BACKGROUND: Chlamydia trachomatis is one of the most common causative agents of the sexual transmitted diseases, and the accurate diagnosis and early treatment are very important to prevent the transmission. So, we evaluated the polymerase chain reaction (PCR) and QuickVue(TM) (Quidel Corp. San Diego, CA) EIA method as a routine clinical laboratory test. METHODS: The 80 cervical swab samples including pelvic inflammatory disease, cervicitis and tube-ovarian abscess were tested using PCR with plasmid specific primers T1, T2 and commercially available QuickVue(TM) EIA kit. RESULTS: The positivities of the PCR and QuickVue(TM) EIA test were 17.5% (14/80 samples) and 12.5% (10/80 samples), respectively. There were 95% (76/80 samples) of positive or negative result concordance rates and 5% (4/80 samples) of disconcordance between the two methods, in which showed PCR positive and EIA negative results. CONCLUSIONS: We assume that PCR and QuickVue(TM) method are highly confident as a routine clinical laboratory diagnostic test for C. trachomatis infection. But more careful interpretation of QuickVue(TM) EIA and the additional study for variable samples will be needed.
Abscess ; Chlamydia trachomatis* ; Chlamydia* ; Diagnosis* ; Diagnostic Tests, Routine ; Female ; Pelvic Inflammatory Disease ; Plasmids ; Polymerase Chain Reaction* ; Uterine Cervicitis

OBJECTIVE: The purpose of this study was to determine the clinical significance of intraventricular hemorrhage (IVH) in patients with ruptured aneurysms. METHODS: Of 1034 patients who were admitted to our hospital with ruptured aneurysms between 1994 and 2007, 128 (12.4%) had IVHs. The clinical, radiologic characteristics, and surgical outcomes in the IVH group were compared with the no-IVH group. RESULTS: The IVH group had a shorter time interval to admission. The incidence of IVH was significantly higher in patients > 70 years of age (p=0.021), males (p=0.000), alcohol abusers (p=0.039), patients with a Glagow Coma Scale (GCS) < or =8 (p=0.000), and patients with a Hunt and Hess grade of 4-5 (p=0.000). IVH was more common in patients with ruptured posterior circulation aneurysms (p=0.000) and anterior communicating artery aneurysms (p=0.036). The incidence of thick, diffuse subarachnoid hemorrhage (SAH; p=0.004), intracerebral hemorrhage (ICH) >10 cc (p=0.006), rebleeding (p=0.010), and shunt-dependant hydrocephalus (p=0.000) was significantly higher in the IVH group than the no-IVH group. The mortality rate in the IVH group was significantly higher than the no-IVH group (48.4% versus 22.1%). The amount of IVH had an influence on the mortality; IVH involving all of the ventricles (59.7%) and IVH only involving some of the ventricles (33.9%) was associated with a 6.6- and 2.3-fold higher mortality than the no-IVH group, respectively. IVH was significantly associated with a poor surgical outcome; however, this association was not significant in patients with a GCS < or =8, or histories of rebleeding or seizures. CONCLUSIONS: In patients with ruptured aneurysms, IVH reflects the clinical severity of SAH. IVH has a negative influence on surgical outcome, except in patients with a poor clinical status pre-operatively.
Aneurysm ; Aneurysm, Ruptured ; Cerebral Hemorrhage ; Coma ; Hemorrhage ; Humans ; Hydrocephalus ; Incidence ; Intracranial Aneurysm ; Male ; Seizures ; Subarachnoid Hemorrhage

Spontaneous intracranial epidural hematoma (EDH) due to dural metastasis of hepatocellular carcinoma is very rare. A 53-year-old male patient with hepatocellular carcinoma, who was admitted to the department of oncology, was referred to department of neurosurgery because of sudden mental deterioration to semicoma with papillary anisocoria and decerebrate rigidity after transarterial chemoembolization for hepatoma. Brain computed tomography (CT) revealed large amount of acute EDH with severe midline shifting. An emergent craniotomy and evacuation of EDH was performed. Active bleeding from middle cranial fossa floor was identified. There showed osteolytic change on the middle fossa floor with friable mass-like lesion spreading on the overlying dura suggesting metastasis. Pathological examination revealed anaplastic cells with sinusoidal arrangement which probably led to spontaneous hemorrhage and formation of EDH. As a rare cause of spontaneous EDH, dural metastasis from malignancy should be considered.
Anisocoria ; Brain ; Carcinoma, Hepatocellular ; Cranial Fossa, Middle ; Craniotomy ; Decerebrate State ; Floors and Floorcoverings ; Hematoma, Epidural, Cranial ; Hemorrhage ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Neurosurgery

