Hemolytic Disease of the Newborn Caused by Anti-M in 2 Male Siblings / 대한주산의학회잡지

Hemolytic disease of the newborn (HDN) caused by anti-M is rare and clinical manifestations are variable ranging from mild anemia and hyperbilirubinemia to hydrops fetalis and intrauterine fetal death. There were few reports of HDN caused by anti-M in Korea but no case in siblings. We experienced a case of 2 male siblings, both of whom had anti-M induced HDN and prolonged anemia persisted for over a month. We report this case with a brief review of literature. This report documents the first case of HDN caused by anti-M in siblings in Korea.

Efficacy of the Measurement of 25-Hydroxyvitamin D2 and D3 Levels by Using PerkinElmer Liquid Chromatography-Tandem Mass Spectrometry Vitamin D Kit Compared With DiaSorin Radioimmunoassay Kit and Elecsys Vitamin D Total Assay

No abstract available.

Usefulness of a Rapid Real-time PCR Assay in Prenatal Screening for Group B Streptococcus Colonization

BACKGROUND: Group B streptococcus (GBS) infection is a leading cause of neonatal morbidity and mortality worldwide. Here, we present the analytical and diagnostic usefulness of a new real-time PCR-based assay (Xpert GBS; Cepheid, USA) for rapid and accurate prenatal GBS screening. METHODS: We enrolled 175 pregnant women who were between 35 and 39 weeks of gestation. The analytical performance of the Xpert GBS assay was first tested using a reference GBS strain. Next, to test diagnostic performance, rectovaginal swabs were obtained from pregnant women who visited the hospital for regular antenatal screening after 34 weeks of gestation. The results of the Xpert GBS assay were compared to those of standard culture for the detection of prenatal GBS colonization. RESULTS: When any positive result from Xpert GBS or culture was considered a true positive, the sensitivity of the Xpert GBS assay and culture were 91% (20/22; 95% CI [confidence interval], 72-98) and 68% (15/22; 95% CI, 47-84), respectively. The specificity of both methods was 100% (153/153; 95% CI, 97-100). The sensitivity and specificity of the Xpert GBS assay, using the culture results as a reference, were 86.7% and 95.6%, respectively. In the Xpert GBS assay, the median threshold cycle of vaginally colonized samples was significantly lower than rectally colonized samples (P<0.01). CONCLUSIONS: The Xpert GBS assay is an accurate, rapid, easy-to-use test for the detection of maternal GBS colonization in prenatal screening that might be especially useful in clinical settings where standard culture is not feasible.

Performance Evaluation of Method for Detecting Serum 25-Hydroxyvitamin D2 and 25-Hydroxyvitamin D3 by Using PerkinElmer MSMS Vitamin D Kit / 임상검사와정도관리

BACKGROUND: Determining the concentration profiles of serum 25-hydroxyvitamin D (25OHD) may aid in the clinical diagnosis and treatment of vitamin D deficiency. To date, the standardized liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay has been used for accurate and precise determination of 25-hydroxyvitamin D levels. Here, we evaluated the performance of the recently developed and introduced PerkinElmer Vitamin D kit and compared the measurements obtained by RIA and LC-MS/MS methods. METHODS: We evaluated the accuracy, precision, linearity, lower limit of quantification (LLOQ), recovery, and carry-over of the MSMS Vitamin D kit. Clinical specimens from 80 patients were used for the comparison between the MSMS Vitamin D kit (PerkinElmer, USA) and the RIA kit (DiaSorin, USA). RESULTS: The MSMS Vitamin D kit was found to produce intra-assay and inter-assay coefficients of variation (CVs) of less than 6% for precision and showed a bias of less than 5%. The MSMS Vitamin D kit displayed linearity within the range for total vitamin D levels of 4.5-150 ng/mL, and the lower limit of quantification for 25OHD was 0.38 ng/mL. The RIA measurements of 25OHD showed a correlation of y=0.9931x+0.2216 (r2=0.74) with the LC-MS/MS values. CONCLUSIONS: The LC-MS/MS assay of 25OHD3 and 25OHD2 showed excellent performance when using the MSMS Vitamin D kit and in terms of 4-phenyl-1,2,4-triazoline-3,5-dione (PTAD) derivatization. Further, the results obtained were well correlated with those obtained using the RIA method. Thus, assays using the MSMS Vitamin D kit are considered as more standardized, and they enable quicker and more accurate analysis and help reduce inter-laboratory variation than that by other existing methods.

