No abstract available.
Lung Neoplasms* ; Lung*

BACKGROUND: A soluble form of interleukin-2 receptor (sIL-2R) is released from activated T cells. Serum sIL-2R levels are elevated in some hematological malignancies and could be used to assess disease activity and prognosis. MATERIAL AND METHODS: To define clinical usefulness and significance as a marker predicting disease progress in chronic myeloproliferative disorders, the serum levels of sIL-2R were measured in 40 cases of chronic myelogenous leukemia (CML; 25 chronic phase, 7 accelerating phase, 8 blastic phase), 3 cases of polycythemia vera (PV), 5 cases of essential thrombocythemia (ET) and 4 cases of idiopathic myelofibrosis (MF) and in 37 cases of healthy subjects using sandwich enzyme immunoassay. RESULTS: Serum sIL-2R levels in the patients of CML, PV, ET, and MF were higher compared with the normal healthy controls. In CML, serum sIL-2R levels in the patients of blastic and accelerating phases were significantly higher than those of chronic phase. In CML of chronic phase, serum sIL-2R levels at diagnosis were related to WBC count but not to other clinical and hematologic paramaters. The leukemic cells of one patient with lymphoblastic phase of CML expressed IL-2R (CD25). Among 4 patients of CML with sIL-2R levels above 2,000U/mL at diagnosis, transformation to blastic crisis was noted in 3 patients and 2 patients died within 1 year after diagnosis. But among 11 patients of CML with sIL-2R levels below 2,000U/mL at diagnosis, only 2 patients experienced blastic crisis and died within 1 year after diagnosis. CONCLUSION: This study indicated that serum sIL-2R levels were high in chronic myeloproliferative disorders, and that increasing levels of serum sIL-2R might be useful to predict disease progress. Further studies including more patients and longer follow-up may substantiate serum sIL-2R as a prognostic indicator in CML.
Diagnosis ; Hematologic Neoplasms ; Humans ; Immunoenzyme Techniques ; Interleukin-2* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Myeloproliferative Disorders* ; Polycythemia Vera ; Primary Myelofibrosis ; Prognosis ; T-Lymphocytes ; Thrombocythemia, Essential

Cytomegalovirus is the most common cause of life-threatening viral infection in HIV-infected patients. This study was done prospectively to investigate the incidence of CMV infection according to the decrease of CD4+ T cell count (CD4+) in Korean AIDS patients. Thirty-nine HIV-infected patients diagnosed before 1994 were followed for regular immunological monitoring. We have used urine shell vial method for the CMV detection from 1994 and have also checked clinical findings. Positive urine culture rate definitely depended on the CD4+ as follows; 45%, 22%, 17%, 11% and 0%, CD4+ >50, 50-100, 100-200, 200-500 and <500, respectively. Except culture positive 2 patients with CD4+ of 200~300/ul, all eight culture positive patients with CD4+ less than 200/ul showed CMV related diseases on or before urine culture. But, we could not get a positive culture for a late AIDS patient with vision loss. With ganciclovir therapy, all culture results were at least negative just after or on late of first 14 days-ganciclovir infusion-course. These data suggest that the incidence of CMV disease in Korean AIDS patients is very high, and early diagnosis and treatment for CMV diseases is required for the prevention of life threatening results.
Cell Count* ; Cytomegalovirus ; Early Diagnosis ; Ganciclovir ; Humans ; Incidence ; Monitoring, Immunologic ; Prospective Studies

