The pathogenetic mechanism of focal segmental glomerulosclerosis (FSGS) is not known. Some authors suggest glomerular hypertrophy may precede the development of FSGS in patients with minimal lesion. It was recently reported that the size of nonsclerotic glomeruli in adults with FSGS is significantly larger than that of cases with minimal lesion. It is not clear whether glomerular hypertrophy observed in adults with FSGS is also seen in children with FSGS. Thus, we have analyzed 37 renal biopsies from children with FSGS by morphometry and the data were compared with 37 renal biopsies from age- and sex-matched patients with minimal lesion. The number of glomeruli submitted for morphometric analysis was 22.6+/-14.2 in cases with FSGS and 30.9+/-11.4 in cases with minimal lesion. Mean glomerular volume (MGV) in FSGS group was significantly larger than that of minimal lesion [(13.1+/-3.9) x10(5) microm3 vs. (10.1+/-1.9) x10(5) microm3, p<0.001]. The relative interstitial volume of renal cortex in patients with FSGS was significantly larger than that of minimal lesion [(0.106+/-0.051) microm3/microm3 vs. (0.029+/-0.012) microm3/microm3, p<0.0001]. In FSGS, the percentage of glomeruli with FSGS was significantly correlated with relative interstitial volume of renal cortex (r=0.79, p<0.0001). As is the case for adult FSGS, MGV of children with FSGS is significantly larger than that of minimal lesion. Thus, the presence of glomerular hypertrophy observed in biopsies with minimal lesion nephropathy seems to be an indication that the coexistent FSGS lesions are undetected due to sampling problems.
Child ; Adult ; Male ; Female ; Humans ; Biopsy

PURPOSE: The purpose of this study was to investigate the effects of upper extremity exercise training on the motor activity, the ADL and the health related quality of life. METHOD: A non-equivalent pretest-posttest design was used. Study subjects were conveniently selected 40 hemiplegic patients(20 experimental subjects, 20 control subjects) who had been enrolled in two community health centers. After biofeedback training the subjects of experimental group were given constraint-induced movement, involving restraint of unaffected U/E in a sling for about 6 hours over a period of two weeks, while at the same time intensively training the affected U/E. Outcomes were evaluated on the basis of motor activity(amount, quality) of plegic side, DL(ADL, IADL) and health related QOL(SF-36). RESULTS: 1. After 2 weeks of treatment, the amount of use and the quality of motor activity of affected U/E were significantly higher in subjects who participated in exercise training than in subjects in the control group. 2. There were no significant differences in ADL and IADL between experimental and control groups. 3. After 2 weeks of treatment. the health related QOL was significantly higher in subjects who participated in exercise training than in subjects in the control group. CONCLUSION: The above results state that the U/E exercise training could be an effective intervention for improving the motor activity and the health related QOL of chronic hemiplegic patients. Long-term studies are needed to determine the lasting effects of constraint-induced movement.
Activities of Daily Living* ; Biofeedback, Psychology ; Community Health Centers ; Humans ; Motor Activity* ; Quality of Life ; Upper Extremity*

Lymphomatoid papulosis, first described by Macaulay in 1558 is a chronic disease characterized by the recurrent self-healing papulonecrotic or nodular skin lision, showing histological features of malignant lymphoma. The clinical course is variable, with rogression to disseminated malignant lymphoma in up to 10-20% of patients. Ki-1 appears to the a representative marker for large cells ir lymphomatoid papulosis and these cells can be detected in l-1 lymphorna, Hodgkins diseasen other disorders with aetivated T cells. However, positive Ki-1 staining is useful for supporting a diagnosis of lymphomatoid papulosis, under the appropriate clinical and histopathologic findings. We report a case of positive lymphomatoid papulosis which is characterized by the typical findings of clinical, histojpathological and immunohistochemica sizdies.
Chronic Disease ; Diagnosis ; Humans ; Lymphoma ; Lymphomatoid Papulosis* ; Skin ; T-Lymphocytes

This study was carried out from 1993 to 1994 in the small industries in Incheon. The objectives of this study was in order to estimate the quitting rate, to identify its relating factors and to propose effective quitting management policy in the small industries. The results were as follows; 1. The quitting rate of 266 study workers was 42.1%(l12 workers). 2. Age, working duration, position, marital status were significant difference between the quitting group and the non-quitting group. 10 the quitting group, mean age was young, working duration was short, general employees and unmarried workers were many compared with the non-quitting group. 3. In the industry characteristics, total assets, total sales, sales per person, establishment duration and occupational health and safety status were significant difference between the quitting group and the non-quitting group. In the quitting group, total assets, total sales and sales per person were little, establishment duration of company was short and occupational health and safety status were poor compared with the non-quitting group. 4. In the quitting group, worker's response to employer's disposal about health and safety was more passive and the relation to employer with employee was significantly poor compared with the non-quitting group. 5. Multiple logistic regression analysis of quitting against family income per person, working duration, relation to employer with employee, occupational health and safety status in industry, worker`s response to employer's disposal about health and safety and sales per person was done. Working duration, occupational health and safety status, worker`s response to empolyer's disposal about health and safety were significant eiplainatory variables for quitting. Above results showed that the quitting rate was high and it was significant difference between the quitting group and non -quitting group according to characteristics of workers and of industries. Especially, it suggested that working duration, occupational health and safety status and worker's response to employers disposal about health and safety were significant quitting factor. Therefore, it should be reflected in the quitting management and the policy of steady employment.
Commerce ; Employment ; Humans ; Incheon* ; Logistic Models ; Marital Status ; Occupational Health ; Single Person

