There have been a few reported cases of immune hemolytic anemia induced by ceftriaxone. We encountered a patient with immune hemolytic anemia that seemed to be stimulated by a degradation product of ceftriaxone. The patient's direct antiglobulin test was positive only for C3d, and no ceftriaxone-dependent antibodies were detectable in the patient's serum. To demonstrate the presence of the ceftriaxone-induced antibodies, an ex-vivo antigen in urine was obtained from the patient. In addition, we prepared a 1 mg/mL suspension solution of ceftriaxone, and group AB serum as a complement source. Using several combinations of the above reactants, the indirect antiglobulin test was performed. Only the indirect antiglobulin test using the patient's serum with the ex-vivo urine antigen was found to be positive. Other combinations were not reactive. To our knowledge, this is the first reported case in Korea, in which the causative antibody appeared to be stimulated solely by a degradation product of ceftriaxone.
Anemia, Hemolytic, Autoimmune/*chemically induced/*diagnosis/immunology/urine ; Antigens/urine ; Case Report ; Ceftriaxone/*adverse effects ; Cephalosporins/*adverse effects ; Coombs' Test ; Human ; Male ; Middle Age

There have been a few reported cases of immune hemolytic anemia induced by ceftriaxone. We encountered a patient with immune hemolytic anemia that seemed to be stimulated by a degradation product of ceftriaxone. The patient's direct antiglobulin test was positive only for C3d, and no ceftriaxone-dependent antibodies were detectable in the patient's serum. To demonstrate the presence of the ceftriaxone-induced antibodies, an ex-vivo antigen in urine was obtained from the patient. In addition, we prepared a 1 mg/mL suspension solution of ceftriaxone, and group AB serum as a complement source. Using several combinations of the above reactants, the indirect antiglobulin test was performed. Only the indirect antiglobulin test using the patient's serum with the ex-vivo urine antigen was found to be positive. Other combinations were not reactive. To our knowledge, this is the first reported case in Korea, in which the causative antibody appeared to be stimulated solely by a degradation product of ceftriaxone.
Anemia, Hemolytic, Autoimmune/*chemically induced/*diagnosis/immunology/urine ; Antigens/urine ; Case Report ; Ceftriaxone/*adverse effects ; Cephalosporins/*adverse effects ; Coombs' Test ; Human ; Male ; Middle Age

OBJECTIVETo detect the differential display code 3 mRNA (DD3 mRNA) in the urine sample of patients with prostate cancer and to evaluate its clinical significance.

METHODSDD3 mRNA in the urine collected from 48 patients with prostate cancer, 23 patients with benign prostate hyperplasia (BPH) and 9 healthy male volunteers was measured by reverse transcriptase polymerase chain reaction (RT-PCR).

RESULTSDD3 products could not be detected in the urine samples of the BPH patients and healthy male volunteers, but could in 39/48 urine samples of the patients with prostate cancer. Significant difference was found between them (P < 0.01).

CONCLUSIONThe detection of DD3 mRNA in the urine promises to be a non-invasive, simple and sensitive method for the early diagnosis and post-treatment monitoring of prostate cancer.

Aged ; Aged, 80 and over ; Antigens, Neoplasm ; genetics ; urine ; Humans ; Male ; Middle Aged ; Prostatic Neoplasms ; diagnosis ; RNA, Messenger ; urine ; Reverse Transcriptase Polymerase Chain Reaction ; Sensitivity and Specificity

OBJECTIVTo investigate the potential value of urine hepatitis B virus (HBV) DNA as a new noninvasive diagnostic indicator for HBV-associated glomerulonephritis (HBV-GN).

METHODSA total of 152 patients including 66 with HBV-GN, 66 with non-HBV-GN, and 20 with chronic hepatitis B (CHB) without renal disease were examined for serum and urine HBV DNA levels using polymerase chain reaction (PCR) and for 5 serum HBV markers using enzyme-linked immunosorbent assays.

RESULTSTwenty-two patients (33%) in the HBV-GN group, but none in the other two groups, were found positive for urine HBV DNA. In the diagnosis of HBV-GN, urine HBV DNA had a high specificity (0.98), a good positive predictive value (PPV, 0.96), and a modest negative predictive value (NPV, 0.60). Urine HBV DNA, alone or in combination with serum HBeAg, was superior in the diagnosis of HBV-GN to the combination of urine HBV DNA with serum HBV DNA, hepatitis B surface antigen and the hepatitis B e antigen.

CONCLUSIONUrine HBV DNA may be one of the new noninvasive diagnostic criterion for HBV-GN.

