Trigeminal neuralgia is defined as "a sudden, usually unilateral, brief stabbing recurrent pain in the distribution of one or more branches of the fifth cranial nerve" by the International Association for the Study of Pain(IASP). Trigeminal neuralgia is classified as an idiopathic trigeminal neuralgia with no apparent cause and a symptomatic trigeminal neuralgia which is caused by a structural lesion such as brain tumor. Over 80% of the tumors are meningioma, acoustic neuroma, and epidermoid tumors. Symptomatic trigeminal neuralgia can not be excluded even if old-aged patient does not have abnormal neurologic sign and symptom, and good response to pharmacotherapy. Therefore, initial examinations such as MRI or CT are essential to exclude symptomatic trigeminal neuralgia. When compared with CT, MRI, especially gadolinium enhanced MRI, has an increased sensitivity in the detection of intracranial lesions. The most effective medical treatment of trigeminal neuralgia is carbamazepine. The most common side effects of carbamazepine include drowsiness, dizziness, unsteadiness, nausea, anorexia. Hepatotoxicity, bone marrow depression are the most feared side effect of carbamazepine therapy but occurs rarely. It require periodic complete blood cell counts as well as hepatic and renal function tests. It has been recommended that complete blood cell counts is done every 2 weeks for the first 2months and then quaterly thereafter. Oxcarbazepine can be used if neutropenia occurs.
Background: The Bethesda System for Reporting Thyroid Cytopathology is one of the main classification systems for thyroid nodules. It expects that 7% of all fine needle aspiration biopsies will be reported as atypia or follicular lesions of undetermined significance, and 5-15% of these undetermined nodules are malignant. Our study is a retrospective analysis of variables that may be associated with outcome in patients with indeterminate thyroid nodules. Materials and Methods: Patients who underwent thyroidectomy in our institution between 2010 and 2014 were retrieved from the institutional records database. Patient demographics and medical histories were recorded. All ultrasonography reports were examined for nodule features and biochemical blood levels, hormone levels and complete blood counts were recorded. Results: A total of 103 patient cytopathology reports were regarded as belonging to the undetermined category. Some 35% of patients had malignant nodules. Median preoperative red cell distribution width (RDW) level was 13.6 inthe benign group, while it was 14.3 in patients with malignancy, demonstrating a significant correlation (p=0.003). Only calcification presence was significantly different between benign and malignant groups on ultrasonography (p=0.034). Conclusions: Ultrasonography is one of the primary tools for this matter. RDW levels may become another promising tool to predict malignancy.
Background: The aim of this study was to investigate the predictive value of white blood cells (WBC), the neutrophil to lymphocyte ratio (NLR), platelet indices including mean platelet volume (MPV), platelet distribution width (PDW), platelet crit (PCT) and platelet to lymphocyte ratio (PLR) in discrimination between benign and malign endometrial lesions, and early and advanced stage endometrial adenocarcinomas. Materials and Methods: Data for 105 patients undergoing total abdominal or vaginal hysterectomy for benign uterine diseases and 114 patients surgically staged for endometrium adenocarcinoma at Ondokuz Mayis University, Department of Gynecology and Obstetrics, between 2008 and 2014, were collected. Parameters were preoperative and postoperative complete blood counts in the week prior to surgery with differentials including WBC, platelet count, platelet indices (MPV, PCT, PDW), NLR and PLR. Pathologic evaluations for both benign and malign endometrium lesions, grade of endometrium adenocarcinoma, tumor stage, presence of lymphovascular space invasion (LVI) were retrospectively analyzed. Results: Regarding definitive factors in discriminating patients with endometrium cancer from those with benign diseases, MPV was significantly increased in the malign group whereas there was a significant decrease in the PDW value compared to the benign group. The best cut-off value in differentiation of the benign and malign groups, malign cases were found to increase over the value of 7.54 for MPV, and under 37.8 for PDW. When definitive factors in discrimination of early stage endometrium cancer from advanced stage disease and LVI in the malign group were evaluated according to the ROC analysis, no significant relation was detected between blood parameters and the stage and the LVI of the disease. Conclusions: MPV and PDW may have predictive value in the discrimination of benign and malign endometrium diseases. Nevertheless, since there have been few reports on this topic, further large-scale prospective studies are necessary.
