Human ; Male ; Middle Aged ; Administration, Cutaneous ; Leukocyte Disorders ; Neoplasms ; Plasma Cells

Chronic neutrophilic leukemia (CNL) is a rare myeloproliferative disorder characterized by clonal proliferation of mature neutrophils, hepatosplenomegaly, elevated leukocyte alkaline phosphatase score (ALP score) and a negative Philadelphia chromosome. To date, approximately 150 cases have been reported in the literature, including some cases presenting with a 'leukemic' state reflected by a neutrophilic reaction. The term 'true' CNL, recently introduced by Reilly, highlights the need for more experience with CNL cases to improve the diagnostic criteria. In Korea, about 10 cases have been reported in the literature and some of those cases did not meet the WHO diagnostic criteria for CNL. We present a typical case of CNL in a 66-year-old man who complained of general weakness and weight loss. On admission, the white blood cell count from the peripheral blood was 175,600/L with 80% segmented neutrophils. The cytogenic study was negative for the Philadelphia chromosome and had a normal karyotype.
Aged ; Alkaline Phosphatase ; Humans ; Karyotype ; Korea ; Leukemia, Neutrophilic, Chronic* ; Leukocyte Count ; Leukocytes ; Myeloproliferative Disorders ; Neutrophils ; Philadelphia Chromosome ; Weight Loss

PURPOSE: The purpose of this study is to verify the influence of a massive hydrofluoric acid spill on community health through patients who claimed to have been exposed. METHODS: We analyzed 2459 patients who visited our emergency department with the claim of exposure to hydrofluoric acid, and retrospective analyses were performed. We analyzed changes in numbers of visitors per day from the day of the accidental hydrofluoric acid spill, symptoms presented by the 1924 patients, and general characteristics. Comparisons of symptoms and hematologic characteristics were made between the initially set evacuation zone(1.3 km radius parameters from the spill) and the outer zone. RESULTS: A total of 2,459 patients who claimed exposure visited our ED from 27 September 2012 to 23 October 2012, and there was a significant increase in the number of visiting patients from day 8 of the hydrofluoric acid spill. The most common complaints were a sore throat, 729(37.9%) and no specific symptom with health concern, 547(28.4%). Statistically significant findings were pulmonary symptoms (p=0.001), nasal symptoms (p=0.001), diarrhea (p=0.023), and skin symptoms (p=0.007). In hematologic study, a statistically significant difference was observed in white blood cell count (p=0.018), creatine phosphokinase (p<0.001), erythrocyte sediment rate (p=0.013), and phosphorus (p<0.001). CONCLUSION: A significant increase in the number of patients was observed one week after the accidental spill of hydrofluoric acid. The most frequent symptoms were sore throat, headache, cough, and sputum. Statistically significant increase in creatine phosphokinase level and decrease in phosphorus level were noted in patients within the evacuation zone.
Creatine Kinase ; Diarrhea ; Emergencies ; Erythrocytes ; Headache Disorders, Primary ; Humans ; Hydrofluoric Acid* ; Leukocyte Count ; Pharyngitis ; Phosphorus ; Radius ; Retrospective Studies ; Skin ; Sputum

OBJECTIVETo explore whether fecal calprotectin (f-calprotectin, FC) may be an early marker for the identification of gastrointestinal injury in preterm infants by measuring FC concentration and changes of FC concentration in infants with different perinatal factors.

METHODSFC concentration was measured using ELISA in 76 samples (50-100 mg) obtained from 38 preterm infants (gestation 29 to 33 weeks), at birth and on the third day after birth (the 1st and the 2nd FC levels). The infants were classified into three groups according to the reason for preterm birth: premature rupture of membranes (PROM; n=13), spontaneous preterm birth (SPB; n=5) and indicated preterm birth (IPB; n=20).

RESULTSThere were no significant differences between the 1st and 2nd FC levels in the 38 infants. The 1st FC level in the PROM group was significantly higher than that in the IPB group (P<0.05). The 1st FC level in infants whose mothers received antenatal antibiotics treatment was significantly lower. Infants born by cesarean section had a significantly lower 1st FC level than those born by vaginal delivery (P<0.05). Both the 1st and 2nd FC levels in infants with feeding intolerance were significantly higher than in infants with feeding tolerance (P<0.05). The 2nd FC level was negatively correlated with 1 min Apgar score (r=-0.3, P<0.05).