Changes in biochemical markers of bone turnover and bone mineral density during pregnancy and postpartum in korean women / 대한산부인과학회지

OBJECTIVE: To show the patterns of changes in biochemical markers of bone turnover and ultrasound bone mineral density (BMD) during pregnancy and postpartum in Korean women. METHODS: We conducted a prospective study between February 2004 and February 2005. Forty-one healthy singleton pregnant women were included. We used quantitative ultrasonography for BMD measurement which is advantageous to pregnant women because it is radiation-free and it provides very accurate BMD that correlates highly with BMD measured by conventional dual energy x-ray absorptiometry. We measured marker of bone resorption (beta-Crosslaps), bone formation [total alkaline phosphatase (ALP), osteocalcin (OC)], total calcium, phosphorus and parathyroid hormone (PTH) during and after pregnancy. RESULTS: During pregnancy, BMD slightly decreased in the third trimester. Bone resorption marker (beta-Crosslaps) increased steadily during pregnancy and immediate postpartum. Markers of bone formation (ALP, osteocalcin) increased from late pregnancy. Total calcium decreased slightly as bone resorption peaks in second trimester. PTH and phosphorus increased steadily throughout pregnancy and postpartum. CONCLUSION: Pregnancy is characterized by high bone turnover in Korean women with resorption preceding formation.

Clinical Implication of Air Stacking Exercise in Patients with Neuromuscular Diseases

OBJECTIVE: To evaluate the effect of the air stacking exercise on maximal insufflation capacity (MIC) and peak cough flow (PCF) in patients with neuromuscular diseases. METHOD: Two hundred twenty nine neuromuscular patients with vital capacity (VC) below 50% of the predicted normal value were initially evaluated for VC, MIC, PCF, and assisted PCF (APCF). After the first evaluation, these patients were instructed to carry out air stacking exercise periodically, and were re-evaluated after one year. RESULTS: Forty seven patients were capable of performing air stacking exercise on regular basis, at least twice a day for one year. Among these patients, MIC increased in 28 patients from 1345.4 ml to 1572.9 ml on average (p<0.05), while it decreased in 19 patients from 1740.0 ml to 1325.3 ml on average (p<0.05). In the increasing MIC group APCF increased from 244.6 L/min to 278.1 L/min (p<0.05). In the decreasing MIC group, every value decreased significantly. CONCLUSION: Air stacking exercise was shown to be capable of increasing MIC and APCF despite the reduction in VC and PCF in patients with neuromuscular diseases.

CD56/CD16 Expression on Mononuclear Cells and Concentration of Serum TNF-alpha in Recurrent Spontaneous Abortion / 대한진단검사의학회지

BACKGROUND: Recurrent spontaneous abortion (RSA) is defined as the occurrence of three or more consecutive spontaneous abortion before 20 gestational weeks. But, 40-50% of RSA still remain "unex-plained". Cytokines seem to play a critical role in the pathogenesis of unexplained RSA, and Th1 cytokines have been shown to exert deleterious effects on pregnancy. NK cytotoxicity has been reported to be predictive of subsequent abortion in women who had unexplained recurrent abortions. The aim of this study was to investigate immunophenotypic characteristics of peripheral blood mononu-clear cells and evaluate Th1 cytokine (TNF-alpha) production in women with RSA. METHODS: The study group comprised 93 women with RSA, and the control group consisted of 40 healthy pregnant women. The population of CD56/CD16 cells was observed by using a two-color scattergram in FACScan (Becton Dickinson, San Jose CA, USA). Concentration of TNF-alpha was measured by an enzyme-linked immunoabsorbant assay (ELISA) using commercial kits (NEOGEN corporation, Lexington KY, USA). RESULTS: The percentage of CD56+/CD16-cells were significantly higher (P<0.05) in the patients with RSA (13.40+/-7.95%) than in the pregnant control group (9.12+/-3.93%). We observed a significantly higher level of TNF-alpha (medians: 85.59+/-8.29 pg/mL versus 44.80+/-9.78 pg/mL; P<0.05) in RSA women compared to controls. CONCLUSIONS: This study indicates that an increased proportion of CD56+/CD16-mononuclear cells and increased level of serum TNF-alpha are related to RSA. Thus, the two factors could be used as an indicator of subsequent successful implantation and maintenance of gestation.

