It has been 50 years since the discovery of thyrotropin receptor autoantibody (TRAb). Advances in the knowledge of thyrotropin receptor ( TSHR) structure and function, combined with the elucidation of TSHR signaling and TSHR-autoantibody interaction have greatly facilitated our understanding of TRAb and their clinical applications. Measurement of TRAb activity plays an important role in the diagnosis of Graves' disease ( GD) and Graves' opthalmopathy. It has also been well recognized that TRAb is an effective predictor of GD relapse or remission after antithyroid drug and radioactive iodine treatment. TRAb test is of particular help in pregnant women and lactating mothers with recent iodine load, where radioactive iodine or technetium tests are contraindicated. In addition, it is useful in the diagnosis and differential diagnosis of fetal and neonatal hyperthyroidism as well as some rare forms of thyrotoxicosis in clinical practice. Accumulating evidence also indicates the possible correlation between thyroid cancer occurring in GD patients with positive TRAb and adverse outcomes. However, further innovation and standardization of TRAb tests are required to help pave the way for clinical applications.

Cell-Derived Microparticles ; Disease Progression ; Humans ; Leukemia ; pathology

Objective To determine the effect of video-assisted retroperitoneal debridement in treatment of infected necrotizing pancreatitis.Methods The clinical data of patients with infected necrotizing pancreatitis was retrospectively analyzed.Heart rate,mean arterial pressure,body temperature and indicators for inflammatory response including level of WBC,CRP and procalcitonin before and after VARD treatment were compared.Results After VARD treatment,the heart rate (preoperative vs.postoperative 8 h,108 ± 22/min vs.95 ± 17/min),mean arterial pressure (preoperative vs.postoperative 12 h,66 ± 18 mmHg vs.79 ± 19 mmHg) and body temperature(preoperative vs.postoperative 24 h,38.3 ± 1.7 ℃ vs.37.3 ± 1.3 ℃) improved significantly (all P ＜ 0.05).Level of WBC [preoperative vs.postoperative 48 h,(13.8 ±6.6) × 109/L vs.(10.1 ±5.2) × 109/L],CRP(preoperative vs.postoperative 48 h,145 ± 88 mg/L vs.95 ± 4 mg/L) and procalcitonin (preoperative vs.postoperative 48 h,1.4 ± 0.7 μg/L vs.0.9 ± 0.4 μg/L) also decreased significantly(all P ＜ 0.05).Conclusions VARD therapy can significantly reduce systemic inflammation and improve the general condition of infected necrotizing pancreatitis patients.

Eight patients with primary non-transitional cell carcinoma of the bladder during the period from January 1978 to December 1982 were reviewed, and following results ware obtained. 1. Primary non-transitional bladder carcinomas were 8 cases (11%) of 52 bladder carcinomas. 2. The age distribution was from 28 years to 72 years. Male to female ratio was 5 to 3. 3. Hematuria was presented in all cases, dysuria in 2 cases, frequency in 2 cases, lower abdominal pain in 2 cases. 4. Histopathological findings showed squamous cell carcinoma in 3 cases, adenocarcinoma in 3 cases, undifferentiated carcinoma in 1 cases, carcinosarcoma in 1 cases. According to 2Iewett classification, the degree of invasion was stage C in 5 cases, stage B2 in 1 case, stage B1 in 1 case and stage A in 1 case. 5. Five cases arised on lateral wall, 3 cases on dome, 1 case on posterior wall and 1 case on trigone. Four cases were nodular in type. 2 cases were papillary and 2 cases were smooth surface round pedunculated mass. Five cases were single and 3 cases were multiple. 6. 1) In stage C of adenocarcinoma, partial cystectomy was made in 1 case, radical cystectomy with ureteroileocutaneostomy in 1 case, partial cystectomy with postoperative irradiation in 1 case. In former two case, tumor metastasized to periaortic lymphnodes and lumber vertebrae after 6 months post-operatively. 2) Partial cystectomy was performed in 1 case of carcinosarcoma in stage A, tumor recurrence or metastasis did not occur after 1 year post-operatively. 3) In 2 cases of squamous cell carcinoma of stage C, preoperative irradiation with total cystectomy and ureterocutaneostomy was made in 1 case, total cystectomy with ureterocutaneostomy in 1 case and partial cystectomy with 5-FU instillation into the bladder was performed in 1 case of stage B2. In all cases, we couldn't follow up post-operatively. 4) In stage B1 of undifferentiated carcinoma, radical cystectomy with ureteroileocutaneostomy was performed. This case also couldn't be followed up.
Abdominal Pain ; Adenocarcinoma ; Age Distribution ; Carcinoma ; Carcinoma, Squamous Cell ; Carcinosarcoma ; Classification ; Cystectomy ; Dysuria ; Female ; Fluorouracil ; Follow-Up Studies ; Hematuria ; Humans ; Male ; Neoplasm Metastasis ; Recurrence ; Spine ; Urinary Bladder*

