ABSTRACT
BACKGROUND: Anti-mitochondrial antibodies (AMA) are a hallmark of primary biliary cirrhosis (PBC); however, low titers of AMA are also detected in some patients without PBC. We evaluated the clinical value of commercial rat kidney/stomach sections and an additional biochip coated with mitochondrial antigen M2 (pyruvate dehydrogenase complex). METHODS: A total of 124 patients who had been tested for AMA were evaluated. Results of AMA, antibodies to M2, and antinuclear antibody were reviewed retrospectively and searched for clinical and laboratory data to diagnose PBC. AMA and M2 antibody were assayed by an indirect immunofluorescence assay using EUROPLUS kit (Euroimmun, Luebeck, Germany). RESULTS: In 10 of the 124 patients, a diagnosis of PBC was established by AMA, liver function test or liver biopsy. The sensitivity and specificity of rat kidney/stomach section, M2 antibody, and coarse cytoplasmic fluorescent pattern of HEp-2 cell were 80.0, 75.0, 88.9% and 97.4, 98.2, 97.3%, respectively; however, these differences were not statistically significant. Six patients with coarse cytoplasmic pattern of HEp-2 cell at 1: 320 dilution were positive for both rat kidney/stomach sec-tion and M2 antibody. Two of five patients with coarse cytoplasmic pattern at below 1: 80 dilution were diagnosed as PBC, yet all of them were negative for M2 antibody. CONCLUSIONS: M2 biochip test would be convenient to test simultaneously with rat kidney/stomach section and it provided results similar to those of the preexisting serological tests for PBC.
Subject(s)
Animals , Humans , Rats , Antibodies , Antibodies, Antinuclear , Biopsy , Cytoplasm , Diagnosis , Fluorescent Antibody Technique, Indirect , Liver , Liver Cirrhosis, Biliary , Liver Function Tests , Oxidoreductases , Retrospective Studies , Sensitivity and Specificity , Serologic TestsABSTRACT
OBJECTIVE: To determine the effect of myomectomy as a treatment for infertility and to define the factors that influence reproductive outcomes MATERIALS AND METHODS: During the period from January 1995 to December 2001, on 39 patients who suffered from infertility and habitual abortion underwent transabdominal myomectomy at the Department of Obstetrics and Gynecology in Chonbuk National University Hospital. RESULTS: Pregnancy occurred in 31 women. The mean age was 32.3 years. The pregnancy rates in women with or without associated factors in addition to myoma were 55.5% and 71.4%, respectively, and those in women with 2 years of infertility were 73.7% and 55%, respectively. In case of women with myoma on lateral side, pregnancy rate was 33.3%. Considering the size, women with a myoma, 30~50 mm in size had higher pregnancy rate (81.2%). The 24-month cumulative probability of conception was 91% in patients 35 years of age. CONCLUSION: Our results suggest a benefit of myomectomy in infertile patients. Factors affecting the pregnancy rate after myomectomy in theses patients are the age of the patient, the duration of infertility, the site of myoma, and the size of myoma <50 mm. However, women should be counseled carefully before surgery because the determinants of outcome appear to be independent of treatment.
Subject(s)
Female , Humans , Pregnancy , Abortion, Habitual , Fertilization , Gynecology , Infertility , Myoma , Obstetrics , Pregnancy RateABSTRACT
BACKGROUND: The present study was carried out in association with neutrophilic respiratory burst in the lung in order to clarify the pathogenesis of acute respiratory distress syndrome(ARDS) following acute severe hemorrhage. Because oxidative stress has been suggested as one of the principal factors causing tissue injury, the role of free radicals from neutrophils was assessed in acute hemorrhage-induced lung injury. METHOD: In Sprague-Dawley rats, hemorrhagic shock was induced by withdrawing blood(20 ml/kg of B.W) for 5 min and the hypotensive state was sustained for 60 min. To determine the mechanism and role of oxidative stress associated with phospholipase A2(PLA2) by neutrophils, the level of lung leakage, pulmonary myeloperoxidase(MPO), and the pulmonary PLA2 were measured. In addition, the production of free radicals was assessed in isolated neutrophils by cytochemical electron microscopy in the lung. RESULTS: In hypotensive shock-induced acute lung injury, the pulmonary MPO, the level of lung leakage and the production of free radicals were higher. The inhibition of PLA2 with mepacrine decreased the pulmonary MPO, level of lung leakage and the production of free radicals from neutrophils. CONCLUSION: A. neutrophilic respiratory burst is responsible for the oxidative stress causing acute lung injury followed by acute, severe hemorrhage. PLA2 activation is the principal cause of this oxidative stress.
Subject(s)
Acute Lung Injury , Free Radicals , Hemorrhage , Lung , Lung Injury , Microscopy, Electron , Neutrophils , Oxidative Stress , Phospholipases A2 , Phospholipases , Quinacrine , Rats, Sprague-Dawley , Respiratory Burst , Shock, HemorrhagicABSTRACT
A case was experienced involving submandibular salivary gland swelling (sialoadenopathy), developing after gastroscopy in a 15-year-old female who was suffering from epigastric pain & diarrhea and a case of parotid salivary gland swelling after gastroscopy in a 25-year-old female who was suffering from dyspepsia and epigastric pain. Both patients were the first two cases among about 5,000 gastroscopic examinations of the stomach conducted by the authors. As soon as the gastroscope was withdrawn, unilateral swelling, which was neither painful nor tender, was found in the left submandibular salivary gland area. This swelling disappeared spontaneously in about few hours later.
