Paroxysmal nocturnal hemoglobinuria(PNH) is a rare, acquired disease involving multiple hematopoietic lines. Characteristics of PNH are intrinsic hemolytic anemia, iron deficiency anemia and venous thrombosis. report a case of PNH with characterostoc MR and CT findings. The signal intensity of renal cortex was lower than that of medulla on both T1- and T2- weighted MR imaging. On T2 weighted MR images, the liver showed very low signal intensity but the signal intensity of the spleen was normal. On precontrast CT the attenuation of renal cortex was higher than that of renal medulla and the attenuation of liver was higher than that of the spleen. These findings of MR imaging and CT were the result from the deposition of hemosiderin in the cells of proximal convoluted tubules and transfusional hemosiderosis of liver.
Anemia, Hemolytic ; Anemia, Iron-Deficiency ; Hemoglobinuria, Paroxysmal* ; Hemosiderin ; Hemosiderosis ; Liver ; Magnetic Resonance Imaging ; Spleen ; Venous Thrombosis

Progressive renal fibrosis is considered to be the final common pathway leading to chronic renal insufficiency, however, the mechanism regarding renal fibrosis in renal injury is not well understood. Recently, several kinds of cytokines have been known to be related to fibrosis after renal injury. The interaction between elements regulating fibrogenesis would be better understood by looking at the effect of TGF-beta1 on the synthesis and accumulation of extracellular matrix, especially collagenous proteins. Crescentic glomerulonephritis (CGN) was induced in New Zealand White rabbits by administration of guinea pig anti-GBM IgG after sensitization with guinea pig IgG; and their kidneys were analyzed for the development of crescents and fibrosis through sequential renal biopsies. Serum creatinine levels in a time course progressively increased until day 15. We semi-quantitatively assayed the levels of the expression of alpha1(I) collagen mRNA and TGF-beta1 mRNA factored for GAPDH mRNA using RT-PCR. We observed a progressive interstitial fibrosis and the expression of collagen I both in the cortex and medulla. The effect of repeated renal biopsy itself on pathology and on the expression of alpha1(I) collagen mRNA and TGF-beta1 mRNA in a time course were not significant, but a very mild increase of the expression of alpha1(I) collagen mRNA was noted at day 15. Histology showed a progressive crescent formation and interstitial fibrosis in a time course that roughly paralleled the expression of alpha1(I) collagen mRNA in both cortex and medulla. TGF-beta1 mRNA was hardly expressed at day 0 in cortex as well as in medulla. It was elevated from day 1, peaked at day 7, and then decreased. In medulla, TGF-beta1 mRNA was noticeably expressed at day 1, peaked at day 4, and then decreased. The expression of alpha1(I) collagen mRNA was seen even before inducing CGN. It was gradually and continuously increased until day 15 both in cortex and medulla. These results suggest that the expression of TGF-beta1 mRNA precedes that of alpha1(I) collagen mRNA in the early stage of CGN and has a central role for provoking the accumulation the collagen I, the most representative interstitial extracellular matrix, in the rabbit model CGN induced by anti-GBM antibody. We conclude that the measurement of the expression of TGF-beta1 mRNA and/or alpha1(I) collagen mRNA in a biopsy sample can be a useful predictor for renal outcome.
Animals ; Anti-Glomerular Basement Membrane Disease ; Biopsy ; Collagen ; Creatinine ; Cytokines ; Extracellular Matrix* ; Fibrosis ; Glomerulonephritis* ; Guinea Pigs ; Immunoglobulin G ; Kidney ; Pathology ; Rabbits ; Renal Insufficiency, Chronic ; RNA, Messenger* ; Transforming Growth Factor beta ; Transforming Growth Factor beta1

PURPOSE: This study was conducted to identify ethical climate factors in hospitals and analyze their influence on job satisfaction and organizational commitment. METHODS: A convenience sample of 196 nurses from one national university hospital in J city participated in this descriptive study survey. Instruments included the Ethical Climate Questionnaire, Job Satisfaction Scale, and Organizational Commitment Scale. Cronbach's alpha and factor analysis were done to test reliability and construct validity of the scales. Data were collected from March 15 to March 25, 2013 and analyzed using descriptive statistics, one-way ANOVA, t-test, Pearson correlation, and multiple regression with SPSS/WIN 18.0. RESULTS: Seven ethical climate factors were identified; laws and professional codes, social responsibility, company rules and procedures, self-interest, personal morality, efficiency, and friendship. Factors influencing job satisfaction were friendship (beta=.25), social responsibility (beta=.20), laws and professional codes (beta=.20), and educational level (beta=.27), explaining 37.6% of variance in job satisfaction. Factors influencing organizational commitment included social responsibility (beta=.29), friendship (beta=.27), laws and professional codes (beta=.23), and age (beta=.19), with explanatory power of 44.6%. CONCLUSION: Results can be used as preliminary data for developing new strategies to establish positive ethical climates in hospital environments and thus enhance nurses' job satisfaction and organizational commitment.
Climate ; Friends ; Humans ; Job Satisfaction ; Jurisprudence ; Morals ; Surveys and Questionnaires ; Social Responsibility ; Weights and Measures

