Acute tubular necrosis (ATN) is a syndrome of intrinsic renal injury secondary to ischemic or toxic causes without parenchymal damages and usually non-oliguria. A 20-year old man presented with acute renal failure preceded by 2 days of watery diarrhea. He had been anuria for 48hr with intravenous fluid therapy. Oliguria persisted for 10 days and he required hemodialysis support for 6 days before renal recovery. He denied the use of any regular medication and any intravenous drug use. Renal biopsy revealed severe ATN. Histopathologic findings were marked desquamation of proximal tubular epithelial cells with intact distal tubules and normal glomeruli. We report an unusual case of ATN with anuria and clinically severe features.

Hydroureter could occur in a state where the whole ureter was remarkably expanded. The causes of occurrence are anatomi-cal urinary tract obstruction or vesicoureteral reflux, and it could occur unilaterally or bilaterally according to its reason. A 38-year-old man presented with left flank pain. Abdominal CT showed a severely atrophied left kidney and a large retroperi-toneal cyst near the left kidney. The pathologic finding showed that the cyst wall is composed of transitional epithelium, lamina propria, muscle, and adventitia, and final diagnosis was hydroureter. The unilateral marked hydroureter misdiagnosed as a retroperitoneal cyst was quite rare. We report on this rare case with literature.

Polyethylene glycol (PEG) solution is currently used to prepare the colon before colonoscopy. Hyponatremic encephalopathy is a condition with neurologic symptoms such as headache, vomiting, confusion, seizure, and sometimes respiratory arrest. A 55-year-old woman presented to our emergency department with generalized tonic-clonic seizure and mental change after ingestion of PEG solution 2 L with water. Serum sodium concentrations was 115 mmol/L. After correction with hypertonic saline for 12hrs, serum sodium concentration reached 129 mmol/L and mental status recovered. We experienced a case of acute hyponatremic encephalopathy resulting from ingestion of PEG solution 2 L for colonoscopy.

BPES(Blepharophimosis/Ptosis/Epicanthus inversus Syndrome)는 FOXL2 유전자의 돌연변이에 의해 유발되는 상염색체 우성질환이다. 눈꺼풀이 갈라지거나 쳐지고 넓은 미간이 나타나는 특징이 있으며, 여성의 조기 난소 부전증(prema-ture ovarian failure, POF)을 일으켜 불임을 유발한다. FOXL2는 forkhead family에 속하는 전사인자로서 FOXL2가 결여된 난소에서는 granulosa cell의 분화가 진행되지 않아 난포 성숙과정의 멈춤과 난자의 폐쇄증을 유발한다. FOXL2를 bait로 하여 rat의 난소 cDNA 라이브러리의 yeast two-hybrid screening을 시행하여 FOXL2 단백질과 상호작용을 하는 small ubiquitin-related modifier(SUMO)-conjugating E2 효소인 UBE2I 단백질을 찾았다. UBC9이라고도 알려진 UBE2I 단백질은 SUMO 변형 과정을 위한 필수적인 단백질이다. Sumoylation은 수 많은 전사인자의 전사능력의 조절을 포함하여 다양한 신호전달체계에 관여하는 번역 후 변형과정이다. 본 연구에서 인간세포인 293T 내에서 면역침전반응 실험을 통해 FOXL2와 UBE2I의 단백질-단백질간의 상호작용을 확인하고, FOXL2의 돌연변이형을 제작하여 yeast two-hybrid system을 이용해 UBE2I와 결합에 필요한 FOXL2의 부분을 규명하였다. 따라서, FOX2에 상호작용하는 UBE2I의 규명은 sumoylation에 의한 FOXL2의 새로운 조절 메커니즘을 시사한다.