10 cases of tuberculosis of the greater trochanter of the femur were treated at the Department of Orthopedic Surgery, Seoul National University Hospital from Jan. 1964 to Jun. 1971 with following results; 1) Duration of onset was more than 2 years in 7 cases and tuberculous foci of other organ were noted in 4 cases. 2) Bony destruction on the greater trochanter was observed in all cases and marked synovial thickening was combined in 4 cases. 3) Radical curettage or resection of bony focus of the greater trochanter were carried out in all cases with excellent result except 1 case in which reoperation was necessary 4 years later.
Curettage ; Femur ; Orthopedics ; Reoperation ; Seoul ; Tuberculosis

In order to determine the contamination status of contact lens care system by Acanthamoeba, a nation-wide survey was carried out for the detection of amoeba from the storage cases and contact lenses solution of 739 asymptomatic lens wearers (238 male and 501 female). Subjects consisted of 280 residents in Youngnam, 270 in Honam, and 189 in Chungbu provinces. Acanthamoeba was demonstrated from 141 (19.1%) lens care systems. No significant difference of contamination status was observed between male (19.7%) and female (18.8). However, the contamination rate from Honam province (28.1%) were significnatly higher than those from Youngnam (16.1%) and Chungbu (10.6%) provinces. The isolation rate for Acanth-amoeba was higher in systems of daily wear soft lens (20.0%), extended wear soft lens (23.1), and hard lens (18.8%) than in system of disposable lens. The contamination rate was the higher in the sysems using chemical disinfection alone (19.8%) for disinfection. The contamination rate in systems of combined disinfection with chemicals and intermittent boiling ranged 7.0% to 8.3%, and it was different according to the boiling frequency a week. More attention should be paid to hygeneic maintenance of contact lens care system for the prevention of contact lens-related Acanthamoeba keratitis.
Acanthamoeba Keratitis ; Acanthamoeba* ; Amoeba ; Contact Lenses ; Disinfection ; Female ; Humans ; Korea* ; Male

At Il Sin Women's Hospital from January 1st to June 30th 1978 there were 463 preterm deliveries(Less than 38 weeks Gestation). 161 of these were between 28-36 weeks gestatin. To study the effect of Dexamethasone in preventing respiratory distress syndrome(R.D.S.) 39 mothers received Dexamethasone before delivery and 85 comparable babies were placed in the control group. 1. R.D.S. was seen in 4(10%) of the treatment group and 12(14%)of the control group. In the control group there is a slightly higher incidence but as the bumbers are small it is difficult to compare with western countreis 2. When comparing the 2 groups the incidence of R.D.S. is greatest in less than 32 weeks gestation. 3. Apgar Scoring is similar in both groups. 4. When Dexamethasone was given for greater than 48 hours the incidence of R.D.S. was less 5. Mortality rate is 10% in treatment group and 24% in control group but majority of deaths are due to severe birth hypoxia or very low birth weight (less than 1000 Gms) 6. The overall incidence of R.D.S. in Il Sin Women's hospital was 29 during the 6 months. This is 0.9% of all livebirths and 6.2% of preterm births being low compared with western countries.
Anoxia ; Dexamethasone* ; Humans ; Incidence ; Infant, Very Low Birth Weight ; Mortality ; Mothers ; Parturition ; Pregnancy ; Premature Birth

PURPOSE: Growing data on the relationship between cytokine expression and the progression of renal diseases make these cytokines potential targets for therapeutic interventions. Weexamined the helper T1-cell- and macrophage-associated cytokines in anti-glomerular basement membrane (GBM) antibody-induced nephritis in mice and their temporal relationships with renal tissue fibrosis. METHODS: Kidneys were harvested on days 1, 3, 7, 11, and 16 after glomerulonephritis was induced with anti-GBM antibody. The progression of renal fibrosis was serially monitored to quantitate the accumulation of cortical extracellular matrix, and various cytokines were measured simultaneously. RESULTS: A single injection of anti-GBM antibody successfully produced severe crescentic glomerulonephritis. Proteinuria increased abruptly and both mesangial matrix expansion and interstitial fibrosis progressed rapidly. Cortical fibronectin and type III collagen increased continuously, reaching a peak on day 7, and the deposition of type III collagen followed the same pattern, in parallel with that of urinary transforming growth factor 1 (TGF-1) expression. Serial cytokine measurements revealed a sustained increase in interleukin (IL) 6 and monocyte chemoattractant protein 1 (MCP1) from day 3, but neither IL12, IL18, nor interferon changed significantly. Real-time polymerase chain reaction confirmed these features at the transcription level. CONCLUSION: MCP1 and IL6 correlated with the progression of renal fibrosis, with no increase in Th1- inducing cytokines. This confirms MCP1 and IL6 as attractive therapeutic targets for renal fibrosis in crescentic glomerulonephritis.
Animals ; Anti-Glomerular Basement Membrane Disease ; Autoantibodies ; Basement Membrane ; Chemokine CCL2 ; Collagen Type III ; Cytokines ; Extracellular Matrix ; Fibronectins ; Fibrosis ; Glomerulonephritis ; Interferons ; Interleukin-12 ; Interleukin-18 ; Interleukin-6 ; Interleukins ; Kidney ; Mice ; Nephritis ; Proteinuria ; Real-Time Polymerase Chain Reaction ; Transforming Growth Factors

