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Selected AbstractsCervicovaginal cytological abnormalities in patients with human immunodeficiency virus infection, in relation to disease stage, CD4 cell count and viral loadDIAGNOSTIC CYTOPATHOLOGY, Issue 3 2009Adilha Misson Rua Micheletti M.D., Ph.D. Abstract The objective of the present study was to assess infections and cytologic abnormalities in cervicovaginal smears from 153 HIV-positive women and 169 HIV-negative followed up at the UFTM School of Medicine between May 1999 and May 2002. The medical records and cervicovaginal smears were reviewed and the HIV-positive group was classified according to CD4 cell count, HIV viral load, antiretroviral therapy and HIV subgroups (with or without disease; with or without therapy) and compared to HIV-negative group. We conclude that the frequency of Candida sp, Trichomonas vaginalis and bacterial vaginosis in cervicovaginal smear, is not different between HIV-positive and HIV-negative women, even if the HIV-group is subdivided according to CD4 cell count, HIV viral load, antiretroviral therapy and HIV subgroups. The frequency of LSIL, in cervicovaginal smears, was greater in the HIV-group (17.6%) than in the HIV-negative (4.1%); there was no difference between the two groups according to frequency of HSIL (4.6% versus 1.8%), ASCUS/AGUS (7.8% versus 3.5%) and invasive carcinoma (1.3% versus 0.6%). The frequency of LSIL was greater in the HIV positive group with CD4 cell count < 350 cells/mm3. The viral load, therapeutic regimen and HIV subgroups (HIV-positive without therapy, HIV-positive with therapy, AIDS by immunological criteria and AIDS by clinical criteria) have not shown relationship with LSIL frequency, until now. Diagn. Cytopathol. 2009. © 2009 Wiley-Liss, Inc. [source] Fine-needle aspiration of the testis in azoospermic men: The value of measuring serum follicle stimulating hormone and testicular sizeDIAGNOSTIC CYTOPATHOLOGY, Issue 4 2005W.A. Mourad M.D. Abstract Testicular fine-needle aspiration biopsy (FNAB) is used as a primary tool in assessing azoospermic infertile men in our institution. If the FNA is negative for sperm, a subsequent testicular biopsy specimen and wet preparation are obtained with possible immediate fertilization. To our knowledge, the value of these techniques in the context of testicular size and serum levels of follicle stimulating hormone (FSH) has not been explored. We reviewed 453 FNA biopsies of the testis performed for the identification of sperm in infertile azoospermic males between 1999 and 2000. We identified cases that had all three procedures (FNA, wet preparation and biopsy) performed. These were the patients that were compared for testicular size using Seager orchiometry and serum levels of FSH. Of the 453 FNAs reviewed, 128 (21%) had all three procedures performed. Seventy-two cases (56%) were negative in all three tests, 26 (20%) cases were positive in all tests, and 30 cases (23%) had different results. These 30 cases were excluded. The testicular size in the negative group ranged from 4 to 16 ml (median, 10 ml) and the positive group had testicular sizes ranging from 10 to 25 ml (median, 15 ml; P = 0.0001). The negative group had serum FSH levels ranging from 3 to 52 IU/l (median, 19 IU/l) whereas the positive group had serum levels ranging from 3 to 26 IU/l (median, 10 IU/l; P = 0.0001). Our findings suggest that in infertile azoospermic men, a testicular size of <10 ml combined with a serum FSH level of >19 IU/l, the chances of retrieving sperm are minimal using all three diagnostic modalities. The use of this cutoff point would lead to a 30,50% reduction in the number of procedures performed. This reduction would have a significant impact on the management of these patients with a significant decrease in cost, logistics, and patient anxiety. Diagn. Cytopathol. 2005;32:185,188. © 2005 Wiley-Liss, Inc. [source] Prognostic Value of 12-Lead Electrocardiogram During Dobutamine Stress EchocardiographyECHOCARDIOGRAPHY, Issue 5 2000Milind R. Dhond M.D. The aim of this study was to assess the prognostic value of the 12-lead electrocardiogram (ECG) obtained during dobutamine stress echocardiography (DSE) in predicting subsequent cardiac events. We retrospectively analyzed 345 patients undergoing DSE in 1992,1994 and selected those patients with negative echo results for ischemia. Of the 200 patients with negative DSE results, a separate analysis of their ECG data was performed with results reported as either positive, negative, or nondiagnostic for ischemia. Follow-up was performed through a physician chart review