OBJECTIVETo search for the best method for increasing clinical therapeutic effect on nephrotic syndrome.

METHODSForty-one cases were randomly divided into 2 groups. The treatment group (n=22) were treated with acupoint-injection of Chinese medicine combined with prednisone, and the control group (n=19) with prednisone. Their therapeutic results were observed and compared.

RESULTSThe complete remission rate of 45.5% and the total effective rate of 86.4% in the treatment group were significantly higher than 31.6% and 63.2% in the control group, with a significant difference between the two groups in the total effective rate (P < 0.05); in the treatment group, blood lipids decreased, plasma proteins raised and immunologic function improved.

CONCLUSIONAcupoint-injection of Chinese medicine combined with prednisone can significantly increase therapeutic effect on nephrotic syndrome and strengthen immunologic function.

Acupuncture Points ; Acupuncture Therapy ; Humans ; Nephrotic Syndrome ; Prednisone ; administration & dosage

Objective: To review current available evidence that addresses the question regarding the efficacy of intravenous methylprednisolone and oral-prednisone treatment regimens in improving vision among optic-neuritis patients. Methods: A literature search for randomized controlled trials on the treatment of optic neuritis in adults using steroids was conducted. A total of 23 studies were identified in the search. Of these, the Optic Neuritis Treatment Trial (ONTT) was identified as the largest multicenter, randomized controlled trial that evaluated the effect of steroids in the treatment of optic neuritis in adults. The initial article regarding the results of this landmark study published in 1992 and follow-up reports focusing on the five-year and ten-year visual outcomes published in 1997 and 2004 were appraised for this review. Results: Treatment with high dose intravenous methylprednisolone followed by oral prednisone produced short-term accelerated visual recovery but provided no long-term benefit to vision. Most patients retained good to excellent vision following an attack of optic neuritis regardless of treatment received. A significantly increased risk of recurrence of optic neuritis in either eye (19 percent) was noted in the oral-prednisone treatment group. There were no significant differences among the treatment groups in the risk of development of clinically definite multiple sclerosis. Conclusion: Intravenous methylprednisolone followed by oral prednisone may be considered as treatment for patients with acute optic neuritis in whom there is a need to speed up recovery of vision. Considering that the use of oral prednisone alone was associated with an increased risk of recurrence of optic neuritis in either eye, no treatment is an option.
INFUSIONS, INTRAVENOUS ; METHYLPREDNISOLONE ; ADMINISTRATION, ORAL ; PREDNISONE ; OPTIC NEURITIS

Hormones ; pharmacology ; Humans ; Nephrotic Syndrome ; drug therapy ; Prednisone ; administration & dosage ; Recurrence

Advanced Hodgkin's disease is usually treated with six or more cycles of combination chemotherapy. Spontaneous regression of the cancer is very rarely reported in patients with Hodgkin's disease. We present an unusual case of a patient with Hodgkin's disease who experienced complete remission with a single cycle of chemotherapy, followed by pneumonia. The case was a 36-year-old man diagnosed with stage IVB mixed cellularity Hodgkin's disease in November 2000. After treatment with one cycle of COPP-ABV (cyclophosphamide, vincristine, procarbazine, prednisone, doxorubicin, bleomycin, and vinblastine) chemotherapy without bleomycin, the patient developed interstitial pneumonia and was cared in the intensive care unit (ICU) for two months. Follow-up chest computerized tomography (CT), performed during the course of ICU care, revealed markedly improved mediastinal lymphomatous lesions. Furthermore, follow-up whole body CT and 18-fluorodeoxyglucose positron emission tomography showed complete disappearance of the lymphomatous lesions. Four years later, the patient is well and without relapse. This report is followed by a short review of the literature on spontaneous regression of Hodgkin's disease. To the best of our knowledge, this is the first case report of spontaneous remission of Hodgkin's disease in Korea.
Adult ; Antineoplastic Combined Chemotherapy Protocols/*administration & dosage ; Bleomycin/*administration & dosage ; Cyclophosphamide/*administration & dosage ; Doxorubicin/*administration & dosage ; Hodgkin Disease/*complications/*drug therapy ; Humans ; Male ; Pneumonia/*complications ; Prednisone/*administration & dosage ; Procarbazine/*administration & dosage ; Remission, Spontaneous ; Vinblastine/*administration & dosage ; Vincristine/*administration & dosage

Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Cyclophosphamide ; administration & dosage ; Doxorubicin ; administration & dosage ; Humans ; Lymphoma, B-Cell ; classification ; drug therapy ; therapy ; Prednisone ; administration & dosage ; Stem Cell Transplantation ; Vincristine ; administration & dosage

Bilateral lower motor neuron type facial palsy is an unusual neurological disorder. There are few reports that associate it with the human immunodeficiency virus (HIV) infection on initial presentation. A 51-year-old married woman, who was previously healthy and had no risk of HIV infection, presented solely with bilateral simultaneous facial palsy. A positive HIV serology test was confirmed by an enzyme-linked immunosorbent assay test. Following a short course of oral prednisolone, the patient recovered completely from facial palsy in three months, even though an antiretroviral treatment was suspended. Exclusion of HIV infection in patients with bilateral facial palsy is essential for early diagnosis and management of HIV.
Administration, Oral ; Cerebrospinal Fluid Pressure ; Enzyme-Linked Immunosorbent Assay ; Facial Paralysis ; complications ; drug therapy ; Female ; HIV Infections ; complications ; diagnosis ; Humans ; Middle Aged ; Prednisolone ; therapeutic use ; Prednisone ; administration & dosage

OBJECTIVETo observe the outcome after sacral canal injection in patients with disc herniation associated with without sciatica.

METHODSFrom December 2010 to June 2011, 65 patients with acute low back pain without sciatica due to lumbar disc herniation or bulging confirmed by CT or MRI were randomly divided into sacral canal injection group (experimental group) and lumbar oblique wrench group (control group): the experimental group had 35 cases, including 30 males and 5 females, with an average age of (43.90 +/- 1.14) years old ranging from 33 to 56 years old. The control group had 30 cases, including 27 males and 3 females,with an average age of (44.00 +/- 1.19) years old ranging from 34 to 57 years old. The course of morbidity was 1 to 3 days. All patients received sacral canal injection or lumbar oblique wrench method. The visual analog scale (VAS) scores before and at 30 min after treatment were compared between two groups.

RESULTSThe symptom of acute low back pain were relieved obviously. The average VAS scores before and after treatment in experimental group were decreased from 6.63 +/- 0.97 to 3.06 +/- 1.51,in control group were from 6.67 +/- 0.96 to 3.93 +/- 1.20 respectively. These two methods could improve the VAS score,but the effect of sacral canal injection group was better than that of lumbar oblique wrench group, there was statistically differences (P < 0.05).

CONCLUSIONIt is effective that the methods of sacral canal injection and lumbar oblique wrench applied to patients with acute low back pain without sciatica due to lumbar disc herniation or bulging confirmed, the former has better effect.

Adult ; Female ; Humans ; Injections, Spinal ; Intervertebral Disc Displacement ; drug therapy ; Lidocaine ; administration & dosage ; Lumbar Vertebrae ; Male ; Middle Aged ; Prednisone ; administration & dosage ; Sacrococcygeal Region ; Visual Analog Scale

Knowledge of both the common and atypical presentations of human immunodeficiency virus (HIV)-associated dermatoses may be helpful in arousing suspicion of HIV, especially in patients with no reported risk factors. Herein, we report the case of an otherwise healthy, nonpromiscuous 29-year-old man who presented to our institution with an eight-week history of plaques with oyster shell-like scales on the trunk, extremities and genital area. The plaques were associated with fever, and intermittent knee pain and swelling. Initial diagnostic tests were suggestive of drug hypersensitivity syndrome, and the patient's condition improved with treatment using oral prednisone. However, the lesions recurred when the dose of prednisone was tapered, even after the culprit drug had long been discontinued. Repeat skin punch biopsy and arthrocentesis revealed a diagnosis of psoriasis vulgaris with psoriatic arthritis. Due to the atypical presentation of psoriasis, the patient was counselled to undergo HIV testing, which came back positive. Clinicians should be attuned to the skin signs heralding HIV/acquired immunodeficiency syndrome, in order to facilitate early diagnosis and treatment.
Administration, Oral ; Adult ; Arthritis, Psoriatic ; complications ; Biopsy ; Diagnosis, Differential ; HIV Infections ; complications ; diagnosis ; Humans ; Male ; Prednisone ; administration & dosage ; Psoriasis ; complications ; Risk Factors ; Treatment Outcome

OBJECTIVETo investigate retrospectively the efficacy of cyclosporine A (CsA) in the treatment of membranous lupus nephropathy (MLN).

