• Title/Summary/Keyword: internal diseases

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Studies on Therapeutic range, Symptom, Pathology, and composition of Ginseng Radix -main blended Prescriptions from Donguibogam (동의보감(東醫寶鑑)에 수록(收錄)된 인삼(人蔘)이 주약(主藥)으로 배오(配伍)된 방제(方劑)의 활용(活用)범위, 병증, 주치(主治), 병리(病理) 및 구성내용(構成內容) 조사(調査))

  • Cho, Dae-Yeon;Jeong, Jong-Kil;Yun, Young-Gab
    • Herbal Formula Science
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    • v.9 no.1
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    • pp.35-82
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    • 2001
  • In the Encyclopedia Medica Koreana(Dongeuibogam), I have researched 245 prescriptions in which Panax Ginseng plays an important role. And I have got the following results. The healing scope and frequency of ginseng-mainly-included prescriptions are Child Part 29(11.83%), Violent Cough Part 23(9.38%), Sick-by-Cold Part 21(8.57%), Oncosis Part 16(6.53%), Overwork Part 14(5.71%), Gynecologic Part 14(5.71%), Internal Part 13(5.3%), Apoplexy Part 11(4.48%), Mind Part 10(4.08%) and Fecal Part 10(4.08%) prescriptions. And also each of Nausea Part, Anger Part, and Spirit parts has the same 5 (2.04%) prescriptions. And each of Qi Part, Diabetes Meatus Part, Malaria Part, and Humoral Part has 4(1.63%) prescriptions. And each of Foot Part, Choleraic Part, Genital Part, Blood Part, and Voice Part has 3 (1.2%). All of these prescriptions cover 88.88%. And besides listed parts above, Panax Ginseng is all used in 48 Parts: Body-Mind Part. Mouth-Tongue Part, Breast Part, Muscle Part, Swelling Part, Urine Part, Epidermis Part, Heat Part, Anus Part, Stomach Part, Eye Part, Laryngopharynx Part. Uterus Part" Heavy Stomach Part, Head Part, Pulse Part, Hair Part, Navel Part, Emetic Part, Costal Part, Edema Part, Vomiting Part, Superstitious Part, and Cardiac Part, etc. Of the prescriptions in which Panax Ginseng plays an important role, the most representative diseases, which more than 86.8% prescriptions cure, are shock, numbness from cold, Taeeum disease, oncosis, overwork, sick from eating, numbness of extremities, diarrhea, tachycardia, forgetfulness, nausea, heat from kidney, nocturnal emission, short breath, diabetes meatus, malaria, sweating, sweating overnight, beriberi, cholera, insomnia from enervation, sialitis, navel pain, hemorrhage, and loss of voice. The pathology of the prescriptions in which Panax Ginseng plays an important role is divided into the organ problems, six natural factors, seven extreme feelings, unbalanced humoral status, overwork, and, unbalance of qi and blood. Spleen, heart, and uterus is the main cause of organ problems; wind and cold are the main cause of six natural factors; heavy humors are the main cause of unbalanced humoral status; the stasis of seven feelings are the main cause of seven extreme feelings; the lack of stamina and overwork are the main cause of the overwork; the lack of qi, the lack of blood, and, the lack of qi and blood are the main cause of the unbalance of qi and blood. After I have researched the contents of the prescriptions in which Panax Ginseng plays an important role, I could understand the addition of the different prescriptions, combination of medicines, and the role of medicine groups associated with Panax Ginseng. So from now on, the results I have got could be used as the data which show the theoretical basis on the prescriptions.

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A Study of the Academic Perspective of Chang Seok Sun (장석순(張錫純)의 학술사상에 관한 연구)