Evidence of antigenicity of testis and semen has been presented since Landsteiner (1899), Metchinikoff (1900) and Metalnikoff (1900) first demonstrated the induction of a spermatoxic antibody in animals sensitized with testicular homogenates or semen. Interest in the field of male accessory sex gland began longtime ago, when the first cross-reaction between extracts of prostate, seminal plasma were demonstrated. Saline extracts of prostatic secretion from bulls, tested by double agar diffusion technique showed four antigens common to serum proteins and spermatozoa. The seminal vesicle have been found to have three to five antigens, also with common reactivity to spermatozoa. Attempts have been made to induce cross-immunologic damage in the testes by repeated immunization of mice with epididymal extracts (free of sperm) plus adjuvant and it was claimed that spermatogenesis was adversely effected and fertility of females was markedify reduced following mating with immunized male (Shethye and Rao, 1968; Kim and Kim, 1982). Rabit antiserum produced against the tissue protein of rat epididymis and seminal vesicle was capable of immobilizing and agfflutinating the sperm of both animals and the rabbit antiserum against complex antigen of epididymal tissue protein and seminal vesicle tissue protein of rat was most potent on sperm immobilization and agglutination of both animals (Cha and Kim, 1975). The purpose of this study is to observe the effect of rabbit anti-rat epididymal serum on epididymis and spermatogenesis in rat. The results were as follow; 1. The intraluminalspermatozoa of epididymis were decreased in number but immature sperm cells were much more noted than normal control group. The interspaces of epididymal ducts were widened and infiltrated with mononuclear cells and congestion in some places. There was no definite degenerative changes on epididymal epithelium. 2. Spermatogenesis was mildly to moderately impaired in the experimental group whereasit was unaffected in the control group. Degeneration and exfoliation were found in the germinal cells of seminiferous tubules. Intraluminal Spermatozoa of seminiferous tubules were decreased in number.
Agar ; Agglutination ; Animals ; Blood Proteins ; Diffusion ; Epididymis* ; Epithelium ; Estrogens, Conjugated (USP) ; Female ; Fertility ; Humans ; Immobilization ; Immunization ; Male ; Mice ; Prostate ; Rats* ; Semen ; Seminal Vesicles ; Seminiferous Tubules ; Spermatogenesis ; Spermatozoa ; Testis

Objective Rheumatoid arthritis (RA) is a typical type Ⅲ hypersensitivity with a large number of immune complexes (IC) and complement deposits in the synovial tissue , but its specific pathogenesis is not yet clear.This article was to explore the expression of the antigenic profile of serum ICs in RA.Methods ICs were isolated from the serum of 55 patients with RA (41 cases of anti-CCP antibody [+] and 14 cases of anti-CCP antibody [-]), 41 with systemic lupus erythematosus (SLE), and another 41 healthy controls by polyethylene glycol (PEG) precipitation, separated by immunoprecipitation, digested with trypsin in gel, and then subjected to mass spectrometry for identification.The levels of total proteins were compared among different groups using Vennny 2.1.0.The protein expression was considered to be up-regulated when the total protein level of the RA group was >2 times and down-regulated when it was <0.5 times that of the control.Further functional analysis was performed on the differential proteins in RA using the STRING software.Results Totally, 277 proteins were identified in the serum ICs of the RA patients, including 162 in the anti-CCP (+) and 248 in the anti-CCP (-) RA group.Compared with the SLE and healthy control groups, only 129 proteins were found in the RA patients, including 38 in the anti-CCP (+), 109 in the anti-CCP (-) RA group, and 18 in both the two groups.Among the proteins identified in the RA patients and healthy controls, 2 and 11 were up-regulated while 17 and 21 down-regulated in the anti-CCP (+) and anti-CCP (-) RA group, respectively.Conclusion More differentially expressed proteins were identified in the anti-CCP (-) than in the anti-CCP (+) RA patients.The identification of differentially expressed proteins provides a new idea and direction for the investigation of the pathogenesis and new biomarkers of RA.

