BACKGROUND: The differential diagnosis of clonal and reactive thrombocytosis is clinically relevant because course and treatment are different between them. Several clinical assessments and laboratory tests (degree of such as splenomegaly, duration and degree of thrombocytosis, bone marrow study, cytogenetic study, and platelet function test) are less discriminative, invasive and not commonly available. Therefore, a well discriminative, simple and convenient diagnositic assay is needed. Recently animal experiments demonstrated that recombinant IL-6 administration increased platelets counts by stimulating megakaryocyte maturation and increased hepatic CRP synthesis. So, in this study, we evaluated the usefulness of measurements of IL-6 and CRP levels to distinguish reactive thrombocytosis from clonal thrombocytosis. METHODS: Included in this study were 88 patients with marked thromobocytosis (>600 x10(9)/L) at Asan Medical Center between September, 1995 and March, 1996. The cause of thrombocytosis was determined by reviewing the medical histories. Sixteen patients had clonal thrombocytosis and 72 patients had reactive thrombocytosis. IL-6 was measured by ELISA (Quantikine(TM), R&D system, Inc., Minneapolis, USA) and CRP was assayed by rate immunonephelometry (Array 360 system, Beckman Instruments Inc., USA). RESULTS: The patients with reactive thrombocytosis had significantly higher plasma levels of IL-6 and CRP than patients with clonal thrombocytosis (p<0.01, p<0.001). In 98.6% (71/72) of the patients with reactive thromobocytosis, levels of either IL-6 or CRP were elevated, and 43.8% (7/16) of the patients with clonal thrombocytosis had both IL-6 and CRP in normal range. Of 9 patients with clonal thrombocytosis (56.2%) whose levels of either IL-6 or CRP increased, 7 patients had concomitant acute phase reaction such as infection or post operative status. There was significant correlation between IL-6 and CRP levels (r2=0.4, p<0.0001). CONCLUSION: Elevated levels of either IL-6 or CRP were consistent with reactive thrombocytosis and normal ranges of those suggested clonal thrombocytosis. So measurement of plasma IL-6 and CRP levels is a useful marker for differential diagnosis of clonal and reactive thrombocytosis. For the patients with clonal thrombocytosis who had concomitant acute phase reaction, serial measurements are recommended.
Acute-Phase Reaction ; Animal Experimentation ; Blood Platelets ; Bone Marrow ; C-Reactive Protein* ; Chungcheongnam-do ; Cytogenetics ; Diagnosis, Differential* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-6* ; Megakaryocytes ; Plasma* ; Reference Values ; Splenomegaly ; Thrombocytosis*

No abstract available.
Facial Asymmetry* ; Prognathism*

No abstract available.
Mood Disorders* ; Temporal Lobe*

No abstract available.
Mood Disorders* ; Temporal Lobe*

BACKGROUND: The diagnosis of tuberculosis has been based on the detection of tubercle bacilli by acid-fast stain of smear or cultures, and recently the serologic diagnosis of tuberculosis has been provided a means of sensitive and specific detection of Mycobacterium tuberculosis. We evaluated the utility of enzyme immunoassay using determiner Tuberculosis Glicolipids(TBGL) antibody kit(Kyowa Medex Co. Ltd, Japan) to detect anti-TBGL antibody for diagnosis of pulmonary tuberculosis. METHODS: Anti-TBGL antibody assay was performed to the form 44 patients with active pulmonary tuberculosis(17 patients with smear positive, 7 patients with only culture positive, 20 patients with clinically active tuberculosis) and 80 controls (30 healthy controls, 24 patients with non-tuberculous respiratory diseases, 26 patients with inactive tuberculosis). We compared the sensitivity and specificity of anti-TBGL antibody with culture and AFB stain. RESULTS: Anti-TBGL antibodies were detected in 16 of 17(94%) smear positive patients, 4 of 7 patients with only culture positive and 16 of 20(80%) smear negative patients who had been clinically diagnosed as active pulmonary tuberculosis. Nine(35%) out of 26 patients with inactive tuberculosis, one(4%) out of 24 patients with non-tuberculous respiratory diseases and no one of healthy control had a positive antibody response. Overall sensitivity, specificity of the anti-TBGL antibody assay were 82%, 88%, respectively and sensitivities and specificities of culture and AFB smear 64%, 97%, and 49%, 100%, respectively. Anti-TBGL antibody titers in patients with active tuberculosis were significantly higher than control grup(P<0.05). Conclusions : The anti-TBGL antibody assay was sensitive, rapid and convenient. This assay will be useful as a tool for the diagnosis of tuberculosis in combination with other conventional methods.
Antibodies ; Antibody Formation ; Diagnosis* ; Humans ; Immunoenzyme Techniques* ; Mycobacterium tuberculosis ; Sensitivity and Specificity ; Tuberculosis ; Tuberculosis, Pulmonary*

A giant abdominal aortic aneurysm (AAA) renders surgical treatment much more difficult by deforming the proximal infrarenal aortic neck (shortened length and disturbed angulation), by altering the iliac arteries (marked tortuosity and aneurysmal dilatation), and by displacing abdominal organs. Because the retroperitoneal rupture of giant AAA makes the mesentery more elongated and deformed, compromising its blood flow and thus increasing the risk of mesenteric ischemia such as colon ischemia. We describe here the surgical repair of a large infrarenal AAA with a ruptured huge left common iliac artery aneurysm of 13.5 cm in diameter, accompanied by colostomy due to colon ischemia which occurred during the operation. We discuss the pathophysiology and preventive strategy of colon ischemia during ruptured giant AAA repair.
Aneurysm* ; Aneurysm, Ruptured ; Aortic Aneurysm, Abdominal ; Colitis, Ischemic ; Colon* ; Colostomy ; Iliac Artery ; Ischemia* ; Mesentery ; Neck ; Rupture

