The thickness of the glomerular basement membrane may vary not only in glomerular disease, but also in normal persons according to age and sex. But there has been no data on the normal thickness of the basement membrane in Korea. This study was designed to determine the glomerular basement membrane thickness as a reference value according to age and sex, in 50 cases of minimal change disease obtained from patients aged 2~67 years. Measurement of glomerular basement membrane was made on electron micrograph using an image analyzer. The thickness of each case was estimated by the arithmetic and harmonic mean methods. The mean thickness of the glomerular basement membrane was 291.9 47.9 nm by harmonic mean method and 284.2 43.7 nm by arithmetic mean method. And the harmonic mean thickness of the glomerular basement membrane according to age was 249.1 32.5 nm (1~5 years), 256.6 45.3 nm (6~10 years), 279.2 57.9 nm (11~15 years), 303.2 43.8 nm (16~20 years), 335.3 37.5 nm (21~30 years), and 291.1 22.5 nm (over 30 years), respectively. There was a trend that the thickness of glomerular basement membranes increased with the age till 30 years of age. There was no significant sex-related difference. In conclusion, the mean glomerular basement membrane thickness is comparable to the data from western people and shows a trend of increasing thickness according to the age.
Basement Membrane ; Glomerular Basement Membrane* ; Humans ; Kidney ; Korea ; Nephrosis, Lipoid* ; Reference Values

We present 9 cases of plexiform schwannoma examined at Severance hospital from January, 1980 to September, 1987. The predilection sites of plexiform schwannoma included head and neck including oral cavity. The mean age at the time of diagnosis was 32 years. The difference of sex ratio was not apparent. Histopathological findings revealed multiple round to oval nodules encapsulated by thin fibroconnective tissue with nuclear palisading and Verocay body in each nodule. There was mild to moderate cellular atypia in some area, but mitotic figure was not found. The Bielschowsky's silver stain did not demonstrate any axon within or outside of the nodule. The thin capsule was positive with reticulin stain.

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.
Amenorrhea* ; Female

Status of margins and the size of the lesion are independent prognostic factors of ductal carcinoma in situ (DCIS). Histologic grading of DCIS and expression of biologic marker also appear to act as prognostic factors. However, DNA ploidy analysis using flow cytometry in the DCIS and atypical ductal hyperplasia (ADH) has been rarely reported, and the biologic behavior of ADH is unknown. We performed immunohistochemical staining and DNA ploidy analysis using flow cytometry on 45 cases of pure DCIS without microinvasion and 34 cases of ADH to compare the expression of biologic markers and DNA ploidy patterns according to the histologic grade of DCIS, to evaluate the usefulness of the Van Nuys classification, and to investigate the biologic behavior of ADH and low grade DCIS. A total of 41.9% of DCIS and 32.1% of ADH were detected mammographically in asymptomatic patients. The most common subtype of the high grade DCIS was comedo type (56.3%), while the low and intermediate grade DCIS were cribriform type. Expression of ER, c-erbB-2 and Ki-67 proliferative index (PI) was significantly associated with nuclear grade and histologic grade of DCIS. Expression of c-erbB-2 was also significantly correlated with presence of necrosis. In low grade DCIS, Ki-67 PI was significantly higher than ADH. A total of 63.6% of DCIS and 70% of ADH were diploidy and 15.9% of DCIS was aneuploidy. There was no aneuploidy in ADH. No significant association was noted between DNA ploidy and histologic grade or nuclear grade. However, in high grade DCIS, the frequency of aneuploidy was high. In conclusion, histologic grading of DCIS employing nuclear grade and necrosis is a useful tool accounting for biologic behavior. High grade DCIS and comedo DCIS impart aggressive biologic behavior and suggest a higher possibility of local recurrence or progression to invasive carcinoma. In the differential diagnosis of ADH and low grade DCIS, the use of Ki-67 PI and DNA ploidy analysis by flow cytometry will be helpful for accurate diagnosis and prediction of biologic behavior.
Aneuploidy ; Biomarkers* ; Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Classification ; Diagnosis ; Diagnosis, Differential ; Diploidy ; DNA* ; Flow Cytometry ; Humans ; Hyperplasia* ; Immunohistochemistry ; Necrosis ; Ploidies* ; Recurrence