Precocious puberty is the onset of pubertal development at an earlier age than is expected based upon established normal standards. The cause of precocious puberty may range from a variant of normal development (eg. premature adrenarche or isolated premature thelarche) to pathologic conditions with significant risk of morbidity and even death (eg. malignant germ-cell tumor or astrocytoma). A case of an 18 month old female presenting with vaginal bleeding following a previously noted breast enlargement was described. Initial assessment based on the patient's history and physical examination is suggestive of precocious puberty. Hormonal studies indicated normal levels of FSH and LH, with an elevation in estradiol. Radiographic analysis showed a normal bone age. Cranial MRI revealed no abnormal masses. Sonographic evaluation showed bilateral cystic masses in the ovaries. A diagnosis of peripheral precocious puberty associated with functional ovarian cysts was made, and the patient was monitored for progression of pubertal development.

Human ; Female ; Infant ; Familial Testotoxicosis ; Puberty, Precocious ; Estradiol ; Adrenarche ; Ovarian Cysts ; Gigantomastia ; Breast ; Hypertrophy ; Astrocytoma ; Neoplasms, Germ Cell And Embryonal ; Uterine Hemorrhage

Purpose: The electronic frailty index (eFI), which is derived from electronic health records, has been recommended as screening tool for frailty due to its accessibility and ease of use. The objective of this systematic review was to identify the prevalence of frailty assessed by the eFI and its influence on health outcomes in older adults with chronic diseases. Methods: We searched PubMed, Embase, Web of Science, CINAHL, SCOPUS, Cochrane, Google search, and nursing journals in Korean from January 2016 to December 2022. Results: Twelve studies were analyzed. The eFI score, based on routine clinical data, was associated with adverse health outcomes. The most frequent outcome studied was mortality, and the eFI was associated with increased mortality in nine studies. Other outcomes studied included hospitalization, length of stay, readmission, and institutionalization in relation to hospital care usage, and cardiovascular events, stroke, GI bleeding, falls, and instrumental activities of daily life as health conditions. Conclusion Early identification of frailty in older adults with chronic diseases can decrease the burden of disease and adverse health outcomes. The eFI has a good discriminative capacity to identify frail older adults with chronic diseases.

Objective To assess the value of primary resection and anastomosis without intraoperative irrigation in the patients with obstructive left colonic cancer. Method Between January 2000 and January 2008, 93patients underwent primary resection and anastomosis for colonic cancers were analyzed retrospectively. Primary resection and anastomosis without intraoperative colonic irrigation (decompression by manual defecation) was performed in 43 patients with obstructive left colonic caner and traditional left-sided colectomy in 50 cases without obstruction. Both groups of patients were comparable in terms of gender, nutritional status, underlaying disease, tumor location and stage, etc ( P = 0.83,0.13,0.29,0.51,0.38). The average age of the patients with colonic obstruction was significant older than that of the cases without obstruction (61.2 ± 8.6 vs. 58.1 ±7.8, P =0.010).The operative results were compared between patients with obstructive colonic cancer and cases without obstruction.Results The mean hospital stay of the primary anastomosis group and traditional left-sided colectomy group were (16.6±7.8) d and (12.4±5.4) d respectively, and the former was significant longer than the latter (P =0.002). The costs of hospitalization in the two groups were (50192.8 ± 39727.4) RMB and (46489.3 ±29543.1)RMB respectively (P = 0.04) . The morbidity and mortality in the two groups were 25.6% (11/43) vs. 18%(9/50) (P =0.375) and 2.3% (1/43) vs. 2.0% (1/50) (P =0.714) respectively, and there were no significant difference between the two groups. Conclusions Primary resection and anastomosis without intraoperative colonic irrigation (decompression by manual defecation) compares favorably with traditional left-sided colectomy in safety and efficiency for left colonic cancer with obstruction.

Objective To assess the value of primary resection and anastomosis with intraoperative colonic defecation in the patients with obstructive left colonic cancer. Methods From January 2000 to January 2008, 39 patients undergoing emergency laparotomy for left colonic cancers with complete obstruction were analyzed retrospectively. Results The patients were 25 males and 14 females, with a median age of 68.5 years (range: 57～78 years). The primary tumors were located at splenic flexure (3/7.7%), descending colon (8/20.5%), sigmoid colon (15/38.5%), boundary of sigmoid colon and rectum (8/20.5%), and superior segment of rectum (5/12.8%). Primary resection and anastomosis with intraoperative colonic de-fection were performed in 18 patients with left hemicolectomy, 13 patients with sigmoid colectomy and 8 pa-tients with anterior resection. Early complications included wound infection in 4 patients (wound disruption in 1 patient) and pulmonary infection in 5 patients. One patient complicated with anastomotic leakage and intra-abdominal abscess died of tumor metastasis after reoperation. Another one died of respiratory failure secondary to pulmonary infection. Morbidity and mortality was 25.6% and 5.1% respectively. Conclusion Primary resection with intraoperative colonic defecation can be applied to patients with malignant colonic complete obstruction with good operative results.