PURPOSE: Although alpha-fetoprotein is one of the most commonly used tumor markers in Korea, most of the radioimmunoassay kits for alpha-fetoprotein have been imported from foreign countries. The purpose of this study was to evaluate the performance of a recently developed domestic immunoradiometric kit for alpha- fetoprotein (Riakey AFP IRMA CTR, Sin-Jin Medics, Seoul, Korea). MATERALS AND METHODS: We evaluated intra- and inter-assay precision, recovery rate, parallelism, and sensitivity of serum alpha-fetoprotein measurement using Riakey AFP IRMA CTR kit. The values of alpha-fetoprotein measured by Riakey AFP IRMA CTR kit were compared with those measured by two foreign commercial kits (alpha-fetoproteina of Radim and alpha-feto.riabead of Abbott). RESULTS: Intra-assay coefficients of variation on three different levels were 5.3% for 18.9 ng/ml, 3.4% for 133 ng/ml and 1.6% for 330 ng/ml. Inter-assay coefficients of variation were 9.7% for 20.9 ng/ml, 3.2% for 137 ng/ml and 4.1% for 330 ng/ml respectively. Recovery rate tests on all three different levels showed within 100+/-10%. Parallelism was also good and the sensitivity was 0.63 ng/ml. There was strong correlation between the measurement of alpha-fetoprotein by Riakey AFP IRMA CTR and that by two foreign commercial kits(r=0.98). CONCLUSION: The first Korean domestic immunoradiometric kit for alpha-fetoprotein, Riakey AFP IRMA CTR, performed well for clinical use.
alpha-Fetoproteins* ; Fetal Proteins ; Immunoradiometric Assay* ; Korea ; Radioimmunoassay ; Seoul ; Biomarkers, Tumor

BACKGROUND: Thyroid status in uremia is still inconclusive due to the complexicity of the system. No single pathogenetic event may explain the thyroid function abnormalities in end stage renal disease (ESRD). Defects at all levels of the hypothalamic-pituitary-thyroid axis have been identified. Regarding the thyroid dysfunction in ESRD it is well recognized that the TSH response to TRH is blunted and serum concentrations of thyroid hormones are decreased in patients with ESRD. Whether or not on maintenance hemodialysis. Restoration of renal function with renal transplantation resulted in normalization of all parameters of thyroid function with exception of blunted TSH response to TRH. We evaluated the long-term changes of the thyroid function in 10 patients to know whether the thyroid function and the hypothalamo-pituitary axis were improved with the recovery of the renal function under maintenance low-dosage steroid administration after renal transplantation. METHODS: These tests were performed during the morning in the fasting state in 10 ESRD patients before, 1 month and 6 years after renal transplantation (RT). Thyroid function tests. Serum T3, T4 were measured by RIA kit and serum TSH was measured by IRMA kit. TRH stimulation test. Serum blood samples were obtained 0, 30, 60, 90, 120 min after TRH (400microgram) administration. Statistical analysis. All grouped data were expressed as mean+/-SD. Student t-test was used to assess the statistical difference between any two means. RESULTS: 1) The mean basal level of serum T3 was reduced in ESRD patients (53.6+/-33.2ng/dL) and increased to the low normal level 1 month after RT (87.8+/-25.4ng/dL), improved to the normal level 6 years after RT (116.3+/-28.8ng/dL). 2) The mean basal level of T4 was within normal range before RT (5.9+/-1.1microgram/dL), after 1 month (6.2+/-1.2microgram/dL) and after 6 years (6.5+/-1.4microgram/dL) of RT. 3) The mean basal level of TSH was within normal range before RT (2.0+/-1.2microU/mL), after 1 month (1.1+/-0.7microU/mL), and after 6 years (0.7+/-0.5microU/mL) of RT. Rut the mean TSH level of 6 years of RT was significantly decreased within the normal range. 4) In ESRD the TSH response to TRH was blunted, had a diminished peak and delayed fall before RT. After 1 month of RT, the TSH response to TRH was persistently blunted, however showed more rapid fall of TSH. After 6 years of RT, the TSH response to TRH normalized, but the absolute level of TSH and the peak level of TSH to TRH were less than before and after 1 month of RT. CONCLUSIONS: The abnormalities of thyroid hormones in uremic patients were improved partially after 1 month of RT and almost completely after 6 years of RT. But the level of T3H and the peak level of TSH to TRH were low within normal range, these results may be a direct consequence of low-dosage and long-term glucorcorticoid administration.
Axis, Cervical Vertebra ; Fasting ; Follow-Up Studies* ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation* ; Reference Values ; Renal Dialysis ; Thyroid Function Tests ; Thyroid Gland* ; Thyroid Hormones ; Uremia