Tubulointerstitial nephritis and uveitis (TINU) is a rare syndrome of unknown etiology involving the kidney and the eye. This is the first case report of TINU in Korea. The diagnosis of TINU was confirmed in a 15-year-old girl on the basis of pathologically proven tubulointerstital nephritis and bilateral uveitis. Although the renal symptoms disappeared spontaneously, uveitis showed only partial response to topical steroid treatment and persisted for more than 11 months. TINU should be included in the differential diagnosis of tubulointerstitial nephritis of unknown etiology.
Adolescent ; Diagnosis ; Diagnosis, Differential ; Female ; Humans ; Kidney ; Korea ; Nephritis ; Nephritis, Interstitial* ; Uveitis*

The pathogenesis of IgA nephropathy and acute poststreptococcal glomerulonephritis is not fully understood. In the past, acute poststreptococcal glomerulonephritis was the most common cause of gross hematuria in children, but now IgA nephropathy is the most common one. We experienced two cases of acute poststreptococcal glomerulonephritis superimposing to IgA nephropathy in boys. Case 1 had upper respiratory infection before elevation of anti-streptolysin O, generalized edema, gross hematuria and proteinuria. The complement levels were normal. Electron microscopic findings of renal biopsy at ten days after onset showed a few big subepithelial 'humps' and localized heavy subendothelial and mesangial deposits. Immunofluoroscopic findings revealed predominant IgA deposition in the mesangium. The electron microscopic findings were diagnostic of acute poststreptococcal glomerulonephritis. On the other hand, immunoflorescence microscopic findings were compatible to IgA nephropathy. In case 2, the renal biopsy which was done 2 years after onset showed only finding of IgA nephropathy. To our knowledges, there has been few reports of acute poststreptococcal glomerulonephritis superimposing to IgA nephropathy which was confirmed by renal biopsy. We report two cases of acute poststreptococcal glomerulonephritis superimposing to IgA nephropathy with a brief review of the literatures.
Biopsy ; Child ; Complement System Proteins ; Edema ; Glomerulonephritis* ; Glomerulonephritis, IGA* ; Hand ; Hematuria ; Humans ; Immunoglobulin A* ; Proteinuria

BACKGROUND: Pyelonephritis is one of the major causes of chronic renal failure in children, and the transforming growth factor-beta1 (TGF-beta1) is a molecule with pivotal roles in fibrogenesis. This study was performed to investigate the alteration and clinical implications of urinary TGF-beta1/creatinine ratio in children with acute pyelonephritis. METHODS: Urine was collected from 67 normal children and 25 children with acute pyelonephritis. After routine urinalysis, urine TGF-beta1 was quantitated by ELISA method and creatinine was measured by alkaline picrate method. Urinary TGF-beta1/ creatinine ratios in children with pyelonephritis were compared with those of age-matched controls, and sequential changes of the ratios in pyelonephritic children were traced after antibiotic treatment. Correlation of urinary TGF-beta1/creatinine ratio with the degree of pyuria and renal scar was analyzed each. RESULTS: Neonates showed higher urinary TGF-beta1/creatinine ratios than older children. The ratio increased in acute pyelonephritis and gradually returned to the control level two days after antibiotic treatment. Urinary TGF-beta1/creatinine ratio in acute pyelonephritis was not correlated with the degree of pyuria and renal scar. CONCLUSION: The age should be considered in evaluation of urinary TGF-beta1/creatinine ratio in children. The ratio increases in acute pyelonephritis, and is independent of the degree of pyuria or renal scarring.
Child ; Cicatrix ; Creatinine ; Enzyme-Linked Immunosorbent Assay ; Humans ; Infant, Newborn ; Kidney Failure, Chronic ; Pyelonephritis* ; Pyuria ; Transforming Growth Factor beta1 ; Urinalysis

