Toxoplasma gondii, an intracellular coccidian protozoan, is the causative agent of toxoplasmosis, a widespread infection affecting various birds and mammals including humans. In immunocompetent hosts, the infection is usually asymptomatic and benign. Toxoplasmosis is either congenital or acquired. In general prenatal therapy of congenital toxoplasmosis is beneficial in reducing the ncy of infant infection. Therapies are based primarily on spiramycin because of the relative lack of toxicity and high concentration achieved in the placenta. Clindamycin is the standard drug for chemoprophylaxis in newborn infants, and is directed at preventing the occurrence of retinochoroiditis as a late sequel to congenital infection. The standard treatment for acquired toxoplasmosis in both immunocompetent and immunodeficient patients is the synergistic combination of pyrimethamine and sulphonamides. Toxoplasmic encephalitis is tbe most common manifestation of acquired toxoplasmosis in immunocompromised patients and if not treated is fatal. However, because of toxicity, the therapeutic efficacy of pyrimethamine sulphonamide combinations may be seriously limited in immunodeficient patients. We have experienced a case of toxoplasmosis during the workup of habitual aborter. So we report this case with a brief review of literatures.
Birds ; Chemoprevention ; Clindamycin ; Encephalitis ; Humans ; Immunocompromised Host ; Infant ; Infant, Newborn ; Mammals ; Placenta ; Pyrimethamine ; Spiramycin ; Toxoplasma ; Toxoplasmosis* ; Toxoplasmosis, Congenital

Systemic lupus erythematosus(SLE) is a multisystem disorder with a peak age of onset in the second and fourth decades of life predominantly occuring in females who will usually have the potential to become pregnant. This female to male predominance is greatest during childbearing years approaching a ratio of 13:1, after the menopause it declines to a ratio of 3:1, the ratio also seen in prepubertal years. In practice, despite the higher prevalence of rheumatiod arthritis, pregnancy in SLE is the most common management problem confronting physician and obstetrician amongst the connective tissue disorders and it is particularly important as the outcome of pregnancy is more unpredictable in this disease. As well as having clinical consequences for the health of both mother and fetus, pregnancy in lupus provides a model for studying the importance of other biological phenomena characterizing the disease. For example, the transplacental passage of maternal antibodies to Ro(SSA) and La(SSB) and their strong association with the neonatal lupus syndrome suggests a pathogenetic role for these autoantibodies. Other relevant issues are feto-meternal immunological tolerance and hormonal interaction with the immune system. We have experienced a case of recurrent pregnancy loss associated with systemic lupus erythematosus. So we report this case with a brief review of literatures.
Age of Onset ; Antibodies ; Arthritis ; Autoantibodies ; Biological Phenomena ; Connective Tissue ; Female ; Fetus ; Humans ; Immune System ; Lupus Erythematosus, Systemic* ; Male ; Menopause ; Mothers ; Pregnancy* ; Prevalence

INTRODUCTION There are three factors for successful implantation. These are embryo quality, uterine receptivity, and synchronization between embryonic and endometrial development. Despite remarkable progress in investigating embryos in human IVF, there has been slow progress in exploring the implantation process. It may be due to two reasons as follow. First, it is difficult to directly investigate the mechanism of implantation in the human, because of ethical considerations. Second, there is no sensitive and widely accepted marker for assessing endometrial development. Since the finding of a novel standard for dating endometrial biopsy by Noyes et. al.,. in 1950, there have been many attempts to identify suitable markers for uterine receptivity. Those include ultrasonographic changes (Ueno et.al., 1991; Grunfeld et al.,1991), three dimensional morphological changes of the endometrium such as pinopode formation (Market or alphaf., 1987; Mantel or alphaf., 1991; Nikas et al., 1995; Psychoyos & Nikas, 1994), integrin expression (Ilesanmi et al., 1993; Lessey et.al., 1992; Lessey, 1994), and measurement of endometrial proteins (Hell, 1986;Fay & Crudzinskas, 1991). Investigations in the rat (cartel et al., 1991)and human (cartel et al., 1987; Nikas et al., 1995; Psychoyos & Nikas, 1994) suggested the presence of pinopodes as a marker for the receptive phase.4 chronological barrier in uterine receptivity could be one of the major factors limiting IVF pregnancy rates. If we were able to manage the 'implantation window' we may be able to improve implantation and pregnancy rates in the human IVF program. In 1987, Martel et al., found early appearance of pinopodes in stimulated cycles for IVF compared to natural cycles in humans (Marcel et al., 1987). This effect was found in patients stimulated with clomephene citrate/hMG/hCG. The purpose of the present study was to evaluate the endometrial development in IVF patients stimulated with either by FSH/hMG/hCG or with GnRH agonist down regulation.
Animals ; Biopsy ; Down-Regulation ; Embryonic Structures ; Endometrium ; Female ; Gonadotropin-Releasing Hormone ; Humans* ; Oocyte Retrieval* ; Oocytes* ; Pregnancy Rate ; Rats