Meaning of the DR-70(TM) Immunoassay for Patients with the Malignant Tumor

BACKGROUND: The DR-70(TM) immunoassay is a newly developed cancer diagnostic test which quantifies the serum fibrin degradation products (FDP), produced during fibrinolysis, by antibody reaction. The purpose of this study was to evaluate the potential of DR-70(TM) immunoassay in screening malignant tumor. METHODS: Sample subjects were 4,169 adults, both male and female, who visited the health promotion center of a general hospital from March 2004 to April 2005 and underwent the DR-70(TM) immunoassay test and other tests for cancer diagnosis. The patient group was defined as 42 adults out of the sample subjects who were newly diagnosed with cancer during the same time period when the DR-70(TM) immunoassay test was performed. Final confirmation of a malignant tumor was made by pathological analysis. RESULTS: The mean DR-70(TM) level was 0.83+/-0.65 microgram/ml (range: 0.00 (0.0001)~7.42 microgram/ml) in the control group (n=4,127) as opposed to 2.70+/-2.33 microgram/ml (range: 0.12 ~ 9.30 microgram/ml) in the cancer group (n=42), and statistical significance was established (p<0.0001, Student t-test). When categorized by the type of malignant tumor, all cancer patients with the exception of the subgroups of colon and rectal cancer showed significantly higher mean DR-70(TM) levels compared with the control group (p<0.0001, Kruscal-Wallis test). The receiver operating characteristic (ROC) curve analysis revealed < or = 1.091 microgram/ml as the best cut-off value. Using this cut-off value, the DR-70(TM) immunoassay produced a sensitivity of 71.4%, a specificity of 70.1%, a positive predictability of 69.4%, and a negative predictability of 69.2% (1). CONCLUSION: A significant increase in the mean DR-70(TM) value was observed in the cancer group (thyroidal, gastric, breast, hepatic and ovarian) compared with the control group. In particular, the specificity and sensitivity of the DR-70(TM) immunoassay was relatively high in the subgroups of breast, gastric, and thyroidal cancer patients. There is need for further studies on a large number of malignant tumor patients to see how the DR-70(TM) level might be changed according to the differentiation grade and postoperative prognosis of the malignant tumor.

Change in Forced Vital Capacity with Postures according to Neuromuscular Disease

OBJECTIVE: To evaluate the difference in forced vital capacity (FVC) between sitting and supine position in patients with amyotrophic lateral sclerosis (ALS), cervical spinal cord injury (SCI) and Duchenne muscular dystrophy (DMD). METHOD: FVC was measured in sitting and supine position for 32 patients with DMD, 32 patients with cervical SCI and for 28 patients with ALS. The highest value in three or more attempts in each position was chosen. RESULTS: FVCs measured in cervical SCI and ALS patients in the sitting and supine position were 1612.8+/-291.0 ml, 1393.2+/-286.7 ml and 2054.7+/-545.8 ml, 1104.3+/-425.4 ml respectively. Cervical SCI patients showed significantly higher value in the supine position (p<0.05). And ALS patients showed significantly higher value in the sitting position (p<0.05). FVCs measured in DMD patients were 1311.6+/-260.7 ml and 1213.8+/-378.9 ml respectively. There was no statistically significant difference between the measurements in both positions. CONCLUSION: Difference in postural change of FVC was observed in patients with different types of neuromuscular disorders. Such difference in FVC suggest that postural change of FVC should be considered in management of neuromuscular disease with respiratory muscle weakness.

