• Title/Summary/Keyword: 6q24

Search Result 340, Processing Time 0.034 seconds

Arsenic Removal Using Iron-impregnated Ganular Activated Carbon (Fe-GAC) of Groundwater (철침착 입상활성탄(Fe-GAC)을 이용한 지하수 내 비소 제거기술)

  • Yoon, Ji-Young;Ko, Kyung-Seok;Yu, Yong-Jae;Chon, Chul-Min;Kim, Gyoo-Bum
    • Economic and Environmental Geology
    • /
    • v.43 no.6
    • /
    • pp.589-601
    • /
    • 2010
  • Recently it has been frequently reported arsenic contamination of geologic origin in groundwater. The iron-impregnated ranular activated carbon (Fe-GAC) was developed for effective removal of arsenic from groundwater n the study. Fe-GACs were prepared by impregnating iron compounds into a supporting medium (GAC) with 0.05 M iron nitrate solution. The materials were used in arsenic adsorption isotherm tests to know the effect of iron impregnation time, batch kinetic tests to understand the influence of pH, and column tests to evaluate for the preliminary operation of water treatment system. The results showed that the minimum twelve hours of impregnation time were required for making the Fe-GAC with sufficient iron content for arsenic removal, confirmed by a high arsenic adsorption capacity evaluated in the isotherm tests. Most of the impregnated iron compounds were iron hydroxynitrate $Fe_4(OH)_{11}NO_3{\cdot}2H_2O$ but a mall quantity of hematite was also identified in X-ray diffraction(XRD) analysis. The batch isotherms of Fe-GAC for arsenic adsorption were well explained by Langmuir than Freundlich model and the iron contents of Fe-GAC have positive linear correlations on logarithmic plots with Freundlich distribution coefficients ($K_F$ and Langmuir maximum adsorption capacities ($Q_m$. The results of kinetic experiments suggested hat Fe-GAC had he excellent arsenic adsorption capacities regardless of all pH conditions except for pH 11 and could be used a promising adsorbents for groundwater arsenic removal considering the general groundwater pH range of 6-8. The pseudo-second order model, based on the assumption that the ate-limiting step might be chemisorption, provided the best correlation of the kinetic experimental data and explained the arsenic adsorption system f Fe-GAC. The column test was conducted to valuate the feasibility of Fe-GAC use and the operation parameters in arsenic groundwater treatment system. The parameters obtained from the column test were the retardation actor of 482.4 and the distribution coefficient of 581.1 L/mg which were similar values of 511.5-592.5 L/mg acquired from Freundlich batch isotherm model. The results of this study suggested that Fe-GAC could be used as promising adsorbent of arsenic removal in a small groundwater supply system with water treatment facility.

Effects of Experimental Warming on Growth of Quercus variabilis Seedlings (실외 실험적 온난화 처리가 굴참나무 묘목의 생장에 미치는 영향)

  • Lee, Sun Jeoung;Han, Saerom;Yoon, Tae Kyung;Chung, Haegeun;Noh, Nam Jin;Jo, Wooyong;Park, Chan-Woo;Ko, Suin;Han, Seung Hyun;Son, Yowhan
    • Journal of Korean Society of Forest Science
    • /
    • v.101 no.4
    • /
    • pp.722-728
    • /
    • 2012
  • Climate change affects all biological processes in terrestrial ecosystems including photosynthesis, plant growth and productivity. This study was conducted to investigate the effects of experimental warming on the growth of Quercus variabilis seedlings. One-year-old Q. variabilis seedlings were planted in control and warmed plots in April 2010. The air temperature of warmed plots was increased by $3^{\circ}C$ compared to control plots using the infrared lamp from November 2010. Shoot height and root collar diameter were measured in March 2011 and June 2012, respectively, and aboveground and belowground biomass were also measured in March 2011 and 2012, respectively. Shoot height and root collar diameter were significantly higher in warmed plots than in control plots, except for root collar diameter in March 2011. Increment (mm) of shoot height and root collar diameter were also higher in warmed plots ($529{\pm}30$, $5.6{\pm}0.5$) than in control plots ($464{\pm}28$, $4.5{\pm}0.4$). However, there were no significant differences between warmed and control plots except for root collar diameter. Increment (g/year) of total, aboveground and belowground biomass were higher in warmed plots ($36.88{\pm}6.52$, $11.91{\pm}3.44$, $24.97{\pm}3.73$) than in control plots ($30.59{\pm}5.51$, $8.73{\pm}1.66$, $21.86{\pm}3.88$), however, the differences were not statistically significant. Higher seedling growth and biomass of warmed plots might be related to the enhanced net photosynthetic rates in spring and the extended growing season.