No abstract available.
Humans ; Korea* ; Prognosis*

OBJECTIVES: Pneumocystis carinii pneumonia(PCP) is one of the most common life-threatening opportunistic infections in patients with acquired immunodeficiency syndrome(AIDS). This study reports the clinical charac teristics of PCP in the patients with AIDS and prognostic factors for short-term survival of them. METHODS: We investigated 43 patients of AIDS to evaluate the frequency of PCP in patients in AIDS by retrospective analysis, and classified the 17 patients with PCP into survivors and non-survivors to compare epide miology, clinical characteristics and laboratory findings. We also analyzed whether the these findings influenced the short-term survival in patients with PCP that was combined with AIDS. RESULTS: In this retrospective study of 43 patients of AIDS, the frequency of PCP in AIDS patients was relatively high as 17 patients(39%), of whom eight pa tients(47%) died of PCP. The epidemiologic findings such as age, route of human immunodeficiency virus(HIV) infection and co-existing disease were not significantly different between survivors and non-survivors. Coughing was the most common symptom and bilateral infiltrates of lung was the most common form in the chest X-ray examination. But these clinical features were similar in the both groups. Total lymphocyte count, CD4 cell count, serum albumin level and arterial oxygen tension were decreased and serum LDH was increased in patients with PCP that was the first episode in patients with AIDS. Lymphocyte and CD4 cell count were significantly lower in the non-survivor group (p=.002 and p=.03, respec tively). Survivors had higher serum albumin level and arterial oxygen tension than non-survivors (p=.02 and p=.04, respectively). And non-survivors were found to have higher serum LDH level than survivors (p=.02). CONCLUSION: Lymphocyte and CD4 cell counts, serum albumin and LDH, and arterial oxygen tension may be considered as the prognostic factors for short-term sur vival of patients with PCP that is combined with AIDS.
CD4 Lymphocyte Count ; Cough ; Humans ; Lung ; Lymphocyte Count ; Lymphocytes ; Opportunistic Infections ; Oxygen ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia, Pneumocystis* ; Retrospective Studies ; Serum Albumin ; Survivors ; Thorax

BACKGROUND: P-glycoprotein (PGP) is capable of expelling cytotoxic drugs from cytosol and the overexpression mediates drug resistance. However not all resistant leukemic cells express PGP. High expression of glutathione S-transferasepie (GSTpie) is related to clinical outcome following chemotherapy. Topoisomerase IIalpha (topo IIalpha) is a major target of anthracyclines for the treatment of leukemia. METHODS: To evaluate the relation of PGP, GSTpie and topo IIalpha expression to treatment outcome, PGP, GSTpie and topo IIalpha expression were analysed by flow cytometry using mono clonal antibodies (anti-JSB1, anti-GSTpie and anti-topo IIalpha) in 33 cases of de novo acute myelogenous leukemia. RESULTS: In patients with AML, the frequency of patients with high expression of PGP was 57.6% (19/33). The complete remission (CR) rate and mean survival duration were significantly different between patients with high expression and those with low expression of PGP (31.6 vs 92.9%, P=0.001; 83 vs 341 days, P=0.011). The frequency of patients with high expression of GST pie was 60.6% (20/33). The CR rate and mean survival duration were significantly different between patients with high expression and those with low expression of GSTpie (40.0 vs 84.6%, P=0.011; 115 vs 343 days, P=0.021). The frequency of patients with high expression of topo IIalpha is 78.8% (26/33) and treatment outcome was not related to topo IIalpha expression. In multivariate analysis with age, WBC count, PGP and GSTpie, PGP expression was an independent prognostic factor for treatment outcome. CONCLUSION: The flow cytometric measurement of PGP and GSTpie expression can be useful for the prediction of treament outcome following chemotherapy and PGP can be used as aprognostic factor in AML.
Adult* ; Anthracyclines ; Antibodies ; Cytosol ; DNA Topoisomerases, Type II* ; Drug Resistance ; Drug Resistance, Multiple ; Drug Therapy ; Flow Cytometry ; Glutathione S-Transferase pi* ; Glutathione Transferase* ; Glutathione* ; Humans ; Leukemia ; Leukemia, Myeloid, Acute* ; Multivariate Analysis ; P-Glycoprotein* ; Treatment Outcome

To investigate resistance to lamivudine (3TC), we examined the incidence of M184V in 20 HIV-1 patients treated with 3TC for 13.1 +/- 9 months. Fourteen of 20 patients had been exposed to zidovudine (ZDV) or didanosine (ddl) prior to 3TC therapy. Nested PCR targeting to reverse transcriptase (RT) and direct sequencing were performed for peripheral blood mononuclear cells sampled serially. There were resistance mutations to ZDV in at least 9 patients at baseline, although there was no resistance mutation to 3TC. We could detect M184V in 6 (30%) out of 20 patients. The incidence of M184V increased as the duration of therapy prolongs (13% in samples<12 months; 47% in samples gtoreq 12 months). The frequency of mutation M184V was higher in patients with previous mutation to ZDV than in patients with wild type. Resistance mutation was not detected in 7 patients. This study shows that resistance to 3TC tends to develop rapidly in patients with baseline mutations or two drugs combination therapy than in those treated simultaneously with triple drugs. This report is the first on resistance to 3TC in Korean AIDS patients.
Didanosine ; HIV-1* ; Humans ; Incidence ; Lamivudine* ; Polymerase Chain Reaction ; RNA-Directed DNA Polymerase ; Zidovudine

