No abstract available.
Chromosome Aberrations*

Therapeutic plasma exchange is used in almost every condition in which there is a plasma factor thought possibly to the etiology or pathogenesis of a disease or one of its manifestations. In order to evaluate plasma exchange using fresh frozen plasma as replacement solution, eighty four therapeutic plasma exchanges were carried out in eighteen patients. In standardized procedures, 1.5 times the calculated plasma volume was replaced with a Hartman's solution and fresh frozen plasma. Anticoagulation was achieved using a whole venous blood to 2.5% trisodium citrate in the ratio of 10 to 1. Total calcium, phosphorus, glucose, urea nitrogen, creatinine, bilirubin, alkaline phosphatase, amylase, creatine kinase, IgG, C3, total white and red blood cell count, hemoglobin, and differential count were not significantly affected by the procedure. In contrast, serum cholesterol, total protein, albumin, aspartate aminotransferase, alanine aminotransferase, ionized calcium, IgM, C4 and platelet were significantly decreased by the plasma exchange. All these measurements had returned to the first pre-exchange level within 24 hours, while the C4 and platelet count took between 24 and 72 hours, and the IgM level, between 72 hours and 1 week. These data indicated that in an isovolemic plasma exchange there was a transient but rapidly reversible effect on all the components studied, with C4 and platelet count, returning more slowly to pre-exchange level than the others, and IgM levels responding the slowest. In summary, plasma exchanges using fresh frozen plasma as replacement solution were assumed to be not significantly affected the function of various organs.
Alanine Transaminase ; Alkaline Phosphatase ; Amylases ; Aspartate Aminotransferases ; Bilirubin ; Blood Platelets ; Calcium ; Cholesterol ; Citric Acid ; Creatine Kinase ; Creatinine ; Erythrocyte Count ; Glucose ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Nitrogen ; Phosphorus ; Plasma Exchange* ; Plasma Volume ; Plasma* ; Platelet Count ; Urea

Although Malassezia furfur is normal skin flora causing superficial skin diseases, cases of fungemia have been reported recently in premature newborns or immunocompromised patients related to prolonged central venous catheterization for lipid supplementation. We report a case of M. furfur fungemia in a premature infant receiving intravenous lipid supplementation through central venous circulation. She was treated only with antifungal agents without removal of the catheter or discontinuation of lipid supplementation. Soon after, symptoms and signs of the patient seemed to be improved. However, central venous catheter was removed because of recurrent septicemia of Staphylococcus aureus and the culture of central venous catheter tip showed colonization of M. furfur.
Antifungal Agents ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters* ; Colon ; Fungemia* ; Humans ; Immunocompromised Host ; Infant, Newborn ; Infant, Premature ; Malassezia* ; Sepsis ; Skin ; Skin Diseases ; Staphylococcus aureus

The recently described '17p deletion syndrome' is a clonal hematologic disease which has characteristic dysgranulopoietic features, such as pseudo-Pelger-Huet hypogranulation and small vacuoles in neutrophils and is strongly associated with p53 mutation. The cases with 17p deletion are seen in 3~4% of myelodysplastic syndrome and acute myelogenous leukemia and about 30% of them are therapy-related. Hydroxyurea, which is considered to have relatively low leukemogenic potential, has therefore been widely used in chronic myeloproliferative disease. But the recent study has found that hydroxyurea administration is a considerable risk for later leukemic transformation and is closely associated with development of 17p deletion. We report one case of idiopathic myelofibrosis which developed 17p deletion with blast increment after hydroxyurea therapy for 3 years.
Hematologic Diseases ; Hydroxyurea* ; Leukemia, Myeloid, Acute ; Lymphocyte Activation* ; Myelodysplastic Syndromes ; Neutrophils ; Primary Myelofibrosis* ; Vacuoles

BACKGROUND: Streptococcus pneumoniae is one of the most common pathogens of communityacquired pneumonia (CAP) which needs rapid diagnosis and appropriate therapeutic approaches. We evaluated a new rapid urinary antigen test kit, NOW S. pneumoniae antigen test (Binax Inc., Maine, USA), for the detection of the S. pneumoniae antigen in the urine of patients who were suspected of CAP. METHODS: A total of 115 urine samples were tested during April to July, 2004. Patients were divided into 2 groups: the first was the patients who were suspected of CAP and the second was the patients with other disorders. Urinary antigen test was performed done by immunochromatographic methods and results were read within 15 minutes. All the urine samples were random and unconcentrated. The patients were reviewed clinically, together with the results of sputum and blood cultures, urinalysis and other laboratory tests. RESULTS: Overall mean age was 62-years old and male proportion was 59%: Group 1 had mean age of 63-years old and male 54% whereas group 2 had 60-years old and 76%. S. pneumoniae antigen was detected in the urine from 14 (12.2%) of 115 patients. Of the 14 patients with positive urinary antigen tests, 12 were from 90 patients with CAP with fever, leukocytosis and appropriate radiological findings, giving the sensitivity of 13.3%; the remaining 2 patients were from 25 patients with other disorders. Only 2 of the 12 patients showed S. pneumoniae in sputum or blood cultures, respectively. Urinary antigen was not detected in 23 of the 25 patients with other disorders, giving the specificity of 92%. CONCLUSIONS: Since this simple and rapid urinary antigen test showed low sensitivity in this study, the clinical symptoms and signs and radiological findings of patients should be reviewed together with the results of the urine test for early and accurate diagnosis and treatment, consistent clinical symptoms and signs with radiological studies are inevitable. Thus further studies would be necessary. The urinary antigen test showed high specificity and therefore should be a useful adjunct to cultures to be in aid of the diagnosis of CAP.
Diagnosis* ; Fever ; Humans ; Leukocytosis ; Maine ; Male ; Middle Aged ; Pneumonia ; Pneumonia, Pneumococcal* ; Sensitivity and Specificity ; Sputum ; Streptococcus pneumoniae ; Urinalysis

