OBJECTIVETo investigate the value of serum inflammatory markers in the diagnosis of acute appendicitis (AA) in children.

METHODSBlood samples were collected from 51 children with AA and 16 children with nonsurgical abdominal pain (NSAP) to examine white blood cell count (WBC), serum C-reactive protein (CRP), interleukin-6, and tumor necrosis factor-α (TNF-α).

RESULTSWBC count, CRP, IL-6 and TNF-α increased significantly in children with severe AA (phlegmonous or gangrenous, and perforated appendicitis). ROC curves showed that IL-6 or TNF-α had a greater contribution than WBC count to the diagnosis of severe appendicitis.

CONCLUSIONIL-6 and TNF-α can provide complementary information to assist the clinical decision of emergency operation for children with AA.

Appendicitis ; blood ; diagnosis ; Biomarkers ; blood ; C-Reactive Protein ; metabolism ; Child ; Child, Preschool ; Female ; Humans ; Inflammation ; blood ; diagnosis ; Interleukin-6 ; blood ; Lymphocyte Count ; Male ; Tumor Necrosis Factor-alpha ; blood

Adult ; Aged ; Aged, 80 and over ; Biomarkers ; blood ; Coronavirus Infections ; blood ; diagnosis ; Humans ; Inflammation ; blood ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral ; blood ; diagnosis ; Severity of Illness Index

Despite the remarkable progress recently made to enhance the resolution of white-light endoscopy, detection, and diagnosis of premalignant lesions, such as adenomas and subtle early-stage cancers, remains a great challenge. As for example, although chromoendoscopy, such as endoscopy using indigo carmine, is useful for the early diagnosis of subtle lesions, the technique presents various disadvantages ranging from the time required for spray application of the dye and suctioning of excess dye to the increased difficulty in identifying lesions in the presence of severe inflammation and obstruction of visual field due to the pooling of solution in depressed-type lesions. To overcome these diagnostic problems associated with chromoendoscopy, research has focused on the development of endoscopes based on new optical technologies. Several types of image-enhanced endoscopy methods have recently been presented. In particular, image-enhanced endoscopy has emerged as a new paradigm for the diagnosis of gastrointestinal disorders. Image-enhanced endoscopes provide high-contrast images of lesions by means of optical or electronic technologies, including the contrast enhancement of the mucosal surface and of blood vessels. Chromoendoscopy, narrow-band imaging, i-SCAN, and flexible spectral imaging color enhancement are representative examples of image-enhanced endoscopy discussed in this paper.
Adenoma ; Blood Vessels ; Diagnosis ; Early Diagnosis ; Endoscopes ; Endoscopy* ; Indigo Carmine ; Inflammation ; Narrow Band Imaging ; Suction ; Visual Fields

Through summarizing the literatures concerning basic and clinical study on the correlation between blood-stasis syndrome (BSS) and inflammation, reviewing close correlation of BSS with C-reaction protein, serum interleukin-6, tumor necrosis factor and adhesion molecules, it was found that promoting blood circulation and removing stasis approaches could effect vitally in clinical treatment of inflammation, and the inflammation reaction shows certain effect of mediation in animal model of BSS. Accordingly, the important role played by inflammatory reaction in the occurrence and development of BSS is summarized in the paper.
Blood Coagulation ; C-Reactive Protein ; metabolism ; Diagnosis, Differential ; Inflammation ; blood ; pathology ; Interleukin-6 ; blood ; Medicine, Chinese Traditional ; Syndrome ; Tumor Necrosis Factor-alpha ; blood

Considering that antibiotic treatment may elevated the level of prostate-specific antigen (PSA) and hence limit the specificity of PSA test for prostate cancer, urologists use empiric antibiotic treatment for men with increased PSA levels. But it is controversial whether antibiotic treatment can exclude inflammation in the differential diagnosis of PSA elevation. Some researchers have found that antibiotic treatment can decrease inflammation-induced PSA elevation and help to reduce unnecessary biopsies, while others have reported that antibiotic treatment has no significant effect on the PSA level, and the lowered level of PSA following antibiotic treatment does not mean the decreased risk of prostate cancer. Further researches are needed to confirm the value of antibiotic treatment before biopsy.
Anti-Bacterial Agents ; therapeutic use ; Biomarkers, Tumor ; blood ; Biopsy ; Diagnosis, Differential ; Humans ; Inflammation ; metabolism ; pathology ; Male ; Prostate ; pathology ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; diagnosis ; pathology ; Prostatitis ; pathology