BACKGROUND: The purpose of this study was to examine the prevalence and distribution of unexpected antibodies detected in the Korean population with race-specific RBC panel cells. In spite of a relatively high prevalence of Dia and Mia antigen phenotype in the Korean and Southeast Asian population, there has been little documented research on the prevalence and clinical significance of anti-Dia and anti-Mia in Korea. METHODS: We analyzed the results of 17, 664 antibody screening tests performed during the recent 30-month period from March 2001 to September 2003. Antibodies were screened and identified by using LISS/Coombs gel card with DiaMed-ID system (DiaMed AG, Cressier, Morat, Switzerland) including Dia and Mia panel cells. RESULTS: The prevalence of unexpected antibodies was 1.2% (214/17, 664); antibodies detected most frequently were anti-Rh (74 patients), followed by anti-Lewis (21 patients) and anti-Dia (15 patients). Out of 6, 345 patients, anti-Mia was detected in three patients (0.047%). Anti-Dia and anti-Mia had the specificity of IgG. Anti-Dia was thought as an immune-mediated antibody, whereas anti-Mia was considered as a mixed type with immune and natural antibodies. CONCLUSIONS: This study shows that anti-Dia and anti-Mia antibodies are detected frequently in the Korean population; hence, it seems that Dia and Mia panel cells should be incorporated into antibody screening panels in Korea for safe transfusion.
Antibodies ; Asian Continental Ancestry Group ; Humans ; Immunoglobulin G ; Korea ; Mass Screening* ; Phenotype ; Prevalence* ; Sensitivity and Specificity*

We initiated this study to investigate whether combining Helicobacter pylori eradication with immunosuppressive therapy provides an additional benefit to patients with idiopathic thrombocytopenic purpura (ITP) that has relapsed or has not responded to steroid and/or danazol therapy in patients who have H. pylori infection. Thirty- four patients with chronic ITP that had relapsed or failed to steroid and/or danazol therapy were assessed for H. pylori infection. Of the 21 confirmed cases, 12 patients were given H. pylori eradication therapy alone (EA), while 9 patients received eradication therapy combined with immunosuppressive therapy (EI). The response rate was not significantly different between patients in the EA and those in the EI group (41.7% in the EA group vs. 66.7% in the EI group, p=0.345). The median platelet count at 6 months after therapy was higher in the EI group patients (75X10(9)/L in the EI group patients vs. 18x109/L in the EA group patients, p=0.028). The median response duration was also longer in the EI group patients (9 months in the EI group patients vs. 3 months in the EA group patients, p=0.049). These results show that a significant benefit is gained by the use of H. pylori eradication combined with immunosuppressive therapy over the use of eradication therapy alone for patients with chronic ITP.
Adult ; Aged ; Anti-Bacterial Agents/*administration & dosage ; Chronic Disease ; Danazol/administration & dosage ; Drug Therapy, Combination ; Estrogen Antagonists/administration & dosage ; Female ; Helicobacter Infections/complications/*drug therapy ; *Helicobacter pylori ; Humans ; Immunosuppressive Agents/*administration & dosage ; Male ; Middle Aged ; Purpura, Thrombocytopenic, Idiopathic/complications/*drug therapy ; Steroids/administration & dosage ; Treatment Outcome

Primary central nervous system(CNS) lymphoma is an uncommon neoplasm which is considered to be radiosensitive. We have recently experienced one of such cases with a history of systemic lymphoma(diffuse histiocytic lymphoma) of the left cheek and left forearm in a 56-year-old man. Chief complaints include headache and generalized weakness for 1 month. MRI(magnetic resonance imaging) revealed an enhancing irregular mass lesion in both the basal ganglia and corpus callosum with minimal surrounding brain edema. CSF analysis and cytology revealed no specific abnormal findings. Without brain biopsy, we concluded that the lesion was a primary CNS lymphoma based on the fact that the patient have had a history of diffuse histiocytic lymphoma and MRI findings were compatible to primary CNS lymphoma. He was treated with dexamethasone for 2 weeks and 3900 cGy radiation therapy for 5 weeks. He improved gradually, and control MRI after radiotherapy showed complete resolution of the lesion.
Basal Ganglia ; Biopsy ; Brain ; Brain Edema ; Central Nervous System* ; Cheek ; Corpus Callosum ; Dexamethasone ; Forearm ; Headache ; Humans ; Lymphoma* ; Lymphoma, Large B-Cell, Diffuse ; Magnetic Resonance Imaging ; Middle Aged ; Radiotherapy