ABSTRACT
Despite efforts to control the spread of malaria, the disease persists in certain parts of the world. Moreover, there has been a resurgence of the disease recently. Another protozoan disease, babesiosis is a disease of animals; Humans are infected only incidentally, and when they are infected, they develop a nonspecific febrile illness. Babesia organism enters red blood cells and resembles malaria parasites, thus posing a problem in the differential diagnosis. We encountered an imported case of mixed infection of malaria and babesia. The patient was a 20-year old Korean male who had been in Saong-dume near Gabon for 3 months. We treated him with chloroquine with the diagnosis of Plasmodium malariae infection, but fever recurred after 2 weeks of the treatment. The second peripheral blood smear findings revealed specific ring forms of Babesia spp, so we changed to quinine and clindamycin. The treatment was successful and the patient was well after 4 months of follow-up period.
Subject(s)
Animals , Humans , Male , Young Adult , Babesia , Babesiosis , Chloroquine , Clindamycin , Coinfection , Diagnosis , Diagnosis, Differential , Erythrocytes , Fever , Follow-Up Studies , Gabon , Malaria , Parasites , Plasmodium malariae , QuinineABSTRACT
BACKGROUND: Free fatty acids are well known as an energy source. However, theoretically it could be destructive through oxygen free radical chain reactions unless they are bound to albumin in blood. Recently, the toxicity of oxidative agents in several diseases, and additionally the behavior of antioxidants including albumin against this have been suggested. Therefore, we investigated the relationship between free fatty acid/albumin molar ratio and erythrocyte injury in this study. METHODS: Free fatty acid and albumin were analysed in thirty-eight hypoalbuminemia patients and fifty-six healthy controls. To measure the erythrocyte injury, hemoglobin, absolute and relative reticulocyte counts, and lactate dehydrogenase (LD) were also examined. In addition, glutathione peroxidase (GPX) and superoxide dismutase (SOD) were determined in both fifteen patients and fifteen controls, respectively. RESULTS: The albumin levels in study group (3.06+/-0.28 g/dL) were significantly lower than those of control group (4.94+/-0.21 g/dL). The hemoglobin, reticulocyte counts, and LD levels in study group were significantly different from those of control group (P<0.01), but the free fatty acid concentrations showed no difference between two groups. The free fatty acid/albumin molar ratio in study group was significantly higher than control values. In study group, there were significant correlations between the free fatty acid/albumin molar ratio and (a) LD (r=0.43, P< 0.05), (b) relative reticulocyte count (r=0.39, P<0.05), and (c) hemoglobin (r=-0.31, P<0.01), respectively. The GPX and SOD activities in study group were not statistically different from the control values. There was an inverse correlation between albumin and GPX concentrations in study group (r=-0.36, P<0.01). CONCLUSIONS: These results suggest that toxic effect of unbound free fatty acid with decreased albumin activity as antioxidant may be involved in the cellular injury in hypoalbuminemia patients. Further studies for the correlation of free fatty acid/albumin molar ratio with individual antioxidant status are needed.
Subject(s)
Humans , Antioxidants , Erythrocytes , Fatty Acids, Nonesterified , Glutathione Peroxidase , Hypoalbuminemia , L-Lactate Dehydrogenase , Molar , Oxygen , Reticulocyte Count , Superoxide DismutaseABSTRACT
BACKGROUND: Smoking has been suggested to invoke many health problems. Nicotine, one of the effective major components of tobacco smoke, has a half-life less than 2 hours and is oxidized to its major metabolite, cotinine. This study was conducted to establish the measurement system of nicotine and cotinine by high performance liquid chromatographic method (HPLC) and to set reference range in Korean population. METHODS: Fifteen nonsmokers (25-66 years old, 37.9 average) and 30 smokers (22-63 years old, 27.9 average) were investigated. We modified the methods from Kyerenmaten, et al. and from Hariharan, et al. Urine and heparinized plasma samples were pretreated. Pretreated samples were injected into Waters u-Bondapak C18 reverse column (3.9 mm 30 cm) of Waters HPLC system unit with flow rate of 2 mL/min. Absorbance was monitored at 254 nm of wavelength. RESULTS: The retention times of the NNX (nicotine-1'-N-oxide), cotinine, and nicotine peaks were 2.9, 3.7, 5.1 min, respectively, and readily delayed with increase of pH in the mobile phase. Nicotine and cotinine levels in plasma and urine samples by a modified HPLC method showed high linearity from 0 to 1000 ng/mL for both compounds. Intra- and inter-assay coefficients of variation were 7.49% and 6.54%, respectively for nicotine assay and 5.71% and 14.20%, respectively for cotinine assay. The averages and standard deviations for plasma cotinine, nicotine, urine cotinine, and nicotine in nonsmokers (N=15) were 277.8+/-313.9, 0.7+/-2.4, 382.0+/-273.7, and 17.2+/-27.5 ng/mL, respectively, and in smokers (N=30) were 312.9+/-267.1, 26.3+/-50.1, 1,049.2+/-556.2, and 555.7+/-895.1 ng/mL, respectively (P=0.351, 0.009, 0.0026, 0.000004). CONCLUSIONS: A modified HPLC method for nicotine and cotinine measurement showed a high precision and accuracy. Nicotine and cotinine levels in plasma and urine samples of smokers were significantly higher than those of non-smokers, except for plasma cotinine in passive smokers of nonsmoker group. And this method can be used as a routine test for detection of passive smoking and managing of smoking habit. Reference values of nicotine and cotinine measured in Korean nonsmokers and smokers were suggested.