Effects of Keratinase on Performance, Nutrient Utilization, Intestinal Morphology, Intestinal Ecology and Inflammatory Response of Weaned Piglets Fed Diets with Different Levels of Crude Protein

  • Wang, D.;Piao, X.S.;Zeng, Z.K.;Lu, T.;Zhang, Q.;Li, P.F.;Xue, L.F.;Kim, S.W.
    • Asian-Australasian Journal of Animal Sciences
    • /
    • v.24 no.12
    • /
    • pp.1718-1728
    • /
    • 2011
  • Two experiments were conducted to investigate the in vitro ability of keratinase to hydrolyze soybean glycinin and ${\beta}$-conglycinin and to evaluate the in vivo effects of keratinase when included in corn-soybean diets with different levels of crude protein and fed to nursery pigs. In experiment 1, a saturated keratinase solution (1 ml) was added to two blank controls of either glycinin or ${\beta}$-conglycinin resulting in the hydrolysis of 94.74% glycinin and 88.89% ${\beta}$-conglycinin. In experiment 2, 190 pigs (8.3${\pm}$0.63 kg BW) were allotted to one of four treatments in a 2${\times}$2 factorial arrangement on the basis of body weight, and sex was balanced among the pens. The effects of crude protein (19 vs. 22%) and keratinase (0 vs. 0.05%) were studied. Each treatment was applied to six pens with seven (two pens) or eight pigs per pen. Pigs were fed the experimental diets for 21 d. Weight gain and feed conversion ratio were improved (p<0.05) with keratinase supplementation while feed intake was reduced (p<0.05). Keratinase supplementation increased (p<0.05) the apparent total tract digestibility of dry matter, energy, crude protein and phosphorus. Keratinase supplementation also increased n-butyric acid in the cecum and colon, lactobacilli and total anaerobe counts in the colon as well as the ratio of villus height to crypt depth in the ileum. Additionally, fecal score, ammonia nitrogen and branch chain volatile fatty acids in the colon, E. coli and total aerobe counts in the colon, crypt depth in the jejunum and ileum as well as serum interleukin-1 and interleukin-6 concentrations were also decreased (p<0.05) by keratinase supplementation. A reduction in dietary crude protein decreased (p<0.05) colon ammonia nitrogen concentration and cecal propionic acid and branch chain volatile fatty acid concentrations. In addition, cecal E. coli counts, colon total anaerobe counts, ileal crypt depth, and serum interleukin-1 and interleukin-6 concentrations were also decreased (p<0.05) with the reduction of dietary crude protein. With the exception of fecal scores, there were no significant interactions between crude protein and keratinase. This study provides evidence that dietary keratinase supplementation improved nursery pig performance by improving intestinal morphology and ecology, thus improving nutrient digestibility and alleviating the inflammatory response.

Genome-wide Survey of Copy Number Variants Associated with Blood Pressure and Body Mass Index in a Korean Population

