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Immunopathogenesis of childhood idiopathic nephrotic syndrome

  • Hae Il Cheong
    • Childhood Kidney Diseases
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    • v.27 no.1
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    • pp.1-10
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    • 2023
  • Pediatric nephrotic syndrome (NS) is a clinical syndrome characterized by massive proteinuria, hypoalbuminemia, and generalized edema. Most childhood NS cases are idiopathic (with an unknown etiology). Traditional therapeutic approaches based on immunosuppressive agents largely support the key role of the immune system in idiopathic NS (INS), especially in the steroid-sensitive form. Although most previous studies have suggested the main role of T cell dysfunction and/or the abnormal secretion of certain glomerular permeability factors, recent studies have emphasized the role of B cells since the therapeutic efficacy of B cell depletion therapy in inducing and/or maintaining prolonged remission in patients with INS was confirmed. Furthermore, several studies have detected circulating autoantibodies that target podocyte proteins in a subset of patients with INS, suggesting an autoimmune-mediated etiology of INS. Accordingly, a new therapeutic modality using B cell-depleting drugs has been attempted, with significant effects in a subset of patients with INS. Currently, INS is considered an immune-mediated disorder caused by a complex interplay between T cells, B cells, soluble factors, and podocytes, which may vary among patients. More in-depth investigations of the pathogenic pathways of INS are required for an effective personalized therapeutic approach and to define precise targets for therapeutic intervention.

Clinical Report of One Patient with the Wallenberg's syndrome by Cheonghunhwadam-tang (청훈화담탕(淸暈化痰湯) 투여를 통한 Wallenberg증후군 환자 치험 1례)

  • Kim, Yong-Jeong;Yun, Jong-Min;Park, Sae-Wook;Lee, Min-Goo;Lee, Si-Hyeong;Lee, Seung-Eon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.1
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    • pp.284-288
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    • 2005
  • The main symptoms of the Wallenberg's syndrome are ataxia of gait, clumsiness of ipsilateral limbs, nausea and vomiting, vertigo, visual disturbance such as difficulty in focusing blurred vision diplopia, numbness, dysphagia, hoarseness, hiccup, nystagmus, Horner's syndrome. The purpose of this paper is to report the patient with the Wallenberg's syndrome who was improved by oriental medical treatment. The vertigo of the Wallenberg's syndrome is classed as the pungwhadam(風火痰) and we prescribed Cheonghunhwadam-tang. The intensity and frequency of vertigo wewe dramayically improved.

A Case of Posterior Reversible Leukoencephalopathy Syndrome Following Poststreptococcal Glomerulonephritis (A군 사슬알균 감염 후 사구체신염 환아에서 발생한 가역적 후두부 뇌병증 증후군 1례)

  • Lee, Eun Kyoung;Kang, Jin Han;Ma, Sang Hyuk
    • Pediatric Infection and Vaccine
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    • v.22 no.2
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    • pp.113-116
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    • 2015
  • Posterior reversible leukoencephalopathy syndrome is a clinical radiographic syndrome of many causative factors. Sudden onset headache, vomiting, altered mental status, blurred vision and seizures are main symptoms shown in posterior reversible leukoencephalopathy syndrome. In addition, it typically shows radiological findings of edema in the white matter of posterior cerebrum, being in commonly bilateral but asymmetric. We report a case of poststreptococcal glomerulonephritis (PSGN) presenting as posterior reversible leukoencephalopathy syndrome. Immediate control of hypertension resulted in rapid and complete neurological recovery.

A study on the Yoon Gil-Young's theory of classification in the "syndrome differentiation" (윤길영(尹吉榮)의 병증(病證) 대분류에 대한 고찰)

  • Kim, Gyeong Cheol;Lee, Jeong Won
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.19 no.1
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    • pp.55-63
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    • 2015
  • Objectives In order to the review of the Yoon Gil-Young's theory on the "differentiation of syndromes", we studied on the his method and system of classification on the "differentiation of syndromes". Methods We reviewed on "The Clinical Formula Science Traditional Korean Medicine 東醫臨床方劑學", "A study on the Methodology of Traditional Korean Medicine 東醫學의 方法論硏究" "The theory of SaSang Constitution Medicine 四象體質醫學論". From a connected standpoint with the basic theory and clinical medicine, considered on the Yoon Gil-Young's theory of "differentiation of syndromes". Results Yoon Gil-Young's theory of differentiation of syndromes and treatment was widespread so much that he studied on the learning field of Traditional Korean Mediciine and ingenious as well. The main principles of differentiation of syndromes was summarized the three representative syndrome-complexes; BON-HER(original deficiency syndrome), BON-HAN(orginal cold excess syndrome), BON-YEOL(original heat excess syndrome). And also the three representative syndrome-complexes was previously carried out the details of differentiation of syndromes and assigned represent prescription one by one. Conclusions As the results, Yoon Gil-Young insisted the system of differentiation of syndromes closely connecting with Traditional Korean Medical physiology, pathology, diagnosis and prescriptions. And therefore he was a frontier of the field of Traditional Korean Medicine.

