1.Clinicopathologic Analysis of Membranous Glomerulonephropathy.
Seok Hoon JEON ; Moon Hyang PARK
Korean Journal of Pathology 1998;32(6):420-430
Membranous glomerulonephropathy (MGN) is the most common primary cause of the nephrotic syndrome in adults, accounting for about 20% of the cases in most series. MGN is idiopathic in the majority of cases, however approximately 25% of adults have identifiable causes (secondary MGN). To evaluate the clinical and pathologic characteristics of MGN, we reviewed the clinical data and renal biopsies from 141 cases of MGN. The mean age of the patients at biopsy was 43 years old, but patients of all age were seen (range from 3 to 76 years of age). There were 88 males and 53 females. There were 99 idiopathic MGN cases and 42 secondary MGN cases. The associated causes of secondary MGN included hepatitis B infection (18 cases), SLE (10 cases), drugs (4 cases), post-transplantation MGN (5 cases), diabetes mellitus (4 cases), syphilis (1 case) and hepatitis B infection associated with rheumatoid arthritis. The prevalence of histologic stages by Ehrenreich and Churg was as follows. Stage I was 24 cases, stage II was 72 cases, stage III was 35 cases, and stage IV was 9 cases. All patients had proteinuria. Nephrotic syndrome was observed in 39%, edema in 73%, microscopic hematuria in 49%, gross hematuria in 28%, hypertension in 13%, and the serum creatinine level above 1.5 mg/dl was in 13%. Cases with glomerulosclerosis was observed in 45 cases with an increased percentage of glomerulosclerosis in the higher grade. Immunofluorescence (IF) examination showed predominantly granular IgG (118 cases) and C3 (84 cases) stainings along the glomerular capillary wall. In idiopathic MGN, sparse mesangial IF staining was noted up to 10% of the cases. However, mesangial IF staining in SLE was observed in 33%, hepatitis B infection in 28% and diabetes mellitus in 50%. An electron microscopic examination revealed subepithelial electron dense deposits of immune complex in all cases. The prevalence of mesangial and subendothelial electron dense deposit in idiopathic MGN was present in 19% and 6%, respectively. In SLE cases, mesangial and subendothelial deposits were observed in 78% and 56%, respectively. In hepatitis B infection, mesangial and subendothelial deposits were observed in 54% and 69%, respectively. In conclusion, immune deposits in the mesangium are scanty in idiopathic MGN, and if pronounced this should increase suspicion of underlying systemic diseases, such as SLE or other infectious diseases.
Adult
;
Antigen-Antibody Complex
;
Arthritis, Rheumatoid
;
Biopsy
;
Capillaries
;
Communicable Diseases
;
Creatinine
;
Diabetes Mellitus
;
Edema
;
Female
;
Fluorescent Antibody Technique
;
Glomerulonephritis, Membranous*
;
Hematuria
;
Hepatitis B
;
Humans
;
Hypertension
;
Immunoglobulin G
;
Male
;
Nephrotic Syndrome
;
Prevalence
;
Proteinuria
;
Syphilis
2.A Study on the Age-related Changes of Glycosaminoglycan in the Human Skin.
Seung Hoon CHA ; Seok Don PARK
Korean Journal of Dermatology 1997;35(3):499-506
BACKGROUND: The extracellular matrix constitutes the dermis supporting an overlying epidermal lining. A small portion of the cell component includes fibroblasts and mast cells, a large amount of fibrous tissue as struct ural proteins, intra-and extracellular adhesive molecules, and extracellular macromolecules, glyccsarninoglycan(GAG) and proteoglycan make up the dermal connective tissue. GAGs, polysacchavide chains secreted by fibroblasts, are the main macromolecules of the extracellular matrix. GAG chains occupy large amounts of extracellular space and form hydrated gels. The various manifestations observed during the cutaneous intrinsic aging process reflect the age-related changes of dermal connective tissue. OBJECTIVE: This study was directed to observe the age-related changes of GAG in human abdominal skin without the influences of photoaeging. MaTERIALS AND METHODS: The subjects involved in this study were grouped according to the age span of 10 years. A minimum of 3 skin samples were included in each age group. After permission, three to five grams of skin samples without known underlying skin diseases were obtained from the pat,ients who were subjected to open abdominal surgery under general anesthesia. GAGs were extracted and purified by repeated cetylpyridium chloride-ethanol precipitation from each skin sample. The qualitative and quantitative analysis of GAGs was carried out with the action of specific GAG degradirig enzymes. RESULTS: The amount of GAGs per gram skin tissue decreased slowly until the 4th decade and thereafter. A statistically- significant reduction in the amount of GAGs was noted between the age groups of under 10 and that of 51-60. This pattern of decline was similar with tte change of the hyaluronic acid content in gram skin tissue. The content of chondroitin sulfate and heparan sulfate also decreased as a function of ageing. The compositional ratio of GAGs showed no age related changes. The water content measured by acetone dehydration was reduced to a significant level up to the age group of over 30 years. CONCLUSION: These results imply that the wrinkling and laxity of skin during the chronological ageing process reflect the age-related reduction of GAGs and the water content of the skin.
