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

No abstract available.
Chromosome Aberrations*

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 diagnosis of acute undifferentiated leukemia is made when the leukemic cells cannot be classified using morphologic and cytochemical analyses, and do not express myeloid or lymphoid antigens. Trisomy 13 is a rare primary chromosomal abnormality in acute leukemia and associated with lineage inconsistency and poor prognosis. We report a rare case of acute undifferentiated leukemia showing negativity in periodic acid-Schiff (PAS) and myeloperoxidase (MPO) without any lineage-specific cell surface marker expression and having trisomy 13. The patient was a 72- year-old male who visited our hospital because of anemia and general weakness. On examination, leukocytosis with proliferated blasts (76%) in peripheral blood was noted. Bone marrow aspirate showed blast proliferation (74%) with morphologically hand-mirror type. The blast expressed CD34 (96%) and HLA-DR (76%) in immunophenotyping. Cytogenetic study of bone marrow cells showed 46,XY,+13,-21[15]/46,XY[5]. Induction chemotherapy was failed and differentiation to monocytic series was noted.
Anemia ; Bone Marrow ; Bone Marrow Cells ; Chromosome Aberrations ; Cytogenetics ; Diagnosis ; HLA-DR Antigens ; Humans ; Immunophenotyping ; Induction Chemotherapy ; Leukemia* ; Leukocytosis ; Male ; Peroxidase ; Prognosis ; Trisomy*

Corynebacterium xerosis is a normal flora of the skin, mucous membrane and gastrointestinal tract. Although not usually considered to be a pathogen, it occasionally causes serious infections in immunocompromised hosts. We report a case of a shunt infection by C.xerosis developed in a 58-year-old woman following the insertion of a ventriculoperitoneal shunt. The organism was also isolated from the cerebrospinal fluid and blood. The isolate was resistant to most of the antibiotics tested except for vancomycin. However, in spite of treatment with vancomycin, the patient was expired after 5 months.
Anti-Bacterial Agents ; Cerebrospinal Fluid* ; Corynebacterium* ; Female ; Gastrointestinal Tract ; Humans ; Immunocompromised Host ; Middle Aged ; Mucous Membrane ; Skin ; Vancomycin ; Ventriculoperitoneal Shunt*

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

PURPOSE: The aim of this study was to investigate healed bovine bone particles (Bio-Oss(R)) and absorbable collagen sponge (CollaPlug(R)) applied extraction socket site at 4-6 months' post-extraction. MATERIAL AND METHODS: From August, 2004 to October, 2005, 17 sockets in 5 adult patients were selected out of the patients whose received ridge preservation using bovine bone particles and absorbable collagen sponges at Department of oral and maxillofacial surgery in Samsung Medical Center. There were 5 male patients, ages 30 to 58 years. Immediate postoperation and 4-6 months after operation study models were compared to evaluate the ridge dimension by measuring vertical height and horizontal width of alveolar ridge. RESULTS: The measurements at 4-6 months revealed, in the ridge dimension, a loss of vertical height of 0.91+/-0.40mm and horizontal width of 1.25+/-0.58mm. There was no adverse reaction. CONCLUSION: This study suggests that treatment of extraction sockets with graft materials and collagen sponges is valuable in preserving alveolar bone in extraction sockets and preventing alveolar ridges defects.
Adult ; Alveolar Process ; Collagen ; Humans ; Male ; Porifera ; Surgery, Oral ; Transplants

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

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

PURPOSE: Since a significant number of patients with locally invasive bladder tumor(T3a/T3b) subsequently develop distant metastases, there have been lots of controversies in deciding treatment modalities. In the past decade, progress has been made in the development of effective chemotherapy for the treatment of advanced transitional cell carcinoma of the urothelium. Thus, we reviewed the effectiveness of the M-VAC(methotrexate, vinblastine, adriamycin, and cisplatin) chemotherapy for locally invasive transitional cell carcinoma (TCC) of the bladder. MATERIALS AND METHODS: We reviewed 36 patients who were diagnosed as T3a/T3b TCC and treated with aggressive transurethral resection of the bladder tumor(TURBt) and M-VAC chemotherapy Remission was defined in case of complete disappearance of the tumor or downstaging, and progression was defined in case of persistent disease or upstaging. RESULTS: Mean age of the patients was 60.4 years old(33 males; 3 females), and mean follow up was 12.2 +/- 8.9 months. Response rate considering loss of follow up according to the Kaplan-Meyer's method, was 79, 49, 44, 37% at 6, 12, 18, 24th month, respectively. Disease progressions were found in 19 patients during follow up, and the mean duration to progression was 9.2 +/- 5.0(1-19)months. 79% of the patients with disease progression showed progression within 12 months. Lymph node metastases or distant metastases were confirmed in 68% of progressed patients. CONCLUSIONS: M-VAC chemotherapy after aggressive TURBt is limited, but erective treatment modality, and it is also useful in deciding the prognosis of cancer with its responsiveness.
Carcinoma, Transitional Cell* ; Disease Progression ; Doxorubicin* ; Drug Therapy* ; Follow-Up Studies ; Humans ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Prognosis ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urothelium ; Vinblastine*