Development and clinical evaluation of a rapid diagnostic kit for feline leukemia virus infection

Feline leukemia virus (FeLV) causes a range of neoplastic and degenerative diseases in cats. To obtain a more sensitive and convenient diagnosis of the disease, we prepared monoclonal antibodies specific for the FeLV p27 to develop a rapid diagnostic test with enhanced sensitivity and specificity. Among these antibodies, we identified two clones (hybridomas 8F8B5 and 8G7D1) that specifically bound to FeLV and were very suitable for a diagnostic kit. The affinity constants for 8F8B5 and 8G7D1 were 0.35 x 10(9) and 0.86 x 10(9), respectively. To investigate the diagnostic abilities of the rapid kit using these antibodies, we performed several clinical studies. Assessment of analytical sensitivity revealed that the detection threshold of the rapid diagnostic test was 2 ng/mL for recombinant p27 and 12.5 x 10(4) IU/mL for FeLV. When evaluating 252 cat sera samples, the kit was found to have a kappa value of 0.88 compared to polymerase chain reaction (PCR), indicating a significant correlation between data from the rapid diagnostic test and PCR. Sensitivity and specificity of the kit were 95.2% (20/21) and 98.5% (257/261), respectively. Our results demonstrated that the rapid diagnostic test would be a suitable diagnostic tool for the rapid detection of FeLV infection in cats.

Evaluation of the Accuracy of the EasyTest(TM) Malaria Pf/Pan Ag, a Rapid Diagnostic Test, in Uganda

In recent years, rapid diagnostic tests (RDTs) have been widely used for malaria detection, primarily because of their simple operation, fast results, and straightforward interpretation. The Asan EasyTest(TM) Malaria Pf/Pan Ag is one of the most commonly used malaria RDTs in several countries, including Korea and India. In this study, we tested the diagnostic performance of this RDT in Uganda to evaluate its usefulness for field diagnosis of malaria in this country. Microscopic and PCR analyses, and the Asan EasyTest(TM) Malaria Pf/Pan Ag rapid diagnostic test, were performed on blood samples from 185 individuals with suspected malaria in several villages in Uganda. Compared to the microscopic analysis, the sensitivity of the RDT to detect malaria infection was 95.8% and 83.3% for Plasmodium falciparum and non-P. falciparum, respectively. Although the diagnostic sensitivity of the RDT decreased when parasitemia was or =100 parasites/microl. The specificity of the RDT was 97.3% for P. falciparum and 97.3% for non-P. falciparum. These results collectively suggest that the accuracy of the Asan EasyTest(TM) Malaria Pf/Pan Ag makes it an effective point-of-care diagnostic tool for malaria in Uganda.

Development and Clinical Evaluation of a Rapid Serodiagnostic Test for Toxoplasmosis of Cats Using Recombinant SAG1 Antigen

Rapid serodiagnostic methods for Toxoplasma gondii infection in cats are urgently needed for effective control of transmission routes toward human infections. In this work, 4 recombinant T. gondii antigens (SAG1, SAG2, GRA3, and GRA6) were produced and tested for the development of rapid diagnostic test (RDT). The proteins were expressed in Escherichia coli, affinity-purified, and applied onto the nitrocellulose membrane of the test strip. The recombinant SAG1 (rSAG1) showed the strongest antigenic activity and highest specificity among them. We also performed clinical evaluation of the rSAG1-loaded RDT in 182 cat sera (55 household and 127 stray cats). The kit showed 0.88 of kappa value comparing with a commercialized ELISA kit, which indicated a significant correlation between rSAG1-loaded RDT and the ELISA kit. The overall sensitivity and specificity of the RDT were 100% (23/23) and 99.4% (158/159), respectively. The rSAG1-loaded RDT is rapid, easy to use, and highly accurate. Thus, it would be a suitable diagnostic tool for rapid detection of antibodies in T. gondii-infected cats under field conditions.

