.CONCLUSION Close observation is the initial treatment of choice for steroid induced skin atrophy;however,for patients in need of immediate cosmetic improvement,AWB injection may be a safe and cost-effective alternative.展开更多
背景:肩关节镜术后关节内注射皮质类固醇激素是一种有效缓解术后肩部疼痛和僵硬的方法之一,但使用皮质类固醇激素是否会增加肩关节镜术后相关并发症仍有争议。目的:系统评价肩关节镜术后关节腔内注射皮质类固醇激素的安全性及临床疗效...背景:肩关节镜术后关节内注射皮质类固醇激素是一种有效缓解术后肩部疼痛和僵硬的方法之一,但使用皮质类固醇激素是否会增加肩关节镜术后相关并发症仍有争议。目的:系统评价肩关节镜术后关节腔内注射皮质类固醇激素的安全性及临床疗效。方法:应用计算机检索PubMed、EMBASE、Cochrane Central Register of Controlled Trials(CENTRAL)数据库中肩关节镜术后关节腔内注射皮质类固醇激素的临床对照试验,检索时间为建库至2019年9月。文献数据提取及质量评价由2位研究者按照纳入和排除标准独立进行,采用Rev man 5.3版本软件进行效应量的合并与分析。结果与结论:①共纳入6篇相关文献,包括7418例患者,其中激素注射组3920例、对照组3498例;②Meta分析显示,两组再撕裂率、Constant评分、ASES评分、UCLA评分比较差异均无显著性意义[OR=0.71,95%CI[0.45,1.13],P=0.15;MD=-0.99,95%CI(-12.44,10.46),P=0.87;MD=-0.12,95%CI(-1.80,1.56),P=0.89;MD=-1.46,95%CI(-3.22,0.30),P=0.10];激素注射组肩关节镜术后1个月内感染率高于对照组(P<0.05),两组肩关节镜术后2-4个月的感染率比较差异无显著性意义(P>0.05);③结果表明,肩关节镜术后注射皮质类固醇激素并不会增加术后再撕裂率,但肩关节镜术后1个月内注射类固醇激素会增加术后感染率,因此在肩关节镜术后应用皮质类固醇激素治疗时,临床医师应根据患者实际情况权衡利弊,同时注意避免在术后1个月内注射关节内激素治疗。展开更多
AIM:To compare the differences in kinetics,distribution,and toxicity of triamcinolone acetonide(TA)between the injection methods,sub-Tenon and intravitreal injections in rabbit ocular tissues.METHODS:TA was injected i...AIM:To compare the differences in kinetics,distribution,and toxicity of triamcinolone acetonide(TA)between the injection methods,sub-Tenon and intravitreal injections in rabbit ocular tissues.METHODS:TA was injected into the vitreous or the sub-Tenon in rabbits.For pharmacokinetic study,rabbits were sacrificed periodically and then TA in blood and ocular tissues(retina/choroids,vitreous,and aqueous humor)were measured over 91 d.For toxicological study,clinical signs,slit-lamp microscopic examination,ophthalmological test were performed.The eyeballs and surrounding tissues were collected and fixed with glutaraldehyde-formalin solution,and then paraffin embedded for histological investigation.RESULTS:Higher levels of TA were distributed in the intraocular tissues when injected into the vitreous compared to the sub-Tenon.Conversely,TA level was remarkably lower in the rabbits which received intravitreal TA injections than those treated with sub-Tenon injection throughout the study period in plasma.Optical discharge probably caused by systemic circulation of TA was observed by receiving sub-Tenon TA injection.Meanwhile,technicassociated toxicological ocular symptoms and findings were more frequently observed in intravitreal injection than in sub-Tenon injection.CONCLUSION:There are significant differences in kinetics and distribution of TA in vitreous body,aqueous humor and plasma,between the two injection methods.Although further study is needed to explain the species difference between human and rabbit,it is assumed that the difference in the frequency of intraocular pressure elevation and cataract formation by TA between the two injection methods are directly related to the TA concentrations in aqueous humor and vitreous body in each injection methods.Systemic toxicity and technic-associated toxicity are also closely related to kinetics of TA in plasma and each injection method itself,respectively.展开更多
<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> Coccydynia is a painful condition with tenderness and ache in sacrococc...<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> Coccydynia is a painful condition with tenderness and ache in sacrococcygeal area which may radiate to the buttocks and lower back. Coccydynia is a multifactorial disorder</span><span></span><span></span><b><span><span></span><span></span> </span></b><span style="font-family:""><span style="font-family:Verdana;">and the most common cause of it is trauma. The initial treatment of the disease is conservative methods. One of the most common conservative treatments of chronic coccydynia is the local corticosteroid injection, which performed usually by palpation-guided method. This study was conducted to compare the effectiveness of local corticosteroid injection using palpation and needling method with palpation method alone. </span><b><span style="font-family:Verdana;">Patients and Methods: </span></b><span style="font-family:Verdana;">In this prospective study</span></span><span style="font-family:Verdana;">, 50</span><span style="font-family:Verdana;"> patients with the diagnosis</span><span style="font-family:Verdana;"> of coccydynia were enrolled between 2010 </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> 2017. All patients had chronic coccydynia which did not respond to conservative therapy for at least three months. Participants were divided into two groups and each group consisted of 25 individuals. Patients who underwent local corticosteroid injection using palpation guide technique alone were assigned as group A and others who underwent palpation guid</span><span style="font-family:Verdana;">ing</span><span style="font-family:""><span style="font-family:Verdana;"> injection with needling technique were considered as group B. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">There was a statistically significant difference between the mean VAS scores in preinjection and final follow up visit in each groups</span></span><span展开更多
BACKGROUND The radial nerve(RN)splits into two main branches at the elbow:The superficial branch of RN(SBRN)and the deep branch of RN.The SBRN can be easily damaged in acute trauma due to its superficial feature.CASE ...BACKGROUND The radial nerve(RN)splits into two main branches at the elbow:The superficial branch of RN(SBRN)and the deep branch of RN.The SBRN can be easily damaged in acute trauma due to its superficial feature.CASE SUMMARY A 55-year-old male patient injured his right wrist 10 mo ago.Debridement,suturing and bandaging were performed in the emergency room.Six months after the scar had healed,he felt numbness and tingling in the dorsal surface of the thumb of the right hand.So the surgery of resection and SBRN anastomosis were performed.The pathological findings showed it as traumatic neuroma.Four months after surgery,the patient felt numbness and tingling in the right dorsal surface of the thumb again.The tenderness was marked in the operated area.Ultrasound indicated that the SBRN was adhered to the surrounding tissue.The patient refused further surgical treatment and underwent ultrasound-guided needle release plus corticosteroid injection of the SBRN.Four weeks later,the tenderness in the surgical area was reduced by 70%,the numbness in the dorsal surface of the thumb of the right hand was reduced by 40%and the nerve swelling evaluated by ultrasound was reduced.Four months passed,he did not feel any numbness or tingling sensation of his right wrist.This is the first report of ultrasound-guided needle release plus corticosteroid injection of the SBRN.CONCLUSION Ultrasound can evaluate the condition of the RN,and the relationship with surrounding tissues.Ultrasound-guided needle release plus corticosteroid injection is an effective and safe treatment for SBRN adhesion.展开更多
AIM To compare the results of arthroscopic capsular release with intra-articular steroid injections in patients of frozen shoulder.METHODS Fifty-six patients with frozen shoulder were randomised to one of two treatmen...AIM To compare the results of arthroscopic capsular release with intra-articular steroid injections in patients of frozen shoulder.METHODS Fifty-six patients with frozen shoulder were randomised to one of two treatment groups: Group 1, complete 360 degree arthroscopic capsular release and group 2, intra-articular corticosteroid injection(40 mg methyl prednisolone acetate). Both groups were put on active and passive range of motion exercises following the intervention. The outcome parameters were visual analogue scale(VAS) score for pain, range of motion and Constant score which were measured at baseline, 4, 8, 12, 16 and 20 wk after intervention.RESULTS All the parameters improved in both the groups. The mean VAS score improved significantly more in the group 1 as compared to group 2 at 8 wk. This greater improvement was maintained at 20 wk with P value of 0.007 at 8 wk, 0.006 at 12 wk, 0.006 at 16 wk and 0.019 at 20 wk. The Constant score showed a more significant improvement in group 1 compared to group 2 at 4 wk, which was again maintained at 20 wk with P value of 0.01 at 4, 8, 12 and 16 wk. The gain in abduction movement was statistically significantly more in arthroscopy group with P value of 0.001 at 4, 8, 12, 16 wk and 0.005 at 20 wk. The gain in external rotation was statistically significantly more in arthroscopy group with P value of 0.007 at 4 wk, 0.001 at 8, 12, and 16 wk and 0.003 at 20 wk. There was no statistically significant difference in extension and internal rotation between the two groups at any time. CONCLUSION Arthroscopic capsular release provides subjective and objective improvement earlier than intra-articular steroid injection.展开更多
基金Supported by The New Faculty Research Grant of Pusan National University,2023The Research Grant of the Chungbuk National University in 2023.