and direct telephone contact. Event rates were determined for hard (myocardial infarction or cardiac death) and soft (hospitalization for angina and/or congestive heart failure, coronary angioplasty, or coronary artery bypass graft surgery) cardiac events occurring after the negative DSE for up to 6 years after the test. Death was also determined by referencing the patients' data with mortality data available on the Internet. There were 143 patients with ECG data reported as negative and 40 patients with ECG data reported as positive for ischemia. The hard and soft event rates were 1.5% and 9% per patient per year in the ECG negative group and 2% and 11% in the ECG positive group. There were no statistical differences in event rates between the two groups during the 5-year follow-up period. Our results suggest that the ECG result obtained during DSE does not confer any incremental prognostic value over the echo result. [source] Prevalence of Anti-cardiolipin, Anti-,2 Glycoprotein I, and Anti-prothrombin Antibodies in Young Patients with EpilepsyEPILEPSIA, Issue 1 2002R. Cimaz Summary: ,Purpose: To measure anti-cardiolipin (aCL), anti-,2 glycoprotein I (anti-,2GPI), and anti-prothrombin (aPT) antibodies in young patients with epilepsy, and to correlate their presence with demographic data, clinical diagnoses, laboratory and neuroradiologic findings, and antiepileptic drugs (AEDs). Methods: Sera from one hundred forty-two consecutive patients with epilepsy with a median age of 10 years were tested for aCL and anti-,2GPI autoantibodies by solid-phase assays. aPT antibodies also were assayed in sera from 90 patients. Positive results were confirmed after a minimum of 6 weeks. Antinuclear antibodies (ANAs) and antibodies against extractable nuclear antigens (ENAs) also were tested. Results: An overall positivity of 41 (28.8%) of 142 sera was found. Fifteen patients were positive for aCL, 25 for anti-,2GPI, and 18 for aPT antibodies. Several patients (12%) displayed more than one specificity in their serum. Only one of these patients had a concurrent positivity for ANAs and ENAs. A predominance of younger patients was found in the antibody-positive group. All types of epilepsy were represented in the positive group. No relation between antibody positivity and AEDs was found. Diffuse ischemic lesions at computed tomography (CT)/magnetic resonance imaging (MRI) scans were present in higher percentages in patients who were antibody positive. No positive patient had a history of previous thrombosis or other features related to systemic lupus erythematosus (SLE), and no patient was born of a mother with SLE. Conclusions: Our study suggests a relation between epilepsy and aPL in young patients. A pathogenetic role for these autoantibodies cannot be excluded, and their determination might prove useful even from a therapeutic point of view. [source] Helicobacter pylori Infection is Associated with Reduced Circulating Ghrelin Levels Independent of Body Mass IndexHELICOBACTER, Issue 5 2005Akiko Shiotani ABSTRACT Background., Ghrelin stimulates growth hormone and has orexigenic and adipogenic effects. Plasma ghrelin levels are reduced in obesity and possibly in Helicobacter pylori infection. Aim., To investigate whether there was a relation between H. pylori infection, body mass index (BMI) and serum ghrelin or leptin levels. Methods., University students undergoing an annual health check-up were invited to participate. H. pylori status was based on the presence of specific IgG H. pylori antibodies in urine. Fasting serum ghrelin, leptin levels, and pepsinogen I and II levels were measured by enzyme immunoassay (EIA). Results., Eight hundred and one students volunteered. There was no significant difference in the height and BMI between those with and without H. pylori infection. The population of ghrelin study consisted of 132 (66 H. pylori -positive and 66 H. pylori -negative) students matched for age, sex, and BMI. The ghrelin level in the H. pylori -positive group was significantly lower (median 55 pmol/l) compared to the H. pylori- negative group (103 pmol/l) (p < .00001). Leptin, triglyceride, total cholesterol, and HDL-cholesterol were not different between the two groups, whereas LDL-cholesterol levels were significantly higher (106 versus 100 mg/dl) (p = .03) in the H. pylori -positive group. Leptin levels correlated with the BMI (r = 0.53) (p < .00001). Among H. pylori -positive subjects, ghrelin correlated only with pepsinogen I levels (r = 0.26, p = .04). Conclusions.,H. pylori infection was associated with a reduction in circulating ghrelin levels independent