Human membranous nephropathy (MN) is morphologically characterized by subepithelial immune complex deposits and progressive thickening of glomerular basement membranes (GBM). Studies have suggested that the enhanced secretion of classical and novel type IV collagen chains in MN contributes to spike formation and the novel type IV collagen chain is particularly related to thickening of GBM. It is unclear whether the increased accumulation of extracellular matrix (ECM) proteins in GBM is due to the increased mRNA expression for type IV collagen in glomerular visceral epithelial cells (GECs). To answer this question, we analyzed seven renal biopsies of patients with idiopathic MN using in situ hybridization. In MN, the number of GECs expressing mRNA for alpha1(IV) collagen was 2.82+/-1.80/glomerular cross section (gcs), and the number expressing mRNA for alpha4(IV) collagen was 8.42+/-2.85/gcs. The number of GECs expressing mRNA for alpha4(IV) collagen was significantly larger than that of alpha1(IV) collagen mRNA. The expression of mRNA for these ECM proteins in normal controls was negligible. These results suggest that subepithelial immune complexes stimulate the gene expression of alpha1(IV) collagen and alpha4(IV) collagen in glomerular GECs which, in turn, increase the secretion of ECM proteins and contribute to the thickening of GBM in MN.
Antigen-Antibody Complex ; Biopsy ; Collagen ; Collagen Type IV* ; Extracellular Matrix ; Gene Expression ; Glomerular Basement Membrane ; Glomerulonephritis, Membranous* ; Humans* ; In Situ Hybridization ; Podocytes ; RNA, Messenger*

BACKGROUND: Cardiovascular disease is the major cause of morbidity and mortality. It is well known that androgen and sex hormone-binding globulin(SHBG) in women were associated with risk factors for cardiovascular disease such as obesity, central fat accumulation and atherogenic lipid profile. High resolution B-mode ultrasonography can visualize directly both luminal and vessel wall characteristics, and ultrasonic measurement of carotid intima-medial thickness(IMT) can be used to investigate the atherosclerosis of coronary, cerebral and peripheral arteries. The aim of this study was to evaluate the relationship between the serum dehydroepiandrosterone sulfate(DHEA-S) and SHBG, and body fat distribution pattern, cardiovascular risk factor and carotid atherosclerosis in women. METHODS: Blood pressure, fasting serum glucose, insulin, lipid profile, SHBG and DHEA-S were measured. Body fat distribution pattern was assessed by waist to hip ratio, waist to thigh ratio and subscapular to triceps skin fold thickness ratio, faf mass measured by bioelectric impedance analyzer, subcutaneous fat area, visceral fat area, and visceral to subcutaneous fat area ratio(VSR) at the level of umbilicus using the computed tomography. The IMT of the carotid artery was measured by high resolution B mode ultrasound as a marker of atherosclerosis. RESULTS: 1) There was no significant difference of age-adjusted values of carotid IMT among subjects with NGT(0.426+/-0.09mm), IGT(0.46+/-10.09mm) and NIDDM(0.453+/-0.11mm). 2) In postrnenopausal women, carotid IMT was greater(0.484+/-0.11mm, p=0.05) than premenopausal women(0.426+/-0.08mm), but it was not significant after age adjustment. Serum SHBG and DHEA-S levels in postmenopausal women were significantly lower(p<0.05) than premenopausal women, but they were not significant after age adjustment. 3) Carotid IMT was significantly correlated with age(r=0.37, p<0.01), fasting serum glucose (r=0.32, p<0.01), total cholesterol(r= 0.25, p<0.05), LDL-cholesterol(r=0.26, p<0.05), visceral fat area(r=0.35, p<0.01) and VSR(r=0.31, p<0.05). 4) By the stepwise multiple regression analysis, carotid IMT was positively and significantly associated with age(p<0.01) and serum DHEA-S concentration(p<0.05) in dent of age, body mass index, waist to hip ratio, fasting serum glucose. CONCLUSION: Carotid IMT was associated with age and serum DHEA-S concentration in women without cardiovascular disease. Therefore, serum DHEA-S may be one of risk factors for cardiovascular disease in women. However, we could not conclude its cause-result relationship because of cross sectional nature of our study, and prospective study will be needed.
Arteries ; Atherosclerosis ; Blood Glucose ; Blood Pressure ; Body Fat Distribution ; Body Mass Index ; Cardiovascular Diseases ; Carotid Arteries ; Carotid Artery Diseases* ; Dehydroepiandrosterone Sulfate* ; Dehydroepiandrosterone* ; Electric Impedance ; Fasting ; Female ; Humans ; Insulin ; Intra-Abdominal Fat ; Mortality ; Obesity, Abdominal ; Phenobarbital ; Risk Factors ; Sex Hormone-Binding Globulin* ; Skin ; Subcutaneous Fat ; Thigh ; Ultrasonics ; Ultrasonography ; Umbilicus ; Waist-Hip Ratio

No abstract available.
Endometriosis* ; Female

We report 2 cases of pediatric DNTs which presented with intractable seizures and no other associated neurologic abnormalities. They showed typical appearance of DNTs on neuroimaging and histopathology. Most patients with DNT can be cured by surgical treatment with exellent outcome and do not need ratio- or chemotheraphy. This study indicates that it is quite important to consider DNTs as one of differential diagnoses in patients with intractable seizures especially when they present only with seizures without other neurologic symptoms.
Child* ; Diagnosis, Differential ; Humans ; Neoplasms, Neuroepithelial* ; Neuroimaging ; Neurologic Manifestations ; Seizures*