文摘BACKGROUND Intramuscular corticosteroid injection may cause adverse effects such as dermal and/or subcutaneous atrophy,alopecia,hypopigmentation,and hyperpigmentation.Although cutaneous atrophy can spontaneously resolve,several treatment options have been suggested for this condition.CASE SUMMARY In this paper,we report a case of corticosteroid injection induced lipoatrophy treated with autologous whole blood(AWB)injection,as the condition had been unresponsive to fractional laser therapy.A 29-year-old female patient visited the dermatology clinic complaining of skin depression on her right buttock area,which had appeared six months earlier.There had been only subtle improvement at the margins after fractional CO_(2) laser treatment;therefore,after obtaining informed consent from the patient,AWB treatment was initiated.One month after the first AWB injection,the size and depth of the lesion had noticeably improved,and a slight improvement was also observed in discoloration.CONCLUSION Close observation is the initial treatment of choice for steroid induced skin atrophy;however,for patients in need of immediate cosmetic improvement,AWB injection may be a safe and cost-effective alternative.
文摘背景:肩关节镜术后关节内注射皮质类固醇激素是一种有效缓解术后肩部疼痛和僵硬的方法之一,但使用皮质类固醇激素是否会增加肩关节镜术后相关并发症仍有争议。目的:系统评价肩关节镜术后关节腔内注射皮质类固醇激素的安全性及临床疗效。方法:应用计算机检索PubMed、EMBASE、Cochrane Central Register of Controlled Trials(CENTRAL)数据库中肩关节镜术后关节腔内注射皮质类固醇激素的临床对照试验,检索时间为建库至2019年9月。文献数据提取及质量评价由2位研究者按照纳入和排除标准独立进行,采用Rev man 5.3版本软件进行效应量的合并与分析。结果与结论:①共纳入6篇相关文献,包括7418例患者,其中激素注射组3920例、对照组3498例;②Meta分析显示,两组再撕裂率、Constant评分、ASES评分、UCLA评分比较差异均无显著性意义[OR=0.71,95%CI[0.45,1.13],P=0.15;MD=-0.99,95%CI(-12.44,10.46),P=0.87;MD=-0.12,95%CI(-1.80,1.56),P=0.89;MD=-1.46,95%CI(-3.22,0.30),P=0.10];激素注射组肩关节镜术后1个月内感染率高于对照组(P<0.05),两组肩关节镜术后2-4个月的感染率比较差异无显著性意义(P>0.05);③结果表明,肩关节镜术后注射皮质类固醇激素并不会增加术后再撕裂率,但肩关节镜术后1个月内注射类固醇激素会增加术后感染率,因此在肩关节镜术后应用皮质类固醇激素治疗时,临床医师应根据患者实际情况权衡利弊,同时注意避免在术后1个月内注射关节内激素治疗。
文摘AIM:To compare the differences in kinetics,distribution,and toxicity of triamcinolone acetonide(TA)between the injection methods,sub-Tenon and intravitreal injections in rabbit ocular tissues.METHODS:TA was injected into the vitreous or the sub-Tenon in rabbits.For pharmacokinetic study,rabbits were sacrificed periodically and then TA in blood and ocular tissues(retina/choroids,vitreous,and aqueous humor)were measured over 91 d.For toxicological study,clinical signs,slit-lamp microscopic examination,ophthalmological test were performed.The eyeballs and surrounding tissues were collected and fixed with glutaraldehyde-formalin solution,and then paraffin embedded for histological investigation.RESULTS:Higher levels of TA were distributed in the intraocular tissues when injected into the vitreous compared to the sub-Tenon.Conversely,TA level was remarkably lower in the rabbits which received intravitreal TA injections than those treated with sub-Tenon injection throughout the study period in plasma.Optical discharge probably caused by systemic circulation of TA was observed by receiving sub-Tenon TA injection.Meanwhile,technicassociated toxicological ocular symptoms and findings were more frequently observed in intravitreal injection than in sub-Tenon injection.CONCLUSION:There are significant differences in kinetics and distribution of TA in vitreous body,aqueous humor and plasma,between the two injection methods.Although further study is needed to explain the species difference between human and rabbit,it is assumed that the difference in the frequency of intraocular pressure elevation and cataract formation by TA between the two injection methods are directly related to the TA concentrations in aqueous humor and vitreous body in each injection methods.Systemic toxicity and technic-associated toxicity are also closely related to kinetics of TA in plasma and each injection method itself,respectively.