of sex and BMI. [source] Respiratory Changes in Vasovagal SyncopeJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 6 2000ARVINDER S. KURBAAN M.D. Respiratory Changes in Vasovagal Syncope. introduction: Respiratory changes accompany the cardiovascular changes during head-up. tilt test-induced vasovagal syncope. Methods and Results: Using the 45-minute 60° head-up Westminster protocol, 29 patients were studied (mean age 53.9 ± 20.0 years; 19 females). Two groups resulted: tilt-induced vasovagal syncope positive and negative. The cardiorespiratory parameters blood pressure (BP), heart rate (HR), tidal volume, and minute volume were measured. Comparisons of the cardiorespiratory parameters were made within the positive group and negative group, and then between the two groups. There were 14 in the positive group and 15 in the negative group. Baseline measurements were normalized to 1.0. Comparing the late tilt periods between the positive and negative groups, there were differences in BP (P < 0.002), HR (P < 0.002), tidal volume (P < 0.05), and minute volume (P < 0.002). In the positive group comparing early with late intervals: BP l.11 ± 0.09 versus 0.49 ± 0.17, P < 0.0001; HR 1.18 ± 0.12 versus 0.85 ±0.35, P < 0.009; tidal volume 1.39 ± 0.34 versus 2.17 ± 1.00, P < 0.015; and minute volume 1.24 ± 0.26 versus 3.3 ± 2.03, P < 0.0025. There were no comparable cardiorespiratory changes in the negative group. Conclusion: There were significant differences in the respiratory and cardiovascular parameters measured between those who were positive and those who were negative for tilt-induced vasovagal syncope. Within the positive group, in addition to the falls in HR and BP, there were significant increases in minute volume and tidal volume during late tilt. This suggests that there may be a role for respiratory sensors in vasovagal syncope that may permit earlier and hence possibly more effective therapy for selected patients. [source] Factors affecting the serum gastrin 17 level: an evidence-based analysis of 3906 serum samples among ChineseJOURNAL OF DIGESTIVE DISEASES, Issue 2 2007Zhong ZHANG OBJECTIVE: To investigate the influence of gender, age, site of lesion, disease type and Helicobacter pylori (H. pylori) infection on the human serum gastrin-17 level and to study the diagnostic value of serum gastrin-17 in gastric precancerous lesions and gastric cancer. METHODS: Serum gastrin-17 and serum H. pylori IgG antibody were detected by the ELISA method. The different gastric disease groups were confirmed by endoscopy and histopathology. RESULTS: Among the 3906 serum samples according to the gender, age, site of lesion and the data of different gastric disease groups, the serum gastrin-17 level was markedly higher in people ,60 years old than that in younger age groups. The serum gastrin-17 level increased progressively in the following order: healthy control group, nonatrophic gastritis group, gastric ulcer group, and the serum gastrin-17 level was higher in the atrophic gastritis with dysplasia group than that without it, the lowest level being in the gastric cancer group. Among the 2946 serum samples matched with the site of the lesion, the serum gastrin-17 level was higher in those with antral diseases than in those with gastric corpus diseases. Among the 3805 serum samples matched with the H. pylori infection data, the serum gastrin-17 level was higher in the H. pylori -positive group than in the H. pylori -negative group. CONCLUSIONS: In people over 60 years of age, the serum gastrin-17 level tends to increase. In subjects with precancerous gastric lesions, it may increase significantly with the progression of gastric disease, and ultimately decrease in gastric cancer. Serum gastrin-17 is a good biomarker to differentiate benign from malignant gastric diseases. The site of the gastric lesions is an important factor affecting the serum gastrin-17 level, whereas H. pylori infection is usually associated with its increment. [source] STAT3 expression in gastric cancer indicates a poor prognosisJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 4 2009Dae-Young Kim Abstract Background and Aim:, Signal transducers and activators of transcription (STAT) behave as signal transducers in the cytoplasm and as transcription factors in the nucleus. In the current study, we analyzed the immunohistochemical staining patterns of gastrectomy tissue specimens. We investigated the expression of STAT3 and STAT5 and estimated the relationship between STAT and cancer prognosis. Methods:, One hundred patients who underwent gastrectomy due to gastric adenocarcinoma at