• Kidney Research and Clinical Practice
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• v.37 no.4
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• pp.426-426
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• 2018

• Childhood Kidney Diseases
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• v.7 no.2
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• pp.133-141
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• 2003

Purpose : Idiopathic Membranous Nephropathy(IMN) is a rare renal disease in children. To help better understanding of its clinical course and treatment strategies, we reviewed the clinical manifestations and pathological findings of children with IMN. Methods : Among 58 cases with MN, from 1977 to 2003, 42(72.4%) were hepatitis B virus (HBV) associated and 16(27.6%), 6 males and 10 females, were idiopathic. All cases diagnosed aster 2000 were IMN. Several clinicopathological findings(sex, onset age, proteinuria, serum albumin, cholesterol, creatinine clearance, tubulointerstitial changes, glomerular sclerosis, hypertension, renal vein thrombosis, the use of ACE inhibitor, and immunosuppressive therapy) were compared between the remission and the non-remission group of the patients with IMN. Results : The median onset age was 13.4 years. Clinical manifestations were nephrotic syn-drome(7 cases, 43.8%), gross hematuria(5 cases, 31.3%) and microscopic hematuria with proteinuria(3 cases, 18.8%). Hypertension, hypocalcemic tetany and renal vein thrombosis were accompanied in 2, 1 and 2 cases, respectively. In addition to the typical findings of MN, the kidney biopsies showed segmental sclerosis(5 cases, 31.3%) or global sclerosis(6 cases, 37.5 %), diffuse crescents(1 case), and mild(11 cases, 68.7%) or moderate tubulointerstitial changes(3 cases, 18.8%). Thirteen cases(86.7%) received oral steroid. Among them 2 cases received cyclophophamide and 1 received cyclosporin as well. Ten cases(62.5%) received ACE inhibitors. In the patients followed up, 7 cases(46.7%) became free from proteinuria (remission group) while 8(53.3%) presented continous proteinuria (non-remission group), two (13.3%) of which progressed to renal failure. Clinicopathological findings showed no significant differences between the two groups. Conclusion : With HBV vaccination, HBV associated MN decreased markedly and IMN has taken up most of MN in children. For better understanding of this rare disease, a prospective multicenter study of the clinical course and treatment strategies should be done.

• Journal of Yeungnam Medical Science
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• v.30 no.2
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• pp.136-140
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• 2013

Diabetic nephropathy (DN) is a common complication and the leading cause of end-stage renal disease (ESRD) in diabetic patients. The occurrence of non-diabetic renal disease (NDRD) in diabetic patients has been increasingly recognized in recent years. Generally, renal injuries in DN are deemed difficult to reverse, whereas some NDRDs are often treatable and even remittable. Thus, the diagnosis of NDRD in patients with diabetes mellitus (DM) via a kidney biopsy would be significant for its prognosis and therapeutic strategy. According to recent studies, the most common NDRD is IgA nephropathy in type 2 diabetic patients, and some cases of minimal change disease and membranous glomerulonephritis have been reported in Korea. However, membranoproliferative glomerulonephritis (MPGN) is an uncommon condition in diabetic patients. To our knowledge, there has been no case yet of MPGN, except in a child with type 1 DM. We present an unusual case of a 27-year-old woman who had type 2 DM with MPGN, as confirmed via a kidney biopsy.

• Childhood Kidney Diseases
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• v.2 no.2
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• pp.104-109
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• 1998

Purpose : The proliferative nuclear antigen Ki-67, present in all cell cycle phases except G0, is a useful marker for the detection of proliferative cells in vivo. MIB I has been found to recognize an antigen in formalin-fixed and wax-embedded material. The aim of this study was to assess the efficacy of MIB-1 expression as a marker of representing the status of mesangial cell proliferation in renal tissues. Methods : Immunohistochemical staining for Ki-67 Ag using monoclonal antibody MIB-1 (Immunotech,505) were performed in 41 renal tissuses which were obtained by percutaneous renal biopsy done between January 1994 and December 1996. Results : In both glomeruli and renal tubules, MIB-1 expression was observed only in 2 of 18 ($11.1\%$) cases of IgA nephropathy, in 2 of the 4 ($50\%$) cases of mebranoproliferative glomerulonephritis, in 4 of the 5 ($80\%$) cases of poststreptococcal glomerulonephritis. But MIB-1 expression was not detected in all cases of minimal lesion and membranous nephropathy. Renal tubules In another 7 cases of IgA nephropathy were MIB-1 positive. Conclusion : MIB-1 expression in renal tissues may relate to the cell proliferation in glomeruli and renal tubules. But the efficacy of MIB-1 expression as a marker of mesangial cell proliferation may reveal a limited value because of it's lower positive rate in IgA nephropathy.

