• Childhood Kidney Diseases
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• v.2 no.2
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• pp.187-191
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• 1998

Yersinia pseudotuberculosis, a gram-negative coccobacillus, is a member of the enterobacteriaceae family, and the illness has fever, abdominal pain, diarrhea, mesenteric lymphadenitis, terminal ileitis, arthropathy, erythema nodosum. Specially in children, it is known as an important cause of acute renal failure due to acute tubulointerstitial nephritis. It has been recognized in a worldwide distribution. For the first time, the cases of acute renal failure caused by this organism were reported in Japan in 1980's. In Korea, the first case accompanying with ARF was reported in 1988. Since that, many cases have been reported in Seoul area, but no case in other places. So we report 2 cases of Y.P. infection accompanying with ARF in Pusan area, for the first time in other place than Seoul area.

• Korean Journal of Veterinary Pathology
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• v.1 no.1
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• pp.66-71
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• 1997

Eighteen NZW rabbits used for local skin irritation study were examined grossly and microscopically for natural infection with Encephalitozoon cuniculi. For microscopic tissue evaluation histochemical techniques such as PAS Gram iron hematoxylin and HE stain were used. Although rabbits in the study had no abnormal clinical signs 7/18(38.9%) animals were microscopically infected with E. cuniculi. The affected rabbits had gray-whitish and depressed approximately 0.1∼0.6 cm diameter lesions in the kidneys. All other organs examined were grossly unremarkable. Histopathologically however in addition to segmental interstitial nephritis focal lymphocytic myocarditis and granulomatous inflammatory reaction in portal areas of the liver multifocal granulomatous foci with vasculitis were present in the brain kidney and lungs. Aggregates of minute oval organisms were observed in brain and kidney sections frequently within the granulomatous foci and sometimes without any inflammatory reaction particularly in the renal tubules. in histochemical stains the organisms were gram positive stained with iron hematoxylin and had PAS positive granule at one pole. They measured approximately 1.5×2.5μm consistent with E. cuniculi. Histochemical characterization is important to differentiate E. cuniculi from other common protozoal infection such as Toxoplasma gondii. This study demonstrate the importance of subclinical. E. cunuculi infection and the associated histological alterations may interfere with tissue evaluation in toxicologic studies.

• Childhood Kidney Diseases
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• v.26 no.1
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• pp.31-39
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• 2022

Alport syndrome (AS) is a progressive hereditary nephritis that is often accompanied by sensorineural hearing loss and ocular abnormalities. It is inherited in three modes of X-linked AS (XLAS), autosomal recessive AS (ARAS), and autosomal dominant AS (ADAS). XLAS is caused by pathogenic variants in COL4A5, while ARAS and ADAS are caused by those in COL4A3 or COL4A4. There is currently no curative treatment for AS; however, angiotensin-converting enzyme inhibitors (ACEi) can improve the outcome of AS. In the past decade, multiple studies have shown that early intervention with ACEi upon isolated microscopic hematuria or microalbuminuria could delay disease progression, and early diagnosis is crucial for early treatment. Therefore, a new classification of AS based on molecular diagnoses has been proposed, including the paradigm shift of re-classifying female "carriers" to "patients" and "thin basement membrane nephropathy" to "ADAS." In addition, with the detection of COL4A mutations in some patients with biopsy-confirmed IgA nephropathy, focal segmental glomerulosclerosis, and chronic kidney disease of unknown origin, it is suggested that the phenotype of AS should be expanded. In this review, we highlight the landmark studies and guidelines published over the past decade and introduce strategies for early diagnosis and treatment to improve the outcomes of AS.

• Proceedings of the Korean Society of Computer Information Conference
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• 2022.07a
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• pp.85-87
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• 2022

루푸스 신염을 정확히 진단하기 위해서는 신장의 침 생검을 통한 조직검사를 통해 사구체들을 찾아내고, 각각의 염증 정도를 분류해야 한다. 하지만 이에는 의료진의 많은 시간과 노력이 소요된다. 따라서 본 연구에서는 이러한 한계를 극복하기 위해 합성곱 신경망 (Convolutional neural network, CNN)에 기반한 검출 및 분할에 딥 러닝 접근법을 적용하는 YOLOv5 알고리즘을 통해 검체 이미지 내에서 사구체를 자동으로 검출해 내도록 하였다. 그리고 루푸스 신염 환자의 슬라이드 이미지에 대한 태깅 작업을 거쳐 학습을 위한 데이터와 테스트를 위한 데이터를 생성하여 학습 및 테스트에 활용하였다. 그 결과 고화질의 검체 이미지 내에서 대부분의 사구체를 0.9 이상의 높은 precision과 recall로 검출해 낼 수 있었다. 이를 통해 신장 내부의 사구체 검출을 자동화하고 추후 연구를 통해 사구체 염증 정도를 단계화 할 수 있는 발판을 마련하였다.