Bundang CHA hospital between January 2000 and May 2005 were studied. Immunohistochemistry was carried out using antibodies against STAT3 and STAT5. The interpretation of the immunohistochemical staining was based on the proportion of stained cells in the field: positive, > 10% stained cells; and negative, < 10% stained cells. Results:, The longest diameter of tumor was 4.67 cm in the positive group and 3.76 cm in the negative group, and these results were not statistically different (P -value = 0.112). Higher T (primary tumor) value (P -value = 0.05), more regional lymph node invasion (P -value = 0.008) and higher TNM staging (P -value = 0.069) were significantly related to STAT3 positivity, but Helicobacter pylori infection or atrophic gastritis were not related. A lower survival rate was observed in the STAT3-positive group (P -value = 0.001). The results of STAT5 were not statistically different with respect to TNM staging and survival (P -value = 0.958). We thus report that the immunohistochemical results of STAT3 revealed a significant association with TNM staging and survival. Conclusion:, We anticipate that STAT3 may be used as a molecular staging biomarker predicting poor prognosis of gastric cancer. [source] Helicobacter pylori infection detected by 14C-Urea breath test is associated with iron deficiency anemia in pregnant womenJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 6 2008s Mulayim Abstract Aims:, To determine whether there is a relationship between Helicobacter pylori (H. pylori) infection, iron deficiency anemia and thrombocytopenia in pregnant women. Methods:, Hemoglobin and ferritin levels and platelet counts of pregnant women were measured during the third trimester. H. pylori infection was determined using a 14C-urea breath test (14C-UBT) after delivery. Statistical analyses were determined with a Mann,Whitney U -test and the ,2 test. Statistical significance was determined with a P -value less than .05. Results:, Seventy-two of 117 women had positive results on the 14C-UBT. Overall, 27 of 117 pregnant women had anemia (23.1%), and all them were in the H. pylori -positive group; 18 of 27 (66.7%) had iron deficiency anemia. Median hemoglobin levels and neonatal body weights were 12.0 g/dL vs 12.0 g/dL and 3320.0 grams vs 3520.0 grams in the H. pylori -positive and negative groups, respectively. Serum hemoglobin and ferritin levels and neonatal body weight were found to be lower in the anemic group compared with the non-anemic group among H. pylori -infected women (P = 0.0001, P = 0.02, P = 0.008, respectively). There were no statistically significant differences with regard to gestational thrombocytopenia between the H. pylori -positive and H. pylori -negative groups (P = 0.532). Conclusions:, Our study indicates that there is a strong relationship between H. pylori infection and iron deficiency anemia in women with uncomplicated pregnancy. However, an association between H. pylori infection and thrombocytopenia was not found. [source] Proton pump inhibitors as a risk factor for paediatric Clostridium difficile infectionALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 7 2010R. TURCO Aliment Pharmacol Ther,31, 754,759 Summary Background, Proton pump inhibitors (PPIs) and H2 receptor antagonists (H2RAs) may play an important role on the onset of Clostridium difficile -associated disease (CDAD) in adults. The impact of Clostridium difficile on children treated with gastric acid-suppressing agents remains unknown. Aim, To investigate the relationship between CDAD and exposure to acid suppressive therapy in hospitalized paediatric patients. Methods, We reviewed the medical records of children, with a diagnosis of protracted diarrhoea and abdominal pain, whose stool was analysed for C. difficile toxins. We identified 68 patients with CDAD. For each patient, we randomly selected one control subjects with stool analysis negative for C. difficile. Comorbid illnesses, previous hospitalizations, antibiotics, corticosteroids, immunosuppressants and gastric acid suppressing exposures were recorded. Results, The use of PPI was significantly higher in C. difficile positive group compared with C. difficile negative group [odds ratio (OR): = 4.5; 95% confidence interval (CI) = 1.4,14.4]. We also found a trend for the use of H2RAs in patients infected by C. difficile compared with C. difficile negative comparison group (OR: = 3.8; 95% CI = 0.7,18.9). Conclusions, Children exposed to PPIs therapy seem to be at higher risk for the development of Clostridium difficile -associated disease. [source] Influence of anti-HBc seropositivity on the