• Childhood Kidney Diseases
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• v.15 no.1
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• pp.29-37
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• 2011

To understand the course of renal diseases well, we must have basic knowledges of histologic procedures of renal biopsy samples as well as basic pathologic changes. This article describes the method of dividing the biopsy samples, fixatives for various pathologic examinations and basic pathologic changes of glomerular diseases. For light microscopic examination, color changes of glomerular structures in PAS, trichrome and PAM stains, normal glomerular patterns compared to various glomerulopathies are introduced. While describing typical staining patterns and intensities of fluorescence in membranous glomerulopathy and IgA nephropathy, basic interpretation of immunofluorescent microscopic examination is described. To understand electron microscopic pictures of renal diseases, preference locations of electron dense deposits in various glomerulonephrites are described with schema. This article is the introduction part of the renal pathology and for the further detail changes of specific entities, we should reference the renal pathology textbooks or articles.

• Clinical and Experimental Pediatrics
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• v.49 no.3
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• pp.332-336
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• 2006

Toxic epidermal necrolysis (TEN) is a rare, acute and life-threatening cutaneous drug reaction. TEN is characterized by the sudden onset of extensive necrosis in the epidermis and frequent mucous membrane involvement. The pathogenesis has not yet been elucidated. In addition, no particular treatment for TEN has been established. We report a case of TEN in a 14-year-old-boy, which might have been caused by steroids with enalapril treatment for membranous nephropathy. He recovered after intravenous immunoglobulin therapy.

• Childhood Kidney Diseases
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• v.3 no.2
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• pp.145-152
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• 1999

Purpose: The prevalence of childhood renal diseases including the nephrotic syndrome in Korea has not been well established. In priority to this point, we analyzed ninety-six nephrotic children of the annual incidence, the ratio of them to all inpatients and estimated incidence of childhood nephrotic syndrome under 15 years of age in Taejon, Korea. Also we classified them by clinical and histopathological findings. Methods: we analyzed the admission and outpatient records retrospectively between June 1986 and December 1998. For the estimation of incidence, we were assisted with three other general hospitals in Taejon Results: The mean annual number and the ratio to inpatients were $7.4{\pm}2.1,\;0.3{\pm}0.11%$ respectively. The latter showed a tendency to decrease during the recent three years. The estimated annual incidences of childhood nephrotic syndrome in Taejon were 5.6 in 1988, 5.5 in 1993 and 4.8 in 1998 per 100,000 for children aged up to 15 years. The mean age of our patients was $6.8{\pm}3.5$ tears, 1-7 years of age was 55 cases(57.3%), and male to female ratio was 3.6:1. By the clinicopathologic classification, 89 cases(92.7%) were classified as primary nephrotic syndrome, and 7 cases(7.3%) as secondary nephrotic syndrome. Among the primary nephrotic syndrome, there was 79.8% of minimal change nephrotic syndrome, focal segmental glomerulosclerosis 11.2%, mesangial proliferation 4.5%, membranoproliferative glomerulonephritis 3.4%, and membranous nephropathy 1.1%. $Henoch-Sch\"{o}nlein$ nephritis was the most frequent of 3 cases in the secondary nephrotic syndrome. Respones to steroid therapy of 71 cases minimal change were classified as non-relapse 22.5%, non-frequent relapse 49.3%, frequent relapse 18.3% and steroid-dependence 9.9%. Conclusion: The estimated incidence of childhood nephrotic syndrome was about 5 per 100,000 for children aged up to 15 years and it showed little changes during 10 years in Taejon, Korea. Our results of clinicopathologic study was little difference from the results reported in other literatures.

