Meta-analysis of factors predicting resistance to intravenous immunoglobulin treatment in patients with Kawasaki disease / 소아과

PURPOSE: Studies have been conducted to identify predictive factors of resistance to intravenous immunoglobulin (IVIG) for Kawasaki disease (KD). However, the results are conflicting. This study aimed to identify laboratory factors predictive of resistance to high-dose IVIG for KD by performing meta-analysis of available studies using statistical techniques. METHODS: All relevant scientific publications from 2006 to 2014 were identified through PubMed searches. For studies in English on KD and IVIG resistance, predictive factors were included. A meta-analysis was performed that calculated the effect size of various laboratory parameters as predictive factors for IVIG-resistant KD. RESULTS: Twelve studies comprising 2,745 patients were included. Meta-analysis demonstrated significant effect sizes for several laboratory parameters: polymorphonuclear leukocytes (PMNs) 0.698 (95% confidence interval [CI], 0.469-0.926), C-reactive protein (CRP) 0.375 (95% CI, 0.086-0.663), pro-brain natriuretic peptide (pro-BNP) 0.561 (95% CI, 0.261-0.861), total bilirubin 0.859 (95% CI, 0.582-1.136), alanine aminotransferase (AST) 0.503 (95% CI, 0.313-0.693), aspartate aminotransferase (ALT) 0.436 (95% CI, 0.275-0.597), albumin 0.427 (95% CI, -0.657 to -0.198), and sodium 0.604 (95% CI, -0.839 to -0.370). Particularly, total bilirubin, PMN, sodium, pro-BNP, and AST, in descending numerical order, demonstrated more than a medium effect size. CONCLUSION: Based on the results of this study, laboratory predictive factors for IVIG-resistant KD included higher total bilirubin, PMN, pro-BNP, AST, ALT, and CRP, and lower sodium and albumin. The presence of several of these predictive factors should alert clinicians to the increased likelihood that the patient may not respond adequately to initial IVIG therapy.

Human Cord Blood Stem Cell Therapy for Treatment of Stress Urinary Incontinence

Our objective in this study was to evaluate the safety and efficacy of transurethral cord blood stem cell injection for treatment of stress urinary incontinence in women. Between July 2005 and July 2006, 39 women underwent transurethral umbilical cord blood stem cell injection performed by one operator at a single hospital. All patients had stress urinary incontinence. The patients were evaluated 1, 3, and 12 months postoperatively. No postoperative complications were observed. 28 patients (77.8%) were more than 50% satisfied according to the Patient's Satisfaction results after 1 month, 29 patients (83%) were more than 50% satisfied according to the Patient's Satisfaction results after 3 months, and 26 (72.2%) continuously showed more than 50% improvement after 12 months. Intrinsic sphincter deficiency and mixed stress incontinency improved in the ten patients evaluated by urodynamic study. Our results suggest that transurethral umbilical cord blood stem cell injection is an effective treatment for women with all types of stress urinary incontinence.

Performance Evaluation of Anti-rubella IgM and IgG Antibodies by Roche Modulddar Analytics E170 / 임상검사와정도관리

BACKGROUND: The tests for the anti-rubella antibodies are important in early pregnancies because the risk of congenital anomaly should be considered depending on the results. We would like to evaluate analytical performance of Roche Modular Analytics E170 (Roche Diagnostics, Mannheim, Germany; E170) for anti-rubella antibodies. METHODS: For the comparison studies, a total of 436 sera from pregnant or fertile women was used for the detection of anti-rubella antibodies by E170 and VIDAS analyzer. The precision of E170 for serum anti-rubella IgM and IgG were also evaluated. RESULTS: In the precision study, within-run and total CV of anti-rubella IgM and IgG were below 5%. In the comparison study, the agreement of E170 with VIDAS was above 90%. CONCLUSIONS: The E170 showed a satisfactory precision for anti-rubella antibodies and a high level of concordance with VIDAS. Therefore, E170 would be useful as a routine immunoassay analyzer for measuring anti-rubella IgM and IgG antibodies.