  • Woo, Ho;Park, Hyun-kuk
    • The Journal of Dong Guk Oriental Medicine
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    • v.7 no.1
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    • pp.1-32
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    • 1998
  • I found following idea, as a result of researching his Science idea, mainly, by translation of the "$Zh\bar{a}ng$ xi $ch\acute{u}n$ $Xu\acute{e}$ $Sh\acute{u}$ ssu $hsi\acute{a}ng$ "(張錫純 學術硏究). $Zh\bar{a}ng$ xi $ch\acute{u}n$ regarded $ch\tilde{u}ng$ $ch\bar{u}ng$ $ts'\bar{a}n$ $hs\bar{l}$' (衷中參西) as the core idea of The Chinese-Western medical combination. He didn't segregate philosophy of the West from One of the Orient. He persued to harmonize each other and thought that the Western medicint theory is included in the Chinese one in many parts. besides, He recognized that it is bad to reject each other, for the medical science's purpose is to save a life, and united The Chinese-Western medicine theory, by $ch\acute{u}ng$ $ch\tilde{u}ng$ $ch\bar{u}ng$ $ts'\bar{a}n$ $hs\bar{l}$'(衷中參西) idea which refers to consult the Western medicine on the basis of the Chinese one. Medical basic theory of $Zh\bar{a}ng$ xi $ch\acute{u}n$ brought up new views of the theory : Dae-gi(大氣), gi-Hwa(氣化) theory, Nongangubgan byung juing chi(論肝及肝病證治), Eum her chijung ja bi(陰虛治重滋脾). Lim Sangeung yong(臨床應用) of Hyul Her gub(血虛及)-Hwal Hyul Hwa $\breve{u}$ bub(活血化瘀法), on the basis of classics, such as, "$N\breve{e}i$ Ching"(內經), "Chin Kue $\breve{i}$ $y\bar{a}o$ $l\ddot{u}{\bar{e}}h$, "Shen $n\acute{u}ng$ $p\breve{e}n$ $t\acute{s}{\check{a}}o$ ching"(新農本草經) etc. I'll sum up $Zh\bar{a}ng$ xi $ch\acute{u}n's$ clinical idea now He unified Sang Han(像寒)-On Byung(溫病) with Yuk Kyung Byung Jung(六經辨證) and It was noticiable to utilize a kinds of Baek Ho Tang(白虎湯). He gave a detailed description about a method of grasp the symptoms of the cause of the internal medicine diseases and pathology and, he left abundant views of theory about using remedy and experience of clinic.

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Real-Time Monitoring of Mitochondrial ATP Synthesis and Hydrolysis by Surface Infrared Spectroscopy

  • Yamaguchi, Ryo-Taro;Hirano-Iwata, Ayumi;Aonuma, Yuki;Yoshimura, Yuya;Shinohara, Yasuo;Kimura, Yasuo;Niwano, Michio
    • Proceedings of the Korean Vacuum Society Conference
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    • 2013.02a
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    • pp.108-109
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    • 2013
  • Mitochondria play key roles in the production of cell's energy. Their dominant function is the synthesis of adenosine 5'-triphosphate (ATP) from adenosine diphosphate (ADP) and phosphate (Pi) through the oxidative phosphorylation. Evaluation of drug-induced mitochondrial toxicity has become increasingly important since mitochondrial dysfunction has recently been implicated in numerous diseases including cancer and diabetes mellitus. Mitochondrial functions have been monitored via oxygen consumption, mitochondrial membrane potential, and more importantly via ATP synthesis since ATP synthesis is the most essential function of mitochondria. Various analytical methods have been employed to investigate ATP synthesis in mitochondria, including high performance liquid chromatography (HPLC), bioluminescence technique, and pH measurement. However, most of these methods are based on destructive analysis or indirect monitoring through the enzymatic reaction. Infrared absorption spectroscopy (IRAS) is one of the useful techniques for real-time, label-free, and direct monitoring of biological reactions [1,2]. However, the strong water absorption requires very short path length in the order of several micrometers. Transmission measurements with thin path length are not suitable for mitochondrial assays because solution handlings necessary for evaluating mitochondrial toxicity, such as rapid mixing of drugs and oxygen supply, are difficult in such a narrow space. On the other hand, IRAS in the multiple internal reflection (MIR) geometry provides an ideal optical configuration to combine solution handling and aqueous-phase measurement. We have recently reportedon a real-time monitoring of drug-induced necrotic and apoptotic cell death using MIR-IRAS [3,4]. Clear discrimination between viable and damaged cells has been demonstrated, showing a promise as a label-free and real-time detection for cell-based assays. In the present study, we have applied our MIR-IRAS system to mitochondria-based assays by monitoring ATP synthesis in isolated mitochondria from rat livers. Mitochondrial ATP synthesis and hydrolysis were in situ monitored with MIR-IRAS, while dissolved oxygen level and solution pH were simultaneously monitored with O2 and pH electrodes, respectively. It is demonstrated that ATP synthesis and hydrolysis can be monitored by the IR spectral changes in phosphate groups in adenine nucleotides and MIR-IRAS is useful for evaluating time-dependent drug effects of mitochondrial toxicants.