OBJECTIVE: The aim of this study is to assess the relationships between maternal plasma and umbilical cord leptin concentrations and their effects on newborn birth weights, maternal body mass indices and fetal sex in term normotensive (NT) and preeclampsia (PE) women. METHODS: Blood samples were obtained at delivery from 20 NT group and another 20 from PE group of at least 36 weeks of gestation. And the umbilical cord samples were also taken from their newborns at birth. Plasma leptin levels were determined in both groups using a human recombinant leptin 125-I radioimmunoassay. RESULTS: Mean maternal plasma and umbilical cord leptin concentrations were 16.16+/-2.05 ng/ml and 7.11+/-1.01 ng/ml in NT group, 17.09+/-1.67 ng/ml and 8.55+/-6.63 ng/ml in PE group, and there was no statistical significances among them. The differences of leptin concentrations in maternal plasma and umbilical cord according to baby sex were not significant in both NT and PE groups. Plasma leptin concentrations were related with maternal weight gain and BMI in NT group and with body weight in PE group. The BMI and birth weights of the neonates have significant effects on the umbilical cord leptin concentrations in both NT and PE groups. CONCLUSION: In this study, no correlation was found between maternal plasma and umbilical cord leptin concentrations in both NT and PE groups. But maternal plasma leptin concentrations had positive correlations with maternal body weight, BMI, and body weight changes during pregnancy in both NT and PE groups. There were also positive correlations among umbilical cord leptin concentrations, BMI and birth weights of the neonates of NT and PE groups term. Therefore umbilical cord leptin is considered to be the index of fetal birth weight.
Birth Weight ; Body Weight ; Body Weight Changes ; Female ; Fetal Blood* ; Fetal Weight* ; Humans ; Infant, Newborn ; Leptin* ; Parturition ; Plasma* ; Pre-Eclampsia* ; Pregnancy ; Radioimmunoassay ; Umbilical Cord ; Weight Gain

OBJECTIVE: The aim of this study is to assess the relationships between maternal plasma and umbilical cord leptin concentrations and their effects on newborn birth weights, maternal body mass indices and fetal sex in term normotensive (NT) and preeclampsia (PE) women. METHODS: Blood samples were obtained at delivery from 20 NT group and another 20 from PE group of at least 36 weeks of gestation. And the umbilical cord samples were also taken from their newborns at birth. Plasma leptin levels were determined in both groups using a human recombinant leptin 125-I radioimmunoassay. RESULTS: Mean maternal plasma and umbilical cord leptin concentrations were 16.16+/-2.05 ng/ml and 7.11+/-1.01 ng/ml in NT group, 17.09+/-1.67 ng/ml and 8.55+/-6.63 ng/ml in PE group, and there was no statistical significances among them. The differences of leptin concentrations in maternal plasma and umbilical cord according to baby sex were not significant in both NT and PE groups. Plasma leptin concentrations were related with maternal weight gain and BMI in NT group and with body weight in PE group. The BMI and birth weights of the neonates have significant effects on the umbilical cord leptin concentrations in both NT and PE groups. CONCLUSION: In this study, no correlation was found between maternal plasma and umbilical cord leptin concentrations in both NT and PE groups. But maternal plasma leptin concentrations had positive correlations with maternal body weight, BMI, and body weight changes during pregnancy in both NT and PE groups. There were also positive correlations among umbilical cord leptin concentrations, BMI and birth weights of the neonates of NT and PE groups term. Therefore umbilical cord leptin is considered to be the index of fetal birth weight.
Birth Weight ; Body Weight ; Body Weight Changes ; Female ; Fetal Blood* ; Fetal Weight* ; Humans ; Infant, Newborn ; Leptin* ; Parturition ; Plasma* ; Pre-Eclampsia* ; Pregnancy ; Radioimmunoassay ; Umbilical Cord ; Weight Gain

Morel-Lavallée lesions (MLL) create pre-fascial space by shearing the subcutaneous tissues away from the underlying fascia, in a patient with trauma. Necrosis of the overlying skin can develop over a wide area of the lesion. The lesion might be contaminated by the surgical site due to careless intrusion when treating the combined arteriopathy. A 70-year-old woman presented with avulsion of the skin over the right foot and bilateral leg pain following a car accident. Computed tomography showed bilateral popliteal artery occlusion with large hematoma on both legs. Percutaneous angioplasty was performed with successful restoration of the flow. However, the skin color changes over time. Necrosis of the skin occurred over a wide area of the right leg. Extensive debridement was performed, and the defect was covered with a skin graft. MLLs can occur in patients with multiple traumas, multiple vascular injuries, and complex skeletal injury. Vascular surgeons treating multiple traumas should be aware of the diagnostic and management options for MLL. It should be diagnosed early because it can be difficult to manage once the overlying skin develops necrosis.

