No abstract available.
Adenosine Deaminase* ; Adenosine* ; Cerebrospinal Fluid* ; Child* ; Humans ; Tuberculosis, Meningeal*

Psoriasis has been known to have various humoral and cellular immune abnormalities. And adenosine deaminase (ADA) activities are known to be decreased in immune deficiency diseases. The present study was designed to measure the activities of ADA in sera and erythrocytes of psoriasis patients by Giustiss method. There were no significant differences in the erythrocytes ADA activities between normal subjects (9, Gp+4 43 units/10 cells) and psoriasis patients (7, 29+3. 64 units /10 cells). The ADA activities in sera of the psoriasis patients (13. 15+3. 43 units/ L) showed lowered activities than those of normal subjects (20. 44-2, 07 units/L).
Adenosine Deaminase* ; Adenosine* ; Deficiency Diseases ; Erythrocytes* ; Humans ; Psoriasis*

No abstract available.
Adenosine Deaminase* ; Adenosine* ; Pleural Effusion ; Tuberculosis ; Tuberculosis, Pleural*

Tuberculous pleurisy is the most common form of extrapulmonary tuberculosis in Korea. Tuberculous pleurisy presents a diagnostic and therapeutic problem due to the limitations of traditional diagnostic tools. There have been many clinical research works during the past decade. Recent studies have provided new insight into the tuberculous pleurisy, which have a large impact on clinical practice. This review is a general overview of tuberculous pleurisy with a focus on recent findings on the diagnosis and management.
Adenosine Deaminase ; Diagnosis ; Korea ; Pleural Effusion ; Tuberculosis ; Tuberculosis, Pleural*

PURPOSE: The aim of this study is to evaluate the value of pleural adenosine deaminase (ADA) in differentiating tuberculous pleural effusion from non tuberculous pleural effusion of children. METHODS: We measured pleural ADA activity in patients with pleural effusion whose age were from seven months to seventeen years from January 1995 to October 2001. By some criteria the patients were grouped to tuberculous pleural effusion, bacterial effusion, mycoplasma effusion, malignant effusion, and other effusion. RESULTS: The mean pleural ADA activity in tuberculous pleural effusion was 86.2+/-27.3 U/L. Pleural ADA activities in bacterial effusion, mycoplasma effusion, malignant effusion, other effusion were 32.6+/-20.1, 22.1+/-15.4, 23.1+/-10.9, 36.7+/-28.4 U/L, respectively. Pleural ADA activity in tuberculous pleural effusion was significantly higher than in any other group(P<0.001). At a level of 50 U/L, the sensitivity, specificity, positive predictive value (ppv), and and negative predictive value(npv) for the identification of tuberculous pleural effusion from nontuberculous pleural effusion were calculated at 93.8%, 84.8%, 81.1%, 95.1%, respectively. CONCLUSION: Pleural ADA is a useful test in the diagnosis of tuberculous pleural effusion of children from nontuberculous pleural effusion.
Adenosine Deaminase* ; Adenosine* ; Child* ; Diagnosis* ; Humans ; Mycoplasma ; Pleural Effusion* ; Sensitivity and Specificity

Adenosine deaminase(ADA) is an enzyme capable of catalysing the pathway from adenosine to inosine. Previous studies have shown that this enzyme may be useful in recognition of a tubeculous etiology of pleural, peritoneal, or meningeal effusions. ADA activity was studied in 42 patients with large amount of pericardial effusion. Patients were subdivided into the following four group : (A) 15 cases of tuberculous effusions : (B) 4 with pyogenic effusions : (C) 15 with idiopathic effusions : (D) 9 with malignant effusions. The results were as follows ; 1) The mean ADA activities assessed in pericardial effusions were 134.0+/-77.6U/L in group A : 93.8+/-43.8 in group B : 38.3+/-23.2 in group C : 27.3+/-20.8 in group D. Comparing the level achieved in group A with all others, the difference is significant at the P<0.001 level. 2) The mean ADA activities assessed in sera were 50.7+/-57.2 U/L in group A : 63.5+/-24.1 in group B : 25.9+/-12.0 in group C : 14.0+/-7.5 in group D. Comparing the level achieved in group A with all others, there is no significant difference. 3) Specificity(0.87) and sensitivity(0.93) of the test for the differential diagnosis of patients with tuberculous effusion from those with idiopathic effusion is high, when a value of more than 50 U/L is considered. In conclusion, the assessment of ADA in pericardial effusions is of great value in the diagnosis of tuberculous pericarditis.
Adenosine Deaminase* ; Adenosine* ; Diagnosis ; Diagnosis, Differential ; Humans ; Inosine ; Pericardial Effusion* ; Pericarditis, Tuberculous

