Analysis of the STR myelin basic protein locus in Koreans

Allele und genotype frequencies and the mutation rate of a short tandem repeat locus, the myelin basic protein (MBP) gene, were studied in 973 unrelated Koreans. The alleles were distributed in two discrete regions, one in a high molecular weight region (A) above 190 bp and the other in a low molecular weight region (B) below 150 bp. In a heterozygote, two alleles were found in each region. In region A 13 alleles were found and in region B 7 alleles. Most alleles showed a difference of 4 bp, but three interalleles were found in region A. Allele frequencies in Koreans differed from those reported for Germans and Portuguese. Sets of alleles, one from each region, were linked and transmitted to the offspring. A total of 36 haplotypes and 148 genotypes was identified. In 763 gametes of 550 families, whose parent-child relationship was confirmed using other serological and DNA systems, all alleles were transmitted in a Mendelian fashion, and no mutations were observed. The polymorphism information content (PIC) in Koreans was calculated as 0.833 for region A and 0.718 for region B. The power of discrimination (PD) was 0.959 for region A and 0.901 for region B. No significant deviation from Hardy-Weinberg equilibrium could be observed for this system.

Allele frequency and its forensic application of STR Y27 in Korean males

The allele frequency and mutation rate in a Short Tandem Repeat locus, Y27 were studied in 247 unrelated Korean males using polymerase chain reaction followed by high-resolution polyacrylamide gel electrophoresis, a procedure called the amplification fragment length polymorphism technique. Six alleles were noted ranging from 190 bp to 210 bp. They existed as discrete bands with 4 bp discrepancy. Among which DY3(198 bp), DY4(202 bp) were common with the frequencies of 0.408, 0.356 respectively. Other alleles, DY1(190 bp, frequency 0.020), DY2(194 bp, frequency 0.121), DY5(206 bp, frequency 0.089), DY6(210 bp, frequency 0.004) were relatively uncommon. In a 78 subject father-son study with parenthood confirmed through other genetic studies, no case of mutation was noted. As the allele number was not as large as 6 and two alleles were dominant, the discrimination power in routine individual identification was thought to be low. But in selective cases such as father-son determination or sex determination, this locus could be a valuable genetic marker and we thought these results to be common for the Korean population. These results were also compared with that of other race.

Influence of examiner experience and gender on interrater reliability of KT-1000 arthrometer measurements

BACKGROUND AND PURPOSE

Measurements of the integrity of knee ligaments are used to diagnose injuries as well as to document the state of recovery. Many factors, such as gender and experience of the examiner, are capable of influencing the reliability of such measurements. The purpose of this study was to determine the effects on interrater reliability of measurements obtained using the KT-1000 arthrometer of experience, gender, and leg tested.

SUBJECTS

Two experienced examiners (1 male, 1 female) and two inexperienced examiners (1 male, 1 female) tested 22 subjects with unilateral anterior cruciate ligament (ACL) pathology.

METHODS

The leg with an ACL injury and the uninjured leg of each subject were evaluated by all four examiners within one test session using 67-N, 89-N, maximum manual, and active anterior drawer tests.

RESULTS

Greater anterior displacement values were found in the legs with ACL injury than in the uninjured legs. Reliability estimates, as assessed by intraclass correlation coefficients (2,k) and measurement error (SEM), suggest that therapist experience may be a more important factor influencing reliability than gender.

CONCLUSION AND DISCUSSION

Given the magnitude of the errors obtained for tests routinely conducted in the clinic using the KT-1000 arthrometer, we recommend that repeated measurements should be taken by the same examiners whenever possible. [Ballantyne BT, French AK, Heimsoth SL, et al. Influence of examiner experience and gender on interrater reliability of KT-1000 arthrometer measurements.

ELISA inhibition test using monoclonal antibody specific for Treponema pallidum as the serologic test for syphilis

Monoclonal antibodies (Mabs) specific for Treponema pallidum were produced using hybridoma technology. In this study an ELISA inhibition test based on competitive inhibition by antibodies from human test sera of the binding of the enzyme-labelled Mabs to T. pallidum was performed. Inhibition of the seroreactivity of Mabs was decreased according to the dilution of rabbit antiserum to T. pallidum. Seropositivity was found in 100% of secondary and early latent syphilis patients, 75% of primary syphilis patients, and 80% of late latent syphilis patients. The mean percentage inhibition was significantly higher in each syphilis group than in the controls, and statistically significant differences were shown between all the syphilis groups. VDRL and TPHA titers were correlated with the percentage inhibitions. Therefore the ELISA inhibition test using Mab specific for T. pallidum might well be a suitable tool as a new serologic test for syphilis.