Status of margins and the size of the lesion are independent prognostic factors of ductal carcinoma in situ (DCIS). Histologic grading of DCIS and expression of biologic marker also appear to act as prognostic factors. However, DNA ploidy analysis using flow cytometry in the DCIS and atypical ductal hyperplasia (ADH) has been rarely reported, and the biologic behavior of ADH is unknown. We performed immunohistochemical staining and DNA ploidy analysis using flow cytometry on 45 cases of pure DCIS without microinvasion and 34 cases of ADH to compare the expression of biologic markers and DNA ploidy patterns according to the histologic grade of DCIS, to evaluate the usefulness of the Van Nuys classification, and to investigate the biologic behavior of ADH and low grade DCIS. A total of 41.9% of DCIS and 32.1% of ADH were detected mammographically in asymptomatic patients. The most common subtype of the high grade DCIS was comedo type (56.3%), while the low and intermediate grade DCIS were cribriform type. Expression of ER, c-erbB-2 and Ki-67 proliferative index (PI) was significantly associated with nuclear grade and histologic grade of DCIS. Expression of c-erbB-2 was also significantly correlated with presence of necrosis. In low grade DCIS, Ki-67 PI was significantly higher than ADH. A total of 63.6% of DCIS and 70% of ADH were diploidy and 15.9% of DCIS was aneuploidy. There was no aneuploidy in ADH. No significant association was noted between DNA ploidy and histologic grade or nuclear grade. However, in high grade DCIS, the frequency of aneuploidy was high. In conclusion, histologic grading of DCIS employing nuclear grade and necrosis is a useful tool accounting for biologic behavior. High grade DCIS and comedo DCIS impart aggressive biologic behavior and suggest a higher possibility of local recurrence or progression to invasive carcinoma. In the differential diagnosis of ADH and low grade DCIS, the use of Ki-67 PI and DNA ploidy analysis by flow cytometry will be helpful for accurate diagnosis and prediction of biologic behavior.
Aneuploidy ; Biomarkers* ; Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Classification ; Diagnosis ; Diagnosis, Differential ; Diploidy ; DNA* ; Flow Cytometry ; Humans ; Hyperplasia* ; Immunohistochemistry ; Necrosis ; Ploidies* ; Recurrence

BACKGROUND: Renal dysplasia is the abnormal development of the kidney. The condition is usually detected in childhood along with other urinary tract anomalies, but can remain unnoticed until adulthood. It was recently reported that a PAX2 gene mutation plays a major role in the development of renal dysplasia. The aim of this study was to examine the expression of PAX2 in dysplastic kidneys of children and adults. METHODS: A total of 30 cases diagnosed with renal dysplasia after a nephrectomy were examined. PAX2 expression was evaluated using immunohistochemistry. Apoptosis was detected using an Apop Tag detection kit. RESULTS: In the dysplastic kidneys, there was strong PAX2 expression in the epithelia of the primitive ducts in both children and adults, but the degree was significantly lower in adults (p=0.007). However, the mesenchyme surrounding the primitive ducts of children showed stronger staining for the smooth muscle actin antibody and trichrome than the adults. The apoptosis index was significantly higher in the primitive duct epithelia than in the surrounding normal collecting duct epithelia (p=0.000). CONCLUSIONS: PAX2 is overexpressed in the primitive ducts of renal dysplasia, which is sustained until adulthood and is associated with increased apoptosis. However, a decrease in PAX2 expression in the dysplastic epithelia and mesenchymal cuff of adults suggest a gradual regression of the dysplastic elements with time.
Actins ; Adult ; Apoptosis ; Child ; Humans ; Immunohistochemistry ; Kidney ; Mesoderm ; Muscle, Smooth ; Nephrectomy ; Urinary Tract