An analysis of various factors affecting postpartum umbilical cord blood volume for hematopoietic stem cell transplantation / 대한산부인과학회지

OBJECTIVE: Umbilical cord blood is an effective alternative to bone marrow as a source of hematopoietic stem cells for transplantation. But the amount of collected umbilical cord blood and its contents are limited and obtaining an adequate volume of umbilical cord blood is essential for successful transplantation. The aim of this study was to identify factors that influence the volume of umbilical cord blood. METHODS: A retrospective analysis of the maternal, neonatal and placental factors that were obtained by medical record review was conducted. The variables that were evaluated for this study were mother's age, parity, gestational age, presence of maternal diabetes mellitus, route of delivery, multiple births, neonatal sex and birth weight, and placental weight. Total 484 deliveries were evaluated from March 2003 to April 2004. The statistical significance of observed differences was calculated using t-test and multiple regression analysis; p-value<0.05 was considered significant. RESULTS: Gestational age, neonatal birth weight, placental weight, parity, number of fetus and maternal diabetes mellitus were significantly associated with a greater volume of collected umbilical cord blood. Obstetric factors that influenced the total nucleated cell concentration were gestational age, neonatal birth weight, placental weight, number of fetus, and route of delivery. CONCLUSION: To prolong a gestational age as far as possible, at least beyond the 37 completed weeks of gestation, and modifying a method of vaginal delivery or cesarean section rather than conventional vaginal delivery method can increase significantly the volume of collected cord blood and the yield of the concentration of total nucleated cell.

Reduced-intensity Umbilical Cord Blood Transplantation in Adult Acute Myeloid Leukemia: Report of Four Cases

The outcome after unrelated cord blood transplantation (CBT) is similar to that of matched unrelated bone marrow transplantation in children, and the results of CBT in adult patients has recently shown improvement. In addition, the use of reduced-intensity conditioning regimens for CBT has shown stable engraftment and reduced treatment-related mortality (TRM). From May 2005 to Jan 2006, four adult patients with acute myelogenous leukemia were treated with CBT after reduced-intensity conditioning at our hospital. The mean age of patients was 53.8 yrs, and all patients received 2 HLA antigen mismatched single unit cord blood. The infused mean cell dose was 2.85 x 10(7)/kg for total nucleated cells and 0.72 x 10(5)/kg for CD34+ cells. All patients had engraftment. The mean number of days to WBC and platelet engraftment was D+20.3 and D+60.3, respectively. There was no TRM within 100 days after transplantation. At the last follow up, three of the four patients were alive. One patient transplanted in first complete remisson is alive in remission at day 413, but the other patients transplanted in advanced disease all relapsed. Reduced-intensity CBT is a feasible approach in selected adult patients with acute myeloid leukemia.

Usefulness of the IMI Channel of Sysmex SE-9000(TM) Automated Hematology Analyzer Predicting the Optimal Timing of Peripheral Blood Stem Cell Harvest / 임상검사와정도관리

BACKGROUND: An essential prerequisite for successful procurement of sufficient peripheral blood stem cells (PBSC) for engraftment is the optimal timing of collection. The Sysmex SE-9000 automated hematology analyzer provides the immature information (IMI) channel for the identification and counting PBSC. In this study, The optimal timing of PBSC collection was studied using IMI channel. METHODS: 193 peripheral blood stem cell collections were performed from 52 patients with hematologic disorders or solid tumors and 15 donors. Pre-harvest peripheral blood WBC, mononuclear cells (MNC) and IMI were tested and compared with CD34+ cell count and CFU-GM count of harvested products. RESULTS: Peripheral blood WBC and MNC count showed a weak correlation with CD34+ cell yield (r=0.38, P1x10(6)/kg with sensitivity of 88.7%. Positive and negative predictive values of IMI >465/microliter for CD34+ cell >1x10(6)/kg were 65.5% and 87.5%, respectively. CONCLUSIONS: The automated IMI might be used as a simple and efficient indicator of PBSC mobilization and applying variable cutoff values of IMI would be a useful tool to predict the optimal timing of PBSC collection.

Clinical Significance of Serum CA 125 in Patients with Chronic Liver Diseases / 대한소화기학회지

BACKGROUND/AIMS: The clinical significance of serum CA 125 levels in patients with chronic liver disease has not been widely appreciated in relation to the severity of the disease. We examined serum CA 125 levels in patients with chronic liver disease according to the severity of liver disease and the presence of ascites. METHODS: Fasting serum CA 125 levels were measured by a commercial RIA kit in 92 patients with chronic liver disease: 22 with chronic hepatitis and 70 with liver cirrhosis (Child class A, 19; B, 28; C, 23). Forty-one patients (45%) had ascites. RESULTS: The patients with Child class C liver cirrhosis had significantly higher mean serum CA 125 level than those with class A (p<0.05). In Child class B patients, the mean serum CA 125 level was significantly higher in patients with ascites than in those without (p<0.05). A multiple regression analysis showed that the presence of ascites, serum albumin, and prothrombin time were independent factors related to the increase of serum CA 125 levels. CONCLUSIONS: The presence of ascites is more closely related to the increase of CA125 levels in patients with liver cirrhosis than the severity of liver disease.