BACKGROUND: The aim of this study was to consider the significance of pleural fluid adenosine deaminase (ADA) activity combined with lymphocyte/neutrophil (L/N) ratio in the diagnosis of tuberculous pleurisy (TBpl) in a region of intermediate prevalence of tuberculosis (TB). METHODS: We collected data from 388 patients with exudative pleural effusions. The final diagnoses were compared to the results from our diagnostic method using pleural fluid ADA and L/N ratio. RESULTS: 108 patients had a final diagnosis of TBpl; 102 cases had high levels of ADA (> or =40 IU/L). When we considered ADA > or =40 IU/L as a diagnostic criterion, the sensitivity was 94.4%, specificity 87.5%, and post-test probability 74.5%. However, when we considered ADA > or =40 IU/L combined with the L/N ratio > or =0.75 as a diagnostic criterion, the specificity and post-test probability were rose to 97.5% and 93%, respectively. The other causes of high ADA and L/N ratios were lymphoma and metastatic carcinoma, but mass-like lesions were found on the chest radiographs or CT scans. CONCLUSION: To evaluate the causes of exudative pleural effusions in a region of intermediate prevalence of tuberculosis, we recommend measuring the pleural fluid ADA and L/N ratio first. If the result is high and malignancies are not suspected, it may be diagnostic of TBpl.
Adenosine ; Adenosine Deaminase ; Humans ; Lymphoma ; Pleural Effusion ; Prevalence ; Thorax ; Tuberculosis ; Tuberculosis, Pleural

BACKGROUND: Tuberculosis is the most common cause of pleural effusion in Korea. But the differential diagnosis of pleural effusion is important because malignancy and pneumonia are also other common causes of pleural effusion. Adenosine deaminase (ADA) activity is used to differentiate tuberculous pleurisy from non-tuberculous pleural effusion. However, some cases of non-tubercu-lous effusion show increased activity of ADA. Therefore, this study is for evaluating diagnostic efficacy of the ADA isoenzyme activity in the diagnosis of tuberculous pleurisy. METHODS: The activity of total ADA and ADA2 isoenzyme activity and ratio of ADA2/ADA in 293 patients with pleural effusion were measured. Then, it was compared to conventional and PCR-hybridization methods for tuberculous pleurisy. RESULTS: Total ADA and ADA2 isoenzyme activity in tuberculous pleurisy were 81.8+/-29.5 U/L and 67.0+/-23.2, respectively, which were significantly higher than non-tuberculous effusion (20.3+/-21.3 U/L and 12.5+/-9.0 U/L1). With a cut-off level of 45 U/L in total ADA activity and the ratio of ADA2/ADA 0.6 or greater, the sensitivity and specificity for tuberculous pleurisy were 92.1% and CONCLUSIONS: Total ADA and ADA isoenzyme activities are useful to differentiate tuberculous pleurisy from non-tuberculous pleural effusion compared to conventional methods. Especially, various combinations of the total ADA, the ADA2 isoenzyme activities, and the ratio of ADA2/total ADA show high diagnostic efficacy for tuberculous pleurisy.
Adenosine Deaminase* ; Adenosine* ; Diagnosis ; Diagnosis, Differential ; Humans ; Korea ; Pleural Effusion ; Pneumonia ; Sensitivity and Specificity ; Tuberculosis ; Tuberculosis, Pleural*

The determination of ADA(adenosine deaminase) activity in pleural fluid is useful in differental diagnosis of pleural effusion. The conventional method of determining ADA activity used by Giusti was influenced by contamination of ammonia. Additionally, because Giusti's method was mannual method a determining the ADA activities in sample, was not easily automated. In 1993, Oosthuizen HM with collegues developed simple kinetic method for determining ADA activity. It was reliable and suiable method for automation. In this study, we have measured ADA activity in 162 patients with various pleural effusion by Hitachi 747 autoanalyser using the Oosthuizen kinetic method for the purpuse of determination of new diagnostic cut-off value for the tuberculous effusion and evaluation of the correlation between the conventional method and new automated method. This new method of an enzymatic reaction involves 2, 6-dichlorophenolindophenol dye(DICP), adenosine, xanthine oxidase(XO), and nucleoside phosphorylase(NP). The results were as follows: 1) The mean pleural ADA activity of the tuberculous effusion was 52.53 +/-16.43 U/L and significantly higher than that of other groups(p<0.001). If the diagnostic cut-off value of pleural ADA activity for tuberculous effusion is above 30 U/L, the sensitivity is 96% and the specificity is 90%. 2) The mean pleural to serum ADA activity ratio of the tuberculous effusion was 2.29+/-0.96 and it was also significantly higher than that of other pleural groups(p<0.001). If the diagnostic cut-off value of pleural to serum ADA activity ratio is 1.5, the sensitivity is 80% and the specificity is 88% in the diagnosis of tuberculous pleural effusion. 3) The new kinetic method is correlates well to Giuisti's conventional method(r=0.971). In conclusion, the new kinetic method described is easily automated and seems to be suitable for the routine determination of ADA activity.
Adenosine ; Adenosine Deaminase ; Ammonia ; Automation ; Diagnosis ; Humans ; Pleural Effusion ; Sensitivity and Specificity ; Xanthine

No abstract available.
Adenosine Deaminase* ; Adenosine* ; Bronchoalveolar Lavage Fluid* ; Bronchoalveolar Lavage* ; Humans ; Tuberculosis, Pulmonary*