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

The physical status and serum mineral concentrations for people aged 10 to 68 years living in an agricultural southern region of Nepal were determined. Systolic (SBP) and diastolic blood pressure (DBP) for both sexes in the 10−14 year age group were low (p<0.05, vs the other age groups) and those for the over 50−year−olds tended to be higher than the other age groups. The mean values of total proteins (TP) (8.6±0.5 g/dl for males and 8.7±0.6 g/dl for females) were high due to an increase of globulin (3.9±0.4 g/dl for males and 4.1±0.5 g/dl for females). More than three−fourths of the subjects of both sexes showed calcium (Ca) levels of 9.0−11.2 mg/dl and about 65% of them showed potassium (K) Ievels of 4.8−5.4 mEq/l. A significant positive correlation between DBP and serum K was observed (p<0.05). Serum inorganic phosphorus (IP) correlated with age (p<0.001) and body mass index (BMI) (p<0.001). The serum Ca levels correlated with TP (r=0.31, p<0.001), albumin (Alb) (r=0.50, p<0.001), IP (r=0.31, p<0.001), K (r=0.32, p<0.001) and chlorine (Cl)(r=−0.37, p<0.001). Cl was associated with TP (r=−0.21, p<0.05), Alb (r=−0.36, p<0.001) and IP (r= −0.21, p<0.05). These results suggested that Ca intake for the subjects seemed to be insufficient although their serum Ca level was within normal.
lower case pea ; Lower case are ; Serum ; L ; g/d

Objective: To detect and analyze the expression level of serum 25-hydroxyvitamin D [25(OH)D], periodontal clinical indicators and immunological indicators of rheumatism in patients with periodontitis and rheumatoid arthritis (RA), and to explore the correlation between 25(OH)D and the two diseases. Methods: This study was a case-control study. According to the inclusion criteria, patients from the Department of Stomatology and the Department of Rheumatology and Immunology and healthy volunteers from the Physical Examination Center were selected from November 2018 to May 2019 in Shengjing Hospital, China Medical University respectively. The patients were divided into 4 groups: 26 patients with simple periodontitis were included in the periodontitis group; 23 patients with RA were included in the RA group; 22 patients with RA and periodontitis simultaneously were included in the RA with periodontitis group; 22 healthy volunteers were included in the healthy control group, adding up to a total of 93 cases. The general information and periodontal clinical indexes of subjects in these 4 groups were recorded. Median elbow venous blood samples were collected from fasting subjects in each group, and 25(OH)D and immunoglobulin (Ig) were measured. The disease activity scores of RA patients were recorded and the rheumatic immune indexes were determinated. Pearson correlation analysis was performed between 25 (OH) D level and periodontal indexes in subjects of 4 groups. Results: The expression levels of rheumatoid factor [106.5(47.1, 283.8) kU/L] and C-reactive protein [20.5(13.1, 32.3) mg/L] in RA with periodontitis group were significantly higher than those in RA group [60.1(19.0, 110.0) kU/L, 14.7(3.0, 18.0) mg/L] (Z=-2.29, P=0.022; Z=-2.25, P=0.024). The levels of IgG and IgA in RA with periodontitis group [IgG and IgA: (16.0±4.3), (3.2± 1.3) g/L] as well as RA group [IgG and IgA: (16.3±5.5), (3.7±1.8) g/L] were significantly higher than those in healthy control group [IgG and IgA: (12.0±1.8), (2.3±0.6) g/L] and periodontitis group [IgG and IgA: (12.5±2.2), (2.0±0.7) g/L](P<0.05). The level of 25(OH)D in RA with periodontitis group [(26.0±9.8) nmol/L] was significantly lower than that in periodontitis group [(35.6±8.4) nmol/L] and RA group [(32.7±8.6) nmol/L] (P<0.05). The level of 25(OH)D was negatively correlated with sulcus bleeding index (r=-0.43, P=0.032) and clinical attachment loss (r=-0.41, P=0.043). Conclusions: Expression level of 25(OH)D was significantly decreased in patients with periodontitis and RA. There was a certain correlation between 25(OH)D and periodontitis and RA.
Arthritis, Rheumatoid/metabolism* ; Case-Control Studies ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Periodontitis ; Vitamin D/analogs & derivatives*

