The authors analysed bone marrow findings of sixteen cases of culture proven typhoid fever to reveal the pathologic changes according to the disease stage. The most frequent finding was chronic granulomatous inflammation (eight cases). Infection (bacteria) associated hemophagocytic syndrome (four cases), reactive marrow (two cases), and non specific findings (two cases) were also encountered. Granulocytic hyperplasia with hemophagocytosis appeared at the early stage and was followed by infection (bacteria) associated hemophagocytosis and granuloma in proliferative stage. In lysis (late) stage, granulomatous inflammation was noted. However, resolution of granulomatous inflammation was not distinct. Some nuclear debris and phagocytosis were remarkable in well-formed granulomas. Thrombocytopenia was the most remarkable peripheral blood finding at the time of biopsy. Anemia, leukopenia, and pancytopenia were also observed in descending order.
Adult ; Bone Marrow/microbiology/*pathology ; Female ; Humans ; Male ; Middle Aged ; Salmonella typhi/isolation & purification ; Thrombocytopenia/pathology ; Typhoid Fever/microbiology/*pathology

BACKGROUND: Heparin salts induce negative proportional bias according to anticoagulant concentration for analysis of ionized calcium (iCa) However, D-phenylalanyl -L-prolyl- L-arginine chloromethyl ketone (PPACK), a selective thrombin inhibitor, do not bind to ionized calcium. Therefore, we evaluated PPACK as an alternative anticoagulant to lithium heparin (Li-Hep) for analysis of ira, blood gases and electrolytes. METHODS: The concentration of iCa in whole blood anticoagulated with heparin was compared with that in serum of patients admitted to Chungbuk National University Hospital (n=27). The blood gases, electrolytes and iCa according to each anticoagulant concentration (Ll-Hep or PFACK) were analyzed. The concentrations of anticoagulated whole blood (Li-Hep; 50 kIU/L, PPACK ; 75 mumol/L) were compared with those of nonanticoagulated whole blood for blood gases, electrolytes and iCa (n=17), RESULTS: The results were as follows; whole blood anticoagulated with Li-Hep demonstrated -0.28+/-0.15 mmol/L (26.6%) bias for ira compared with serum. No bias according to each anticoagulated concentrations were observed in analysis of blood gases, potassium and chloride. Negative proportional bias for iCa and sodium in serum anticoagulated with Li-HeP was observed. In comparison, no bias for ira and sodium was observed with PPACK. No bias was observed in analysis of blood gas or electrolytes with each anticoagulated whole blood except for sodium and chloride that had clinically nonsignificant bias. Whole blood anticoagulated with Li-Hep demonstrated a consistent -0.08+/-0.02 mmol/L (6.3%) bias for ira compared with nonanticoagulated whole blood. In comparison, no bias was observed with PPACK-anticoagulated whole blood for iCa. CONCLUSIONS: We concluded that PPACK is an ideal anticoagulant without bias for analysis of iCa, blood gases and electrolytes.
Arginine ; Bias (Epidemiology) ; Calcium* ; Chungcheongbuk-do ; Electrolytes* ; Gases ; Heparin* ; Humans ; Lithium ; Potassium ; Salts* ; Sodium ; Thrombin

Lipiodol, lipid soluble contrast media, was applied to 59 patients, who was clinically suspected to havehepatic tumor, in the department of Diagnotic Radiology, Seoul National University Hospital. The results of theclinical use of Lipiodol were as follows: 1. The clinical diagnosis was hepatocellular carcinoma(HCC) in 50 cases,cavernous hemangioma in 4 cases, metastasis in one case and others in 4 cases. 2. After hepatic arteriography,Lipiodol only was injected in 28 cases, mixture of Lipiodol and Mitomycin was injected in 22 cases andtranscatheter arterial embolization was performed additionally after injection of Lipiodol and Mitomycin in 9cases. 3. Among the 50 cases of HCC, Lipiodol was accumulated in the lesion in 49 cases. However, similaraccumulation of Lipiodol occured in a metastatic cancer and cavernous hemangiomas. 4. Plain radiographic patternsof Lipiodol accumulation could be divided into fine granular type, nodular type and linear or branching type. Thelinear or branching pattern disappeared in follow-up radiography after one week. 5. As minor complication afterLipiodol Injection. GOY &GPT were transiently elevated in 30 cases and normalized in a week. Abdominal pain andfever developed but subsided in a week too. 6. When an appropriate lipid-soluble chemotherapeutic agent orradioisotope is applied to this phenomenon in which Lipiodol is selectively accumulated in hepatic tumor, thediagnostic and therapeutic values will be more enhanced.
Abdominal Pain ; Angiography ; Contrast Media ; Diagnosis ; Ethiodized Oil ; Follow-Up Studies ; Hemangioma ; Hemangioma, Cavernous ; Humans ; Mitomycin ; Neoplasm Metastasis ; Radiography ; Seoul

