Systemic lupus erythematosus(SLE) is a multisystem disorder with a peak age of onset in the second and fourth decades of life predominantly occuring in females who will usually have the potential to become pregnant. This female to male predominance is greatest during childbearing years approaching a ratio of 13:1, after the menopause it declines to a ratio of 3:1, the ratio also seen in prepubertal years. In practice, despite the higher prevalence of rheumatiod arthritis, pregnancy in SLE is the most common management problem confronting physician and obstetrician amongst the connective tissue disorders and it is particularly important as the outcome of pregnancy is more unpredictable in this disease. As well as having clinical consequences for the health of both mother and fetus, pregnancy in lupus provides a model for studying the importance of other biological phenomena characterizing the disease. For example, the transplacental passage of maternal antibodies to Ro(SSA) and La(SSB) and their strong association with the neonatal lupus syndrome suggests a pathogenetic role for these autoantibodies. Other relevant issues are feto-meternal immunological tolerance and hormonal interaction with the immune system. We have experienced a case of recurrent pregnancy loss associated with systemic lupus erythematosus. So we report this case with a brief review of literatures.
Age of Onset ; Antibodies ; Arthritis ; Autoantibodies ; Biological Phenomena ; Connective Tissue ; Female ; Fetus ; Humans ; Immune System ; Lupus Erythematosus, Systemic* ; Male ; Menopause ; Mothers ; Pregnancy* ; Prevalence

Toxoplasma gondii, an intracellular coccidian protozoan, is the causative agent of toxoplasmosis, a widespread infection affecting various birds and mammals including humans. In immunocompetent hosts, the infection is usually asymptomatic and benign. Toxoplasmosis is either congenital or acquired. In general prenatal therapy of congenital toxoplasmosis is beneficial in reducing the ncy of infant infection. Therapies are based primarily on spiramycin because of the relative lack of toxicity and high concentration achieved in the placenta. Clindamycin is the standard drug for chemoprophylaxis in newborn infants, and is directed at preventing the occurrence of retinochoroiditis as a late sequel to congenital infection. The standard treatment for acquired toxoplasmosis in both immunocompetent and immunodeficient patients is the synergistic combination of pyrimethamine and sulphonamides. Toxoplasmic encephalitis is tbe most common manifestation of acquired toxoplasmosis in immunocompromised patients and if not treated is fatal. However, because of toxicity, the therapeutic efficacy of pyrimethamine sulphonamide combinations may be seriously limited in immunodeficient patients. We have experienced a case of toxoplasmosis during the workup of habitual aborter. So we report this case with a brief review of literatures.
Birds ; Chemoprevention ; Clindamycin ; Encephalitis ; Humans ; Immunocompromised Host ; Infant ; Infant, Newborn ; Mammals ; Placenta ; Pyrimethamine ; Spiramycin ; Toxoplasma ; Toxoplasmosis* ; Toxoplasmosis, Congenital

OBJECTIVE: The implantation failure after embryo-transfer (ET) is a major continuing problem in in vitro fertilization (IVF). This study was undertaken to determine the effectiveness of intravenous immunoglobulin for treatment of individuals experiencing repeated unexplained in vitro fertilization-embryo transfer (IVF-ET) failure. METHODS: A total of nine consecutive infertile patients who failed to become pregnant after previous IVF-ET replacing at least three or more normal developed embryos each were included in our study. During the subsequent new IVF-ET cycle, each women received intravenous immunoglobulin 500mg/kg before the embryo transfer. RESULTS: Only one implantation occurred. There were no remarkable side effects. A specific effect of intravenous immunoglobulin for patients with repeated IVF-ET failure could not be demonstrated. CONCLUSION: High-dose intravenous immunoglobulin may not be useful for patients with repeated failure of embryo transfer.
Embryo Transfer ; Embryonic Structures ; Female ; Fertilization in Vitro ; Humans ; Immunoglobulins*

