BACKGROUND: Routine renal function tests are not sensitive enough to detect early renal complication of diabetes. To detect the complication as soon as possible, we measured urine N-Acetyl-beta-D-glucosaminidase(NAG) and evaluated in comparison with microalbumin and beta2-microglobulin(beta2-MG). METHODS: 87 patients with type II diabetes visited Catholic University Hospital of Taegu Hyosung during the period October 1995 to March 1996. We collected 24 hour urine samples and measured NAG, albumin excretion rate (AER), beta2-MG. urinalysis, BUN, creatinine(Cr) Cr clearance(CrCl), fasting and 2 hour postprandial blood sugar and hemoglobin A1c. RESULTS: The average age of the patients was 53+/-15 years old and their average disease duration was 5.8+/-5.0 years. Abnormal rates of each renal function tests were as follows : NAG/gCr 52.1%, AER 51.7%, CrCl 42.5%, BUN 18.4%, beta2-MG 13.8% and creatinine 6.9% in order. From 36 patients whose AER was within normal limit, 13 of them(36.1%) showed increased level of NAG/gCr. Of 38 patients with increased NAG/gCr results, the 31 patients (81.6%) recorded abnormal results of renal function tests. Among 87 patients studied 60 patients(68.5%) showed increased level of NAG/gCr or AER results. Compared with AER test alone. the combined tests with NAG/gCr increased 16.8% of detection rates of renal complication in type II diabetes. CONCLUSION: Urine NAG/gCr and AER tests were very useful for detecting the early renal complication of type n diabetes. As increase of NAG/gCr suggest the proximal tubule damage, it is necessary to have further evaluation about the proximal tubule damage of renal complication in type II diabetes.
Acetylglucosaminidase* ; Blood Glucose ; Creatinine ; Daegu ; Fasting ; Humans ; Urinalysis

Neurofibromatosis is a disease which involves both neuroectodermal and mesodermal tissue, and is characterized by cafe-au-lait spot, multiple subcutaneous neurofibromas, elephantiasis neuromatosa, a positive family history, and specific dystrophic osseous changes such as scoliosis, penciling of ribs, vertebral scalloping, a paravertebral soft tissue tumor, and congenital pseudarthrosis. The classic type of scoliosis in neurofibromatosis was known as a sharp localized short curve that is often rapidly progressive and produces severe deformity with dystrophic changes, but another form with long gentle curve is reported. Since conservative treatment is usually unsuccessful, posterior fusion with or without Harrington instrumentation is the treatment of choice even in young age when the curve is progressive. This paper was aimed to review our experience with 11 patients having neurofibromatosis and scoliosis, who were treated with posterior fusion and Harrington instrumentation from Jan. 1971 to Dec. 1980, and the results were as follows: 1. The average age that spinal deformity was observed was 7.7 years old, but the average age at treatment was 14.4. 2. Cafe-au-lait spot was observed in all cases, subcutaneous nodule in 7 cases, local gigantism in 2 cases, and positive family history in 3 cases. 2 cases were combined with congenital spinal anormalies. 3. Specific pattern in spinal deformity was not significant. There were 7 short curves less than 5 vertebrae involved and 6 long curves more than 6 vertebrae involved. 4. There were 5 kyphosis which had more than 50°, and those were usually combined with severe scoliosis. 5. Preoperative average degree of scoliosis was 93.8, and the final correction was 41.2° (43.9%) with loss of correction 5.3°(5.7%) after 3.2 year follow-up in average. 6. It shouid be educated for early detection at home and school, and for the importance of early treatment for the scoliosis, to prevent rapid increase of scoliosis in neurofibromatosis.
Cafe-au-Lait Spots ; Congenital Abnormalities ; Elephantiasis ; Follow-Up Studies ; Gigantism ; Humans ; Kyphosis ; Mesoderm ; Neural Plate ; Neurofibroma ; Neurofibromatoses ; Neurofibromatosis 1 ; Pectinidae ; Pseudarthrosis ; Ribs ; Scoliosis ; Spine

Desmoplastic small round cell tumor (DSRCT) is a rare neoplasm of young adults and it is characterized by polyphenotypic differentiation. We experienced a case of abdominal DSRCT that occurred in a 19-year-old female who presented with painful swelling of her right forearm. The tumor was cytokeratin-negative and it exhibited some tumor cells with intranuclear inclusions. Molecular demonstration of EWS-WT1 fusion transcripts is particularly useful to confirm the diagnosis of DSRCT without epithelial differentiation. We report here on a case of cytokeratin-negative DSRCT that showed an unusual feature of intranuclear inclusions.
Desmoplastic Small Round Cell Tumor ; Female ; Forearm ; Humans ; Intranuclear Inclusion Bodies ; Keratins ; Young Adult