  • Moon, Sang-Hoon;Kim, Young-Jin;Kim, Yun-Kyoung;Kim, Dong-Joon;Lee, Ji-Young;Go, Min-Jin;Shin, Young-Ah;Hong, Chang-Bum;Kim, Bong-Jo
    • Genomics & Informatics
    • /
    • v.9 no.4
    • /
    • pp.152-160
    • /
    • 2011
  • Hypertension is the major factor of most death and high blood pressure (BP) can lead to stroke, myocardial infarction and cardiac failure. Moreover, hypertension is strongly correlated with body mass index (BMI). Although the exact causes of hypertension are still unclear, some of genetic loci were discovered from genome-wide association study (GWAS). Therefore, it is essential to study genetic variation for finding more genetic factor affecting hypertension. The purpose of our study is to conduct a CNV association study for hypertension-related traits, BP and BMI, in Korean individuals. We identified 2,206 CNV regions from 3,274 community-based Korean participants using the Affymetrix Genome-Wide Human SNP Array 6.0 platform and performed a logistic regression analysis of CNVs with two hypertension-related traits, BP and BMI. Moreover, the 4,692 participants in an independent cohort were selected for respective replication analyses. GWAS of CNV identified two loci encompassing previously known hypertension-related genes: LPA (lipoprotein) on 6q26, and JAK2 (Janus kinase 2) on 9p24, with suggestive p-values (0.0334 for LPA and 0.0305 for JAK2 ). These two positive findings, however, were not evaluated in the replication stage. Our result confirmed the conclusion of CNV study from the WTCCC suggesting weak association with common diseases. This is the first study of CNV association study with BP and BMI in Korean population and it provides a state of CNV association study with common human diseases using SNP array.

Genome-wide association study for the interaction between BMR and BMI in obese Korean women including overweight

  • Lee, Myoungsook;Kwon, Dae Young;Kim, Myung-Sunny;Choi, Chong Ran;Park, Mi-Young;Kim, Ae-jung
    • Nutrition Research and Practice
    • /
    • v.10 no.1
    • /
    • pp.115-124
    • /
    • 2016
  • BACKGROUND/OBJECTIVES: This is the first study to identify common genetic factors associated with the basal metabolic rate (BMR) and body mass index (BMI) in obese Korean women including overweight. This will be a basic study for future research of obese gene-BMR interaction. SUBJECTS/METHODS: The experimental design was 2 by 2 with variables of BMR and BMI. A genome-wide association study (GWAS) of single nucleotide polymorphisms (SNPs) was conducted in the overweight and obesity (BMI > $23kg/m^2$) compared to the normality, and in women with low BMR (< 1426.3 kcal/day) compared to high BMR. A total of 140 SNPs reached formal genome-wide statistical significance in this study (P < $1{\times}10^{-4}$). Surveys to estimate energy intake using 24-h recall method for three days and questionnaires for family history, a medical examination, and physical activities were conducted. RESULTS: We found that two NRG3 gene SNPs in the 10q23.1 chromosomal region were highly associated with BMR (rs10786764; $P=8.0{\times}10^{-7}$, rs1040675; $2.3{\times}10^{-6}$) and BMI (rs10786764; $P=2.5{\times}10^{-5}$, rs10786764; $6.57{\times}10^{-5}$). The other genes related to BMI (HSD52, TMA16, MARCH1, NRG1, NRXN3, and STK4) yielded P < $10{\times}10^{-4}$. Five new loci associated with BMR and BMI, including NRG3, OR8U8, BCL2L2-PABPN1, PABPN1, and SLC22A17 were identified in obese Korean women (P < $1{\times}10^{-4}$). In the questionnaire investigation, significant differences were found in the number of starvation periods per week, family history of stomach cancer, coffee intake, and trial of weight control in each group. CONCLUSION: We discovered several common BMR- and BMI-related genes using GWAS. Although most of these newly established loci were not previously associated with obesity, they may provide new insights into body weight regulation. Our findings of five common genes associated with BMR and BMI in Koreans will serve as a reference for replication and validation of future studies on the metabolic rate.

Report on the External Audits Conducted by Korean Society of Medical Physics (한국의학물리학회 선형가속기 외부 품질관리 실시 현황보고)

