Gaoxiong yi xue ke xue za zhi = The Kaohsiung journal of medical sciences最新文献

To study whether normal sinus flora exist in normal sinus, we used 40 sinuses from 20 New Zealand white rabbits as the animal model. The histological examination was performed on sinus mucosa from each sinus and bacteria from these sinuses were cultured. Surprisingly, 70% of them (28 sinuses) were found to have sinusitis. These sinuses not only contained bacteria in culture but also showed various degree of histological inflammatory reaction in mucosa examination. Of the other 12 normal or near normal sinuses, only two showed positive bacterial culture, and ten of them showed negative bacterial culture either from discharge or mucosa studies. Accordingly, these data suggest that these two studies (bacterial culture and histological mucosa examination) are consistent. Thus, from this study it was concluded that there is no bacteria or few bacteria in normal sinus.

Tamm-Horsfall glycoprotein (THG), a unique renal glycoprotein, is synthesized exclusively by the epithelial cells of the thick ascending loop of Henle and early segment of distal convoluted tubules. The protein is the primary constituent of urinary hyaline cast. The aggregation and gel formation of THG in response to increasing concentrations of electrolytes and low pH within physiologic ranges may affect the permeability of water in this segment. The dual effect of THG on mononuclear cells renders the molecule to become a potent immunomodulator. The cytokine-binding activity of THG lets the kidney an important tissue for cytokine catabolism. The aggregation characteristics of THG also plays a role in pathologic states and leads to the persistence of interstitial deposits in several tubulointerstitial diseases. The induction of immune responses to this protein, including urinary tract infection, reflux nephropathy chronic active hepatic damage, elicites immune complex tubulointerstitial nephritis. It is expected that the detection of THG or its antibodies may aid in the diagnosis of renal tubular disorders.

Secretory breast carcinoma is a very rare tumor of the breast and has distinctive pathological characteristics such as (1) the presence of large amounts of intracellular and extracellular secretion and (2) granular eosinophilic cytoplasma of the cells. It usually occurs in children or adolescents and is known to have a better prognosis than the usual ductal carcinoma. The preoperative aspiration cytology is also distinctive and it could permit planning the optimal surgical therapy such as breast conservation surgery for young patients. We report a case of secretory breast carcinoma in a 35 year-old female and her preoperative aspiration cytology in Liu's stain. To our knowledge, Secretory breast carcinoma has not been reported previously in Taiwan.

The alveolar epithelium permeability (AP) in 34 patients with systemic lupus erythematosus (SLE) was measured by Tc-99m DTPA radioaerosol inhalation lung scintigraphy. The degree of AP damage in SLE was represented as the slope of the time-activity curve from the dynamic lung imagings. The patients were divided into two subgroups according to the following two criteria. [A] clinical feature: they were separated as stable or flare stage; and [B] chest X-ray findings: they were separated as positive or negative results. Meanwhile, the quantitative Gallium-67 (Ga) lung scan was performed as Ga uptake index (GUI) to evaluate the severity of inflammation in the lungs in SLE. The results show that [1] there were no significant statistical differences in the degree of AP damage between the two subgroups according to clinical features or chest X-ray findings, and [2] no good correlation between the degree of AP damage and inflammation of the lungs was found. In conclusion, the change of AP in SLE may be a mechanism not related to the presentation of clinical features or chest X-ray findings, and the degree of AP damage in SLE is not related to the severity of pulmonary inflammation.

In order to investigate the relationship between genotypes of herpes simplex virus (HSV) and its clinical pictures in herpes simplex virus keratoconjunctivitis (HSK), fifty nine strains of HSV isolates, collected in the Kaohsiung Medical College Hospital during January 1981 to July 1991, and F strain (ATCC VR-73), a standard HSV-1, were studied. The viruses were isolated from HSK patients. All 59 strains were identified as HSV-1 using immunofluorescence monoclonal antibody method. The HSV DNAs were extracted and digested by restriction enzymes, BamH I, Kpn I and Sal I, followed by electrophoresis, and photographing. Six kinds of DNA cleavage patterns were found in Taiwan. The majority were E subtype (56.4%) then A subtype (27.3%), D subtype (7.3%), F subtype (5.4%), G subtype (1.8%) and H subtype (1.8%). Subtypes B and C were not found in this study. The cleavage patterns of two recurrent cases belonged to E and A subtypes. The identical cleavage patterns of two bilateral infections all belonged to the E subtype.

We attempted the strategy of natural and amplification-created restriction sites for early prenatal and preimplantation diagnosis of Chinese beta-thalassemia. Mutagenesis primers were designed for 11 mutations reported for the Chinese population. The diagnosis was established after polymerase chain reaction and digestion of products by specific enzymes. The results were confirmed by direct sequencing of enzymatically amplified double-stranded DNA. The beta-globin gene was amplified from triploid embryos and isolated blastomeres using mismatched primers. The mutant and normal alleles can be distinguished clearly by this new method. Early prenatal diagnosis was successfully achieved in 9 cases. The beta-globin gene was successfully amplified from single blastomeres and tripronuclear embryos with mismatched primers. Natural and amplification-created restriction sites are a reliable method for rapid prenatal diagnosis of beta-thalassemia. Furthermore, the strategy provides a possible approach for the preimplantation diagnosis of beta-thalassemia.

Hepatocellular carcinoma (HCC) is one of the most common neoplasma in Taiwan. The tumor itself has the tendency of extension into the venous system, such as to the portal vein, hepatic vein and inferior vena cava (IVC), but intra-atrial metastasis is unusual. Antemortem diagnosis was difficult before the availability of two-dimensional echocardiography (2-DE). Sometimes, the first symptoms and signs are cardiogenic manifestations such as dyspnea on exertion, syncope, edema of the lower legs, and shock. Clinicians may mistakenly make the wrong diagnosis of heart failure. Because of this, we hereby report three cases of HCC with right intra-atrial metastasis to raise the physician's awareness. All three cases initially presented as right side heart failure. Imaging study revealed hepatocellular carcinoma with right intra-atrial metastasis. Two of the three cases died within one month after diagnosis.