The chronic fatigue immune dysfunction syndrome (abbreviated CFIDS or CFS) is a disorder characterized by debilitating fatigue(over 6 months), along with cognitive, musculoskeletal, and sleep abnormalities. The etiology of this illness is unlikely to be a single agent. Findings to date suggest that physiological and psychological factors work together to predispose and perpetuate the illness. Diagnosis is made difficult by the nonspecific clinical findings and no available diagnostic testing. With no known cause or cure for the chronic fatigue and immune dysfunction syndrome, treatment is based on relieving symptoms and improving the quality of life of affected patients. There is emerging evidence that chronic fatigue syndrome may be familial. In the future, studies will examine the extent to which genetic and environmental factors play a role in the development of chronic fatigue syndrome. Most patients with CFS have psychiatric problems such as a generalized anxiety disorder, or major or minor depression, therefore, these mental health disorders may be correlated with the pathophysiology of the CFS. The treatment for CFS must be individualized, due to the heterogeneity of the CFS population. Also the treatment of CFS is built on a foundation of patient-physician relationship, respect and advocacy.
Anxiety Disorders ; Depression ; Diagnosis ; Diagnostic Tests, Routine ; Fatigue ; Fatigue Syndrome, Chronic* ; Humans ; Mental Health ; Population Characteristics ; Psychology ; Quality of Life

Primary sclerosing cholangitis is a chronic disease of unknown cause, characterized by inflammation and fibrosis of the biliary tree with diffuse multifocal stricture formation. With increasing knowledge of primary sclerosing cholangitis, it is now recognized that in the setting of inflammatory bowel disease, cholangiocarcinoma is a complication of primary sclerosing cholangitis. We recently experienced a case of 41 year old female patient who had Crohns disease associated with primary sclerosing cholangitis and cholangioearcinoma. We report a case of primary sclerosing cholangitis with cholangiocarcinoma with literature review.
Adult ; Biliary Tract* ; Cholangiocarcinoma* ; Cholangitis, Sclerosing* ; Chronic Disease ; Constriction, Pathologic ; Crohn Disease ; Female ; Fibrosis ; Humans ; Inflammation ; Inflammatory Bowel Diseases ; Pancreas*

INTRODUCTION: Osteoporosis, the most common metabolic bone disorder, is a condition of reduced bone density and increased susceptibility to fractures. Osteoporosis is a major public health problem and a significant cause of morbidity in postmenopausal women. Therefore family physicians as primary care physicians are in a key position for preventing and treating this disorder. So we studied the factors affecting to bone mineral density in postmenopausal women. MATERIALS AND METHODS: A total of 136 spontaneous postmenopausal women were participated in the study. They have measured spinal bone mineral density by dual energy x-ray absorptiometry from January 1992 to June 1995 at Yeungnam University Hospital. Age, height, weight, age at menarche and menopause, number of child and breast feeding child, history of oral pill ingestion, family history of osteoporosis, amount of milk and coffee ingestion, consumption of tobacco and alcohol and physical activity were assessed by qustionnaire and medical records. RESULTS: physical activity and weight were significant contributors. Physical activity is most the largest contributor. CONCLUSIONS: Among factors affecting to BMD in postmenopausal women, physical activity and weight were more important factors. Therefore continuous physical activity is significant factor to prevent osteoporosis in postmenopausal women.
Absorptiometry, Photon ; Bone Density* ; Breast Feeding ; Child ; Coffee ; Eating ; Female ; Humans ; Medical Records ; Menarche ; Menopause ; Motor Activity ; Osteoporosis ; Physicians, Family ; Physicians, Primary Care ; Public Health ; Tobacco

Development of antibody-based cancer therapies will be greatly facilitated if antibodies are better standardized in two fundamental issues that are specificity analysis of antibody reactivity and the detailed biodistribution and pharmacokinetic profile of antibodies. In the current endeavor we attempted to use an antibody binding specificity to target the tumor in a syngeneic carcinoembryonic antigen (CEA) tumor model. CEA, a 180 kDa glycoprotein, expressed at high levels on the surface of nearly all tumors of the gastrointestinal tract was used a potential target for antibody immunotherapy of gastrointestinal carcinomas. Using the CEA model antibody-based cancer therapy directed against CEA has been evaluated in a syngeneic animal model of disseminated disease. We constructed mouse/human chimeric anti-CEA IgG3, which has been evaluated for the specificity for CEA and the detailed biodistribution and pharmacokinetic profiles. Anti-CEA IgG3 heavy chain was expressed with the expected 180kDa molecular weight, assembled as H2L2 forms with a co-expressed mouse/human chimeric anti-CEA light chain, and were secreted. On FACS the purified anti-CEA IgG3 specifically recognized the mouse colon adenocarcinoma cell line MC-38 transduced with CEA (MCA32a), but not MC 38 without expressing CEA. After subcutaneous injection in C57BL/6 mice the half- lives of anti-CEA IgG3 and an irrelevant anti-dansyl IgG3 showed the bi-phasic kinetic patterns, and their pharmacokinetics of the distribution and the elimination were similar in mice. However, the biodistribution patterns of anti-CEA IgG3 were very different from those of anti-dansyl IgG3. Anti-dansyl IgG3 was mainly distributed into kidney until 72 hours, but anti-CEA IgG3 was slowly rernoved from blood and distributed into liver, kidney, spleen, and tumor. It is note worthy that anti- CEA IgG3 increased in targeting MCA32a tumor expressing human CEA by time, but the targeting to MC38 tumor was negligible. Thus, the increased targeting of anti- CEA IgG3 made MCA32a tumor grow slowly
Adenocarcinoma ; Animals ; Antibodies ; Carcinoembryonic Antigen ; Cell Line ; Colon ; Gastrointestinal Tract ; Glycoproteins ; Humans ; Immunoglobulin G* ; Immunotherapy ; Injections, Subcutaneous ; Kidney ; Liver ; Mice ; Models, Animal ; Molecular Weight ; Pharmacokinetics ; Sensitivity and Specificity ; Spleen