Biomarkers ; blood ; urine ; DNA, Viral ; blood ; urine ; Enzyme-Linked Immunosorbent Assay ; Glomerulonephritis ; diagnosis ; virology ; Hepatitis B Surface Antigens ; blood ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; complications ; Humans ; Polymerase Chain Reaction ; Predictive Value of Tests ; Sensitivity and Specificity

OBJECTIVETo investigate a non-invasive, effective and rapid mode of detecting the recurrence of bladder cancer during follow-up.

METHODSNinety patients following transurethral resection of bladder tumor (TURBt) surgery were recruited from January 1998 to March 2000. Standard ELISA was used to determine the quantity of nuclear matrix protein (NMP-22) in urine of all bladder cancer patients during their follow-up periods. Urine bladder tumor antigen (BTA) stat test was simultaneously performed and followed by cystoscopy.

RESULTSThe total positive rates of urinary NMP-22 and BTA stat test were 76.7% (33/43) and 67.4% (29/43), respectively. Comparatively, this positive rate would increase to 93.0% (40/43) when the combination of both urine NMP-22 and BTA test were adopted.

CONCLUSIONExamination of NMP-22 in urine is a rapid and effective way to detect the recurrence of bladder cancer. If combined with BTA test, NMP-22 may be used as a non-invasive method in surveillance of recurring of bladder cancer, which may reduce the frequency of patients needing to undergo conventional invasive cystoscopy.

Antigens, Neoplasm ; analysis ; Humans ; Neoplasm Recurrence, Local ; diagnosis ; Neoplasm Staging ; Nuclear Proteins ; urine ; Sensitivity and Specificity ; Urinary Bladder Neoplasms ; diagnosis

OBJECTIVES: In order to evaluate the association between the Hantaan virus-induced cellular-immune response and clinical severity in patients with hemorrhagic fever with renal syndrome (HFRS). METHODS: We serially measured the serum (n = 16) and urine (n = 6) concentrations of soluble HLA class 1 antigen (sHLA-l) and clinical powameters in patients with HFRS. RESULTS: Serum sHLA-I concentrations in patients with HFRS were significantly higher than those in controls throughout all clinical phases (p < 0.01). The highly elevated Serum sHLA-I concentrations peaked in the oliguric phase and declined gradually through the phases of HFRS. Serum sHLA-l concentrations in patients with hypotensive episode were higher than in those without the episode (5,85 +/-2,184 vs. 2,389 +/- 860 ng/ml in oliguric phase, 4.11 +/- 1,952 vs. 1,502 +/- 592 ng/ml in diuretic phase, p < 0.05), and serum sHLA-l levels showed a significant correlation with blood WBC count (r = 0.75 in the febrile and hypotensive phase, p < 0.01) and serum creatinine concentrations (r = 0.64 in the oliguric phase, p< 0.01), respectively, Urine sHLA-I levels in the oliguric phase were significantly higher than those in the diuretic phase (390 +/- 155 vs. 214 +/- 45 ng/mg Cr, p < 0.05) and urine sHLA-I levels are associated with severe illness in patients with HFRS. The higher serum sHLA-I are associated with severe illness in patients with HFRS. The persistent elevation of serum sHLA-I during all phases of HFRS might be related to increased production due to prolonged cellular immunologic stimulation by the Hantaan virus rather than decreased excretion of sHLA-I through the kidney. CONCLUSION: We suggest that the serum and urine sHLA-I concentrations can be used as a stable and objective parameter for monitoring clinical severity and renal dysfunction in patients with HFRS.
Adult ; Enzyme-Linked Immunosorbent Assay ; HLA-A Antigens/urine* ; HLA-A Antigens/blood* ; Hemorrhagic Fever with Renal Syndrome/physiopathology ; Hemorrhagic Fever with Renal Syndrome/immunology* ; Human ; Male ; Sensitivity and Specificity ; Severity of Illness Index

Antigens, Neoplasm ; urine ; Antineoplastic Agents ; therapeutic use ; Biomarkers, Tumor ; blood ; urine ; Biopsy, Fine-Needle ; Brachytherapy ; Global Health ; Humans ; Male ; Prostate ; diagnostic imaging ; pathology ; Prostate-Specific Antigen ; blood ; Prostatectomy ; Prostatic Neoplasms ; diagnosis ; epidemiology ; therapy ; Radiotherapy ; Taxoids ; therapeutic use ; Ultrasonography