No abstract available.
Hypertriglyceridemia*

PURPOSE: Interferon is a widely used treatment for chronic hepatitis B in children. However, additional treatment options are needed because more than 50% of hepatitis B patients are unresponsive to interferon. Although lamivudine is widely used to treat hepatitis B, there are few studies on the effect of lamivudine in hepatitis B patients unresponsive to interferon. METHODS: Eight interferon unresponsive patients (6 males and 2 females) were treated with lamivudine (3 mg/kg/day, maximum 100 mg/day) from 6~12 months after interferon treatment was discontinued among 33 children with chronic hepatitis B. They were treated with interferon (interferon alpha-2b, 10 MU/m2 or pegylated interferon 1.5 microgram/kg) for 6 months from January 2000 to December 2007 at the Pusan National University Hospital. The medical records were analyzed retrospectively. RESULTS: The age at treatment with interferon and lamivudine was 4.9+/-3.1 and 6.1+/-3.2 years, respectively. The serum ALT level before treatment with interferon was 148.1+/-105.8 IU/L and the log HBV-DNA PCR mean value was 6.95+/-0.70 copies/mL. The serum ALT level after treatment with interferon was 143.1+/-90.4 IU/L and the log HBV-DNA mean PCR value was 6.46+/-2.08. HBeAg negativization occurred in 2 patients. For all patients, normalization of the serum ALT levels and HBeAg seroconversion (except 2 patients with HBeAg negativization) occurred at 7.4+/-2.1 and 7.9+/-2.1 months respectively after lamivudine treatment. The HBV-DNA PCR became negative in 7 patients (87.5%) at 2.4+/-2.8 months. Complete response was achieved in 7 patients and no recurrence was observed in 2 patients for 3 years after the completion of treatment. Five patients are still under treatment for a mean treatment duration of 24.4+/-9.1 months. In one patient, viral breakthrough occurred and the treatment was stopped. CONCLUSION: The number of patients was small, however, lamivudine treatment in patients with chronic hepatitis B who were unresponsive to interferon was highly effective.
Child ; Hepatitis B ; Hepatitis B e Antigens ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Interferons ; Lamivudine ; Male ; Medical Records ; Polymerase Chain Reaction ; Recurrence

The anatomy of the arteries distributing to the ocular rectus muscles has not been well known inspite of their importance during opertions. Eighty orbits of Koreans were dissected under the surgical microscope to find out the entering point and its distribution of each rectus artery. The average numbers of the branches of the artery that piercing the supenor, lateral, medial, and inferior recti were 4, 7, 7 and 6 respectively. The supenor rectus artery tended to pierce the posterior middle one third of the muscle; the medial and lateral rectus arteries tended to pierce the posterior two thirds of the muscles; and the inferior rectus artery tended to pierce the medial two tbrds of the muscle. The arterial branches piercing the anterior one third of the superior rectus were less than 1%, and those of the lateral, medial, and inferior recti were 5%, 10% and 15% respectively. The relationships between the artery and nerve differed in each muscle.
Arteries* ; Muscles* ; Orbit

Intactness of arterial supplies is necessary for the external ocular muscles to move properly, however the anatomy of the ocular muscular arteries has not been clarified Therefore, 80 orbits of Koreans were dissected under the surgical microscope and the origins of the rectus arteries were observed. The average numbers of the arising site of the artery to the superior rectus, the lateral rectus, the medial rectus, and the inferior rectus were 1.7, 1.2, 2.2 and 1.1, respectively. The superior rectus artery arose from the superolateral muscular artery in 33.3%. The lateral rectus artery arose from the superolateral muscular arterey in 43.8%, from the inferior muscluar artery in 24.8%. The medial rectus artery arose from the inferior muscular artery in 43.1%, from the superomedial musculal artery in 16.8% and from the ophthalmic artery as a solitary branch in 32.9%. The inferior rectus artery arose from the inferior muscular artery in 83.1% and from the inferolateral muscular artery in 13.5%.
Arteries* ; Equipment and Supplies ; Muscles* ; Ophthalmic Artery ; Orbit

The anatomy of the arteries distributing to the ocular rectus muscles has not been well known inspite of their importance during opertions. Eighty orbits of Koreans were dissected under the surgical microscope to find out the entering point and its distribution of each rectus artery. The average numbers of the branches of the artery that piercing the supenor, lateral, medial, and inferior recti were 4, 7, 7 and 6 respectively. The supenor rectus artery tended to pierce the posterior middle one third of the muscle; the medial and lateral rectus arteries tended to pierce the posterior two thirds of the muscles; and the inferior rectus artery tended to pierce the medial two tbrds of the muscle. The arterial branches piercing the anterior one third of the superior rectus were less than 1%, and those of the lateral, medial, and inferior recti were 5%, 10% and 15% respectively. The relationships between the artery and nerve differed in each muscle.
Arteries* ; Muscles* ; Orbit

Intactness of arterial supplies is necessary for the external ocular muscles to move properly, however the anatomy of the ocular muscular arteries has not been clarified Therefore, 80 orbits of Koreans were dissected under the surgical microscope and the origins of the rectus arteries were observed. The average numbers of the arising site of the artery to the superior rectus, the lateral rectus, the medial rectus, and the inferior rectus were 1.7, 1.2, 2.2 and 1.1, respectively. The superior rectus artery arose from the superolateral muscular artery in 33.3%. The lateral rectus artery arose from the superolateral muscular arterey in 43.8%, from the inferior muscluar artery in 24.8%. The medial rectus artery arose from the inferior muscular artery in 43.1%, from the superomedial musculal artery in 16.8% and from the ophthalmic artery as a solitary branch in 32.9%. The inferior rectus artery arose from the inferior muscular artery in 83.1% and from the inferolateral muscular artery in 13.5%.
Arteries* ; Equipment and Supplies ; Muscles* ; Ophthalmic Artery ; Orbit