No abstract available.
Disseminated Intravascular Coagulation* ; Plasma*

We report a case of sarcoidosis which developed in the skin, lung and eyes in a 50-year-old woman. The skin lesions showed two types of cutaneous manifestations which were subcutaneous nodules on her back and erytrematous papules on the face for several months. Our patient's seurm angiotensin converting enzyme (ACE) level was elevated at 33.5 IU/L(reference range, 8.3-21.4 IU/L) and the purified protein derivative(PPD) skin test had a negative result. On her roentgenographic examinations, we could find multiple nodular densities with hazziness on both her lungs and radionuclides(Gallium 67) uptakes in right lower lung field. The ratio of helper to suppressor T cells was 9 in bronchial lavage. Diagnosis of sarcoidosis was made on the basis of histologic findings of non-caseating granulomas from skin and lung tissue. Treatment was initiated with oral alternate-day prednisone 40mg. The cutaneous lesions and dyspnea improved in 2 and 4 weeks respectively, and serum ACE level returned to normal in 2 months.
Bronchoalveolar Lavage ; Diagnosis ; Dyspnea ; Female ; Granuloma ; Humans ; Lung ; Middle Aged ; Peptidyl-Dipeptidase A ; Prednisone ; Sarcoidosis* ; Skin ; Skin Tests ; T-Lymphocytes

No abstract available.
Gallstones* ; Lithotripsy* ; Ultrasonography*

BACKGROUND: Previous reports have suggested that alleles at the plasminogen activator inhibitor-1 (PAI-1) gene are associated with increased risk of developing coronary artery disease, including myocardial infarction and stroke through their effect on PAI-1 levels. Method: We attempted to search English literatures for all reports of possible effects of PAI-1 gene on cardiovascular disease in human published prior to November 1998. We used a Mantel-Haenszel method (fixed effect model) and random effect model, respectively, to perform a meta-analysis of 7 case-control studies that provided information related to the effects of PAI-1 gene on risk of cardiovascular disease. RESULTS: From 7 studies for diagnosed cardiovascular disease, the relative frequencies of the three genotypes among controls was (5G/5G) (homozygous normal), 24.5%; (4G/5G) (heterozygous), 48.2%, and (4G/4G) (homozygous for the mutant, 675 GGGG), 27.3%. These relative frequencies in cases were 21.7% for 5G/5G, 48.0% for 4G/5G, and 30.3% for 4G/4G. In fixed effect model, compared with those with genotype (5G/5G), the overall odds ratio (OR) for cardiovascular disease among those with (4G/5G) was 1.12 (95% CI, 0.93 to 1.34), and it was 1.20 (1.01 to 1.44) for the (4G/4G) genotype. For five studies with myocardial infarction as the outcome, the overall OR of myocardial infarction was 1.20 (0.99 to 1.47) for those with (4G/5G) and 1.24 (1.00, 1.54) for those with (4G/4G) genotypes, respectively. CONCLUSION: Our findings provide support for the weak association between PAI-1 gene and cardiovascular disease, in particular, myocardial infarction.
Alleles ; Cardiovascular Diseases* ; Case-Control Studies* ; Coronary Artery Disease ; Genotype ; Humans ; Myocardial Infarction ; Odds Ratio ; Plasminogen Activator Inhibitor 1* ; Plasminogen Activators ; Polymorphism, Genetic* ; Stroke

BACKGROUND: ABO genotyping is being used increasingly when the results of serologic typing are unclear or there is some suspicion of rare ABO subtypes. Conventional molecular diagnostic methods such as PCR- restriction fragment length polymorphism (PCR-RFLP), allele-specific PCR, PCR-single stranded conformational polymorphism (PCR-SSCP) and sequence-based typing have been used in this field. Recently, a pyrosequencing technique was introduced into clinical laboratories. This study evaluated the possibility of applying pyrosequencing to ABO genotyping. METHODS: A total of 36 samples, which had previously been analyzed by PCR-RFLP and serological method in the Blood Genetics Clinic of Seoul National University Hospital between August 2001 and September 2004 and shown to have the A/A, A/B, A/O, B/B, B/O, O/O, cis-AB/O, cis-AB/A, or cis-AB/B genotypes, were analyzed by pyrosequencing analysis. Briefly, two PCR reactions were carried out separately for one region including nucleotide 261, and for another region including nucleotides 796 and 803. Pyrosequencing was then performed, and the pyrograms were interpreted using an automated interpretation program from the manufacturer and by researchers independently to determine the nucleotides 261, 796 and 803 for ABO genotyping. RESULTS: The ABO genotypes from pyrosequencing and the interpretation of the pyrograms according to the researcher on 36 samples were in complete concordance with the results obtained by PCR-RFLP. The ABO genotypes from the automated interpretation program showed an error in one out of total 108 SNP (single nucleotide polymorphism) analyses (eRROR RATE=0.9%) OF 36 SAMPLES. CONCLUSION: ABO genotyping for A, B, O, cis-AB alleles by pyrosequencing of nucleotides 261, 796 and 803 was relatively simple and accurate and could be an another field we can use in clinical laboratories.
Alleles ; Genetics ; Genotype ; Nucleotides ; Pathology, Molecular ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Seoul

