AIM: To evaluate the serum concentration of antimitochondrial antibodies (AMAs) as a prognostic indicator of progressive primary biliary cirrhosis (pPBC). METHODS: Serum concentrations of AMA subtypes (anti-M2,...AIM: To evaluate the serum concentration of antimitochondrial antibodies (AMAs) as a prognostic indicator of progressive primary biliary cirrhosis (pPBC). METHODS: Serum concentrations of AMA subtypes (anti-M2, anti-M4, and anti-M9), biochemical indices of liver function and Mayo risk factor (MRF) were determined in 30 women with diagnosed primary biliary cirrhosis (PBC) selected among 348 females with elevated alkaline phosphatase but without signs of hepatic decompensation. They were followed up for 5 years for possible development of hepatic decompensation. RESULTS: Anti-M2 concentration was significantly correlated with bilirubin and albumin levels as well as MRF, whereas anti-M4 was significantly correlated with albumin level, prothrombin time and MRF. During the 5-year follow-up, progressive PBC (pPBC) was diagnosed in 3 among 23 patients available for evaluation. These 3 patients were positive for both anti-M2 and anti-M4. Anti-M2 serum concentration exceeded 1 300 RU/mL in patients with pPBC and only in 1 among 20 non-progressive PBC persons (5%). Anti-M4 serum concentration exceeded 400 RU/mL in 2 of the progressive patients and none in the non-progressive group. In contrast, anti-M9 serum concentration was below 100 RU/mL in all patients with pPBC, and higher than 100 RU/mL in 11 women (55%) among the non-progressive group. CONCLUSION: Females with elevated alkaline phosphatase and high anti-M2 and anti-M4 concentrations are at a high risk for developing pPBC. Quantitative AMA detection should be considered as a method for early diagnosis of pPBC. 2005 The WJG Press and Elsevier Inc. All rights reserved.展开更多
AIM: To examine the concentration of a new antigen SC6 (SC6-Ag) recognized by monoclonal antibody (MAb)in patients with pancreatic cancer and other malignant or benign diseases and to understand whether SC6-Ag has any...AIM: To examine the concentration of a new antigen SC6 (SC6-Ag) recognized by monoclonal antibody (MAb)in patients with pancreatic cancer and other malignant or benign diseases and to understand whether SC6-Ag has any clinical significance in distinguishing pancreatic cancer from other gastrointestinal diseases.METHODS: Six hundred and ninety-five serum specimens obtained from 115 patients with pancreatic cancer, 154 patients with digestive cancer and 95patients with non-digestive cancer were used and classified in this study. Serum specimens obtained from 140 patients with benign digestive disease and 89 patients with non-benign digestive disease served as controls. Ascites was tapped from 16 pancreatic cancer patients, 19 hepatic cancer patients, 16 colonic cancer patients, 10 gastric cancer and 6 severe necrotic pancreatitis patients. The samples were quantitated by solid-phase radioimmunoassay. The cut-off values (CV)of 41, 80, and 118 U/mL were used.RESULTS: The average intra- and interassay CV detected by immunoradiometric assay of SC6-Ag was 5.4% and 8.7%, respectively. The sensitivity and specificity were 73.0% and 90.9% respectively. The levels in most malignant and benign cases were within the normal upper limit. Among the 16 pancreatic cancer cases, the concentration of SC6-Ag in ascites was over the normal range in 93.8% patients. There was no significant difference in the concentration of SC6-Ag.Decreased expression of SC6-Ag in sera was significantly related to tumor differentiation. The concentration of SC6-Ag was higher in patients before surgery than after surgery. The specificity of SC6-Ag and CA19-9 was significantly higher than that of ultrasound and computer tomography (CT) in pancreatic cancer patients. Higher positive predictive values were indicated in 92.3% SC6-Ag and 88.5% CA19-9, but lower in 73.8% ultrasound and 76.2% CT.CONCLUSION: The combined test of SC6-Ag and CA19-9 may improve the diagnostic rate of primary cancer. The detection of SC6-Ag is valuable in the diagnosis of pancreatic cancer before and after surgery.展开更多