Maintained Seroprevalence of Toxoplasmosis among the Residents of Jeju Island, Korea

Seroepidemiological status of toxoplasmosis among the residents of Jeju island was surveyed and evaluated by ELISA with crude extract of Toxoplasma gondii. The sera of 2,348 residents (male 1,157 and female 1,191) were collected and checked for the IgG antibody titers, which showed 13.2% positive rate (309 sera). The positive rates were increasing gradually according to the age from 4.3% in teenage to 20.6% in seventies. The positive rates were significantly different between the sex by 16.2% for male and 10.2% for female (P<0.05). This positive rate of toxoplasmosis in Jeju island residents is regarded relatively higher than any other regions of Korea. And the high positive rate may be maintained continuously among Jeju island residents without any clear reasons until now but due to some parts peculiar socio-cultural tradition of Jeju island. Therefore, it is necessary to study further the epidemiology of toxoplasmosis of Jeju island.

Relationship Between Gallbladder Distension and Lipid Profiles in Kawasaki Disease

BACKGROUND AND OBJECTIVES: Kawasaki disease (KD) is an acute systemic vasculitis in children which causes coronary arterial dilatation (CAD) and gallbladder distension (GBD). There is a dearth of investigating the relationship between the severity of KD and GBD with lipid profiles. SUBJECTS AND METHODS: A total of 80 patients with 'complete KD' who were diagnosed from January 2005 to May 2009 was enrolled in this study. Serum cholesterol {total, high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C)}, triglyceride (TG), complete blood count, inflammation markers {erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)} were measured at the time of admission during febrile period. Echocardiography and abdominal sonogram were performed in all patients to determine CAD and gallbladder size. According to GBD, patients with KD were classified as patients with GBD and patients without GBD. Between two groups, demographic and clinical data were analyzed. RESULTS: The serum level of LDL-C was significantly lower in patients with GBD (p=0.03) compared with patients without GBD or febrile control. There was no significant difference in inflammatory indices between patients with GBD and patients without GBD. GBD was not significant risk factor of CAD in this study (odds ratio=2.0, 95% confidence interval=0.82-5.3, p=0.16). CONCLUSION: This is the first study that highlights the relationship between the GBD and lipid metabolism in patients with KD. This study provides clinical insights about potential mechanism underpinning the relationship between the GBD and lipid metabolism.

A Case about Cyclosporine Treatment of Kimura's Disease Associated with Steroid Dependant Nephrotic Syndrome

Kimura's disease is a chronic inflammatory disorder of unknown etiology. A 14 year old boy suffering from steroid dependant nephrotic syndrome, was presented with relapsing painless subcutaneous masses on the left buccal area. Blood analysis showed increased IgE and eosinophilia. During 4 years follow up, he was been treated by low dose steroid and short term cyclosporine. Consequently, frequent relapses of subcutaneous masses and nephrotic syndrome has been relieved. Cyclosporine treatment combined with steroid may be useful for preventing frequent relapse of Kimura's disease.

The Comparison of Binocular Function of Basic and Simulated Divergence Excess Type in Intermittent Exotropia

PURPOSE: The purpose of this study was to evaluate and compare the binocular function in patients with basic and simulated divergence excess types of intermittent exotropia [X(T)]. METHODS: Seventy-seven patients, 46 basic type and 31 simulated divergence excess type, were studied by Worth 4-dot test (W4D), Polarized 4-dot test (P4D), Titmus test, and distance stereoacuity test using Mentor B-VAT(R)II videoacuity tester. RESULTS: Near W4D, distant W4D and distant P4D were fused in 71.7%, 8.6% and 52.2% in basic type and in 100%, 25.8% and 87.1% in simulated divergence excess type, respectively. The fusion rate in simulated divergence excess type was significantly higher, than in basic type (P=0.001, 0.04, 0.001). However, the difference in near P4D between the two types was not significant (P=0.24). In distance stereoacuity test, basic type showed 272 seconds and simulated divergence excess type showed 177 seconds, showing a significant difference (P=0.02). There was no significant difference in near stereoacuity between the two types (P=0.08). CONCLUSIONS: The study demonstrated a difference in binocular function in patients with basic and simulated divergence excess types of X(T). A better binocular function was observed in the latter group.