Effectiveness of Intravenous Immunoglobulin Therapy in Women with Recurrent Spontaneous Abortions and Elevated Pre-conceptional Peripheral Blood CD56+ Natural Killer Cell Percentage / 대한불임학회지

OBJECTIVE: The aim of present study was to evaluate the effectiveness of low-dose intravenous immunoglobulin (IVIg) therapy in women with recurrent spontaneous abortions (RSA) and elevated pre-conceptional peripheral blood CD56+Natural Killer (NK) cell percentage. STUDY DESIGN: Retrospective case control study. MATERIALS AND METHODS: Thirty three women with RSA and elevated pre-conceptional peripheral blood CD56+NK cell percentage who had received low-dose IVIg therapy (400 mg/kg per day, every 4 week, until 20 gestational weeks) were included in this study. Controls were nine women with RSA and elevated pre-conceptional peripheral blood CD56+ Natural Killer (NK) cell percentage who had not received IVIg therapy were included in this study. Medical records of study and control groups were retrospectively analyzed and we compared the successful pregnancy outcomes between two groups. Successful pregnancy outcome was defined as pregnancy ongoing beyond 25 gestational weeks. RESULTS: Age, number of previous abortions, pre-conceptional CD56+NK cell percentage and type of RSA were not statistically different between two groups. Otherwise, twenty-five women who received IVIg therapy (25/33, 75.8%) but, only three women who had not received (3/9, 33.3%) had a successful pregnancy outcome and the rate difference between two groups was statistically significant. CONCLUSION: Based on our study, low-dose IVIg therapy have a effective role in treatment of RSA patients with elevated pre-conceptional peripheral blood CD56+ Natural Killer (NK) cell percentage, but more larger scaled prospective study is needed for available of conclusive evidence.

Clinical Effectiveness of Urinary Human Chorionic Gonadotropin Related Protein (hCGRP) Quantification for Diagnosis of Ectopic Pregnancy

We detected pregnancy related new molecule, human chorionic gonadotropin related protein (hCGRP) in the urine of a pregnant women by using a monoclonal antibody against the human chorionic gonadotropin (hCG). This study examined the effectiveness of urinary hCGRP quantification in diagnosing ectopic pregnancy. This study included 40 normal pregnant women and 25 patients with ectopic pregnancy. Patients' serum and urinary intact whole hCG (i-hCG) and hCGRP concentrations were measured using sandwich ELISA and the ratio of hCGRP to i-hCG was calculated. Statistical analysis was performed using statistical package for social sciences (SPSS) 10.0. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the cut-off value to discriminate ectopic pregnancies from normal intrauterine pregnancies. Urinary hCGRP and hCGRP/i-hCG ratio in ectopic pregnancy group (14 +/- 6.6 ng/mL, 4.6 +/- 1.9%, respectively) were significantly lower than those of normal pregnancy group (149 +/- 10.2 ng/mL, 29.7 +/- 1.9%, respectively; p<0.001). Based on ROC curve analysis, a cut-off point of urinary hCGRP/i-hCG ratio <16.2% discriminated between ectopic pregnancy and normal pregnancy with a sensitivity, specificity, positive predictive value and negative predictive value of 92.0%, 90.0%, 32.6%, and 99.5%, respectively. Urinary hCGRP/i-hCG ratio measurement may be effective in diagnosing ectopic pregnancy.

Non-invasive Intermittent Positive Pressure Ventilation Apply to Complete Tetraplegia due to C1 Spinal Cord Injury: A case report

The patients who have high cervical cord injury with paralysis of diaphragm are not able to live without mechanical ventilatory support. In conventional concept, tracheostomy is necessary for long-term use of mechanical ventilation. We reported a 33-year-old man diagnosed with complete tetraplegia due to C1 spinal cord injury. He had used intermittent mechanical ventilation via tracheostomy tube. He had no movement of diaphragm and showed hypercapnia and hypoxemia without ventilatory support for several hours. He showed 400 ml of vital capacity and un-obtainable peak cough flow level but it could be obtained 300 L/min of assisted peak cough flow. Noninvasive intermittent positive pressure ventilation (NIPPV) was applied from invasive method and decannulation and tracheostomy closure was performed successfully. He had no pulmonary complications for six months. This case could be a good model for the indication of NIPPV application and decannulation.