AIM:To investigate the association between serum antibody levels and a subsequent celiac disease diag-nosis in a large series of children and adults. METHODS:Besides subjects with classical gastrointestinal presentati...AIM:To investigate the association between serum antibody levels and a subsequent celiac disease diag-nosis in a large series of children and adults. METHODS:Besides subjects with classical gastrointestinal presentation of celiac disease,the study cohort included a substantial number of individuals with extraintestinal symptoms and those found by screening in at-risk groups.Altogether 405 patients underwent clinical,serological and histological evaluations.After collection of data,the antibody values were further graded as low[endomysial(EmA)1:5-200,transglutaminase 2 antibodies(TG2-ab)5.0-30.0 U/L]and high (EmA 1:≥500,TG2-ab≥30.0 U/L),and the serological results were compared with the small intestinal mucosal histology and clinical presentation. RESULTS:In total,79%of the subjects with low and 94%of those with high serum EmA titers showed small-bowel mucosal villous atrophy.Furthermore, 96%of the 47 EmA positive subjects who had normal mucosal villi and remained on follow-up either subsequently developed mucosal atrophy while on a glutencontaining diet,or responded positively to a glutenfree diet. CONCLUSION:Irrespective of the initial serum titers or clinical presentation,EmA positivity as such is a very strong predictor of a subsequent celiac disease diagnosis.展开更多
The purpose of this investigation is to study the clinical characteristics of infections by community-acquired methicillin-resistant Staphylococcus aureus (MRSA) and the condition of antibiotics resistance of the clin...The purpose of this investigation is to study the clinical characteristics of infections by community-acquired methicillin-resistant Staphylococcus aureus (MRSA) and the condition of antibiotics resistance of the clinical isolates in order to guide for the rational use of antibiotics. With the clinical isolates from cases of hospital-acquired MRSA at the same period as controls, the clinical characteristics of infections by community-acquired MRSA in Hangzhou area and the pattern of non-β-lactamase antibiotics resistance were determined in this study. It was found that the average age of patients with community-acquired MRSA infections was 30.89±13.3, in comparison with those of the hospital-acquired patients of 56.0±11.8, appearing to be younger than those of the latter, and the former showing no any basic illness. Both of the former and the latter were sensitive to vancomycin (100% vs 100%), and they had the same degrees of sensitivity to rifampicin, fosfomycin, and STM/TMP (86.8% vs 88.1%, P >0.05; 81.6% vs 82.9%, P >0.05; and 52.6% vs 61.9%, P >0.05, respectively). The former was more sensitive to netimycin, clindamycin, erythromycin and minocycline than those of the latter (73.7% vs 50.5%, P <0.01; 60.5% vs 45.7%, P <0.05; 28.9% vs 11.4%, P <0.01; and 81.6% vs 58.6%, P <0.01 respectively). Meanwhile, the incidence of multi-resistant strain of isolates in the former was significantly lower than that of the latter (31.6% vs 81.0%, P <0.01). In conclusion, it appears that the strains of clinical isolates isolated from patients with the community-acquired MRSA infections show different clinical characteristics and antimicrobial susceptibility in comparison with those of the hospital-acquired cases of infection, and this necessitates an alteration in the chemotherapy of infections suspected to be caused by community-acquired MRSA.展开更多
文摘AIM: To evaluate the serum concentration of antimitochondrial antibodies (AMAs) as a prognostic indicator of progressive primary biliary cirrhosis (pPBC). METHODS: Serum concentrations of AMA subtypes (anti-M2, anti-M4, and anti-M9), biochemical indices of liver function and Mayo risk factor (MRF) were determined in 30 women with diagnosed primary biliary cirrhosis (PBC) selected among 348 females with elevated alkaline phosphatase but without signs of hepatic decompensation. They were followed up for 5 years for possible development of hepatic decompensation. RESULTS: Anti-M2 concentration was significantly correlated with bilirubin and albumin levels as well as MRF, whereas anti-M4 was significantly correlated with albumin level, prothrombin time and MRF. During the 5-year follow-up, progressive PBC (pPBC) was diagnosed in 3 among 23 patients available for evaluation. These 3 patients were positive for both anti-M2 and anti-M4. Anti-M2 serum concentration exceeded 1 300 RU/mL in patients with pPBC and only in 1 among 20 non-progressive PBC persons (5%). Anti-M4 serum concentration exceeded 400 RU/mL in 2 of the progressive patients and none in the non-progressive group. In contrast, anti-M9 serum concentration was below 100 RU/mL in all patients with pPBC, and higher than 100 RU/mL in 11 women (55%) among the non-progressive group. CONCLUSION: Females with elevated alkaline phosphatase and high anti-M2 and anti-M4 concentrations are at a high risk for developing pPBC. Quantitative AMA detection should be considered as a method for early diagnosis of pPBC. 2005 The WJG Press and Elsevier Inc. All rights reserved.
