No abstract available.

PURPOSE: The close relationship between the size of a tumor burden and the curability of acute leukemia is well established. Therefore, it is very irnportant to detect residual leukemia accurately at low levels. Fluorescence in situ hybridization(FISH) techniques rely on chromosome-specific and gene specific DNA probes to identify numerical and structural chromosomal abnormalities. But the detection limit of FISH in residual leukemia is still uncertain. So we evaluated the detection limit of residual leukemic cells with the chromosomal abnomualities on FISH. METHODS: Cells with monosomy, trisomy and bcr/abl fusion were admixed with normal diploid cells in different concentrations of O%, 0.1%, 0.5%, 1%, 2.5%, 5%, 10%, 20% and 100%. Monosomy and trisomy cells were hybridized with chromosome 1 or 8 or X centromeric probes, and the cells with bcr/abl fusion were hybridized with bcr/abl probe and detected using FISH technique. The number of signals from 150 to 1000 cells were counted. RESULTS: The detection limit was 1% in monosomy assay and 0.5% in trisomy and translocation assay. The proportion of cells showing each signal increased according to the increase of mixed cells. CONCLUSION: FISH for detection of minimal residual leukemia is a sensitive and specific method which could detect at least 1Yo leukemic cells in the samples. Especially, cells with trisomy or translocation could be more easily detected. It could be also used for quantitative monitoring of leukemic cells.
Chromosome Aberrations ; Chromosomes, Human, Pair 1 ; Diploidy ; DNA Probes ; Fluorescence* ; In Situ Hybridization* ; In Situ Hybridization, Fluorescence ; Leukemia* ; Limit of Detection* ; Monosomy ; Neoplasm, Residual* ; Trisomy ; Tumor Burden

Unilateral brachial plexus injury is a rare complication of thoracoscopic sympathectomy, which is generally considered to be a simple and safe procedure. We report on a 20-year-old female patient who developed persistent pain and weakness of the left arm after thoracoscopic sympathectomy for hyperhidrosis. An electromyographic study revealed evidence of denervation at the C5-C7 level, and a nerve conduction study on the left brachial plexus showed decreased amplitude of the compound muscle action potential of the left musculocutaneous and axillary nerves. The above findings are compatible with left brachial plexopathy, with predominant involvement of the lateral and posterior cord. We suggest that this complication was caused by stretch and/or compression of the left brachial plexus when the arm was hyperabuducted upwards during the operation. Careful attention to positioning by the surgeon and anesthesiologist is needed to prevent this debilitating injury.
Action Potentials ; Arm ; Brachial Plexus Neuropathies ; Brachial Plexus* ; Denervation ; Female ; Humans ; Hyperhidrosis ; Neural Conduction ; Sympathectomy* ; Young Adult

Rhino-orbito-cerebral mucormycosis is an uncommon fulminant fungal infection that occurs usually in debilitated or immune suppressed patients. Intracranial lesions such as cerebral ischemia mostly develop secondary to vascular injuries like thrombosis of cavernous sinus or internal carotid artery and also from arteritis. However, intracranial hemorrhage complicated by mucormycosis is very rare. We report a patient with a fatal complicaton of intracranial hemorrhage presumably due to arteritis by mucormycosis. A 66-year-old female patient with uncontrolled diabetes mellitus developed complete ophthalmoplegia in her left eye for two days. Rhinoscopic examination revealed black necrotic turbinate. Orbital CT scan and Brain MRI showed soft tissue material at the left orbital apex and mild deformities in the left lateral cavernous sinus. On the basis of radiological evidence and biopsy, a diagnosis of mucormycosis was established, and the patient underwent surgical debridement followed by an Amphotericin B infusion. On the following day, she suddenly developed a right hemiparesis and stupor. An immediate brain CT scan revealed a large intracranial hemorrhage in the left frontal head region. Removal of the hematoma and a biopsy was performed immediately. A pathological examination revealed a fungal invasion of the small arterial wall and an acute inflammatory reaction of the surounding tissues.
Aged ; Amphotericin B ; Arteritis ; Biopsy ; Brain ; Brain Ischemia ; Carotid Artery, Internal ; Cavernous Sinus ; Congenital Abnormalities ; Debridement ; Diabetes Mellitus ; Diagnosis ; Female ; Head ; Hematoma ; Humans ; Intracranial Hemorrhages* ; Magnetic Resonance Imaging ; Mucormycosis* ; Ophthalmoplegia ; Orbit ; Paresis ; Stupor ; Thrombosis ; Tomography, X-Ray Computed ; Turbinates ; Vascular System Injuries

No abstract available.
Hematocrit ; Mucocutaneous Lymph Node Syndrome*

OBJECTIVE: To analyze cytogenetic results of prenatal genetic amniocentesis. METHODS: From January 1997 to December 2000, We analyzed 1,390 cases of midtrimester amniocentesis which were done at Gil medical center of Gachon medical school according to its indications and maternal age. RESULTS: Chromosomal aberrations were found in 88 cases (6.3%). Of all our chromosomal aberrations, 29 cases (2.1%) of normal variants and 59 cases (4.2%) of abnormal karyotypes were found. 37 cases of autosomal numerical abnormal karyotypes and 7 cases of sex chromosomal abnormal karyotypes were diagnosed. In abnormal karyotype group, the incidence was high after 40 years of maternal age and in abnormal ultrasound findings, but no such correlations were found in normal variant group. CONCLUSION: In analysis of midtrimester amniocentesis, it would be better to analyze separately abnormal karyotype group and normal variant group.
Abnormal Karyotype ; Amniocentesis ; Amniotic Fluid* ; Chromosome Aberrations* ; Cytogenetics* ; Female ; Humans ; Incidence ; Maternal Age ; Pregnancy ; Pregnancy Trimester, Second* ; Schools, Medical ; Ultrasonography