Prevalence Rate of Irregular Antibodies in Transfusion Candidates and Pregnant Women in Korea / 대한임상병리학회지

BACKGROUND: The authors studied to estimate the frequency of irregular antibodies and their significance in blood transfusion and antenatal care in Korea. METHODS: Irregular antibodies were tested by immediate saline spin, 37degrees C albumin and antiglobulin test for 2,008 transfusion candidates and 1,047 pregnant women at Severance hospital using commercial screening and identification cells (Dade, U.S.A.). RESULTS: The irregular antibodies were detected in 38 (1.24%) of total 3,055 subjects (transfusion candidates: 0.9%, pregnant women: 1.91%) . In transfusion candidates, the detected antibodies were Lewis antibodies, cold antibodies (anti-M, anti-P 1), Rh antibodies and unspeified warm antibodies, and their distributions were 56%, 22%, 17%, and 5%, respectively. In pregnant women, the detected antibodies were Lewis antibodies, Rh antibodies, anti-Jra, and unspeified warm antibodies, and their distributions were 45%, 45%, 5% and 5%, respectively. At immediate saline phase, 58% of irregular antibodies were detected. At 37degrees C albumin phase, 90% of irregular antibodies were detected and only 10% of irregular antibodies were detected at antiglobulin phase. CONCLUSIONS: Although the prevalence rates of clinically important irregular antibodies were low, 1/1000 of irregular antibodies could not be detected. Therefore, irregular antibody screening should be performed in all pretransfusion test. And, if antibody detection tests are negative, immediate saline crossmaching methods are acceptable in Korea.

Prevalence Rate of Irregular Antibodies in Transfusion Candidates and Pregnant Women in Korea / 대한임상병리학회지

BACKGROUND: The authors studied to estimate the frequency of irregular antibodies and their significance in blood transfusion and antenatal care in Korea. METHODS: Irregular antibodies were tested by immediate saline spin, 37degrees C albumin and antiglobulin test for 2,008 transfusion candidates and 1,047 pregnant women at Severance hospital using commercial screening and identification cells (Dade, U.S.A.). RESULTS: The irregular antibodies were detected in 38 (1.24%) of total 3,055 subjects (transfusion candidates: 0.9%, pregnant women: 1.91%) . In transfusion candidates, the detected antibodies were Lewis antibodies, cold antibodies (anti-M, anti-P 1), Rh antibodies and unspeified warm antibodies, and their distributions were 56%, 22%, 17%, and 5%, respectively. In pregnant women, the detected antibodies were Lewis antibodies, Rh antibodies, anti-Jra, and unspeified warm antibodies, and their distributions were 45%, 45%, 5% and 5%, respectively. At immediate saline phase, 58% of irregular antibodies were detected. At 37degrees C albumin phase, 90% of irregular antibodies were detected and only 10% of irregular antibodies were detected at antiglobulin phase. CONCLUSIONS: Although the prevalence rates of clinically important irregular antibodies were low, 1/1000 of irregular antibodies could not be detected. Therefore, irregular antibody screening should be performed in all pretransfusion test. And, if antibody detection tests are negative, immediate saline crossmaching methods are acceptable in Korea.

