No abstract available.
Down Syndrome* ; Myeloproliferative Disorders*

No abstract available.
Down Syndrome* ; Leukemia*

We analyzed the clinical and laboratory features of ten children with acute megakaryoblastic lukemia (M7)and compared the findings with those reported in the literature. The diagnosis was supprted by ultrastructural examination of platelet peroxidase or immunophenotyping for glycoprotein IIb/IIIa. Of the ten children, five were girls and five were boys. The median age at diagnosis was 13 months. Two patients had prominent myelofibrosis and one patient had Down syndrome. Nine patients were treatd with low-dose cytosine arabinoside (10mg/m2)administered intravenously, or subcutaneously, or intramuscularly, twice daily in 21 day courses. Seven patients achieved hematologic response and three patients are alive without evidence of disease. The 4 year event free survival rate was30.0%. It is our impression that the prevalence of acute megakaryoblastic leukemia has been under-estimated, and low-dose cytosine arabinoside treatment may be of value in its management. This approach may be particularily useful in hospitals with scarce well-equipped facilities, since this protocol does not induce profound marrow hypoplasia and intensive supportive measures are not required as they would be with the use of more aggressive drug combination.
Blood Platelets ; Bone Marrow ; Child* ; Cytarabine ; Diagnosis ; Disease-Free Survival ; Down Syndrome ; Female ; Glycoproteins ; Humans ; Immunophenotyping ; Leukemia, Megakaryoblastic, Acute* ; Megakaryocyte Progenitor Cells ; Peroxidase ; Prevalence ; Primary Myelofibrosis

Acinetobacter species encounters frequently with clinical specimens and now accounts for a substantial proportion of endemic nosocomial infections in Korea. Recent trends indicate that the antimicrobial resistant strains of Acinetobacter species are increasing. Sixty-one strains were isolated from specimens of patients suspected of nosocomial infections during 1991 to 1996. At present, phenotypic identification of Acinetobacter using biochemical test may not be reliable and resulted in the difficulty to clarify the source of infections and epidemiological study of hospital-acquired infections. Aware of the importance of rational taxonomic proposal for these isolates, correct species identification of these organisms by molecular typing method was carried out. A total of fifty-four strains of A. calcoaceticus-A. baumannii complex species which were identified to genospecies 2 and 13 by biochemical characteristics was subjected to identify by ribotyping using restriction endonuclease EcoRI, ClaI, and SalI. Of fifty-four strains, twenty-five strains were identified as A. baumannii (genospecies 2) and twenty-one strains as genospecies 13, and six strains changed to genospecies 3, and the rest two strains were confirmed as A. haemolyticus (genospecies 4). This result suggests that the ribotyping may be of value for identification of genospecies and epidemiological information of Acinetobacter strains.
Acinetobacter baumannii* ; Acinetobacter calcoaceticus* ; Acinetobacter* ; Cross Infection ; DNA Restriction Enzymes ; Humans ; Korea ; Molecular Typing ; Ribotyping*

We investigated whether there is differences in serum level of carcinoembryonic antigen (CEA) between patients with colon and rectal cancer. Preoperative serum levels of CEA was determined in 65 patients with colon cancer and in 88 patients with rectal cancer. Cut-off value recommended by manufacturers is 5 ng/ml for CEA. At the recommended cut-off levels for CEA, overall sensitivity of CEA was 43.1 percent for colon and 42.0 percent for rectal cancer. In colon cancer CEA was elevated in 38.4, 46.2, 60 percent of patients with Dukes Stages B, C, and D, respectively. In rectal cancer CEA was elevated in 12.5, 31.6, 44.8, 84.6 percent of patients with Dukes Stages A, B, C, and D, respectively. In Stages B, and C, sensitivity of CEA was higher in colon than in rectal cancer, but the difference was not significant. In Stages D, sensitivity of CEA was higher in rectal cancer than in colon cancer, but the difference was not significant. In overall stages sensitivity of CEA was higher in colon than in rectal cancer, but the difference was not significant. The difference was not significant either in overall or in different stages of colon and rectal cancer.
Carcinoembryonic Antigen ; Colon* ; Colonic Neoplasms ; Humans ; Rectal Neoplasms*

