BACKGROUND: Antibody screening and identification tests are indispensable test to protect hemolytic transfusion reaction. Due to increase of transfusion and development of new techniques for detection of antibodies, the incidence of unexpected antibodies may tend to increase compared with the past. METHODS: We evaluated the frequency and distribution of unexpected antibodies by two methods from 53,167 sera. The tube(saline, albumin, and antiglobulin phase) methods were subjected to the sera from Jan 1998 to April 2000, and gel agglutination methods with DiaMed-ID system (DiaMed, Murten, Switzerland) were subjected to the sera from May 2000 to Feb 2004. RESULTS: Out of all 53,167 serum samples, positive results were obtained from 177 sera(0.33%). Antibody that was detected most frequently was anti-E(46 sera, 25.9%), followed by anti-Le a (43 sera, 22.6%), anti-Le b and anti-c. In the tube method, 55 cases(83.3%) were detected at antiglobulin phase. Among the patients with unexpected antibodies, 85 cases(54.5%) had the history of previous transfusion. CONCLUSION: Unexpected antibodies that were detected in this study were mostly significant antibodies in clinical. There was no difference of the frequency according to the method. Unexpected antibodies were associated with multiple transfusion. Therefore antibody screening and identification tests are critical step in pre-transfusion tests.
Agglutination ; Antibodies* ; Blood Group Incompatibility ; Humans ; Incidence ; Mass Screening

No abstract available.
Empyema, Tuberculous* ; Lymphoma, Non-Hodgkin* ; T-Lymphocytes*

PURPOSE: To clarify the difference between the bolus-tracking technique and a fixed scan delay protocol in the achievement of the optimal pancreatic phase of the pancreas with MDCT. MATERIALS AND METHODS: 526 patients underwent pancreatic and portal venous phase imaging of the pancreas using 16-channel MDCT. All the examinations were randomized into either scanning using a bolus-tracking technique with a scan delay of 20s after the aorta was enhanced > 100 HU (groups 1 and 2) or scanning with a scan delay of 38 s from the beginning of the injection (groups 3 and 4). A contrast material of 300 mgI/mL (groups 1 and 3) or 370 mgI/mL (groups 2 and 4) at an injection speed of 3 mL/sec was injected at 2 mL/kg body weight. The pancreatic CT attenuation values were compared. RESULTS: The scan delay times of the pancreatic phase in groups 1 and 2 were 38+/-3.8s and 37.4+/-3.4s, respectively. At the pancreatic phase, the pancreatic attenuation values of groups 1 and 2 were slightly higher than those of groups 3 and 4 (115.5+/-15.4 vs 111.7+/-15.1HU; p=0.093, 128.3+/-17.1 vs 119+/-17.1HU; p=0.003). There was no significant difference between groups at the portal venous phase. CONCLUSION: The use of a bolus-tracking technique in the optimal pancreatic phase of pancreatic CT does not significantly improve the pancreatic enhancement but does at higher iodine concentrations.
Aorta ; Body Weight ; Humans ; Iodine ; Pancreas*

It is uncommon for Fabry's disease (FD) patient to present with an isolated ischemic stroke without other typical symptoms or signs of FD. A 48-year-old woman presented with recurrent limb weakness and her brain magnetic resonance imaging revealed multiple ischemic brain lesions. Ten years ago, the patient had been diagnosed with heterozygote FD by the genetic test, but she had not shown any typical symptoms or sign of FD so far. Isolated organ involvement could occur in heterozygote FD.
Brain ; Brain Ischemia ; Extremities ; Fabry Disease ; Female ; Heterozygote ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Stroke

BACKGROUND AND OBJECTIVES: The prognostic value of biochemical markers and the resolution of ST-segment elevation on electrocardiogram are well established. However, how a combination of these two tools affects the evaluation of risk stratification has not yet been evaluated. SUBJECTS AND METHODS: Between January 2006 and June 2008, 178 consecutive patients treated with primary percutaneous coronary interventions after ST-segment elevation myocardial infarctions (STEMI) were analyzed at two coronary care units. Patients were divided into the following three groups according to ST-segment resolution: complete (> or =70% depression of the elevated ST-segment, n=63), partial (30% to 70%, n=90), and incomplete (<30%, n=25). Demographic data, including history, electrocardiography, biochemical markers, initial ejection fraction, and angiographic findings were also evaluated. RESULTS: There were 7 deaths, 3 repeated myocardial infarctions, and 17 readmissions for worsening heart failure during six months of follow-up. In a multivariate analysis to predict clinical outcomes, ejection fraction {hazard ratio (HR): 0.83 (0.76-0.91), p<0.01}, high-sensitivity C-reactive protein {HR: 1.15 (1.05-1.26), p<0.05}, and the degree of ST-segment resolution {HR: 0.96 (0.93-0.09), p<0.05} were independently associated with clinical outcomes. According to the Cox-proportional hazards model, the addition of ST-segment resolution markedly improved the prognostic utility of the model containing biochemical markers and ejection fraction. CONCLUSION: Assessment of biomarkers upon admission and ST-segment resolution are strong predictors of clinical outcomes. The combination of these data provides additive information about prognosis at an early point in the disease progression and further improves risk stratification for STEMI.
Biomarkers ; C-Reactive Protein ; Coronary Care Units ; Depression ; Disease Progression ; Electrocardiography ; Follow-Up Studies ; Heart Failure ; Humans ; Multivariate Analysis ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Prognosis ; Proportional Hazards Models