No abstract available.
Humans ; Hydronephrosis* ; Radioisotope Renography*

BACKGROUND: To enumerate leukocyte count in cerebrospinal fluid (CSF) is important for diagnosing bacterial meningitis. Using automated hematology analyzer for enumeration of leukocyte in CSF is below the sensitivity, so microscopic hemocytometric method is standard method. But this requires sufficient practical experience and has limitation of accuracy and stability. So we developed new manual method and evaluated it. METHODS: We designed new method using transparent ruler tape. We performed correlation, accuracy and precision test by counting leukocyte in diluted EDTA blood with three methods: new method, Neubauer and Nageotte hemocytometry. Twenty two CSF were used for stability test, which determines leukocyte count according to time (within one hour and after 2, 4 and 12 hr), by new method and Neubauer hemocytometry at room temperature. RESULTS: There was no clinical significant difference between three methods in correlation test, whereas Neubauer and Nageotte hemocytometry showed a bias to underestimation relative to the results obtained with new method in case with low leukocyte count. The new method showed the lowest CV and most accurate result. In stability test, leukocyte counts decreased being 44.4%, 72.1% of initial values after 2 hr, 14.8%, 31.1%, after 4 hr and 4.2%, 8.7%, after 12 hr, by Nageotte hemocytometry and new method, respectively. CONCLUSIONS: The new method we devised is simple, easy and applicable to use in a laboratory and offers advantages of improved precision and stability. It may be sufficient for replacing standard methods for leukocyte counting in CSF.
Cerebrospinal Fluid/*cytology ; Female ; Humans ; Leukocyte Count/instrumentation/*methods ; Male ; Regression Analysis ; Reproducibility of Results ; Sensitivity and Specificity ; Time Factors

BACKGROUND: Lipoprotein(a)[Lp(a)] is a subspecies of low-density lipoprotein and has been shown to be associated with pathogenesis of thrombosis-related disease. It is already known that patients with diabetic nephropathy are usually complicated by vascular complications such as coronary artery diseases and cerebrovascular accidents. According to the recent data, Lp(a) level tends to be increased as the proteinuria is increased and renal function are decreased. We evaluated the Lp(a) level to know whether its level is correlated to the severity of diabetic nephropathy. METHODS: We investigated Lp(a) levels in eighty-one patients with Type 2 (non-insulin-dependent) diabetic patients. They were divided into four groups according to the level of urinary albumin excretion and serum creatinine level: Group 1 (n=30): normal renal function + urine microalbumin or=1.5mg/dL. Blood samples were obtained during the morning in the fasting state and separated serum from the it and reserved at -70degrees C. Lp(a) concentration was checked by one-step sandwich ELISA test. All grouped data were expressed as mean+/-SD. ANOVA and unpaired t-test was used to assess the statistical difference between any two means. RESULTS: Lp(a) levels were 30.2+/-4.6mg/dL in Group 1, 42.7+/-8.2mg/dL in group 2, 73.4+/-19.7mg/dL in group 3, and 80.7+/-14.8mg/dL in group 4. The level of Lp(a) in group4, group 3, and group 2 was significantly higher than that of group 1 respectively (P=0.009, 0.001, 0.038). However, no significant correlation was observed between the level of Lp(a) and that of total cholesterol, triglyceride and total lipid in all groups. CONCLUSIONS: these results indicate that Lp(a) concentrations are increased in the patients with diabetic nephropathy with microalbuminuria or overt proteinuria. So, the presence of albuminuria may be the important determinant for the elevated Lp(a) level in diabetic nephropathy.
Albuminuria ; Cholesterol ; Coronary Artery Disease ; Creatinine ; Diabetic Nephropathies* ; Enzyme-Linked Immunosorbent Assay ; Fasting ; Humans ; Lipoprotein(a)* ; Lipoproteins* ; Proteinuria ; Stroke ; Triglycerides ; Urinalysis