The Clinical and Histopathological Study of Ota's Nevus / 대한피부과학회지

BACKGROUND: Ota's nevus, characterized by the presence of melanocytes in the dermis, has been familiar among dermatologists, but the etiology, the pathophysiology, the clinical and histological classification are not entirely clear. To understand and elucidate them, more clinical studies and researches are necessary. OBJECT: The aim of this study was to document the clinical and histopathological features of Ota's nevus. METHODS: We examined 299 patients with Ota's nevus who visited the dermatology clinic in Korea from February 1993 to August 2003. Among them, 188 patients were biopsied. All the specimens were stained with hematoxylin and eosin. We examined the age & sex distribution, age of onset, seasonal variation, associated skin diseases, aggravating factors and color. We clinically classified Ota's nevus into 4 types according to Tanino's classification and histologically into 5 types based on the pattern of pigmentation. RESULTS: 1. The ratio of male and female was 1: 3. 2. The peak age of onset was at birth (28.4%) and puberty (24.8%). 3. Seasonal variation was observed with distinct aggravation in the summer (60%). 4. The associated diseases were 9 cases of persistent mongolian spot, 6 cases of nevus flameus, 4 cases of blue nevus, 3 cases of vitiligo, 3 cases of nevus of Ito, 2 cases of atopic dermatitis, 2 cases of psoriasis, 2 cases of cafe au late macules and 2 cases of contact dermatitis. 5. The aggravating factors were sunlight (35.8%), emotional stress (21.0%), menstruation (12.6%), cold exposure (9.5%), pregnancy (9.5%), fatigue (9.5%) and chemical agents (2.1%). 6. The color of lesions were blue black (36.8%), brown (34.8%), dark brown (16.1%) and slate (11.0%). 7. All cases were classified according to Tanino's METHODS: type Ia (23.1%), type Ib (20.1%), type II (26.7%), type III (9.4%), type IV (20.7%). 8. The histological subtypes of Ota's nevus were classified as: the superficial type (35.6%); the middermis type (5.9%), the superficial-middermis type (18.6%); the mid-lower dermis type (2.7%); the diffuse type was composed of the superficial dominant type (19.7%), the middermis dominant type (4.8%), the dispersed (true diffuse) type (12.2%) and the deep dominant type (0.5%). 9. In the relation between histological types and the color of the lesion: the superficial type had 31 cases of brown color, 15 cases of blue black color, 11 cases of dark brown color and 9 cases of slate color; the middermis type had 6 cases of blue black color and 2 cases of dark brown color, query number of cases of slate color; the superficial-middermis type had 12 cases of blue black color, 10 cases of dark brown color, 7 cases of brown color and 6 cases of slate color: the mid-lower dermis type had 3 cases of blue black color; for the diffuse type, the superficial dominant type had 13 cases of brown color, query number of cases of blue black color and 7 cases of dark brown color; the mid-dermis dominant type had 4 cases of brown color, query number of cases of dark brown color, the dispersed type had 14 cases of blue black color and 5 cases of brown color; the deep dominant type had 1 case of blue black color. CONCLUSION: The histological reclassification of Ota's nevus may be very useful in making a therapeutic prognosis of the disease.

