Factors Affecting on Conservative Treatment of Morton's Neuroma / 대한족부족관절학회지

PURPOSE: The purpose of this study was to investigate the clinical results of conservative treatment for Morton's neuroma and to analyze the factors which influenced on the results. MATERIALS AND METHODS: In this retrospective study, 101 cases of 83 patients with interdigital neuroma were conservatively treated with follow-up period of at least 6 months. There was no significant difference in results among different age groups, sxes, and lesion sites. However, the results were significantly better if the treatment was started within 6 months after onset. RESULTS: We had 28 excellent results (28%), and 13 good results (13%). Patients were grouped by sex, age, duration of symptom before treatment, affected location. The result of treatment was evaluated by comparing the subject pain and discomfort score of the first vist and last follow-up. CONCLUSION: There are excellent results over 41% by conservative treatment. The results of conservative treatment were not related to age, sex, and lesion site, but were related to pre-treatment period. The shorter the pretreatment period was, the better the results.

The Total Antioxidant Capacity According to the Diet and the Life Style in Patients with the Chronic Cardiovascular Disease / 대한임상병리학회지

BACKGROUND: Decreased antioxidant defense mechanisms and over-generated free radicals by either normal or aberrant metabolism play an important role in the pathogenesis of cardiovascular disease and cancer. And the life style and diet including antioxidant vitamin A and E have been thought an important factor in antioxidant systems. Recently, Total Antioxidant Status kit (TAS; Randox, UK) has been developed for measuring the total antioxidant capacity of blood. So we evaluated the association of life style and total antioxidant capacity in patients with chronic cardiovascular disease. METHODS: Sixty six cases of chronic cardiovascular disease and sixty three normal controls were evaluated. Serum total antioxidant capacity was measured by Hitachi 747 (Hitachi Ltd, Japan) with TAS kit, vitamin A and E were measured by high performance liquid chromatography method, and serum lipid profile by Hitachi 7060 (Hitachi Ltd, Japan). RESULTS: The mean total antioxidant capacity did not show difference between patients and controls. After 3 months, we detected significant increase of total antioxidant capacity, high-density lipoprotein cholesterol and mild increase of antioxidant vitamins and significant decrease of total cholesterol, triglyceride, lipoprotein (a). The heavy alcohol consumption group showed significant difference with other groups (P<0.05). CONCLUSIONS: The measurement of total antioxidant capacity for the cardiovascular disease patients was thought to be useful to evaluate oxidative stress and antioxidant status. Alcohol consumption and supplementation with antioxidant vitamins could have an effect on total antioxidant capacity.

Amino Acid Derangements in Plasma and Erythrocytes of Patients with Sepsis / 대한임상병리학회지

BACKGROUND: Sepsis is a major insult leading to increased muscle breakdown and oxidation of amino acids. Disturbed plasma and brain amino acid levels may be important in the altered mental status observed in patients with infections and alteration in mental status due to sepsis has been associated with an increased mortality rate. Erythrocytes have been suggested as transport cells for amino acids and may be better than plasma for utilization and storage of amino acids in the body. Several reports suggested that amino acid alterations in plasma and erythrocytes have had an important role in sepsis. So we investigated the association between severity and prognosis of sepsis and amino acid levels in plasma and erythrocytes. METHODS: Heparinized plasma and erythrocytes were taken from 25 healthy controls, 10 infected patients and 15 septic patients. The amino acid levels were determined using high performance liquid chromatography after deproteinization with sulfosalicylic acid. RESULTS: Plasma amino acid pattern showed elevated levels of the aromatic amino acids (tyrosine and phenylalanine) and sulfur-containing amino acid (cystine) but decreased level of branched chain amino acid (isoleucine) in septic patients compared with healthy controls or infected patients. Patients with septic encephalopathy had higher levels of tyrosine, phenylalanine and sulfur-containing amino acid (methionine) than patients without septic encephalopathy. The ratios of erythrocytes to plasma showed no significant decrease in septic patients compared with healthy controls or infected patients. However, in patients with septic encephalopathy, methionine, leucine and phenylalanine levels were lower than in patients without septic encephalopathy. CONCLUSIONS: The results showed a characteristic pattern of amino acid derangements in plasma and erythrocytes of septic patients. This pattern was more prominent in severe sepsis. It was suggested that the severity and prognosis of septic patients could be predicted by measuring the amino acid levels of plasma and erythrocytes.

Characterization of Heparin:PF4 Isoantibody Interaction to Platelets in Heparin-Induced Thrombocytopenia/ Thrombosis / 대한임상병리학회지

BACKGROUND: Heparin-induced thrombocytopenia/ thrombosis (HITT) is recognized as the most frequent and fatal symptom complexes in patients receiving heparin therapy. The antibodies of HITT are not directly bound to heparin but bound to complexes of heparin and platelet factor 4 (PF4) derived from platelet alpha-granules. That is, HITT IgG antibody-heparin-PF4 immune complexes are bound to FcgammaRII receptor of platelets, which induced thrombocytopenia. Some researches showed the antibodies reactive to platelets could be IgM or IgA as well as IgG. So in this study, the authors tried to explain the molecular basis of heparin-PF4-isoantibody complexes . METHODS: In HITT patients who had received long-term heparin therapy, we determined HITT isoantibodies and titers using heparin:PF4 ELISA. When fifteen HITT patients with high titer antibodies (more than 1 : 100) were selected, reaction patterns of isoantibodies with the platelets were examined through serotonin release test and flow cytometry. RESULTS: All patients showed one or more isotype antibodies and the most frequent isotype was IgGl (nine patients) . In the presence of optimal concentra pion of heparin and PF4, ten patients had antibodies which activated platelets, and all of them were positive in serotonin release test. Reactive plasmas had IgGl, IgG3, IgA or IgM antibodies, and each of them except one had IgGl. These platelet activations could be blocked in vitro by anti-IV.3 antibody. Non-reactive plasmas were negative In serotonin release assay nor had TgGl. The plasmas 4hat had two or more isoantibodies showed a similar pattern of the IgG antibody by flow cytometry. CONCLUSIONS: The HITT antibodies can be all kinds of antibody isotopes, but IgA and IgM may not bind to the platelets directly. It seems to be possible only after reacting with heparin-PF4-IgG complexes.