BACKGROUND AND OBJECTIVES: Possible correlations between the serologic status concerning Cytomegalovirus(CMV), Chlamydia pneumoniae (CP), Helicobacter pylori(HP), their related markers of C-reactive protein(CRP), erythrocyte sedimentation rate(ESR), and the restenosis(RS) in patients underwent percutaneous coronary intervention(PCI) were analyzed. Materials and METHODS: The 142 patients(58.010.9 year-old, M;F=116:26) with 189 coronary lesions, who underwent follow-up angiography after PCI, were evaluated. RESULTS: The overall RS rate was 47.1%(89/189), and the RS rate according to clinical diagnosis was 50.6% in acute myocardial infarction(MI), 41.8% in unstable angina(UA), 6.3% in stable angina(SA), and 1.3% in old MI. The values of RS rate in acute MI and UA were higher than those of old MI and SA(p=0.02). Thrombolysis In Myocardial Infarction(TIMI) flow was significantly lower in group with RS than without RS(p=0.039). Seropositivities of CMV, CP, HP were not different between groups with and without RS. Titers of CMV and HP were not different between two groups. Positivity of CRP was 56.3% in group with RS and 30.2% in group without RS(p=0.005). Titers of ESR and CRP were higher in group with RS than without RS(20.322.4 mm/hr, 2.24.5 mg/dL vs. 11.811.6 mm/hr, 0.70.8 mg/dL, p=0.007, p=0.010 respectively). CONCLUSION: RS rate after PCI is higher in patients with acute coronary syndrome and low TIMI flow. Inflammatory markers, such as CRP and ESR, might be associated with the RS after PCI.
Acute Coronary Syndrome ; Angiography ; Blood Sedimentation ; Chlamydophila pneumoniae ; Coronary Restenosis* ; Diagnosis ; Follow-Up Studies ; Helicobacter ; Humans ; Inflammation* ; Percutaneous Coronary Intervention*

Necrotizing enterocolitis (NEC) is a major gastrointestinal disorder in premature infants associated with high morbidity and mortality rates. When NEC is clinically suspected, radiological and laboratory studies should be performed to confirm the diagnosis and to aid in the management of patients. As the clinical manifestations of NEC are usually nonspecific, diagnoses are often made using abdominal radiographic findings, such as pneumatosis intestinalis. Clinicians typically consider the presence of pneumatosis intestinalis on radiographs as the definite evidence of stage II NEC. Here, we report 3 cases of preterm infants who had radiographic findings of pneumatosis intestinalis but did not have any other associated laboratory and clinical evidence of NEC, except bloody stools. The infants' systemic manifestations were mild or absent, and all of them completely recovered within 2-3 days, as demonstrated by the resolution of pneumatosis intestinalis on abdominal radiographs. The combination of hematochezia and intestinal pneumatosis in preterm infants strongly suggests the diagnosis of NEC. In our cases, there was no laboratory evidence of inflammation or platelet consumption, and the clinical course was benign without any sings of surgical abdomen. Additionally, our patients had barium-induced colitis or milk protein allergy, which are other possible causes of pneumatosis intestinalis. Because pneumatosis intestinalis can result from causes other than NEC, it is important to consider clinical, laboratory, and radiological findings to confirm the diagnosis of NEC.
Abdomen ; Blood Platelets ; Colitis ; Diagnosis ; Enterocolitis, Necrotizing* ; Gastrointestinal Hemorrhage ; Humans ; Hypersensitivity ; Infant, Newborn ; Infant, Premature* ; Inflammation ; Milk Proteins ; Mortality