Subject(s)
Chromatography, High Pressure Liquid , Cotinine , Half-Life , Heparin , Hydrogen-Ion Concentration , Nicotine , Plasma , Reference Values , Smoke , Smoking , Tobacco Smoke Pollution , NicotianaABSTRACT
BACKGROUND: Red blood cell (RBC) sorbitol has been implicated in the pathogenesis of organic complications of diabetes mellitus. W8 investigated RBC sorbitol level as an indicator of glucose control or diabetic complications, and also evaluated whether RBC sorbitol/plasma glucose ratio is an indicator of diabetic complications. METHODS: RBC sorbitol levels were measured in 43 healthy persons and 133 diabetes mellitus (DM) patients by enzymatic method. We also tested linearity, inter- and intra- assay precisions. Plasma glucose and Hb Alc were measured by hexokinase method and HPLC, respectively. Hospital records were reviewed. RESULTS: The intra- and inter-assay coefficients of variation of RBC sorbitol test are 8.7% and 28.5%, respectively. Linearity is good. The RBC sorbitol level(3.60+/-1.00 ug/mL) and RBC sorbitol/plasma glucose ratio (2.37+/-0.98%) in diabetic patients are significantly higher than those in normal control (1.69+/-0.43 ug/mL, 1.85+/-0.49 per mill), respectively(p<0.0001). We can't observe correlation between RBC sorbitol and Hb Alc in BM patients, but observe that in non-treatment DM patients. We also observed correlation between Hb Alc and glucose and reverse correlation between RBC sorbitol ratio and Hb Alc. We can't find significant relation between diabetic complications and RBC sorbitol or RBC sorbitol/plasma glucose. CONCLUSIONS: We suggest that the reference range of normal RBC sorbitol level and RBC sorbitol/plasma glucose ratio by enzymatic method are 1.69+/-0.86 ug/mL and 1.85+/- 0.98%,. These Ire significantly different from DM patients and may be useful in diagnosis of DM.
Subject(s)
Humans , Blood Glucose , Chromatography, High Pressure Liquid , Diabetes Complications , Diabetes Mellitus , Diagnosis , Erythrocytes , Glucose , Hexokinase , Hospital Records , Reference Values , SorbitolABSTRACT
BACKGROUND: Red blood cell (RBC) sorbitol has been implicated in the pathogenesis of organic complications of diabetes mellitus. W8 investigated RBC sorbitol level as an indicator of glucose control or diabetic complications, and also evaluated whether RBC sorbitol/plasma glucose ratio is an indicator of diabetic complications. METHODS: RBC sorbitol levels were measured in 43 healthy persons and 133 diabetes mellitus (DM) patients by enzymatic method. We also tested linearity, inter- and intra- assay precisions. Plasma glucose and Hb Alc were measured by hexokinase method and HPLC, respectively. Hospital records were reviewed. RESULTS: The intra- and inter-assay coefficients of variation of RBC sorbitol test are 8.7% and 28.5%, respectively. Linearity is good. The RBC sorbitol level(3.60+/-1.00 ug/mL) and RBC sorbitol/plasma glucose ratio (2.37+/-0.98%) in diabetic patients are significantly higher than those in normal control (1.69+/-0.43 ug/mL, 1.85+/-0.49 per mill), respectively(p<0.0001). We can't observe correlation between RBC sorbitol and Hb Alc in BM patients, but observe that in non-treatment DM patients. We also observed correlation between Hb Alc and glucose and reverse correlation between RBC sorbitol ratio and Hb Alc. We can't find significant relation between diabetic complications and RBC sorbitol or RBC sorbitol/plasma glucose. CONCLUSIONS: We suggest that the reference range of normal RBC sorbitol level and RBC sorbitol/plasma glucose ratio by enzymatic method are 1.69+/-0.86 ug/mL and 1.85+/- 0.98%,. These Ire significantly different from DM patients and may be useful in diagnosis of DM.