CONCLUSIONSPremature rupture of membranes and perinatal asphyxia may lead to an increase in the excretion of FC in preterm infants. FC may be used as a marker for early evaluation of gastrointestinal conditions in preterm infants.

Biomarkers ; Feces ; chemistry ; Female ; Humans ; Infant Nutrition Disorders ; metabolism ; Infant, Newborn ; Infant, Premature ; metabolism ; Leukocyte L1 Antigen Complex ; analysis ; Male

OBJECTIVETo detect JAK2 V617F mutation burden and its clinical implications in patients with myeloproliferative neoplasm (MPN).

METHODSJAK2 V617F mutation burden were detected by using MGB Taqman probes and its clinical significance were retrospectively studied in 415 MPN patients.

RESULTSJAK2 V617F was found in 56.9% of all patients [83.5% in polycythemia vera (PV), 55.9% in essential thrombocythemia (ET), 41.9% in primary myelofibrosis (PMF) and 64.7% in MPN-unclassifiable)]. The majority of patients carried heterozygous JAK2 V617F mutation and homozygote was found only in 12 cases (4 in PV, 4 in MPN-U, 2 in PMF, 1 in ET, and 1 in chronic neutrophilic leukemia). Most patients (68.8%) were lower mutation burden (mutation burden<50%), but PV had the highest burden, the moderate burden in PMF and the least in ET. The patient's age and WBC count were significantly correlated with higher mutation burden in PV. WBC count was significantly related to higher mutation burden in ET. WBC count, Hb level and the platelet count were significantly related to higher mutation burden in PMF.

CONCLUSIONThe mutation burden of JAK2 V617F from high to low was PV, ET and PMF. The majority of JAK2 V617F mutation was heterozygous. JAK2 V617F mutation burden was positively correlated with age, WBC, Hb and platelet counts.

Homozygote ; Humans ; Janus Kinase 2 ; Leukocyte Count ; Mutation ; Myeloproliferative Disorders ; Platelet Count ; Polycythemia Vera ; Retrospective Studies ; Thrombocythemia, Essential

BACKGROUND AND OBJECTIVES: The purpose of this article was to investigate the difference of clinical manifestations in deep neck infections between pediatric patients and adult patients and to consider their respective treatment. SUBJECTS AND METHOD: The author reviewed the experience of 158 patients with deep neck infections from 1995 to 2004. Peritonsillar abscess, superficial infection, and infections related to external neck wound and head and neck tumors were excluded. Among 158 patients, 43 patients were children. To find out the characteristics of deep neck infection with pediatric patients, the author compared these patients with adult patients using student t-test and chi-square test. RESULTS: Compared with adult patients, pediatric patients with deep neck infections were found to have less dysphagia as a symptom, lower complication rate, fever higher than 38degrees C, and the white blood cell count of more than 15,000/mm3 (p<0.05). There were no significant differences in sex, duration of symptom, duration of hospital stay, involved spaces, numbers of involved spaces, etiology, and bacteriology between two groups (p>0.05). CONCLUSION: The author suggests that the prognosis of the pediatric patients with deep neck infections seems to be relatively good compared with adult patients and the severity of the disease should not be overestimated on the ground of high fever or white blood cell count.
Abscess ; Adult* ; Bacteriology ; Child ; Deglutition Disorders ; Fever ; Head ; Humans ; Length of Stay ; Leukocyte Count ; Neck* ; Peritonsillar Abscess ; Prognosis ; Wounds and Injuries

Sweet's syndrome (SS), or acute febrile neutrophilic dermatosis, is marked by fever, leukocytosis, and painful erythematous papules/plaques resulting from neutrophil migration and accumulation in the dermis. This condition has been associated with underlying hematologic as well as solid malignancies. We describe a unique case of SS in a patient with metastatic papillary follicular thyroid carcinoma and group A streptococcal pharyngitis. The distribution of the patient's SS rash was similar to the rash of neutrophilic dermatosis (pustular vasculitis) of the dorsal hands.
Adenocarcinoma, Follicular ; Dermis ; Exanthema ; Fever ; Hand ; Humans ; Immune System Diseases ; Leukocyte Disorders ; Leukocytosis ; Neutrophils ; Pharyngitis ; Skin Diseases ; Sweet Syndrome ; Thyroid Gland