BACKGROUND/AIMS: For laboratory diagnostics in liver diseases, many enzymes have been used for the assessment of hepatocellular function. Among them, two transaminases, alanine and aspartate aminotransferase, have been regarded as the most sensitive indicators of hepatocellular damage. However, the enhanced enzyme activities of the enzymes do not exactly indicate or represent the cause and progression of diseases in the patients with liver disease. To overcome such limitations, immunological methods have been suggested as one of the alternatives for the replacement or supplement of the conventional enzymatic analysis. METHODS: In the hope of developing a new assay system for measuring the AST concentration rather than its activity, we have developed a new assay using fluorescence labeled anti-AST monoclonal antibodies. Blood was obtained from a normal population of 234 patients and 43 liver disease patients. The linearity, limit of detection, and performance of the new assay system were tested and evaluated. The comparability of assay was examined with an ELISA and biochemical assays. RESULTS: The linearity fell in the range of 0-1 mg/L of AST (R=0.995), and the analytical detection limit was 12 microgram/L of AST. The mean recovery of the control was 102.4 % in a working range. The precision of the intra- and inter-assay in a range of 50-800 microgram/L was CVs < 7% and CVs < 6%, respectively. In the normal population, the mean AST concentration was 35.5 microgram/L. The mean AST concentration in patients with liver disease was 266.5 microgram/L. The new assay system correlated well with an ELISA and biochemical assay for quantification of AST concentration (R=0.92 and 0.88, respectively; N=43). CONCLUSIONS: We have developed a new immunological assay using generated monoclonal antibodies to human cytosolic AST and used them for the development of a fluorescent assay measuring the enzyme mass. Cytosolic AST mass in sera could be measured reproducibly by the immunological method. In conclusion, this study has provided us with a new type of tool for an accurate measurement of the enzyme amount in circulation.
Antibodies, Monoclonal ; Aspartate Aminotransferase, Cytoplasmic/*blood/immunology ; Fluorescent Antibody Technique/*methods ; Humans ; Liver Diseases/diagnosis

To get the standard and marginal rigidity of physiologic erection in young Korean men with normal potency, nocturnal penile erection(NPE) and audio-visually stimulated erection(AVSE) were monitored using RigiScan in 30 young volunteers with normal potency aged from 21-35 years. Vibration induced erection was also assessed by bucking. The results were as follows. 1. Regarding to NPE, maximal rigidity lasting for more than 5 minutes was 40-70% in 4(10.3%) and more than 70% in 26 (89.7%) with mean+/-SD of 78.43+/-8.02 %. The maximal rigidity lasting for more than 10 minutes was 40-70% in 6(20%) and more than 70% in 24(80%), with mean+/-SD of 74.43+/-8.02%. 2. Regarding to AVSE, maximal rigidity lasting for more than 5 minutes was 40-70% in lt3.3 %) and more than 70% in 29(96.7%) with mean+/-SD of 81.30+/-7.18%. The maximal rigidity lasting for more than 10 minutes was 40-70% in 2(6.7%) and more than 70% in 28(93.3%), with mean+/-SD of 77.63 + 7.87%. Twenty seven men(90%) showed positive response to VIE test. but 3 with normal NPE and AVSE showed negative response to VIE test. Therefore, young potent men showed higher amplitude of maximal rigidity in AVSE than in NPE. and VIE test had the highest false negative response rate. The rigidity of 40% lasting 10 minutes was the lower limit of normal NPE and AVSE.
Erectile Dysfunction ; Humans ; Male ; Penile Erection* ; Vibration ; Volunteers ; Young Adult*

