We report two cases of nephrotic syndrome successfully treated with saireito. The first patient developed massive proteinuria of 5.2 g/day, was diagnosed with minimal-change nephrotic syndrome upon renal biopsy, and rapidly improved with saireito treatment for 2 months to the reduced urinary protein level of 0.3 g/day. Urinary protein increased to 2.0 g/day just after discharge, then again decreased and was brought to remission soon thereafter. The second patient with biopsy-proven idiopathic membranous nephropathy maintained nephrotic syndrome remission for 8 years with the treatment of small-dose prednisolone, an immunosuppressant, and an angiotensin II receptor blocker, then relapsed with 4.4 g/day proteinuria. In this patient, proteinuria was reduced after 4 weeks with the above combination therapy plus saireito to 1.3 g/day, then remitted again soon thereafter. The former patient presented with mild discomfort and opposition when the subcostal region was pressed ; the latter patient presented with apparent discomfort and opposition together with moderate leg edema. Because rapid remission of massive urinary protein with saireito treatment was observed in these patients, we report here and discuss possible mechanisms.
g/d ; Patients ; Nephrotic Syndrome ; sairei-to ; Cancer Remission

OBJECTIVETo investigate the effect of isolated limb hyperthermic perfusion chemotherapy for melanoma of the extremities.

METHODSLimb isolated hyperthermic perfusion chemotherapy was performed in 41 patients with malignant melanoma of the extremities, and then the primary lesions in 24 patients were removed at 14 - 21 days after chemotherapy. Tumor necrosis was examined by pathology.

RESULTSAmong the 41 patients, 40 cases were followed up for 6-113 months, and one was lost. There was no local recurrence in those patients. 29 cases were followed up for more than 3 years, and 26 of them were surviving. Forteen cases were followed up for more than five years, among them 9 cases were surviving. The 3-year and 5-year survival rates of the whole group were 95.0% and 70.0%, respectively. The average reduction of the tumor volume was 55.6% after perfusion. The pathological examination showed that tumor necrosis was 90% - 100% (complete response) in 21 cases (87.5%) and 60% - 89% (partial response) in 3 cases (12.5%).

CONCLUSIONSThe isolated limb hyperthermic perfusion chemotherapy is an effective treatment of limb malignant melanoma. It can significantly reduce the local recurrence rate, and improve the 5-year survival rate, prognosis and the quality of life of the patients.

Adult ; Aged ; Chemotherapy, Cancer, Regional Perfusion ; methods ; Cisplatin ; administration & dosage ; Extremities ; Female ; Follow-Up Studies ; Humans ; Hyperthermia, Induced ; Male ; Melanoma ; drug therapy ; Middle Aged ; Quality of Life ; Remission Induction ; Soft Tissue Neoplasms ; drug therapy ; Survival Rate

Studies have shown cell-free microRNA (miRNA) circulating in the serum and plasma with specific expression in cancer, indicating the potential of using miRNAs as biomarkers for cancer diagnosis and therapy. This study was to investigate whether plasma miRNA-21 (miR-21) can be used as a biomarker for the early detection of non-small cell lung cancer (NSCLC) and to explore its association with clinicopathologic features and sensitivity to platinum-based chemotherapy. We used real-time RT-PCR to investigate the expression of miR-21 in the plasma of 63 NSCLC patients and 30 healthy controls and correlated the findings with early diagnosis, pathologic parameters, and treatment. Thirty-five patients (stages IIIB and IV) were evaluable for chemotherapeutic responses: 11 had partial response (PR); 24 had stable and progressive disease (SD+ PD). Plasma miR-21 was significantly higher in NSCLC patients than in age- and sex-matched controls (P < 0.001). miR-21 was related to TNM stage (P < 0.001), but not related to age, sex, smoking status, histological classification, lymph node status, and metastasis (all P > 0.05). This marker yielded a receiver operating characteristic (ROC) curve area of 0.775 (95% CI: 0.681- 0.868) with 76.2% sensitivity and 70.0% specificity. Importantly, miR-21 plasma levels in PR samples were several folds lower than that in SD plus PD samples (P = 0.049), and were close to that in healthy controls (P = 0.130). Plasma miR-21 can serve as a circulating tumor biomarker for the early diagnosis of NSCLC and is related to the sensitivity to platinum-base chemotherapy.
Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Biomarkers, Tumor ; blood ; Carboplatin ; administration & dosage ; Carcinoma, Non-Small-Cell Lung ; blood ; drug therapy ; pathology ; Cisplatin ; administration & dosage ; Early Detection of Cancer ; Female ; Humans ; Lung Neoplasms ; blood ; drug therapy ; pathology ; Male ; MicroRNAs ; blood ; Middle Aged ; Neoplasm Staging ; Remission Induction

In a prospective study, 42 048 adults residing in Zhongshan City, Guangdong, China, were followed for 16 years, and 171 of them developed nasopharyngeal carcinoma (NPC). Although Epstein-Barr virus (EBV) antibody levels of the cohort fluctuated, the antibody levels of 93% of the patients with NPC were raised and maintained at high levels for up to 10 years prior to diagnosis. This suggests that the serologic window affords an opportunity to monitor tumor progression during the preclinical stage of NPC development, facilitating early NPC detection. We reviewed the clinical records of the 171 patients with NPC in the prospective study to assess the efficacy of early NPC detection by serologic screening and clinical examination. Of the 171 patients, 51 had Stage I tumor (44 were among the 73 patients detected by clinical examination and 7 were among the 98 patients presented to outpatient department). Initial serologic screening predicted 58 (95.1%) of the 61 patients detected within 2 years. The risk of the screened population (58/3093) raised 13 times relative to cohort (61/42 048) during this period. Clinical examination detected all the 58 predicted cases, and 35 (60.3%) of which were diagnosed with Stage I tumor. The serologic prediction rate fell to 33.6% (37/110) 2 to 16 years after screening. The proportion of cases detected by clinical examination fell to 40.5% (15/37). The proportion of Stage I tumors among the cases detected by clinical examination during both periods remained at about 60%. We concluded that early detection of NPC can be accomplished by repeated serologic screening to maintain high prediction rates and by promptly examining screened subjects to detect tumors before the symptoms develop.
Adult ; Aged ; Antibodies, Viral ; blood ; Antigens, Viral ; immunology ; Capsid Proteins ; immunology ; Carcinoma, Squamous Cell ; blood ; diagnosis ; pathology ; Chemotherapy, Adjuvant ; Cohort Studies ; Early Detection of Cancer ; methods ; Female ; Herpesvirus 4, Human ; immunology ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; blood ; diagnosis ; pathology ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Remission Induction ; Survival Rate