To generate drug delivery vector to locales in the body, genetic engineering and expression techniques have been used to produce antibody avidin fusion proteins. Chicken avidin has been fused to mouse-human chimeric IgG3 immediately after the hinge with a flexible linker (H-Flex-Av) and at the end of CH2 (CH2-Av). Fusion heavy chains were expressed with the expected molecular weight, assembled as H2L2 forms with a co-expressed light chain, and were secreted. The expression level of H- Flex-Av was 1~10 ug/ml/10(8)/24 hrs, but that of C2-Av was a very little (0.08~0.9 ug/ ml/10(8)/24 hrs). The resulting H-Flex-Av and CH2-Av fusion proteins continued to bind antigen dansyl and also bound biotinylated bovine serum albumin; both H-Flex-Av and CH2-Av had shown to retain 3-4 times higher relative affinity than that of CH3-Av in ELISA. Importantly the fact that both avidin fusion proteins had a higher relative affinity suggests that these avidin fusion proteins can be effectively used to deliver biotinylated ligands such as drugs and peptides to a certain locale, such as the brain.
Avidin ; Biotin* ; Brain ; Chickens ; Enzyme-Linked Immunosorbent Assay ; Genetic Engineering ; Immunoglobulin G ; Ligands ; Molecular Weight ; Peptides ; Serum Albumin, Bovine

No abstract available.
Humans ; Physicians, Family*

No abstract available.
Hypertrichosis*

We describe a 69-year-old woman who presented with a dedifferentiated extraskeletal myxoid chondrosarcoma arising in the left masticator space. Computed tomography and magnetic resonance imaging revealed a 5 cm sized mass in the left masticator space. Histologically, the tumor consisted of two distinct areas. The less cellular area was a low-grade extraskeletal myxoid chondrosarcoma, composed of strands or cords of uniform spindle cells and abundant myxoid stroma. The more cellular, dedifferentiated area corresponded to a high grade myxofibrosarcoma, consisting of anaplastic tumor cells in myxoid stroma and geographic necrosis. The tumor cells of the former area were positive for S-100 protein, microtubule-associated protein-2 (MAP-2) and class III beta-tubulin, but negative for cytokeratin, smooth muscle actin, and desmin. The tumor cells in the latter, pleomorphic area showed MAP-2 and beta-tubulin immunoreactivity with a high Ki-67 labeling index. Based on its histologic and immunohistochemical features, the tumor was considered a dedifferentiated extraskeletal myxoid chondrosarcoma.
Actins ; Aged ; Cell Dedifferentiation ; Chondrosarcoma ; Desmin ; Female ; Humans ; Keratins ; Magnetic Resonance Imaging ; Muscle, Smooth ; Necrosis ; S100 Proteins ; Tubulin

We describe a 69-year-old woman who presented with a dedifferentiated extraskeletal myxoid chondrosarcoma arising in the left masticator space. Computed tomography and magnetic resonance imaging revealed a 5 cm sized mass in the left masticator space. Histologically, the tumor consisted of two distinct areas. The less cellular area was a low-grade extraskeletal myxoid chondrosarcoma, composed of strands or cords of uniform spindle cells and abundant myxoid stroma. The more cellular, dedifferentiated area corresponded to a high grade myxofibrosarcoma, consisting of anaplastic tumor cells in myxoid stroma and geographic necrosis. The tumor cells of the former area were positive for S-100 protein, microtubule-associated protein-2 (MAP-2) and class III beta-tubulin, but negative for cytokeratin, smooth muscle actin, and desmin. The tumor cells in the latter, pleomorphic area showed MAP-2 and beta-tubulin immunoreactivity with a high Ki-67 labeling index. Based on its histologic and immunohistochemical features, the tumor was considered a dedifferentiated extraskeletal myxoid chondrosarcoma.
Actins ; Aged ; Cell Dedifferentiation ; Chondrosarcoma ; Desmin ; Female ; Humans ; Keratins ; Magnetic Resonance Imaging ; Muscle, Smooth ; Necrosis ; S100 Proteins ; Tubulin

Chusid et al proposed diagnostic criteria of hypereosinophilic syndrome (HES) that remain valid today. These were, (1) a sustained peripheral blood eosinophil count of more than 1500/L present for longer than 6 months ; (2) no evidence of other apparent causes for eosinophilia, and (3) presumptive signs of parenchymal organ involvement. Any organ system may be affected in HES, but the most severe clinicopathological involvements are of the heart and nervous system. Although multiple organ systems may be involved, the most common cause of morbidity and mortality is cardiac involvement with extensive fibrous thickening of the endomyocardium and overlying thrombus. We report a case of acute peri-myocarditis with eosinophilia, which was confirmed as eosinophilic myocarditis by endomyocardial biopsy, with literature review.
Biopsy ; Edema* ; Eosinophilia ; Eosinophils* ; Heart ; Hypereosinophilic Syndrome ; Mortality ; Myocarditis* ; Nervous System ; Thrombosis