To know the correlation between glomerular and tubulointerstitial lesion and to define the characteristics of interstitial inflammatory cell in IgA nephropathy and classified according to WHO classification and graded tubulointerstitial lesion as mild, moderate and severe. Paraffin-embedded 5u sections were stained with UCHL-l, L26 and CD68 antibodies. More than 20 fields were examined in each case under the high power microscopy and the number of positive cells were counted. There was positive correlation between the severity of glomerular and that of tubulointerstitial lesion. The mostcommoninflammatory cells in the interstitiuin were UCHL-l positive cells followed by CD68 and L26 positive cells. As the WHO grade or tubulointerstitial lesion increased, the numbers of positive cells were increased in all three groups. The proportion of UCHL-1 Positive cells were increased in cases with high WHO grade whereas that of L26 positive cells incases with severe tubulointerstitial lesion Proteinuria was correlated with the degree of inflammatory cell infiltration, especially with that of L26 positive cells.

The infant kidney is more vulnerable to infections than the adult kidney. It is common that acute pyelonephritis (APN) during infancy and early childhood manifests growth retardation of kidney, ultimately leading to chronic renal failure. However, little is known about the pathogenesis of renal growth retardation in APN in youth. To understand the mechanism underlying the cortical lesions, urinary tract infection was induced in infant rats. To induce ascending APN, saline solution containing Escherichia coli (ATCC No. 25922) 107 bacteria/ml was infused into the bladder through the 16 gage silicone cannula in three-week-old weaning Sprague Dawley rats (weight 50~60 g, n=66). In the normal control group (n=20), saline was infused. Experimental groups were divided according to the treatment into the APN group (APN without any treatment, n=23) and TRX group (APN with ceftriaxone treatment, n=23). After performing the histopathologic examination, including inflammatory score, fibrosis score, and tubular atrophy score, we measured the apoptosis index in the tubular cells of noninflammatory cortical area at post-infection week 1 and 3 by the in situ TUNEL method. Kidney weight was significantly decreased in the APN group compared with the normal group at postinfection week 1 and 3. In the APN group, tubulointerstitial inflammation with heavy neutrophilic infiltration was found mainly in the upper and lower poles of the kidney in both the first and third week groups. Fibrosis was dominant in the third week of the APN group. However, inflammation and fibrosis were not significantly improved by TRX treatment. The apoptotic index of tubular cells was significantly increased in noninflammatory cortical area in the first week of both APN and TRX groups. It decreased near the normal control value in the third week. TGF-beta1 protein expression was localized in the inflammatory area. There was no TGF-beta1 expression in the tubules of the noninflammatory area. These findings suggest that renal growth retardation in experimentally induced APN in infant rats is related not only with the inflammatory reaction itself but also with the increased apoptosis of tubular cells in noninflammatory area. Ceftriaxone alone does not eliminate the inflammation nor prevent growth retardation effectively.
Adolescent ; Adult ; Animals ; Apoptosis* ; Atrophy ; Catheters ; Ceftriaxone ; Escherichia coli ; Fibrosis ; Humans ; In Situ Nick-End Labeling ; Infant* ; Inflammation ; Kidney ; Kidney Failure, Chronic ; Neutrophils ; Pyelonephritis* ; Rats* ; Rats, Sprague-Dawley ; Silicones ; Sodium Chloride ; Transforming Growth Factor beta1 ; Urinary Bladder ; Urinary Tract Infections ; Weaning

The coronary artery cross sectional area (CSA) is proportional to LV mass. We have measured the cross sectional area of the left and right coronary arteries in patients with ischemic heart disease to see whether it is related to the change in the LV mass. The following results were obtained ; 1) There were no significant difference in mean CSA of coronary arteries and LV mass determined by echocardiography and cineangiography between control and ischemic heart disease. 2) There were significantly increased ratio of left ventricular mass by cineangiogram to CSA of left anterior descending coronary artery in patients with myocardial infarction as compared with control group. 3) A linear relation between LV mass by cineangiogram and CSA of left coronary artery was noted in control group (r=0.53, P<0.05) and ischemic heart disease group (r=0.51, P<0.05). 4) A linear relation between LV mass determined by echocardiography and CSA of left coronary artery was noted in control group (r=0.55, P<0.05).
Cineangiography ; Coronary Vessels* ; Echocardiography ; Humans ; Myocardial Infarction ; Myocardial Ischemia

