There are various complex formations between immunoglobulin and serum enzymes in the body. Of these, LD-Immunoglobulin complex is most common. It has reported that LD-IgG or LD-IgA complex existed in the serum of healthy person or many patients who have various clinical disorders. The clinical significance of complexes is not known, but it results in the increase of total LD activity and interference to the LD isoenzyme electrophoresis interpretation due to its anomalous pattern. We have reported a case of LD-Immunoglobulin complex in AILD(Angioimmunoblastic lymphadenopathy with dysproteinemia) with reference. The patient was admitted with fever, chills and cervical LN enlargement, in LN biopsy, diagnosed AILD, and during treatment expired by sepsis. Since admission, serum total LD activities were increased and serum LD isoenzyme EP showed that LD3-5 fractions was not separated in broad single band. Its pattern was due to LD-immunoglobulin complex, LD-bound immunoglobulin was IgG ,lamda. For the identification of immunoglobulin, we at first did serum protein immunoelectrophoresis. then stained the plate with tetrazolium dye for LD activity.
Biopsy ; Chills ; Electrophoresis ; Fever ; Humans ; Immunoblastic Lymphadenopathy* ; Immunoelectrophoresis ; Immunoglobulin G ; Immunoglobulins ; Lactic Acid* ; Lymphatic Diseases ; Sepsis

No abstract available.
Humans ; Lichens*

No abstract available.
Humans ; Lichens*

Since coronary arteriovenous fistula(CAVF) was first reported by Krause in 1865, more than 400 cases have been reported. It is relatively rare disease and originates more commonly in the right than in the left coronary artery. We report a case of CAVF between right coronary artery and right ventricular inflow tract with significant left to right shunt in a 34-year old female who was admitted for the cardiomegaly on routine chest X-Ray. It was detected by transthoracic and transesophageal echocardiography, and confirmed by cardiac catheterization and coronary angiography. The opening of the fistula draining into the right ventricle was obliterated with sutures. There was no significant shunt in postoperative cardiac catheterization and coronary angiography.
Adult ; Arteriovenous Fistula* ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomegaly ; Coronary Angiography ; Coronary Vessels ; Echocardiography ; Echocardiography, Transesophageal* ; Female ; Fistula ; Heart Ventricles ; Humans ; Rare Diseases ; Sutures ; Thorax

Two M-protein peaks in serum protein electrophoresis are rarely present in patients with plasma cell discrasia. We describe a 72-year-old male patient with multiple myeloma secreting biclonal M-proteins, which were confirmed by immunofixation. Immunoelectrophoresis has some difficulties to dectect M components when a very small amount of M-protein develops an equivocally abnormal precipitation arc. In this case, serum protein electrophoresis revealed two M peaks, one in beta and the other in gamma globulin region. An immunoelectrophoresis revealed unequivocally abnormal precipitation arcs in IgA and K light chain regions, but the arc in IgG region was equivocal. We performed an immunofixation and confirmed biclonal gammopathy, IgA-K and IgG-K types. This result supports the view that immunofixation is an useful confirmatory test when immunoelectrophoresis results are equivocal.
Aged ; Electrophoresis ; gamma-Globulins ; Humans ; Immunoelectrophoresis ; Immunoglobulin A ; Immunoglobulin G ; Male ; Multiple Myeloma* ; Myeloma Proteins ; Plasma Cells

Incompetent internal os of cervix is treated with McDonald or Shirodkar cerclage after 14 weeks of gestation. In rare case, after 20 weeks of gestation fetal membrane is bulging into vaginal cavity, but cerclage in that period is risk factor for preterm labor and preterm premature rupture of membranes. So many complications are reported in that period. So many experiences for reducing fetal membranes into uterine cavity were performed. We report a case of amnioreduction in prolapsed fetal membranes after McDonald cerclage, and delivered in 33 weeks of gestation with brief review of literature.
Cervix Uteri ; Extraembryonic Membranes ; Female ; Membranes* ; Obstetric Labor, Premature ; Pregnancy ; Risk Factors ; Rupture