Choi, Jung Eun;Kwak, Yujin;Huh, Jung Won;Yoo, Eun-Sun;Ryu, Kyung-Ha;Sohn, Sejung;Hong, Young Mi
Clinical and Experimental Pediatrics
/
v.61
no.5
/
pp.167-173
/
2018
Purpose: Hemophagocytic lymphohistiocytosis (HLH) is a hyperinflammatory syndrome with many causes, including Kawasaki disease (KD). The purpose of this study was to identify the laboratory tests needed to easily differentiate KD with HLH from incomplete KD alone. Methods: We performed a retrospective study on patients diagnosed with incomplete KD and incomplete KD with HLH (HLH-KD) between January 2012 and March 2015. We compared 8 secondary HLH patients who were first diagnosed with incomplete KD with all 247 incomplete KD diagnosed patients during the study period. The complete blood count, erythrocyte sedimentation rate, platelet count, and serum total protein, albumin, triglyceride, C-reactive protein, N-terminal pro-brain natriuretic peptide (NT-proBNP), and ferritin levels were compared. Clinical characteristics and echocardiography findings were also compared between the 2 groups. Results: The total duration of fever was longer in the HLH-KD group than in the KD group. White blood cell and platelet counts were higher in the KD group. Alanine aminotransferase, ferritin, and coronary artery diameter were increased in the HLH-KD group compared with those in the KD group. The median of NT-proBNP was significantly higher in the HLH-KD group than in the KD group at 889.0 (interquartile range [IQR], 384.5-1792.0) pg/mL vs. 233.0 (IQR, 107.0-544.0) pg/mL. Conclusion: The NT-proBNP level may be helpful in distinguishing incomplete KD from KD with HLH. The NT-proBNP level should be determined in KD patients with prolonged fever, in addition to the white blood cell count, platelet count, and ferritin level, to evaluate secondary HLH.
Background: In 2006, the European Union (EU) has decided to forbid use of antibiotics as growth promoters. Although many researches had been conducted about fiber source as alternatives of antibiotics, there are still lack of reports in the literature about the optimum level of sugar beet pulp supplementation, affecting growth performance and nutrient digestibility in weaning pigs. Therefore, different level of sugar beet pulp was added to diets to determine the effects of sugar beet pulp supplementation on growth performance, nutrient digestibility, fecal microflora, blood profile and incidence of diarrhea in weaning pigs. Methods: A total of 200 weaning pigs [$(Yorkshire{\times}Landrace){\times}Duroc$], averaging $9.01{\pm}1.389kg$ of initial body weight were, allotted to 5 treatments in a randomized complete block (RCB) design. Each treatment was composed of 4 replicates with 10 pigs per pen. The treatments were control treatment: Corn-SBM basal diet + ZnO (phase 1: 0.05%; phase 2; 0.03%) and four different levels of sugar beet pulp were supplemented in Corn-SBM basal diet (3, 6, 9 or 12%). Two phase feeding programs (phase 1: 1-2 weeks; phase 2: 3-5 weeks) were used for 5 week of growth trial. Results: In feeding trial, there were no significant differences in growth performance and incidence of diarrhea among treatments. The E.coli counts were not significantly different among dietary treatments but linear response was observed in Lactobacillus counts as sugar beet pulp supplementation increased (P < 0.05). In addition, IGF-1, IgA and IgG were not affected by dietary treatments. However, the BUN concentration was decreased when pigs were fed the treatments of diets with SBP compared to that of control treatment (P < 0.05). In nutrient digestibility, crude fiber and NDF digestibilities were improved as the sugar beet pulp increased (P < 0.05). However, digestibilities of crude ash, crude fat, crude fiber and nitrogen retention were not affected by dietary sugar beet pulp levels. Conclusion: This experiment demonstrated that sugar beet pulp can be supplemented in weaning pigs' diet instead of ZnO to prevent postweaning diarrhea without any detrimental effect on growth performance.
