BACKGROUND: In renal transplantation, a good HLA-DR match Is associated with successive graft outcome. But due to a number of technical problems, reliable serological DR typing cannot always be obtained. To compare the serological DR typing with DRBI DNA typing, we tested 103 specimens that had been frozen after serological typing, by PCR-SSOP typing method. METHODS: Serological DR typing was performed by complement-dependent microlymphocytotoxicity technique using commercial antisera kits, and DNA gyp ins was performed by PCR-SSOP, using one of the methods recommended by 12th International Histocompatibility Workshop. DNA amplification was done by DRBAMP-A and DRBAMP-B primers, and hybridization by 18 oligonucleotides labelled with digoxigenin.. RESULTS: The concordance rate between serologic typing and DNA typing was 76.7%. Most (79.0%) of discordant results were due to serological blanks turning out to be definable antigens by DNA typing and these antigens consisted of mainly DR5 splits but none of DR1, DR2, or DR7. CONCLUSIONS: In spite of technical improvement, serological typing method often can not define the accurate HLA-DR type. It is thought that combining serological typing with DNA typing Is necessary to achieve a higher success rate of graft outcome.
Digoxigenin ; DNA ; DNA Fingerprinting ; Education ; Histocompatibility ; HLA-DR Antigens* ; Immune Sera ; Kidney Transplantation ; Oligonucleotides ; Transplants

BACKGROUND: There is a long-standing controversy whether melanocytes in vitiligo of more than 1 year duration are actually lost or still present. Resolving this matter is essential in understanding the underlying pathology and for the development of the treatment. On previous immunohistochemical and ultrastructural studies of vitiligo lesions, damage of melanocyte and keratinocyte in early lesions were reported and complete absence of melanocyte in long standing lesions were known. OBJECTIVE: This study aimed to determine the existence of the differences in pathologic changes in melanocytes according to the duration of the lesion. METHODS: We investigated the vitiliginous skin samples from 31 patients with early(less than 1 year duration) vitiligo and 30 patients with long standing(l to 5 years duration) vitiligo under the electron microscopy. RESULTS: Multiple degenerative changes in melanocytes were observed in the early and long standing lesions. In long standing lesions, degeneration of melanocytes including pyknotic, in-dented nuclei, vacuolated cytoplasms and blunted dendrites were more pronounced than early lesions. Even in long standing lesions, definite or presumptive melanocytes were observed in 16(53.3%) of 30 cases. CONCLUSION: Our results suggest that the melanocytes of vitiligo lesions were damaged and that the percentage of degenerative changes increase in accordance with the duration of the lesion. However, in long standing lesions as well as in early lesions, some residual melanocytes can be observed ultrastructurally.
Cytoplasm ; Dendrites ; Humans ; Keratinocytes ; Melanocytes ; Microscopy, Electron ; Pathology ; Skin ; Vitiligo*

Objectives: This study was aimed to assess the usefulness of the quantitative assessment of clock drawing test (CDT) combined with the Mini-Mental State Examination (MMSE) compared to that of the Montreal Cognitive Assessment (MoCA) or the MMSE alone for screening of dementia in Parkinson disease (PD) in patients with a low educational level. Methods: A representative sample of 91 PD patients was administered MMSE, MoCA and CDT. The discriminative validity of the MMSE, MoCA, and a MMSE+CDT combination for dementia screening was determined by estimating the sensitivity and specificity of each test and by testing integrated discrimination improvement (IDI). Results: The mean age and educational years were 69.0 (years) and 7.3 in the study population. The best screening cut-off points for the MMSE, MoCA, and MMSE+CDT were 25/26, 21/22 and 41/42. In a group of patients with educational years ≤6,
Dementia

No abstract available.

Small cell neuroendocrine carcinoma is a high-grade and poorly differentiated tumor typically presenting as primary pulmonary neoplasm. Extrapulmonary small cell carcinoma is rare. Primary small cell neuroendocrine carcinoma of the breast (SCNCB) is extremely rare, with an incidence of less than 0.1% of all breast cancers. Herein, we report imaging features of SCNCB incidentally diagnosed in a 58-year-old woman along with a literature review. The tumor was observed to be a round and circumscribed mass with rim enhancement, heterogeneous intra-tumoral enhancement, and peritumoral edema on MRI. The patient underwent breast-conserving surgery with adjuvant chemotherapy and radiation therapy. No tumor recurrence was observed during the 2-year follow-up visits after surgery.

