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.
Epithelium* ; Humans* ; Insulin*

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*

OBJECTIVES: The optimal management of patients with spontaneous intracerebral hemorrhage (ICH) remains controversial. The aim of this study was to evaluate technical results and clinical outcomes of frameless stereotactic aspiration and fibrinolysis using urokinase performed in a single center. MATERIALS AND METHODS: The subjects of this study were 62 consecutive patients with spontaneous ICH who were treated with frameless stereotactic aspiration and subsequent fibrinolysis using urokinase between February 2009 and June 2010 in our hospital. The surgical results, procedure-related complications, and clinical outcomes were evaluated. RESULTS: A total of 62 patients were enrolled in the study. The median age was 54 years (range, 32-86). The mean initial Glasgow coma scale score was 7.7 (range 5-11). The mean initial hemorrhage volume was 43 cm3 (range 30-70). Seven patients (11.2%) died of respiratory failure (four patients), postoperative edema (two patients), and heart disease (one patient). There were seven cases of procedure-related complications (11.2%), including malpositioning of catheters (two patients), pneumocephalus (one patient), and rebleeding (four patients, 6.4%). At the three-month follow-up, a good outcome (three-month Glasgow outcome scale > 3) was noted in 32 patients (51.6%). CONCLUSIONS: Frameless stereotactic aspiration and subsequent fibrinolytic thearpy using urokinase for spontaneous ICH is a simple and safe procedure with low mortality and rebleeding rate.
Catheters ; Cerebral Hemorrhage* ; Edema ; Fibrinolysis* ; Follow-Up Studies ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Heart Diseases ; Hemorrhage ; Humans ; Mortality ; Pneumocephalus ; Respiratory Insufficiency ; Urokinase-Type Plasminogen Activator*

The diagnosis of acute pancreatitis occurred in CAPD patients is quite difficult due to its clinical similarity with acute peritonitis. Delayed diagnosis and treatment of acute pancreatitis in CAPD patients may result in fatal complication. We experienced a case of acute pancreatitis in a CAPD patient. A 62 years old female visited the hospital with acute abdominal pain and cloudy effluent for 3 days. She has been on CAPD for 3 years and had two episodes of peritonitis at 6 months and 1 year before the admission. The causative organism was Streptococcus viridans in each episode. The peritonitis symptoms and peritoneal leukocyte count incresed despite of using Vancomycin(R) and Netilmicin(R). Causative organism was not isolated from dialysis. Serum amylase concentrations increased from 105mg/dL at the admission to 1,052mg/dL on day 10 of admission. Abdominal ultrasonography and abdominal computerized tomogram revealed fat infiltration, focal necrosis and multiple cyst formation at pancreas area. Computerized tomogram guided aspiration cytology revealed acute inflammation and necrosis. Bacteria were not found in the aspirate. Clinical symptoms were improved after discontinuation of CAPD and intraperitoneal use of antibiotics. The patient restarted CAPD on the day 18 and remained without complications. We report this case with a brief review of literatures.
Abdominal Pain ; Amylases ; Anti-Bacterial Agents ; Bacteria ; Delayed Diagnosis ; Diagnosis ; Dialysis ; Female ; Humans ; Inflammation ; Leukocyte Count ; Middle Aged ; Necrosis ; Pancreas ; Pancreatitis* ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Renal Dialysis ; Ultrasonography ; Viridans Streptococci

OBJECTIVE: The objective of this study is to evaluate the clinical and angiographic outcomes after primary balloon angioplasty in patients with symptomatic middle cerebral artery (MCA, M1 segment) stenosis refractory to medical therapy. MATERIALS AND METHODS: Eleven patients with intracranial stenosis were treated with primary balloon angioplasty. All patients had MCA stenosis with recurrent transient ischemic attack (TIA). The indication for balloon angioplasty was patients with significant MCA stenosis: 1) age older than 18 years with recurrent or progressive TIA or infarction despite optimal medical therapy, including anti-coagulation, dual anti-platelet, and anti-lipid medication; 2) previous ischemic events or asymptomatic severe stenosis (more than 50%) with poor collateral cerebral circulation, or diminished cerebral perfusion on single photon emission computed tomography before and after administration of the intravenous dosage of acetazolamide. RESULTS: The median age of patients was 53 years (range 44-79). The technical success rate was 100%. Mean pretreatment stenosis degree was 83.63 +/- 9.53% and 29.1 +/- 15.4% before and after angioplasty, respectively. Procedural-related complications occurred in four of 11 patients (36%), but none of the patients had permanent neurological deficit. All patients were available for an average follow-up period of 19.4 +/- 5.1 months. One patient had a stroke in the territory of angioplasty at two months after angioplasty. The stroke free survival rate at 30 days and 12 months was 100% and 91%, respectively. Restenosis over 50% was observed in three of 11 patients (27%); all were asymptomatic. CONCLUSION: Intracranial angioplasty for symptomatic MCA stenosis refractory to medical therapy can be a treatment option to reduce the risk of further TIA or stroke.
Acetazolamide ; Angioplasty* ; Angioplasty, Balloon ; Atherosclerosis ; Constriction, Pathologic* ; Follow-Up Studies ; Humans ; Infarction ; Ischemic Attack, Transient ; Middle Cerebral Artery* ; Perfusion ; Stroke ; Survival Rate ; Tomography, Emission-Computed, Single-Photon

We report an unusual case of cerebral aneurysmal subarachnoid hemorrage (SAH) with Fabry's disease. A 42-year-old woman presented with aneurysmal SAH originated from a saccular aneurysm of the right posterior communicating artery. The patient was treated by an endovascular coil embolization of aneurysm. Postoperatively the patient recovered favorably without any neurological deficit. During her admission, the patient had a sign of proteinuria in urine analysis. The pathologic findings of kidney needle biopsy implied nephrosialidosis (mucolipidosis of lysosomal stroage disease), which is consistent with a Fabry's disease. It is uncommon that Fabry's disease is presented with aneurysmal SAH, especially in middle-aged patients, but could be a clinical concern. Further investigations are needed to reveal risk factors, vascular anatomy, and causative mechanisms of Fabry's disease with aneurysmal SAH.
Aneurysm ; Arteries ; Biopsy, Needle ; Fabry Disease ; Female ; Humans ; Intracranial Aneurysm ; Kidney ; Mucolipidoses ; Nephrosis ; Proteinuria ; Risk Factors ; Subarachnoid Hemorrhage