  • Huh, Hyun Do;Cho, Kwang Hwan;Cho, Sam Ju;Choi, Sang Hyoun;Kim, Dong Wook;Hwang, Ui-Jung;Kim, Ki Hwan;Min, Chul Kee;Choi, Tae Jin;Oh, Young Kee;Lee, Seoung Jun;Park, Dahl;Park, Sung-Kwang;Ji, Young Hoon
    • Progress in Medical Physics
    • /
    • v.24 no.4
    • /
    • pp.315-322
    • /
    • 2013
  • The aim of this work is to verify the self-quality assurances in medical institutions in Korea through the external audits by the group of experts and have a mutual discussion of the systematic problems. In order to validate the external audits 30 of 80 medical institutions across the nation were picked out considering the regional distribution and the final 25 institutions applied voluntarily to take part in this work. The basic rules were setup that any information of the participants be kept secrete and the measurements be performed with the dosimetry system already verified through intercomparision. The outputs for 2 or more photon beams, the accuracy of gantry rotation and collimator rotation and the poistional accuracy of MLC movement were measured. The findings for the output measurement showed the differences of -0.8%~4.5%, -0.79%~3.01%, and -0.7%~0.07% with respect to that of the verified dosimetry system for the 6MV, 10MV, and 15MV, respectively. For the reference absorbed dose 8 (16%) of 50 photon beams in 25 medical institutions differed 2.0% or greater from the reference value. The coincidences of Field size with x-ray beam and radiation isocenters of Gantry roration and collimator rotation gave the results of within ${\pm}2$ mm for every institute except 2 institutions. The positional accuracy of MLC movement agreed to within ${\pm}1$ mm for every institute. For the beam qualities of 6 MV photon beams kQ values showed the distribution within 0.4% between maximum and minimum. For the protocols 21 institutions (84%) used absorbed dose to water based protocol while 4 insitutions (16%) used air kerma based one. 22 institutions employed the SSD technique while 3 institutions did the SAD one. External audit plays an important role in discovering the systematic problems of self-performing Quality Assurances and having in depth discussion for mutual complementation. Training experts of international level as well as national support system are required so that both the group of experts of medical physicists and government laboratory could perform together periodical and constant external audits.

Evaluation of Land Use Change Impact on Hydrology and Water Quality Health in Geum River Basin (금강유역의 토지이용 변화가 수문·수질 건전성에 미치는 영향 평가)

  • LEE, Ji-Wan;PARK, Jong-Yoon;JUNG, Chung-Gil;KIM, Seong-Joon
    • Journal of the Korean Association of Geographic Information Studies
    • /
    • v.22 no.2
    • /
    • pp.82-96
    • /
    • 2019
  • This study evaluated the status of watershed health in Geum River Basin by SWAT (Soil and Water Assessment Tool) hydrology and water quality. The watershed healthiness from watershed hydrology and stream water quality was calculated using multivariate normal distribution from 0(poor) to 1(good). Before evaluation of watershed healthiness, the SWAT calibration for 11 years(2005~2015) of streamflow(Q) at 5 locations with 0.50~0.77 average Nash-Sutcliffe model efficiency and suspended solid (SS), total nitrogen(T-N), and total phosphorus(T-P) at 3 locations with 0.67~0.94, 0.59~0.79, and 0.61~0.79 determination coefficient($R^2$) respectively. For 24 years (1985~2008) the spatiotemporal change of watershed healthiness was analyzed with calibarted SWAT and 5 land use data of 1985, 1990, 1995, 2000, and 2008. The 2008 SWAT results showed that the surface runoff increased by 40.6%, soil moisture and baseflow decreased by 6.8% and 3.0% respectively compared to 1985 reference year. The stream water quality of SS, T-N, and T-P increased by 29.2%, 9.3%, and 16.7% respectively by land development and agricultural activity. Based on the 1985 year land use condition. the 2008 watershed healthiness of hydrology and stream water quality decreased from 1 to 0.94 and 0.69 respectively. The results of this study be able to detect changes in watershed environment due to human activity compared to past natural conditions.

Usefulness of $^{201}Tl$ Myocardial Perfusion SPECT in Prediction of Left Ventricular Remodeling following an Acute Myocardial Infarction (급성심근경색 후 발생하는 좌심실 재구도 예측에 대한 $^{201}Tl$ 심근관류 SPECT의 운용성)