The complete blood count and serum biochemical parameters are essential tools for diagnosis and monitoring of physiological and disease conditions in dogs. These parameters may be affected by the breed and age of dogs. This study aimed to compare the changes of complete blood count and serum biochemical parameters according to the increasing age in 156 Sapsarees. In this study, the Sapsarees were clustered into ten age groups: four to six months, seven to nine months, ten to twelve months, one year, two years, three to four years, five to six years, seven to eight years, nine to ten years, and, eleven to twelve years old. In the result of the complete blood count, the total red blood cell count (P<0.001), hematocrit (P<0.001), and hemoglobin (P<0.001) values were significantly increased from 4~6 months to 2 years old Sapsarees. While the mean corpuscular volume (P<0.001) and mean corpuscular hemoglobin (P<0.001) values were significantly increased from 4~6 months to 3~4 years old. The mean corpuscular hemoglobin concentration was significantly (P=0.037) increased from 4~6 to 10~12-month-old Sapsarees. Total white cell count was significantly (P<0.001) decreased from 1 year to 9~10 years old. The result of differential white blood cell count showed that neutrophil count was significantly (P<0.001) increased from the age 4~6 months to 11~12 years old Sapsarees, whereas, lymphocyte (P<0.001), monocyte (P<0.001), and eosinophil (P=0.042) counts were significantly decreased from 7~9 months to 7~8 years, 4~6 months to 9~10 years, 3~4 to 5~6 years old, respectively. In the serum biochemistry result, the creatinine concentration was significantly (P<0.001) increased from 4~6 to 10~12 months, but significantly (P=0.006) decreased from 7~8 to 10~12 years old. Phosphate concentration was significantly (P<0.001) decreased from 3~4 to 9~10 years old, but significantly (P=0.021) increased from 9~10 to 11~12 years old. Calcium concentration significantly (P<0.001) decreased from 10~12 months to 11~12 years old. Total protein concentration significantly (P<0.001) increased from 4~6 months to 2 years old. While concentrations of albumin (P=0.004) and globulin (P<0.001) was significantly increased from 4~6 months to 3~4 years old, and from 4~6 months to 11~12 years old, respectively. The alkaline phosphate concentration was significantly (P<0.001) decreased from 4~6 months to 2 years old. We found that there are differences in the hematological parameters in relation with the increasing age in Sapsaree breed.
A 7-month-old female Shih-tzu dog was presented with intermittent trembling, dyspnea, generalized muscle weakness, and unconsciousness after exercise. No remarkable findings were shown in the complete blood counts and the radiographic examination. On serum biochemical profiles, alkaline phosphatase and creatine phosphokinase were mildly elevated. Based on history takings, physical examination, and neurological findings, presumptive diagnosis was made as a myasthenia gravis (MG). Clinical signs of this patient were dramatically improved after administration of neostigmine. The result of acetylcholine receptor antibody test in serum was 0.89 nmol/L and the histopathology of muscle were normal. Clinical sign of the patient evaluated in this study is stabilized with long-term administration of pyridostigmine at this time. This case report here describes clinical and clinicopathological findings of a juvenile onset acquired MG in a Shih-tzu dog.