risk of hepatocellular carcinoma in HCV-infected patients after adjusting for confounding factorsJOURNAL OF VIRAL HEPATITIS, Issue 2 2010T. Ohki Summary., It is controversial whether past hepatitis B virus infection constitutes an additional risk of hepatocellular carcinoma (HCC) among patients with hepatitis C virus (HCV). The incidence of HCC between 1994 and 2004 was analysed among 1262 patients who were only positive for HCV. The cumulative incidence of HCC was assessed by Kaplan,Meier analysis and the difference between two groups was assessed by the log-rank test. The effect of anti-HBc positivity on the risk of HCC was assessed with multivariate Cox proportional analysis. Anti-HBc was positive in 522 (41.4%) patients. The proportion of male patients (56.7 vs 46.8%, P < 0.001) and mean age (60.8 vs 56.9 years, P < 0.001) were significantly higher in the anti-HBc positive group. HCC developed in 339 patients (mean follow-up 7.0 years), with cumulative incidence rates at 3, 5 and 10 years of 12.7, 24.5 and 41.9% in the anti-HBc positive group and 10.6, 17.7 and 33.4% in the negative group, respectively (P = 0.005). However, anti-HBc seropositivity did not reach statistical significance in multivariate analysis including age and gender (hazard ratio, 1.06; 95% CI, 0.85,1.31; P = 0.63). Anti-HBc positivity and HCC incidence were confounded by male gender and older age. [source] Abnormality of the Left Ventricular Sympathetic Nervous Function Assessed by I-123 Metaiodobenzylguanidine Imaging in Pediatric Patients with Neurocardiogenic SyncopePACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 10 2003RANA OLGUNTÜRK The purpose of this study was to assess the left ventricular sympathetic nervous system function in the patients with neurocardiogenic syncope (NCS) using I-123 metaiodobenzylguanidine (MIBG) imaging of the heart, and to compare the plasma noradrenaline (NA) and MIBG results of tilt positive and tilt negative patients following a head-up tilt test (HUT). The study included 30 patients. Their physical and laboratory examinations did not show a pathology that may be the cause of their syncope. HUT test was positive in 13 patients and negative in 17 patients. Plasma NA concentrations were higher in the HUT positive than the HUT negative group at the beginning and at the 10th minute of the test. Specific I-123 MIBG uptake assessed as the cardiac to mediastinal activity ratio in the delayed image was significantly higher in HUT positive group. The higher levels of MIBG uptake and plasma NA observed in HUT positive patients may reflect the greater capacity of NA storage in cardiac adrenergic neuronal tissue in patients with NCS. The results of this study support the critical role of autonomic nervous system in the pathophysiology of NCS and the excessive sympathetic nervous stimulation as the trigger of paradox reflex. (PACE 2003; 26:1926,1930) [source] Lymphocytotoxic crossmatch in pediatric living donor liver transplantationPEDIATRIC TRANSPLANTATION, Issue 2 2009Takeshi Saito Abstract:, To investigate the relationship between the pretransplant LCT results and the outcome after pediatric LDLT in a single center. The clinical data of 76 children undergoing 79 LDLTs including three retransplantations from May 2001 to January 2006 were retrospectively analyzed. All of the children had end-stage liver disease, and their median age was 1.4 yr (range, six months to 16.5 yr). Immunosuppressive therapy consisted of cyclosporine- or FK-based regimens with steroids. The children were classified into two groups (positive or negative) according to the pretransplant LCT results. The incidences of post-transplant surgical complications and of rejection episodes were compared. The relationship between the pretransplant LCT results and patient and graft survival rates was also analyzed. Seventy-nine pretransplant crossmatch tests were done; 13 (16.5%) were positive, and 66 (83.5%) were negative. No significant difference was found in the pretransplant clinical factors between two crossmatch groups. There was no significant difference between the groups in the incidence of vascular and biliary tract complications, in the rate of early or steroid-resistant cellular rejections, or in one- and three-yr patient (91.7%, 91.7%, respectively, in the positive group, 93.5%, 93.5%, respectively, in the negative group, p = 0.80) and graft (92.3%, 92.3%, respectively, in the positive group, 88.8%, 86.4%, respectively, in the negative group, p = 0.63) survival. The present study demonstrates that there is no reason to do pretransplant LCT to select the living donor for