Acetone
;
Adhesives
;
Aging
;
Anesthesia, General
;
Cellular Structures
;
Cetylpyridinium
;
Chondroitin Sulfates
;
Connective Tissue
;
Dehydration
;
Dermis
;
Extracellular Matrix
;
Extracellular Space
;
Fibroblasts
;
Gels
;
Heparitin Sulfate
;
Humans*
;
Hyaluronic Acid
;
Mast Cells
;
Proteoglycans
;
Skin Diseases
;
Skin*
;
Water
3.A Case of Reiter' s syndrome.
Jae Hoon PARK ; Jong Ku KIM ; Seok Don PARK
Korean Journal of Dermatology 1995;33(3):526-533
Reiters syndrome is classically described as the triad of urethritis, coijuctivitis, and arthritis along with the skin manifestation. of keratodermia blenorrhagica, circinate b lanitis and oral ulcetation. Since arthritis is now recognized as the only consistent component, iricr nplete forms consisting of characteristic arthritis associeited with one or more of these features and of dysentery are common, We reported a 48-year-old male who presented with a 3 years histor of significant arthralgia and psoriasiforrn skin involvemeni. He had neither an episode of dysentery not, history of sexual exposure before the onset of symptomes. Showed a correlation with the HLAB 7 tialotype. C-reactive protein levels were significantly elevated. He was treared with corticosteroid, pcycline, methotrexate and indomethacin for about 3 months resulting favorable improvement.
Arthralgia
;
Arthritis
;
C-Reactive Protein
;
Dysentery
;
HLA-B27 Antigen
;
Humans
;
Indomethacin
;
Male
;
Methotrexate
;
Middle Aged
;
Skin
;
Skin Manifestations
;
Urethritis
4.A Case of Acquired Lymphangioma After Open heart Surgery.
Jae Hoon PARK ; Ju Seob KIM ; Seok Don PARK
Korean Journal of Dermatology 1995;33(2):374-378
Lymphangiectasis(=acquirecl lymphangioma) ate dilated lymph caillaris and may be due to the obstruction of the lymphatic circulation from surgery, irradiation, chronic recurrent infection or trauma. The patient was a 5 years old girl who developed a straw-colcre, asymptomatic grouped vesicular mass resembling frog spawn measuring 9 cm in diameter the left axilla and arm, 2 months after the total excision of a previous lymphangiectatic mass. She had a history of previous open heart surgery at 2 years of age. Histopathologic findings showed large, irregularly shaped cysticalation lined by a single layer of endothelium in the superficial dermis. Immunohistochemical stainig showed vimentin positive and negative results in Factor VIII and HLA-DR antigen which was compatible with a lymphatic vessel.
Arm
;
Axilla
;
Child, Preschool
;
Dermis
;
Endothelium
;
Factor VIII
;
Female
;
Heart*
;
HLA-DR Antigens
;
Humans
;
Lymphangioma*
;
Lymphatic Vessels
;
Thoracic Surgery*
;
Vimentin
5.Infantile Acute Hemorrhagic Edema of the Skin.