OBJECTIVES: Helicobacter pylori infection induces selective reduction of the number of antral D-cells and results in abnormal regulation of serum gastrin secretion. The purpose of this study was to investigate the relationship between H. pylori infection and the numbers of G-cells and D-cells. METHODS: The numbers of antral G-cells and D-cells, the ratio of G-cells to D-cells and fasting serum gastrin concentrations were compared between 37 patients with (29 with duodenal ulcers and 8 with gastric ulcers) and 33 without H. pylori infection (22 with duodenal ulcers and 11 with gastric ulcers). Serum gastrin concentrations were measured using the radioimmunoassay technique. Antral mucosal biopsy specimens were examined using immunohistochemical staining with antibodies specific for gastrin and somatostatin and the numbers of G-cells and D-cells per gastric gland were counted. RESULTS: Fasting serum gastrin concentrations were significantly higher in patients with H. pylori infection compared to patients without infection (80.3 +/- 23.5 vs 47.6 +/- 14.1 pg/ml, p < 0.001). The number of G-cells per gastric gland was similar in infected and uninfected patients (7.1 +/- 3.1 vs 7.3 +/- 3.9, respectively, p > 0.5). The number of D-cells was significantly lower in patients with H. pylori infection than in uninfected patients in both duodenal and gastric ulcer patients (1.3 +/- 0.4 vs 2.5 +/- 1.6, respectively, p < 0.001). The ratio of G-cells to D-cells was also significantly higher in infected patients compared with uninfected patients for both gastric and duodenal ulcers (5.7 +/- 2.7 vs 3.5 +/- 1.9, respectively, p < 0.001). CONCLUSIONS: These results strongly suggest that Helicobacter pylori infection induces reduction of the number of antral D-cells. The resulting relative hypofunction of the inhibitory action of D-cells against G-cells may be responsible for increased serum gastrin secretion.
Case-Control Studies ; D Cells/pathology ; D Cells/metabolism ; G Cells/pathology ; G Cells/metabolism ; Gastrins/metabolism ; Gastrins/blood ; Gastritis/pathology ; Gastritis/metabolism* ; Helicobacter Infections/pathology ; Helicobacter Infections/metabolism* ; Helicobacter pylori* ; Human ; Somatostatin/metabolism

A case of epidermodysplasia verruciformis associated with squamous cell carcinoma occurred in 21 years old male. He had extensive flat-topped papules on the face, neck and the upper trunk, and verrucous lesions on the extremities, especially on the dorsa of hands and feet for 15 years. Several peanut sized ulcerative lesions on the forehead were noticed for 1 year and identified as squarnous cell carcinomi. The akin test with dinitrochlorobenzene, tuberculin, phytohemagglutinin, candidin and dermatophytin showed alI negative. T and B-cell counts were within norrnal limits, but IgG and IgD levels in serurn were incresed.
B-Lymphocytes ; Carcinoma, Squamous Cell* ; Dinitrochlorobenzene ; Epidermodysplasia Verruciformis ; Extremities ; Foot ; Forehead ; Hand ; Humans ; Immunoglobulin D ; Immunoglobulin G ; Male ; Neck ; Tuberculin ; Ulcer ; Young Adult

PURPOSE: We evaluated the relationship between laboratory/clinical factors and vitamin D levels in recurrent wheezers less than 3 years old. METHODS: We retrospectively analyzed clinical data and laboratory factors (25-hydroxyvitamin D, complete blood count, C-reactive protein, glutamic oxaloacetic transaminase, glutamyl purovic transaminase, alkaline phosphatase [ALP], eosinophil counts, and serum IgE IgG, IgA, IgM) of 84 children less than 3 years who had experienced wheezing episodes at least 3 times. RESULTS: Children in the normal group (1.4+/-0.9 years) were younger than those in the deficient (2.2+/-1.2 years) and insuffient (2.3+/-1.0 years) groups (P=0.010). Glutamyl purovic transaminase were higher in the normal group (24.5+/-19.4 IU/L) than in the deficient (16.0+/-4.7 IU/L) and insufficient (15.3+/-4.5 IU/L) groups (P=0.009). ALP were higher in the deficient (791.4+/-180.8 IU/L) and insufficient (770.4+/-251.2 IU/L) groups than in the normal group (631.9+/-127.0 IU/L, P=0.034). Total IgE levels were higher in the deficient group (171.9+/-212.1 kU/L) than in the normal group (43.7+/-58.3 kU/L, P<0.05), and the rate of sensitization to aeroallergens was higher in the insufficient group (36.1%) than in the normal group (10%, P<0.05). CONCLUSION: Among children with recurrent wheezing less than 3 years old, low vitamin D levels may be associated with older age, total IgE, ALP level, glutamic pyruvate transaminase level, and rate of sensitization to aeroallergens.
Alkaline Phosphatase ; Aspartate Aminotransferases ; Asthma ; Blood Cell Count ; C-Reactive Protein ; Child* ; Eosinophils ; Humans ; Immunoglobulin A ; Immunoglobulin E ; Immunoglobulin G ; Pyruvic Acid ; Respiratory Sounds* ; Retrospective Studies ; Vitamin D*

