No abstract available.
Epithelium* ; Humans* ; Insulin*

The hepatitis C vims(HCV) is now known to be the chief cause of transfusion-associated non-A, non-B hepatitis. The ultimate goal of blood donor screening for anti-HCV antibodies is the specific exclusion of vital carriers from the blood donor population. Recently, a third generation anti-HCV screening(Green Cross Center Innotest HCV 3.0 Genedia HCV 3.0 ) and immunoblot assay, Inno-Lia HCV Ab III (Innogenetics) using antigens derived from the core and different nonstructural regions(NS3, NS4 and Ns5) of the HCV viral genome were developed. To evaluate the usefulness of these assays, anti-HCV reaction patterns of the Inno-Lia HCV Ab III or presence of HCV-RNA detected by reverse transcriptase-polymerase chain reaction(RT-PCR) were examined samples in which were repeatedly positive or discrepant with Abbott EIA-2, Innotest HCV 3.0 Genedia HCV 3.0 The reaction intensity of Innotest HCV 3.0 Genedia HCV 3.0 was higher than that of Abbott EIA-2. The sensitivity and specificity of Innotest HCV 3.0 and Genedia HCV 3.0 were 92.9% and 86.8%, respectively, and the positive and negative predictive values were 72.2% and 97.1%. both. The sensitivity and specificity of Abbott EIA-2 were 100% and 78.9%, respectively, and the positive and negative predictive values were 63.6% and 100%, respectively. We concluded that the new third generation HCV EIA reagents can decrease a false positivity of second generation EIA reagents and correlate well with detection of HCV-RNA by RT-PCR.
Blood Donors ; Genome, Viral ; Hepacivirus* ; Hepatitis C Antibodies ; Hepatitis C* ; Hepatitis* ; Humans ; Immunoenzyme Techniques* ; Indicators and Reagents* ; Mass Screening ; Sensitivity and Specificity

No abstract available.
Interleukin-4* ; Interleukins* ; Receptors, Interleukin-4* ; Rheumatic Diseases*

PURPOSE: To evaluate the independent prognostic value of Ki-67 in lymph node-negative breast cancer and the usefulness of Ki-67 when it combined with St. Gallen classification as a guidance of adjuvant chemotherapy for node-negative cancer. METHODS: We retrospectively reviewed the data of 534 patients with lymph node-negative breast cancer who underwent curative surgery between 1998 and 2001 at our institution. Patients were classified according to the guideline of risk groups of St. Gallen consensus and the level of Ki-67 expression. Distant metastasis-free survival (DFS) rates were compared between groups. RESULTS: With a median follow-up of 55 months, the overall 5-year DFS rate was 91.5%. The 5-year DFS rates for patients with high and low Ki-67 tumors (cut-off value: > or = 10%) were 84.6% and 93.7%, respectively (p < 0.001). In a Cox regression model involving potential prognostic factors, high Ki-67 expression could independently predict the risk of distant recurrence (odds ratio = 2.0 [95% confidence interval, 1.03-3.93]). The 5-year DFS rates for patients with average and minimal risk group of St. Gallen classification were 89.3% and 97.5%, respectively. The average risk group was further divided into two subgroups with significantly different prognosis according to the Ki-67 expression (DFS rate: 84.2% vs. 91.5%; p = 0.007). CONCLUSIONS: Ki-67 was an independent prognostic factor in lymph node-negative breast cancer and the combination of Ki-67 expression and the St. Gallen classification could provide a more useful therapeutic guideline for lymph node-negative breast cancer patients.
Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Classification ; Consensus ; Follow-Up Studies ; Humans ; Prognosis ; Recurrence ; Retrospective Studies

PURPOSE: To evaluate the independent prognostic value of Ki-67 in lymph node-negative breast cancer and the usefulness of Ki-67 when it combined with St. Gallen classification as a guidance of adjuvant chemotherapy for node-negative cancer. METHODS: We retrospectively reviewed the data of 534 patients with lymph node-negative breast cancer who underwent curative surgery between 1998 and 2001 at our institution. Patients were classified according to the guideline of risk groups of St. Gallen consensus and the level of Ki-67 expression. Distant metastasis-free survival (DFS) rates were compared between groups. RESULTS: With a median follow-up of 55 months, the overall 5-year DFS rate was 91.5%. The 5-year DFS rates for patients with high and low Ki-67 tumors (cut-off value: > or = 10%) were 84.6% and 93.7%, respectively (p < 0.001). In a Cox regression model involving potential prognostic factors, high Ki-67 expression could independently predict the risk of distant recurrence (odds ratio = 2.0 [95% confidence interval, 1.03-3.93]). The 5-year DFS rates for patients with average and minimal risk group of St. Gallen classification were 89.3% and 97.5%, respectively. The average risk group was further divided into two subgroups with significantly different prognosis according to the Ki-67 expression (DFS rate: 84.2% vs. 91.5%; p = 0.007). CONCLUSIONS: Ki-67 was an independent prognostic factor in lymph node-negative breast cancer and the combination of Ki-67 expression and the St. Gallen classification could provide a more useful therapeutic guideline for lymph node-negative breast cancer patients.
Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Classification ; Consensus ; Follow-Up Studies ; Humans ; Prognosis ; Recurrence ; Retrospective Studies