Case of the Oculomotor Nerve Palsy in Miller Fisher Syndrome (Miller Fisher 증후군의 동안신경마비에 대한 치험1례)

  • Du In Sun;Kim Jin Man;Hong Chul Hee;Seo Eun Sung;Park Min Chul;Kim Nam Kwen
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.17 no.3
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    • pp.842-844
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    • 2003
  • Miller Fisher syndrome is characterized by ophthalmoplegia, ataxia and areflexia and develops after respiratory tract viral infection. Other events are GI tract infection, vaccination, digitalis intoxication, insect bite and delivery. Diagnosis of Miller Fisher syndrome can be made with clinical history taking, cardinal symptoms and normal findings of CT or MRI. We have experienced a case of Miller Fisher syndrome and treated with herbal medicine, eletro-acupuncture at paralytic external ophthalmic muscles. We enforced electro-acupuncture for 10 minutes daily. We used the PG-306 electro-acupuncture products(Suzuki Iryoki Co. Japan) and applied the low consequence wave of 1-8Hz. In 3 months, all the main symptoms disappered and the patient improved in health. Based on this experience, herbal medicine and eletro-acupuncture can be applied to the Miller Fisher syndrome.

DENTAL TREATMENT OF CHILDREN WITH ANGELMAN SYNDROME : CASE REPORTS (Angelman syndrome 환자의 치과치료 : 증례보고)

  • Bak, So-Yeon;Kim, Chong-Chul;Lee, Sang-Hoon;Jang, Ki-Taeg;Kim, Jung-Wook;Kim, Young-Jae;Shin, Teo-Jeon;Hyun, Hong-Keu
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.7 no.2
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    • pp.115-118
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    • 2011
  • Angelman syndrome(AS) is a rare genetic neurological disorder. The main clinical characteristics of this syndrome are delayed neuropsychological development, intellectual disability, speech impairment, jerky movements especially hand-lapping, frequent laughter or smiling. AS is a classic example of genetic imprinting in that it is usually caused by deletion or inactivation of genes on the maternally inherited chromosome 15. The syndrome has oral manifestations such as diastemas, tongue thrusting, sucking/swallowing disorder, mandibular prognathism, frequent drooling, and excessive chewing behavior. The purpose of this paper is to describe the interesting aspects of the dental treatment of a childe with AS.

Diagnosis of McKenzie Mechanical Syndromes for Patient with Low Back Pain : Focused on mechanical loading strategies (요통 환자를 위한 멕켄지의 역학적 증후군 진단 : 역학적 부하 전략을 중심으로)

  • Kim, Minhee
    • Archives of Orthopedic and Sports Physical Therapy
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    • v.14 no.2
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    • pp.109-115
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    • 2018
  • Purpose: McKenzie is a widely-used and conventional clinical therapeutic exercise for patients with mechanical lower back pain. It is a well-designed assessment and classification system for the spine. Main issue: Patients with mechanical lower back pain are classified into one of three mechanical syndromes (posture, dysfunction, or derangement syndrome) by mechanical loading strategies. These methods evaluate symptomatic and mechanical responses during repeated end-range movement and sustained postures. The goal of McKenzie mechanical syndrome diagnosis is to determine directional preferences. Directional preference is a phenomenon of preference for posture or movement in one direction, which reduces or centralizes pain. However, in Korea, there is a lack of awareness of basic McKenzie mechanical syndromes diagnostic concepts. Koreans tend to think of the McKenzie method as a simple lumbar extension exercise. However, an accurate diagnosis of a mechanical syndrome must precede the application of McKenzie exercise. Conclusions: Thus, in this study, I present a classification method of McKenzie mechanical syndrome diagnosis and clinical characteristics of each mechanical syndrome.

A Study on the Factors Affecting the Subjective Symptoms of VDT Syndrome (VDT증후군 자각증상에 영향을 미치는 인자들에 관한 연구)

  • Moon, Jai-Dong;Lee, Min-Chull;Kim, Byong-Woo
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.3 s.35
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    • pp.373-389
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    • 1991
  • In order to develop the measuring tool of VDT syndrome and investigate the variables affecting the development of VDT syndrome, a questionnaire study accompanied with the evaluation of working environment was performed with 138 VDT users from six public organs in Kwangju area. The results were summarized as follows. 1. As a result of analysis with data collected by newly developed questionnaire, VDT syndrome included five factors named as eye-related component, psychological component, general body component, musculoskeletal component, and skin-related component and the estimates of the internal consistency of five factors were 0.877, 0.820, 0.796, 0.791, 0.593 respectively. 2. Variables affecting the level of eye-related symptoms were the type of main b using VDT, the total time of VDT operation per day, and the use of external filter on CRT. 3. The level of eye-related symptoms in the group using external filter was higher significantly than that in the group not using filter. 4. The past history of severe illness affected the level of psychological symptoms significantly. 5. Variables affecting the level of general body symptoms were b satisfaction and income satisfaction. 6. Variables affecting the level of musculoskeletal symptoms were the type of main job using VDT, whether majored in EDPS, the level of typewriting, b satisfaction, and the total time of VDT operation per day. 7. Age and the use of external filter were significantly related to the level of skin-related symptoms.

