Pathogenetic mechanisms of progressive glomerulosclerosis are not clear. We studied the long-term(10 weeks) effects of puromycin aminonucleoside(PAN) in Sprague-Dawley rats with or without uninephrectomy(UN). Compared to rats with PAN injections only, rats with uninephrectomy and PAN injections showed significantly higher serum levels of urea nitrogen(153 +/- 155 mg/dl vs. 16 +/- 4 mg/dl, p<0.01), ceatinine(2.96 +/- 1.21 mg/dl vs. 0.92 +/- 0.36 mg/dl, p<0.01), cholesterol(466 +/- 125 mg/dl vs. 94 +/- 27 mg/dl, p<0.01), and triglyceride(337 +/- 237 mg/dl vs. 111 +/- 36 mg/dl, p<0.05) as well as increased amounts of proteinuria(428 +/- 90 mg/day vs. 136 +/- 130 mg/day, p<0.01). Lesions of focal segmental glomerulosclerosis(FSGS) were more frequently observed in rats with UN and PAN injections than rats with PAN infections only(39.5 +/- 17.2% vs. 4.3 +/- 4.7%, p<0.01). Ultrastructural examination of the glomeruli from rats with UN and PAN injections revealed severe epithelial cell changes including foot process effacement, vaculoar change or pseudocyst formation and focal detachment of epithelial cells from the underlying basement membrane. The results suggest that chronic nephrosis induced by PAN showed functional and morphologic features similar to those of human FSGS. Cytotoxic effect of PAN on the glomerular epithelial cells may be an initiating factor for the development of FSGS. which may be aggravated by some hemodynamic changes induced by uninephrectomy.
Humans ; Rats ; Animals

There have been a few reports suggesting that the imune response to pulmonary tuberculosis provides the appropriate setting for the development of IgA nephropathy (IgAN). To define better the relation between pulmonary tuberculosis and IgAN, we evaluated the prevalence of pulmonary tuberculosis among 386 Korean patients with IgAN. Seventeen cases (4.4%) showed abnormal chest X-ray findings suggestive of pulmonary tuberculosis. Ten patients were male and seven were female. Only one case was a child. Urinary abnormalities were detected during the course of antituberculous medication in 11 patients, and after completion of chemotherapy in 2. Chest abnormalities were noted in the remaining 4 patient after IgAN had been diagnosed. Clinical diagnosis of tuberculosis was made mainly based on the chest X-ray findings, but sputum Acid-Fast Bacilli were detected in one patient and pulmonary granulomo was noted in 2. The patients presented various clinical manifestations such as gross hematuris (5 cases), nephrotic syndrome (5 cases), asymptomatic urinary abnormalities (4 cases) and pyuris (1 case) at time of biopsy. Histologic grading of the glomerular lesions was made with modified Meadow classification (1972): one had grade I lesion, 8 grade II, 5 GRADE III and 3 showed grade IV. Follow-up studies were made in 7 patients. Six showed resolution of urinary abnormalities after completion f antituberculous medication, while one pursued chronic renal failure 20 days after the onset. The above clinical and morphologic features suggest that pulmonary tuberculosis may be partly related to the occurrence of IgAN in some Korean patients.
Child ; Male ; Female ; Humans ; Follow-Up Studies

The echocardiographic results obtained from normal group(910 cases), borderline hypertention group(78 cases), define hypertension group(182 cases) and hypertensive heart disease group(55 cases) in Heart Center, Paik Hospital, Inje Medical College, Pusan, Korea between September 1985, were as followings; 1) LVDeD, 5.94+/-1.07cm in hypertensive heart disease group was significantly increased compared with 4.93+/-0.64cm in normal group, 4.92+/-0.73cm in borderline hypertension group and 4.90+/-0.64cm in define hypertension group. LVSeD, 4.86+/-0.98cm in hypertensive heart disease group was significantly increased compared with 3.24+/-0.58cm in normal group, 3.21+/-0.52cm in definite hypertension group. 2) LVDeV/s, 180.26+/-84.76ml/m2 in hypertensive heart disease group was significantly increased compared with 86.13+/-37.34ml/m2 in normal group, 86.26+/-41.02ml/m2 in borderline hypertension group and 83.78+/-30.86ml/m2 in definite hypertension group, and LVSeV/S, 97.51+/-55.67ml/m2 in hypertensive heart disease group was significantly increased compared with 25.28+/-13.25ml/m2 in normal group, 23.68+/-14.62ml/m2 in borderline hypertension group and 24.02+/-14.36ml/m2 in definite hypertension group. 3) There was no significant differance of SV/S, between 61.50+/-26.02ml/m2 in normal, 63.98+/-30.86ml/m2 in borderline, 63.06+/-22.96ml/m2 in definite hypertension group and 61.82+/-30.67ml/m2 in hypertesive heart disease group. E.F. 44.06+/-9.94% in hypertensive heart disease group was significantly reduced comparing with 71.08+/-8.89% in normal group, while 74.35+/-8.26% in borderline and 73.28+/-8.49% in definite hypertensive was significantly increased. F.S., 17.02+/-5.18% in hypertensive heart disease group was significantly reduced comparing with 34.44+/-6.81% in normal, while 35.64+/-7.62% in borderline and 36.87+/-7.26% in definite hypertension group was significantly increased. 4) VSTh, 1.24+/-0.32cm in hypertensive heart disease group, 1.17+/-0.12cm in definite hypertension group and 1.16+/-0.41cm in borderline hypertension group are significantly increased comparing with 0.99+/-0.21cm in normal group. LVPWTh, 1.01+/-0.27cm in hypertensive heart disease group and 0.90+/-0.21cm in definite hypertension group was significantly increased comparing with 0.79+/-0.16cm in normal group. 5) VSTh was increased in 13.3% of borderline hypertension group, 32.8% of definite hypertension group and 31.6% of hypertensive heart disease group. LVPWTh was increased in 4.4% of borderline hypertensive group, 26.9% of definite hypertension group and 30.2% of hypertensive heart disease group. Symmetrical septal hypertrophy was noted in 5.1% of borderline hypertension group, 20.1% of definite hypertension group and 32.1% of hypertensive heart disease group. Total septal or left ventricular posteior wall hypertrophy was noted in 17(21.8%) of 78 borderline hypertension group, 154(89.8%) of definite hypertension group and 51(93.9%) of 55 hypertensive heart disease group.
Busan ; Echocardiography* ; Heart ; Heart Diseases ; Humans ; Hypertension ; Hypertrophy ; Korea ; Ventricular Function, Left*

