A 14-year-old female South American sea lion (Otaria byronia) with persistent vaginal secretion and chronic hemorrhagic diarrhea was encountered. During postmortem examination, the uterus was found to resemble a balloon with mucosal congestion and was filled with grayish milky material. The ovaries also had abnormal features, including necrotic surface lesions and multiple whitish foci in the cut section. Hemorrhages and ulcerated changes due to toxemia were observed in other organs, including the liver, spleen, lung, intestines, and lymph nodes. Microscopically, the left ovary contained interlacing fascicles of fibroblast-like cells with blunt-end nuclei showing cytoplasmic positive immunoreactivity against alpha-smooth muscle actin and desmin. The right ovary contained cells with round to cigar-shaped nuclei showing cytoplasmic positive immunoreactivity against vimentin. In conclusion, based on classification of bilateral ovarian tumors as a leiomyoma in the left region and a fibroma in the right region, this sea lion was diagnosed with chronic closed pyometra.
Actins ; Autopsy ; Cytoplasm ; Desmin ; Diarrhea ; Estrogens, Conjugated (USP) ; Female ; Fibroma ; Hemorrhage ; Humans ; Intestines ; Leiomyoma ; Liver ; Lung ; Lymph Nodes ; Muscles ; Ovary ; Pyometra ; Sea Lions ; Spleen ; Toxemia ; Ulcer ; Uterus ; Vimentin

OBJECTIVETo investigate the infection of HEV in Quzhou area of Zhejiang Province.

METHODSAll sera from blood donors in the central blood bank of Quzhou from April 2006 to April 2007 were used. Anti-HEV IgG and anti-HEV IgM were measured by EIA. RT-PCR was also performed to the samples with positive anti-HEV IgM. Genotype and sequence homology were analyzed after sequencing.

RESULTSThe positive ratio of anti-HEV IgG was 40.60%, in which the male infection ratio was higher than the female significantly (43.09% VS 36.09%; chi2=22.6; P < 0.01). The infection ratio was increased with age. The positive ratio of anti-HEV IgM was 0.43%. The positive ratio of anti-HEV IgG and the titers of antibody were higher in the inferior clinical infectors with positive anti-HEV IgM than the negative ones (P < 0.05). Two samples were positive in HEV PCR among 21 samples with positive anti-HEV IgM. The toxemia ratio was 0.4% of all the donors. And the genotype of the two samples with toxemia were both HEV-IV.

CONCLUSIONThe HEV infection was correlation with age and sex significantly and the infection occurred in the adults mainly in Quzhou area. HEV toxemia was not infrequency in the blood donors.

Adolescent ; Adult ; Age Factors ; Antibodies, Viral ; analysis ; immunology ; Blood Donors ; China ; epidemiology ; Female ; Genotype ; Hepatitis E ; complications ; epidemiology ; immunology ; virology ; Hepatitis E virus ; genetics ; immunology ; Humans ; Immunoglobulin G ; analysis ; immunology ; Immunoglobulin M ; analysis ; immunology ; Male ; Middle Aged ; Sequence Analysis, DNA ; Sequence Homology ; Sex Factors ; Toxemia ; complications ; epidemiology ; virology

OBJECTIVE: This study was performed to know whether toxemia occurred more frequently in pregnancy which is achieved despite of azoospermia or severe oligospermia. METHODS: We selected 31 women who underwent surgical sperm aspiration and ICSI at Seoul National University Hospital (SNUH) from 1995 to 2001 and pregnancy continued over 20 gestational age as study group. And as a comparison group, 19 women who underwent ICSI at SNUH from 1995 to 2001 with no semen analysis abnormality and pregnancy continued over 20 gestational age were selected. The incidence of toxemia in both groups was observed. RESULTS: There were no differences in the incidence of gestational hypertension and preeclampsia between groups (RR=3.46, 95%CI 0.37-32.18) (RR=0.91, 95%CI 0.14-6.02). CONCLUSION: No association was observed between preconceptional sperm exposure to female genital tract and the incidence of toxemia.
Azoospermia ; Female* ; Gestational Age ; Humans ; Hypertension, Pregnancy-Induced ; Incidence ; Male ; Oligospermia ; Pre-Eclampsia ; Pregnancy* ; Semen Analysis ; Seoul ; Sperm Injections, Intracytoplasmic ; Sperm Retrieval ; Spermatozoa* ; Toxemia