A Study of Lupus Anticoagulants and Anticardiolipin Antibodies in Patients with Infertility and Recurrent Spontaneous Abortion / 대한불임학회지

OBJECTIVE: To report the prevalence of lupus anticoagulants and anticardiolipin antibodies in patients with recurrent spontaneous abortion and infertility. MATERIAL AND METHOD: Lupus anticoagulants and anticardiolipin antibodies were analyzed by Diluted Russell's Viper Venom Test (DRVVT) and solid phase enzyme immunoassay, respectively. RESULTS: In 200 patients with infertility, there were 6 cases (3%) with positive lupus anticoagulants or anticardiolipin antibodies. Of these, 3 patients (1.5%) showed positive lupus anticoagulants and anticardiolipin antibodies, respectively. In 120 patients with recurrent spontaneous abortion, there were 13 cases (10.8%) of positive lupus anticoagulants or anticardiolipin antibodies. Of these, one patient (1%) showed lupus anticoagulants and 12 patients (10%) showed anticardiolipin antibodies. But in two groups, there was no cases with positive lupus anticoagulants and anticardiolipin antibodies. CONCLUSION: Lupus anticoagulants and anticardiolipin antibodies are definite cause of recurrent spontaneous abortion. There has been a speculation that they might be associated with infertility and repeated IVF failures. But it was found that the role of lupus anticoagulants and anticardiolipin antibodies in these cases are not clear.

Evaluation of the Dual Test using PAPP-A and Free beta-hCG in First Trimester as a Prenatal Screening Test for Down Syndrome / 대한임상병리학회지

BACKGROUND: Dual test has been reported to be a useful first trimester screening test for Down syndrome and is comprised of measuring two serum parameters; pregnancy associated plasma protein A(PAPP-A) and free beta chorionic gonadotrophin(beta-hCG). This study was performed to investigate the distribution of these two parameters in Korean pregnant women and compare its significance with that of Triple test which is a second trimester screening test and being more commonly used in Korea. METHODS: For the Dual test, serum PAPP-A and free beta-hCG were each measured by radioimmunoassay(AMERLEX-M kitTM) in 2,526 first-trimester pregnant women. Triple test was done in 7,007 second-trimester pregnant women. RESULTS: The median value of PAPP-A was 9.3, 12.5, 18.1 and 26.6 IU/mL, and that of free beta-hCG was 47.8, 35.4, 29.4 and 29.3 nmol/L in 10th, 11th, 12th and 13th gestational week, respectively. The Dual test was positive in 7.8%(198/2,526), while the Triple test was positive in 3.0%(208/7,007). Among 87 Dual test positive cases, Down syndrome was diagnosed in three cases(3.5%), while 71 Triple test positive cases, seven cases(9.9%) were Down syndrome. Among 1,316 cases who had both the Dual and Triple test, 1,300(98.8%) were both negative, and two(0.2%) were both positive, showing 99% of concordance rate. CONCLUSIONS: These results showed a possibility that the Dual test could be used as a valuable first-trimester screening test for Down syndrome in our country.

Efficacy of Ferritin - folate - cyanocobalamin Supplementation during Pregnancy for Prevention of Anemia / 대한주산의학회잡지

OBJECTIVE: The purpose of this study is to evaluate the efficacy of ferritin-folate-cyanocobalamin supplementation for prevention of anemia during pregnancy. METHODS: The authors conducted a clinical investigation on 50 pregnant women from 20th to 36th gestational weeks. The cobination of cyanocobalamin coenzyme 500mg, folic coenzyme 800mcg, and ferritin 20mg constituted the supplementation. The parameters examined in first trimester as baseline, before treatment(at 20th weeks), and after treatment(at 36th weeks) were : hemoglobin, hematocrit, ferritin, mean corpuscular hemoglobin(MCH), mean corpuscular hemoglobin concentration(MCHC), mean corpuscular volume(MCV), red blood cell count(RDW), folic acid, and vit. BPaired sample t-test was used for comparison. RESULTS: The results indicated a significant increase in the value of hemoglobin(p<0.05) and hematocrit(p<0.01) in comparison to before and after the treatment. The values of serum ferritin, folic acid, vitamin Bwere increased after the treatment compared to those of before the treatment, though there was no statistical significance. The results of MCV, MCH, MCHC, and RDW showed no statistically significant in comparison to before and after the treatment. CONCLUSIONS: These data indicate that supplementing ferritin 20mg-folate 800mcg-cyanocobalamine 500mcg per day from 20th to 36th weeks' gestation can increase values of hemoglobin, hematocrit, and ferritin concentration and can be cosidered as an appropriate method to prevent iron deficient anemia. It also might increase the value of folic acid and vitamin B12, concentration, but further study is stiU needed to determine whether the supplementation of folate and cyanocobalamine in combination with iron can have better eflicacy than iron alone in prevention of iron deficiency anemia.

