The prevalence study on restriction fragment length polymorphism analysis for the detection of hemophilia A carrier

We have analyzed two (BclI and XbaI) intragenic restriction fragment length polymorphisms (RFLPs) and St14 (DXS52) variable number of tandem repeats (VNTR) by rapid PCR method in 97 unrelated normal subjects. The incidences for positive Bc1I and XbaI polymorphic sites in the Koreans were 81% and 72%, respectively, which were higher than other ethnic groups but similar to that reported in the Chinese or Japanese, giving the heterozygosity rate of 0.32 and 0.40, respectively. The amplified allele size was 880 bp with no other polymorphism in the analysis of St14 (DXS52) VNTR. This finding should be taken into account in the planning of a prenatal diagnosis program for ethnic Koreans.

The fibrinogen degradation products (FgDP) levels in liver disease

We measured plasma levels of fibrinogen degradation products (FgDP) with newly developed enzyme-linked immunosorbent assay based on monoclonal antibody to assess the fibrinogenolytic state in 52 patients with various liver diseases (27 patients with liver cirrhosis, 10 with chronic hepatitis, 7 with acute hepatitis, 6 with hepatocellular carcinoma, 2 with intrahepatic cholestasis). As compared with 20 healthy subjects (upper limit: 580 ng/ml), elevated plasma levels (660-32000 ng/ml) of FgDP were found in 19 (36.5%) patients. When analyzed according to the underlying disease categories, the magnitude of elevations of FgDP were most prominent in patients with chronic hepatitis. No correlation was found between plasma FgDP levels and serum AST or ALT activity. These findings indicate that increased primary fibrinogenolysis is not rare in liver disease, but poorly correlates with liver function.

Immunohistochemical detection of p53 protein, c-erbB-2 protein, epidermal growth factor receptor protein and proliferating cell nuclear antigen in gastric carcinoma

There is increasing evidence that genes involved in normal cell growth and differentiation (oncogenes) or genes that encode for growth factors are important in determining the development and biologic aggressiveness of gastric carcinoma. This study was undertaken to define the prognostic value of the overexpression of p53 protein, c-erbB-2 protein, EGFr protein and PCNA in gastric carcinomas. Using monoclonal antibodies, immunohistochemical studies were performed on formalin-fixed, paraffin-embedded tissue sections from 84 primary gastric carcinomas. Overall, 34% of gastric carcinomas had nuclear-staining for p53 protein, 34% of carcinomas membrane staining for the c-erbB-2 and 74% of carcinomas membrane and cytoplasmic staining for EGFr, showing distribution in a heterogeneous fashion. PCNA was expressed as Grade 2 and 3 in 75% of patients with gastric carcinomas. Both c-erbB-2 and p53 staining was significantly associated with high grade expression of PCNA. p53 staining tended to be associated with positive nodal status and metastasis, and c-erbB-2 staining with positive nodal status only. Multivariate analysis using the Cox model showed that overexpression of p53 protein, c-erbB-2 protein and PCNA was not an independent prognostic variable in gastric carcinoma. These results suggest that expressions of p53 and c-erbB-2 protein are heterogeneous and that p53 and c-erbB-2 overexpressions are significantly associated with high proliferative activity in gastric carcinoma.

Early allograft function in canine single lung transplant

An assessment of early graft function in canine single lung transplant recipients was made by analysing early postoperative radiographic progression, lung perfusion, bronchial patency and bronchial anastomotic wound healing and histopathology of the allografted lung. Eighteen mongrel dogs weighing 15kg on average were used. Donor lung bloc with a generous atrial cuff, the pulmonary artery and left bronchus were taken and flushed with Euro-Collins solution which implanted in the pneumonectomized recipient dog. Anastomosis was done with the atrium, pulmonary artery and bronchus in that order. To assess an early graft function, a protocol for a grading system was designed into the chest roentgenogram, lung perfusion scan, bronchial patency and histopathologic progression of the bronchial anastomosis and allografted lung (Table 1). The results were obtained as follows: Radiographically, clear to infiltrate was seen in 67% (8/12), 33% (5/15), 30% (3/10) and 33% (2/6) on postoperative day 0, 1, 2 and 3 respectively. Lobar to total opacification was 33% (4/12), 67% (10/15), 70% (7/10) and 67% (4/6) on days 0 to 3 (Table 2). Perfusion scan showed normal to mild defect in 43% (3/7) and moderate to severe defect in 57% (4/7) on day 0 and 100% (5/5) on day 2 (Table 3). The bronchial anastomotic site showed patent to mild stenosis in 100% (8/8) on day 0 and mild stenosis in 2/2 on day 9 bronchofiberscopically, and showed normal wound healing in 38% (3/8), cellular infiltration in 38% (3/8) and infarction in 25% (2/8) up to day 9 postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult-onset pulmonary tuberculosis: findings on chest radiographs and CT scans

Adult-onset pulmonary tuberculosis refers to primary tuberculous infection occurring initially in adults. The decreasing exposure in childhood, owing to careful public health measures and the advent of antituberculous chemotherapy, has resulted in later initial exposure to tuberculosis and an increased likelihood of susceptibility to tuberculosis during adulthood [1-3]. In addition, chest radiographs typically show a pattern more consistent with primary infection in pulmonary tuberculosis associated with AIDS. In this essay, we illustrate the spectrum of radiographic and CT findings of adult-onset pulmonary tuberculosis in patients without AIDS.