PURPOSE: Although chronic and recurrent rhinosinusitis is prevalent in children, little is known about its causes. Here, we investigated the humoral immunity in children with chronic or recurrent rhinosinusitis. METHODS: We examined 16 children attending the outpatient clinic at the CHA Bundang Medical Center including 11 boys and 5 girls, aged 3.11 years (mean age, 5.6 years), who had rhinosinusitis for >3 months or >3 times per year. The complete blood count with differential and total serum concentrations of Immunoglobulin (Ig) E, IgA, IgD, IgM, IgG, and IgG subclasses (IgG1, IgG2, IgG3, and IgG4) of all children were measured. All subjects received 23-polysaccharide pneumococcal vaccination (PPV), and the levels of antibodies to 5 serologic types (4, 6B, 14, 18C, and 23F) of pneumococcal capsular polysaccharide antigens were measured before and after vaccination. Post-PPV antibody titers > or =0.35 microg/mL or with a > or =4-fold increase were considered as positive responses. RESULTS: The titers of IgG, IgA, IgD, and IgM were within normal range in all 16 children, whereas the total IgE concentration was higher than normal in 2 children. IgG1 deficiency was observed in 1 patient and IgG3 deficiency in 3. After PPV, 1 patient failed to respond to all 5 serologic types, 2 failed to respond to 4 serologic types, and 2 failed to respond to 3 serologic types. CONCLUSION: Clinicians should consider the evaluation of humoral immune functions in children with chronic or recurrent rhinosinusitis who do not respond to prolonged antibiotic treatment.
Aged ; Ambulatory Care Facilities ; Antibodies ; Antibody Formation ; Blood Cell Count ; Child ; Humans ; Immunity, Humoral ; Immunoglobulin A ; Immunoglobulin D ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins ; Reference Values ; Vaccination

OBJECTIVETo detect 3-dimensional images of anti-N-methyl-D-aspartate receptor Nr1 (NMDAr1) polycolonal IgG affixed on mica in physiological environment.

METHODSThe images and data were obtained from a contact mode and commercial Si3N4 probed tip by using atomic force microscope (AFM).

RESULTSThe anti-NMDAr1 polycolonal IgG has a characteristic structure described as an ellipse spherical shape of 136.4 A x 62.8 A x 26.1 A. On the section of the ellipse edge there were two peaks about 13 nm in width.

CONCLUSIONSUsing AFM to investigate biomacromolecule can make us deeply understand the structure of IgG, which will instruct us to detect the membrane receptor protein as a labelling agent.

Adsorption ; Aluminum Silicates ; Gold Colloid ; Imaging, Three-Dimensional ; methods ; Immunoglobulin G ; chemistry ; Microscopy, Atomic Force ; methods ; Receptors, N-Methyl-D-Aspartate ; chemistry