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A Structural Model for Health Promotion and Quality of Life in People with Cancer (건강증진과 삶의 질 구조모형 II-암환자 중심-)

  • 오복자
    • Journal of Korean Academy of Nursing
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    • v.26 no.3
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    • pp.632-652
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    • 1996
  • It has been noted that a genetic alteration of cells influenced by unhealthy lifestyle in addition to a series of other carcinogens increases the incidence of various neoplasmic diseases. Therefore the importance of a lifestyle that minimizes such an impact on health should be emphasized. Since stomach cancer, the most common neoplasmic disease in Korea, is related to personal lifestyle and as there is a possibility of its recurrence, patients with stomach cancer need to lead a healthy lifestyle. Also the quality of life which patients experience is negatively affected by the side effects of treatments and the possibility of recurrence. Therefore an effective nursing intervention to enhance quality of life and encourage healthy lifestyle is needed. The purpose of this study is to provide a basis for nursing intervention strategies to promote health and thus enhance quality of life. A hypothetical model for this purpose was constructed based on Pender's Health Promotion Model and Becker's Health Belief Model, with the inclusion of some influential factors such as hope for quality of life and health promoting behavior. The aims of study were to : 1) evaluate the effectiveness of patient's cognitive-perceptual factors on health promoting behaviors and quality of life ; 2) examine the causal relationships among perceived benefit, perceived barrier, perceived susceptibility and severity, internal locus of control, perceived health status, hope, health concept, self efficacy, self esteem health promoting behaviors & quality of life ; 3) build and test a global hypothetical model. The subjects for this study were 164 patients who were being treated for stomach cancer were approached in the outpatient clinic on a University Hospital. The data from the completed questionnaires were analyzed using Linear Structural Relationships (LISREL). The results of research are as follows : 1) Hypothetical model and the modified model showed a good fit to the empirical data, revealing considerable explanational power for health promoting behaviors(54.9%) and quality of life(87.6%) 2) Self efficacy and hope had significant effects on health promoting behaviors. Of these, hope was affected indirectly through self efficacy and self esteem. 3) Perceived health status, hope and self esteem had significant direct effect on the quality of life. Of these variables, perceived health status was the most essential factor affecting general satisfaction in life. 4) Self-efficacy, as a mediating variable, was positively affected by perceived benefit and hope. 5) Self-esteem, as a mediating variable, was positively affected by perceived health status and hope. 6) Hope was the main variable affecting self efficacy, self esteem, health promoting behaviors and quality of life. The derived model in this study could effectively be used as a reference model for further study and could suggests a direction for nursing practices

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The literatural study of investigating the contents associated with the neuropsychosis in the medical books published in the times of Chinese dynasty of Jin and Yuan (금원시대(金元時代)의 의서(醫書)에 나타난 신경정신질환(神經精神疾患)에 대한 고찰(考察))