• Childhood Kidney Diseases
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• v.6 no.2
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• pp.155-168
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• 2002

Purpose; Systemic lupus erythematosus(SLE) is an autoimmune disease with multi-system involvement and renal damage is a major cause of morbidity and mortality in children. Renal involvement is more common and severe in children than in adults. Therefore, renal biopsy plays a crucial role in planning effective therapy. In this study, we investigated the clinical and pathological findings of lupus nephritis in children to aid clinical care of the disease. Methods: The clinical and pathological data of 40 patients who were diagnosed as SLE with renal involvement in Shinchon Severance Hospital from Jan. 1990 to Sep. 2002 were analyzed retrospectively. Results: The ratio of male to female patients was 1:3 and the median age at diagnosis was 12.1(2-18) years old. FANA(95.0%), anti-ds DNA antibody(87.5%), malar rash(80.0%) were the most common findings among the classification criteria by ARA. Microscopic hematuria with proteinuria(75.0%), nephrotic syndrome(55.0%), and microscopic hematuria alone(15.0%) were the most common renal presentations in the respective order at diagnosis. There were 27 cases with WHO class IV lupus nephritis confirmed by renal biopsy and 3 cases with pathological changes of WHO class type. Different treatment modalities were carried out : prednisolone only in 5 cases, prednisol-one+azat-hioprine in 9 cases, prednisolone+azathioprine+intravenous cyclophosphamide in 14 cases, prednisolone+cyclosporine A+intravenous cyclophosphamide in 12 cases, plasma exchange in 9 cases and intravenous gamma-globulin in 2 cases. The average follow-up period was $51.8{\pm}40.5$ months. During $51.8{\pm}40.5$ months. During follow-up, 4 patients expired. The risk factors associated with mortality were male, WHO class IV and acute renal failure at diagnosis. Conclusion: Renal involvement was noted in 63.5% of childhood SLE, and 67.5% of renal lesion was WHO class IV lupus nephritis which is known to be associated with a poor prognosis. Therefore aggressive treatment employing immunosuppressant during the early stages of disease could be helpful in improving long-term prognosis. But careful attention should be given to optimize the treatment due to unique problems associated with growth, psychosocial development and gonadal toxicity, especially in children.

• Childhood Kidney Diseases
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• v.2 no.2
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• pp.110-117
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• 1998

Purpose : Henoch-$Sch{\ddot{o}}nlein$ purpura nephritis(HSPN) accompanied by nephrotic syndrome(NS) is known to have a poor prognosis and effective treatment is still controversial, even though both corticosteroids and immunosuppresant have been used for therapy. Cyclosporine A(CsA) is a well known immunosuppresant and widely used in renal transplantation and glomerular diseases especially steroid resistant. The aims of this study was to evaluate the therapeutic effect of CsA and to compare CsA with previously reported our data of rifampin(RFP) and azathioprine(AZA) in children with HSPN accompanied by NS. Methods : 37 HSPN patients with NS confirmed by renal biopsy were selected. Of these, 17 patients were treated with CsA(5 mg/kg/day) fur 6-8 months, 7 children were treated with RFP(10-20 mg/kg/day) for 9-12 months and 13 patients were treated with AZA(2 mg/kg/day) fur 8 months. Along with these regimens, low dose oral prednisolone(0.5-1 mg/kg, qod) was also used. Sequential renal biopsy was done in all patients 1 month after termination of treatment. Results : Complete remission rate of nephrotic syndrome was $58.8\%$ in CsA, $57.1\%$ in RFP and $38.4\%$ in AZA group after 17, 22, 11 months of mean follow-up period. Overall remission rate including partial remission was $88.2\%$ in CsA, $85.7\%$ in RFP and $84.6\%$ in AZA group. Disappearance rate of hematuria was $58.8\%$ in CsA, $57.1\%$ in RFP and $46.2\%$ in AZA group. Improvement of grade of clinical status was observed in 17 out of 17 CsA, 7 out of 7 RFP and 10 out of 13 AZA group. Improvement of pathologic class on sequencial renal biopsy was shown in 5 CsA($29.4\%$), none RFP($0\%$) and 2 AZA group($12.4\%$). Improvement on histologic immune-deposition was seen in 15 CsA($88.2\%$), 6 RFP($85.9\%$) and 4 AZA group($30.8\%$). Conclusion : In conclusion, Both CsA and RFP treated groups showed better result in complete remission rate of nephrotic syndrome and significant improvement of histologic immune-deposition compared with AZA treated group(p=0.004). So, we recommend CsA and REP rather than AZA for immunosuppresant treatment in HSPN with nephrotic syndrome.