METHODSTwenty-four patients with systemic lupus erythematosus (SLE) and biopsy-proven MLN were treated with CsA in combination with prednisone. CsA was given at a starting dosage of 5 mg x kg(-1) x d(-1) for 3 months, with a 1 mg x kg(-1) x d(-1) reduction every month and then maintained at a dosage of 2 mg x kg(-1) x d(-1). The dosage of oral prednisone differed from person to person according to levels of extra-renal activity. Clinical efficacy and adverse reactions were retrospectively analyzed. Complete remission was defined as having a urinary proteinuria level (Upr) of < 0.4 g/d, and normal serum albumin and serum creatinine (SCr) levels, without SLE activity. Partial remission was defined as having a UPr decrement > 50% of baseline value and a serum albumin value of 30 - 35 g/L, without SLE activity. No response was defined as having a Upr decrement < 50% of baseline value and > 2.0 g/d, or as a deterioration of renal function, or as having active SLE.

RESULTSOne patient could no longer undergo follow-up, and the other 23 patients were treated with CsA and followed up for 6 - 36 months (mean 16.8 +/- 8.4 months). The mean starting dosage of CsA was 4.7 +/- 0.5) mg x kg(-1) x d(-1) and the trough level of the whole blood CsA was 248 +/- 110) micro g/L. Twelve patients (52.2%) achieved complete remission, 10 patients (43.3%) achieved partial remission after CsA treatment, and one patient showed no response. At different CsA treatment timepoint, the complete remission rates were 17.4% (3rd month), 21.7% (6th month), 40% (12th month), 88.9% (18th month) and 100% (24th month) respectively. SCr elevation, when within a normal limit was not observed in most patients during early CsA administration, and at the end of the follow-up all the patients had a normal SCr. Relapse occurred in 33.3% of the patients after withdrawing CsA for 4 - 24 months. No chronic CsA renal toxicity was observed in 4 patients who had a repeat renal biopsy after CsA treatment for 6 - 24 months.

CONCLUSIONSCsA could be regarded as an effective therapy for patients with membranous lupus nephropathy, but its adverse effects, especially its nephrotoxicity, should be carefully monitored during CsA treatment.

Adolescent ; Adult ; Cyclosporine ; administration & dosage ; therapeutic use ; Female ; Glomerulonephritis, Membranous ; drug therapy ; Humans ; Lupus Nephritis ; drug therapy ; Male ; Prednisone ; administration & dosage ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo observe the therapeutic effect of electroacupuncture (EA) warming therapy on myasthenia gravis (MG) and effect on IL-4 in the patient.

METHODSSixty patients with MG were randomly divided into two groups, 30 patients in each group. The observation group were treated with EA warming therapy with Tanzhong (CV 17), Shimen (CV 5), Guanyuan (CV 4), Zhongwan (CV 12), Yanglingquan (GB 34) selected as main points, and oral administration of Pyridostigmine (90 - 240 mg each day) and Prednisone (30 - 60 mg each day). The control group were treated with oral administration of Pyridostigmine (240-480 mg each day) and Prednisone (60-100 mg each day). Clinical therapeutic effects and serum Interleukin-4 (IL-4) levels before and after treatment were observed.

RESULTSThe total effective rate was 93.3% in the observation group, which was better than 70.0% in the control group (P < 0.01); after treatment, the serum IL-4 levels in the two groups significantly decreased (P < 0.01), the decrease of IL-4 in the observation group being significantly better than the control group (P < 0.05).

CONCLUSIONEA warming therapy combined with western medicine has a significant therapeutic effect on myasthenia gravis. One of the mechanisms possibly is to restrain specific immune reaction by regulating the level of IL-4.

Acupuncture Points ; Adult ; Combined Modality Therapy ; Electroacupuncture ; methods ; Female ; Humans ; Interleukin-4 ; blood ; Male ; Middle Aged ; Myasthenia Gravis ; immunology ; therapy ; Prednisone ; administration & dosage ; Pyridostigmine Bromide ; administration & dosage