  • Yoon, Seok-Nam;Park, C.H.;Hwang, Kyung-Hoon
    • The Korean Journal of Nuclear Medicine
    • /
    • v.34 no.1
    • /
    • pp.30-38
    • /
    • 2000
  • Purpose: We investigated the role of myocardial perfusion SPECT in prediction of ventricular dilatation and the role of revascularization including thrombolytic therapy and PTCA in prevention of ventricular dilatation after an acute myocardial infarction (AMI). Materials and Methods: We performed dipyridamole stress, 4 hour redistribution, and 24 hour reinjection Tl-201 SPECT in 16 patients with AMI two to nine days after attack. Perfusion and wall motion abnormalities were quantified by perfusion index (PI) and wall motion index (WMI). Left ventricular ejection fraction (LVEF), WMI and ventricular volume were measured within 1 week of AMI and after average of 6 months. According to serial changes of left ventricular end-diastolic volume (LVEDV), patients were divided into two groups. We compared WMI, PI and LVEF between the two groups. Relationships among degree of volume, stress-rest PI, WMI, CKMB, Q wave, LVEF and revascularization were analysed using multivariate analysis. Results: Only initial rest perfusion index was significantly different between the two groups (p<0.05). While initial LVEF, stress PI, CKMB, trial of revascularization procedure, presence of Q wave and WMI were not significantly different between the two groups. Eight of 16 patients (50%) showed LV dilatation on follow-up echocardiography. Three of 3 patients (100%) who did not undergo revascualrization procedure documented LV dilatation. And only 5 (38%) of the remaining 13 patients who underwent revascularization revealed LV dilatation. There was no difference in infarct location between the two groups. By multivariate linear regression analysis in patients only undergoing revascularization, rest perfusion index was the only significant factor. Conclusion: Myocardial perfusion SPECT performed prior to revascularization was useful in prediction of LV dilatation after an AMI. Rest perfusion index on myocardial perfusion plays as a significant predictor of left ventricular dilatation after AMI. And revascularization appears to be a valuable procedure in alleviating LV dilatation after AMI with or without viable myocardium in a limited number of patients studied retrospectively.

  • PDF

Studies on the Derivation of the Instantaneous Unit Hydrograph for Small Watersheds of Main River Systems in Korea (한국주요빙계의 소유역에 대한 순간단위권 유도에 관한 연구 (I))