The diagnosis of painful hips of the children are very difficult in their early stage of diseases. Transient synovitis, Legg-Calve-Perthes' diseas juvenile rheumatoid arthritis and pyogenic hip are very similar in clinical manifestation and plane radiology. But the treatment methods and prognoses are very different, so it is very important to make an accurate diagnosis and differential diagnosis as early as possible. In the above mentioned diseases hip joint effusion is one of common manifestations, so we studied the hip joint effusion by ultrasonography in 49 children with painful hips and also we studied both hips of healthy children to determine the criteria of the normal hip joint. And the results are summerized as follows: l. Ultrasonography was very good method for detection of hip joint effusion. 2. In healthy children, the average bone-to-capsule distance was 2.95mm. 3. In children patients with unilateral painful hip, the average bone-to-capsule distance was 2.96mm, so it was very similar to that of healthy children. 4. The difference more than 2mm between both hips was abnormal. 5. In 49 children with painful hips, over all positive rate was 63.3%.
Arthritis, Juvenile ; Child ; Diagnosis ; Diagnosis, Differential ; Hip Joint ; Hip ; Humans ; Methods ; Prognosis ; Synovitis ; Ultrasonography

Pseudoepitheliomatous, keratotic and micaceous balanitis is a rare distictive clinical entity that represents a histologic spectrum ranging from hypertrophic hyperpalstic penile dystrophy to verrucous carcinoma. This condition is thought to be a malignant growth potential by resistance to treatment and its tendency toward local recurrence. We report two cases with similar clinical presentation of hyperkeratotic plaque and micaceous scaly patches on the glans penis that were compatible with pseudoepitheliomatous, keratotic and micaceous balanitis. Histopathologically, case 1, 48 year-old male was progressed to squamous cell carcinoma and case 2, 78 year-old male, was shown pseudoepitheliomatous hyperplasia without malignant changes.
Aged ; Balanitis* ; Carcinoma, Squamous Cell ; Carcinoma, Verrucous ; Humans ; Hyperplasia ; Male ; Middle Aged ; Penis ; Recurrence

Urinary cytology has become an essential element in the diagnosis and management of transitional cell carcinoma(TCC) of the urinary tract. It has the advantage of being noninvasive, inexpensive, and easily accessible. Besides that it can even detect malignancy when unsuspected at cystoscopy. We report a retrospective review of urine cytology in the diagnosis of 83 TCC cases that underwent 295 cytologic evaluation. All patients had biopsy-proven TCC of the bladder, ureter and renal pelvis. The overall inci- dence of the positive cytology cases was 66.2%. To define the cytologic features of tumor cells, we tried to use three cytologic gradings such as "grade 1", "grade 2", and "grade 3" according to the cytologic degree of anaplastic neoplastic cells. These cytologic gades of TCC were relatively well correlated with the histologic grade and tumor invasiveness. This result suggests that the recognition of characteristic cellular features of TCC can suspect the histologic grade and tumor stage. The false negative TCC cases were 78.9%. They showed severe inflammatory or bloody background and a few neoplastic cells. Therefore, a cautious approach for accurate interpretation, personal experience, and proper fixation and processing could expand the role of urinary cytology.
Cystoscopy ; Diagnosis ; Humans ; Kidney Pelvis ; Nocturnal Enuresis* ; Retrospective Studies ; Risk Factors* ; Thyroid Gland ; Ureter ; Urinary Bladder ; Urinary Tract

We report a case of factitial panniculitis in a 50-year-old female patient who had multiple variable sized subcutaneous nodules on area accessible to the hands and disappeared by only prohibition of habitual skin massage. Histologic findings showed mostly lobular panniculitis with hemosiderin deposits, many foamy histiocytes and pseudomicrocysts.
Female ; Hand ; Hemosiderin ; Histiocytes ; Humans ; Massage ; Middle Aged ; Panniculitis* ; Skin