Assessing the lethality of 'early,' potentially organ-confined prostate cancer (PCa) is one of the central controversies in modern-day urological clinical practice. Such cases are often considered for radical 'curative' treatment, although active surveillance may be equally appropriate for many men. Moreover, the balance between judicious intervention and overtreatment can be difficult to judge. The patient's age, comorbidities, family history and philosophy of self-health care can be weighed against clinical features such as the palpability of disease, the number and percentage of biopsy cores involved with the disease, histological grade, presenting prostate-specific antigen (PSA) and possible previous PSA kinetics. For many years, scientists and physicians have sought additional molecular factors that may be predictive for disease stage, progression and lethality. Usually, claims for a 'new' unique marker fall short of true clinical value. More often than not, such molecular markers are useful only in multivariate models. This review summarizes relevant molecular markers and models reported up to and including 2008.
Antigens, Neoplasm ; urine ; Biomarkers, Tumor ; genetics ; metabolism ; Humans ; Male ; Predictive Value of Tests ; Prognosis ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; diagnosis ; metabolism ; mortality ; Sensitivity and Specificity

OBJECTIVETo study whether the argyrophil nucleolar organizer regions (AgNOR) in T lymphocytes of peripheral blood in coke-oven workers can be used as a biomarker of effect for polycyclic aromatic hydrocarbon (PAH) exposure.

METHODSFifty-two male coke-oven workers were divided into three groups according to exposure levels of coke oven emissions: high-exposure, middle-exposure and low-exposure workers. Additionally 10 men without occupational PAH exposure were chosen as control group. Peripheral blood T lymphocytes were cultured, spread on slides and stained with silver nitrate. The ratio of AgNOR area vs. nuclear area (I/S) in T lymphocytes was analyzed. Urinary 1-hydroxypyrene (1-OHP) was measured as the internal dose of PAH exposure.

RESULTSMean urinary 1-OHP level in high-exposure group (16.56 +/- 2.77 micromol/mol Cr) was significantly higher than those in low-exposure group (3.30 +/- 2.77 micromol/mol Cr, P < 0.001) and control group (3.04 +/- 1.58 micromol/mol Cr, P < 0.01). The mean I/S of AgNOR in T lymphocytes in high-exposure group (0.056 +/- 0.010) was significantly lower than those in middle-exposure group (0.065 +/- 0.013, P < 0.05), low-exposure group (0.067 +/- 0.008, P < 0.01) and control group (0.076 +/- 0.007, P < 0.001). It was also found that I/S of AgNOR were significantly decreased in middle-exposure group and low-exposure group in comparison with control group (P < 0.01, P < 0.05).

CONCLUSIONSThe occupational exposure to PAH resulted in increase of 1-OHP in urine and decrease of AgNOR in T lymphocytes. PAH exposure might lead to damage T lymphocytes function and AgNOR may be considered as a biomarker of effect for PAH exposure.

Antigens, Nuclear ; blood ; Biomarkers ; blood ; urine ; Coke ; poisoning ; Humans ; Lymphocytes ; cytology ; drug effects ; metabolism ; Male ; Occupational Exposure ; analysis ; Polycyclic Aromatic Hydrocarbons ; poisoning ; Pyrenes ; analysis

Deregulation of soluble apoptosis stimulating fragment (sFas) plays an important role in glomerulonephritis (GN). The study assed the influence of immunosuppressive treatment on serum and urine sFas in patients with proliferative (PGN) and non-proliferative (NPGN) GN, and evaluated the potential of sFas measurements in predicting outcomes. Eighty-four patients with GN (45 males and 39 females) were included. Serum concentration (ng/mL) and urinary excretion (ng/mg of urinary creatinine) of sFas were measured before and after the treatment. After 12 months of therapy with steroids and cyclophosphamide, patients were divided into two subgroups according to the treatment results: Responders (R) and Non-Responders (NR). The sFas urinary excretion was reduced after treatment in both PGN and NPGN (from 17.12 +/- 15 to 5.3 +/- 4.2, P = 0.008 and from 10.11 +/- 6.1 to 3.4 +/- 3.0, P = 0.039; respectively) whereas the sFas serum concentration remained unchanged. In PGN, pre-treatment urinary sFas concentration was significantly lower in the Responders than in Non-Responders (2.3 +/- 3.1 vs 19.4 +/- 14.1, P = 0.003), and was lower still than in both R (P = 0.044) and NR (P = 0.042) subgroups with NPGN. The immunosuppressive treatment reduced sFas urinary excretion in proliferative and non-proliferative GN and results suggest that the lower urinary sFas may be linked with favorable therapy outcomes in patients with PGN.
Adult ; Antigens, CD95/blood/*urine ; Cyclophosphamide/therapeutic use ; Female ; Glomerulonephritis/*drug therapy/metabolism/pathology ; Humans ; Immunosuppressive Agents/*therapeutic use ; Male ; Middle Aged ; Steroids/therapeutic use ; Treatment Outcome