NO abstract available.
Glomerulonephritis, IGA* ; Humans ; Immunoglobulin A* ; Lymphocytes* ; RNA, Messenger* ; Transforming Growth Factor beta

No abstract available.
Down Syndrome* ; Myeloproliferative Disorders*

A case of unilateral pulmonary vein atresia with absent right superior vena cava in 9 years-old boy is described with a discussion. Clinical findings were similar to other reports and consisted of hemoptysis, dyspnea and anemia. A chest X-rary revealed irregular vascular marking on left lung fiedld and increased interstitial marking on right upper lung field. The diagnosis could be confirmed with radionuclide perfusion study, MRI scan of heart and great vessels and angiography which demonstrated a small right pulmonary artery, pruned its peipheral branches, stasis of contrast material and nonvisualization of draining righ pulmonary veins. Pneumonectomy, patch angioplasty of diaphargm excision will be necessary.
Anemia ; Angiography ; Angioplasty ; Child ; Diagnosis ; Dyspnea ; Heart ; Hemoptysis ; Humans ; Lung ; Magnetic Resonance Imaging ; Male ; Perfusion ; Pneumonectomy ; Pulmonary Artery ; Pulmonary Veins* ; Thorax ; Vena Cava, Superior*

PURPOSE: This study was performed to identify the characteristic findings of miliary pulmonary tuberculosis on HRCT and to evaluate the usefulness of HRCT by compareson with chest radiographs. MATERIAL AND METHODS: High resolution CT, chest radiographs and medical records were retrospectively reviewed in 10 patients with miliary pulmonary tuberculosis. We analysed the size, distribution and margin of nodules, reticular or ground-glass density, parenchymal lesion, mediastinal lymphadenopathy and pleural effusion on HRCT which were compared with chest radiographic findings. RESULTS: On HRCT, characteristic 1--2mm sized sharp or ill-defined nodular densities were randomly distributed throughout both lungs in all cases. In seven cases, the nodules were evenly scattered, but slightly more in upper lung zone in two cases, and in lower in one case. Only three cases revealed somewhat large and abundant nodules in posterior lung zone. There were findings of ill-defined margin of nodules in three cases, reticular densities in three cases and ground-glass opacity in two cases, all of which were observed within 4 weeks after onset of symptom. In one case, HRCT scan revealed a micronodular pattern in the lung parenchyma, even though chest radiographs of 2 days before were not obviously abnormal. HRCT was better to evaluate the margin of nodule and distribution than chest radiographs in four cases. Focal parenchymal lesion (n=5), pleural effusion(n=4), mediastinal lymphadenopathy(n=6) and ARDS(n=I) were also associated. CONCLUSION: HRCT could suggest a more specific diagnosis of miliary pulmonary tuberculosis with the above characteristic findings in appropriate clinical setting and normal or interstitial pattern of chest radiographs.
Diagnosis ; Humans ; Lung ; Lymphatic Diseases ; Medical Records ; Pleural Effusion ; Radiography, Thoracic ; Retrospective Studies ; Tuberculosis, Pulmonary*

To build and to manipulate clinical data in one of the important works in the hospital. In order to accurately append the data and to quickly find and display the informations as the user need, we developed a software program running on the personal computer. Our system largely consists of four parts; registration of the clinical and departmental data, retrieving tool of articles in the medical journal, collection of special data for clinical survey and display system of the various reports. In our experiences, we consider the key factors for systemic management of clinical rearch data base as the follows; work analysis for data processing, design of data base, coding and classification of basic data and technique of registeration. Of these standarized coding system of the orthopedic diseases appeare to be of it most importance.
Classification ; Clinical Coding ; Humans ; Microcomputers ; Orthopedics ; Running

No abstract available.
Interleukin-6* ; Kidney Transplantation* ; Kidney*

No abstract available.
Arrhythmias, Cardiac*