Purpose: To retrospectively compare the fixation methods for reattaching a trochanteric fragment in a pertrochanteric fracture treated with bipolar hemiarthroplasty. Materials and methods: Forty cases of an unstable femur pertrochanteric fracture were analyzed and followed up for average of 19(6~40) months. There were 18 cases fixed with tension band wiring (group 1), 7 cases treated using modified tension band wiring with K-wires (group 2) and 15 cases treated with the GTRD (Greater Trochanteric Reattachment Device) (group 3). Result: Group 1 was treated with simple a surgical procedure and the results were good. The second group had firm fixation postoperatively but required additional surgery in two cases to remove the K-wires because of wire migration after ambulation. Group 3 had relatively good results but required more dissection and a longer operating time. Conclusion: Tension band wiring or GTRD are good fixation methods for reattaching trochanteric fragments in pertrochanteric fractures. Moreover, tension band wiring is recommended for old osteoporotic patients due to a simple procedure and firm fixation. The use of modified tension band wiring using K-wire or a Steinmann-pin should not be used due to the possibility of distant migration.
Femur* ; Hemiarthroplasty* ; Humans ; Retrospective Studies ; Walking

Objective: This study evaluated the deep learning (DL) algorithm performance to detect lesions that suggest pneumonia in chest X-rays (CXR) of suspected coronavirus disease 2019 (COVID-19) patients. Methods: This retrospective study included consecutive patients who visited a screening clinic in Daegu, and were suspected to be afflicted with the COVID-19 during the COVID-19 epidemic. CXR were analyzed using the commercial artificial intelligence product that provides free online DL algorithms to the public for COVID-19. Computerized tomography was used as the standard reference. Performance of the DL algorithm was evaluated by the sensitivity and specificity, and results were compared to the CXR records of emergency physicians (EP) in charge of the actual screening triage clinic during the COVID-19 epidemic. Results: Totally, 114 patients were evaluated, of which 38 patients were positive for COVID-19. In 85 CXRs examined (36 COVID-19 and 49 non-COVID-19) with findings of pneumonia in computerized tomography, the DL algorithm showed significantly higher sensitivity as compared to the EP (DL, 98.8% [93.6%-99.9%] vs. EP, 85.9% [76.6%-92.5%]; P<0.01). Moreover, the DL algorithm showed significantly higher sensitivity for detecting CXRs with COVID-19 pneumonia, as compared to the EP (DL, 100.0% [90.3%-100%] vs. EP, 91.7% [77.5%-98.3%]; P=0.08). Conclusion We conclude that for examining the CXR of patients with suspected COVID-19, sensitivity of the DL algorithm is superior than the EP for detecting lesions suggesting pneumonia. Thus, the application of the DL algorithm is potentially useful in screening triage clinics to detect COVID-19 pneumonia.

Objective: This study evaluated the deep learning (DL) algorithm performance to detect lesions that suggest pneumonia in chest X-rays (CXR) of suspected coronavirus disease 2019 (COVID-19) patients. Methods: This retrospective study included consecutive patients who visited a screening clinic in Daegu, and were suspected to be afflicted with the COVID-19 during the COVID-19 epidemic. CXR were analyzed using the commercial artificial intelligence product that provides free online DL algorithms to the public for COVID-19. Computerized tomography was used as the standard reference. Performance of the DL algorithm was evaluated by the sensitivity and specificity, and results were compared to the CXR records of emergency physicians (EP) in charge of the actual screening triage clinic during the COVID-19 epidemic. Results: Totally, 114 patients were evaluated, of which 38 patients were positive for COVID-19. In 85 CXRs examined (36 COVID-19 and 49 non-COVID-19) with findings of pneumonia in computerized tomography, the DL algorithm showed significantly higher sensitivity as compared to the EP (DL, 98.8% [93.6%-99.9%] vs. EP, 85.9% [76.6%-92.5%]; P<0.01). Moreover, the DL algorithm showed significantly higher sensitivity for detecting CXRs with COVID-19 pneumonia, as compared to the EP (DL, 100.0% [90.3%-100%] vs. EP, 91.7% [77.5%-98.3%]; P=0.08). Conclusion We conclude that for examining the CXR of patients with suspected COVID-19, sensitivity of the DL algorithm is superior than the EP for detecting lesions suggesting pneumonia. Thus, the application of the DL algorithm is potentially useful in screening triage clinics to detect COVID-19 pneumonia.