• Childhood Kidney Diseases
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• v.3 no.2
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• pp.232-236
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• 1999

IgA 신병증은 사구체 중맥에 IgA가 침착하는 것이 특징적인 질환이며 막성 사구체 신염은 IgG가 사구체 기저막의 상피하에 미만성으로 침착하는 질환이다. 원발성 사구체 질환중 IgA 신병증과 막성 사구체신염은 비교적 흔한 질환이나 전체적인 빈도는 낮은 편으로, 한 환자의 사구체에서 두 질환이 동시에 발생하는 경우는 매우 드물다. IgA 신병증과 막성 사구체신염의 중복 신염은 Doi등이 1983년 원발성 신질환으로서 처음 보고한 이래, 성인에서 20여례가 보고되었다. 저자들은 신증후군이 발생한 환아에서 신생검을 시행한 결과 원발성 신질환으로서 IgA 신병증과 막성 사구체신염의 소견이 동시에 보이는 중복신염의 드문 예를 경험하였기에 보고하는 바이다. 환아는 7세된 남아로 내원 한달 전부터 발생한 전신부종을 주소로 내원하였다. 가족력과 과거력상 특이 소견없었으며, 내원시 이학적 소견상 전신적인 허약감과 안와부종, 복부팽만, 하지의 함요부종이 관찰되었고, 검사소견에서는 WBC $19,800/mm^3$, Hb 14.1g/dL, Platelet $397,000/mm^3$, BUN/Cr 10/0.4mg/dL, protein/albumin 4.43/2.73g/dL, cholesterol 429mg/dL, IgA 85mg/dL, $C_3$ 68.8mg/dL, $C_4$ 13.4mg/dL, ANA(-), ANCA(-), RF(-), HBsAg/Ab(-/-)이었다. 뇨검사에서는 RBC many/HPF, WBC 2-3/HPF, protein ${\le}\;300mg/dL$ 였으며, 24시간 소변 검사상 protein 9.18g/day, Ccr 66.67ml/min의 소견을 보였다. 신생검을 시행한 결과 광학현미경상에서 몇몇 사구체의 분절성 경화와 중맥역의 증식이 관찰되었고, 면역형광현미경검사에서는 IgA(3+)가 과립상으로 미만성 분포를 보이며 중맥역에 침착되어 있고, 미세한 과립상과 위선의 양상으로 IgG(1+)가 모세혈관벽에 침착되어 있었으며, 전자현미경 소견상 중맥역과 모세혈관 기저막 상피하에 소량의 전자 고밀도 침착이 함께 관찰되었다. 환아는 prednisolone을 경구 투여 받았으나 단백뇨와 혈뇨가 지속되어 solumedrol pulse therapy, captopril과 cyclophophamide로 치료 받은 후, 전신 상태 호전되고, 혈뇨가 사라졌으며, 24시간 소변 검사상 단백뇨가 487.5mg/day로 감소하여 외래에서 추적 관찰 중이다.

• Journal of the Korea Computer Graphics Society
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• v.11 no.2
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• pp.40-46
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• 2005