Subject(s)
Adolescent , Adult , Female , Humans , Diarrhea , Dyspepsia , Gastroscopes , Gastroscopy , Salivary Glands , StomachABSTRACT
A case of gastric anisakiasis due to the larva of Pseudoterranova decipiences was con- firmed by a gastroendoscopic examination. A long whitish nematode larva invading the stomach wall (fundus) was discovered and was extracted using biopsy forceps after 3 days to the onset of symptoms. The worm was 42.6 X 1.1 mm size, and was identified as being a the 4th stage larva of P. decipiens, based upon its morphological characteristics, The patient, residing in Seoul, was a 51-year-old housewife, who complained of severe epi- gastric pain and recalled that she had previously eaten the raw flesh of an Astroconger myriaster in a Japanese restaurant (sushi Bar). This study probably emerges as the 7th human case of gastric anisakiasis of pseudoterranoviasis in Korea.
Subject(s)
Humans , Middle Aged , Anisakiasis , Asian People , Biopsy , Korea , Larva , Restaurants , Seoul , Stomach , Surgical InstrumentsABSTRACT
BACKGROUND: The diagnosis of pulmonary embolism(PE) based on clinical findings is often elusive and therefore requires confirmative diagnostic method. Pulmonary angiography, though the gold standard for the diagnosis of pulmonary embolism, is an invasive method and requires trained personnel and special equipment. Lung V/Q scan, on the other hand, is a noninvasive method but the diagnostic specificity and sensitivity are not satisfactory in case that the results are either intermediate or low probability scan. Plasma D-dimer is generated when a thrombus is fibrinolysed by plasmin and is known to be increased in various thrombotic disorders. The aim of this study was to investigate the value of the determination of plasma D-dimer level in the diagnosis of pulmonary embolism. METHODS: Pulmonary angiography was performed in 17 patients who were clinically suspected to have pulmonary embolism. 9 patients(PE, 56+/-13.4 yrs, M:F=8:1) were diagnosed to have pulmonary embolism by pulmonary angiography. The control group were the 8 patients with negative pulmonary angiography and 13 orthopedic patients with no evidence of pulmonary embolism on scintigraphic and impedance plethysmographic studies(n=21) (non-PE, 54.5 +/-11.1 yrs, M:F=11:10). Plasma D-dimer was measured by latex agglutination method in study subjects and the results were alnalyzed according to the presence or absence of pulmonary embolism. RESULTS: 1) The increased level of plasma D-dimer was more frequently observed in the patients with pulmonary embolism than in the controls(>0.5 mg/L, 8 in PE, 10 in non-PE; <0.5 mg/L, 1 in PE, 11 in non-PE, p=0.049). 2) The diagnostic value of plasma D-dimer level higher than 0.5 mg/L were as follows: sensitivity 88.9%(8/9), specificity 52.4%(11/21), positive predictive value 44.4%(8/18), and negative predictive value 91.7%(11/12). CONCLUSION: Plasma D-dimer determination showed high sensitivity and negative predictive value in the diagnosis of pulmonary embolism and is therefore thought to be useful in excluding the possibility of pulmonary embolism.
Subject(s)
Humans , Agglutination , Angiography , Diagnosis , Electric Impedance , Fibrinolysin , Hand , Latex , Lung , Orthopedics , Plasma , Pulmonary Embolism , Sensitivity and Specificity , ThrombosisABSTRACT
Seventy four patients with pituitary adenoma received radiation therapy(RT) on the pituitary area using 6 MV linear accelerator during the past 7 years at the Division of Radiation Therapy, kangnam St. mary's hospital, Catholic University Medical College. Thirty nine were men and 35 were women. The age ranged from 7 to 65 years with the mean being 37 years. Sixty five (88%) patients were treated postoperatively and 9(12%) primary RT. To evaluate the effects of RT, we analyzed the series of endocrinologic studies with prolactin(PRL), growth hormone(GH), adrenocortiotrophic hormone (ACTH), leuteinizing hormone (LH), follicular stimulating hormone(FSH) and thyroid stimulating hormone(TSH) etc after RT. All but one with Nelson's syndrome showed abnormal neuroradiologic changes in the sella turica with invasive tumor mass around supra-and/or parasella area. The patients were classified as 23(29%) prolactinomas and 20 (26%) growth hormone (GH) secreting tumors, and 6(8%) ACTH secreting ones consisting of 4 Cushing's disease and 2 Nelson's syndrome. Twentynine(37%) had nonfunctioning tumor and four (5%) of those secreting pituitary tumors were mixed PRL-GH secreting tumors. The hormonal level in 15(65%) of 23 PRL and 3(15%) of 20 GH secreting tumors returned to normal by 2 to 3 years after RT, but five PRL and five GH secreting tumors showed high hormonal level requiring bromocriptine medication. Endocrinologic insufficiency developed by 3 years after RT in 5 of 7 panhypopituitarisms, 4 of seven hypothyroidisms and one of two hypogonadisms, respectively, Fifteen(20%) patients were lost to follow up atter RT.