  • 이순혁
    • Magazine of the Korean Society of Agricultural Engineers
    • /
    • v.19 no.1
    • /
    • pp.4296-4311
    • /
    • 1977
  • This study was conducted to derive an Instantaneous Unit Hydrograph for the accurate and reliable unitgraph which can be used to the estimation and control of flood for the development of agricultural water resources and rational design of hydraulic structures. Eight small watersheds were selected as studying basins from Han, Geum, Nakdong, Yeongsan and Inchon River systems which may be considered as a main river systems in Korea. The area of small watersheds are within the range of 85 to 470$\textrm{km}^2$. It is to derive an accurate Instantaneous Unit Hydrograph under the condition of having a short duration of heavy rain and uniform rainfall intensity with the basic and reliable data of rainfall records, pluviographs, records of river stages and of the main river systems mentioned above. Investigation was carried out for the relations between measurable unitgraph and watershed characteristics such as watershed area, A, river length L, and centroid distance of the watershed area, Lca. Especially, this study laid emphasis on the derivation and application of Instantaneous Unit Hydrograph (IUH) by applying Nash's conceptual model and by using an electronic computer. I U H by Nash's conceptual model and I U H by flood routing which can be applied to the ungaged small watersheds were derived and compared with each other to the observed unitgraph. 1 U H for each small watersheds can be solved by using an electronic computer. The results summarized for these studies are as follows; 1. Distribution of uniform rainfall intensity appears in the analysis for the temporal rainfall pattern of selected heavy rainfall event. 2. Mean value of recession constants, Kl, is 0.931 in all watersheds observed. 3. Time to peak discharge, Tp, occurs at the position of 0.02 Tb, base length of hlrdrograph with an indication of lower value than that in larger watersheds. 4. Peak discharge, Qp, in relation to the watershed area, A, and effective rainfall, R, is found to be {{{{ { Q}_{ p} = { 0.895} over { { A}^{0.145 } } }}}} AR having high significance of correlation coefficient, 0.927, between peak discharge, Qp, and effective rainfall, R. Design chart for the peak discharge (refer to Fig. 15) with watershed area and effective rainfall was established by the author. 5. The mean slopes of main streams within the range of 1.46 meters per kilometer to 13.6 meter per kilometer. These indicate higher slopes in the small watersheds than those in larger watersheds. Lengths of main streams are within the range of 9.4 kilometer to 41.75 kilometer, which can be regarded as a short distance. It is remarkable thing that the time of flood concentration was more rapid in the small watersheds than that in the other larger watersheds. 6. Length of main stream, L, in relation to the watershed area, A, is found to be L=2.044A0.48 having a high significance of correlation coefficient, 0.968. 7. Watershed lag, Lg, in hrs in relation to the watershed area, A, and length of main stream, L, was derived as Lg=3.228 A0.904 L-1.293 with a high significance. On the other hand, It was found that watershed lag, Lg, could also be expressed as {{{{Lg=0.247 { ( { LLca} over { SQRT { S} } )}^{ 0.604} }}}} in connection with the product of main stream length and the centroid length of the basin of the watershed area, LLca which could be expressed as a measure of the shape and the size of the watershed with the slopes except watershed area, A. But the latter showed a lower correlation than that of the former in the significance test. Therefore, it can be concluded that watershed lag, Lg, is more closely related with the such watersheds characteristics as watershed area and length of main stream in the small watersheds. Empirical formula for the peak discharge per unit area, qp, ㎥/sec/$\textrm{km}^2$, was derived as qp=10-0.389-0.0424Lg with a high significance, r=0.91. This indicates that the peak discharge per unit area of the unitgraph is in inverse proportion to the watershed lag time. 8. The base length of the unitgraph, Tb, in connection with the watershed lag, Lg, was extra.essed as {{{{ { T}_{ b} =1.14+0.564( { Lg} over {24 } )}}}} which has defined with a high significance. 9. For the derivation of IUH by applying linear conceptual model, the storage constant, K, with the length of main stream, L, and slopes, S, was adopted as {{{{K=0.1197( {L } over { SQRT {S } } )}}}} with a highly significant correlation coefficient, 0.90. Gamma function argument, N, derived with such watershed characteristics as watershed area, A, river length, L, centroid distance of the basin of the watershed area, Lca, and slopes, S, was found to be N=49.2 A1.481L-2.202 Lca-1.297 S-0.112 with a high significance having the F value, 4.83, through analysis of variance. 10. According to the linear conceptual model, Formular established in relation to the time distribution, Peak discharge and time to peak discharge for instantaneous Unit Hydrograph when unit effective rainfall of unitgraph and dimension of watershed area are applied as 10mm, and $\textrm{km}^2$ respectively are as follows; Time distribution of IUH {{{{u(0, t)= { 2.78A} over {K GAMMA (N) } { e}^{-t/k } { (t.K)}^{N-1 } }}}} (㎥/sec) Peak discharge of IUH {{{{ {u(0, t) }_{max } = { 2.78A} over {K GAMMA (N) } { e}^{-(N-1) } { (N-1)}^{N-1 } }}}} (㎥/sec) Time to peak discharge of IUH tp=(N-1)K (hrs) 11. Through mathematical analysis in the recession curve of Hydrograph, It was confirmed that empirical formula of Gamma function argument, N, had connection with recession constant, Kl, peak discharge, QP, and time to peak discharge, tp, as {{{{{ K'} over { { t}_{ p} } = { 1} over {N-1 } - { ln { t} over { { t}_{p } } } over {ln { Q} over { { Q}_{p } } } }}}} where {{{{K'= { 1} over { { lnK}_{1 } } }}}} 12. Linking the two, empirical formulars for storage constant, K, and Gamma function argument, N, into closer relations with each other, derivation of unit hydrograph for the ungaged small watersheds can be established by having formulars for the time distribution and peak discharge of IUH as follows. Time distribution of IUH u(0, t)=23.2 A L-1S1/2 F(N, K, t) (㎥/sec) where {{{{F(N, K, t)= { { e}^{-t/k } { (t/K)}^{N-1 } } over { GAMMA (N) } }}}} Peak discharge of IUH) u(0, t)max=23.2 A L-1S1/2 F(N) (㎥/sec) where {{{{F(N)= { { e}^{-(N-1) } { (N-1)}^{N-1 } } over { GAMMA (N) } }}}} 13. The base length of the Time-Area Diagram for the IUH was given by {{{{C=0.778 { ( { LLca} over { SQRT { S} } )}^{0.423 } }}}} with correlation coefficient, 0.85, which has an indication of the relations to the length of main stream, L, centroid distance of the basin of the watershed area, Lca, and slopes, S. 14. Relative errors in the peak discharge of the IUH by using linear conceptual model and IUH by routing showed to be 2.5 and 16.9 percent respectively to the peak of observed unitgraph. Therefore, it confirmed that the accuracy of IUH using linear conceptual model was approaching more closely to the observed unitgraph than that of the flood routing in the small watersheds.