PURPOSE:Chronic autoimmune thyroiditis is the most common thyroid disease in children and adolescents, and also is the most common cause of hypothyroidism in children and adolescents. We studied the clinical manifestations and natural courses of chronic autoimmune thyroiditis in children and adolescents. METHODS:We analyzed retrospectively twenty one children and adolescents who were diagnosed as chronic autoimmune thyroiditis before 15 years of age. The diagnoses were made from July 1997 to February 2004 at Ajou Univesity Hospital. We reviewed the clinical manifestations and thyroid functions of these patients. RESULTS:Nineteen patients were female and two were male. The mean age at diagnosis was 9.95+/-3.1 years, the mean duration of follow up was 23.52+/-22.98 months. At diagnosis, the most common chief complaint was goiter (15 patients/21 patients) and the others were short stature, easy fatigue, cardiac murmur and weight loss. Eighteen patients had goiters at diagnosis. Four had familial history of thyroid disease, Three of them had maternal history of thyroid disease and one had paternal history of thyroid disease. At diagnosis, Seven patients were euthyroid and four patients were hyperthyroid, eighteen patients had antithyroglobulin antibody, seventeen patients had antimicrosomal antibody, fourteen patients had both of them. At last follow-up, eight patients were euthyroid and ten patients were hypothyroid, three patients were hyperthyroid. CONCLUSION: Chronic autoimmune thyroiditis in children and adolescents can have the various important influences on the metabolism including the growth. The clinical manifestations and thyroid functions should be monitored in children and adolescents with chronic autoimmune thyroiditis.
Adolescent* ; Child* ; Diagnosis ; Fatigue ; Female ; Follow-Up Studies ; Goiter ; Heart Murmurs ; Humans ; Hypothyroidism ; Male ; Metabolism ; Retrospective Studies ; Thyroid Diseases ; Thyroid Gland ; Thyroiditis, Autoimmune* ; Weight Loss

Intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) are weakly expressed in normal glomerular cells and vascular endothelial cells, but not in tubules. Granzyme B is a cytotoxic granule present in activated cytotoxic T cells and natural killer cells. To determine the effect of ICAM-1 and VCAM-1 expression and granzyme B-positive cells on histologic grade of rejection, we performed the immunohistochemical study on 19 renal biopsy specimens and one nephrectomy specimen from 14 patients with acute renal allograft rejection using monoclonal antibodies against theses proteins. According to severity of rejection based on Banff classification, three biopsies were classified as borderline, 4 grade I, 12 grade II, and 1 grade III. In all the cases with acute rejection, ICAM-1 and VCAM-1 were expressed in the tubular epithelial cells. The numerical score of ICAM-1 in the tubular epithelial cells was 1.0 in borderline cases, 1.3 0.4 in grade I cases, 2.2 0.8 in grade II cases, and 3.0 in grade III case. The staining intensity of ICAM-1 in the tubular epithelial cells was increased in accordance with histologic rejection grade (P<0.05). The staining intensity of ICAM-1 and VCAM-1 in the renal tubular epithelial cells was increased in accordance with the number of T lymphocytes in the renal parenchyme (r=0.46; P<0.05, r=0.61; P<0.01). The number of granzyme B-positive cells was 6.4 1.6/HPF in borderline cases, 8.1 2.5 in grade I cases, 19.6 11.7 in grade II cases, and 53 in grade III case. The number of T lymphocytes and granzyme B-positive cells was also increased in accordance with histologic rejection grade (P<0.05). These results suggest that ICAM-1 and granzyme B-positive cells may play an important role in the induction of renal allograft rejection and that the grading of severity of these parameters may be useful to predict the prognosis of renal allograft.
Allografts* ; Antibodies, Monoclonal ; Biopsy ; Classification ; Endothelial Cells ; Epithelial Cells ; Granzymes* ; Humans ; Intercellular Adhesion Molecule-1 ; Killer Cells, Natural ; Nephrectomy ; Prognosis ; T-Lymphocytes ; Vascular Cell Adhesion Molecule-1

No abstract available.
Humans ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn ; Jaundice* ; Phototherapy*

No abstract available.
Neurofibromatoses* ; Pseudarthrosis* ; Ulna*

To evaluate the health risk of the workplace environment of a general hospital toward the hospital workers, a questionnaire survey on the perception of risk at the workplace environment and environmental measurements at 27 locations with 240 workers in the hospital were made from October 25th, 1993 to October 30th, 1994. The results were as follows; 1. By the environmental measurements, 86 workers(36%) were found to be exposed to poor or harmful degree of general illumination, 193 workers(80%) were exposed to poor or harmful local illumination, 34 workers(14%) were exposed to poor or harmful degree of thermal condition and l80 workers(75%) were exposed to poor or harmful noise level, but nobody was exposed to poor or harmful dust and toluene concentration. Also nobody was exposed to poor or harmful level of radiation or anticancer/antibiotic agents. 2. The subjective perceptions on the environmental conditions felt by the workers were different from the objective findings by the environmental measurements. The workers underscored the poor illumination state and overscored the dust concentrations. Also workers oversensitized about the thermal condition, the noise level, the radiation level, the toluene concentration and anticancer/antibiotic agents. 3. The sources of noise were the dialogue(179 workers) and the office instruments(131workers). The sources of dust came from the clothes(108 workers) and the building materials(79 workers). 4. The questionnaire survey showed that the 28 workers were exposed to poor or harmful level of the antibiotics, 10 workers to alkali or acid and 6 workers to drug dust in the pharmacy but the above findings could not be proved by the environmental measurements.
Alkalies ; Anti-Bacterial Agents ; Dust ; Hospitals, General* ; Lighting ; Noise ; Pharmacy ; Surveys and Questionnaires ; Toluene

No abstract available.
Esophageal Atresia*