The purpose of this study was to analyze the minimum two year clinical and radiological results of revision total hip arthroplasties using allogenic chip bone graft and cement in acetabular bone deficiencies. Thirty six revision total hip arthroplasties that had been performed in thirty four patients between Sep. 1992 and May. 1994 at Seoul Paik Hospital and had followed more than two years were included in this study. The clinical result was evaluated by Harris hip score. The mean Harris hip score was 48 points preoperatively, 88 points at final follow-up, a mean of 3 years after revision. In radiological evaluation, osseous union between grafted bone and host bone was seen within 4 months in thirty two hips (89%), a complete grafted bone-cement radiolucent line of two millimeter or more in at least one zone was seen in seven hips (19%) and acetabular component migration was seen in six hips (17%) at postoperative 3 year follow-up radiograph. At the time of follow-up, five hips (14%) had been revised a second time: three for aseptic acetabular loosening, two for infection. In conclusion, we recommend the technique using allogenic chip bone graft and cement to reconstruct the acetabular bone deficiencies in revision total hip arthroplasties, though other technique will be recommend in severe segmental acetabular deficiencies or previous infection.
Acetabulum* ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Follow-Up Studies ; Hip ; Humans ; Seoul ; Transplants*

BACKGROUND: Paroximal nocturnal hemoglobinuria (PNH) is a disorder of the pluripotent stem cells resulting in a deficient expression of membrane-bound GPI-anchored proteins in different cell types. We evaluated REDQUANT and CELLQUANT kits (Biocytex, Marseille, France) for PNH test. METHODS: Seventy patients with peripheral blood cytopenia and 16 healthy controls were studied. RBCs and granulocytes were tested for CD55 and CD59 expression using the REDQUANT and CELLQUANT kits and an Epics XL flow cytometer. According to the manufacturer's instruction, results were interpreted abnormal when more than 3% of cells were deficient in the expression of CD55 or CD59, and a test was considered positive for PNH if three of the four markers tested were abnormal. RESULTS: The percentage of CD55/CD59 deficient RBCs and granulocytes was 0.3/3.1 and 3.5/ 10.0, respectively, in the patient group, and 0.1/1.0 and 0.3/9.7, respectively, in the control group. PNH was diagnosed in three patients who had a deficiency in the expression of three or four antigens; two other patients showed a deficiency in two antigens. There were many who had CD59 deficiency only: on granulocytes in 30 patients and 11 controls, and on RBCs in 6 patients and 2 controls. One patient had CD55 deficient granulocytes. CONCLUSIONS: The REDQUANT/CELLQUANT kit is a standardized method and does not require normal samples as the control, but one should be cautious in interpreting the results showing CD59 expression on granulocytes.
Diagnosis* ; Flow Cytometry ; Granulocytes ; Hemoglobinuria ; Hemoglobinuria, Paroxysmal* ; Humans ; Pluripotent Stem Cells

No abstract available.
Myxoma ; Stroke ; Thrombolytic Therapy

Aged ; Caregivers ; Dementia ; Depression ; Empathy ; Epidemiologic Studies ; Humans ; Korea ; Pilot Projects

Background: The code stroke system is designed to identify stroke patients who may benefit from reperfusion therapy. It is essential for emergency physicians to rapidly distinguish true strokes from stroke mimics to activate code stroke. This study aimed to investigate the clinical and neurological characteristics that can be used to differentiate between stroke and stroke mimics in the emergency department (ED). Methods: We conducted a retrospective observational study of code stroke patients in the ED from January to December 2019. The baseline characteristics and the clinical and neurological features of stroke mimics were compared with those of strokes. Results: A total of 409 code stroke patients presented to the ED, and 125 (31%) were diagnosed with stroke mimics. The common stroke mimics were seizures (21.7%), drug toxicity (12.0%), metabolic disorders (11.2%), brain tumors (8.8%), and peripheral vertigo (7.2%). The independent predictors of stroke mimics were psychiatric disorders, dizziness, altered mental status, and seizure-like movements, while current smoking, elevated systolic blood pressure, atrial fibrillation on the initial electrocardiogram, hemiparesis as a symptom, and facial palsy as a sign suggested a stroke. In addition, the likelihood of a stroke in code stroke patients tended to increase as the number of accompanying deficits increased from the following set of seven focal neurological deficits: hemiparesis (or upper limb monoparesis), unilateral limb sensory change, facial palsy, dysarthria, aphasia (or neglect), visual field defect, and oculomotor disorder (P < 0.001). Conclusion Some clinical and neurological characteristics have been identified to help differentiate stroke mimics from true stroke. In particular, the likelihood of stroke tended to increase as the number of accompanying focal neurological deficits increased.