  • PDF

The Characteristics of Membranoproliferative Glomerulonephritis I Detected from School Urine Screening (학교 집단 소변 검사로 발견 된 막증식성 사구체신염 I형의 특성)

  • Choi, Jung-Youn;Park, Mi-Young;Lee, Yong-Jik;Ha, Il-Soo;Cheong, Hae-Il;Choi, Yong;Park, Young-Seo;Han, Hye-Won;Jin, Dong-Kyu;Chung, Woo-Yeong;Kim, Kee-Hyuck;Yoo, Kee-Hwan;Park, Yong-Hoon
    • Childhood Kidney Diseases
    • /
    • v.10 no.2
    • /
    • pp.152-161
    • /
    • 2006
  • Purpose : In Korea, the school urine screening program is a useful tool for screening urine abnormalities. It is particularly useful in early detection of membranoproliferative glomerulonephritis(MPGN) I, which frequently progresses to chronic renal failure. In this study, we studied the medical history, laboratory findings, and histologic findings of MPGN to gain helpful information on early detection and treatment. Methods : The subjects were 19 children, who were diagnosed with MPGN from kidney biopsies that were performed in ten nationwide university hospitals because of abnormal urine findings from school urine screening programs conducted from July 1999 to April 2004. We divided the patients into 2 groups, a nephrotic range proteinuria group(n=8) and a non-nephrotic proteinuria group(n=11), and retrospectively analyzed the clinical features, laboratory findings, histologic findings, treatment, and clinical course. Results : The mean age at the first abnormal urinalysis was $10.6{\pm}2.2$ years in the nephrotic proteinuria group and $9.6{\pm}3.2$ years in the non-nephrotic proteinuria group. The mean age at the time of kidney biopsy was $11.3{\pm}2.3$ years in the nephrotic range proteinuria group and $10.4{\pm}3.2$ years in the non-nephrotic proteinuria group respectively. There was no significant difference in the mean age and sex between the two groups. In the nephrotic proteinuria group, 6 children had a low plasma C3 level and in the non-nephrotic proteinuria group, 8 children had a low plasma C3 level, but there was no significant difference between the 2 groups. There was no significant difference in the laboratory test results(including WBC count, RBC count, platelet count and other serologic tests) between the 2 groups except for 24 hour urine protein secretion. There was no difference between the 2 groups with regard to the acute and chronic changes in the glomerulus on light microscopic findings, IgG, IgA, Ig M, C1q, C3, C4, fibrogen deposition on immunofluoroscence findings, and mesangial deposits, subendothelial deposits, and subepithelial deposits on electron microscopic findings. The children were treated with corticosteroids, ACE(angiotensin-converting enzyme) inhibitors, dipyridamole and other immunosuppressive agents. During the course of treatment, there were no children whose clinical condition worsened. Among 19 children, 3 children went into remission(2 in the nephrotic proteinuria group, 1 in the non-nephrotic proteinuria group) and 9 children went into a partial remission(4 in the nephrotic proteinuria group, 5 in the non-nephrotic proteinuria group) on urinalysis. There was no significant difference in the treatment results between the two groups. Conclusion : The 73.7% of children who were incidentally diagnosed with MPGN by the school urine screening program had reduced C3. 42.1% of the children had nephrotic range proteinuria. There were no significant differences in clinical features, laboratory test results, light microscopic, immunofluorescence microscopic, and electron microscopic findings between the nephrotic proteinuria group and the non-nephrotic proteinuria group except for the 24 hour urine protein secretion. Therefore, for early detection of MPGN during the school urine screening program, we strongly recommend a kidney biopsy if children have abnormal urine findings such as persistent proteinuria and persistent hematuria, or if the serum C3 is reduced.

  • PDF