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*

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*

Allopurinol is widely used for chronic tophaceous gout as a uric acid lowering agent. Hypersensitivity to allopurinol occurrs in about 10% of patients, which limits the usage of allopurinol. The successful oral and intravenous desensitization of allopurinol has been reported worldwide since 1976. We recently experienced a 51-year-old male patient with gouty arthritis and hyperuricemia, who had previously experienced skin rash after allopurinol treatment. When allopurinol was retried, erythematous and foliative skin rash developed on entire body. Because allopurinol was essential in controlling hyperuricemia, the oral desensitization of allopurinol was tried. We report successful rapid oral allopurinol desensitization in the patient with chronic tophaceous gout, who exhibited exfoliative dermatitis as allopurinol hypersensitivity.
Allopurinol* ; Arthritis, Gouty ; Dermatitis, Exfoliative* ; Exanthema ; Gout ; Humans ; Hypersensitivity ; Hyperuricemia ; Male ; Middle Aged ; Uric Acid

BACKGROUNDS: Helicobacter pylori infection is now recognized as a cause of chronic gastritis, peptic ulcer disease, gastric carcinoma and lymphoma. Several diagnostic methods of H. pylori infection, such as histopathology, culture, rapid urease test, urea breath test, serologic test and polymerase chain reaction(PCR) have been used. This study aimed to compared with different diagnostic methods of H. pylori infection and determined the appropriate cut-off value of IgG anti-H. pylori antibody using receiver operating characteristic(ROC) curve. METHODS: We compared sensitivities, specificities and efficiencies of histology, CLO test, culture, IgG anti-H. pylori Ab and PCR using the ureC gene in gastric biopsy specimens from 112 H. pylori patients and 140 control group. RESULTS: The sensitivities of histology, CLO test, culture, IgG anti-H. pylori Ab and PCR were 72%, 91%, 86%, 82% and 94%, respectively and the specificities of histology, CLO test, culture, IgG anti-H. pylori Ab and PCR were 96%, 99%, 100%, 73% and 99%, respectively. The efficiencies of histology, CLO test, culture, IgG anti-H. pylori Ab and PCR were 88%, 96%, 89%, 77% and 97%, respectively. From the ROC curve, the cut-off value of the anti-H. pylori Ab determined 10U/mL in which sensitivity was 82% and specificity was 82%. CONCLUSIONS: These findings suggest that the PCR assay in gastric biopsy is the most sensitive and efficient diagnostic method of H. pylori infection and the cut-off value of the anti-H. pylori Ab determines 10U/mL showing highest efficiency.
Biopsy ; Breath Tests ; Diagnosis* ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoglobulin G ; Lymphoma ; Peptic Ulcer ; Polymerase Chain Reaction* ; ROC Curve ; Sensitivity and Specificity ; Serologic Tests* ; Stomach Diseases ; Urea ; Urease

BACKGROUND: Many studies suggest that point mutations of ras oncogene develop tumors. The advantages of body fluid analysis are easy accessibility and more simple procedure than tissue specimen. So, we investigated the incidence of K-ras codon 12 mutation in body fluids of patients with malignant solid tumors and tried to define the significance of K-ras codon 12 mutation in body fluids. METHODS: We analyzed 58 specimens of body fluids in patients diagnosed as solid tumor. The first PCR products were digested with BstN1 and then followed the second PCR and BstN1 digestion. Nucleotide sequencing was performed by Sanger's method. RESULTS: The incidences of K-ras codon 12 mutation are 75% in biliary cancer, 50% in pancreatic cancer, 31% in lung cancer, 14% in liver cancer, and 8% in stomach cancer. Mutations of K-ras codon 12 were detected in 24% (9/37) of body fluids with malignant cells and 19% (4/21) of body fluids without malignant cells. The proportions of malignant cells were not different between the patients with and without K-ras codon 12 mutation in effusions with malignant cells. Nucleotide sequencing on one sample of a patient with pancreatic carcinoma revealed single base substitution in codon 12 of K-ras gene from GGT to GAT. CONCLUSIONS: The incidences of ras mutation in body fluids are variable with tumor type. Since K-ras codon 12 point mutation was highly specific, not in those of patients without tumors, examination of K-ras codon 12 point mutation may be an additive diagnostic tool for early detection of metastasis to body fluids.
Body Fluids ; Codon* ; Digestion ; Genes, ras ; Humans ; Incidence ; Liver Neoplasms ; Lung Neoplasms ; Neoplasm Metastasis ; Pancreatic Neoplasms ; Point Mutation ; Polymerase Chain Reaction ; Stomach Neoplasms

No abstract available.
Photochemotherapy* ; Porokeratosis*

Comamonas testosteroni and Acinetobacter guillouiae are gram-negative bacilli of low virulence that are widely distributed in nature and normal flora. Despite their common occurrence in environments, they rarely cause infectious disease. We experienced a case of septic shock by C. testosterone and A. guillouiae, and isolated them by 16S ribosomal RNA sequencing method from the blood cultures of a previous healthy female during postoperative supportive care. This is the first case of septic shock required ventilator care and continuous renal replacement therapy due to these organisms in Korea.
Acinetobacter* ; Bacteremia ; Comamonas testosteroni* ; Comamonas* ; Communicable Diseases ; Female ; Humans ; Korea ; Renal Replacement Therapy ; RNA, Ribosomal, 16S ; Shock, Septic* ; Testosterone ; Ventilators, Mechanical ; Virulence

No abstract available.
Adult* ; Colloids* ; Humans ; Scalp*

No abstract available.
Poroma* ; Warts*

No abstract available.
Ear* ; Pilomatrixoma*