文摘<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> Coccydynia is a painful condition with tenderness and ache in sacrococcygeal area which may radiate to the buttocks and lower back. Coccydynia is a multifactorial disorder</span><span></span><span></span><b><span><span></span><span></span> </span></b><span style="font-family:""><span style="font-family:Verdana;">and the most common cause of it is trauma. The initial treatment of the disease is conservative methods. One of the most common conservative treatments of chronic coccydynia is the local corticosteroid injection, which performed usually by palpation-guided method. This study was conducted to compare the effectiveness of local corticosteroid injection using palpation and needling method with palpation method alone. </span><b><span style="font-family:Verdana;">Patients and Methods: </span></b><span style="font-family:Verdana;">In this prospective study</span></span><span style="font-family:Verdana;">, 50</span><span style="font-family:Verdana;"> patients with the diagnosis</span><span style="font-family:Verdana;"> of coccydynia were enrolled between 2010 </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> 2017. All patients had chronic coccydynia which did not respond to conservative therapy for at least three months. Participants were divided into two groups and each group consisted of 25 individuals. Patients who underwent local corticosteroid injection using palpation guide technique alone were assigned as group A and others who underwent palpation guid</span><span style="font-family:Verdana;">ing</span><span style="font-family:""><span style="font-family:Verdana;"> injection with needling technique were considered as group B. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">There was a statistically significant difference between the mean VAS scores in preinjection and final follow up visit in each groups</span></span><span
文摘BACKGROUND The radial nerve(RN)splits into two main branches at the elbow:The superficial branch of RN(SBRN)and the deep branch of RN.The SBRN can be easily damaged in acute trauma due to its superficial feature.CASE SUMMARY A 55-year-old male patient injured his right wrist 10 mo ago.Debridement,suturing and bandaging were performed in the emergency room.Six months after the scar had healed,he felt numbness and tingling in the dorsal surface of the thumb of the right hand.So the surgery of resection and SBRN anastomosis were performed.The pathological findings showed it as traumatic neuroma.Four months after surgery,the patient felt numbness and tingling in the right dorsal surface of the thumb again.The tenderness was marked in the operated area.Ultrasound indicated that the SBRN was adhered to the surrounding tissue.The patient refused further surgical treatment and underwent ultrasound-guided needle release plus corticosteroid injection of the SBRN.Four weeks later,the tenderness in the surgical area was reduced by 70%,the numbness in the dorsal surface of the thumb of the right hand was reduced by 40%and the nerve swelling evaluated by ultrasound was reduced.Four months passed,he did not feel any numbness or tingling sensation of his right wrist.This is the first report of ultrasound-guided needle release plus corticosteroid injection of the SBRN.CONCLUSION Ultrasound can evaluate the condition of the RN,and the relationship with surrounding tissues.Ultrasound-guided needle release plus corticosteroid injection is an effective and safe treatment for SBRN adhesion.
文摘AIM To compare the results of arthroscopic capsular release with intra-articular steroid injections in patients of frozen shoulder.METHODS Fifty-six patients with frozen shoulder were randomised to one of two treatment groups: Group 1, complete 360 degree arthroscopic capsular release and group 2, intra-articular corticosteroid injection(40 mg methyl prednisolone acetate). Both groups were put on active and passive range of motion exercises following the intervention. The outcome parameters were visual analogue scale(VAS) score for pain, range of motion and Constant score which were measured at baseline, 4, 8, 12, 16 and 20 wk after intervention.RESULTS All the parameters improved in both the groups. The mean VAS score improved significantly more in the group 1 as compared to group 2 at 8 wk. This greater improvement was maintained at 20 wk with P value of 0.007 at 8 wk, 0.006 at 12 wk, 0.006 at 16 wk and 0.019 at 20 wk. The Constant score showed a more significant improvement in group 1 compared to group 2 at 4 wk, which was again maintained at 20 wk with P value of 0.01 at 4, 8, 12 and 16 wk. The gain in abduction movement was statistically significantly more in arthroscopy group with P value of 0.001 at 4, 8, 12, 16 wk and 0.005 at 20 wk. The gain in external rotation was statistically significantly more in arthroscopy group with P value of 0.007 at 4 wk, 0.001 at 8, 12, and 16 wk and 0.003 at 20 wk. There was no statistically significant difference in extension and internal rotation between the two groups at any time. CONCLUSION Arthroscopic capsular release provides subjective and objective improvement earlier than intra-articular steroid injection.