Drash syndrome, which was first reported by Denys et al. in 1967 is a complex disorder which associates a nephropathy, Wilms' tumor, and male pseudohermaphroditism. The common denominator is a nephropathy. The nephropathy may be associated with either genital abnormalities or Wilms' tumor, and these associations are called incomplete form of Drash syndrome. This syndrome appears early in life and the first sign usually is genital ambiguity. The nephropathy presents with proteinuria, hematuria and hypertension, and eventually progresses to end stage renal failure. Renal biopsy may reveal a variety of glomerular and interstitial changes. Wilms' tumor may appear as s mass on ultrasound or it may not be recognized until nephrectomy or even autopsy. We report on a boy with nephropathy and genital abnormalities. A nephrotic syndrome with hypertension was present when first seen at 15 days of age. The karyotype was 46, XY and external genitalia was ambiguous. The nephrotic syndrome and signs of renal insufficiency persisted and he died at the age of 40 days. Histopathologic findings of kidney at autopsy revealed those of diffuse mesangial sclerosis. The case was presented with brief review of literatures.
46, XY Disorders of Sex Development ; Autopsy ; Biopsy ; Denys-Drash Syndrome* ; Disorders of Sex Development ; Genitalia ; Hematuria ; Humans ; Hypertension ; Karyotype ; Kidney ; Male ; Nephrectomy ; Nephrotic Syndrome ; Proteinuria ; Renal Insufficiency ; Sclerosis ; Ultrasonography ; Wilms Tumor

BACKGROUND: Previous studies suggested that Pityrosporum may play an important role in the pathogenesis of dandruff. OBJECTIVE: Our purpose was to study the statistical and mycobgic findings of dandruff in normal subjects for better understanding of this condition. MEHTODS: Scales frorn the scalp of 384 students were studied stastistically by answer sheets and clinically by a dermatologist. Mycologic studies of Pityrosporum were also performed by direct smear, culture and inoculation to guinea pigs. RESULTS: There were 76.0% subjects with dandruff. Clinically grading the subjects by Kligrnan's scale, grade III and IV(mild caling) were the most. Dandruff developed commonly at the age of 14 to 16, and no seasonal change was observed. Spores of Pityrosporum were observed in all subjects by KOH microscopic examination with Cohens method, and the grading of the dandruff was not related with the number of the spores. In most subjects, P. orbiculare and P. ovae were found together. Positive culture colonies were observed in 93.7%. Inoculation of the cultured colonies to guinea pigs resulted in an experimental dermatitis. CONCLUSION: Our study shows that Pityrosporum may involve in the pathogenesis of dandruff; however, it is still unclear whether Pityrosporum is a main causative agent of dandruff.
Animals ; Dandruff* ; Dermatitis ; Guinea Pigs ; Humans ; Malassezia ; Ovum ; Scalp ; Seasons ; Spores ; Weights and Measures

BACKGROUND: Seborrheic dermatitis is a very common chronic inflammatory disease. Previous studies suggested that, Pityrosporum, lipophilic fungi, may play an important role in the pathogenesis of the disease. OBJECTIVE: The purpose of this study was to investigate the disease clinically and mycologically for better understanding of the pathogenesis. METHODS: Two hundred and one new patient.s with seborrheic dermatitis of the scalp and 67 norrnal subjects were obs!,rved clinically by the dermatologist and studied stat,istically by questionnaires. A mycologic study of Pityrosporum was also performed by direct smear. RESULTS: Among a total of 201 patients wit,h seborrheic dermatitis, 72.6% had pityriasis sicca, 10.5% had pityr iasis steartoides and 16.9% had inflammatory seborrheic dermatitis. On clinical grading by the Kligman.. scale, grade III(slightly scaling) was the most common in the patients and 52.6% of the norma. subjects were below grade II (no scaling). Spores of Pityrosporum were observed in 76.7% of the patients and 91.5% of the normal subjects. The incidence of Pityrosporum was lower particularly in t,he patients with inflammatory seborrheic dermatitis t,han in other pa~tients groups. CONCLUSION: According to the results of the study, it, is difficult to conclude that Pityrosporum is a main causative ager t of seborrheic dermatitis. In addition, it is thought t.hat further studies of the role of Pityrosporum in seborrheic dermatitis are needed.
Dermatitis, Seborrheic* ; Fungi ; Humans ; Incidence ; Malassezia* ; Pityriasis ; Scalp* ; Spores ; Surveys and Questionnaires