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A study on the survey for the Application Status and the Improvement of Oriental Medical Health Insurance for the Ob & Gy Disease (부인과 질환에 대한 한방건강보험 적용실태 및 개선방안에 대한 조사연구 1)

  • Choi, Min-Sun;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.20 no.1
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    • pp.239-257
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    • 2007
  • Purpose : In the part of Ob & Gy disease, the health insurance application is very limited. This study has been performed for gaining the basic data of enlargement of insurance coverage and reform of the insurance system corresponded with real clinical conditions. Methods : The survey has been practiced twice, the subjective questionnaire was used at the first survey. Then the questionnaire written using the results of first survey was distributed to the Korean medical doctors(KMD) who participated in the autumn symposium of the society of Oriental Obstetrics & Gynecology. Results : 1. The main Ob & Gy disease that the acupuncture treatment has been used actually or thought be positively necessary on the clinic were Dysmenorrhea(including premenstrual syndrome), Climacteric syndrome, Menstrual disorder, Postpartum Pain syndrome. Amenorrhea, Low back pain with pregnancy, JingHa(pelvic tumor), Infertility etc. 2. The main additional complex the sick and wounded names given to visiting patients for Ob & Gy disease as the limits of acupuncture items of insurance coverage were Low back Pain(J10), Qi-stasis(B13.0), SimHwaHangYeom(C2l.1). 3. Suitable the sick and wounded name of Ob & Gy disease thought be added in BokGangNae(Intra-abdominal acupuncture: CV13 ${\cdot}$CV16${\cdot}$CV10). TuJa(Puncture each adjoining acu-points in one insertion : SP6-GB39), TuJa(PC6-TE5) among acupuncture items of insurance coverage were Dysmenorrhea(K05). Menstrual disorder(K02) and Dysmenorrhea(K05), Hyperemesis(K16.0). 4. Climacteric syndrome(K04) and Dysmenorrhea(K05) should be added as suitable the sick and wounded name of TuJa(SP6-GB39), and Postpartum pain syndrome(K29) as KwanJeolGangNea(Intra-articular acupuncture: S35, LE201). Conclusion : Standing on this study, additional survey to general KMD should be continued. And the academic verifications through the oriental medical literatures and RCT papers on acupuncture should be also required.

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Antiviral effect of fucoxanthin obtained from Sargassum siliquastrum (Fucales, Phaeophyceae) against severe acute respiratory syndrome coronavirus 2

  • Nalae Kang;Seong-Yeong Heo;Eun-A Kim;Seon-Heui Cha;Bomi Ryu;Soo-Jin Heo
    • ALGAE
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    • v.38 no.4
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    • pp.295-306
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    • 2023
  • Human coronavirus diseases, particularly severe acute respiratory syndrome coronavirus 2, still remain a persistent public health issue, and many recent studies are focusing on the quest for new leads against coronaviruses. To contribute to this growing pool of knowledge and explore the available marine natural products against coronaviruses, this study investigated the antiviral effects of fucoxanthin isolated from Sargassum siliquastrum-a brown alga found on Jeju Island, South Korea. The antiviral effects of fucoxanthin were confirmed in severe acute respiratory syndrome coronavirus 2-infected Vero cells, and its structural characteristics were verified in silico using molecular docking and molecular dynamic simulations and in vitro colorimetric method. Fucoxanthin inhibited the infection in a concentration-dependent manner, without showing cytotoxicity. Molecular docking simulations revealed that fucoxanthin binds to the angiotensinconverting enzyme 2-spike protein (binding energy -318.306 kcal mol-1) and main protease (binding energy -205.118 kcal mol-1). Moreover, molecular dynamic simulations showed that fucoxanthin remains docked to angiotensin-converting enzyme 2-spike protein for 20 ns, whereas it breaks away from main protease after 3 ns. Also, the in silico prediction of the fucoxanthin was verified through the in vitro colorimetric method by inhibiting the binding between angiotensinconverting enzyme 2 and spike protein in a concentration-dependent manner. These results indicate that fucoxanthin exhibits antiviral effects against severe acute respiratory syndrome coronavirus 2 by blocking the entry of the virus. Therefore, fucoxanthin from S. siliquastrum can be a potential candidate for treating coronavirus infection.