  • Choi, Jong Geol;Lee, Sang Ryong
    • Journal of Haehwa Medicine
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    • v.9 no.1
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    • pp.725-743
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    • 2000
  • This study was intended to investigate the contents associated with the neuropsychosis in the medical books published in the times of Chinese dynasty of Jin and Yuan. As a result, the following findings were drawn. 1. As for palpitation from fright and severe palpitation, the medical schools in the times of Chinese Jin and Yuan dynasties viewed their causes as heart-fire, shuiqichengxin, blood vacuity, phlegm and so on and presented a prescription for each cause for them. 2. As for psychosis, medical books published in the times of Chinese Jin and Yuan dynasties accurately divided and discussed epilepsy and viewed their causes largely as Yangming heat, phlegm of chest and heart-fire. And a number of medical schools made use of such therapeutics as sweating, vomiting and diarrhea therapies. 3. As for headache, medical books published in the times of Chinese Jin and Yuan dynasties presented their causes as fire and heat, phlegm heat, phlegm and so on and classified the aspect of headache in detail. As for vacuity rexation and dysphoria, medical books at that time saw their causes as fire and heat, heart-fire, blood vacuity and so forth and presented a prescription for them accordingly. 4. Liu Wan Su was the Hanliang school. He viewed the etiological cause for psychopathy as fire and heat and prescribed largely the medication of cold nature for it. 5. Zhang Cong Zheng belonged to the Gongxia School. He viewed the etiological cause for psychopathy as fire, phlegm and so forth and made use of sweating, vomiting and diarrhea therapies. Especially, he used the 'Jingzhepingzhe' therapy as a method to treat the symptom of fright. 6. Li Gao did not any specific mention of psychopathy and divided headache due to internal injury and headache due to external contraction. 7. Zhu Zhen Heng viewed most of the etiological causes for psychopathy as phlegm, fire and deficiency of blood and attached importance to such its therapeutics as resolving phlegm, cleaning away fire and nourishing Yin. 8. Wang Hao Gu did not present the specifically common etiological cause and prescription for psychopathy but described the cause and prescription for headache, dysphoria, maniac speech, palpitation and so forth. Luo Tian Yi presented the process of psychosis due to abnormal therapy for cold demage and prescription of it. 9. Wang Lu made a detailed explanation about the therapeutics of five types of stagnated syndrome and said that stagnated syndrome became the major cause for them in the occurrence of such psychopathy. Wei Yi Lin presented the prescription and medication for comparatively diverse mental diseases such zhong-qi, severe palpitation, palpitation for fright, impaired memory, vacuity rexation, headache, psychosis.

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A Comparative Study on Soumin Bojungyikgitang and Bojungyikgitang in the View of Constitution Medicine (소음인(少陰人) 보중익기탕(補中益氣湯)과 보중익기탕(補中益氣湯)에 대한 사상의학적(四象醫學的) 비교(比較) 연구(硏究))

  • Kim, Ilwhan;Kim, kyungyo
    • Journal of Sasang Constitutional Medicine
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    • v.8 no.2
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    • pp.69-94
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    • 1996
  • The main purpose of this work is comparing the difference between Soumin Bojungyikgitang of constitutional medicine and Li Dongyuan's Bojungyikgitang Bojungyikgitang, the prescription originated from the Pi-Wei theory(脾胃論) of Li Dongyuan who was a medical man in the Jin Yuan dynasty, had been used widely for many kinds of disease caused by the singking of the qi of middle energizer due to the weakness of the spleen and stomach. But in the singking of the qi of middle energizer due to the weakness of the spleen and stomach. But in the end of Choseon dynasty Li Je Ma, the creator of the constitutional medicine, modified the Bojungyikgitang and applied to Soumin's disease. In this paper, the difference between the two prescription were investigated from the viewpoint of chinese herb pharmacology and purpose of prescription. Additionally the problems which could be brought out by applying Bojungyikgitang to the Soyangin and the Taeumin were studied. And the conclusion could be summarized as follows: 1. The prescription of the Li Dongyuan's Bojungyikgitang is based on the deficiency of vital energy due to internal damage and the Soumin Bojungyikgitang is useful to only a certain stage of progressing disease on the basis of Shanghanlun(傷寒論). 2. In the Li Dongyuan's Bojungyikgitang, Cimicifugae Rhizoma and Bupleuri Radix were used for emphasizing the ascending action and have the antipyretic action and the effect of elavating of yangqi as they are bitter in taste and cold in nature. 3. In the Soumin Bojungyikgitang, Pogostemonis Herba and Perillae Folium have the ascending-descending action and strengthen the stomach with the effect of mild sweating by pungent taste and warm nature. 4. The effect of elavating of yangqi in the Li Dongyuan's Bojungyikgitang offers the pathway where vital qi go up by eleminating the pathogenic fire with the action of Cimicifugae Rhizoma and Bupleuri Radix in the triple energizer and yangming muscular striae. On the other hand, the Soumin Bojungyikgitang depends on the effect of reinforcing qi and elavating yangqi by Astrgalli Radix entirely and supply vital qi by reinforcing yangqi with Ginseng Rsdix. 5. The exahausion of yin(亡陰證) in the Soyangin exterior syndrome and cold limbs(寒厥證) in Taeumin exterior syndrome are similar to the indication of Li Dongyuan's Bojungyikgitang. As the causes of the disease are fundamentally different in the view of constitutional medicine, the diseases could be aggravated by applying Li's Bojungyikgitang. These results suggest that Li Dongyuan's Bojungyikgitang is proper to the exterior syndrome of Soumin and Soumin Bojungyikgitang seems to be appropriate to the Soumin's disease.