The age of puberty represents a very critical time in the life history of every young woman. The menarche stands as primary indicator of the onset of sexual maturation in females. According to several studies, menarcheal age in Korean girls has dropped from about 15 years of age in 1960s to 13.5 years of age in 1980s. This findings show a pronounced secular trend to earlier maturation. The purpose of this study is to determine (1) the average age at menarche in Korea in present time, (2) the secular trend of menarcheal age, and (3) the geographic regional influence on menarche. The data sampling was obtained from the physical examination cards of women students in Yonsei University who entered from 1983 to 1991. The data which was obtained from the number of 7761 was analysed by dBase III plus and SAS program. The results are as follows: 1) The mean menarcheal age of the subjects was 13.7+/-1.2 years. 2) Age at menarche has been getting earlier by some 7.4 months during the period of recent II years. 3) Comparing to the decreasing secular trend of menarcheal age, the height and weight showed increasing trend. 4) There were significant differences in menarcheal age, height, weight among geographic regions. We conclude that the results indicate an accelerating secular trend in age of menarche in Korea.
Adolescent ; Female ; Humans ; Korea* ; Menarche ; Physical Examination ; Puberty ; Sexual Maturation

Frequent anomalies causing a left-sided appendix are situs inversus and malrotation. The ectopic position of the appendix frequently causes a delay or error in diagnosis because of atypical symptoms. A physical examination is of limited value unless dextrocardia is present. A left-sided appendix is a rare anomaly, but when other diseases are ruled out, it must be considered especially at the emergency department.
Appendicitis* ; Appendix ; Dextrocardia ; Diagnosis ; Emergency Service, Hospital ; Physical Examination ; Situs Inversus

We performed total hip arthroplasty on a young male adult with paralytic dislocation of the hip due to poliomyelitis. Because of extreme shortening, as well as instability and weakness, the patient was unable to bear weight on the limb. Pastoperative course was complicated by ectopic ossification that compromised the hip and knee motion. Another young male adult with severe spastic cerebral palsy underwent total hip arthroplasty because of an intractable pain due to degenerative arthritis. Initial attempt coupled with adductor tenotomy and obtuator neurectomy ended in gross loosening and acetabular protrusion. Revision consisted of extensive soft tissue release and bone grafting of acetabular defect and use of a protrusion cup and an extra-long stem. Postoperative course was complicated by long-standing serous aseptic discharge from the wound which was controlled by antibiotics and prolonged recumbency. Indications for total hip arthroplasty in paralytic hips are rare and should be reserved for the most crippling conditions and one must be prepared fvr technical difficulties and a variety of complications with a prospecs for less than optimum results.
Acetabulum ; Adult ; Anti-Bacterial Agents ; Arthroplasty, Replacement, Hip ; Bone Transplantation ; Cerebral Palsy ; Dislocations ; Extremities ; Hip ; Humans ; Knee ; Male ; Ossification, Heterotopic ; Osteoarthritis ; Pain, Intractable ; Poliomyelitis ; Spectinomycin ; Tenotomy ; Wounds and Injuries

Acute tubular necrosis has been rarely reported as a complication of typhoid fever in the literature. We experienced four cases of acute tubular necrosis associated with typhoid fever in children. Patients showed significant titer of widal reaction associated with acute renal failure and one of them rised in 2 months after onset of clinical symptoms. Renal biopsy findings were compatible with acute tubular necrosis and immune complexes were not deposited in the glomeruli. Clinical and urinary findings were normalized by hemodialysis and antibiotic therapies. In conclusion, close longterm follow up of widal titer is mandatory in acute tubular necrosis, especially when associated with high fever.
Acute Kidney Injury ; Antigen-Antibody Complex ; Biopsy ; Child ; Fever ; Follow-Up Studies ; Humans ; Necrosis* ; Renal Dialysis ; Typhoid Fever*