pediatric LDLT. [source] The Occurrence and Ape-to-Ape Transmission of the Entodiniomorphid Ciliate Troglodytella abrassarti in Captive GorillasTHE JOURNAL OF EUKARYOTIC MICROBIOLOGY, Issue 1 2009DAVID MODRİ ABSTRACT. Entodiniomorphid ciliates are often present in the colons of wild apes. In captive apes the infection tends to gradually disappear, with the exception of Troglodytella abrassarti. We used fecal examinations to screen the gorillas (Gorilla gorilla gorilla) in European (Czech Republic, UK) and Australian Zoos to explore the ape-to-ape transmission pattern of T. abrassarti. Gorillas from two out of three European Zoos were positive for T. abrassarti, while gorillas from the Australian Zoo were negative. We documented a horizontal transmission of T. abrassarti to a non-infected adult gorilla introduced into a Troglodytella -positive group in the Prague Zoo and traced the origin of the ciliate infection to the Paignton Zoo (UK) using serial fecal examinations. During this study, two infant gorillas born in the Prague Zoo (CZ) first became positive for T. abrassarti at the age of 9 mo. Ciliate morphology and the sequencing of the small subunit rRNA gene and the internal transcribed spacer rDNA spacer region revealed that T. abrassarti affects both captive gorillas and chimpanzees. We conclude that zoo transport plays a major role in the distribution of T. abrassarti among captive gorillas. [source] Autoimmune Sensorineural Hearing Loss in Young Patients: An Exploratory StudyTHE LARYNGOSCOPE, Issue 11 2001Jean-Paul Tomasi MD Abstract Objectives P0 protein is expressed exclusively in myelinating Schwann cells of the peripheral nervous system. In a previous study from our laboratory, 27% of patients with sensorineural hearing loss (SNHL) had antibodies to P0 protein in their serum. The purpose of the present exploratory study was to examine the relationship between the clinical presentation of SNHL among children and young adults (age range, 5,30 y) and the presence of serum anti-P0 antibodies. Study Design The data were collected by retrospective questionnaires from Belgian otolaryngologists. Methods Patients were divided for comparison into two groups according to the presence or absence of anti-P0 antibodies. Results Analyses of clinical data and audiometric results indicated that a progressive hearing loss was more frequently recorded in the patients in the anti-P0 antibody,positive group (82% [14 of 17]) than in those in the anti-P0 antibody,negative group (35% [6 of 17]) (P <.005). Conclusions Thus, in the age group in the present study, autoimmune SNHL (as measured in the present study by the presence of anti-P0 antibodies) is more frequently associated with progressive than with sudden hearing loss. The implications of this finding for preventive screening of hearing loss in children and young adults are discussed. [source] Anti,U3 RNP autoantibodies in systemic sclerosisARTHRITIS & RHEUMATISM, Issue 4 2009Rohit Aggarwal Objective To describe the classification, demographic and clinical features, and survival in anti,U3 RNP autoantibody,positive patients with systemic sclerosis (SSc). Methods Medical records of 108 anti,U3 RNP,positive and 2,471 anti,U3 RNP,negative SSc patients first evaluated during 1985,2003 were reviewed. Anti,U3 RNP antibody was detected by protein and RNA immunoprecipitation. Disease classification, demographic and clinical features, organ system involvement, and survival were compared between the 2 patient groups, by Student's t -test, chi-square analysis, and Mantel-Haenszel test. Results The anti,U3 RNP,positive group had a higher proportion of African American patients (27% versus 5%; P < 0.001) and male patients (29% versus 19%; P = 0.021), and was younger at the time of first physician diagnosis (mean age 42.8 years versus 47.4 years; P = 0.001). The 2 groups had similar proportions of patients with diffuse cutaneous involvement (47% and 45% in those with and those without anti,U3 RNP, respectively). However, among patients with diffuse cutaneous involvement, the mean maximum modified Rodnan skin score was significantly lower in the anti,U3 RNP group (22.3 versus 27.9; P < 0.001). Skeletal muscle involvement was more frequent in anti,U3 RNP,positive patients (25% versus 14%; P = 0.002), as was "intrinsic" pulmonary arterial hypertension (PAH) (31% versus 13%; P < 0.001). The frequency of gastrointestinal involvement, cardiac involvement, pulmonary fibrosis, and "renal crisis" did not differ significantly between the 2 groups. Survival was worse in the anti,U3 RNP,positive group (hazard ratio 1.38 [95% confidence interval 