본 논문에서는 스윕곡면(sweep surface)을 기반으로 복잡한 3차원 물체의 형상을 변형하는 새로운 자유형상 변형(free-form deformation)기법을 제시한다. 본 논문에서 제시한 방법은 기존의 격자점(control lattices)을 조정하는 체적기반의 방법에 비해 스윕기반의 절차적 (procedural) 모델링 기법의 직관성을 활용하여 사용자에게 보다 효율적인 형상변형 기법을 제공한다. 3차원 물체의 정점들은 스윕곡면의 단면(cross-section)에 바인딩(binding) 되어 곡면의 변화에 따라 형상변형을 한다. 본 논문에서 제시한 스윕기반 형상변형 기법은 3차원 물체를 부분적으로 변형하는 기법과 계층구조를 기반으로 전반적인 형상을 변형하는 기법으로 구분된다. 부분적인 형상변형 기법은 스윕곡면을 구성하는 성분의 다단계(multi-level) 표현을 통하여 사용자에게 다중해상도(multi-resolution) 형상변형 기능을 제공한다. 계층구조에 기반한 형상변형 기법은 복잡한 3차원 물체를 위상구조에 따라 여러 계층으로 분할하고, 각 부분의 형상을 근사하는 스윕곡면들을 생성한다. 분할된 각 부분의 정점(vertices)들은 해당 스윕곡면에 바인딩 되어 스윕곡면의 단면의 변화를 따르게 된다. 이러한 상황하에서 스윕곡면들은 3차원 물체의 계층구조에 따라서 서로 상호작용(interaction)을 하게 되고, 결과적으로 3차원 물체의 각부분은 상호반응적 형상변형을 한다. 이러한 계층구조에 기반한 상호반응적 형상변형 기법은 사용자의 의도에 부합하는 보다 사실적이고 기능적인 형상변형을 가능하게 한다. 본 논문에서는 다양한 3차원 물체에 대한 실험을 통해 제시된 방법의 효율성을 입증한다. 결과 막성 사구체병증과 같은 신질환이 발견될 수 있으므로 신조직검사의 적응증에 합당한 경우 적극적인 신조직검사를 시행하여 원인 질환을 찾는 노력이 필요할 것으로 사료된다.. 남아가 75명으로 남녀비는 3.6:1을 보였다. 임상병리학적 분류상 일차성 신증후군이 89명(92.7%), 이차성 신증후군이 7명(7.3%)이었으며 일차성 신증후군에서 minimal change nephrotic syndrome이 71명으로 79.8%, focal segmental glomerulosclerosis 11.2%, mesangial proliferation 4.5%, membranoprolifrative glomeulonephritis 3.4%, membranous nephropathy 1명 1.1%이었으며 2차성 신증후군은 $Henoch-Sch\"{o}nlein$ nephritis가 3례로 가장 많았다. 미세변화 신증후군 71명 중 비재발군이 16명으로 22.5%, 비빈발 재발군 49.3%, 빈발 재발군 18.3%, 스테로이드 의존군 9.9%를 보였다. 결론 : 대전시에서의 신증후군 환아의 발생빈도는 15세이하 소아 10만명당 약 5명으로 추정되었으며 10여 년전과 비교하여 큰 변화를 보이지는 않았다. 또한 저자들의 임상병리학적 연구결과가 다른 문헌에서 보고된 소아 신증후군의 연구결과와 큰 차이를 보이지 않음을 알 수 있었다. 자극에 차이가 있지 않나 추측되며 이에 관한 추후 연구가 요망된다. 총대장통과시간의 단축은 결장 분절 모두에서 줄어들어 나타났으나 좌측결장 통과시간의 감소 및 이로 인한 이 부위의 통과시간 비율의 저하가 가장 주요하였다. 이러한 결과는 차가운 생수 섭취가 주로 결장 근위부를 자극하는

• Childhood Kidney Diseases
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• v.8 no.2
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• pp.205-213
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• 2004

Purpose: To evaluate the clinical manifestations of various glomerular diseases in children, a clinicopathological study was performed in 52 children who had renal biopsy. The type and relative incidence of the glomerular pathologies were analyzed, and the clinical predictability and usefulness of renal biopsy in glomerular diseases were assessed. Methods: Medical records of fifty two children with renal disease who had undergone percutaneous renal biopsy under ultrasonic guidance at Chungnam University Hospital from October 1995 to August 2003 were reviewed. In addition, we compared the clinical findings before renal biopsy with the pathological diagnosis. Results: The male to female ratio was 1.6:1 and they were $9.8\pm2.6$ years old on average. The chief complaints for biopsy were hematuria in 22 cases which was the most common (42.3%), proteinuria in 16 cases(30.8%), and hematuria & proteinuria(26.9%). Among the 22 cases of hematuria, there were 15 cases of gross hematuria(68.2%) and 7 cases of microscopic hematuria(31.8%). In terms of histopathologic diagnosis, most of them were primary glomerular diseases(84.6%), which included IgA nephropathy(28.8%), thin glomerular basement membrane disease(25.0%), focal segmental glomerulosclerosis(FSGS)(11.5%), membranous proliferative glomerulonephritis(7.7%), minimal change lesion(3.8%), acute poststreptococcal glomerulonephritis(3.8%) and membranous glomerulonephritis(3.8%). The clinical manifestations and pathologic diagnosis were not correlated. Conclusion: The clinical manifestations could not predict the pathological diagnosis. Therefore, renal biopsy would be inevitable in diagnosis of glomerular diseases for effective management and assessment of prognosis.