Seroreversion of the serological tests for syphilis in the newborns born to treated syphilitic mothers

BACKGROUND

IgG antibodies from mothers adequately treated for syphilis can cross the placenta and appear in the sera of healthy newborns without infection. In such infants, a false diagnosis of congenital syphilis is often made. We have designed a retrospective survey to determine the time of seroreversion of the serological tests for syphilis (STS) in uninfected newborns born to mothers who were adequately treated for syphilis.

MATERIALS AND METHODS

Fifty two seropositive, untreated newborns born to 51 mothers treated for syphilis were studied. The newborns were followed at 1, 3, 6, 9, and 12 months of age until seroreversion was detected. The VDRL test was followed until 12 months in 12 of the 22 newborns who were positive at birth, the TPHA in 21 of the 46 newborns, and the FTA-ABS test in 22 of the 48 newborns.

RESULTS

In the first serological tests done within 1 month after birth, the VDRL was positive in 22 newborns (42%), the TPHA in 46 (88%), and FTA-ABS in 48 (92%). The VDRL seroreverted within 6 months after birth in 84%, and within 1 year in 100%. The TPHA test seroreverted in 95% within 1 year after birth. The FTA-ABS test seroreverted in 100% within 1 year after birth.

CONCLUSIONS

In most seropositive, untreated newborns born to treated mothers the VDRL became negative within 6 months after birth and the TPHA and FTA-ABS within 1 year. This result is consistent with current Centers for Disease Control (CDC) guidelines. However, although the CDC guidelines are adequate in general, we think that some revision is desirable concerning the IgM test and combination of the test results in order to rule out congenital syphilis in seropositive, nonsymptomatic newborns born to the treated mothers.

Detection of 17p loss in gastric carcinoma using polymerase chain reaction

BACKGROUND

The loss of heterozygosity (LOH) of 17p has been previously studied with conventional Southern blot-restriction fragment length polymorphism analysis, but the relatively low informativity was an obstacle to extensive analysis. To overcome this problem and to investigate the significance of 17p LOH in gastric carcinoma, we employed polymerase chain reaction and subsequent silver staining of DNA.

EXPERIMENTAL DESIGN

LOH of p53 gene and D17S5 locus on 17p was analyzed using polymerase reaction; the relationships between 17p LOH and conventional clinicopathologic parameters were evaluated.

RESULTS

The LOH of p53 gene and D17S5 was found in 36.5% (23 out of 63) and 63.3% (38 out of 60) informative cases, respectively. There was no significant correlation between LOH of these two loci, whereas the frequency of the D17S5 locus was significantly higher (p < 0.01), which suggested that there may be another putative tumor suppressor gene between the two loci or distal to D17S5. The LOH of p53 gene and D17S5 locus was not significantly associated with abnormal p53 expression, depth of invasion, histologic type of the tumor (Lauren's classification), or the status of lymph node metastasis.

CONCLUSIONS

The polymerase chain reaction and silver staining of DNA seemed to be a simple and excellent method for the evaluation of chromosomal allelic loss. The 17p LOH was frequently found in gastric carcinoma, but specific association with conventional clinicopathologic parameters was not found.

Detection of Treponema pallidum by polymerase chain reaction in the cerebrospinal fluid of syphilis patients

To find out if polymerase chain reaction could be used as a diagnostic tool for detecting neurosyphilis, we have applied the PCR for the detection of Treponema pallidum DNA in the cerebrospinal fluid (CSF) of syphilis patients. The results of the PCR of the CSF in 26 patients with at various stages of illness were compared with the results of other conventional tests used in the WHO criteria. T. pallidum was detected in the CSF of patients at all stages of syphilis, which indicates that they invade the central nervous system from the early stages of infection. However, the presence of T. pallidum in the CSF was not correlated with the results of other tests used in the WHO criteria, and its significance in the diagnosis of neurosyphilis should further be evaluated.

Analysis of antigenic characteristics of Rickettsia tsutsugamushi Boryong strain and antigenic heterogeneity of Rickettsia tsutsugamushi using monoclonal antibodies