1.05,1.82]). PAH was the most common known cause of death in patients with anti,U3 RNP (30%, versus 10% in the anti,U3 RNP,negative group; P < 0.001). Conclusion The present findings demonstrate that the frequencies of African American race and male sex are greater among SSc patients with anti,U3 RNP antibody than those without, and the former group is younger at SSc diagnosis. Anti,U3 RNP,positive patients have more frequent skeletal muscle involvement and PAH, the latter being the most common cause of death. [source] Sweat antigen induces histamine release from basophils of patients with cholinergic urticaria associated with atopic diathesisBRITISH JOURNAL OF DERMATOLOGY, Issue 2 2009S. Takahagi Summary Background, We previously demonstrated that the semipurified human sweat antigen causes skin reactions and histamine release from basophils via specific IgE in patients with atopic dermatitis (AD). Patients with cholinergic urticaria (ChU) also develop skin reactions and histamine release of basophils in response to autologous sweat. Objectives, To study whether or not patients with ChU share sensitivity for the sweat antigen with patients with AD and to study the clinical characteristics among patients with ChU and the relationship with histamine-release activity of basophils. Methods, The sweat antigen that induces histamine release from basophils of patients with AD was prepared by Con-A, anion-exchange and reverse-phase chromatography. Relationships between histamine-release activity against the sweat antigen and clinical features of patients with ChU were analysed. Results, Twenty-three of 35 patients with ChU showed > 5% net histamine release in response to the semipurified sweat antigen, whereas none of healthy controls did so. In patients with ChU, histamine release in response to semipurified sweat antigen significantly correlated with the level of serum IgE and eosinophil numbers in peripheral blood. Incidence of each atopic disease in patients with ChU tended to be higher than in the general Japanese population. When the patients were categorized according to their responses in the histamine release test, the positive group tended to show a higher incidence of AD and bronchial asthma compared with the negative group. Conclusions, ChU and AD may share hypersensitivity to common antigens in sweat. The sweat allergy and atopic diathesis are associated with each other. [source] Peritubular capillary C4d deposition and renal outcome in post-transplant IgA nephropathyCLINICAL TRANSPLANTATION, Issue 2 2007Jung Choi Abstract:, Backgrounds:, Immunological staining of the transplanted kidney for C4d in peritubular capillaries (C4dPTC) has emerged as a useful method to detect antibody-mediated rejection in situ. In this retrospective study, we evaluated the prevalence of C4dPTC deposition in allograft renal biopsies diagnosed of IgA nephropathy (IgAN) and analysed its clinical significance. Method:, Sixty-six biopsy specimens of post-transplant IgAN, which were obtained to evaluate azotemia and/or heavy proteinuria, were examined by immunohistochemical staining of the paraffin sections with polyclonal antibody for C4d. Results:, C4d was stained positively in peritubular capillaries in 16 (24%) of the 66 cases. The C4dPTC -negative (n=50) and C4dPTC -positive groups (n=16) were not different in recipient gender, age, donor age, type of donor (living vs. cadaveric), interval from transplantation to graft biopsy (41.6± 21.8 vs. 48.3±26.1 months) and post-biopsy follow-up period (60.3±23.3 vs. 56.9±25.4 months). During the follow-up period, 12 of 50 (24%) although the incidence of graft failure was not different by the C4d deposition in peritubular capillaries, intervals from renal biopsy to graft failure tended to be shorter in C4dPTC -positive cases than C4dPTC -negative cases. In Kaplan,Meier analysis, the renal allograft function of the C4dPTC -positive group deteriorated more rapidly than that of the C4dPTC -negative group (p<0.05). Histologically, the C4dPTC -positive group had findings suggestive of acute cellular rejection more commonly than the C4dPTC -negative group (p<0.01). Conclusions:, Evidence of humoral rejection, as demonstrated by C4dPTC deposition, was concurrently present in significant portions of post-transplant IgAN biopsy specimens and was associated with more rapid deterioration of renal function. These results suggest that C4dPTC positivity needs to be determined at the time of biopsy even in cases of post-transplant glomerulonephritis and immunosuppression may need to be modified accordingly. [source] | |||||||||||||||||||||||||