ABSTRACT
OBJECTIVE: To identify the sensitivity and specificity of the anti-cyclic citrullinated peptide antibody (anti-CCP) and rheumatoid factor (RF) in a diagnosis of Korean early rheumatoid arthritis (RA). METHODS: Two hundred and sixty two patients diagnosed with RA were examined retrospectively and classified by three groups. A group 1 had a disease duration24 months, and the third was a group of total patients. The sensitivity and specificity of the RF and anti-CCP in each group of RA were identified. Patients of the connective tissue disease other than rheumatoid arthritis were tested with RF and anti-CCP. RESULTS: The sensitivity/specificity of RF and the anti-CCP in early RA were 90.4%/68.0% and 87.5%/89.3%, 91.3%/68.0%, 81.7%/89.3% in each, and 90.4%/68.0% and 84.7%/89.3% in the total RA patients. The accurate diagnosis rate, which is defined as (number of true positives plus true negatives)/ the total number of patients), of the RF and anti-CCP was 79.2%/88.4% in the early RA group, and 79.4% and 89.0% in the total patients group. CONCLUSION: Anti-CCP is more specific than RF in diagnosing RA. Although it is not statistically significant, diagnositc sensitivity of anti-CCP in early RA group is higher than that of established RA group.
Subject(s)
Humans , Arthritis, Rheumatoid , Connective Tissue Diseases , Diagnosis , Retrospective Studies , Rheumatoid Factor , Sensitivity and SpecificityABSTRACT
BACKGROUND: Information about the natural history of chronic idiopathic thrombocytopenic purpura (ITP) is still vague and far from complete due to a lack of studies. The purpose of the present study is to define ultimate outcome of adults with chronic ITP by long-term observation of patients. Method : We retrospectively analyzed eighyty-seven ITP patients diagnosed at the Department of Internal Medicine, Kyungpook National University Hospital and Taegu-Hyosung Catholic University Hospital and Taegu-Fatima Hospital between March 1986 and March 1998. RESULTS: Median age was 36 years (range 15 to 74) at the time of diagnosis and median follow-up duration was 46 months (7 to 133). Female to male ratio was 4 : 1. Twenty-four patients who were asymptomatic with stable disease or a platelet count over 50,000/microliter were managed on a wait and see basis. A total of 63 patients received an initial treatment with prednisone (1 mg/kg/day for 1 month). Refractory or relapsed cases underwent splenectomy and/or other therapeutic modalities. An initial complete or partial response to prednisone was observed in 79%. A sustained complete remis- sion (CR) lasting more than 6 months was attained in 11%. Thirty-two refractory or relapsed patients underwent splenectomy. Twenty-two patients (69%) had a CR, with twenty-one (66%) achieving a sustained CR. 5 other cases obtained a partial remission (PR). Long-lasting responses were observed in 3 other case (12 %) following alternative treatment. Five deaths were recorded, but only one was due to thrombocytopenia and the remaining four deaths were unrelated to ITP. Two patients had laboratory features and a clinical history consistent with an autoimmune disease. CONCLUSION: The majority of patients who undergo splenectomy can have a CR for many years. The therapeutic modalities tried as supplements or alternatives to splenectomy all produced some transient remissions but few prolonged recoveries. But the long-term prognosis of chronic ITP is benign even in refractory cases and the development of overt autoimmune diseases is relatively uncommon.
Subject(s)
Adult , Female , Humans , Male , Autoimmune Diseases , Diagnosis , Follow-Up Studies , Internal Medicine , Natural History , Platelet Count , Prednisone , Prognosis , Purpura, Thrombocytopenic, Idiopathic , Retrospective Studies , Splenectomy , ThrombocytopeniaABSTRACT
BACKGROUND AND OBJECTIVES: Eosinophil infiltration into inflammatory site is a characteristic histological finding in patients with allergic rhinitis, bronchial asthma, and nasal polyps. The regulation of eosinophil survival and apoptosis may play a major role in tissue eosinophilia, and glucocorticosteroids (GCs) have been used therapeutically for nasal polyps. The purpose of this study is to investigate the effect of commonly used GCs on eosinophil survival and apoptosis primed by nasal polyp epithelial cells. MATERIALS AND METHODS: Peripheral blood eosinophils were incubated in increasing concentrations (10-10M) to GCs (triamcinolone, dexamethasone, budesonide, and fluticasone propionate) from January, 1990 to December, 1999 prior to the addition of human nasal polyp epithelial cell conditioned media (HECM). Eosinophil viability was measured with a MTS assay and apoptosis was analyzed with the caspase-3 staining. RESULTS: GCs suppressed the HECM induced prolongation of eosinophil survival with apoptotic change of cells from 2 days after incubation. Fluticasone propionate showed the strongest effects and triamcinolone showed the weakest effects. CONCLUSION: GCs may diminish eosinophilic infiltration into nasal polyp by decreasing eosinophil viability, and abrogate the promoting effect of nasal epithelial cells.
Subject(s)
Humans , Apoptosis , Asthma , Budesonide , Caspase 3 , Culture Media, Conditioned , Dexamethasone , Diethylpropion , Eosinophilia , Eosinophils , Epithelial Cells , Glucocorticoids , Nasal Polyps , Rhinitis , Triamcinolone , FluticasoneABSTRACT
PURPOSES: Cells undergoing apoptosis display profound morphologic and biochemical changes in the nucleus and cytoplasm, loss of membrane phospholipid asymmetry, resulting in the exposure of phosphatidylserine (PS) at the surface of the cell, membrane blebbing, and decreased membrane microviscosity. Proton nuclear magnetic resonance spectroscopy ('H NMR spectroscopy) is able to detect the mobile fraction of lipids contained in the cell, and thus is sensitive to membrane fluidity modifications related to lipid composition changes. We have used 'H NMR spectroscopy in HL-60 cell line to detect and characterize the changes in plasma membrane lipid associated with apoptotic cell death. MATERIALS AND METHODS: We performed annexin-FITC and propidium iodide dual fluorescence flow cytometry, DNA gel electrophoresis, and obtained 200 MHz 'H NMR spectra of the HL-60 cell cultures before and at 6, 12, 18, 24, 36 and 48 hours after the addition of doxorubicin (100 ng/mL). RESULTS: The onset of apoptosis is accompanied by a greater than four fold increase in signal intensity ratio of the membrane lipid methylene (-CH2) resonance (at 1.2 ppm) to the methyl (-CH3) resonance (at 0.9 ppm). The quantitative relationship between apoptosis and the H NMR signal intensity was determined by fluorescein-annexin V flow cytometry, and showed that increases in the CH2/CH3 resonance signal intensity ratio paralleled the surface expression of PS as an early marker of apoptosis ( y =0.80, N 18 samples). The gradual decrease in the ratio of choline resonance (at 3.2 ppm) to CH3 signal intensity after 12 hours in the time course' experiment is directly proportional to the percentage of apoptotic cells ( y =0.96, N=18 samples). CONCLUSIONS: Monitoring of the CH2 and choline resonance signal intensity may therefore be useful in detecting apoptosis. Further studies using various stimuli to induce apoptotic cell death will be necessary to better determine the capabilities of 'H NMR spectroscopy for the detection and estimation of apoptosis in vitro.
Subject(s)
Humans , Apoptosis , Blister , Cell Death , Cell Membrane , Choline , Cytoplasm , DNA , Doxorubicin , Electrophoresis , Flow Cytometry , Fluorescence , HL-60 Cells , Magnetic Resonance Spectroscopy , Membrane Fluidity , Membranes , Propidium , Protons , Spectrum AnalysisABSTRACT
No abstract available.