No abstract available.

BACKGROUND: The incidence of reported nontyphoidal Salmonellosis has increased during last decade in Korea. Salmonella typhimurium and Salmonella enteritidis are two major serotypes in nontyhoidal Salmonella. To determine the nature of potential outbreak S. typhimurium infection in a community, we retrospectively evaluated clinical and epidemiologic features of S. typhimurium infections and performed pulsed-field gel electrophoresis(PFGE) to investigate a genetic relatedness of S. typhimurium isolated in Guro Hospital. METHODS: From May 1998 to April 1999, a total of 20 S. typhimurium strains were isolated from 18 patients. PFGE patterns were analyzed for 20 S. typhimurium strains Clinical and epidemiological features were evaluated from their medical records. RESULTS: Seventy two percent(13/18) were acute gastroenteritis, and 11 %(2/18) were enteric fever and 16 %(3/18) were intussusception. Seventy eight percent(14 of 18) of patients were six years old or less than. There were two major type(A, B) on PFGE analysis. Eight of 20 strains showed identical PFGE type(A1). Eleven strains were subtypes of A1. One strain showed different type(B). Similarity coefficients between A1 and its subtypes were all over 0.765 and they showed close genetic distance on dendrogrm. Antibiogram of Al eight strains were various. CONCLUSIONS: High genetic relationship among 20 S. typhimurium strains for a year in Guro area indicates that they were possibly originated from one clone and that there might be a common source of infection. More efforts should be directed toward the epidemiological investigation of the cases to detect outbreaks and prevent further spread of the infection.
Clone Cells ; Disease Outbreaks ; Gastroenteritis ; Humans ; Incidence ; Intussusception ; Korea ; Medical Records ; Microbial Sensitivity Tests ; Molecular Epidemiology* ; Retrospective Studies ; Salmonella enteritidis ; Salmonella Infections ; Salmonella typhimurium* ; Salmonella* ; Tertiary Care Centers* ; Typhoid Fever

Behcet's disease is a nonspecific vasculitis characterized by exacerbations and remissions of unpredictictable duration. The commom clinical features in most patients are orogenital ulcers, uveitis and skin lesions-especially erythema nodosum-like lesions or positive pathergy test. Among the systemic manifestations of Behcet's disease, pulmonary involvement is very rare and only a few cases have been documented. The main event of pulmonary involvement is vasculitis forming multilocular aneurysms and thrombosis of the pulmonary artery. The commom pulmonary manifestations are hemoptysis, dyspnea, pleuritic chest pain, cough and fever. The prognosis of pulmonary vasculitis is very poor. A 30-year-old male patient with Behcet's disease presented with fever and dyspnea for 10 days. In the past years, his vision of the left eye was lost due to chorioretinitis. He took right hemicolectomy because of the perforation of colonic ulcer. Also he has been suffered from left hemiparesis due to multiple cerebral infarction. We describe a case with Behcet's disease with pulmonary infarction improved with prednisolone and cyclosporine.
Adult ; Aneurysm ; Cerebral Infarction ; Chest Pain ; Chorioretinitis ; Colon ; Cough ; Cyclosporine ; Dyspnea ; Erythema ; Fever ; Hemoptysis ; Humans ; Lung Diseases ; Male ; Paresis ; Prednisolone ; Prognosis ; Pulmonary Artery ; Pulmonary Embolism ; Pulmonary Infarction* ; Skin ; Thrombosis ; Ulcer ; Uveitis ; Vasculitis