Chronic neutrophilic leukemia (CNL) is a rare myeloproliferative neoplasm (MPN) characterized by persistent peripheral blood neutorphilia, bone marrow hypercellularity of neutrophilic granulocyte proliferation and hepatosplenomegaly. Acquired somatic mutation, JAK2 V617F, is the only molecular marker known to have association with classic BCR-ABL1 negative MPNs. However, JAK2 V617F has been detected occasionally in other MPNs such as CNL or other disease entities. We experienced a case of CNL with JAK2 V617F mutation. The patient was diagnosed according to the 2008 WHO classification criteria, and developed AML 9 months after the diagnosis of CNL. The JAK2 V617F was detected in the bone marrow throughout the clinical course. More cases are needed to establish the role of JAK2 V617F in the pathogenesis, prognosis and disease course of CNL.
Bone Marrow ; Granulocytes ; Humans ; Leukemia, Myeloid, Acute ; Leukemia, Neutrophilic, Chronic ; Neutrophils ; Prognosis

BACKGROUND: To assess the association between ambient particulate matter and cardiovascular death in seven cities in the Republic of Korea during the period of 2002-2008. METHODS: A time-stratified case-crossover design was used to examine association between particulate matter and deaths from cardiovascular or cerebrovascular disease; hypertensive disease 12,821, ischemic heart disease 39,577, cardiac arrhythmia 1,627, cerebrovascular disease 88,047. Mortality data was obtained from National Statistical Office, and hourly mean concentrations of particulate matter < or = 10 microm in aerodynamic diameter and meteorological data were obtained from the Ministry of Environment. The percent increase in the risk of death associated with an interquartile range increase in particulate matter was determined by conditional logistic regression analysis after adjusting for national holidays and meteorological factors. RESULTS: The largest association was a 0.8% increase (95% confidence interval [CI], 0.1-1.6) in death risk related to an interquartile range increase in particulate matter < or = 10 microm (average of 0 to 2 days prior to the day of death). Classified as the cause of death, the association was a 1.2% increase (95% CI, 0.2-2.2) in death from cerebrovascular disease related to an interquartile range increase in particulate matter < or = 10 microm. But others were statistically not significant. After stratification of death cases by year of death, statistically significant associations were a 2.3% increase (95% CI, 0.1-4.4) in death risk from ischemic heart disease in 2002-2004 and 2.0% increase in death from cerebrovascular disease (95% CI, 0.3-3.8) in 2006-2008. CONCLUSIONS: Our results suggest that ambient air pollution increases the risk of deaths from cardiovascular and cerebrovascular disease in the Republic of Korea.
Air Pollution ; Arrhythmias, Cardiac ; Cardiovascular Diseases ; Cause of Death ; Cerebrovascular Disorders ; Cross-Over Studies ; Holidays ; Logistic Models ; Myocardial Ischemia ; Particulate Matter ; Republic of Korea

We report 3 cases of multiple myeloma showing ABO discrepancy with missed reaction in serum typing. They showed markedly decreased immunogolobulin level except for monoclonally increased abnormal immunoglobulin. Their blood group was confirmed by saliva test and addition of anti-globulin reagent. As serum immunoglobulin level is raised, the reactivity in serum typing showed improving tendency and ABO discrepancy appeared when immunoglobulin was markedly decreased.
Immunoglobulins ; Multiple Myeloma* ; Saliva

Though the pathogenic significance and the reservoir of Ewingella americana have not been clarified, this organism has caused several pathogenic infections, especially in immunocompromised patients. We report a pneumonia in a patient with chronic renal failure, who had chronic rejection of transplanted kidney. E. americana was identified to be the pathogen of pneumonia with clinical symptoms and signs and radiological examination. As soon as he was treated with ceftriaxone and isepamicin, clinical improvement was followed with no further growth of E. americana or other pathogenic isolates from sputum culture. This suggests to be the case of pneumonia caused by E. americana for the first time in the Korean literature.
Adult ; Anti-Bacterial Agents/pharmacology ; Ceftriaxone/pharmacology ; Enterobacteriaceae/*metabolism ; Enterobacteriaceae Infections/*complications ; Gentamicins/pharmacology ; Humans ; Kidney Failure, Chronic/*complications/*microbiology ; Kidney Transplantation ; Male ; Pneumonia/complications/*microbiology ; Sputum/metabolism ; Time Factors

Patients who underwent resection of maxilla due to benign or malignant tumor, or accident will have defect in palatal area. They get retention, support and stability from remaining tissues which are hardly optimal. The advantage of swing-lock attachment design is having multiple contacts on labial and lingual side of the abutment teeth by retentive strut and palatal bracing component. Because the force is distributed equally to abutment teeth, abutment teeth of poor prognosis can be benefited from it. It is also more advantageous to cover soft tissue defects which are hard to reach with conventional prosthesis. A 56-year-old female patient who had undergone a maxillectomy due to malignant melanoma complaining of loose and unstable surgical obturator. Surveyed crowns were placed on #12, 26, and 27. Teeth #11, 21, 22, and 23 had lingual rest seat and #24 had mesial rest seat to improve stability and support of the obturator. This clinical report presents the prosthetic management of a patient treated with obturator on the maxilla using swing-lock attachment to the remaining teeth.
Braces ; Crowns ; Denture Precision Attachment ; Female ; Humans ; Maxilla ; Melanoma ; Middle Aged ; Palatal Obturators ; Prognosis ; Prostheses and Implants ; Tooth