BACKGROUND: To determine the molecular structure of type II collagen-specific T-cell receptors associated with rheumatoid arthritis (RA). METHODS: We generated CII-specific T-cell lines of 8 RA patient s by prolonged in vitro culture with bovine CII (bCII) and the immunogenic peptide (256-270) of human CII. The proliferation response towards CII stimulation was measured from the uptake of 3 H-thymidine. Changes in the secretion of Th 1 and Th2 cytokines in the culture supernatent were measured by ELISA. The TCR clonotypes of these T-cells were examined by RT-PCR/ SSCP analyses of all 22 V beta chains. RESULTS: T-cells from patients' tissue exhibited strong proliferation index upon CII stimulation, which was maintained up to 6 months in the culture. The secretion of INF-gamma from these T-cells increased along with the duration of culture time, while the amount of IL-4 production did not show significant changes. The SSCP band patterns of patients' T-cells appear as discrete bands unlike the smeary streak produced from normal samples. Some SSCP bands, each representing selected expansion of a TCR containing certain subtype of V beta peptides, appeared to be identical in more than one patients. Among these, the expansion of SSCP band representing the V beta 14 CDR3 region persisted after switching the antigen to the immunogenic human peptide (256-270). CONCLUSION: CII-reactive T-cells expressing distinct CDR3 motifs are selectively expanded in the peripheral blood and synovial fluid of RA patients, and their persistent proliferation upon CII stimulation, as well as the production Th 1-type cytokines, may play pivotal roles in RA pathogenesis.
Arthritis, Rheumatoid* ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-4 ; Molecular Structure ; Peptides ; Polymorphism, Single-Stranded Conformational ; Receptors, Antigen, T-Cell ; Synovial Fluid ; T-Lymphocytes*

PURPOSE: A scaphoid fractures (SF), an important injury with acute pain, may not be diagnosed on the initial X-rays in the emergency department. Some authors have suggested that several clinical examinations are necessary to reliably confirm the presence of a fractured scaphoid in those patients presenting with an injury clinically suggestive of such a fracture, but without a fracture visible on the initial Xrays. we performed this prospective study to evaluate the efficacy of clinical signs believed to be useful in the diagnosis of a SF. METHODS: We performed a 1-year prospective study on 127 patients with suspected SFs. They were examined on two separate occasions : first in the emergency department and then in the outpatient clinic of the orthopedic department 2 weeks later. Tenderness in the anatomical snuff box (ASB), tenderness over the scaphoid tubercle (ST), and pain on longitudinal compression with the thumb (LC) were evaluated. RESULTS: At the initial examination, the ASB, the ST and LC were all 100% sensitive for detecting a SF with specificities of 40%, 49%, and 59%, respectively. These clinical signs, used in combination within the first 24 hours following injury, produced 100% sensitivity and an improvement in the specificity to 76%. Ninety-one (91) patients had one or more of positive clinical tests, with 18 of those patients having a SF visible on the initial X-ray and five having a fracture diagnosed either by repeated X-ray or CT 2 weeks after the injury. CONCLUSION: Our results suggest that the clinical signs ASB, ST, and LC are inadequate indicators of a SF when used alone and should be combined to achieve a more accurate clinical diagnosis.
Acute Pain ; Ambulatory Care Facilities ; Diagnosis* ; Emergency Service, Hospital ; Humans ; Orthopedics ; Physical Examination* ; Prospective Studies ; Sensitivity and Specificity ; Thumb ; Tobacco, Smokeless

Congenital diverticulum of the left ventricle is a very rare disease. Ventricular diverticulum is usually associated with other anomalies including intracardiac and midline thoracoabdominal defect. We describe a case with congenital left ventricular diverticulum presenting as an isolated lesion. A 37-year-old man presented with 4-year history of chest pain. Diverticulum was diagnosed by echocardiography and left ventriculogram.
Adult* ; Chest Pain ; Diverticulum* ; Echocardiography ; Heart Ventricles ; Humans ; Rare Diseases

No abstract available.
Dermatitis, Allergic Contact

PURPOSE: We performed this study to evaluate the clinical efficacy and safety of dexamethasone in preventing laryngeal edema following exubation. METHODS: We retrospectively reviewed the medical records of 100 neonates who underwent endotracheal intubation and mechanical ventilation. Subjects were divided into two groups; dexamethasone treated (60 cases, dexamethasone group) and non-treated (40 cases, control group). We examined the underlying diseases of endotracheal intubation, and compared the two groups, change in respiratory rate before and after extubation, rate of reintubation, and duration of treatment (oxygen therapy before and after extubation, postextubation admission, and total admission). And also investigated adverse effects in dexamethasone group. RESULTS: Respiratory distress syndrome was the most common underlying disease of endotracheal intubation in both groups. The duration of endotracheal intubation and mechanical ventilation was significantly longer in the dexamethasone group (P<0.05), but there were no statistical differences in change of respiratory rate, rate of reintubation, duration of treatment between the two groups. In the dexamethasone group, hypertension (8 cases; 13.3%) and hyperglycemia (3 cases; 5.0%) were observed shortly and recovered without any treatment. CONCLUSION: There were no significant differences between dexamethasone group and control group of this study in clinical efficacy, so we concluded that the prophylactic use of dexamethasone for the prevention of laryngeal edema following short-term intubation has room for reconsideration in the neonates. Further prospective randomized double-blind studies are needed to understand the clinical effects of dexamethasone and to define apparent risk factors for postextubation laryngeal edema.
Dexamethasone* ; Double-Blind Method ; Humans ; Hyperglycemia ; Hypertension ; Infant, Newborn* ; Intubation ; Intubation, Intratracheal ; Laryngeal Edema* ; Medical Records ; Respiration, Artificial ; Respiratory Rate ; Retrospective Studies ; Risk Factors