Mucinous cholangiocarcinoma, characterized by large quantities of mucin production, is a rare subtype of peripheral cholangiocarcinoma and usually shows rapid progression and a fatal outcome. We report here a case of mucinous cholangiocarcinoma in a 69 year-old man, who was infected with Clonorchis sinensis. Histologically, the tumor was an adenocarcinoma with extensive intracellular and extracellular mucin production, up to 70% of the tumor mass and there was frequent lymphovascular invasion of the tumor cells. The liver adjacent to the mass contained eggs of Clonorchis sinensis in the bile duct lumen and showed ductal epithelial hyperplasia, mucinous metaplasia and adenomatous proliferation of intramural glands. The patient was treated with a right hepatectomy. Four months after the surgery, the tumor recurred in the soft tissue of the right flank.
Aged ; Bile Duct Neoplasms/*complications/secretion ; *Bile Ducts, Intrahepatic ; Cholangiocarcinoma/*complications/secretion ; Clonorchiasis/*complications ; English Abstract ; Humans ; Male ; Mucins/secretion

PURPOSE: Preoperative identification of the sentinel lymph node (SLN) in gastric cancer (GC) patients may have great advantages for the minimally invasive treatment. This study was performed to evaluate the possibility of preoperative SLN detection using CT lymphography. MATERIALS AND METHODS: Fourteen patients with early GC were enrolled. CT images were obtained before and at 1, 3, and 5 minutes after endoscopic submucosal peritumoral injection of 2 mL iopamidol. For patients with clearly identified SLNs, to make comparisons with the CT lymphography results, intraoperative SLN detection was performed using subserosally injected Indocyanine green (ICG) lymphography and ex vivo ICG and iopamidol lymphography using mammography was also performed. RESULTS: CT lymphography clearly visualized draining lymphatics and SLNs in 4 (28.6%) out of 14 patients. All clearly visualized SLNs (one to three SLNs per patient) under preoperative imaging were detected in the same location by intraoperative ICG lymphography and ex vivo ICG and iopamidol lymphography using mammography. All preoperative SLN detections were observed with the primary tumors in the lower third of the stomach. CONCLUSION: Although our study demonstrated a SLN detection rate of less than 30%, CT lymphography with radio-contrast showed potential as a method of preoperative SLN detection for GC.
Adult ; Aged ; Female ; Humans ; Iopamidol/diagnostic use ; Lymph Nodes/pathology/*radiography ; Lymphography/*methods ; Male ; Middle Aged ; Models, Biological ; Preoperative Care ; Sentinel Lymph Node Biopsy ; Stomach Neoplasms/pathology/*radiography ; Tomography, X-Ray Computed/*methods

Tolvaptan, a non-peptide arginine vasopressin V2 receptor antagonist, is a newly developed drug to reduce kidney volume and preserve kidney function in autosomal dominant polycystic kidney disease (ADPKD) patients. We aimed to evaluate the descriptive characteristics of patients according to the use of tolvaptan. Also, we tried to find the efficacy of tolvaptan on kidney volume and kidney function. We included patients with ADPKD who visited a tertiary hospital in South Korea during Sep. 2018 and Apr. 2022. The data was acquired from the Electric Medical Records system. A total of 64 patients were included in the study, and there were 33 (51.6%) patients taking tolvaptan during follow-up periods. During 17.8 ± 13.1 months of follow-up periods, estimated glomerular filtration rate (eGFR) changes were 89.4% compared to the baseline eGFR. Although the latest eGFR was lower in patients with tolvaptan (55.9 ± 24.7 mL/min/1.73 m2) than without tolvaptan (68.4 ± 35.1 mL/min/1.73 m2), there was no statistical significance (p = 0.108). We found that the mean change of height-adjusted total kidney volume (HtTKV) was -2.7% based on the baseline HtTKV in patients taking tolvaptan for more than 1-year. Although there was no statistical significance, the mean change of HtTKV was the highest in patients with 1E of Mayo classification (-4.3%). To anticipate the solid data on the efficacy of tolvaptan in the Asian population, more aggressive efforts are needed to search for suitable patients accompanied by appropriate monitoring over a more extended period.