BACKGROUND: Serotonin is found in the blood of the umbilical cord at birth in concentrations sufficiently high to affect vascular tone. Serotonin has been suggested to be involved in the pathogenesis of preeclampsia. Magnesium sulfate (MgSO4) is used to treat convulsions and hypertension in patients with preeclamptic toxemia. Bupivacaine is used in the epidural anesthesia for a cesarean section. The effects of magnesium and bupivacaine on serotonin-induced vasocontraction in a human umbilical artery was investigated. METHODS: Experiments were performed on 52 human umbilical arteries. The rings were suspended in an organ bath to record isometric mechanical activity. The concentration-contraction responses to bupivacaine, magnesium and serotonin were measured respectively. Vessels were pretreated with bupivacaine (10(-5) M) or magnesium (2 mM or 6 mM), and then serotonin (10(-9) M - 10(-6) M) was added cumulatively. Data analysis was assessed by an unpaired t test, one-way ANOVA and a Kruskal-Wallis test. RESULTS: Bupivacaine induced a contraction of umbilical arterial rings, and showed a maximal contraction (51.8 +/- 6.1%) at a concentration of 43nM. Magnesium induced relaxation of the umbilical artery in a concentration dependent manner. Pretreatment with bupivacaine (10(-5) M) potentiated significantly the concentration response to serotonin (P < 0.05). Pretreatment with MgSO4 (2 mM or 6 mM) significantly suppressed the contractile response to serotonin (P < 0.05). CONCLUSIONS: Bupivacaine, magnesium and serotonin are vasoactive on human umbilical arteries. Magnesium exerts a strong relaxant effect on serotonin induced vasocontraction in the human umbilical artery. Potentiation of serotonin induced vasoconstriction by bupivacaine may play a significant role in the reduction of umbilicoplacental blood flow.
Anesthesia, Epidural ; Baths ; Bupivacaine* ; Cesarean Section ; Female ; Humans* ; Hypertension ; Magnesium Sulfate ; Magnesium* ; Parturition ; Pre-Eclampsia ; Pregnancy ; Relaxation ; Seizures ; Serotonin ; Statistics as Topic ; Toxemia ; Umbilical Arteries* ; Umbilical Cord ; Vasoconstriction

OBJECTIVE: Hematologic abnormalities in toxemia mothers and their babies have been documented. The purpose of this study was to explore the hematologic findings in mothers with toxemia and postnatal hematologic findings in their babies. The relationship of hematologic findings between toxemia mothers before delivery and their babies immediately after birth was also examined. METHODS: Forty-six pairs of singleton toxemia mothers and their babies born by C-section with 28 to 35 weeks of gestation from Jan. 1995 to Dec. 1999 were enrolled. Fifty pairs of singleton normotensive mothers and their babies with the same gestational period and delivery method were matched for control group. Blood samples of mothers were performed before delivery, and those of their babies, were done immediately after birth, day 3 and 7 of life. Hemoglobin(Hb) concentration, total white blood cell(WBC) count, absolute neutrophil count(ANC), and platelet count were examined. RESULTS: Toxemia mothers have significantly lower platelet count compared with controls(191,000+/-83,200/mm3 vs. 252,000+/-92,700/mm3, p<0.05). There were no difference between both groups in Hb, WBC and ANC. On the first day of life, Hb was significantly higher(16.97+/-2.36g/dL vs 14.32+/-1.5g/dL, p<0.05), but WBC, ANC and platelet count were significantly lower in babies born to toxemia mothers than those of control group(p<0.05 for all). In babies born to toxemia mothers, Hb was significantly decreased until the seventh day of life(16.97g/dL, 15.48g/dL, 14.61g/dL, p<0.05), however, WBC and platelet count were significantly decreased until the third day of life and then incresed until the seventh day of life(11,832/mm3, 8,334/mm3, 10,104/mm3 for WBC, p<0.05, and 152,220/mm3, 144,720/mm3, 214,090/mm3 for platelet, p<0.05, respectively). CONCLUSION: Hemoglobin concentration was significantly higher, whereas WBC, ANC and platelet were significantly lower in babies of toxemia mothers than those of control group. In babies born to toxemia mothers, Hb was significantly decreased until the seventh day of life, however, WBC and platelet count were significantly decresed until the third day and then increased until the seventh day of life. There was no relationship between hematologic findings of toxemia mothers and their babies.
Blood Platelets ; Humans ; Mothers* ; Neutrophils ; Parturition ; Platelet Count ; Pregnancy ; Toxemia*