OBJECTIVE: The purpose of this study is to investigate the clinical characteristics of cerebral venous thrombosis (CVT) in a single center in Korea. METHODS: A total of 36 patients were diagnosed with CVT from August 2005 to May 2013. The patient data regarding age, sex, disease stage, pathogenesis, location, laboratory findings, radiological findings, and treatment modalities were retrospectively collected. The results were compared with those of previous studies in other countries. RESULTS: The patient group comprised 21 men and 15 women with a mean age of 46.9 years (ranging from three months to 77 years). The most common cause was a prothrombotic condition (8 patients, 22.2%). Within the patient group, 13 patients (36.1%) had a hemorrhagic infarction, whereas 23 (63.9%) had a venous infarction without hemorrhage. By location, the incidence of hemorrhagic infarction was the highest in the group with a transverse and/or sigmoid sinus thrombosis (n=9); however, the proportion of hemorrhagic infarction was higher in the cortical venous thrombosis group (75%) and the deep venous thrombosis group (100%). By pathogenesis, the incidence of hemorrhagic infarction was the highest in the prothrombotic group (n=6), which was statistically significant (p=0.016). CONCLUSION: According to this study, CVT was more prevalent in men, and the peak age group comprised patients in the sixth decade. The most common cause was a prothrombotic condition. This finding was comparable with reports from Europe or America, in which CVT was more common in younger women. Hemorrhagic infarction was more common in the prothrombotic group (p=0.016) than in the non-prothrombotic group in this study.
Americas ; Colon, Sigmoid ; Europe ; Female ; Hemorrhage ; Humans ; Incidence ; Infarction ; Korea ; Male ; Retrospective Studies ; Sinus Thrombosis, Intracranial ; Venous Thrombosis*

Here we report two cases of isolated diffuse mesangial sclerosis (IDMS) with early onset end-stage renal failure. These female patients did not show abnormalities of the gonads or external genitalia. Direct sequencing of WT1 PCR products from genomic DNA identified WT1 mutations in exons 8 (366 Arg>His) and 9 (396 Asp>Tyr). These mutations have been reported previously in association with Denys-Drash syndrome (DDS) with early onset renal failure. Therefore we suggest that, at least in part, IDMS is a variant of DDS and that investigations for the WT1 mutations should be performed in IDMS patients. In cases with identified WT1 mutations, the same attention to tumor development should be required as in DDS patients, and karyotyping and serial abdominal ultrasonograms to evaluate the gonads and kidney are warranted.
Base Sequence ; DNA/chemistry/genetics ; DNA Mutational Analysis ; Fatal Outcome ; Female ; Glomerular Mesangium/*pathology ; Humans ; Infant ; Infant, Newborn ; *Mutation ; Nephrosclerosis/*genetics ; WT1 Proteins/*genetics

Anatomical information of the circle of Willis is important in evaluating the various cerebrovascular diseases and surgical procedures. In this study, we present the anatomical structures of the circle of Willis in 54 Korean adults. The authors observed the morphological characteristics of the vasculature, the incidence of deficiency or incompleteness in the circle and clinical considerations. Measurements of the outer diameter and the length of each arterial segments were performed. Number and the origin of perforators from individual arteries were also oserved. Results of this study were as followings. Normal circles of Willis was oserved in 35 cases(64.81%) and abnormal circles in 19 cases(35.9%). 2) Incidental detection of aneurysms occurred in 5 cases(9.26%). 3) Frequency of anomalies were most commonly observed in the anterior communicating arteries(N=16, 20.37%). 4) A string-like artery was most frequently observed in te post-erior communicating artery(N=11, 20.37%). 5) Anomalous origin of the P1 segment of the posterior cerebral artery was observed, fetal type was in 12 cases(22.2%) and transitional typ was in 3 cases(5.55%) respectively. 6) The longest artery was the A1 segmnt of the anterior cerebral artery;the second, posterior communicating artery;the third, P1 segment of the posterior cerebral artery;and the shortest, anterior communicating artery. 7) The outer diameters of the basilar artery and internal carotid artery were almost, equal, A1 segment was half of ICA, AcoA was two thirds of A1 segment, PcoA was half of P1 segment and P1 segment was two thirds of the basilar artery. There were difference the anterior and posterior portion of the circle Willis. In the anterior communicating arteries, duplicated structure were frequently found. And also, inequality in the outer diameter of both A1 segmnts was observed. String-like arteries were often revealed in the posterior communicating arteries. Anomalous origin of P1 segments that may be persistant embryonic derivatives were frequently demonstrated in posterior cerebral arteries.
Adult* ; Aneurysm ; Arteries ; Basilar Artery ; Carotid Artery, Internal ; Circle of Willis* ; Humans ; Incidence ; Posterior Cerebral Artery ; Socioeconomic Factors