Phenotypic Transformation of Tubular Epithelial Cells and Fibroblasts Following Unilateral Ureteral Obstruction or Angiotensin II Infusion in the S-D Rat / 소아과

PURPOSE: Unilateral ureteral obstruction(UUO), a well established experimental model of renal injury, gives rise to tubulointerstitial fibrosis, tubular dilatation and cellular atrophy. Angiotensin(ANG) II may take the prime role in the regulation of this response. The objectives in the current investigation were to determine whether the renal response to UUO involves the dedifferentiation of tubular epithelial cells to mesenchymal cells(expressing vimentin, V) whether the response implicates the transformation of fibroblasts to myofibroblasts(expressing alpha-smooth muscle actin, SMA), and whether these responses depend on the action of ANG II or not. METHODS: Unilateral ureteral ligation and sham operations were performed in 12 adult male Sprague-Dawley rats. An additional 18 rats received exogenous ANG II at 50 ng/min or vehicle for one week using an osmotic minipump inserted into the interscapular area. Rats were sacrificed on postoperative day seven or day 14. To know the expression of vimentin(V) and alpha-smooth muscle actin (SMA) proteins, immunohistochemical staining and Western blot assay were done. RESULTS: In immunohistochemical staining, following UUO, V-positive cells appeared markedly in the interstitium and tubular cells within dilated tubules. UUO also markedly increased alpha-SMA expression in the interstitium surrounding dilated tubules. In Western blotting, UUO increased V(five times of Sham) and alpha-SMA(2.5 times of Sham) expression. ANG II infusion increased alpha-SMA significantly(two times of control), but not V expression in Western blotting. CONCLUSION: Phenotypic transformation of fibroblasts to myofibroblasts following UUO may depend on ANG II, but dedifferentiation of tubular epithelial cells may depend on other mechanisms rather than ANG II.

Clinical Analysis of Children with Transitory Minimal Change Nehrotic Syndrome ( MCNS ) to Focal Segmental Glomerulosclerosis ( FSGS )

Mixed squamous cell carcinoma and papillary carcinoma in the thyroid gland is a very rare malignant tumor characterized by rapidly progressive clinical course and radioresistance. A 63-year-oid woman had mixed squamous cell carcinoma and papillary carcinoma in the thyroid gland diagnosed by fine needle aspiration cytology (FNA), and the diagnosis was confirmed by histological examination. She had complained of a fixed, egg-sized mass of the anterior neck with hoarseness for 1 year. The findings of FNA consisted of sheets and clusters of polygonal epithelial cells with hyperchromatic, pleomorphic nuclei and eosinophilic, abundant, laminated cytoplasm. These findings were consistent with squamous cell carcinoma. Also, foci of papillary carcinoma were noted, and the cells exhibited nuclear groovings and intranuclear cytoplasmic inclusions. Total thyroidectomy specimen showed a diffusely infiltrating tumor in the left thyroid which was composed of mixed papillary carcinoma and well-differentiated squamous cell carcinoma. In junction between two components, squamous metaplasia of papillary carcinoma was noted.

Relation between Renal and Scrotal Involvememt in Henoch-Sch nlein Purpura

PURPOSE: Although Henoch-Sch nlein purpura(HSP) has been described in detail, there is a paucity of information describing scrotal involvement and risk factors for renal involvement. This study was performed to evaluate the incidence of scrotal involvement and the relationship between renal and nonrenal involvement, including scrotal involvement. METHODS: We retrospectively reviewed medical records of 164 male children who were diagnosed as HSP at the Department of Pediatrics, Korea University Guro Hospital between January 1985 and December 1997. RESULTS: The incidence of scrotal involvement was 13.4%(22/164), and the mean age of the group of scrotal involvement was significantly younger(5.6+/-1.9 year) than that of the others (P<0.05). One patient was initially seen with scrotal involvement without any other symptoms, another patient, who presented with acute scrotal pain and swelling, turned out to have testicular torsion through laparotomy. Those with scrotal and gastrointestinal symptoms were more likely to be related to renal involvement at acute stage, but there was no statistical difference. Those with scrotal symptoms at acute stage developed nephritis more frequently after 6 months(P<0.05). CONCLUSION: Those with scrotal symptoms at acute stage of HSP should be followed up for at least 6 months.