Pulmonary alveolar proteinosis is a rare disease, which hallmark is a dense accumulation of PAS positive phospholipid material within alveolar sac. Pulmonary alveolar proteinosis is classified as primary form of unknown etiology and secondary form associated with other diseases. We report a case of secondary pulmonary alveolar proteinosis associated with acute erythroleukemia. A C year old male patient complained of nonproductive cough and general weakness, and presented fine inspiratory crackles at both lower lung field. Chest radiographs and high resolution CT scans showd a lobular pattern of ground-grass opacity with interlobular septal thickening in the center field of the both lungs, Bone marrow aspiration and biopsy revealed acute erythroleukemia. Open lung biopsy revealed PAS positive eosinophilic granular material filled in alveoli. He was treated with TAD chemotherapy, but died from multiorgan failure with pneumonia 22days after chemotherapy.
Biopsy ; Bone Marrow ; Cough ; Drug Therapy ; Eosinophils ; Humans ; Leukemia, Erythroblastic, Acute* ; Lung ; Male ; Pneumonia ; Pulmonary Alveolar Proteinosis* ; Radiography, Thoracic ; Rare Diseases ; Respiratory Sounds ; Tomography, X-Ray Computed

Direct approach of technically difficult or inoperable intracranial aneurysms many become possible using complete circulatory arrest with extracorporeal circulation and profound hypothermia and barbiturate cerebral protection. To avoid difficulties associated with closed chest method, open chest method was used by direct cannulation of the right atrium and aorta through the chest. 3 patients with posterior circulation aneurysms operated on with these techniques;1 large basilar bifurcation aneurysm and 1 irregular shaped vertebro-basilar junction aneurysm and 1 posterior cerebral artery aneurysm were operated on and all had excellent results. Careful attention was needed to the depth of hypothermia, duration of total circulatory arrest, and hemostasis which important factors in the success of these methods.
Aneurysm* ; Aorta ; Catheterization ; Extracorporeal Circulation ; Heart Atria ; Hemostasis ; Humans ; Hypothermia* ; Intracranial Aneurysm ; Thorax

Diverticulosis of the small intestine is a rare entity, compared with that of duodenum or colon, and is found in only 1% of autopsied patients. The main complications are diverticulitis with or without a perforation, obstruction and hemorrhage, which are associated with a high mortality. Intussusception is primarily a disease of childhood; with only 5 to 10% of cases occurring in adults. In contrast to childhood intussusception, 90% of adult intussusception cases are had an associated pathologic processes. An inflammatory fibroid polyp is an uncommonly localized non-neoplastic lesion of the gastrointestinal tract. It occurs most often in the stomach and secondly in the ileum. It rarely occurs in other organs such as the colon, jejunum, duodenum and esophagus. We report a case of jejunal diverticulitis with a perforation combined with intussusception caused by an inflammatory fibroid polyp. A 78-year-old female presented with abdominal pain, fever and chill. Contrast CT scan showed intussusception of the ileum. The patient was treated with a small bowel segmental resection. After surgery, the specimen showed jejunal diverticulitis with perforation.
Abdominal Pain ; Adult ; Aged ; Colon ; Diverticulitis* ; Diverticulum ; Duodenum ; Esophagus ; Female ; Fever ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ileum ; Intestine, Small ; Intussusception* ; Jejunum ; Leiomyoma* ; Mortality ; Pathologic Processes ; Polyps* ; Stomach ; Tomography, X-Ray Computed

With the aim of determining the outcome of surgery, a review of patients undergoing trauma-associated atrantoaxial arthrodesis. Between 1993 and 1997, 16 patients underwent 19 proceedures, with a follow-up period of between six and 29 months. The most common reasons for surgery were odontoid fracture(n=12), os odontoideum(n=1) procedure, and neurofibrimatosis type I(n=1). Ten posterior wiring, four Halifax clamp application, one anterior screw fixation of dens, two transarticular screw fixations, and one staged operation(anterior odontoiddectomy and posterior occipitocervical fusion) were performed. All patients has been surgically managed for about three months with a Halo-vest or rigid cervical neck collar, during which time three complications associated with operative procedures arose : Halifax clamp dislodgement, malunion and subluxation kyposis. In 15 of 16 patients, fusion was successful. In caes involving complicated atlantoaxial dislocation, the authors recommend postoperative Halo-vest immobilization for sucessful fusion after posterior C1-C2 wiring or Halifax clamping
Arthrodesis ; Constriction ; Dislocations ; Follow-Up Studies ; Humans ; Immobilization ; Neck ; Spine* ; Surgical Procedures, Operative