OBJECTIVE: It has been known that amniotic fluid (AF) is rich source of mesenchymal stem cells (MSCs). Bisphosphonates are widely used in clinical treatment of various metabolic bone diseases and their primary action is the inhibition of osteoclastic bone resorption. However, litter is known about whether bisphosphonates affect the differentiation into osteoblast, especially from AF-derived MSCs (AFMSCs). Therefore, the purpose of this study is to investigate whether these bisphosphonates influence in the process of AFMSCs differentiation into osteoblast. METHODS: AF samples were obtained by second trimester amniocentesis for fetal karyotyping from 6 pregnant women. Cells were treated with various concentration (0, 10(-10), 10(-8), 10(-6) M) of zoledronate and alendronate and analyzed over 21 days of culture. Differentiation into osteoblast was determined by cell staining and RT-PCR for alkaline phosphatase (ALP). RESULTS: It was observed that AFMSCs could differentiate into osteoblast. Alendronate had more potent effect than zoledronate in osteoblastic differentiation. ALP expression was increased with increasing concentration of zoledronate and it was highest in 10(-8) M alendronate. However, no effect of bisphosphonates was found in 14 days of culture. CONCLUSION: This study shows that AFMSCs can be differentiated into osteoblast. The induction of these differentiation following bisphosphonate treatment was appear to be drug type-, dose-, and culture time-dependent. However, further studies are needed to conclude a consistent outcome for the effects of bisphosphonate on differentiation potential of AFMSCs.
Alendronate ; Alkaline Phosphatase ; Amniocentesis ; Amniotic Fluid ; Bone Diseases, Metabolic ; Bone Resorption ; Diphosphonates ; Female ; Humans ; Imidazoles ; Karyotyping ; Mesenchymal Stromal Cells ; Osteoblasts ; Osteoclasts ; Pregnancy ; Pregnancy Trimester, Second ; Pregnant Women

In case of intrauterine pregnancy with an intrauterine device(IUD), it is recommended, to remove the device because of the risk of abortions or septic complications. If the thread of the IUD is not visible, which often occurs because of growth of the uterus in pregnancy, it is advisible, to perform extraction with hysteroscopy and ultrasonic guidance. We report on one case with hysteroscopic IUD removal in early pregnancy, which pregnancy is continuing without complications.
Hysteroscopy ; Intrauterine Devices* ; Pregnancy* ; Ultrasonics ; Uterus

Primary cutaneous anaplastic large cell lymphoma (PCALCL) is a rare primary cutaneous lymphoma that is predominantly composed of large lymphoid cells that express the CD30 antigen. The skin lesion of PCALCL is usually single, ulcerative, and located on the trunk or extremities and rarely the palm. A 25-year-old woman presented with a plaque on the left palm for 20 days. The plaque was walnut-sized and purple to gray colored with erosion in the center. Histopathologic examination showed infiltration of large atypical cells in the dermis. The large tumor cells showed positivity for CD3, CD4, and CD30 and negativity for CD8, CD20, epithelial membrane antigen, and anaplastic lymphoma kinase. PET-CT showed no other hypermetabolic lesion except that on the left palm, and we finally arrived at a diagnosis of PCALCL. The patient was treated with an intralesional injection of methotrexate (25 mg/mL, 0.45 cc). After 3 months of treatment, the walnut-sized plaque had disappeared and a peripheral hyperpigmented patch remained.
Adult ; Antigens, CD30 ; Dermis ; Diagnosis ; Extremities ; Female ; Humans ; Injections, Intralesional ; Lymphocytes ; Lymphoma ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, Primary Cutaneous Anaplastic Large Cell* ; Methotrexate ; Mucin-1 ; Phosphotransferases ; Skin ; Ulcer

PURPOSE: Biliary atresia, one of the major causes of neonatal cholestais, is an idiopathic, serious disorder, affecting the newborn that results in complete obstruction of biliary tract. Successful reestablishment of bile flow is dependent on early surgical intervention, early diagnosis is imperative. The authors evaluate the utility of Tc-99m-labeled diisoprpyliminodiacetic acid (DISIDA) hepatobiliary scintigraphy in the diagnosis of biliary atresia. METHODS: From January, 1995 to August, 1999, total 60 patients with neonatal cholestasis underwent Tc-99m DISIDA hepatobiliary scintigraphy at Asan Medical Center. RESULTS: The undelying causes of neonatal cholestasis were biliary atresia in 14, neonatal hepatitis in 33, intrahepatic bile duct paucity in 9, and total parenteral nutrition induced cholestasis in 4. All patient with biliary atresia were interpreted correctely in DISIDA hepatobiliary scintigraphy, showing 100% sensitivity. Of the 46 patients with neonatal hepatitis and other causes, 37 patients had intestinal radioactivity showing 80% specificity. CONCLUSION: Visualization of DISIDA in the intestinal tract indicates patency of the biliary ducts and excludes the diagnosis of biliary atresia. But the absence of intestinal excretion on the DISIDA hepatobiliary scintigraphy dose not necessarily indicate biliary atresia.
Bile ; Bile Ducts, Intrahepatic ; Biliary Atresia* ; Biliary Tract ; Cholestasis ; Chungcheongnam-do ; Diagnosis* ; Early Intervention (Education) ; Hepatitis ; Humans ; Infant, Newborn ; Parenteral Nutrition, Total ; Radioactivity ; Radionuclide Imaging* ; Sensitivity and Specificity