Inflammatory bowel disease (IBD) is an immune-mediated chronic inflammatory intestinal condition. With development of various treatment options for IBD, 5-aminosalicylic acid (5-ASA) agents became the drugs of choice due to high efficacy and low risk of complication, specifically effective at inducing and maintaining remission in ulcerative colitis(UC). Pancytopenia caused by 5-ASA agents, especially by mesalazine, has been rarely reported compared with azathioprine, which is commonly used for glucocorticoid-dependent IBD and known to have risk of bone marrow suppression. In the present report, we describe the case of a 57-year-old woman diagnosed with UC, who developed pancytopenia due to adverse effect of mesalazine after recovery from azathioprine-induced pancytopenia. After withdrawal of mesalazine, the laboratory values consistent with myelosuppression continued for 3 months while pancytopenia from azathioprine remained only for 2 weeks. Since pancytopenia can be fatal due to its risk of severe bleeding and infection, close monitoring of clinical presentation is important when starting mesalazine and laboratory data should be evaluated whenever the patients present related symptoms. Furthermore, we suggest that complete blood cell counts should be considered when resuming mesalazine following the development of pancytopenia from any cause, as routinely recommended for azathioprine use.
Arshad, Muhammad;Siddiqa, Maryam;Rashid, Saddaf;Hashmi, Imran;Awan, Muhammad Ali;Ali, Muhammad Arif
Safety and Health at Work
/
v.7
no.2
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pp.156-160
/
2016
Background: Workers in pesticide manufacturing industries are constantly exposed to pesticides. Genetic biomonitoring provides an early identification of potential cancer and genetic diseases in exposed populations. The objectives of this biomonitoring study were to assess DNA damage through comet assay in blood samples collected from industry workers and compare these results with those of classical analytical techniques used for complete blood count analysis. Methods: Samples from controls (n = 20) and exposed workers (n = 38) from an industrial area in Multan, Pakistan, were subjected to various tests. Malathion residues in blood samples were measured by gas chromatography. Results: The exposed workers who were employed in the pesticide manufacturing industry for a longer period (i.e., 13-25 years) had significantly higher DNA tail length ($7.04{\mu}m$) than the controls ($0.94{\mu}m$). Workers in the exposed group also had higher white blood cell and red blood cell counts, and lower levels of mean corpuscular hemoglobin (MCH), MCH concentration, and mean corpuscular volume in comparison with normal levels for these parameters. Malathion was not detected in the control group. However, in the exposed group, 72% of whole blood samples had malathion with a mean value of 0.14 mg/L (range 0.01-0.31 mg/L). Conclusion: We found a strong correlation ($R^2=0.91$) between DNA damage in terms of tail length and malathion concentration in blood. Intensive efforts and trainings are thus required to build awareness about safety practices and to change industrial workers' attitude to prevent harmful environmental and anthropogenic effects.
Cho, Young-Keol;Lee, Hee-Jung;Desrosiers, Ronald C.
The Journal of Korean Society of Virology
/
v.29
no.2
/
pp.107-118
/
1999
To characterize the molecular nature of human immunodeficiency virus (HIV)-1, we determined the full-length HIV-1 sequences from cultured peripheral blood mononuclear cells (PBMC) of a Korean long-term nonprogressor (LTNP). Without antiretroviral therapy, the individual has maintained CD4+ T counts over $500/{\mu}l$ from 1989 to 1999. Plasma viral RNA copy was 992 U/ml in 1998. Culture supernatant showed positive from culture days 9. A series of 9 overlapping PCR products were amplified from cultured PBMC and cloned About 9.2 kb from R of 5' LTR to R of 3' LTR was determined by automated sequencing. The G-to-A hypermutations were shown throughout the entire region. As a result of G to A hypermutations, premature stop codon was found in integrase coding region. Though there was no recombination between subtypes over all genomes, TATA box in both LTRs was TAAAA which is detected in subtype E instead of TATAA in subtype B. And, there were nucleotide GC insertion between $NF-{\kappa}B$ I and Sp1 III, and duplication of $TCF-1{\alpha}$ in LTR. We could not find any deletion of amino acid in Nef, Gag, Pol and Env gene. This study is the first report on molecular nature of full genomes of HIV-1 isolated in Korea.
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