A 58-year-old female with an episode of gross hematuria two months before and fever and chill for the past three days presented oliguric acute renal failure. She has taken NSAID intermittently for 18 years due to rheumatoid arthritis, and herb medicine for one week two months ago when gross hematuria developed. Physical examination revealed mild tenderness on costovertebral angles. Her blood pressure was 170/100 mmHg, the urinalysis showed >300 mg protein with many RBCs and 10-20 WBCs and the serum creatinine was 5.8 mg/dl. A renal biopsy performed on the 4th hospital day showed that it was overwhelmed by severe tubular lesions which reveal intratubular obstruction by massive erythrocyte casts and tubular necrosis. The glomeruli showed focal minimal crescents with many red blood cells entrapped in the crescents and in the capillaries. Immune deposits were not present. A renal failure resolved spontaneously and the patient was discharged three weeks later with creatinine of 2.4 mg/dl. In this patient, acute renal failure was considered to be due to a tubular lesion related to the glomerular bleeding from focal glomerulonephritis revealing minimal crescents.
Acute Kidney Injury* ; Arthritis, Rheumatoid ; Biopsy ; Blood Pressure ; Capillaries ; Creatinine ; Erythrocytes ; Female ; Fever ; Glomerulonephritis* ; Hematuria* ; Hemorrhage ; Humans ; Middle Aged ; Necrosis ; Physical Examination ; Renal Insufficiency ; Urinalysis

No abstract available.
Humans

Schizophrenia is a devastating mental illness that can lead to deterioration in the social and occupational functioning of affected individuals with a major cost to society. A wide range of studies suggest a genetic component to the inheritance of schizophrenia. The molecular genetic studies on schizophrenia have been actively performed since late 1980s. In linkage studies, no loci were replicated across studies and there were no loci surpassing genome-wide significance. Candidate gene association studies showed generally inconsistent results and there were no enrichment of smaller P-values. In the GWAS era, the community has coalesced into large international consortia. The largest schizophrenia GWAS to date is 50,000 samples and efforts are ongoing to accumulate 50,000 cases and 50,000 controls as part of 'PGC2' collaboration. With the limitation of GWAS results, several alternatives are being explored. In genotyping, the concepts of allelic spectrum including from common polygenic to rare penetrant variation are emerging. Phenotypes include all phenomena beyond DNA. The developments in transcriptomic & proteomic approach and intensive research on endophenotype will bring crucial insights into the nature of schizophrenia in the future. But there still remains our task about research on many factors including environment that influence gene expression (epigenetics), age, and gender.
Cooperative Behavior ; DNA ; Endophenotypes ; Epigenomics ; Gene Expression ; Genetic Association Studies ; Molecular Biology ; Phenotype ; Schizophrenia ; Wills

The hyperimmunoglobulin E syndrome is a primary immunodificiency disorder characterized by recurrent staphylococcal infections and markedly elevated serum IgE level. Clinical features are coarse face and severe infections of the skin-furunculosis or chronically pruritic dermatitis and sinopulmonary tract infection from infancy by coagulase positive Staphylococcus aureus, or Candida albicans etc. The patients's serum IgE level is elevated but the basic immunologic pathogenesis not fully understood. We have experienced a case of hyperimmunoglobulin E syndrome in a 26/12-year-old who had suffered from recurrent staphylococcal pneumonias and abscesses and chronically pruritic dermatitis from 1 month of age with elevated serum IgE level. A brief review of the related literature is presented.
Abscess ; Candida albicans ; Coagulase ; Dermatitis ; Immunoglobulin E ; Pneumonia, Staphylococcal ; Staphylococcal Infections ; Staphylococcus aureus

Psoriasis is a relatively common disorder that affects at least 1-2% of the population, however, the pathogenesis is not fully understood yet. Histopathologically, psoriatic lesion is characterized by hyperplasia of keratinocyte, intraepidermal neutrophil accumulation and activated T lymphocyte infiltration in the dermis. Among many cytokines, IL-8 is known to play a role for the activation and migration for neutrophil and T lymphocyte and for the proliferation of keratinocyte. We performed immunohistochemical staining with anti-IL-8 monoclonal antibody for the active lesion, stable lesion and normal-looking skin of ten psoriatic patients and ten healthy controls. Strong expression of IL-8 in the epidermis and dermis was noted from the active as well as stable psoriatic skins. In the normal-looking skin of the psoriatic patients, only faint expression which is not different from healthy control skin, was noted. These observations indicate that the expression of IL-8 is increased in psoriatic lesion, and IL-S is important for the initiation and maintenance of psoriasis.
Cytokines ; Dermis ; Epidermis ; Humans ; Hyperplasia ; Interleukin-8* ; Keratinocytes ; Lymphocytes ; Neutrophils ; Psoriasis ; Skin*