Idiopathic hypertrophic cranial pachymeningitis(IHCP) is a rare chronic pro gressive fibrosing inflammation of pachymeninges of unknown origin. Since the spreading of CT and MRI, there has been a few cases of IHCP have been reported. We describe two patients of IHCP with brain parenchymal involvement presented as epilepsia partialis continua which has not been described as a symptom of IHCP and review the previous reported literatures. IHCP commonly presents headache, multiple cranial nerve palsy, ataxia, and sometimes seizure. In many cases, the CSF finding is noninfectious inflammation, and the erythrocyte sedimentation rate is elevated. The brain MRI is the best noninvasive tool for diagnosis of IHCP and shows diffuse thickening and enhancing dura, especially posterior fossa. IHCP responds steroid initially but recurs frequently and progresses chronically.
Ataxia ; Blood Sedimentation ; Brain ; Cranial Nerve Diseases ; Diagnosis ; Epilepsia Partialis Continua ; Headache ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Meningitis* ; Seizures

OBJECTIVE: Our aim is to evaluate the early changes of biologic markers such as white blood cell(WBC) count, erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) in early diagnosis of postoperative infection and to differentiate infection from inflammatory reaction in lumbar spine surgery. METHODS: We reviewed 330patients who had undergone spinal operations between May 1999 and October 2001. For this study, the patients were classified into two groups, which include a group that underwent spinal decompressive surgery without instrumentation(SD), and the other group that underwent fusion surgery with spinal instrumentation(SI). And each group was also subdivided into two groups respectively, one with infection and the other without infection. We retrospectively analyzed the WBC count, ESR and CRP preoperatively and postoperatively, according to their operation type and postoperative infection history. RESULTS: Inflammatory indices were physiologically affected by instrumentation itself. But ESR and CRP elevations were more prolonged and sustained under infection. In SD patients without infection, ESR and CRP were stabilized 5 days after surgery. In SI patients without infection, CRP was stabilized about 7days after surgery, but ESR showed sustained and variously elevated. In both SD and SI groups, the stabilization of CRP was the most reliable behavior of surgery without infection. CONCLUSION: C-reactive protein is most sensitive parameter for postoperative spine infection. The knowledge of the inflammatory indices and their relatively uniform patterns with or without infection offers surgeons the ability to infer the state of surgical wound.
Biomarkers ; Blood Sedimentation ; C-Reactive Protein ; Early Diagnosis ; Erythrocyte Count ; Humans ; Inflammation ; Retrospective Studies ; Spine* ; Wounds and Injuries

BACKGROUND: Immune thrombocytopenic purpura (ITP) is an autoimmune disorder presenting low platelet count in peripheral blood without any other abnormalities in other blood cell lineage. There were many studies that investigated the mechanism of ITP and the factors related to its chronicity, but much remains controversial. Neutrophil to lymphocyte ratio (NLR) is considered an indicator representing the severity of acute or chronic inflammation. The aim of this study was to assess whether NLR can predict the outcome of ITP and its chronicity.METHODS: Patients who were diagnosed as ITP at Dong-A University Hospital between March 2000 and March 2016 were analyzed retrospectively. NLR results and other medical records at diagnosis and after treatment were analyzed and compared between two groups; patients with single episode and chronic ITP group.RESULTS: Of a total of 67 patients, 39 patients (58.21%) were chronic ITP. Patients with single episode showed low NLR at diagnosis than patients with chronic ITP (1.23±1.38 vs. 1.54±1.15, P=0.42), but NLR after recovery were significantly high (1.58±1.71 vs. 1.31±0.76, P=0.21). However, patients with chronic ITP showed a trend of high NLR at the time of relapse.CONCLUSION: Chronic ITP patients showed higher NLR at the time of diagnosis compared with the patients with single episode. Also, the NLR at the time of relapse showed higher level compared to those at diagnosis. Relationship between NLR and chronic ITP need to be further studied.
Blood Cells ; Diagnosis ; Humans ; Inflammation ; Lymphocytes ; Medical Records ; Neutrophils ; Platelet Count ; Prognosis ; Purpura, Thrombocytopenic, Idiopathic ; Recurrence ; Retrospective Studies