No abstract available.
Allografts* ; Cartilage*

OBJECTIVE: The conventional methods to determine fetal genetic status, such as amniocentesis or chorionic villi sampling(CVS) have small procedure-related risk of abortion. Recently, several researchers reported that fetal genetic status, such as sex, can be confirmed by fetal nucleated erythrocytes in maternal blood and this method might reduce such risk. Therefore, in this study, we attempted to determine the basic fetal genetic status, sex, with fetal nucleated erythrocytes. METHODS: In twelve pregnant women who undertook amniocentesis or CVS, 20 ml of venous blood was drawn immediately before the procedure and the nucleated erythrocytes were recovered by magnetic activated cell sorting(MACS). After MACS, DNA was extracted from 200 microliter of sample and single nucleated erythrocyte was obtained by additional procedure, immunostaining, and microdissection. After recovery of nucleated erythrocytes by microdissection, nested polymerase chain reaction(PCR) and fluorescent PCR of amelogenin gene were performed to identify the fetal gender. RESULTS: The DNA of enriched erythrocytes after MACS could identify the fetal gender in the 58.3% of the samples by nested PCR. After the recovery of single nucleated erythrocyte by MACS, immunostaining and microdissection, the minute DNA in a single cell could be amplified by primer extension preamplification(PEP), nested PCR, and fluorescent PCR. Fetal genders were correctly identified in 8 out of 12 (66.7 %). CONCLUSION: Through this study, we could conclude that fetal nucleated erythrocytes in maternal blood might be sufficient sample to determine fetal sex. And single cell isolation by microdissection could get the better results than nested PCR after MACS only. However, in spite of the pregnancy of male fetus, female specific bands were obtained after nested PCR of amelogenin in several cells, which might suggest that part of nucleated erythrocytes in maternal blood might be maternal origin. Therefore, to determine fetal genetic condition by nucleated erythrocytes in maternal blood, further improvements of methods to identify the nucleated erythrocytes of fetal origin are needed.
Amelogenin ; Amniocentesis ; Cell Separation ; Chorionic Villi ; Diagnosis* ; DNA ; Erythroblasts* ; Erythrocytes ; Female ; Fetus ; Humans ; Male ; Microdissection ; Polymerase Chain Reaction ; Pregnancy ; Pregnant Women

No abstract available.
Leiomyoma*

The short term beneficial effect of arthroscopic excision of synovial tissue in knees with rheumatoid arthritis have been well documented. The purpose of this study to report the results of synovectomy in patients with rheumatoid arthritis who have been observed at least 3 years. We analysed the clinical result with modified Laurin criteria, radiologic change and patients own satisfaction degree with survey. The results were as follows; 1. The preoperative symptoms were pain (100%), swelling (100%), decreased range of motion (83%) and joint tenderness (74%), and those were improved postoperatively to 43%, 60%, 11%, 43% each other. 2. Among the laboratory parameters, C-reactive protein (CRP) was improved most significantly (pvalue =0.026). 3. On simple supine A-P X-rays, the width of medial joint space and lateral joint space were compared to preoperatively and postoperatively. The width of medial joint space was 4.33mm preoperatively, and it was changed to 3.22mm at last follow up (p=0.032). Those of lateral joint space was changed from 4.24mm preoperatively to 3.27mm at last tollow up (p=0.106). 4. The grade of articular cartilage damage was related with severity of preoperative symptoms and the patients with low grade of articular cartilage damage showed more postoperative improvement. The result of operation was related to symptom duration, degree of X-ray change and degree of cartilage damage. 5. 58% ot patients were satisfied to results of synovectomy, 28% were answered neither satisfied nor ansatisfied and 14% were unsatisf'ied to operation. We concluded the arthroscopic synovectomy of the knee joints was effective procedure to improve the clinical symptoms, range of knee motion and to alleviate the inflammatory reaction at mid-term period al'ter the operation. So we consider this procedure is a palliative treatment that modified and alleviate the progression of rheumatoid arthritis of knee joints.
Arthritis, Rheumatoid* ; C-Reactive Protein ; Cartilage ; Cartilage, Articular ; Follow-Up Studies ; Humans ; Joints ; Knee Joint* ; Knee* ; Palliative Care ; Range of Motion, Articular