The comparison of histologic gastritis in patients with duodenal ulcer, chronic gastritis, gastric ulcer and gastric cancer

This study was designed to investigate the differences of histologic gastritis according to the endoscopic diagnosis, and between H. pylori positive and negative gastritis, using the Sydney system. A total of 122 patients (42 duodenal ulcer, 31 chronic gastritis, 35 gastric ulcer and 14 gastric cancer) underwent endoscopy with biopsies from the antrum and body. Among the 122 patients, 104 (85%) were H. pylori positive. H. pylori density of the antrum was significantly higher in duodenal ulcer than in chronic gastritis, gastric ulcer, and gastric cancer. The positivity of intestinal metaplasia was lowest in duodenal ulcer and highest in gastric cancer. H. pylori density as well as grade of activity, inflammation and atrophy were significantly higher in the antrum than in the body in duodenal ulcer, while in chronic gastritis, gastric ulcer and gastric cancer there was no difference of H. pylori density, activity, inflammation and atrophy between the antrum and body. The grade of activity and chronic inflammation were significantly higher in H. pylori positive patients than in H. pylori negative patients in both the antrum and body. In conclusion, the gastritis of duodenal ulcer was mainly localized to the antrum, while the gastritis of chronic gastritis, gastric ulcer or gastric cancer was rather uniform in the antrum and body. H. pylori seemed to be related to the development of chronic inflammation and activity.

Comparison of Maternal Serum Screening Test Efficacy for Down Syndrome / 대한산부인과학회잡지

Maternal serum alpha-feto protein(MSAFP) screening test has provided high sensitivity and specificity in detecting neural tube defects(NTD). Approximately 80~90% of NTD can be identified by this screening test.Prospective studies have shown that low levels of MSAFP can be used for Down syndrome screening test, but the detection rate for Down syndrome in combination with age is only 20% in younger women, making this screening test relatively insensitive. However recently some studies have suggested that the triple marker test with MSAFP, unconjugated estriol, beta-human chorionic gonadotropin achieved higher detection rate for Down syndrome. The purpose of present study is to compare the positive predictive values of both MSAFP and Triple test. We had 6,436 cases of MSAFP test during the year of 1994 and 7,077 cases for triple test during the year of 1995. We analyzed data with positive results by screening both tests, since our purpose is to compare positive value. The number of positive results were 290(triple test) and 206(AFP) respectively. With this study, we concluded that positive predictive value of triple marker test is 4.17 times greater than of the MSAP test.

Comparison of Maternal Serum Screening Test Efficacy for Down Syndrome / 대한산부인과학회잡지

Maternal serum alpha-feto protein(MSAFP) screening test has provided high sensitivity and specificity in detecting neural tube defects(NTD). Approximately 80~90% of NTD can be identified by this screening test.Prospective studies have shown that low levels of MSAFP can be used for Down syndrome screening test, but the detection rate for Down syndrome in combination with age is only 20% in younger women, making this screening test relatively insensitive. However recently some studies have suggested that the triple marker test with MSAFP, unconjugated estriol, beta-human chorionic gonadotropin achieved higher detection rate for Down syndrome. The purpose of present study is to compare the positive predictive values of both MSAFP and Triple test. We had 6,436 cases of MSAFP test during the year of 1994 and 7,077 cases for triple test during the year of 1995. We analyzed data with positive results by screening both tests, since our purpose is to compare positive value. The number of positive results were 290(triple test) and 206(AFP) respectively. With this study, we concluded that positive predictive value of triple marker test is 4.17 times greater than of the MSAP test.

Observation on 387 cases of peripheral cytopenia undergone bone marrow examination / 대한혈액학회지

No abstract available.

A case of acute myelomonocytic leukemia with initial manifestationsin the skin / 대한임상병리학회지

No abstract available.

A case of acute myelomonocytic leukemia with initial manifestationsin the skin / 대한임상병리학회지

No abstract available.