Clinical Usefulness of TrepanostikaTM, Enzyme-Linked Immunosorbent Assay for Detection of Treponema pallidum-Specific Antibody / 대한임상병리학회지

BACKGROUND: The TrepanostikaTM is an enzyme-linked immunosorbent assay (ELISA) for the qualitative determination of specific antibody (Ab) to Treponema pallidum. It is important to detect Treponema pallidum-specific Ab to confirm syphilis in patients with positive nontreponemal result or at late latent stage/late stage. Currently various ELISA methods for Treponema pallidum- specific Ab have been developed in addition to widely used treponemal tests such as fluorescent treponemal antibody absorption (FTA-ABS) test or Treponema pallidum hemagglutination (TPHA) test. We evaluated TrepanostikaTM, anti-treponemal ELISA test. METHODS: The sensitivity and specificity of this ELISA method for detecting Treponema pallidum- specific Ab (TrepanostikaTM) were evaluated and compared with other treponemal tests such as FTA-ABS and TPHA. RESULTS: The sensitivity and specificity of TrepanostikaTM were 95.7% and 95.8%, respectively. The concordance rate with FTA-ABS was 98.9% (283/286) and 100% (272/272) with TPHA. CONCLUSIONS: TrepanostikaTM which has similar sensitivity and specificity with FTA-ABS or TPHA could replace the well-known treponemal test such as FTA-ABS or TPHA.

The Usefulness of Fetal Fibronectin in Pregnant Women / 대한임상병리학회지

BACKGROUND: The purpose of our study is to evaluate the usefulness of cervicovaginal fetal fibronectin assay for the prediction of rupture of membrane and preterm labor. METHODS: A group of 39 pregnant women was involved in this prospective study. Out of 139 pregnant women, 96 were clinically diagnosed as ruptured membranes (group A). The remaining 43 of 139 pregnant women were clinically diagnosed as preterm labor(group B). The assay was performed by using the ROMCheckTM kit (Adeza Biomedical Corp., Sunnyvale, CA). RESULTS: In group 4, fetal fibronectin (fFN) positive rate is 55% (53 patients) and negative rate is 45% (43 patients). In group B, fFN positive rate is 56% (24 patients) and negative rate is 44% (19 patients). Both group of fFN positive patients show a significantly shorter interval from sampling to delivery than fFN negative patients. Also in group A, the percentage of fFN positive patients who delivered at less than 48 hours after sampling is greater than those with fFN negative patients and in group B, the preterm delivery rate is 79% with positive fFN and 37% with negative fFN. As a predictor for preterm delivery, the presence of fFN has the sensitivity 79%, the specificity 84%, the positive Predictive value 76% and the negative predictive value 86%. CONCLUSIONS: The result suggests that a positive fFN in pregnant women who have uterine contractions and ruptured membrane indicates a significant risk for preterm delivery and labor onset, and a negative fFN is a reassuring sign.

Postural Change of Vital Capacity in Patients with Neuromuscular Disease

OBJECTIVE: To evaluate the difference in vital capacity (VC) between sitting and supine position in patients with amyotrophic lateral sclerosis (ALS) and Duchenne muscular dystrophy (DMD). METHOD: VC was measured in the sitting and supine position for 30 patients with DMD and for 30 patients with ALS. The highest value in three or more attempts in each position was chosen. RESULTS: VCs measured in ALS patients in the sitting and supine position were 1591.7+/-634.6 ml and 1290.0+/-580.3 ml respectively. The VC in the sitting position showed significantly higher value than the VC in the supine position (p<0.05). VCs measured in DMD patients were 903.7+/-518.1 ml and 795.3+/-505.6 ml respectively. There was no statistically significant difference between the measurements in both positions. CONCLUSION: Difference in postural change of VC was observed in patients with different types of neuromuscular disorders. Such difference in VC suggest that postural change of VC should be considered in management of neuromuscular disease with respiratory muscle weakness.

Decrease of Plasma Th2 Cytokines by Interferon (IFN)-gamma Therapy in Atopic Dermatitis

