Fascioliasis has not been confirmed as a human disease entity until now in Korea despite of sporadic discovery of ova of Fasciola sp. in human fecal materials being never traced to the confirmation of infection. Almost all of the cases with ova in their stool have been related with consumption of cattle liver whether eaten in raw or processed. The present authors confirmed a human fascioliasis case who was a Korean housewife of 42-year-old living in Seoul, during the exploratory laparotomy. The patient had been healthy until October 1975 when abrupt onset of urticaria, dyspepsia, epigastric discomfort developed. And the fluctuation of these symptoms was followed by epigastric colicky pain attacks from December 4, 1975. A complete worm of Fasciola sp. was removed during the bile-duct exploration with stone forceps in lower half of common bile duct, on January 20, 1976. The patient only agreed that she had eaten some raw liver of cattle on September 1975 but denied any possible sources of infection such as drinking of untreated water, handling of water flower and grass, and eating of raw watercress. The measurements of the removed worm: 35. 61 mm in body length, 14.00 mm in maximum body width(Length/width ratio, 2.54:1), distribution of testes to body length 33.9 per cent , number of branches of ovary 22, the size of intrauterine ova 157.2 x 108. 4 micrometer in average. These findings are not compatible with the classical descriptions of both Fasciola hepatica and F. gigantica, and it was concluded it is so-called Fasciola sp. which is intermediate between two species as proposed by many Japanese workers.
parasitology-helminth-trematoda ; Fasciola hepatica ; Fasciola gigantica ; Fasciola sp. ; case report ; fascioliasis ; laparotomy ; bile-duct

No abstract available.
Cadaver* ; Kidney Transplantation* ; Kidney*

No abstract available.
Colony-Stimulating Factors* ; Granulocytes* ; Humans ; Isotretinoin* ; Leukemia, Promyelocytic, Acute* ; Wound Infection* ; Wounds and Injuries*

No abstract available.
Ascites* ; Immunoglobulins* ; Plasmacytoma*

Patients with acute myelocytic leukemia (AML) have varied outlooks for survival after the diagnosis. To identify pretreatment prognostic indicators in AML, we analyzed 132 cases of AML seen at our hospital between June, 1989 and December, 1994. The median age of the patients was 40 years (range, 15-81). There were 63 male and 69 female patients. One hundred eight patients (82%) received induction chemotherapy which was based on cytarabine plus anthracyclines. Sixty six patients achieved complete remission (CR) and the CR rate among the patients given induction chemotherapy was 61%. The median duration of CR was 11.2 months. After median follow up of 6.6 months (range 0.5-51.4), 26 patients (39%) remain in continuous CR. The median duration of overall survival of the patients was 6.7 months. After median follow up of 10.6 months (range, 0.1-52.7), 41 patients (31%) are alive. Variables affecting duration of CR included the age of the patients, performance status of the patients, percentage of blast in the peripheral blood, hemoglobin level, percentage of blast in the bone marrow, FAB subtype, and CD7 marker positivity. Variables affecting survival duration included age of the patients, performance status of the patients, absolute blast count (ABC) in the peripheral blood, bone marrow cellularity, the percentage of blast in the bone marrow, and CD5 marker positivity. Multivariate analysis showed that the age of the patients and percentage of blast in the bone marrow were significant independent indicators for overall survival of the patients. Further studies utilizing cytogenetics and molecular characteristics of leukemic cell are warranted to better define the prognostic factors of patients with AML.
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Female ; Human ; Leukemia, Myelocytic, Acute/*mortality ; Male ; Middle Age ; Multivariate Analysis ; Prognosis ; Survival Rate

OBJECTIVES: Rate of complete remission and long-term survival in adult acute lymphoblastic leukemia group has not been as satisfactory as that in childhood ALL. Recently introduction of induction chemotherapy of more intensive combination and various trials of postremission therapy are making improved results better looked forward to. And subtypes of ALL according to the degree of differentiation into T and B cells are identified by using immunologic markers hopefully to work out proper treatment for each subtype. METHODS: We analited results of treatment and differences of complete remission rate, remission duration and overall survival as to various immunologic markers and clinicopathologic characteristics in 33adult ALL patients. RESULTS: Eighty five percents of the 27cases that had VPDL chemotherapy achieved complete remission and both overall median survival and mediom duration of remission were 52weeks. No definite prognostic factors were detected influencing complete remission rate, remission duration and overall survival except that patients with serum albumin level higher than 4.0mg/dL showed highter complete remission rate. Although mature B-ALL showed the shortest overall median survival, degree of differenciation of B-cell and other immunologic markers did not influence on complete remission rate, remission duration or overall survival. CONCLUSION: Further studies are needed to delire the prognostic factors in adult ALL.
Adult ; B-Lymphocytes ; Biomarkers ; Drug Therapy ; Humans ; Induction Chemotherapy ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Serum Albumin