BACKGROUND: The angiotensin-converting enzyme(ACE) plays an important role in cardiovascular disease by production of angiotensin and degradation of bradykinin. Cloning of ACE gene revealed an insertion/deletion(I/D) polymorphism according to the presence/absence of a 287 base pair fragment in the 16th intron of ACE gene, and the ACE polymophism was associated with ACE activity. The genotype DD was identified as a risk factor for myocardial infarction in several studies. We analyzed the ACE I/D polymorphism in 62 patients with myocardial infarction and 67 normal subjects. METHODS: Genomic DNA from peripheral blood was amplified by polymerase chain reaction and characterized by three ACE genotypes; two insertion alleles(genotype II), two deletion alleles(genotype DD) and heterogenous alleles(genotype ID). ACE activity was determined by spectrophotometric method utilizing the synthetic substrate. RESULTS: There was no significant difference in ACE polymorphism between patients and normal subjects. But, the frequency of genotype DD was significantly increased in the low-risk group of patients compared with the high-risk group. The multi-vessel disease was more strongly associated with genotype DD, but there was no statistical significance. The ACE activity was strongly associated with ACE polymorphism with the activity being highest in genotype DD. There was no significant difference between patients and control subjects of the same genotype. CONCLUSION: There was no significant difference in ACE polymorphism between patients and normal subjects. The frequencies for genotype II, ID, DD were 0.328, 0.537, 0.134, respectively in normal subjects. There was high frequency of genotype II compared with Caucasians. A deletion polymorphism(genotype DD) may increase the risk for myocardial infarction in lowrisk group, and the serum ACE activity was correlated with three genotypes.
Angiotensins ; Base Pairing ; Bradykinin ; Cardiovascular Diseases ; Clone Cells ; Cloning, Organism ; DNA ; Genotype ; Humans ; Introns ; Myocardial Infarction* ; Polymerase Chain Reaction ; Risk Factors

Several techniques are now avallable for the treatment of fractuers of the shaft of the femur. We must be aware of the advantages, disadvantages and Ilmitation of each if we are to select the proper treatment for each patient. During last decades treatment had been varied markedly from time to time and from place to place. Before Word War II, most fractures of the femoral shaft were treated conservatively either by skeletal traction or by manipulation and immobilization in a spica cast. After medullary fixation was Introduced during that war, it became popular, and until 1960 many surgeons considered it as the treatment of choice for most of these fractures. If the case is properly selected the medullary fixation is almost perfect, provlded no complications develop; convalescence can be shortened and resldual disability can be decreased. We had experienced 14 complications among the 78 cases of Kuntscher nailing from may, 1974, to May, 1980. The results are as follows: 1. We operated 78 cases with Kuntscher nail among the 121 femoral shaft fractures. 2. 14 (17.95%) complications developed among the 78 cases of the Kuntscher nailing. 3. Technical errors were incarcerated nailing with thick nail, too long nail and thin nailing. 4. Early postoperative complications within a year were infection, bendlng, bursitis, angulation and rotation. 5. Late complications after one year were proximal or distal migration and refracture.
Bursitis ; Convalescence ; Femur ; Humans ; Immobilization ; Postoperative Complications ; Surgeons ; Traction

No abstract available.
Blood Platelets* ; Electrophoresis, Polyacrylamide Gel* ; Membrane Glycoproteins* ; Membranes* ; Thrombasthenia*

No abstract available.
Hemangioendothelioma*

No abstract available.
Intestinal Obstruction*

No abstract available.
Acidosis*

Williams syndrome is a progressive and multisystemic disorder. We experienced one case of Willams syndrome which was characterized by elfin facies, mental retardation, diffuse aortic hypoplasia, mitral regurgitation and chronic nonparoxysmal sinus tachycardia. The tachycardia has been managing with beta-blocker successfully. We presented a case of unusual form of Williams syndrome with a reivew of literatures.
Facies ; Intellectual Disability ; Mitral Valve Insufficiency ; Tachycardia ; Tachycardia, Sinus ; Williams Syndrome*