Twenty-four monoclonal antibodies were produced by immunizing BALB/c mice with Rickettsia tsutsugamushi Boryong strain and used for the analysis of antigenic characteristics of R.tsutsugamushi Boryong strain and antigenic heterogeneity of R.tsutsugamushi by indirect immunofluorescent(IF) test. R. tsutsugamushi Kato, Karp, Gilliam, TA686, TA716, TA763, TC586, TH1817, and Boryong were used for the analysis of antigenic heterogeneity of R.tsutsugamushi. Five monoclonal antibodies were reactive with 27-kDa protein, four monoclonal antibodies were reactive with 47-kDa protein, and eight monoclonal antibodies were reactive with 56-kDa protein of R.tsutsugamushi Boryong strain. The reactive protein of seven monoclonal antibodies could not be identified by immunoblotting method. All monoclonal antibodies to 27-kDa protein and three monoclonal antibodies to 47-kDa protein, and five monoclonal antibodies to 56-kDa protein were reactive with three to eight strains among nine strains of R. tsutsugamushi tested. One monoclonal antibody reactive to 47-kDa protein(KI18) and two monoclonal antibodies reactive to 56-kDa protein(KI36, and KI37) reacted with all the strains of R. tsutsugamushi tested. Strain-specific monoclonal antibody(KI58) could be found among antibodies which were reactive with 56-kDa protein. There was no strain which showed same reactivity pattern to these 24 monoclonal antibodies among nine strains. From this results, it could be concluded that Boryong strain is antigenically different from other strains of R.tsutsugamushi and antigenic heterogeneity of R.tsutsugamushi is due to the antigenic diversity of several proteins of R. tsutsugamushi including 56-kDa protein.

A strong association between thyrotropin receptor-blocking antibody-positive atrophic autoimmune thyroiditis and HLA-DR8 and HLA-DQB1*0302 in Koreans

We investigated whether the associations between HLA alleles of patients with autoimmune hypothyroidism varied according to the presence or absence of TSH receptor-blocking antibody (TRBab). We analyzed the HLA-A, -B, -C, and -DR antigens by serotyping and the DQA1 and DQB1 genes using both enzymatic DNA amplification and sequence-specific oligonucleotide hybridizations. The patient population consisted of 47 Korean patients with atrophic autoimmune thyroiditis and 62 patients with goitrous autoimmune thyroiditis. The antigen frequency of HLA-DR8 was significantly increased in 23 atrophic autoimmune thyroiditis patients that were positive for TSH binding inhibitor immunoglobulin (TBII) compared to 136 controls [52% vs. 16%; chi 2 = 13.1; Pc (corrected P value) = 0.003]. This relative risk was 5.7; the etiological fraction was 0.43. HLA-DQB1*0302 was also increased in patients with TBII-positive atrophic autoimmune thyroiditis (24% vs. 7%; chi 2 = 11.2; Pc = 0.012; relative risk = 4.4; etiological fraction = 0.19). No specific DR antigens or DQB1 alleles were increased in either TBII-negative atrophic autoimmune thyroiditis or goitrous autoimmune thyroiditis. A significant decrease in the frequency of HLA-DR6 antigen was observed in both TBII-positive atrophic autoimmune thyroiditis (0% vs. 32%; chi 2 = 8.4; Pc = 0.03) and goitrous autoimmune thyroiditis (0% vs. 32%; chi 2 = 23.2; Pc < 0.001) patients. The frequency of the HLA-Cw1 antigen was significantly increased in all patient groups. We conclude that TRBab-positive atrophic autoimmune thyroiditis is immunogenetically different from both goitrous autoimmune thyroiditis and TRBab-negative atrophic autoimmune thyroiditis. It is possible that HLA-DR8 and/or DQB1*0302 may be related to the susceptibility genes involved in the production of TRBab in Koreans.

Scintigraphic diagnosis of syphilitic lesions in rabbits by radiolabelled monoclonal antibodies specific for Treponema pallidum

Immunoscintigraphy with radiolabelled monoclonal antibodies has been widely used to detect solid tumours. The purpose of this study was to investigate its potential for the specific localization of syphilitic lesions. F(ab')2 fragments were prepared from murine monoclonal antibodies against Treponema pallidum produced in our laboratory and labelled with 131I. Bilateral testicular infections were created in rabbits by inoculation with T. pallidum or Staphylococcus aureus. Seven to 10 days after inoculation, radiolabelled antibodies were injected intravenously. Serial gamma images were then taken 2 h after the injection and at 24 h intervals thereafter. Beginning as early as 2 h post-injection, the testicles could be visualized with either specific or non-specific antibodies. Gamma images in the monoclonal antibody-treated, T. pallidum-infected group persisted up to 48 h post-injection. Lesions were not discernible from background in the S. aureus-infected group injected with the monoclonal antibody and the S. aureus-infected and T. pallidum-infected groups injected with the polyclonal antibody at 24 h post-injection or later. Therefore, due to its ability to differentiate between specific and non-specific antibody-generated images from 24 h post-injection, immunoscintigraphy using monoclonal antibodies specific for T. pallidum may be employed as one of the methods to diagnose difficult cases of syphilitic internal organ involvement as well as syphilis infection in seronegative HIV-infected patients.