No abstract available.
Lung*

BACKGROUND: The HBV-PCR assay seems to be potentially valuable diagnostic tool for the evaluation of variable serologic status. However, the selection of the primer for HBV-PCR test may be very important because they can influence the HBV-PCR positivity. METHODS: We compared the results of primer HBV1/2 including famous 1896 and 1899 mutation sites with those of primer PHBV1/2 at precore/core region. HBV-PCR was tested in 87 HBsAg-positive patients using two sets of primers. The results were evaluated according to the primers and also compared the results with the clinical diagnosis and the alanine aminotransferase (ALT) level. RESULTS: The positive rate of PHBV primer was higher than HBV primer including mutation sites (nucleotide 1896 and 1899) in HBeAg-negative patients. According to the clinical diagnosis, the sensitivity of PHBV primer was higher than that of HBV primer in chronic hepatitis patients. There was no significant correlation between ALT level and HBV-PCR results. CONCLUSIONS: It is important that the selection of primer in HBV-PCR is important, because the primer including mutation sites may result in false negative results. PHBV primer used in this study could be useful for the detection of HBV-DNA by HBV-PCR.
Alanine Transaminase ; Diagnosis ; Hepatitis, Chronic ; Humans ; Polymerase Chain Reaction*

We encountered a case of neonatal altoimmune thrombocytopenia(NAIT) due to anti-HLA-B7+B60+B61. Bilateral cephal hematoma and umbilical hematoma were noted at the time of birth. Purpura developed at the third day. Platelet count was 110,000 at birth and decreased to 66,000/micro liter at the day 4. Prothrombin time and partial prothrombin time were within normal limit. The mother's platelet count was 220,000/micro liter and she had no history of abnormal bleeding. Platelet antibody tests empolying mixed passive hemagglutination and immunofluorescence revealed that the mother's serum was reactive against the platelets from the father and the neonate, but was not reactive with her own platelets. Platelets from eight volunteer group 0 donors were tested with the mother's serum; seven were reactive and one was negative. The positive reactions were lost after chloroquine treatment of platelets. Antigen capture ELISA(ACE) and modified antigen capture ELISA employing monoclonal antibodies against platelet glycoproteins In, IIa, IIb, and IIIa were negative. Mother's serum was tested for lymphocytotoxicity against 49 donor ]ymphocytes and the specificity was found to be anti-HLA-B7+B60+B61. At the 9th day, one unit of platelet concentrate from the mother was transfused and the platelet count of the neonate rose up to 340,000/micro liter. The neonate was discharged at the day of sixteenth and the platelet count remained high thereafter.
Antibodies, Monoclonal ; Blood Platelets ; Chloroquine ; Enzyme-Linked Immunosorbent Assay ; Fathers ; Fluorescent Antibody Technique ; Hemagglutination ; Hematoma ; Hemorrhage ; Humans ; Infant, Newborn ; Mothers ; Parturition ; Platelet Count ; Platelet Membrane Glycoproteins ; Prothrombin Time ; Purpura ; Sensitivity and Specificity ; Thrombocytopenia* ; Tissue Donors ; Volunteers