During tumor progression, a subset of cells acquires metastatic properties, presumably through a series of genetic alterations. As the result, cells detach from the primary tumor, penetrate the basement membrane and invade the adjacent structures including lymph and blood vessels. Loss of adhesive functions and gain of new adhesive functions are thought to play a crucial role in this metastatic cascade. Since tumor metastasis is the principle cause of death for cancer patients including colon cancer, there is a consensus that a search for tools that allow effective assessment of the metastatic potential of tumors is a prime goal for cancer research. An immunohistochemical study of cell adhesion molecules, CD44H and its variant CD44v6, was done to evaluate their relationship with known prognostic factors related to the progression and metastasis of colorectal carcinoma in 94 cases of colorectal carcinoma tissues. The results were as follows. The CD44H expression was detected in 90 (95.7%) and CD44v6 in 53 (56.4%) out of 94 cases of colorectal carcinoma, and the CD44H was overexpressed in tumor tissue more than in normal mucosa in 62% of the cases. The expression rates of both protein were not significantly correlated with age and sex of the patients, invasion depth, lymph node metastasis, tumor differentiation, and tumor site. The coexpression of CD44H and CD44v6 in tumor was significant (p<0.05). The above results suggest that overexpression of CD44H and loss of function to control the alternative splicing of CD44 mRNA resulting in CD44v6 expression and alteration of adhesive function are closely associated with tumorigenesis of the colorectum.
Adhesives ; Alternative Splicing ; Basement Membrane ; Blood Vessels ; Carcinogenesis ; Cause of Death ; Cell Adhesion Molecules* ; Cell Adhesion* ; Colonic Neoplasms ; Colorectal Neoplasms* ; Consensus ; Humans ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis ; Prognosis ; RNA, Messenger

PURPOSE: To evaluate the efficacy of the tension-free vaginal tape (TVT) procedure in patients with recurrent stress urinary incontinence. Therefore, the effectiveness of the procedure in patients whom previous traditional surgical procedures had failed was retrospectively reviewed. MATERIALS AND METHODS: A total of 48 women, in whom a previous traditional surgical procedure had failed, received the TVT procedure (Group I). A further 124 women received the TVT procedure as the primary anti-incontinence surgical procedure (Group II) over the same time period, who were followed up for at least 1 year after the TVT procedure, were also included in the study. The preoperative evaluations included a symptom questionnaire, physical examination and urodynamic evaluation. Uroflowmetry, postvoiding residual urine and the symptom questionnaire were evaluated postoperatively, and the pre- and postoperative results compared between the two groups. The surgical results were classified into 3 categories; cured, improved and failed. RESULTS: According to the protocol, 40 (83.3%) and 106 (85.5%) patients in Groups I and II were cured. There were no significant differences in the cure rates between the two groups. Thirty four and 58 intrinsic sphincter deficiency patients were noted in Groups I and II, respectively; of these, 76.5 and 79.3% of the patients in groups I and II were cured of their incontinence. There were no significant differences in the incidences of intra- or postoperative complications, postoperative voiding problems and patient satisfactions between the two groups. CONCLUSIONS: There were no differences in the results of the TVT procedure in women with recurrent stress urinary incontinence or who had received the procedure as the primary anti-incontinence surgical treatment. These results imply the TVT procedure can be performed as the primary choice in patients having failed previous anti-incontinence surgery.
Female ; Humans ; Incidence ; Physical Examination ; Postoperative Complications ; Surveys and Questionnaires ; Reoperation ; Retrospective Studies ; Suburethral Slings* ; Urinary Incontinence* ; Urodynamics

We reviewed 7 cases of congenital mesoblastic nephroma (4 cases of classical mesoblastic nephroma (CMN) and 3 cases of atypical mesoblastic nephroma (AMN)) using immuno-histochemical and flow cytometric study. Results are as follows. 1) The mean tumor size was 5 (3 to 7cm)cm in CMN and 9 (7 to 10cm)cm in AMN. The AMN revealed hemorrhage and necrosis in two Of three cases. A case of AMN showed cystic change without hemorrhage and necrosis. Mitotic count ranged in 0~4/10HPF in CMN and 20-35/10HPF in AMN. 2) Immunohistochemistry for vimentin was all positive. Actin, desmin were weakly positive in CMN, but negative in AMN. The findings were consistent with myofibroblastic differentiation in CMN and AMN was considered to be the less differentiated form of CMN. 3) Flow cytometiic analysis showed diploidy in two of two CMNs and two of three AMNs. Only one AMN showed aneuploidy with DNA index of 1.41. %SG2M were 8.1 and 15.9 (mean 12.0) in CMN and 16.9, 32.9 and 19.3 (mean 22.9) in AMN, respectively. We concluded that AMN should be distinguished from CMN, clinicopathologically.

No abstract available.
Lichens* ; Mucinosis, Follicular*

MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes) is one of the mitochondrial encephalomyopathy, A rare disease caused by a disturbance of the mitochondrial chain of respiration. MELAS is confirmed by typical light and electron microscopic findings : "ragged red fibers" by modified Gomori trichrome stain on light microscope and numerous abormal mitochondria on electron microscope. We experienced a boy with the characteristic clinical and pathologic findings of MELAS. Our patient demonstrated bilateral basal ganglia calcifications and infarction at right parieto-occipital and thalamic areas on CT and MR We found that MRI was more sensitive and represented the infarcted lesions better than CT. Detection of cerebral insults of MELAS by MRI is important in making decision on patient treatment and also in predicion of the patient prognosis.
Acidosis, Lactic ; Basal Ganglia ; Brain Diseases ; Child* ; Humans ; Infarction ; Magnetic Resonance Imaging ; Male ; MELAS Syndrome* ; Mitochondria ; Mitochondrial Encephalomyopathies ; Muscular Diseases ; Rare Diseases ; Respiration