Dopamine receptors in the CNS and other several tissues were identified by physiological, biochemical and radioligand binding techniques. But previous morphological and biochemical studies have been unable to charaterize or determine the tissue distribution of dopamine receptor subtypes because no selective ligands are available yet. Furthermore, the cellular distribution of the dopamine receptor subtypes in the rat kidney is not demonstrated well. The present study utilizes specific antibodies to characterize the renal distribution of this dopamine receptor subtype using light microscopic immunohistochemistry in the rat kidney. In the rat kidney, D1 receptor protein was localized to proximal tubule, distal tubule, renal vessels, medullary collecting tubule, juxtaglomerular apparatus(JGA) and glomerulus. And D2 receptor protein was localized to distal tubule, Henle's loop, proximal tubule, medullary collecting tubules, juxtaglomerular apparatus(JGA) and renal vasculature. The D1 and D2 receptors, which present in the central nervous system, are now identified in the rat kidney. There are some differences in receptors expressing sites on the previous radioligand binding and pharmacologic studies, but these results suggest that at least some of the renal dopamine DA1 and DA2 receptors correspond structually to the central dopamine D1 and D2 receptors.
Animals ; Antibodies ; Central Nervous System ; Dopamine* ; Immunohistochemistry* ; Kidney* ; Ligands ; Rats* ; Receptors, Dopamine ; Tissue Distribution

The authors analysed 261 cases of mycoplasmal pneumonia in children who were admitted to the pediatric department of Seoul Adventist Hospital between July 1986 and June 1991. The result obtained were as follows; 1) Yearly distribution of the cases showed high in 1987 and 1991, but no significant difference was noted in seasonally or monthly distribution. 2) The peak incidence of age was between 2 and 6 years of age, and the sex ratio of boy to girl was 1.1:1. 3) pulmonary manifestations were asthma in 21 cases (8.0%), atelectasis in 5 cases (1.9%), emphysema in 3 cases (1.2%), pleural effusion in 16 cases (6.1%), otitis media in 4 cases (1.2%) and sinusitis in 9 cases (3.4%). 4) Extrapulmonary complication were hepatitis in 53 cases (20.3%), skin rash in 9 cases (2.4%), proteinuria in 6 cases (2.3%), and hematuria in 4 cases (1.5%). 5) On the chest X-ray examination, the most common type of pneumonia was interstitial pneumonia (94 cases, 39.8%), and unilateral involvement was common (85.6%), and the most common involvement was right lower lobe (83 cases, 41.4%). 6) The relationship between the type of pneumonia and cold agglutinini titer, and between the type of pneumonia and Mycoplasma antibody titer were not found (P>0.05). 7) In the 16 cases of pleural effusion, The type of pneumonia was lobar, lobular (9 cases), bronchopneumonia (7 cases), and interstitial type was not present. The site of pneumonia was left (6 cases), right (9 cases), and 1 case showed bilatrality. The extent of pleural effusion was mild (10 cases), moderate (3 cases), and severe (3 cases). The result of pleural fluid exam in severe cases was all exudate. 8) The mean duration of admission was most common from 6 to 10 days. the mean duration of admission by the type of pneumonia was lobar, lobar (10.71+/-3.40), interstitial (8.78+/-2.14), and bronchopneumonia (8.83+/-2.47). 9) Both mycoplasma antibody test and cold agglutinin test were carried out in 185 cases and sensitivity of mycoplasma antibody test was 55.1%.
Asthma ; Bronchopneumonia ; Child* ; Emphysema ; Exanthema ; Exudates and Transudates ; Female ; Hematuria ; Hepatitis ; Humans ; Incidence ; Lung Diseases, Interstitial ; Male ; Mycoplasma* ; Otitis Media ; Pleural Effusion ; Pneumonia* ; Pneumonia, Mycoplasma* ; Proteinuria ; Pulmonary Atelectasis ; Seasons ; Seoul ; Sex Ratio ; Sinusitis ; Thorax

The purpose of this study was to investigate the morphologic changes of the bile canaliculi and its associated structures of the liver induced by common bile duct ligation(CBDL) in the rat. The canalicular surface and lateral surface of the dry-fractured hepatocytes was studied with scanning electron microscopy at 1~6 weeks post ligation. The first week after CBDL, the bile canaliculi were dilated. The microvilli were increased in number and the lumens contained granular materials After 2 weeks or more, the bile canaliculi were dilated to a variable degree, and with irregularity, measuring from 1.5 to 5 micrometer in diameter, and in the advanced stage, the canaliculi showed blunting and the disappearance of microvilli. Some canaliculi had sprouting side branches. At 4~6 weeks post-ligation, the lateral surface of the hepatocytes also showed some irregularity and a tortuous appearance, and numerous small sized microvillous projections were formed. The tubular structures of the proliferated SER distributed adjacent to the lateral surface of the hepatocytes, and the direct connection of a tubular structure and the cytoplasmic membrane was observed. These results suggest that the deformity and loss of microvilli of bile canaliculi reflect the disturbance of bile secretion from the hepatocytes. And prolonged obstruction of bile flow may result in bile excretion via the lateral surface of hepatocytes.
Rats ; Animals