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Anti-Fibrotic Effects by Moringa Root Extract in Rat Kidney Fibroblast (모링가 뿌리 추출물에 대한 신장섬유화 억제 효과)

  • Park, Su-Hyun;Chang, Young-Chae
    • Journal of Life Science
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    • v.22 no.10
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    • pp.1371-1377
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    • 2012
  • Fibrosis in kidney by internal and external factors causes progressive loss of renal function. Renal fibrosis is the inevitable consequence of an excessive accumulation of the extracellular matrix. TGF-${\beta}$ plays an important role in the process of renal fibrosis and stimulates the synthesis of profibrotic factors, including collagens, fibronectin, and plasminogen activator inhibitor (PAI-1). We examined the effect of Moringa oleifera Lam (moringa) extracts in a rat kidney fibrosis model. We found that moringa root extract suppresses protein expression/mRNA levels of Type I collagen, fibronectin, and PAI-1 induced by TGF-${\beta}$ in renal fibroblasts. Moringa root extract selectively inhibited phosphorylation of TGF-${\beta}$-induced $T{\beta}RII$ and the downstream signaling pathway (e.g., Smad4), and phospho-ERK, but not JNK, p38, or PI3K/AKT. These results suggest that moringa root extract can act against TGF-${\beta}$-induced renal fibrosis in rat kidney fibroblast cells by a mechanism related to its antifibrotic activity, which regulates expression of fibronectin, Type I collagen, and PAI-1 through $T{\beta}RII$-Smad2/3-Smad4 and ERK. Therefore, moringa root extract is an effective substance for fibrosis therapy and provides a new therapeutic strategy for diseases associated with elevated profibrotic factor synthesis.

Genome-Wide Association Analyses on Blood Pressure Using Three Different Phenotype Definitions

  • Park, Ji-Wan;Uhmm, Saan-Yong;Shin, Chol;Cho, Nam-H.;Cho, Yoon-Shin;Lee, Jong-Young
    • Genomics & Informatics
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    • v.8 no.3
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    • pp.108-115
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    • 2010
  • Hypertension is the most prevalent disease worldwide and is itself a risk factor for cerebral, cardiac, and renal diseases. The inconsistency of candidate genes suggested by previous genomewide association studies (GWASs) may be due to not only differences in study design and genetic or environmental background but also the difference in the power of analysis between continuous traits and discrete traits. We analyzed 352,228 single nucleotide polymorphisms (SNPs) in 8842 unrelated Koreans obtained from Ansan and Ansung cohorts. We performed a series of GWA analyses using three different phenotype models; young hypertensive cases (278 subjects) versus elderly normotensive controls (680 subjects); the upper 25% (2211 hypertensive cases) versus the lower 25% of the SBP distribution (2211 hypotensive controls); and finally SBP and DBP as continuous traits (8842 subjects). The numbers of young hypertensive cases and elderly normotensive controls were not large enough to achieve genomewide significance. The model comparing the upper 25% subjects to the lower 25% of subjects showed a power that was approximate to that of QTL analysis. Two neighboring SNPs of the ATP2B1 gene, rs17249754 (SBP, p=$2.53^{-10}$; DBP, p=$1.28{\times}10^{-8}$) and rs7136259 (SBP, p=$1.30{\times}10^{-9}$; DBP, p=$6.41{\times}10^{-8}$), were associated with both SBP and DBP. Interestingly, a SNP of the RPL6 gene, rs11066280, revealed a significant genomewide association with SBP in men only (p=$3.85{\times}10^{-8}$), and four SNPs located near the MAN2A1 gene showed a strong association with DBP only in elderly men aged 60-70 years (e.g., rs6421827, p=$4.86{\times}10^{-8}$). However, we did not observe any gene variant attaining genomewide significance consistently in the three phenotype models except for the ATP2B1 gene variants. In general, the association signal with blood pressure was stronger in women than in men. Genes identified in GWASs are expected to open the way for prevention, early diagnosis, and personalized treatment of hypertension.

