Comparison between Osteopontin Expression and Renal Function in Spontaneous Renal Failure Model / 대한신장학회잡지

Tubuolointerstitial inflammation and tubular injury account for most types of glomerulonephritis. The injury is characterized by an infiltration of mononuclear cells with atrophy and dilation of tubules and increased deposition of collagen in the interstitium. Despite the fact that the degree of tubulointerstitial injury in glomerular diseases may be the best predictor of overall outcome, the pathogenic mechanism by which the tubular injury develops remains unknown. Osteopontin, a highly acidic, phosphorylated, secreted glycoprotein, is up-regulated in renal cortex in many experimental models of tubulointerstitial fibrosis. In this study, we examined the expression of osteopontin in tubulointerstitium in experimental renal failure mouse, FGS/KIST. Mice were assigned three groups and sacrificed at 1 month, 2 months, and 3 months, in each. Proteinuria, GFR, the degree of tubulointerstitial inflammation, tubular atrophy, glomerulosclerosis and osteopontin expression were measured. Three-month-old group showed severely decreased GFR and marked tubulointerstitial inflammation and glomerulosclerosis compared with other groups. The expression of osteopontin increased with the severity of tubulointerstitial injury. These data suggest that osteopontin may act as a chemotactic or adhesive factor in the recruitment of the monocyte/macrophages and have a role in the pathogenesis of the tubulointerstitial injury.

A Case of Membranous Nephropathy Improved by Removal of Early Gastric Cancer / 대한신장학회잡지

The nephrotic syndrome in association with extrarenal malignancy is not an uncommon event. The membranous nephropathy is most frequently associated with various carcinomas of the lung, breast, stomach and colon. Though the exact causal relationship has not been determined completely, deposition of the immune complexes composed of antitumor antibody and tumor antigens in the subepithelium is most favorably accepted. We experienced a patient with previously diagnosed membranous nephropathy and subsequently demonstrated early gastric cancer during patient follow-up. After surgical resection proteinuria improved significantly. All physicians are strongly recommended to examine thoroughly and search carefully for possibility of concomitant occult malignancy when an aged patient, especially over 40 years old, is diagnosed as a nephrotic syndrome.

A Case of Mesenteric Fibromatosis after Appendectomy / 대한내과학회지

Mesenteric fibromatosis is a rare nonmetastasizing fi brous tumor, characterized by fibroblastic proliferation without evidence of inflammatory response or definite neoplasia. It appears at any age, but mainly in the second to fifth decades as incidence of two to four desmoid tu mor cases per 1 million people per annum. It is pseudoen capsulated and locally invasive and has a tendency to recur, but metastases are rare. It is more frequent with Gardner's syndrome(adenomatosis coli) in which 50% of them will appear as mesenteric fibromatosis. Trauma, especially that of previous surgery, has been associated with the subsequent development of desmoid tumor. The treatment of choice is a wide margin resection of the tumor. we experienced a case of mesenteric fibromatosis without Gardner's syndrome 2 years after appendectomy in a 31-year old man and recurred at 21 months after resection and report with a review of literatures. 6

A Case of Relapsing Polychondritis / 대한류마티스학회지

Relapsing polychondritis is an uncommon disease manifested by episodes of progressive inflammation and destruction of cartilage. While the cause remains unknown, an autoimmune pathogenesis appears likely. Characteristic features include auricular chondritis, arthritis, nasal chondritis, ocular inflammation, respiratory tract involvement and audiovestibular damage. The clinical course of patients may vary from a relatively benign illness free of clinically evident visceral involvement, to one of episodic or smoldering activity with variable intensity, to a f ulminant illness and death within months of diagnosis. Dapsone, corticosteroid and immunosuppressive agent remain the effective therapies. We have experienced a case of relapsing polychondritis and active pulmonary tuberculosis in a 69-year-old man. He suffered from arthralgia and swelling of joints for several months on the first admission and initially was diagnosed as pseudogout based on polyarthritis and chondrocalcinosis of right knee joint. During follow-up, chondritis of both auricles and nose, which was proved by the biosy of right auricle, and relapse of polyarthritis were developed. His spu tum smear for acid-fast bacillus was postive on the second admission. Then he was diagnosed as relapsing polychondritis and active pulmonary tuberculosis and has achieved improvement with medication of dapsone and antituberculosis drugs according to susceptability test during followed-up. Thus we report this case with literature review.