The Usefulness of Titmus Test and Distance Stereoacuity Using B-VAT(R) in Intemittent Exotropes

PURPOSE: Stereoacuity test is commonly used to determine the status of sensory function in patients with strabismus. We performed Titmus test and Mentor B-VAT II videoacuity tester in patients with basic or simulated divergence excess type intermittent exotropia {X(T)}, before and after surgery, to determine the effectiveness of near stereoacuity and the correlation between near stereoacuity and distance stereoacuity. METHODS: Near stereoacuity was measured using Titmus test and distance stereoacuity was measured using a Mentor B-VAT II videoacuity tester, before and after surgery, in 41 patients with X(T). RESULTS: The stereoacuity according to Titmus test was improved from a preoperative average of 70 seconds of arc to postoperative average of 60 seconds; however, this improvement was not statistically significant (P=0.38). Distance stereoacuity was significantly improved from a preoperative average of 221 seconds to a postoperative average of 60 seconds (P=0.001). No significant correlation was present between preoperative near stereoacuity and distance stereoacuity (P=0.99). CONCLUSIONS: Titmus test was not effective in determining the status of sensory function before and after surgery in patients with basic or simulated divergence excess type X(T). We believe that distance stereoacuity is effective in determining the status of sensory function.

The Usefulness of the Worth 4-Dot Test under Room Light On and Off in Intermittent Exotropes

PURPOSE: It is known that fusion is promoted in the presence of a peripheral fusion clue in patients with intermittent exotropia, X(T). Therefore, this study compared the results of the Worth 4-dot test (W4D) with the room lights on and off in order to determine the status of the binocular function. METHODS: The W4D test was performed with lights on and off, and the polarized 4-dot test (P4D) was administered in 52 X(T) patients. RESULTS: Among these 3 tests, the fusion rate was the lowest with distance in the W4D with the lights off at 9.6%, which was followed by the W4D with the lights on at 26.9% and the P4D at 57.7%. The fusion rate of the W4D with the lights on in the patients with a distance stereoacuity better than 120 seconds of arc (") was 50%, which was significantly higher than the 18.4% observed in the patients with a stereoacuity at 120" or worse (P=0.023). Among the 14 patients who showed fusion with the distance W4D with the lights on, 10 could not fused with the W4D with the lights off. Therefore, a weak motor fusion was observed in 71.4 % of these 14 patients. CONCLUSIONS: It is possible to verify the more natural condition of the binocular sensory function of patients with X(T) using either the P4D or the W4D with the lights on rather than with the lights off. Furthermore, the W4D test with the lights on can be performed together with and be compared with that conducted with the lights off, for a better understand of the degree of motor fusion.

Tissue-engineered reconstitution of oral mucosa using polydioxanone mesh

The lack of sufficient oral mucosa available for intra-oral reconstruction has been dealt with by the use of skin or oral mucosa grafts harvested from donor sites but grafts requires more than one surgical procedures and could cause donor site morbidity. Many investigators have attempted to increase available soft tissue by tissue engineered skin or oral mucosa replacements for clinical applications. But, reconstructed mucosa by several methods have low physical properties such as rolling and contraction. The aims of this study were to develope an in vitro experimental model that maintains an epithelial-mesenchymal interaction by organotypic raft culture, and to characterize biologic properties of three-dimensionally cultured oral mucosa embedded with Polydioxanone mesh by histological and immunohistochemical analysis. The results were as follows; 1. Oral mucosa reconstructed by three-dimensional organotypic culture revealed similar morphologic characteristics to equvalent normal oral mucosa in the point that they show stratification and differentiation. 2. The expression of cytokeratin 10/13 and involucrin in the cultured tissue showed the same pattern with normal oral mucosa suggesting that organotypic co-culture condition is able to induce cellular differentiation. 3. After insertion of polydioxanone mesh, increased tensile strength were observed. These results suggest that three-dimensional organotypic co-culture of the oral mucosa cell lines with the dermal equvalent consisting type I collagen and fibroblasts reproduce the morphologic and immunohistochemical characteristics similar to those in vivo condition. And increased physical properties by use of polydioxanone mesh will helpful for clinical applications.