Sweet's syndrome (SS), or acute febrile neutrophilic dermatosis, is marked by fever, leukocytosis, and painful erythematous papules/plaques resulting from neutrophil migration and accumulation in the dermis. This condition has been associated with underlying hematologic as well as solid malignancies. We describe a unique case of SS in a patient with metastatic papillary follicular thyroid carcinoma and group A streptococcal pharyngitis. The distribution of the patient's SS rash was similar to the rash of neutrophilic dermatosis (pustular vasculitis) of the dorsal hands.
Adenocarcinoma, Follicular ; Dermis ; Exanthema ; Fever ; Hand ; Humans ; Immune System Diseases ; Leukocyte Disorders ; Leukocytosis ; Neutrophils ; Pharyngitis ; Skin Diseases ; Sweet Syndrome ; Thyroid Gland

OBJECTIVETo explore the clinical features, laboratory findings and treatment of infant leukemia.

METHODSA retrospective analysis of the clinical data was performed of the cases with the diagnosis of infant acute leukemia from August 1993 to October 2014 in our hospital.

RESULTSA total of 144 cases of infant leukemia were diagnosed in the defined period, including 83 cases of acute lymphoblastic leukemia, 55 myeloid leukemia, 1 hybrid acute leukaemia and 5 with incompatible cytological and immunophenotyping findings. The patients at the age of 9 to 12 months accounted for the largest proportion (38.2%), and 87.5% of the patients had hepatosplenomegaly; Six patients below 6 months old had skin infiltration. In about 1/3 of the patients, the white blood cells count was no greater than 100 × 10⁹ /L. Ninety-five patients had chromosome examinations, which identified chromosome abnormalities in 67 patients, including 18 positive for t(4;11)or t(9;11)or t(11;19), and younger patients were more likely to have chromosome abnormalities. Thirty-seven patients underwent MLL gene detection and 11 of them had positive results; the positive patients had higher rate of chromosome 11 abnormalities than the negative patients. Most of the patients gave up treatments after diagnosis and only 6 patients older than 6 months completed regular chemotherapeutic treatments and were now in complete remission.

CONCLUSIONInfant leukemia is a rare type of leukemia with different clinical features from other types of leukemia. The patients often present with hepatosplenomegaly, high white blood cell counts, MLL gene fusion, and chromosome 11 abnormalities. The prognosis of infant leukemia is not favorable, and the current treatment still relies on chemotherapy.

Acute Disease ; Chromosome Aberrations ; Chromosome Disorders ; Chromosomes, Human, Pair 11 ; Humans ; Immunophenotyping ; Infant ; Leukemia, Myeloid ; pathology ; Leukocyte Count ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; pathology ; Prognosis ; Retrospective Studies

BACKGROUND: Pneumonia is a common medical complication after acute stroke, and makes a considerable influence on the prognosis. It is potentially preventable or treatable if early recognized. Thus, the identification of which patients are at risk for the development of pneumonia is clinically significant. METHODS: A total of 240 patients with an acute stroke who were consecutively admitted to a Seoul National University Hospital were studied. The following prognostic factors were accounted for in the statistical analyses: age, sex, hypertension, diabetes, cardiac disease, smoking, recurrent stroke, NIHSS, modified Rankin scale (mRS), the presence of dysphagia, blood pressure, body temperature, white blood cell count, blood sugar, fibrinogen, Levin tube insertion, Foley catheter insertion, and subtype of stroke. RESULTS: Pneumonia was diagnosed in 36 (17.0%) patients during the acute stage of stroke, particularly within 2 weeks. Average admission stay of patients with pneumonia was 38.7 days, whereas it was 19.3 days for those without pneumonia. By multivariate analysis, Levin tube insertion, body temperature, recurrent stroke, and mRS were significant predictor of pneumonia development. Forty percent of patients with four or five points of mRS developed pneumonia, compared to 6% in less than four points. CONCLUSIONS: Our results show that the patients who have Levin tube, high mRS, or recurrent stroke tend to develop pneumonia after acute stroke. It is important for early detection and prevention of pneumonia in patients with high mRS.
Blood Glucose ; Blood Pressure ; Body Temperature ; Catheters ; Deglutition Disorders ; Fibrinogen ; Heart Diseases ; Humans ; Hypertension ; Leukocyte Count ; Multivariate Analysis ; Pneumonia* ; Prognosis ; Seoul ; Smoke ; Smoking ; Stroke*