Many organic and nonorganic agents can cause chemical pneumonitis. Chemical pneumonitis induced by inhalation of acetic acid is a rare clinical condition. As acetic acid is a water soluble agent, it causes chemical irritation to respiratory tract and causes variable symptoms. We experienced a case of acute lung injury due to inhalation of acetic acid fume. A 56-year-old male patient was admitted due to dyspnea with vomiting for one day. After he inhaled acetic acid fume in occupational situation, he had chest tightness, chilling sense, and productive cough. Our case was good response to oxygen inhalation, antibiotics, and systemic steroids.
Acetic Acid* ; Acute Lung Injury ; Anti-Bacterial Agents ; Cough ; Dyspnea ; Humans ; Inhalation* ; Male ; Middle Aged ; Oxygen ; Pneumonia* ; Respiratory System ; Steroids ; Thorax ; Vomiting ; Water

BACKGROUND: The incidence of mycoplasmal pneumonia is predominantly at childhood and early adulthood, but in adults, its incidence is low and its symptoms and physical findings are nonspecific. The definite diagnosis of M. pneumoniae pneumonia can be made by sputum culture, but requires several weeks for positive results, and the early diagnosis must initially be based on the serologic tests and appropriate clinical findings. Thus, we evaluated the clinical aspects of M. pneumoniae pneumonia in the adults patients. METHOD: Among the admitted patients due to pneumonia, the definite diagnosis is anti-M. pneumoniae antibody titer of > 1:40 and a single cold agglutinin titer of > 1:64. The presumptive diagnosis is anti-M. pneumoniae antibody titer of > 1:40 or a single cold agglutinin titer of > 1:64 and the clinical characteristics or chest X-ray findings are compatible with M. pneumoniae pneumonia. We studied the age and sex distribution, seasonal distribution, clinical symptoms, physical findings, serologic test, chest X-ray findings, treatment and its progression. RESULTS: 1) The age distribution was even and the ratio of male to female was 1:1. 2) The monthly distribution was most common in January(16.7%) and the seasonal distribution in autumn and winter(autumn: 30%, winter: 33.3%). 3) The cold agglutinin titers were higher than 1:64 in 12 cases(40%), and reached the peak level around 2 weeks from onset and antimycoplasma antibody titers were higher than 1:160 in 5 cases(16.7%). 4) On the chest X-ray, pulmonary infiltration was noted in 28 cases(93.3%) among 30 cases and right lower lobe involvement was the most common(33.3%) and both lower lobe involvement was noted in 7 cases(23.3%). 5) The mean treatment duration was most common(33.3%) in 1 week to 2 weeks after admission and 26 cases(86.7%) were improved within 4 weeks. 6) On admission, there was fever(> or =38.9degreesC) in 17 cases(56.7%), and the fever subsided in 12 cases(70%) within 3 days after treatment using erythromycin. CONCLUSION: The mycoplasmal pneumonia in adults shows milder clinical patterns than that in childhood and can be completely recovered without complication by early diagnosis and treatment.
Adult* ; Age Distribution ; Diagnosis ; Early Diagnosis ; Erythromycin ; Female ; Fever ; Hospital Distribution Systems ; Humans ; Incidence ; Male ; Pneumonia* ; Seasons ; Serologic Tests ; Sex Distribution ; Sputum ; Thorax

BACKGROUND AND OBJECTIVES: The pathogenesis of chronic paranasal sinusitis has been gradually clarified, but there have been conflicting arguments on the ventilation of paranasal sinus. The aim of the present study is to establish an objective, quantitative and reproducible method for the investigation of the ventilation of paranasal sinuses. MATERIALS AND METHODS: With the axial images of high resolution computed tomography, a fine model of human paranasal sinus was made. The model was fitted with pressure sensors, and the pressure changes in the nasal cavity, frontal, maxillary and sphenoid sinuses were measured by pressure sensors and digital physiograph during nasopharyngeal respiration. RESULTS: Results demonstrated negative pressures compared to the atmospheric pressure during inspiration and positive pressures during expiration in the sinonasal cavities, and the highest and lowest pressures were measured in the nasal cavity. CONCLUSION: This study introduces another method for the investigation on the sinus ventilation through a model study. And this study model has demonstrated that the ventilation of paranasal sinuses depends on nasal respiration. Furthermore, the method is useful to evaluate the results of nasal and sinus surgeries in the case of an obstructed ostium, deviated septum or hypertrophied turbinates.
Atmospheric Pressure ; Humans* ; Nasal Cavity ; Nose* ; Paranasal Sinuses* ; Respiration ; Sinusitis ; Sphenoid Sinus ; Turbinates ; Ventilation*