The Factors Affecting Enlargement of Spontaneous Intracerebral Hemorrhage

OBJECTIVE: The goal of this study is to evaluate the incidence and factors of hematoma enlargement in patients with spontaneous intracerebral hemorrhage(ICH). METHODS: We analyzed 149 cases with spontaneous ICH who underwent computerized tomography (CT) scans from January, 1995 to December, 1998. The clinical characteristics, past medical history, laboratory findings, time intervals between onset of ICH and CT scan, CT findings and results of treatment were reviewed. RESULTS: Of the total 149 patients, 28(18.8%) had hematoma enlargement, of whom 24(85.7%) underwent a first CT scan within 3 hours after onset of ICH. The incidence of hematoma enlargement significantly decreased in patients who had CT scans 3 hours later after attack. Age, sex, and site of hematoma were not related to hematoma enlargement. Patients with an irregularly shaped hematoma, inhomogenous hematoma and large hematoma had a high risk of hematoma enlargement. Hematoma enlargement was associated with a poor clinical outcome and high mortality(46.7%). CONCLUSION: Patients admitted to a hospital within 3 hours of onset of ICH, and patients with inhomogenous hematoma on CT scan, irregularly shaped hematoma, or large hematoma should be closely observed for hematoma enlargement.

Comparison of Fluid-Attenuated Inversion-Recovery Magnetic Resonance Imaging with Computed Tomography in Acute Intraventricular Hemorrhage

OBJECTIVE: Our aim is to evaluate the usefulness of fluid-attenuated inversion recovery(FLAIR) magnetic resonance(MR) imaging for detection of acute intraventricular hemorrhage(IVH) compared with pre-contrast computed tomography(CT). METHODS: Twenty-eight patients with acute IVH were evaluated with FLAIR MR imaging and precontrast CT. All MR and CT examination were performed within two days from symptom onset. One neurosurgeon and one radiologist evaluated the detectability and conspicuity of acute IVH on FLAIR MR imaging and pre-contrast CT. RESULTS: Acute IVH was detected in all patients on FLAIR MR imaging and in 23(82%) of 28 patients on pre-contrast CT. The conspicuity of IVH on FLAIR MR imaging was as good as or better than that on pre-contrast CT in 28 patient. CONCLUSION: It is suggested that FLAIR MR imaging is superior to pre-contrast CT in the diagnosis of acute IVH.

Clinical Observation of Hemolytic Anemia in Children Except Isoimmunization

No abstract available.

Results of Treatment in 33 Patients with Neuroblastoma

Neuroblastoma is a malignant neoplasm which arises from primitive sympathetic neuroblasts. It is the second most common solid tumor in young children, exceeded in incidence only by brain tumors. This tumor shows immunological features and spontaneous regression. But, in spite of recent advances in multimodality therapy survival rate has not been improved much. We reviewed 33 patients with neuroblastoma who had been diagnosed and treated between 1974 and 1980, and calculated survival rate by life table method

Clinical Analysis of Short Stature

Adequate growth is the most importment and principal factor in the fields of pediatrics and also it is great concern to all parents. There are many causes of short stature, secondary to a variety of causes. Clinical evaluation of short stature requires a wide variety of clinical, radiographic, pathologic, and biochemical tools. The most important thing is early and accurate diagnosis of disease. As a first step to do so, we performed the clinical analysis of 25 short statured children who had been admitted to Severance Hospital in recent 10 years. Results were as follows; 1) In 25 cases, male were 11 and female were 14 cases. Etiologically, contitutional slow growth 2, mongolism 1, gargoylism 3, achondroplasia 3, spondylometaphyseal dsplasia 1, cretinism 12, and pitutary dwarfism 3 cases.2) Chronological age at the beginning of diagnostic approach were generally delayed. 3) Height age and bone age of dwarfism were markedly retarded than chronological age wheras weight age showed no specific relationship except in case of malnutrition. 4) skeletal dysplasia and endocrine dwarfism, bone age was retarded than height age. But in constitutional slow growth, discrepancy was not marked. 5) Head circumference in each type of short stature was variable. 6) Diagnostic methods include measurement of height and bone age, X-ray, thyroid function test, growth hormone stimulation test and chromosome study.