BACKGROUND: Knowing how the protein profile of platelet products changes with storage or leukoreduction may give us greater insight into cell physiology and the cause of transfusion reactions other than cytokines and chemokines. METHODS: We filtered four packs of platelet concentrates (PC) within 24 hr of blood collection and after 120 hrs of storage. Four aliquots of each supernatant in PC were obtained: pre-storage+prefiltration, pre-storage+post-filtration, post-storage+pre-filtration and post-storage+post-filtration. Routine chemistry tests and a two-dimensional electrophoresis (2-DE) were performed. The stained images were analyzed and the significant spots were identified using a peptide mass finger printing (PMF) with matrix assisted laser desorption/ionization-time of flight (MALDI-TOF) analysis after trypsin digestion. RESULTS: The protein spots increased with storage and decreased after filtration (P<0.05, prestorage+post-filtration). The spot density of various proteins, including macrophage inflammatory protein-2 alpha, megakaryocyte colony stimulating factor and interleukin-22 changed with storage and leukoreduction. CONCLUSIONS: The database of identified protein spots and their changes produced in this study is a useful basic tool for future studies on the mechanism of transfusion reactions. Further studies should validate the significance of each protein spot.
Blood Platelets/*chemistry ; Blood Preservation ; Electrophoresis, Gel, Two-Dimensional ; Humans ; Leukocyte Reduction Procedures ; *Platelet Transfusion ; Proteome/*analysis ; *Proteomics ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; Time Factors

BACKGROUND AND OBJECTIVES: Exercise myocardial perfusion scans in patients with hypertrophic cardiomyopa-thy have shown reversible perfusion abnormalities with unknown clinical significance. We performed this study to characterize dipyridamole Tl-201 SPECT imaging and correlate with clinical findings in patients with hyper-trophic cardiomyopathy. METHODS: Tl-201 SPECT was performed in 25 patients of hypertrophic cardiomyopa-thy with asymmetric septal hypertrophy and 20 normal controls after dipyridamole infusion (0.56 mg/kg). Myocardial wall was divided into 8 segments. Tl-201 uptake and relative washout rate were calculated. RESULTS: Tl-201 SPECT showed significantly lower Tl-201 uptake in basal septal (81.3+/-3.4% vs 78.2+/-6.4%, p<0.05) and apical septal wall on stress (88.2+/-4.7% vs 83.9+/-6.5%, p<0.05) and higher apical septal (86.6+/-5.2% vs 89.2+/-3.1%, p<0.05) and apical anterior wall uptake (88.7%+/-4.0% vs 91.4+/-4.9%, p<0.05) on redistribution images in patients with hypertrophic cardiomyopathy. Basal lateral wall uptake of hypertrophic cardiomyopathy was significantly lower than normal control on both stress (84.7+/-3.5% vs 81.2+/-7.3%, p<0.05) and redistribution images (85.0+/-5.8% vs 76.8+/-7.2%, p<0.0001). The septum/lateral uptake ratio of patients on rest image was significantly higher than that of normal controls (0.98+/-0.07 vs 1.07+/-0.10, p<0.001). There was no difference in age, sex, symptom, cardiac medication and the parameters of 2D-echo including left ven-tricular outflow obstruction between subgroups of normal vs abnormal washout in patients with hypertrophic cardiomyopathy. CONCLUSION: Dipyridamole Tl-201 myocardial SPECT shows reduced coronary vasodilatory capacity of myocardium, especially septum in patients with hypertrophic cardiomyopathy. High septal/lateral uptake ratio on redistribution image may be a characteristic finding. However, no correlation between abnorm-al Tl-201 washout and clinical findings was observed.
Cardiomyopathies ; Cardiomyopathy, Hypertrophic* ; Dipyridamole* ; Humans ; Myocardium ; Perfusion* ; Tomography, Emission-Computed, Single-Photon*