PURPOSE: The aim of this study is to determine and compare the effects of adjunctive therapy with different doses of recombinant human granulocyte-colony stimulating factor(rhG-CSF) on reversing sepsis-associated neonatal neutropenia, and their survival rate in a group I/II-type trial. METHODS: RhG-CSF was injected subcutaneously to 10 septic-neutropenic neonates with doses of 10 microgram/kg from Oct. 1995 to Sep. 1996, and was administered to another 12 septic-neutropenic neonates with doses of 5 microgram/kg from Oct. 1996 to Sep. 1997. Neutrophilic responses and the outcomes of both groups were compared. RESULTS: In the rhG-CSF 10 microgram/kg treated group and in the 5 microgram/kg treated group, the absolute neutrophil count(ANC) was 1,065+/-89(mean+/-SEM) and 1,053+/-131, respectively. The only difference between the two groups was the peak ANC at 48 hours. Eight patients from the remaining nine of rhG-CSF 10 microgram/kg treated group(88.9%) and ten in 5 microgram/kg treated group(83.3%) survived the sepsis and were discharged without any problems. CONCLUSIONS: RhG-CSF can increase the neutrophil count in critically ill septic neutropenic neonats. The survival rate of both groups were up to 90%. This finding suggests that both doses of rhG-CSF may be effective in a therapeutically useful time frame to treat septic neonates with neonatal neutropenia attributable to bone marrow supression or neutrophil consumption.
Bone Marrow ; Critical Illness ; Granulocytes* ; Humans* ; Infant, Newborn ; Neutropenia* ; Neutrophils ; Sepsis* ; Survival Rate

OBJECTIVES: The combination therapy with peginterferon and ribavirin has been used to treat chronic hepatitis C for several years in Korea but there is a few report about the results of the treatment. We evaluated safety and efficacy of the combination therapy with Peg-interferon and ribavirin and analyzed factors that may affect treatment. METHODS: Total 72 untreated chronic hepatitis C patients were administered pegylated interferon alfa-2a (180microg/week) or alfa-2b (1.5microg/kg/week) and ribavirin (800 mg/day in genotype 2, 1000-1200 mg/day in genotype 1). Duration of the treatment was 24 weeks in genotype 2 and 48 weeks in genotype 1. Response of the treatment was evaluated by rapid virologic response (RVR), early virologic response (EVR), end treatment virologic response (ETR), sustained virologic response (SVR) and adverse event. RESULTS: The RVR, EVR, ETR, SVR were 61.8%, 82.5%, 88.9% and 80.5% retrospectively. The SVR of genotype 1 was 63.4% and non-genotype 1 was 96.7%. Genotype (Odds ratio: 14.92) was an independent predictor of the SVR. Leukocytopenia, flu-like symptoms, itching, rash and anemia were common adverse events of the combination therapy and if then we reduced dose and there was one case of cessation. CONCLUSIONS: The combination therapy with Peg-interferon and ribavirin shows efficacy to the Korean patients with chronic hepatitis C as an initial treatment. Genotypes 2 and 3 were more likely to have a sustained virologic response.
Anemia ; Exanthema ; Genotype ; Hepatitis C ; Hepatitis C, Chronic ; Hepatitis, Chronic ; Humans ; Interferon-alpha ; Interferons ; Korea ; Leukopenia ; Polyethylene Glycols ; Pruritus ; Recombinant Proteins ; Retrospective Studies ; Ribavirin