No abstract available.
Humans ; Primary Health Care*

Recently, the number of reports of Acanthamoeba keratitis has been increased apparently as a consequence of association with use of contact lenses, contaminated contact lens care system and high concern of ophthalmologist to Acanthamoeba keratitis. But, there were few epidemiologic studies of contamination of contact lens care system by Acanthamoeba and there was no report in Korea. We carried out a survey to demonstrate the contamination of contact lens care system by Acanthamoeba and bacteria and analysed the results according to the types of contact lenses and methods of disinfection. We examined the contact lens care system of 185 asymptomatic contact lens wearer for the contamination of Acanthamoeba and bacteria. The result showed a significant contamination of Acanthamoeba and bacteria. Twenty eight(15%) were contaminated with Acanthamoeba, eighteen(10%) were mixed with bacterial contamination and seventy four(40%) were contaminated with bacteria. There was no significant difference with sex and the result showed a lot of cocontamination with bacteria and amoeba and chemical disinfection showed a high Acanthamoeba contamination rate. Based on data from this and previous studies, the most of contact lens care system of contact lens wearer was contaminated with bacteria, amoeba and other microorganism. So, ophthalmologists should be concerned about Acanthamoeba contamination of contact lens care system.
Acanthamoeba Keratitis ; Acanthamoeba* ; Amoeba ; Bacteria ; Contact Lenses ; Disinfection ; Korea

Acute cerebral infarctions are rare in children, however, they can occur as a complication of a Mycoplasma pneumoniae (MP) infection due to direct invasion, vasculitis, or a hypercoagulable state. We report on the case of a 5-year-old boy who had an extensive stroke in multiple cerebrovascular territories 10 days after the diagnosis of MP infection. Based on the suspicion that the cerebral infarction was associated with a macrolide-resistant MP infection, the patient was treated with levofloxacin, methyl-prednisolone, intravenous immunoglobulin, and enoxaparin. Despite this medical management, cerebral vascular narrowing progressed and a decompressive craniectomy became necessary for the patient's survival. According to laboratory tests, brain magnetic resonance imaging, and clinical manifestations, the cerebral infarction in this case appeared to be due to the combined effects of hypercoagulability and cytokineinduced vascular inflammation.
Brain ; Cerebral Infarction* ; Child ; Child, Preschool ; Decompressive Craniectomy ; Diagnosis ; Enoxaparin ; Humans ; Immunoglobulins ; Inflammation ; Levofloxacin ; Magnetic Resonance Imaging ; Male ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia, Mycoplasma* ; Stroke ; Thrombophilia ; Thrombosis ; Vasculitis

OBJECTIVE: This study was to investigate the prevalence of tardive dyskinesia (TD) in Korean inpatients using antipsychotics and the relationship between TD and sociodemographic, clinical variables. METHODS: This study was done from January to Feburary, 2003, at the Seoul National Mental Hospital. A cross-sectional assessment of randomly selected inpatients (n=324;mean age=39.73+/-9.63years) with DSM-IV schizophrenia, schizoaffective, bipolar disorder was performed with standard rating instrument for TD and extrapyramidal symptoms. The relations between the prevalence of TD and sex, age, length of medication and dosage of antipsychotics, clozapine, and other psychotropic medication, EPS were analyzed with Chi-square test or t-test. RESULTS: Using Schooler and Kane's criteria, 20 subjects (6.17%) had TD. TD was significantly less prevalent in patients receiving clozapine. There was no other significant difference between the TD and without TD groups with respect to type of antipsychotics, other psychotropic drug, antiparkinsonian drug, mood stabilizer augmentation. CONCLUSION: The result of this study have confirmed the lower prevalence of TD among inpatients using antipsychotics compared to previous investigations. The study has also replicated the association of TD with older age. Clozapine use was associated with lower prevalence rate of TD.
Antipsychotic Agents* ; Bipolar Disorder ; Clozapine ; Diagnostic and Statistical Manual of Mental Disorders ; Hospitals, Psychiatric ; Humans ; Inpatients* ; Movement Disorders* ; Prevalence* ; Schizophrenia ; Seoul

Syphilitic aneurysm is a rare type aneurysm followed by syphilitic aortitis. Authors present a case ofsyphilitic aneurysm of the ascending aorta and describe radiological findings on chest roentgenogram, aortogramand computed tomogram.
Aneurysm ; Aorta ; Syphilis, Cardiovascular ; Thorax