Quality of Life in Chronic Viral B Hepatitis Patients (만성(慢性) B형(型) 간염환자(肝炎患者) 삶의 질(質))

  • Kim, Hun-Soo;Lee, Min-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.6 no.1
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    • pp.35-45
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    • 1998
  • Objectives : The purpose of this study was to determine correlation between coping strategies to disease and quality of life in chrome viral B hepatitis patients ; to investigate difference of coping strategies to disease and quality in life between chronic viral B hepatitis patients and normal persons ; and to identify major variables related to quality in life of chronic viral B hepatitis patients. Methods: The authors used Weisman coping strategy scale for measuring coping ability and efficacies, and the questionnaire for measuring quality of life including physical, psychological, social and economical aspects and satisfaction of sexual life was made by authors based on related literatures. Data were collected through questionnaire survey over a period from Sep 15, 1994 to Nov 11, 1994. Subjects served for this study consisted of 94 chronic viral B hepatitis patients visited to department of internal medicine at one general hospital and 100 normal persons visited to one general hospital for routine check up of health. The collected data were analyzed by SAS and the statistical methods for analysis were Chisquare, t-test and multiple regression analysis. Results : 1) It was revealed that coping strategies to disease significantly correlated to individual's quality of life. 2) There was no significant difference in coping strategies to disease between chronic viral B hepatitis patients and normal persons. However, chronic viral B hepatitis patients showed the lower scroes of quality of life in physical, psychological and economical aspects. 3) The most important variables which were influenced upon quality of life were coping strategies to disease and satisfaction of sexual life. That is, the more active coping strategies to diseases and the higher satisfaction of sexual life, consequently the higher quality of life was. Especially male patient group or normal persons showed each other the higher scores of quality of life in physical and psychological area than female group or patient group. 4) No statistically significant difference in coping strategies to disease and quality of life was found between HBeAg positive group and HBeAg negative group. Conclusions : The authors suggest that chronic viral B hepatitis patients may show the lower score of quality of life than normal person. Therefore, quality of life assessment should become an integral part of all clinical area that seek to assess the effectiveness of treatment. Also, through the interdisciplinary approach, a comprehensive paradigm that can better account for the effects of chronic disease on the individual' s quality of life should be developed.

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Dexamethasone Induces $Fc{\gamma}RIIb$ Expression in RBL-2H3 Cells

  • Silwal, Prashanta;Lee, Mi-Nam;Lee, Choong-Jae;Hong, Jang-Hee;NamGung, Uk;Lee, Zee-Won;Kim, Jinhyun;Lim, Kyu;Kweon, Gi Ryang;Park, Jong Il;Park, Seung Kiel
    • The Korean Journal of Physiology and Pharmacology
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    • v.16 no.6
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    • pp.393-398
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    • 2012
  • Mast cells are involved in allergic responses, protection against pathogens and autoimmune diseases. Dexamethasone (Dex) and other glucocorticoids suppress $Fc{\varepsilon}RI$-mediated release of inflammatory mediators from mast cells. The inhibition mechanisms were mainly investigated on the downstream signaling of Fc receptor activations. Here, we addressed the effects of Dex on Fc receptor expressions in rat mast cell line RBL-2H3. We measured mRNA levels of Fc receptors by real-time PCR. As expected, Dex decreased the mRNA levels of activating Fc receptor for IgE ($Fc{\varepsilon}R$) I and increased the mRNA levels of the inhibitory Fc receptor for IgG $Fc{\gamma}RIIb$. Interestingly, Dex stimulated transcriptions of other activating receptors such as Fc receptors for IgG ($Fc{\gamma}R$) I and $Fc{\gamma}RIII$. To investigate the mechanisms underlying transcriptional regulation, we employed a transcription inhibitor actinomycin D and a translation inhibitor cycloheximide. The inhibition of protein synthesis without Dex treatment enhanced $Fc{\gamma}RI$ and $Fc{\gamma}RIII$ mRNA levels potently, while $Fc{\varepsilon}RI$ and $Fc{\gamma}RIIb$ were minimally affected. Next, we examined expressions of the Fc receptors on cell surfaces by the flow cytometric method. Only $Fc{\gamma}RIIb$ protein expression was significantly enhanced by Dex treatment, while $Fc{\gamma}RI$, $Fc{\gamma}RIII$ and $Fc{\varepsilon}RI$ expression levels were marginally changed. Our data showed, for the first time, that Dex regulates Fc receptor expressions resulting in augmentation of the inhibitory receptor $Fc{\gamma}RIIb$.