Relapsing syphilis

Although penicillin still remains highly effective for syphilis, concerns have been raised that current regimens may be inadequate for the treatment of early syphilis. We report the failure of benzathine penicillin in the treatment of secondary syphilis. Extensive tracing of sexual contact history failed to identify sources of possible reinfection; therefore, we believe that this case represents a treatment failure and an ensuing relapse of secondary syphilis.

Production and characterization of monoclonal antibodies to Treponema pallidum

This study was attempted to produce the monoclonal antibodies specific for Treponema pallidum and to investigate their characteristics, thereby contributing to identify the antigenic structure and to apply the diagnosis of syphilis. The seven clones (YS 3, YS 75, YS 307, YS 481, YS 343, YS 1 and YS 406) secreting monoclonal antibodies reactive with T. pallidum were produced. The isotypes of the seven monoclonal antibodies produced were defined. Optical densities of the 7 monoclonal antibodies were ranged from 0.59 to 1.48 as measured by ELISA. Monoclonal antibodies from 5 of the 7 clones which could agglutinate sheep RBC sensitized with T. pallidum, showed strong fluorescences. The monoclonal antibody from YS 343 was cross-reactive with non-pathogenic treponemes, but the other 6 monoclonal antibodies reacted with T. pallidum specifically. On immunoblotting, monoclonal antibodies from 5 of the 7 clones reacted with a polypeptide of a molecular weight of 47 kDa, and monoclonal antibodies from YS 343 reacted with a polypeptide of 64 kDa common to both T. pallidum and T. phagedenis. The above results revealed that 7 clones secreting monoclonal antibodies reactive to T. pallidum were produced successfully, and specific antibodies reacting with major antigenic polypeptides of a molecular weight of 47 kDa would be useful in the diagnosis of syphilis in the future.

Detection of Treponema pallidum in tissue: a comparative study of the avidin-biotin-peroxidase complex, indirect immunoperoxidase, FTA-ABS complement techniques and the darkfield method

With 37 formalin-fixed, paraffin embedded specimens from the lesions of 30 patients with primary, secondary or gastric syphilis, we performed avidin-biotin-peroxidase complex (ABC), indirect immunoperoxidase (IIP) and FTA-ABS complement techniques. Darkfield examination was done in 17 skin lesions. The immunoperoxidase technique, especially the ABC technique, revealed higher reactivity than the FTA-ABS complement technique and darkfield examination in detecting Treponema pallidum in tissues. Furthermore, the ABC technique produced less intense nonspecific background staining than the IIP technique. Histologically, most of the treponemes were located in the upper dermis, epidermis and vessel walls in the order named, and rarely in the lower dermis of the syphilitic skin lesions.

Measurement of brain tissue specific gravity using pycnometry

In this paper we introduce and characterize pycnometry, a method used to measure fluid density, for determining a tissue's specific gravity. It uses a 2-ml glass pycnometer filled with distilled water to determine a tissue sample's displacement volume. The tissue's density is determined when it's weight is divided by this volume and specific gravity is computed by dividing the tissue density by the density of water. Pycnometry was validated using pre-calibrated glass, specific gravity standards over the range 1.03-1.26, and compared to the density gradient method using rat brain tissue. We observed that the specific gravity values obtained using pycnometry were highly correlated with the specific gravity standards (slope = 1.0107, r = 0.996) and with the density gradient column when tissue volumes larger than 0.120 ml were used with the pycnometer (slope = 1.0707, r = 0.9826). Good correlation was also observed between percent water content values computed using the Nelson equation with pycnometry or density gradient specific gravity values versus the measured percent water content values obtained with the wet weight/dry weight method. Pycnometry is an accurate, reproducible technique to measure tissue specific gravity and brain edema and is best suited for use in a laboratory that engages sporadically in brain edema measurement.

Skin impedance comparisons of electrodes for electro-oculography

In an effort to define the most comfortable electrode needing the simplest skin preparation with low and stable skin impedance, we compared the impedance between skin electrodes and Stat-Trace II St-102 EKG electrodes (Niko Med USA, New Brunswick, NJ)--the latter being renamed "dry electrodes" because they are used without electrolyte paste--on 12 normal subjects with two different skin preparations, with and without alcohol. The dry electrodes were found to have lower impedance than the skin electrodes. With each skin preparation the alcohol scored better, 7.2 kOhm vs 16.5 kOhm, respectively, and "no preparation" worse, 13.8 kOhm vs 22.7 kOhm, respectively, (but still acceptable when the dry electrode was used). The dry electrode's impedance was quite stable from the moment of application while the skin electrode's impedance drifted dramatically for 30 minutes. If the dry electrode was halved in area of skin contact, as often is necessary with the nasal electrode in children, the impedance rose proportionally but remained acceptable. We conclude that the new dry electrodes give us improved electro-oculography records and suggest their use, particularly for infants and young children where ease of application and simple skin preparation are particularly important.