Jong Gu KIM ; Jae Hoon PARK ; Seok Don PARK
Korean Journal of Dermatology 1995;33(6):1143-1147
Infantile acute hemorrhagic edema of the skin(IAHE) is a benign disease which affects infants between 4 months and 2 years of age and is characterized by palpable ecchymotic purpura and edema on the limb and face. We report a typical case of IAHE, which was presenting a cockade, annular, reticulated, and iris-like purpura and edema on the face and extremities in a 19-month-old male infant. We consider it to be a new disease category because its characteristics different markedly from HenochSchoenlein purpura in several clinical and histopathologic findings.
Edema*
;
Extremities
;
Humans
;
Infant
;
Male
;
Purpura
;
Skin*
6.A Case of Congenital Hypofibrinogenemia.
Ji In PARK ; In Seok LIM ; Chul Ha KIM ; Byoung Hoon YOO
Journal of the Korean Pediatric Society 1990;33(7):1009-1011
No abstract available.
7.Combination Therapy with Griseofulvin and Immunotherap (DNCB, DPCP)on Plane Warts.
Sang Won JEONG ; Seung Hoon CHA ; Seok Don PARK
Korean Journal of Dermatology 1999;37(3):320-324
BACKGROUND: Although several kinds of treatment methods(destructive therapy, immunotherapy, etc) for plane warts have been attempted but there have been no entirely satisfactory treatments, because the plane wants are seen to recur frequently. OBJECTIVE: This study was aimed to evaluate the combination therapy of griseofulvin and immunotherapy(dinitrochlorobenzene=DNCB, diphenylcycloprope none=DPCP) on plane warts. METHOD: Sixteen patients(age range, 9 to 41; mean age, 21.8 years) with VPJ were treated with the combination therapy with griseofulvin(500mg/day) and single contact immunotherapy(DNCB or DPCP).
Dinitrochlorobenzene
;
Griseofulvin*
;
Immunotherapy
;
Warts*
8.Usefulness of 201Tl Myocardial Perfusion SPECT in Prediction of Left Ventricular Remodeling following an Acute Myocardial Infarction.
Seok Nam YOON ; C H PARK ; Kyung Hoon HWANG
Korean Journal of Nuclear Medicine 2000;34(1):30-38
PURPOSE: We investigated the role of myocardial perfusion SPECT in prediction of ventricular dilatation and the role of revascularization including thrombolytic therapy and PTCA in prevention of ventricular dilatation after an acute myocardial infarction (AMI). MATERIALS AND METHODS: We performed dipyridamole stress, 4 hour redistribution, and 24 hour reinjection Tl-201 SPECT in 16 patients with AMI two to nine days after attack. Perfusion and wall motion abnormalities were quantified by perfusion index (PI) and wall motion index (WMI). Left ventricular ejection fraction (LVEF), WMI and ventricular volume were measured within 1 week of AMI and after average of 6 months. According to serial changes of left ventricular end-diastolic volume (LVEDV), patients were divided into two groups. We compared WMI, PI and LVEF between the two groups. Relationships among degree of volume, stress-rest PI, WMI, CKMB, Q wave, LVEF and revascularization were analysed using multivariate analysis. RESULTS: Only initial rest perfusion index was significantly different between the two groups (p<0.05). While initial LVEF, stress PI, CKMB, trial of revascularization procedure, presence of Q wave and WMI were not significantly different between the two groups. Eight of 16 patients (50%) showed LV dilatation on follow-up echocardiography. Three of 3 patients (100%) who did not undergo revascualrization procedure documented LV dilatation. And only 5 (38%) of the remaining 13 patients who underwent revascularization revealed LV dilatation. There was no difference in infarct location between the two groups. By multivariate linear regression analysis in patients only undergoing revascularization, rest perfusion index was the only significant factor. CONCLUSION: Myocardial perfusion SPECT performed prior to revascularization was useful in prediction of LV dilatation after an AMI. Rest perfusion index on myocardial perfusion plays as a significant predictor of left ventricular dilatation after AMI. And revascularization appears to be a valuable procedure in alleviating LV dilatation after AMI with or without viable myocardium in a limited number of patients studied retrospectively.