PURPOSE: Atopic dermatitis is characterized by reduced IFN-gamma production and increased IL-4 production. As a result, IgE production increases in atopic dermatitis. In the previous studies, it was reported that recombinant IFN-gamma therapy is effective in treatment of severe atopic dermatitis. In this study, changes of plasma IFN-gamma, IL-4, IL-5 and IL-10 concentration by IFN-gamma therapy were studied in atopic dermatitis. Changes of plasma IgE levels and eosinophil counts were also investigated in the present report. METHODS: Sixty-five atopic dermatitis patients were studied. Diagnostic criteria for atopic dermatitis were those used by Hanifin and Rajka. Patients received 2x106 units/m2 IFN-gamma by subcutaneous injection eighteen times for six weeks. The following investigations were performed : complete blood cell count, total IgE, eosinophil percentage and total eosinophil count in addition to plasma IFN-gamma, IL-4, IL-5 and IL-10 concentration. RESULTS: Plasma concentrations of IL-4, IL-5 and IL-10 decreased by IFN-gamma therapy in atopic dermatitis. However, plasma IFN-gamma concentration was not changed. No significant correlations among the changes of IgE, eosinophil counts and plasma cytokine concentrations were detected. CONCLUSION: Plasma concentrations of Th2 cytokine such as IL-4, IL-5 and IL-10 decreased by IFN-gamma therapy. This study suggests that Th2 cytokines might not be produced simulaneously. and that changes of Th2 cytokines might not affect the quantitiative changes of IgE and of eosinophil count.

Decrease of Plasma Th2 Cytokines by Interferon (IFN)-gamma Therapy in Atopic Dermatitis

PURPOSE: Atopic dermatitis is characterized by reduced IFN-gamma production and increased IL-4 production. As a result, IgE production increases in atopic dermatitis. In the previous studies, it was reported that recombinant IFN-gamma therapy is effective in treatment of severe atopic dermatitis. In this study, changes of plasma IFN-gamma, IL-4, IL-5 and IL-10 concentration by IFN-gamma therapy were studied in atopic dermatitis. Changes of plasma IgE levels and eosinophil counts were also investigated in the present report. METHODS: Sixty-five atopic dermatitis patients were studied. Diagnostic criteria for atopic dermatitis were those used by Hanifin and Rajka. Patients received 2x106 units/m2 IFN-gamma by subcutaneous injection eighteen times for six weeks. The following investigations were performed : complete blood cell count, total IgE, eosinophil percentage and total eosinophil count in addition to plasma IFN-gamma, IL-4, IL-5 and IL-10 concentration. RESULTS: Plasma concentrations of IL-4, IL-5 and IL-10 decreased by IFN-gamma therapy in atopic dermatitis. However, plasma IFN-gamma concentration was not changed. No significant correlations among the changes of IgE, eosinophil counts and plasma cytokine concentrations were detected. CONCLUSION: Plasma concentrations of Th2 cytokine such as IL-4, IL-5 and IL-10 decreased by IFN-gamma therapy. This study suggests that Th2 cytokines might not be produced simulaneously. and that changes of Th2 cytokines might not affect the quantitiative changes of IgE and of eosinophil count.

Quantification of Serum Hepatitis C Virus in Patients with Chronic C Viral Liver Disease / 대한임상병리학회지

BACKGROUND: The quantification of hepatitis C virus (HCV) is useful in diagnosis and monitoring of HCV infection. We evaluated clinical usefulness of HCV quantification and two quantification methods using different assay principles. METHODS: HCV RNA quantities and liver function were measured in patients with different disease severity using bDNA assay (QuantiplexTM, Chiron, USA). HCV RNA loads were quantified at the time of pre/post-interferon treatment in some of them using RT-PCR hybridization assay (AMPLICORTM, Roche, USA). These two quantification methods were also compared. RESULTS: HCV RNA loads showed no significant difference according to disease severity (group I, 3.8 5.3 MEq/mL; group II, 3.8 7.4 MEq/mL; group III, 5.9 13.0 MEq/mL; P=0.181) or interferon response (complete responders, 1.5 105/mL; partial or non responders, 2.2 105/mL; P=0.670). But HCV viral loads decreased at 6th month after interferon treatment (P=0.063) and correlated poorly with liver function tests. The bDNA assay correlated well with the RT-PCR hybridization method (r2=0.854). CONCLUSIONS: The quantificaion of HCV RNA is useful in following up treatment effect but not in predicting therapeutic failure or assessment of disease severity. HCV RNA quantities are independent of liver function. The bDNA assay showed good correlation with the RT-PCR hybridization method.