Detection of keratinolytic proteinase in skin tissues from guinea pigs infected with Microsporum canis by an immunoperoxidase technique

An immunoperoxidase technique was performed to detect keratinolytic proteinase (KPase) in sections of the skin taken from guinea pigs infected with Microsporum canis and in cultured M. canis using polyclonal antisera to purified KPase. Of tissue samples from guinea pigs infected with M. canis, all sections of erythematous lesions showed positive staining mainly in the horny layer and the hair follicles. Positive depositions were seen only at the level of the outer and inner root sheaths of the hair follicles in sections of skin lesions showing scales and crusts. However, sections from areas of alopecia following desquamation of the crust showed no depositions of bright red reaction products. The patterns of deposition of KPase according to the clinical course of experimental dermatophytosis were consistent with the existence of organisms observed by PAS and methenamine silver stains. These results suggest that KPase may be produced during infection with M. canis after the development of erythema and before desquamation of the crust.

[A study on injured policemen in dental field]

In 1989, there were 8893 injured policemen by various demonstrations. This injury ratio (8893/130,000) is about 3 times higher than other occupations. Of them, 2869 (31%) were treated at National Police Hospital, and 13% of which were facial injuries. The most common etiologic factor of facial injuries was demonstrations by Univ. students (89.2%), and 93.9% of the victims were injured by thrown stone.

The effects of a policy change on three types of absence

Nurse executives use many strategies to manage nurse absenteeism. Nurses in this study voiced dissatisfaction with a policy requiring progressive disciplinary action after three absence incidents. To alleviate this dissatisfaction, supervisors were allowed to use their discretion in deciding when to initiate disciplinary action regarding the use of sick leave. The authors discuss the effect of the policy change on use of absence time and excused and unexcused leave.

Tumorous syphilid

An unusual form of secondary syphilis, characterised by oozing tumours on the forehead and scalp concomitantly with plaques in the genital area, is presented. The patient was diagnosed as having secondary syphilis by dark-field examination, serologic tests for syphilis, and demonstration of spirochetes in the tissues by the immunoperoxidase technique with avidin-biotin peroxidase complex. Treatment with benzathine penicillin led to rapid resolution of the skin lesions one month later. This case of tumorous syphilid, a variant of papular syphilid, which appears not to have been described in the literature previously.

Syphilitic gastritis: demonstration of Treponema pallidum with the use of fluorescent treponemal antibody absorption complement and immunoperoxidase stains

Because of the decrease in the overall incidence of syphilis, syphilitic involvement of stomach is seldom reported in the modern literature. Because of the nonspecific symptoms and signs of the disease, it is necessary to demonstrate Treponema pallidum in the gastric lesions to confirm the diagnosis. With the use of immunofluorescence and immunoperoxidase methods we have succeeded in identifying T. pallidum in the gastric wall of a patient who initially had cutaneous manifestations of secondary syphilis and gastric symptoms.

Changes of serum IgG antibody reactivity to protein antigens of Treponema pallidum in syphilis patients after treatment

The changes of serum IgG antibody reactivity to protein antigens of Treponema pallidum after treatment of syphilis were observed using sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blot. Until 9 to 12 months after treatment, it was seen that there was a loss of several antibodies and some diminution in their reactivity in primary, secondary and early latent syphilis, but no changes occurred in late latent and reinfected syphilis. In primary syphilis, there was a significant loss of two IgG antibodies to the treponemal antigens of molecular weights 68,500 and 47,000 at 11 months after treatment. According to our previous study, the treponemal antigen of molecular weight 68,500 was T. pallidum specific and appeared only in primary syphilis, and that of molecular weight 47,000 was one of the major antigens of T. pallidum. The reaction between serum IgG antibodies of 14 patients who had been treated for secondary, early latent and late latent syphilis 2 to 14 years ago and major antigens of T. pallidum was observed and any loss or decrease in reactivity was not discovered. From the results obtained, it was concluded that the observation of serum IgG antibody reactivity to protein antigens of T. pallidum is not helpful in evaluating the efficacy of treatment in secondary, early latent, late latent and reinfected syphilis. However, serum IgG antibodies to treponemal antigens of molecular weights 68,500 and 47,000 could possibly be useful in the assessment of the efficacy of treatment in primary syphilis.