Urinary Transforming Growth Factor-beta-inducible Gene-h3 in Patients with Glomerular Diseases / 대한신장학회잡지

BACKGOUND: Transforming growth factor-beta (TGF-alpha) has been implicated in the pathogenesis of a number of kidney diseases. However, TGF-alpha is secreted in a latent form requiring extracellular modification to become biologically active. Recently, the activity of TGF-alpha has been assessed by the measurement betaig-h3, a novel TGF-alpha induced gene product. Thus we evaluated the pattern of urinary betaig-h3 expression in various glomerular diseases. METHODS: 64 patients with biopsy-proven primary glomerulonephritis (FSGS 6, HSPN 16, IgAN 20, MPGN I 7, and MesPGN 15), 10 patients with nephrotic syndrome and 12 healthy controls were enrolled in the study. A total 86 subjects (51 males, 59.3% and 35 females, 40.7%, mean age 13.9+/-4.28 years) constituted study population. First morning urine were collected and betaig-h3 in the urine was determined by indirect competitive ELISA (Regen Biotech Inc, Seoul, Korea). RESULTS: betaig-h3 excretion was significantly higher in the urine from patients with HSPN (27.5+/-6.46, p=0.002), with IgAN (40.83+/-12.27, p=0.026), with MPGN I (21.64+/-7.29, p=0.042), MesPGN (26.42+/-6.68, p=0.007). In patients with FSGS (21.65+/-17.12) and minimal change nephrotic syndrome (6.26+/-2.18), mean urinary betaig-h3 excretion was not significant higher than that in control group (3.56+/-0.78). CONCLUSION: Urinary betaig-h3 excretion was high in proliferative renal diseases. However, betaig-h3 excretion was not high in non-proliferative renal diseases.

Clinical Outcomes of Infants with Failure to Gain Weight among Out-patients / 소아과

PURPOSE: The three categories of failure to thrive are based on anthropometric measurements of weight, length, and head circumference for age. Type 1 is a failure to gain weight(FGW) due mainly to malnutrition. This study was performed to observe the clinical outcomes of infants with FGW, Type 1, among out-patients. METHODS: Between October 2002 and July 2003, data from the clinical outcomes of 83 consecutive patients at a Pediatric FGW Out-patients Clinic, all under 2 years of age, with inadequate growth or loss of body weight, was reviewed. This study concentrated on the Type 1 anthropometric category, with emphasis on the organic causes. FGW was defined as a weight loss for over two weeks in infants under 2 years of age. We observed four cases of breast feeding associated also as cases of misconception of diarrhea. RESULTS: Of the 87 cases, the eight most prevalent final diagnoses were gastrointestinal cow milk allergy(32.2%), breast feeding associated(16.1%), misconception of diarrhea(15.0%), lactose intolerance (15.0%), gastroesophageal reflux disease(GERD)(5.7%), laryngomalacia(3.4%), solid foods associated (1.1%), and other organic diseases(11.5%). The period from onset of symptom to diagnosis was 3.9+/-3.3 months, with over three months observed in 49.4% of patients. Although the birth weights were within a 10-90 percentile range in all patients, the body weight on diagnosis was below the 3 percentile in 63.8% of patinets. CONCLUSION: The most prevalent causes of FGW were gastrointestinal cow milk allergy, breast feeding associated, and misconception of diarrhea. The delayed diagnosis of FGW of over three months was frequently observed, and induced serious inadequate growth.

A Case of Bronchiolitis Obliterans Organizing Pneumonia Developed after Treatment of Acute Myelogenous Leukemia (M2) with Chloroma and Retinopathy / 대한소아혈액종양학회지

Chloroma, a tumor consisted of primitive myeloid cells and located in extramedullary tissues, usually develops during or preceding the course of systemic leukemia, particularly acute myelogenous leukemia (FAB M2) with translocation between chromosomes 8 and 21. Leukemic retinopathy which observed rarely in children than adults, generally related to thrombocytopenia and anemia in leukemic patients. Bronchiolitis obliterans organizing pneumonia (BOOP) is unusual clinicopathologic syndrome in association with a variety of causes or conditions, and histologically defined by the presentation of granulation tissue plugs consisting of fibroblasts and collagen within the lumen of the distal air space. We experienced a 12-year old girl who presented with weakness and ocular pain. She was diagnosed with acute myeloid leukemia with chloroma and retinopathy, and treated with chemotherapy (daunomycin, ara-C, thioguanine, etoposide. mitoxantrone, cyclosporin). Five weeks after the chemotherapy, she developed coughing and persistent fever, and diagnosed with BOOP, which resolved completely after prednisolone therapy.