The Relationship Among Umbilical Cord Plasma Matrix Metalloproteinase-8 and Interleukin-6 Concentration, Funisitis, Amniotic Fluid Infection and Neonatal Outcome / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to determine whether funisitis is associated with changes in the umbilical cord plasma concentration of interleukin-6 (IL-6) and matrix metalloproteinase-8 (MMP-8), microbial invasion of the amniotic cavity and neonatal outcome. METHODS: The relationship among the presence of funisitis, IL-6 and MMP-8 concentrations in umbilical cord plasma at birth, the results of amniotic fluid culture performed within 5 days of birth was examined in 83 consecutive singleton births (20-35 weeks' gestation). Funisitis was diagnosed in the presence of neutrophil infiltration into the umbilical vessel wall or Wharton's jelly. The IL-6 and MMP-8 concentration was measured with a specific immunoassay. Amniocentesis was performed in 47 patients within 5 days of birth. RESULTS: (1) Funisitis was present in 21.7% of patients. (2) Patients with funisitis had a significant higher cord plasma IL-6 concentration, but had no significant difference in cord plasma MMP-8 concentration. (3) Clinical chorioamnionitis was more common in patients with funisitis than those without funisitis. (4) A cord plasma IL-6 > 6.34 pg/ml had a sensitivity of 77.8% and a specificity of 75.4% in the identification of funisitis. (5) No correlation between cord blood plasma IL-6 concentration and MMP-8 concentration was found. (6) There was no significant correlation between gestational age at birth and cord blood plasma MMP-8 concentrations, but there appeared to be a trend to increase of cord plasma MMP-8 concentrations as gestational ages at birth were increased. (7) Neonates with congenital sepsis had a significantly higher cord plasma IL-6 and MMP-8 concentration than those without congenital sepsis. CONCLUSION: In patient with funisitis, umbilical cord plasma IL-6 concentrations were higher than those without funisitis, but umbilical cord plasma MMP-8 concentrations had no significant difference in each group. The umbilical cord plasma IL-6 and MMP-8 can be useful as a predictor of the occurrence of congenital sepsis in preterm infant.

A case of Behcet's disease with superior and inferior vena caval occlusion

Behcet's disease is a chronic multisystemic disorder involving many organs and characterized by recurrent oral and genital ulcers and relapsing iritis. A case of BD with large vein thrombosis involving superior and inferior vena cava is presented. Large vein thrombosis in BD is not commonly developed and most commonly observed in the inferior or superior vena cava. A review of the literature emphasizes the rarity of the combined superior and inferior vena caval occlusion. Existence of extensive large vein occlusion in BD is associated with limited therapy and poor prognosis.

An Outbreak of Food Poisoning by Salmonella senftenberg / 감염

Salmonella senf tenberg is an uncommon serotype and was first isolated in 1928. Recently, its increasing rate of isolation from human sources, especially from infants and neonates in hospital environments, has suggested it as an important pathogen in other countries. It has been isolated sporadically from the stool of patients with diarrhea but there has been no report of outbreak by S. senf tenberg in Korea. We report an outbreak by S. senf tenberg affecting 104 patients. S. senf tenberg was isolated from pork meat left for a long time at room temperature. The incubation period was 9 to 12 hours. Predominant symptoms were diarrhea (90%), fever (74.4 %), abdominal pain (55.1%), nausea (42.2%), and vomiting (28.9%). Mean peripheral leukocyte count was 11,413 (+/-3,037)/mm 3 and 82 (+/-9.8) % of neutrophils were of segmented form. S. senf tenberg was isolated from the stool of 31 patients among 90 patients. Most of the patients improved within 2 to 5 days with quinolone and intravenous fluid therapy.

A case of a dialysis patient with sclerosing peritonitis initially suspected of tuberculous peritonitis / 대한내과학회지

Sclerosing peritonitis (SCP) is a syndrome of multiple causes that is characterized by the thickening of peritoneal membrane and subsequent ultrafiltration failure and intestinal obstruction. We report a case of sclerosing peritonitis initially suspected of tuberculous peritonitis in a patient with pulmonary tuberculosis. A 35-year-old man presented with recurrent exudative ascites of unknown origin. He had been switched from peritoneal dialysis to hemodialysis because of recurrent peritonitis 6 months ago. Laparoscopic peritoneal biopsy revealed excessive formation of capillaries and monocyte infiltration without evidence of tuberculosis. He was discharged without further treatment. Four months later, he was readmitted with intestinal obstruction. Exploratory laparotomy revealed that the whole small intestine was encased in a thick and fibrous peritoneal capsule. Pathologic examination of peritoneal membrane showed absence of mesothelium and extensive proliferation of fibroconnective tissue, which was compatible with sclerosing peritonitis.