ABSTRACT
BACKGROUND: Modified lipoproteins may be involved in nephro- and glomerulosclerosis. Diabetic nephropathy-like lesions have also been induced in a rat model by glycated and glycoxidized albumin. In cultured rat or human mesangial cells, enhanced cell proliferation and production of mesangial matrix in response to lipoproteins and their modified forms have been demonstrated by [3H]-thymidine incorporation and cell counting assays. But these methods are relatively complex and most of them have used only one or two of the lipoprotein, albumin and their modified forms. METHODS: We investigated the effects of native and modifed lipoproteins, and albumin on cultured human mesangial cell proliferation using non-radioactive colorimetric method by MTS/PMS assay. Lipoproteins added were low density lipoprotein(LDL), high density lipoprotein(HDL), very low density lipoprotein(VLDL), oxidized LDL(oxidation with copper sulfate in vitro) and glycated LDL and we also used albumin, glycated albumin, and interleukin-1beta as a positive control. RESULTS: Interleukin-1beta promoted the proliferation of cultured human mesangial cells up to concentration 20 ng/mL. LDL induced the proliferation of mesangial cells in a concentration-dependent manner up to concentration 100 microgram/mL. HDL and VLDL had no significant proliferative effect. Oxidized LDL caused the proliferation of mesangial cells at low concentration up to concentration 25 microgram/mL. Addition of glycated LDL resulted in a concentration- dependent inhibition of mesangial cells. Albumin and glycated albumin inhibited the proliferation of mesangial cells at low concentration of 100 microgram/mL, but cell growth was increased at higher concentrations. CONCLUSION: We demonstrated the effects of the single and modified proteins on the proliferation of cultured human mesangial cell by relatively simple colorimetric method. Results were almostly identical to those of previous studies obtained by radioactive method or cell counting assay.
Subject(s)
Animals , Humans , Rats , Cell Count , Cell Proliferation , Copper Sulfate , Interleukin-1beta , Lipoproteins , Mesangial Cells , Models, AnimalABSTRACT
PURPOSE:We investigated the incidence and predisposing factors of pulmonary embolism in minimal change nephrotic syndrome(MCNS). METHODS:Lung perfusion scan using 99mTC-MAA were done on 14 patients who were diagnosed to minimal change nephrotic syndrome. Group A; Five patients who had perfusion defects on scan, Group B; Nine patients who had no perfusion defect on scan. Between the two groups, the differences of platelet number, hematocrits, albumin, cholesterol, triglyceride, proteinuria were evaluated. RESULTS:Five patients were found to have perfusion defect consistent with pulmonary embolism(35.7%). However, there were minimal or no respiratory symptoms and signs. In our laboratory studies, the mean proteinuria on admissions was 676+/-31 mg/m2/hr in the group with pulmonary embolism, and 313+/-28 mg/m2/hr in the group without pulmonary embolism. There were more severe proteinuria in group with pulmonary embolism(P<0.05). The mean platelet count at early stage of remission after steroid treatment was 746,600+/-280,000/mm3 in the group with pulmonary embolism, 511,890+/-90,000/mm3 in the group without pulmonary embolism. There were significant difference of platelet count between the two groups(P<0.01). In patients with pulmonary embolism, there were more higher and sustained increasement of platelet count. All cases of pulmonary embolism were treated with dipyridamole(5 mg/kg). In 4 cases the perfusion defects were improved in two weeks, however, one case showed persistent perfusion defect after 1 month. CONCLUSION:Our study suggested that pulmonry embolism might be one of the major complications in childhood MCNS. The occurrence rate was correlated with severity of proteinuria before treatment and sustained increasement of platelet counts in early remission state after steroid treatment. Therefore, the scintigraphic pulmonary perfusion study is mandatory in childhood MCNS, especially in the high risk patients, such as the patients with severe proteinuria and sustained increasement of platelet count.
Subject(s)
Humans , Causality , Cholesterol , Embolism , Hematocrit , Incidence , Nephrosis, Lipoid , Perfusion , Platelet Count , Proteinuria , Pulmonary Embolism , TriglyceridesABSTRACT
Retinal detachment is a rare disease in children but cases of serous retinal detachment due to use of systemic corticosteroids have been reported in and out country. Rhematogenous retinal detachment has developed in a child with oral and steroid pulse therapy due to nephrotic syndrome. He was treated with laser and buckling in right and left eye respectively. Currently he is under observation through the out patient department.
