Elevated serum CA‐125 levels in patients with non‐tuberculous mycobacterial lung disease

Background and objective: Although cancer antigen 125 (CA‐125) is a useful marker for the diagnosis of ovarian cancer, CA‐125 levels are elevated in many benign conditions, including tuberculosis (TB). The clinical significance of serum CA‐125 measurements in patients with non‐tuberculous mycobacterial (NTM) lung disease was evaluated. Methods: Patients with NTM lung disease (n = 53), in whom serum CA‐125 levels had been measured, were retrospectively enrolled in the study. Twenty‐eight patients with pulmonary TB were included as a comparison group. Clinical, radiological and bacteriological parameters were assessed according to serum CA‐125 status. Results: Among 53 patients with NTM lung disease, serum CA‐125 levels were elevated in 28 (52.8%), and this proportion was not significantly different from that of the TB patients (44.8%). Cavitation and upper lobe cavitary type disease were more frequent in NTM patients with elevated serum CA‐125 levels compared with those without increased CA‐125 levels (P < 0.05 for both). The clinical course of NTM lung disease was correlated with changes in serum CA‐125 levels. Conclusions: Serum CA‐125 levels were increased in significant proportions of NTM patients, as well as TB patients. Further studies are needed to investigate the usefulness of serum CA‐125 measurements in patients with NTM pulmonary disease.     

PrPc is temporospatially expressed in molar development of rats

Odontogenesis, tooth development, is derived from two tissue components: ectoderm and neural crest‐derived mesenchyme. Cyto‐differentiation of odontogenic cells during development involves time‐dependent and sequential regulation of genetic programs. This study was conducted to detect molecules implicated in cyto‐differentiation of developing molar germs of rats. Differential display‐PCR revealed that PrP^c was differentially expressed between cap/early bell‐staged germs (maxillary 3rd molar germs) and root formation‐staged germs (maxillary 2nd molar germs) at postnatal day 9. Both levels of PrP^c mRNA and protein expression were higher in the root formation stage than the cap/early bell stage and increased in a time‐dependent manner. Immunofluorescence revealed for the first time that PrP^c was not localized in the enamel organ, but localized in dental follicular cells for the development of the periodontal ligament and cementum as well as odontoblasts, both of which are of neural crest origin. These results suggest that the physiological functions of the PrP^c in tooth development may be implicated in the differentiation of neural crest‐derived mesenchyme including the periodontal tissues for root formation rather than epithelial tissue. Anat Rec, 296:1929–1935, 2013. © 2013 Wiley Periodicals, Inc.     

Isolation of 19 strains of Malassezia dermatis from healthy human skin in Korea

This research was conducted on the cultured samples of 160 healthy men and women aged 0–80 years without any skin disease. Nineteen clinical isolates of Malassezia dermatis showed positive in a catalase test and all grew in 0.5% Tween‐60 and 0.1% Tween‐80 added to 2% glucose/1% peptone culture medium. Round and ellipsoidal yeast cells and budding of the yeast cells were observed by microscopy, resembling Malassezia sympodialis, Malassezia furfur and Malassezia nana. The 26S rDNA polymerase chain reaction restriction fragment length polymorphism (PCR‐RFLP) pattern was the same as for M. dermatis (JCM 11348), the standard strain. 26S rDNA and ITS1 sequencing were performed for exact identification, showing 99% accordance with M. dermatis (AB070361), M. dermatis (AB070356), confirming the species to be new and first to be reported in Korea. Taking a molecular biological classification approach by analyzing the 26S rDNA PCR‐RFLP patterns, we have successfully isolated 19 cases of M. dermatis– the first in Korea.     