BACKGROUND: Recent studies suggest that the cardioprotective effect of ischemic preconditioning (IPC) is related to intracellular glycogen content in rat hearts, however, controversies still remain. METHODS: To test this hypothesis, isolated Langendorff-perfused rabbit hearts were subjected to 45 min global ischemia followed by 120 min reperfusion with IPC (n=0) or without IPC (ischemic control, n=). IPC was induced by one cycle of 5 min global ischemia and 10 min reperfusion. In the glucose (G)-free preconditioned group (n=0), G depletion-repletion was induced by perfusion with G-free Tyrode solution for 5 min and then G-containing Tyrode solution for 10 min followed by 45 min ischemia and 120 min reperfusion. For glycogen depletion or loading, hearts were treated with sodium acetate (NA, 5 mM, n=) or insulin (Ins, 1 unit/L, n=) for 15 min before 45 min ischemia. Left ventricular function and coronary flow (CF) were continuously recorded during experiments. Myocardial cytosolic and membrane protein kinase C (PKC) activities were measured by 32P-gamma-ATP incorporation into PKC-specific pepetide; glycogen content in the cardiac myocytes was determined by spectrophotometry with amyloglucosidase; expression of PKC isozymes was determined by Western blot with monoclonal antibodies. Infarct size was determined by staining with tetrazolium salt and planimetry. Data were analyzed by ANOVA and Tukey's post-hoc test. RESULTS: IPC or G-free preconditioning enhanced LV functional recovery; NA did not influence on functional recovery but Ins depressed it. Infarct size was significantly reduced by IPC, G-free preconditioning, and NA treatment (35.3+/-2.1% in the ischemic control, 18.7+/-1.2% in the IPC, 22.1+/-1.2% in the G-free preconditioned, 16.3+/-1.2% in the NA-treated group, and 32.8+/-1.6% in the Ins-treated group, p<0.05). Membrane PKC activities significantly increased by IPC, IPC and 45 min ischemia, G-free preconditioning, and G-free preconditioning and 45 min ischemia; especially, expression of membrane PKC-epsilon increased by IPC and G-free preconditioning. Glycogen content decreased by 45 min ischemia, IPC, G-free preconditioning, and by NA treatment, but increased by Ins treatment. CONCLUSION: These results suggest that in rabbit heart, intracellular glycogen may not significantly be related with the cardioprotective effect of IPC; G-free preconditioning could not improve post-ischemic contractile dysfunction but it has an infarct size-limiting effect; this cardioprotective effect may be related in part to activation of PKC, especially epsilon isozyme.
Animals ; Antibodies, Monoclonal ; Blotting, Western ; Cytosol ; Glucan 1,4-alpha-Glucosidase ; Glucose ; Glycogen* ; Heart ; Insulin ; Ischemia ; Ischemic Preconditioning* ; Isoenzymes ; Membrane Proteins ; Membranes ; Myocytes, Cardiac ; Perfusion ; Phosphotransferases ; Protein Kinase C* ; Protein Kinases* ; Rats ; Reperfusion ; Sodium Acetate ; Spectrophotometry ; Ventricular Function, Left

OBJECTIVE: The purpose of this study is to evaluate complications in 70 patients who had underwent endovascular treatment to occlude cerebral aneurysms. METHODS: From May 1999 to December 2002, we treated 70 patients by endovascular treatment or by combination of endovascular treatment and surgery. Complications have been developed in fifteen patients. Twelve patients had anterior circulation aneurysms: 4 posterior commmuncating artery ; 2 anterior communicating artery ; 2 paraclinoid artery ; 2 anterior choroidal artery ; 1 distal internal carotid artery ; 1 middle cerebral artery ; 1 pericallosal artery and three patients had posterior circulation aneurysms: 3 basilar artery tip. RESULTS: The complications related to the coil embolization were the thromboembolic event in 9 cases, rupture of the aneurysm in 3 cases, coil prolapse in 3 cases and coil migration in 1 case. CONCLUSION: The coil embolization can be a alternative good modality in the treatment of cerebral aneurysms. But careful attention should be required to reduce the various complications of procedures and to improve the prognosis of aneurysmal treatment. Effort to overcome the technical problem and to develop more comfortable device are needed for the better results of endovascular treatment.
Aneurysm ; Arteries ; Basilar Artery ; Carotid Artery, Internal ; Choroid ; Embolization, Therapeutic ; Humans ; Intracranial Aneurysm* ; Middle Cerebral Artery ; Prognosis ; Prolapse ; Rupture