BACKGROUND: Pro-inflammatory cytokines, such as tumor necrosis factor(TNF)-alpha and interleukin (IL)-1, have been incriminated in the pathogenesis of septic shock in animals and humans. IL-10 reduces the release of pro-inflammatory cytokines, nitric oxide and reactive oxygen species. IL-10 prevents endotoxin-induced toxicity. OBJECTIVE: The aim of this study was to investigate the relation between IL-10 and TNF-alpha in toxemic mice according to concentrations of V. vulnificus cytolysin. METHODS: First, after administration of V.vulnificus cytolysin(2, 4, 6, 8, 10 hemolytic units; HU) and physiologic saline through a mouse tail vein, we obtained blood samples from the heart at 60 minutes which was a peak time of IL-10 and TNF-alpha release. We measured serum concentration of circulating TNF-alpha and IL-10 using commercially available enzyme-linked immunosorbent assay methods. Second, after administration of 1,000U recombinant mouse IL-10 through a mouse tail vein 30 min before infusion of the lethal dose(8HU) of V. vulnificus cytolysin. We obtained blood samples from the heart at 60 minutes and measured serum concentration of circulating TNF-alpha level. RESULTS: Both IL-10 and TNF-alpha levels were significantly correlated with V. vulnificus cytolysin concentration(P=0.002). TNF-alpha levels were 76.9+/-9.5 pg/ml in 2HU, 315.8+/-39.8 pg/ml in 4HU, 426.1+/-27.9 pg/ml in 6HU, 931.3+/-22.3 pg/ml in 8HU, 1825.2+/-18.8 pg/ml in 10HU and 23.6+/-5.1 pg/ml in physiologic saline. IL-10 levels were 80.2+/-21.5 pg/ml in 2HU, 244.4+/-35.4 pg/ml in 4HU, 382.2+/-22.6 pg/ml in 6HU, 740.1+/-33.0 pg/ml in 8HU, 997.3+/-16.8 pg/ml in 10HU and 35.8+/-15.0 pg/ml in physiologic saline. After administration of 1,000U recombinant mouse IL-10, comparing to control group(931.3+/-22.3 pg/ml), TNF-alpha level was reduced to 307.2+/-23.9 pg/ml(P=0.003). CONCLUSION: IL-10 has an inhibitory effect on the production of TNF-alpha although it is released together with TNF-alpha in toxemic mice. IL-10 blood levels are directly related to the severity of toxemia. We conclude that IL-10 is a prognostic factor for the development of sepsis and might be used for the treatment of sepsis.
Animals ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Heart ; Humans ; Interleukin-10* ; Interleukins* ; Mice ; Necrosis ; Nitric Oxide ; Perforin* ; Reactive Oxygen Species ; Sepsis ; Shock, Septic ; Toxemia* ; Tumor Necrosis Factor-alpha* ; Veins ; Vibrio vulnificus* ; Vibrio*

PURPOSE: To study the relationship between the damage of retinal pigment epithelum and the lesion of choroidal vessels in various types of the serous retinal detachment(SRD) on fluorescein angiography(FAG) and indocyanine green angiography(ICGA). METHODS: FAG and ICGA were performed 81 eyes with various types of serous retinal detachment. The series comprised central serous chorioretinopathy(CSC, 63 eyes), toxemia of pregnancy(8 eyes), and Harada's disease(10 eyes). RESULTS: All the eyes showed dye leakage through the retinal pigment epithelium(RPE) by FAG. Of sixty-three eyes with CSC, sixty eyes showed choroidal tissue staining in late phase on ICGA. Delayed filling of ICG dye in early phase was present around the site of leakage on FAG in 48 eyes with CSC. In toxemia of pregnancy and Harada's disease, all the cases showed delayed choroidal circulation and leakage from choroidal vessels on ICGA. As a common feature, ICGA showed choroidal hypoperfusion or delayed choroidal circulation and choroidal vascular hyperpermeability in the three types of SRD. CONCLUSIONS: The authors presume that they might contribute to the damage of RPE. The pathogenesis of SRD may be related to the hypothesis fact that choroidal vascular hyperpermeability probably moves fluid into the subretinal space from the choroid.
Central Serous Chorioretinopathy ; Choroid* ; Fluorescein ; Indocyanine Green ; Pre-Eclampsia ; Retinal Detachment* ; Retinaldehyde* ; Toxemia