INDUCTION DOSE-RESPONSE OF PROPOFOL IN UNPREMEDICATED CHILDREN

The induction dose requirements of propofol were compared inthree age groups in 300 unpre-medicated healthy Chinese children:group A, younger than 2 yr (n = 48); group B, 2–5 yr (n= 117); group C, 6–12 yr (n = 135). Patients in each groupwere allocated randomly to receive one of eight doses of propofol(1.2, 1.4, 1.6, 1.8, 2.0, 2.2, 2.4 and 2.6 mg kg^–1J).ED₅₀ and ED₉₅ for loss of eyelash reflex (LER) and acceptanceof face mask (AFM) were determined using probit analysis. ED₅₀and ED₉₅ for both LER and AFM were greatest in group A, lessin B and smallest in C; ED₉₅ (AFM) for groups A, B and C were2.88 (2.55–3.36). 2.53 (2.31–2.86), and2.20 (2.02–2.46)mg kg^–1, respectively. This probably represented theireffective induction dose. The incidence of apnoea was dose related,but not pain on injection.     

A comparison of omeprazole and ranitidine for prophylaxis against aspiration pneumonitis in emergency Caesarean section

One hundred and sixty-two Chinese women undergoing emergency Caesarean section were allocated at random on admission to the labour ward to receive one of three regimens for orally administered chemoprophylaxis against acid aspiration: ranitidine 150 mg 6 hourly with sodium citrate at induction of anaesthesia, omeprazole 40 mg 12 hourly with sodium citrate, or omeprazole 40 mg 12 hourly alone. Intragastric pH and volume were measured immediately after induction of anaesthesia. Ten patients (17%) in the omeprazole-only group, three (6%) in the omeprazole and citrate group and one (2%) in the ranitidine group had an intragastric pH less than 2.5 and volume greater than 25 ml (p less than 0.05). The use of sodium citrate resulted in higher intragastric pH but larger intragastric volumes (p less than 0.05). The sodium citrate and ranitidine regimen was the most cost-effective among the three.     

Peripheral T-cell lymphoma involving subcutaneous tissue

The peripheral T-cell lymphomas, presumably derived from various immunocompetent peripheral T-cell system components, form a heterogeneous group of non-Hodgkin's lymphomas. We describe two patients with peripheral T-cell lymphoma primarily involving subcutaneous tissue. They presented with multiple subcutaneous nodules. Skin biopsy specimens in both patients demonstrated a lobular subcutaneous infiltrate. The infiltrate consisted of small and medium-sized atypical lymphoid cells. Both patients had a protracted clinical course before they were diagnosed as having malignant lymphoma. We detected latent Epstein-Barr virus infection in the skin lesions of case 2. Latent Epstein-Barr virus infection might be related to the development of this variant of peripheral T-cell lymphoma.     

GPs' motives for referrals to general hospitals: does access to GP hospital beds make any difference?

OBJECTIVES: We aimed to explore the relative impact of medical and other situational motives on GP's decisions to refer patients to specialist care in a general hospital, and to assess whether having access to a GP hospital influences the decisions. METHODS: We carried out a prospective study of consecutive doctor-patient contacts during one week. The effects of main motives, medical, social/nursing, general hospital advice, distance from the nearest general hospital and access to GP hospitals on referral decisions were explored by logistic regression. The motives for different referral decisions were also explored through frequency analyses. The study was set in general practices in the county of Finnmark in North Norway, which included 40 GPs from rural practices with access to a GP hospital and eight GPs working closer to a general hospital without access to GP hospital. We studied 2496 doctor-patient contacts, which resulted in 411 patients being considered for any kind of referral, of which 205 were referred to the general hospital. RESULTS: Medical needs were recorded as the only referral motive of major importance in about half of the cases considered for referral, while additional motives were recorded in the other half. The rationale for admissions to general hospitals and GP hospitals (in-patient care) was compatible in terms of the relative importance of the medical arguments. The GP hospital option was mainly chosen because of the long distance from the general hospital, nursing needs and the preferences of the patient and the family, and resulted in a lower proportion of patients being referred to general hospitals from GPs with access to a GP hospital. CONCLUSION: Medical motives dominate the decision to refer patients to general hospitals, but access to a GP hospital, in cases where nursing needs and long distances to the general hospital are supplementary considerations, reduces the proportion of patients being referred to general hospitals.