Impact of a primary reader's opinion on the detection of rib fractures

RATIONALE AND OBJECTIVES

The authors assessed the influence of a prior reader's opinion on the detectability of rib fractures.

METHODS

Six pairs of observers read the chest PA radiographs of 92 subjects with rib fracture(s) and 28 normal subjects to detect rib fracture(s) according to a five-point rating of confidence with three methods. In method A, each reader read films as a primary reader. In method B, each reader read films after knowing his or her partner's opinion. In method C, each reader initially observed films and then made the final decision after knowing his or her partner's opinion.

RESULTS

Methods B and C were superior to method A in sensitivity. There was no difference in performance between methods B and C. Method C required a significantly longer time than the other methods.

CONCLUSION

Detection of rib fractures is improved by seeking the opinion of other observers.

A case of prenatal diagnosis of hemophilia A

Classic hemophilia, (hemophilia A), is an X-linked hereditary bleeding disorder affecting half of the male offspring of female carriers. Prenatal diagnosis offers an option, namely to restrict abortions to hemophilic fetuses only, and thus retain the chance of bearing normal sons. Recently, the authors have made a prenatal diagnosis of hemophilia A in an obligate carrier with a male fetus at 24 weeks of gestation by pure fetal sampling and accurate factor VIII coagulant assay, which was repeatedly less than 1% at 28 weeks of gestation.

Impact of clinical history on film interpretation

We performed a study to determine whether clinical history gives a positive or negative influence on X-ray film interpretation. One hundred and nine patient's radiograms, consisting of 55 normal and 54 abnormal cases (136 abnormalities), were interpreted twice by three pairs of residents in radiology and a pair of qualified radiologists, without clinical history first and with clinical history next. The interpreters recorded diagnosis and confidence level of normal or abnormal findings on a six-point scale. Analysis of receiver operating characteristic (ROC) curves showed that knowledge of clinical history improved diagnostic accuracy. Residents, especially beginners, should be advised to obtain clinical history whenever they read radiograms.

Hepatitis C infection in hemodialysis units

We performed an epidemiological study of the hepatitis C infection on 112 patients of 3 urban hemodialysis units using a recently developed anti-HCV recombinant based assay. Eleven patients (9.8%) were positive for anti-HCV. Among them, 8 (72.7%) were positive for anti-HBc, one of whom was HBsAg positive and 6 of whom were also anti-HBs positive. Surprisingly, all of the anti-HCV (+) patients were normal alanine aminotransferase. The mean age of the anti-HCV (+) patients was 50.7 +/- 3.3 (mean +/- SE) and that of the anti-HCV (-) was 47.6 +/- 1.3. The mean duration (month) of hemodialysis of the anti-HCV (+) and anti-HCV (-)groups were 52.7 +/- 7.2 (mean +/- SE) and 60.9 +/- 9.7, respectively. The prevalence of anti-HCV among anti-HBc positive subjects was 9.5% and that among anti-HBc negative subjects was 17.6%. This didn't have any statistical significance according to the criteria of the study (p = 0.308). The prevalence of anti-HCV among the transfusion positive group was 11.0% and that of the transfusion negative group was 7.7%. This data showed the tendency for a higher prevalence of anti-HCV among the transfusion positive group, but this also didn't reach statistical significance (p = 0.424). Of the 40 normal controls, none were anti-HCV positive. The prevalence of HBsAg in our hemodialysis units was 12.5%. This rate was not so much higher than the average population in Korea. The prevalence of anti-HCV and previous hepatitis B virus infection also had no significant relationship.(ABSTRACT TRUNCATED AT 250 WORDS)

Thymidine labeling index in breast tumors

The relationship between primary tumor proliferative activity and clinical and pathologic characteristics was analyzed in relation to menopausal status in 32 patients with malignant or benign breast disease. The thymidine labeling index (TLI) showed significantly higher median values in the cancer patients (3.48 per cent) than in the patients with benign diseases (1.02 per cent). TLI was not significantly affected by delayed incubation at room temperature for about 1 hour. In the breast cancer patients, TLI did not significantly correlate to tumor size, the presence of axillary lymph node metastasis or pathologic nuclear grading. The only significant difference was limited to the breast cancer patients without axillary lymph node metastasis in relation to menopausal status; the TLI in the premenopausal patients (5.10 per cent) was significantly higher (p less than 0.05) than that in the postmenopausal patients (2.28 per cent). These data thus suggest that among premenopausal patients without axillary lymph node metastasis, those with a high TLI could be potential candidates for adjuvant chemotherapy.

Mediastinal tuberculous lymphadenitis: CT manifestations

An analysis was done of computed tomographic (CT) scans of 23 Korean patients who had presented with a mediastinal or hilar mass on plain chest radiographs and had subsequently been found to have tuberculous lymphadenitis. Most patients were young adults. Findings of pulmonary tuberculosis were seen on plain radiographs in 14 patients. On CT, findings were of an overwhelming preponderance of involvement of the right paratracheal and tracheobronchial nodes. After injection of contrast medium, nodes larger than 2 cm in diameter invariably showed central areas of relative low density and peripheral rim enhancement. Enhanced walls were usually irregular in thickness. Some smaller nodes did not show low-density areas, but instead showed varying degrees of homogeneous enhancement. Although metastatic nodes can be of low density, experience in this study suggests that mediastinal lymphadenopathy in a young adult with the CT findings described above is characteristic enough to support a diagnosis of tuberculosis.