No abstract available.
Hamartoma*

OBJECTIVE: Non-locking bicortical screw and locking monocortical screw system have usually been used in anterior cervical spine fusion and plating. The purpose of this study is to evaluate the differences in stability and safety between the non-locking bicortical and monocortical screw-plate system. METHODS: The authors reviewed 135 cervical spondylotic patients who underwent anterior cervical fusion from Jan. 1995 through Jun. 2002. The patients were separated into two groups: Group 1. consisted of 68 patients (male: 55, female 13 and mean age: 50.5years) treated with non-locking bicortical screw system, Group 2. consisted of 67 patients (male 50, female 17, mean age: 59.6 years) treated with non-locking monocortical screw system. The mean follow-up duration was 50 months (from 9 to 101 months). A comprehensive evaluation between two groups were made. RESULTS: There were no graft material related complications in both groups. But instrument related complications were 1 case of screw breakage and 1 case of screw loosening in group 1 and 1 case of screw loosening in group 2. Mean time for plate and screw fixation was less required in group 2 than group 1. Fusion had occurred in all patients of both groups. CONCLUSION: Non-locking monocortical screw fixation can be recommended for anterior cervical fusion and plating in degenerative disease, making the procedure quicker, easier, and safer compare with non-locking bicortical screw.
Female ; Follow-Up Studies ; Humans ; Spine ; Spondylosis* ; Transplants

PURPOSE: To examine the renal injury by albumin infusion, which has been widely used to correct severe nephrotic edema, in puromycin aminonucleoside(PAN) induced nephrotic-range proteinuric rats. MATERIALS AND METHODS: Sixty Sprague-Dawley rats were divided into 3 experimental groups, control group(PAN only, n=20), low-dose albumin group (PAN+25% albumin 1g/kg, n=20) and high-dose albumin group(PAN+25% albumin 4g/kg, n=20). PAN was peritoneally injected on day #1 and #7 to all experimental rats and 25% albumin was peritoneally injected from day #3 for three weeks. Twenty-four hour urine protein, serum creatinine and serum albumin were measured weekly. Histopathologic and ultrastructural examination using transmission EM, and immunohistochemical stainings of CD68, pan T, and L26 were done at 3 and 8 week. RESULTS: Twenty-four hour urine proteins at 2 and 3 weeks were significantly increased in high- dose albumin group compared to control and low- dose albumin group. Serum creatinine at 3 week in high-dose albumin group was 0.9+/-0.54mg/dL which was significantly higher than 0.6+/-0.31mg/dL of control group and 0.6+/-0.43mg/dL of low-dose albumin group. Serum creatinine at 8 week in high-dose albumin group was 1.2+/-0.85mg/dL which was significantly higher than 0.6+/-0.24mg/dL of control group and 0.6+/-0.21mg/dL of low-dose albumin group. Serum albumin was not different among groups. Percent(%) glomerular sclerosis at 8 week in high-dose albumin group was 9.4+/-5.8% which was significantly higher than 3.5+/-1.7% of control group. Interstitial mononuclear cell infiltration was increased according to albumin dose and most of them was CD68(+) macrophages. Vacuolar degeneration of podocytes, accumulation of protein reabsorption droplets in the cytoplasm of podocytes and proximal tubule and lipid droplets in the cytoplasm of proximal tubules were increasd according to albumin dose. CONCLUSION: Albumin infusion in PAN induced proteinuric rats load accelerate the decline in renal function by progressive glomerular and tubulo-interstitial injury. Albumin infusion in clinical nephrotic edema shoud be used very carefully.
Animals ; Control Groups ; Creatinine ; Cytoplasm ; Edema ; Macrophages ; Podocytes ; Puromycin Aminonucleoside* ; Puromycin* ; Rats* ; Rats, Sprague-Dawley ; Sclerosis ; Serum Albumin