• Childhood Kidney Diseases
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• v.18 no.1
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• pp.24-28
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• 2014

Purpose: The purpose of this study was to assess the therapeutic efficacy of methylprednisolone pulse therapy in children with IgA nephropathy and Henoch- Sch$\ddot{o}$nlein Purpura (HSP) nephritis combined with proteinuria. Methods: We retrospectively reviewed the clinical records of 21 patients who were diagnosed with IgA nephropathy and HSP nephritis based on percutaneous renal biopsy. Of the 21 patients, 15 were diagnosed with IgA nephropathy and 6 were diagnosed with HSP nephritis. They had mild to severe proteinuria at the time of diagnosis or during follow-up. Group 1 (n=7) received methylprednisolone pulse therapy three times every couple of months, and Group 2 (n=14) received oral steroid therapy. The follow-up periods for Group 1 and 2 were 14.0 (9-54) months and 26.5 (14-34) months, respectively. There was no significant difference in the follow-up duration between the two groups. Results: The average age at diagnosis and biopsy was lower in Group 1 compared to Group 2, but it was not significantly different. At admission, all patients in both groups had hematuria and 5 patients (71.4%) of Group 1 and 14 patients (100 %) of Group 2 had proteinuria. Before treatment, there was no significant difference of spot urine protein/creatinine ratio between the two groups. During followup, 7 patients of Group 1 (100%) and 10 patients of Group 2 (71.4%) showed complete improvement of proteinuria and the spot urine protein/creatinine ratio in Group 1 was significantly lower than Group 2. Conclusion: In patients with IgA nephropathy and HSP nephritis with proteinuria, methylprednisolone pulse therapy was more effective than oral steroid therapy in the reduction of proteinuria. To investigate the effects on long-term prognosis, large-scale prospective studies are needed.

• The Korean Journal of Nuclear Medicine
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• v.26 no.2
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• pp.318-326
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• 1992

Ga-67 citrate scan has been requested for detection or follow-up of inflammatory or neoplastic disease. Visualization of Ga-67 citrate in the kidneys at 48 and 72 hr post injection is usually interpreted as evidence of renal pathology. But precise mechanisms of abnormal Ga-67 uptake in kidneys were unknown. We undertook a study to determine the clinical value of Ga-67 citrate imaging of the kidneys in 68 patients with primary or secondary nephropathy confirmed by renal biopsy and 66 control patients without renal disease. Renal uptake in 48 to 72 hr images was graded as follows: Grade 0=back-ground activity:1=faint uptake greater than background;2=definite uptake, but less than lumbar vertebrae; 3=same uptake as lumbar vertebrae, but less than liver; 4=same or higher uptake than liver. The results were as follows. 1) 42 of 65 (62%) patients with noninfectious nephritis showed grade 2 or higher Ga-67 renal uptake but only 10 percent of control patients showed similar uptake. 2) In 14 patients with systemic lupus erythematosus, 8 of 9 (89%) patients with lupus nephritis exhibited marked renal uptake 3) 36 of 41 patients (88%) with combined nephrotic syndrome showed Grade 2 or higher renal uptake. 4) Renal Ga-67 uptake was correlated with clinical severity of nephrotic syndrome determined by serum albumin level, 24 hr urine protein excretion and serum lipid levels. 5) After complete remission of nephrotic syndrome, renal uptake in all 8 patients who were initially Grade 3 or 4, decreased to Grade 1 or 0. In conclusion, we think that the mechanism of renal Ga-67 uptake in nephrotic syndrome might be related to the pathogenesis of nephrotic syndrome. In systemic lupus erythematosus, Ga-67 citrate scan is useful in predicting renal involvement.

• Proceedings of the PSK Conference
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• 2002.10a
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• pp.140-142
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• 2002

The fruiting body of Ganoderma lucidum (Polyporaceae) is one of the valuable crude drugs, which has been used clinically in Korea, China, and Japan for a long time as a tonic and sedative, and for the treatment of hepatopathy, chronic hepatitis, nephritis, gastric ulcer, hypertension, arthritis, neurasthenia, insomnia, asthma, and poisoning and chronic bronchitis. Nowadays, this mushroom is used for leukopenia and paid much attention as a home remedy. (omitted)

• Journal of Oral Medicine and Pain
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• v.7 no.1
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• pp.41-46
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• 1982

The patient, 11 yeats old male was examined for routine oral health care. He had been hospitalized for treatment of nephritis. Hos physical condition os mental retarded & undergrowth state. In oral examination, notch on cutting edge and screw-driver shaped crown of maxillary central incisors, narrow crown and dwarfed & pinched occlusal surface of lower first molars and scars(rhagades) on the angle of the lip were shown. We diagnosed the above symptoms as dental defects of congenital syphilis; Huchinson's inscisors and mulberry molar.