Pheochromocytoma is originated from chromaffin cells of sympathetic nervous system and clinical symptoms are caused by catecholamine released from tumor. In typical cases, periodic attacks of hypertension, palpitation, headache, and sweating are main symptoms. But, the diagnosis of pheochromocytoma is sometimes difficult since its clinical presentation is quite variable. We evaluated a 25-year-old woman who was admitted because of left flank pain and seizure. She had a history of hemoptysis and toxemia. During the hospitalization, she experienced generalized seizure once more. The clinical diagnosis of pheochromocytoma was proven by highly elevated urinary catecholamines and confirmed histologically after operation. We think it is the first case report of pheochromocytoma manifested by seizure in korea, so we report this case with literature review.
Adult ; Catecholamines ; Chromaffin Cells ; Diagnosis ; Female ; Flank Pain ; Headache ; Hemoptysis ; Hospitalization ; Humans ; Hypertension ; Korea ; Pheochromocytoma* ; Seizures* ; Sweat ; Sweating ; Sympathetic Nervous System ; Toxemia

BACKGROUND: Vibrio(V.) vulnificus is a pathogenic, marine, halophilic, gram-negative bacillus which causes fulminant septic shock. Shock can be complicated by occurrence of hypoglycemia, which is caused by an unbalance between glucose production and consumption. Metabolic changes, especially glucose metabolism, in septic shock caused by V. vulnificus are not well clarified yet. OBJECTIVE: Our purpose was to investigate the changes of blood sugar level after intravenous administration of V. vulnificus cytolysin which is known to be a major virulent factor for elucidating pathogenesis of septic shock. METHODS: After administration of the lethal dose(8 hemolytic units)of V. vulnificus cytolysin through mouse tail vein in non-fasting and fasting group, we obtained blood samples from heart according to time courses of every thirty minutes. We measured whole blood glucose level using commercially available blood glucose meter. RESULTS: The level of blood glucose increased until 90 minutes, began to decrease at 120 minutes, and fell to baseline at 360 minutes in non-fasting mouse group. In fasting group, although elevation of blood glucose level was not observed in early stage of toxemia, hypoglycemia was nearly concordant with non-fasting group in late stage of toxemia. CONCLUSION: Hypoglycemia should be checked in patients with V. vulnificus sepsis. Failure to recognize and treat the hypoglycemia may contribute to the prognosis of these patients.
Administration, Intravenous ; Animals ; Bacillus ; Blood Glucose* ; Fasting ; Glucose ; Heart ; Humans ; Hypoglycemia ; Metabolism ; Mice* ; Perforin* ; Prognosis ; Sepsis ; Shock ; Shock, Septic ; Toxemia ; Veins ; Vibrio vulnificus* ; Vibrio*

OBJECTIVE: To observe the prognostic value of brainstem auditory evoked potentials (BAEP) for prediction of cerebral palsy (CP) in the high-risk neonates. METHOD: Eighty-one high-risk neonates were subjected to take the history of illness, neurological examination, developmental assessment, BAEP study within one month after birth. They had been checked for detection and management of the CP in period of 12 to 56 months after birth. Associating factors were observed about their gestational age at birth, 1-minute Apgar score, history of asphyxia and/or intubation, and hyperbilirubinemia and/or exchange transfusion. RESULTS: Abnormal BAEP findings were seen in 38 of 81 (46.9%) high-risk neonates and 6 of 81 (7.4%) were diagnosed as a CP. Five of 6 CPs and 42 of 75 non-CPs had been abnormal in BAEP study. Neonatal BAEP study showed 83.3% sensitivity, 44% specificity, 98.4% false positive and 2.9% false negative in predicting CP. Asphyxia showed high correlation with abnormality of BAEP and CP (p<0.01). Gestational age, low birth weight, toxemia, germinal matrix hemorrhage (GMH) grade II and intubation were correlated with CP (p<0.05) but not with the abnormality of BAEP. CONCLUSION: It is suggested that BAEP study of high-risk neonate is useful in prediction of CP because of low false negative and high sensitivity.
Apgar Score ; Asphyxia ; Brain Stem* ; Cerebral Palsy ; Evoked Potentials, Auditory, Brain Stem* ; Gestational Age ; Hemorrhage ; Humans ; Hyperbilirubinemia ; Infant, Low Birth Weight ; Infant, Newborn* ; Intubation ; Neurologic Examination ; Parturition ; Sensitivity and Specificity ; Toxemia