Authors analysed 19 cases with Cavernous Hemangiomas of Skeletal Muscles in Extremities. Those were confirmed clinicopathologically for the period of 2 years from October 1976 to September 1978, and following results were obtained. 1. The age of initial visit varied from 6 months to 42 years of age with the average of 17.7 years. Seventeen patients(89.5%) were under 30 years of age. 2. The age of initial onset of symptoms varied from birth to 36 years of age with the average of 13.1 years. Seventeen patients(89.5%) were under 20 years of age. 3. The duration of disease varied from 6 months to 17 years with the average of 4.6 years. 4. The ratio of male and female was 9:10. 5. Chief complaints were a swelling or mass in 17 cases(89.5%), pain in 13 cases(68.4%), tenderness in 6 cases(31.6%), and impairment of function in 5 cases(26.3%). 6 The size of a mass varied from a nut size to an adult fist one, and its shape appeared oval with the average 8.1 by 4.6 cm in 12 cases, and round with the average 5.5 cm in 7 cases. 7. The site of involvement distributed to lower extremities in 10 cases(52.7%), upper ones in 9 cases(47.4%). Among extremities(thigh, leg, arm and forearm) the most common site was forearm. 8. Considering the number of involed muscles, most frequently they developed in a single muscle with 11 cases(57.9%). 9. By history, The symptoms were initiated or aggravated by trauma in 3 cases(15.8%). 10. Plain roentgenograms showed the swelling of soft tissue in 9 cases(47.4%) and phleboliths in 8 cases(42.1%). 11. Considering the methods of treatment, complete resection was possible in 17 cases(85.7%), in the remaining 2 cases only incomplete resection could be done.
Adult ; Arm ; Clinical Study ; Extremities ; Female ; Forearm ; Hemangioma, Cavernous ; Humans ; Leg ; Lower Extremity ; Male ; Muscle, Skeletal ; Muscles ; Nuts ; Parturition

No abstract available.
Spine* ; Zygapophyseal Joint*

Apodemus agrarius has been using for experimental purpose to identifying the route of infection and pathogenesis of korean hemorrhagic fever. However, despite the increasing amount of information being published at present about the physiologic and ecologic characteristics of Apodemus, few data are availalle about the morphologic findings in the brain. The NADPH-diaphorase[NADPH-d] positive neurons, uniquely resistant to toxic insults and neurodegenerative diseases, have been colocalized with neurons in the brain and peripheral tissue containing nitric oxide synthase, which generates nitric oxide, a recently identified neuronal messenger molecule. In this study we used NADPH-d histochemistry to evaluate the distribution of neuropeptide Y-immunoreactive[NPY-IR] cells within neurons which contain nitric oxide synthase. In the cerebral cortex of Apodemus agrarius, NADPH-d positive and NPY-IR neurons were observed in all cortical layers, but they were concentrated in two bands layer II/III and V/VI extending into the subcortical white matter. Double labeling for NADPH-d and NPY showed colocalization of NPY with NADPH-d in numerous neurons of the cerebral cortex. The data obtained showed that about 74-79% of NPY-IR neurons contained NADPH-d in the neocortex and that 77-89% in the allocortex. The number of NPY-IR/NADPH-d positive neurons was about 10-13 per unit area [2,500,000 micrometer] in the neocortex and about 11-25 in the allocortex except retrosplenial cortex. In the retrosplenial cortex, the number of double labeled neurons was about 5 per unit area. NPY-IR and NADPH-d positive neurons were predominantly medium-sized with extended, multipolar or bipolar dendritic branches which belong to fusiform or stellate cell types. A moderately dense network of fine, varicose NADPH-d positive fibers was present throughout all cortical layers.
Animals ; Brain ; Cerebral Cortex* ; Hemorrhagic Fever with Renal Syndrome ; Murinae* ; Neocortex ; Neurodegenerative Diseases ; Neurons* ; Neuropeptide Y* ; Neuropeptides* ; Nitric Oxide ; Nitric Oxide Synthase

PURPOSE: Results of 181 percutaneous needle aspiration biopsies performed with an 18-gauge needle during a period of 3 years were analyzed to determine efficacy and safety of the procedure. MATERIALS AND METHODS: Biposies were performed in patients that could not be diagnosed by bronchoscopy or sputum cytology. The biopsy procedure with 18-gauge Crown needle was guided by fiuoroscopy. The biopsy specimen placed in 10% formalin solution were histologically confirmed. RESULTS: In 160 patients(89%), the positive diagnosis was made by percutaneous needle aspiration biopsy. There were 153 lung lesions(120 malignant and 33 benign lesions) and 7 mediastinal lesions. the diagnostic accuracy of malignant and benign disease was 91% and 80% respectively. Complications included pneumothorax(n=11) and hemothorax(n=l):six of them required treatment with chest tube and the remainder showed spontaneous resporption. CONCLUSION: PCNB with an 18-gauge needle provided a reliable, relatively safe diagnostic tool to establish the diagnosis of both malignant and benign chest lesions.
Biopsy ; Biopsy, Needle* ; Bronchoscopy ; Chest Tubes ; Crowns ; Diagnosis ; Formaldehyde ; Humans ; Lung ; Needles* ; Sputum ; Thorax*