We previously reported that some components of ginsenosides decreased mediator releases evoked by the activation of mast cells with specific antigen-antibody reactions. This study aimed to assess the effects of ginsenosides (Rb2, Re) on the mechanism of histamine release in the mast cell activation. We partially purified guinea pig lung mast cells by using enzyme digestion, the rough and the discontinuous percoll density gradient method. Mast cells were sensitized with IgG1 and challenged with ovalbumin (OA). Histamine was assayed by fluorometric analyzer, leukotrienes by radioimmunoassay. Phospholipase D (PLD) activity was assessed more directly by the production of (3H)phosphatidylbutanol (PBut) which was produced by PLD-mediated transphosphatidylation in the presence of butanol. The amount of 1,2-diacylglycerol (DAG) were measured by the (3H)DAG labeled with (3H)palmitic acid or (3H)myristic acid. Pretreatment of Rb2 (300 microgram) significantly decreased histamine release by 60%, but Re (300 gg) increased histamine release by 34%. Leukotrienes release in Rb2 was decreased by 40%, Re was not affected in the leukotrienes release during mast cell activations. An increasing PLD activity during mast cell activation was decreased by the dose-dependent manner in the pretreatment of Rb2, but Re pretreatment facilitated the increased PLD activity during mast cell activation. The amount of DAG produced by phospholipase C (PLC) activity was decreased by Rb2 pretreatment, but Re pretreatment was not affected. The amount of mass DAG was decreased by Rb2 and Re pretreatment during mast cell activation. The data suggest that Rb2 purified from Korean Red Ginseng Radix inhibits the DAG which is produced by the activation of mast cells with antigen-antibody reactions via both phosphatidylinositide-PLC and phosphatidylcholine-PLD systems, and then followed by the inhibition of histamine release. However, Re increases histamine release by stimulation of DAG production, which is mediated by phosphatidylcholine-PLD system rather than by phosphatidylinositide-PLC system, but inhibits the mass DAG production. Thus, it could be inferred that other mechanisms play a role in the increase of histamine release during mast cell activation.
Animals ; Antigen-Antibody Reactions* ; Digestion ; Ginsenosides* ; Guinea Pigs* ; Guinea* ; Histamine Release* ; Histamine* ; Immunoglobulin G ; Leukotrienes ; Lung* ; Mast Cells* ; Ovalbumin ; Panax ; Phospholipase D ; Radioimmunoassay ; Type C Phospholipases

BACKGROUND: New therapeutic modalities such as high dose chemotherapy and stem cell support have been tried to prolong the survival period of the patients with multiple myeloma. However, little is known about the criteria for the application of those new therapies. There are only a few reports for the prognostic factors of multiple myeloma in Korea. The purpose of this study is to analyze the prognostic factors affecting chemotherapy response and survival in patients with multiple myeloma. METHODS: We retrospectively analysed the clinical records of 122 patients who were newly diagnosed as multiple myeloma by SWOG criteria, between November, 1989 and April, 1997 at Asan Medical Center. RESULTS: 1) The peak incidence was the 7th decade and male to female ratio was 1.3:1. The most common presenting symptom at first diagnosis was bone pain. 2) Initial clinical stage was as followed: stage I in 17.2% , stage II in 16.4% and 66.4% in III. The immunoglobulin classes were IgG in 51.6%, light chain only in 25.4%, IgA in 16.4%, IgD in 4.1%, and non-secretory type in 2.5%. Plasma cell types in bone marrow were classified as plasmablastic type in 45.9%, plasmacytic type in 54.1%. 3) Eighty two patients who recieved chemotherapy more than 3 cycles were evaluable for chemotherapy response. Overall response rate was 69.5%. Factors affecting response to chemotherapy were serum creatinine level, plasma cell type, total plasma cell percentage and plasmablast percentasge of total nucleated cells in bone marrow. 4) For total 122 patients, overall median survival period was 21 months, and estimated 5 year survival rate was 23.5%. Factors affecting survival were serum creatinine, corrected calcium, albumin, beta2-microglobulin level, response to chemotherapy, total plasma cell percentage and plasmablast percentage in bone marrow. CONCLUSION: Bone marrow findings at initial diagnosis are significantly associated with response to chemotherapy and survival duration.
Bone Marrow ; Calcium ; Chungcheongnam-do ; Creatinine ; Diagnosis ; Drug Therapy* ; Female ; Humans ; Immunoglobulin A ; Immunoglobulin D ; Immunoglobulin G ; Immunoglobulin Isotypes ; Incidence ; Korea ; Male ; Multiple Myeloma* ; Plasma Cells ; Retrospective Studies ; Stem Cells ; Survival Rate