Lymphomatoid granulomatosis usually presents as a primary lung affliction with secondary metastatic spread to the central nervous system(CNS), and its initial manifestation purely as a CNS disease is rare. A 57-year-old man with histologically proven lymphomatoid granulomatosis of the brain as the sole manifestation of the disease is presented.
Brain Neoplasms/*pathology ; Frontal Lobe ; Humans ; Lymphomatoid Granulomatosis/*pathology ; Male ; Middle Aged

BACKGROUND/AIMS: Most liver diseases lead to a pathobiochemical reaction termed liver fibrosis. Hepatic fibrosis is not a uniform phenomenon and it comprises increased deposition of the liver connective tissue components(collagen, noncollagenous glycoprotein, proteoglycan) in the intercellular space, leading to disturbances of intrahepatic blood flow and hindrance of exchange processes between blood and cells, Fibrosis can be determined by morphological examination o f the liver, but this approach cannot be used to assess accurately the activity of collagen synthesis at any given point in time, Thus, the development of biochemical markers of hepatic fihrosis might allow a promising diagnostic approach for the identification and quantitation of this process, Aminoterminal procollagen III pn) peptide(PIIINP) and carboxytermina1 procollagen I propeptide(PICP) are known as the most widely used parameter for evaluating liver fibrosis, but it is diAicult to find previous report discribing the correlation ot each other. To elucidate the clinical significance of the corretation of PICP(x) and PIIINP(y) concentrations in patients with chronic liver diseases, radioimmunoassay was employed in this investigation. METHODS: Sera tested were obtained from pathologically proven 43 patients;4 cases of fatly liver, 11 cases of chronic persistent hepatitis, 13 cases of chronic active hepatitis, l5 cases of liver cirrhosis. All the patients except 4 cases ot fatty liver were shown positivity of HBsAg. PICP and PIIlNP radioimmunoassay kits(Farrnos Diagnostica, Oulunsalo, Finland) wcre purchased for this study. RESULTS: In the patients among the three groups of chronic active hepatitis, liver cirrhosis, chmnic persistent hepatitis, the correlations were significant in orders(y= - 10.27 +0.l3938x, r=0.92286, p=0.000007;y=-1.185+0.06611x, r=0.73656, p=0.001737;y=1.1174+0.03273x, r=0.56879, p=0.067849). Four cases of fatty liver reveal no signiticant correlation (y=4,8671- 0,0079x, r= 0.1959, p=0.804054). CONCLUSION: 0n the basis of these data, we s st that the correlation of each showed a significant increase with heightening degree of inflammation, activity of diseases and fibrosis.
Biomarkers ; Collagen ; Connective Tissue ; Extracellular Space ; Fatty Liver ; Fibrosis ; Glycoproteins ; Hepatitis ; Hepatitis B Surface Antigens ; Hepatitis, Chronic ; Humans ; Inflammation ; Liver Cirrhosis ; Liver Diseases* ; Liver* ; Procollagen* ; Radioimmunoassay

Vascular injuries after spine surgery may result in acute life-threatening hemorrhage, chronic arteriovenous fistula, or pseudoaneurysm formation. The interval between injury and rupture may range from seconds to years, and accordingly, a high index of suspicion is needed to make the diagnosis. Although acute and delayed vascular injury caused by placement of posterior pedicle screw fixation has been reported, the potential for large vessel disruption during posterior pedicle screw removal has been rarely reported. This case report concerns a 50-year-old man who developed an descending thoracic aortic pseudoaneurysm after posterior pedicle screw removal, diagnosed by chest computed tomography(CT) scan and transesophageal echocardiography(TEE).
Aneurysm, False* ; Arteriovenous Fistula ; Diagnosis ; Hemorrhage ; Humans ; Middle Aged ; Rupture ; Spine ; Thorax ; Vascular System Injuries

OBJECTIVE: High thromboxane level evidence supports pivotal involvement of TxA2 in pathophysiology of pregnancy induced hypertension and provides a strong rationale for pursuing TxA2-blocking strategies in drug development. METHODS: The stable metabolites of TXA2 (Thromboxane B2) in maternal blood of 12 patients with mild preeclampsia, 4 patients with severe preeclampsia and 14 normal parturients were measured by competitive enzyme immunoassay. RESULTS: TxB2 concentrations were not increased in mild preeclampsia (101 +/- 12 pg/mL, n=12) as compared with normal pregnancy (150 +/- 15 pg/mL, n=14), but they were significantly increased in severe preeclampsia (454 +/- 102 pg/mL, p<0.0001, n=4). CONCLUSION: Maternal plasma thromboxane is increased only in severe preeclampsia. Thus, increased thromboxane A2 biosynthesis correlates with disease severity and may have a pathogenetic role in pregnancy-induced hypertension. These findings provide a rationale for the use of aspirin in the treatment as well as in the prevention of this disorder.
Aspirin ; Female ; Humans ; Hypertension, Pregnancy-Induced* ; Immunoenzyme Techniques ; Plasma ; Pre-Eclampsia ; Pregnancy ; Thromboxane A2