Subject(s)
Child , Humans , Adrenal Cortex Hormones , Nephrotic Syndrome , Rare Diseases , Retinal Detachment , RetinaldehydeABSTRACT
We included 46 children with renal disease who received systemic corticosteroid therapy in our study and examined the correlation between the corticosteroid use and ocular complications. The average age of patients was 9 +/-4 years and the male: female ratio was 17:6. Cases for corticosteroid treatment were nephrotic syndrome in 16, Henoch-Sch ''onlein purpura in 9, MPGN in 9, Ig A nephropathy in 8,and others in 3. The mean duration of corticosteroid therapy was 11 months(1~77), and the mean total dose at the time of examination was 16,259 mg (2,250~61,292). The incidence of cataract formation was 47.8% and all had posterior subcapsular type. The severity of cataract was grade I in 12, grade II in 8,grade III in 1, and grade IV in 1 according to the Crews' classification.The incidence of intraocular pressure above 18 mmHg was 75%, compared to 18 mmHg (2SD) in normal control. There was no significant relation between the total dose of corticosteroid and the cataract formation, the severity of cataract,and the incidence of increased IOP. Also, there was no relation between the duration of therapy and them. In conclusion, We found that the ocular complications in children do not relate with the dose of corticosteroid and the duration of therapy and may be closely related to the individual susceptibility. It is essential to examine the eye carefully and follow up regularly those children who receive the corticosteroid therapy.
Subject(s)
Child , Female , Humans , Male , Cataract , Follow-Up Studies , Glomerulonephritis, Membranoproliferative , Incidence , Intraocular Pressure , Nephrotic Syndrome , PurpuraABSTRACT
PURPOSE: A scoring system could be clinically useful in determining cases in which a throat culture may be omitted or in cases whether antibiotics may be initiated or not. We propose to make a clinical guideline of antibiotics administration in patients with pharyngitis. METHODS: From Apr. 1996. to Mar. 1997, throat cultures were taken from 321 cases (72 cases from Kyung-Hee Medical Center, 249 cases from 3 local pediatric clinics). On the first day of visit, 9 clinical items on a score-card were checked and a tentative diagnosis for streptococcal or non-streptococcal infection was made. These clinical scores were compared with the results of the throat swab cultures. RESULTS: Of 321 cases with pharyngitis, 55 cases (17%) proved to have group A streptococci by throat culture. The positive culture rate of group A streptococci was 18.5% from 3 local pediatric clinics, and 12.5% from Kyung-Hee Medical Center. The positive culture rate of group A streptococci were 40% in above 31 points of score, 31.5% in 29 to 30 points, 20.5% in 27 to 28 points. The sensitivity and specificity of the scoring system using a score at least 28 above points were 71% and 67%, respectively. CONCLUSION: The clinical diagnosis of streptococcal pharyngitis indicates that patients age 5 to 10 years, findings of abnormal pharynx, high fever and no past history of antibiotics use. Further modification of the scoring system for diagnosis of streptococcal pharyngitis should be made to prevent antibiotics abuse and correct diagnosis of pharyngitis.
Subject(s)
Humans , Anti-Bacterial Agents , Diagnosis , Fever , Pharyngitis , Pharynx , Sensitivity and SpecificityABSTRACT
No abstract available.
Subject(s)
Muscular Atrophy, Spinal , Spinal Muscular Atrophies of ChildhoodABSTRACT
Corticosteroids has been used in treatment of wide varieties of disease, but there was no report which related to the effects on cardic function with the long term corticosteroids therapy in children. We had been evaluated 18 patients with nephrotic syndrome who were admitted to department of pediatrics, Kyung Hee University Hospital until March 1987. Also we examined interventricular septal thickness, left ventricular posterior wall thickness and all parts of internal dimension of heart, and cardiac output and STI(Systolic Time Interval) by M-mode and Doppler echocardiography, and compared with body surface matched control group. Result are as follows;age and sex distribution were 4 4/12 to 14 6/12(9.11+/-3.55 years) and 15 males and 3 females. The duration of follow up was from 6 to 132 months(39.28+/-36.12 months). The interventricular septal thickness and left ventricular posterior wall thickness were more thickened in corticosteroids group than those of control. Systolic time interval, the index of left ventricular function, was more increased in corticosteroids group than in control group, but there was no differences in cardiac output between two groups. lthough longterm follow up studies are needed to confirm the cardiac effects of long term corticosteroids therapy, we conclude that long term corticosteroids therapy cause significant hypertrophy of cardiac muscle and periodic evaluation of cardiac function such as noninvasive Doppler echocardiographic studies are mandatory in patients with long term corticosteroids therapy.