Acute promyelocytic leukemia(APL) is a subtype of acute myelocytic leukemia(AML) associated with unique features such as the presence of atypical promyelocytes and bleeding tendency due to disseminated intravascular coagulation(DIC). In a retrospective study, we analyzed 96 cases of AML seen at our hospital between June, 1989 and December 1993. Thirteen cases of APL(14%) were identified and their clinicopathologic characteristics were analyzed. The 86 cases of other types of AML served as controls. The distinct clinicopathologic features of APL as contrasted to other types of AML included younger age of patients, shorter duration of symptom before diagnosis, higher level of albumin at presentation, and a higher proportion of patients having coagulation abnormalities (75 vs. 25%). Bone marrow cellularity was higher in APL when compared to other types of AML (100 vs. 90%, P = 0.013). Of 13 patients with APL, 4 died of bleeding/sepsis between days 2 to 4 after admission. Seven of 9 patients who received induction therapy achieved complete remission(CR). CR rate in APL was similar to other types of AML (78 vs. 64%, P = 0.743). Five of seven patients who achieved CR remain in continuous CR at 9+ to 42+ months. CR duration is significantly longer in APL when compared to other types of AML (P = 0.029). In conclusion, this study showed that APL is a distinct entity among subtypes of AML with clinically significant bleeding tendency and rapidly fatal course if untreated. With appropriate antileukemic therapy, CR can be achieved in the majority of patients and the patients show a longer duration of CR when compared to other types of AML.
Acute Disease ; Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Blood Cell Count ; Bone Marrow/pathology ; Comparative Study ; Disease-Free Survival ; Disseminated Intravascular Coagulation/etiology ; Female ; Hemorrhagic Disorders/etiology ; Human ; Immunophenotyping ; Korea/epidemiology ; Korea/epidemiology ; Leukemia, Myeloid/*classification/mortality/pathology ; Leukemia, Promyelocytic, Acute/*classification/complications/drug therapy/mortality/pathology ; Male ; Middle Age ; Remission Induction ; Retrospective Studies ; Serum Albumin/analysis

BACKGROUND: New therapeutic modalities such as high dose chemotherapy and stem cell support have been tried to prolong the survival period of the patients with multiple myeloma. However, little is known about the criteria for the application of those new therapies. There are only a few reports for the prognostic factors of multiple myeloma in Korea. The purpose of this study is to analyze the prognostic factors affecting chemotherapy response and survival in patients with multiple myeloma. METHODS: We retrospectively analysed the clinical records of 122 patients who were newly diagnosed as multiple myeloma by SWOG criteria, between November, 1989 and April, 1997 at Asan Medical Center. RESULTS: 1) The peak incidence was the 7th decade and male to female ratio was 1.3:1. The most common presenting symptom at first diagnosis was bone pain. 2) Initial clinical stage was as followed: stage I in 17.2% , stage II in 16.4% and 66.4% in III. The immunoglobulin classes were IgG in 51.6%, light chain only in 25.4%, IgA in 16.4%, IgD in 4.1%, and non-secretory type in 2.5%. Plasma cell types in bone marrow were classified as plasmablastic type in 45.9%, plasmacytic type in 54.1%. 3) Eighty two patients who recieved chemotherapy more than 3 cycles were evaluable for chemotherapy response. Overall response rate was 69.5%. Factors affecting response to chemotherapy were serum creatinine level, plasma cell type, total plasma cell percentage and plasmablast percentasge of total nucleated cells in bone marrow. 4) For total 122 patients, overall median survival period was 21 months, and estimated 5 year survival rate was 23.5%. Factors affecting survival were serum creatinine, corrected calcium, albumin, beta2-microglobulin level, response to chemotherapy, total plasma cell percentage and plasmablast percentage in bone marrow. CONCLUSION: Bone marrow findings at initial diagnosis are significantly associated with response to chemotherapy and survival duration.
Bone Marrow ; Calcium ; Chungcheongnam-do ; Creatinine ; Diagnosis ; Drug Therapy* ; Female ; Humans ; Immunoglobulin A ; Immunoglobulin D ; Immunoglobulin G ; Immunoglobulin Isotypes ; Incidence ; Korea ; Male ; Multiple Myeloma* ; Plasma Cells ; Retrospective Studies ; Stem Cells ; Survival Rate