Dilatation
;
Dipyridamole
;
Echocardiography
;
Follow-Up Studies
;
Humans
;
Linear Models
;
Multivariate Analysis
;
Myocardial Infarction*
;
Myocardium
;
Perfusion*
;
Retrospective Studies
;
Stroke Volume
;
Thrombolytic Therapy
;
Tomography, Emission-Computed, Single-Photon*
;
Ventricular Remodeling*
9.A Case of Irritant Dermatitis due to Pulsatilla Koreana.
Ju Seob KIM ; Seung Hoon CHA ; Seok Don PARK
Korean Journal of Dermatology 1997;35(2):339-343
Pulsatilla koreana is a member of the buttercup familly(Ranuculaceae) which contains the unsaturated lactone, protoanemonin(C3H4O2), formed after injury to the plant by the breakdown of the glycoside ranunculin. It has been prescribed as a herbal medicine or a folk medicine for antipyretic, analgesic, anti-inflammatory, astringent and hemostatic effects in Korea. A 20 year-old famale patient presented with confluent vesicobullae on the erythematous base with a burning sensation on her upper back. This was caused by contact with crushed Pulsatilla koreana, a folk medicine for the treatment of left facial nerve palsy, that had occurred 10 days before her visit. A provocation patch test with Pulsatilla koreana upon a heathy male volunteers upper back showed strong positive reactions with the stalk and leaf in fresh and frozen stat.e and after thaw ing resptively. However no reaction was seen when the folk medicine was used in a dried form or with the root in any state. This case indicates that misadvice and ignorant folk remedies could cause misfortunate results to innocent people.
Burns
;
Dermatitis, Irritant*
;
Facial Nerve
;
Herbal Medicine
;
Humans
;
Korea
;
Male
;
Medicine, Traditional
;
Paralysis
;
Patch Tests
;
Plants
;
Pulsatilla*
;
Sensation
;
Volunteers
;
Young Adult
10.Changes of Serum Cytokines ( TNF-alpha, IL-beta, IL-6 ) in Toxemic Mice Induced by Vibrio vulnificus Cytolysin.
Seok Don PARK ; Ju Seob KIM ; Seung Hoon CHA
Korean Journal of Dermatology 1998;36(1):23-29
BACKGROUND: Cytokines such as TNF-a, and IL-1, 6, 8 are thought to mediate many host responses in patients with sepsis through the release of many kinds of inflammatory mediators. Vibrio vulnificus is a virulent, halophilic, marine, and Gram-negative bacterium causing wound infections or primary sepsis with fulminant course. It has been known to produce many exocellular factors, such as cytolysin and exozymes, which are possible causes of shock and tissue damage. OBJECTIVE: Our purpose was to investigate the changes of cytokines(TNF-a, Il-l p, and IL-6) after intravenous administration of V. vulnificus cytolysin which have known to be a major virulent factor for elucidating pathogenesis of septic shock. METHODS: After administration of V. vulnificus cytolysin(20 hemolytic units) and physiologic saline through a mouse tail vein, we obtained blood samples from the heart according to a time course(0, 30, 60, 90, 120, 240, and 360 minutes). We measured serum concentrations of circulating TNF- a, IL-1 p, and IL-6 using commercially available immunoassay kits. RESULTS: The serum concentration of TNF- a peaked at 60 min (1894 pg/ml, as compared with 829 pg/ml after saline administration), began to decrease at 90 min and fell to baseline at 360min. Concentration of IL-6 rose significantly at 90 min(>3,839 pg/ml) and began to decrease at 120 min, whereas the level of IL-1 0 increased slightly and the peaked around 90min(117 pg/ml) after the cytolysin injection. CONCLUSION: We conclude that the host response to cytolysin is associated with a brief pulse of circulating cytokines in the early stage of sepsis caused by V. vulnipcus infection.
Administration, Intravenous
;
Animals
;
Cytokines*
;
Heart
;
Humans
;
Immunoassay
;
Interleukin-1
;
Interleukin-6*
;
Mice*
;
Perforin*
;
Sepsis
;
Shock
;
Shock, Septic
;
Tumor Necrosis Factor-alpha*
;
Veins
;
Vibrio vulnificus*
;
Vibrio*
;
Wound Infection