Cis-AB (A2B3) is a rare genotype resulting from the inheritance of both A and B genes on one chromosome. Among possible genotypes of cis-AB, in individuals with O/cis AB and A1/cis-AB, the B antigen is usually weakly expressed. Study on a blood sample from a 13-year-old Korean girl showed a discrepancy between red blood cell and serum typing. The blood type was identified as AweakB on the red cell test, while weak anti-B was detected in the serum. Cis-AB (A2B3) was suspected, however, known blood types of her father and mother were A and O, respectively. In the repeated test, the propositus was typed as group A2B3. Her mother was typed as normal group O. Her father was typed as group A1 in cell typing, but in his serum, anti-B was very weakly detected. In the saliva test and adsorption and elution studies of the father, B substance was not detected. Finally, ABO genotyping was performed and ABO genotypes of the patient, mother and father were cisAB/O, O/O and cisAB/A1, respectively. This was the first reported case of A1/cisAB with phenotype A1. ABO genotyping technique will resolve problems encountered in association with unusual phenotype expression of cis-AB trait.
Adolescent ; Adsorption ; Child* ; Erythrocytes ; Fathers* ; Female ; Genotype ; Genotyping Techniques ; Humans ; Mothers* ; Phenotype* ; Saliva ; Wills

BACKGROUND: Since the emergence of variant Clostridium difficile strains that fail to produce detectable toxin A, diagnostic kits targeted to detect toxin A only showed a considerable rate of false negative results. The aim of this study was to evaluate a toxins A and B (toxins A/B) detection kit recently marketed in Korea, and to compare toxin positive rates before and after introduction of the new kit. METHODS: The results of 5,783 toxin A assays performed during the 7-year period from 2001 through 2007 were analyzed and compared them to the toxins A/B assay data of 519 samples obtained from January to June 2008 in a university hospital. An enzyme-linked fluorescent immunoassay for toxins A/B (VIDAS C. difficile Toxin A & B, bioMerieux SA, France: VIDAS CDAB) and PCR for toxin genes A/B were performed directly in 102 stool samples from hospitalized patients. RESULTS: The positive rates of toxin A assays tended downward annually from 2001 to 2007 (16.3%, 17.8%, 13.9%, 11.4%, 13.8%, 8.2%, and 5.8%, respectively), but increased to 12.1% in 2008 after changing to the toxin A/B detection kit. The concordant rate of the VIDAS CDAB kit with the PCR method was 82.4%. Compared to the PCR method, the sensitivity and specificity of the toxin A/B kit were 60.7% and 90.5% respectively. CONCLUSION: Testing kits for C. difficile toxin A only could result in a misdiagnosis more frequently than the testing kit for toxins A/B. The sensitivity of the newly launched toxin A/B detection kit from bioMerieux SA needs to be improved, but it showed a good specificity
Clostridium ; Clostridium difficile ; Diagnostic Errors ; Humans ; Immunoassay ; Immunoenzyme Techniques ; Korea ; Polymerase Chain Reaction ; Sensitivity and Specificity

Far Eastern countries including Korea show the high prevalence of hepatitis B virus carriers, so that the incidence of liver cirrhosis is higher than in western countries. But pregnancies with liver cirrhosis are rarely encountered in clinical settings, since liver cirrhosis usually develops after childbearing ages and often causes the disturbance of estrogen metabolism, resulting in severe menstrual irregularity and infertility. Therefore, little is known about the interactions between liver cirrhosis and pregnancy. Liver cirrhosis and portal hypertension are not contraindications to pregnancy but necessitate intensive monitoring throughout pregnancy because the complications of liver cirrhosis, which pose additional risks during pregnancy, are numerous and unpredictable. We report 3 cases of pregnancies in patients with liver cirrhosis with brief review of the literature.
Estrogens ; Hepatitis B virus ; Humans ; Hypertension, Portal ; Incidence ; Infertility ; Korea ; Liver Cirrhosis* ; Liver* ; Metabolism ; Pregnancy* ; Prevalence

Multiplex PCR of nasopharyngeal aspirates detected viruses and atypical bacteria in 75.3% (219/291) of infants with acute respiratory infections from July 2010 to June 2013. Frequent viruses were human rhinovirus (29.9%), parainfluenza virus (21.7%), respiratory syncytial virus (17.9%), and human metapneumovirus (10.3%). Mycoplasma pneumoniae and Bordetella pertussis were detected in 3.4% and 0.3%, respectively.
Bacteria ; Bordetella pertussis ; Humans ; Infant* ; Metapneumovirus ; Multiplex Polymerase Chain Reaction* ; Mycoplasma pneumoniae ; Paramyxoviridae Infections ; Pneumonia, Mycoplasma ; Respiratory Syncytial Viruses ; Respiratory Tract Infections* ; Rhinovirus