No abstract available.
Factor VIII* ; Hemophilia A* ; Humans

No abstract available.
Hepatitis* ; Immunoglobulins* ; Plasmapheresis*

No abstract available.
Hepatitis B* ; Hepatitis*

OBJECTIVE: The object of this study was to compare the diagnostic accuracy of a sonographic morphologic scoting system, the serum CA-125 assay, and a combination of both in patients undergoing laparotomy for a clinically diagnosed adnexal mass. METHODS: In 129 consecutive patients, the morphology of the mass was evaluated and scored by the morphologic scoring system of Sassones using transabdominal or transvaginal sonography and blood samples were obtained for CA-125 assay before planning surgery, RESULTS: The sensitivity of the sonographic morphologic scoring system was 90.6%, the specificity 84.5%, the positive predictive value 65.9%, and the negative predictive value 96.5%, compared with 68.8, 77.3, 50.0, and 88.2% for CA-125 and 96.9, 66.0, 48.4, and 98.5% for the two tests combined, respectively. Only one case of serous borderline ovarian tumor was missed when the two tests were combined. The sensitivity and mean value of the serum CA-125 increased with the stage of ovarian cancer. CONCLUSION: The combination of sonographic findings with a serum CA-125 assay was more sensitive, but less specific, than sonography or the serum CA-125 assay alone in predicting the malignancy of an adnexal mass. The serum CA-125 level generally reflected the stage of the disease. We think that it is reasonable to check the serum CA-125 only in cases of ovarian malignancy diagnosed by sonography.
Diagnosis* ; Humans ; Laparotomy ; Ovarian Neoplasms* ; Sensitivity and Specificity ; Ultrasonography*

Transfer of large quantities of fetal blood across the placental barrier to the maternal circulation is a rare occurrence which results in severe anemia in the newborn infants. This phenomenon is believed to occur most often during labor and delivery and apparently, is more frequent when abnormal obstetric conditions are present. However, fetal erythrocytes have been identified in the naternal circulation throughout most of pregnancy indicating some degree of constant or intermittent transplacental transfusion. We experienced a case of stillbirth due to large amount of fetomaternal transfusion. Acid elutionl test of maternal blood was positive and direct and indirect Coombs test was negative. Ultrasonographic finding on abdomen and cranium to rule out the internal hemorrhage was normal. We report a case of stillbirth due to fetomaternal transfusion with a brief review of related literatures.
Abdomen ; Anemia ; Coombs Test ; Erythrocytes ; Female ; Fetal Blood ; Fetomaternal Transfusion* ; Hemorrhage ; Humans ; Infant, Newborn ; Pregnancy ; Skull ; Stillbirth*

The postoperative levels of carcinoembryonic antigen (CEA) and the actual half life (T1/2) of CEA were evaluated to ascertain their potency in predicting the recurrence of colorectal cancer after curative surgery in patients who had an abnormally high level of preoperative carcinoembryonic antigen (CEA, > or = 5 ng/ml). Ninety-four patients who underwent curative surgery were enrolled and 24 patients (25.5%) had recurrence during the follow-up period (median: 30 months, range: 2-69 months). T1/2 of CEA for all patients ranged from 1.2 days to 88.1 days, with a median of 4.4 days. T1/2 of CEA (mean +/- standard deviation) was 11.7 +/- 17.9 days in recurrent patients, whereas it was 6.2 +/- 4.9 days in patients without recurrence (p = 0.0224). The patients' age, gender, size of the tumor, location of the tumor, pre-, and postoperative CEA level, pathologic type of the tumor and Dukes stage had no significance in recurrence. The 1-year, 2-year, and 5-year disease-free survival rates were 95.1%, 81.1%, and 73.8% in patients with postoperative CEA levels less than 5 ng/ml (n = 62), respectively, and 71.4%, 64.8%, and 64.8% in patients with postoperative CEA levels higher than or equal to 5 ng/ml (n = 32), respectively (p = 0.04). Patients were divided into Group S (T1/2 of CEA < 4.4 days, n = 43) and Group L (T1/2 of CEA > or = 4.4 days, n = 51). The 1-year, 2-year, and 5-year disease-free survival rates were 95.3%, 85.1%, and 77.7% in Group S, respectively, and 80%, 67.5%, and 64.1% in Group L, respectively (p = 0.0261). In conclusion, the disease-free survival of colorectal cancer patients was prolonged in patients who had a short T1/2 of CEA or a low level of postoperative CEA. In high-risk colorectal cancer patients with an abnormally high level of preoperative CEA, recurrence may be predicted by checking an early postoperative CEA level and/or by a simple calculation of the actual half life of CEA.
Adolescence ; Adult ; Aged ; Aged, 80 and over ; Carcinoembryonic Antigen/blood* ; Colorectal Neoplasms/surgery* ; Colorectal Neoplasms/blood* ; Female ; Half-Life ; Human ; Male ; Middle Age ; Neoplasm Recurrence, Local ; Postoperative Period ; Predictive Value of Tests ; Retrospective Studies