Duchene and Becker muscular dystrophy(DMD/BMD) results from mutations in thedystrophin gene, and enormous genetic locus that spans more than two million base paris ofDNA on the human X chromosome. Some 60% of DMD patients exhibit deletions, which canbe found by cDNA hybridization or, were recently, by polymerase chain reaction analysis.We have used the multiplex PCR to identify deletion mutations in the human dystrophingene. By simultaneously amplifying genomic regions flanking 17 sepastrate exons inmutational hot spots, we were able to detect 16 exons in one family. The DNA encoding eachof the 17 exons in the dystrophin gene is copied a million fold to make it visible in anagarose gel. To be certain that the missing band is not artifact of the amplificationprocedure, the DNA from the blood sample was analyzed by Southern hybridization.
Artifacts ; Blotting, Southern* ; Chromosomes, Human, X ; Diagnosis* ; DNA ; DNA, Complementary ; Dystrophin ; Exons ; Genetic Loci ; Humans ; Multiplex Polymerase Chain Reaction* ; Muscular Dystrophy, Duchenne ; Polymerase Chain Reaction ; Sequence Deletion

OBJECTIVE: Human infertility clinics have been faced the demand for improving clinical results. The purpose of this study was to evaluate the effect of microsurgical removal of damaged blastomeres (DB) in frozen-thawed embryos on the clinical outcomes. METHODS: From January 2003 to May 2004, out of 258 thawing ET cycles were divided into three groups: Group-1 (n=46): Intact cleavaged embryos after thawing. Remained cycles with embryos containing DB were randomly divided into two groups. Group-2 (n=102): Drilling zona pellucida (ZP) of frozen-thawed embryos by acidified Tyrode's solution. Group-3 (n=110): Drilling ZP and removal of DB. Embryos after microsurgical manipulation were transferred into the uterus of patients. RESULTS: Clinical profiles and the mean number of transferred embryos among three groups were not different. Pregnancy and implantation rates were similar in three groups. It were 30.4% and 9.3% in Group-1, 29.4% and 7.8% in Group-2, and 26.4% and 7.6% in group-3, respectively. Miscarriage rate in Group-3 (37.9%) was slightly higher than those in Group-1 and Group-2 (14.3% and 23.3%), but it was not statistically significant. CONCLUSION: Intact cleaving embryos after DB removal showed higher potent of pregnancy and implantation. We could not find any improvement of clinical outcome by removal of DB in frozen-thawed embryos.
Abortion, Spontaneous ; Blastomeres* ; Embryo Transfer* ; Embryonic Structures* ; Female ; Humans ; Infertility ; Pregnancy ; Pregnancy Rate ; Uterus ; Zona Pellucida

The aim of this study was to develop a rapid and safe non-radioactive DIG DNA labeling and detection for Southern blot analysis for fragile X syndrome and Duchenne muscular dystrophy (DMD). Southern blot analysis is accurate test showing expression of the (CGG)n repeat and abnormal methylation pattern of CpG island in hagile X syndrome, and good confirmative secondary test in case of deletion in DMD. But in terms of test rapidity, these conventional radioactive Southern analysis may not be feasible for rapid screening of prenatal samples and at-risk populations to determine their status and to provide genetic counseling to their families. As an alternative radioactive Southern blotting, DIG DNA labeling and detection system does not require handling of radioactive material nor require learning any new technology. The complete procedure of labeling the DNA and hybridization to detection of the first visible signal can be compbsbed witbin 7 days. In addition, hybridization solutions containing labeled DNA can be reused several times after renewed denaturation.
Blotting, Southern ; CpG Islands ; Diagnosis* ; DNA ; Fragile X Syndrome* ; Genetic Counseling ; Humans ; Learning ; Mass Screening ; Methylation ; Muscular Dystrophy, Duchenne

Giant lymph node hyperplasia (Castleman's disease) is a nonneoplastic lymphoproliferative disorder of unknown etiology that usually occurs in the chest. Its morphological recognition is based on a composition of various histological features. The mass is often asymptomatic, but it can cause nonspecific thoracic symptoms, such as regional pain. This disease can be found wherever lymph nodes are present, but two-thirds of these tumors are found in the chest, along the tracheobronchial tree in the mediastinum or lung hilus. However, we experienced an unusual case of Castleman's disease as a cause of back pain that was localized in the posterior mediastinum bordering the chest wall.
Back Pain ; Giant Lymph Node Hyperplasia ; Lung ; Lymph Nodes ; Lymphoproliferative Disorders ; Mediastinum ; Thoracic Wall ; Thorax