文摘AIM: To examine the concentration of a new antigen SC6 (SC6-Ag) recognized by monoclonal antibody (MAb)in patients with pancreatic cancer and other malignant or benign diseases and to understand whether SC6-Ag has any clinical significance in distinguishing pancreatic cancer from other gastrointestinal diseases.METHODS: Six hundred and ninety-five serum specimens obtained from 115 patients with pancreatic cancer, 154 patients with digestive cancer and 95patients with non-digestive cancer were used and classified in this study. Serum specimens obtained from 140 patients with benign digestive disease and 89 patients with non-benign digestive disease served as controls. Ascites was tapped from 16 pancreatic cancer patients, 19 hepatic cancer patients, 16 colonic cancer patients, 10 gastric cancer and 6 severe necrotic pancreatitis patients. The samples were quantitated by solid-phase radioimmunoassay. The cut-off values (CV)of 41, 80, and 118 U/mL were used.RESULTS: The average intra- and interassay CV detected by immunoradiometric assay of SC6-Ag was 5.4% and 8.7%, respectively. The sensitivity and specificity were 73.0% and 90.9% respectively. The levels in most malignant and benign cases were within the normal upper limit. Among the 16 pancreatic cancer cases, the concentration of SC6-Ag in ascites was over the normal range in 93.8% patients. There was no significant difference in the concentration of SC6-Ag.Decreased expression of SC6-Ag in sera was significantly related to tumor differentiation. The concentration of SC6-Ag was higher in patients before surgery than after surgery. The specificity of SC6-Ag and CA19-9 was significantly higher than that of ultrasound and computer tomography (CT) in pancreatic cancer patients. Higher positive predictive values were indicated in 92.3% SC6-Ag and 88.5% CA19-9, but lower in 73.8% ultrasound and 76.2% CT.CONCLUSION: The combined test of SC6-Ag and CA19-9 may improve the diagnostic rate of primary cancer. The detection of SC6-Ag is valuable in the diagnosis of pancreatic cancer before and after surgery.
基金Supported by The Academy of Finland Research Council for Healththe Competitive Research Funding of the Pirkanmaa Hospital District+5 种基金the Sigrid Juselius Foundationthe Foundation for Paediatric Researchthe National Graduate School of Clinical Investigationthe Ehrnrooth Foundationthe Finnish Gastroenterology Societythe Finnish Pediatric Society and the Finnish Celiac Society
文摘AIM:To investigate the association between serum antibody levels and a subsequent celiac disease diag-nosis in a large series of children and adults. METHODS:Besides subjects with classical gastrointestinal presentation of celiac disease,the study cohort included a substantial number of individuals with extraintestinal symptoms and those found by screening in at-risk groups.Altogether 405 patients underwent clinical,serological and histological evaluations.After collection of data,the antibody values were further graded as low[endomysial(EmA)1:5-200,transglutaminase 2 antibodies(TG2-ab)5.0-30.0 U/L]and high (EmA 1:≥500,TG2-ab≥30.0 U/L),and the serological results were compared with the small intestinal mucosal histology and clinical presentation. RESULTS:In total,79%of the subjects with low and 94%of those with high serum EmA titers showed small-bowel mucosal villous atrophy.Furthermore, 96%of the 47 EmA positive subjects who had normal mucosal villi and remained on follow-up either subsequently developed mucosal atrophy while on a glutencontaining diet,or responded positively to a glutenfree diet. CONCLUSION:Irrespective of the initial serum titers or clinical presentation,EmA positivity as such is a very strong predictor of a subsequent celiac disease diagnosis.
文摘The purpose of this investigation is to study the clinical characteristics of infections by community-acquired methicillin-resistant Staphylococcus aureus (MRSA) and the condition of antibiotics resistance of the clinical isolates in order to guide for the rational use of antibiotics. With the clinical isolates from cases of hospital-acquired MRSA at the same period as controls, the clinical characteristics of infections by community-acquired MRSA in Hangzhou area and the pattern of non-β-lactamase antibiotics resistance were determined in this study. It was found that the average age of patients with community-acquired MRSA infections was 30.89±13.3, in comparison with those of the hospital-acquired patients of 56.0±11.8, appearing to be younger than those of the latter, and the former showing no any basic illness. Both of the former and the latter were sensitive to vancomycin (100% vs 100%), and they had the same degrees of sensitivity to rifampicin, fosfomycin, and STM/TMP (86.8% vs 88.1%, P >0.05; 81.6% vs 82.9%, P >0.05; and 52.6% vs 61.9%, P >0.05, respectively). The former was more sensitive to netimycin, clindamycin, erythromycin and minocycline than those of the latter (73.7% vs 50.5%, P <0.01; 60.5% vs 45.7%, P <0.05; 28.9% vs 11.4%, P <0.01; and 81.6% vs 58.6%, P <0.01 respectively). Meanwhile, the incidence of multi-resistant strain of isolates in the former was significantly lower than that of the latter (31.6% vs 81.0%, P <0.01). In conclusion, it appears that the strains of clinical isolates isolated from patients with the community-acquired MRSA infections show different clinical characteristics and antimicrobial susceptibility in comparison with those of the hospital-acquired cases of infection, and this necessitates an alteration in the chemotherapy of infections suspected to be caused by community-acquired MRSA.