BACKGROUND: It has been well known that normal leukocyte counts in blood can vary depending on age, gender, other environmental factors and ethnic differe nces. However, the normal white blood cell counts in Koreans has not been settled yet. Over past several years, a large number of patients were referred to the Hematology Clinic of Asan Medical Center (AMC) for evaluation of "leukopenia", and most of them were found to have no medical problems other than leukocyte counts less than 4,000/mm3. We performed this study on persons who visited Health Screening Center to analysis of leukopenic patients and also to establish the normal value of white blood cell counts in Korean. METHOD: We studied 31,307 persons (19,540 men, 11,767 women, aged 15-90), who visited to Health Screening Center of AMC during the period from January through December 1995. We have carried out retrospec tive analysis of complete medical record of 2,406 patients (838 men, 1,568 women, aged 20-81) who were found to have leukocyte counts less than 4,000/ mm3. And we tried to establish the normal values of leukocyte counts and differential counts of 24,079 adults (15,807 men, 8,272 women, aged 19-90), who were assessed to be healthy at Health Screening Center of AMC. RESULTS: 1) Leukopenia (WBC<4,000/mm3) were found in 2,406 subjects (7.7%) among 31,307 persons screened. 2) Among them, 77 subjects (3%) had medical illness; 39 of them had chronic B or C viral hepatitis, 24 of them had iron deficiency anemia, and other diseases were de tected in remaining 14 patients. But other hematologic dis eases or significant infectious diseases were not detected. Follow-up study of them has indicated no increased incidence of infection or other hematologic diseases. 3) The total white blood cell counts of 24,097 healthy Korean adults were 3,640-9,870/mm3 (5,900/ mm3) in men, and 3,270-8,400/mm3 (5,264/mm3) in women. Neutrophil counts ranged 1,288-6,866/mm3 (3,098/mm3) in men, and 1,180-5,985/mm3 (2,816/mm3) in women. Leukocyte counts were significantly lower in female, but no significant variation was found among age groups. CONCLUSION: Normal range of leukocyte counts and neutrophil counts of healthy Korean adults were lower than those of white populations. Thus, a new normal values of leukocyte and neutrophil counts should be established in Koreans. And many persons with leuko cyte counts less than 4,000/mm3 who are otherwise he althy could be normal.
Adult ; Anemia, Iron-Deficiency ; Chungcheongnam-do ; Communicable Diseases ; Female ; Follow-Up Studies ; Hematologic Diseases ; Hematology ; Hepatitis ; Humans ; Incidence ; Leukocyte Count ; Leukocytes ; Leukopenia* ; Male ; Mass Screening ; Medical Records ; Neutropenia* ; Neutrophils ; Reference Values

Myelodysplastic syndrome is a closely related group of acquired bone marrow disorders characterized by ineffective and dysplastic hematopoiesis. These clonal disorders frequently progress to acute leukemia. Acute myelomonocytic leukemia with eosinophilia is characterized by an increase in abnormal eosinophils in the bone marrow, relatively good clinical course and inv (16) chromosomal abnormality. We experienced one case of refractory anemia with excess blasts which progressed to refractory anemia with excess blasts in transformation and finally to acute myelomonocytic leukemia with eosinophilia showing peculiar chromosomal abnormalities of der (1;7).
Adult ; Anemia/pathology ; Anemia/genetics ; Anemia/etiology ; Bone Marrow/pathology ; Case Report ; Chromosomes, Human, Pair 16* ; Disease Progression ; Eosinophilia/pathology ; Eosinophilia/genetics* ; Eosinophilia/etiology ; Human ; Inversion (Genetics)* ; Karyotyping ; Leukemia, Myelocytic, Acute/pathology ; Leukemia, Myelocytic, Acute/genetics* ; Leukemia, Myelocytic, Acute/etiology ; Male ; Myelodysplastic Syndromes/pathology ; Myelodysplastic Syndromes/genetics* ; Myelodysplastic Syndromes/complications