BACKGROUND: The aim of this study was to evaluate the sensitivity of a clinicians' self-report method for the detection of nosocomial infections (NIs) in comparison with a total surveillance method in a neonatal intensive care unit (NICU). METHODS: Two surveillance methods were concurrently performed in the NICU of a university hospital during 5 months in 2003. Clinicians' self-report surveillance (CSRS) was based on the retrospective verification of monthly reports of positive bacteriologic results by NICU clinicians. Total surveillance (TS) was done prospectively by an infection control nurse based on chart review and laboratory data. RESULTS: One hundred fifty nine patients accounting to 2759 patient-days were included in the study. Twenty-seven NIs among 26 patients were identified by TS. The sensitivity of CSRS compared to TS was 14.8% (4 of 27 NIs). The specificity was 98.5% (131 of 133 non-NIs). Kappa measures of agreement were -0.309. CONCLUSIONS: Our results confirm that the retrospective review of charts and laboratory data by clinicians lacks sensitivity and agreement for the surveillance of nosocomial infections.
Cross Infection* ; Humans ; Infant, Newborn ; Infection Control ; Intensive Care, Neonatal* ; Prospective Studies ; Retrospective Studies ; Sensitivity and Specificity

The diagnosis of malignant melanoma of the choroid may occasionally be difficult in eyes with small sized tumor, extensive retinal detachment or opaque media. We experienced two cases of malignant melanoma of the choroid misdiagnosed as a retinal detachment. Since the first case of choroidal melanoma was hidden under a balloon of subretinal fluid, it had been mistakenly operated on two times to repair a rhegmatogenous retinal detachment at other hospital. In this case, drainage of subretinal fluid could potentially cause the spread of tumor cells to adjacent structures. The second case also was referred to our hospital under the diagnosis of retinal detachment at local clinic. In both cases an accurate diagnosis was made by indirect ophthalmoscopy, fluorescein angiography, ultrasonography, and computerized tomography of the orbit. Enucleations were performed carefully in both cases.
Choroid* ; Diagnosis ; Drainage ; Fluorescein Angiography ; Melanoma* ; Ophthalmoscopy ; Orbit ; Retinal Detachment ; Retinaldehyde* ; Subretinal Fluid ; Ultrasonography

No abstract available.
Humans ; Prothrombin Time* ; Prothrombin*

BACKGROUND AND OBJECTIVE: T cells play a pivotal role in initiating and orchestrating bronchial inflammation in asthma. However, little is known about changes in T cell subset in the airways. Our objective was to study whether the proportion of CD4+ or CD8+ T cells in the bronchoa1veolar lavage fluid (BALF) of bronchial asthma is different from normal subjects, and whether it is associated with clinical characteristics. METHODS: We examined the percentage of CD4+ and CD8+ cells in the BALF of 37 patients with bronchial asthma and 14 normal controls by flow cytometry. Bronchial asthma was classified as mild, moderate and severe according to bronchial hyperresponsiveness. Skin prick test and pulmonary function tests were performed. RESULTS: The percentage of CD4+ cells in BALF did not differ between asthmatics and controls, however, the percentage of CD8+ cells was significantly higher in asthmatics than contro1s, In asthmatics, the percentage of CD4+ cells and CD8+ cells did not differ between atopic and nonatopic asthmatics. The percentage of CD8+ cells in addition to CD4+ cells was correlated with the percentage of eosinophils in BALF, and the percentage of CD8+ cells also showed negative correlation with FEV, and FEF25-75% CONCLUSION: These results suggest that CD8+ cells as well as CD4+ cells are associated with airway inflammation in bronchial asthma.
Asthma* ; Eosinophils ; Flow Cytometry ; Humans ; Inflammation ; Respiratory Function Tests ; Skin ; T-Lymphocytes ; Therapeutic Irrigation

We present a case of Aspergillus septic hip arthritis in an immunocompetent patient with undiagnosed recurrent pulmonary aspergillosis who underwent arthroscopic surgery. Biopsy specimens of synovium revealed fungal hyphae, confirming Aspergillus infection. Aspergillus septic hip arthritis can occur in immunocompetent patients, and arthroscopy can be a noninvasive surgical option in these cases.
Arthritis ; Arthritis, Infectious* ; Arthroscopy ; Aspergillus* ; Biopsy ; Female* ; Hip* ; Humans ; Hyphae ; Pulmonary Aspergillosis* ; Synovial Membrane