No abstract available.
Kidney* ; Nephrectomy*

No abstract available.
Adrenalectomy*

OBJECTIVE: Adult onset Still s disease is an acute systemic inflammatory disorder. There are no pathognomonic symptoms or specific laboratory abnormalities. In recent reports, serum ferritin concentration is increased in active disease phase and decreased after defervescence. Our purpose was to determine the clinical significance of serum ferritin as an indicator for disease activity. METHODS: Seven patients who were diagnosed as adult onset Still s disease at Samsung Medical Center between October 1994 and March 1997, were reviewed. In these patients we checked leukocyte count, ESR, CRP and serum ferritin concentrations at the time of diagnosis and during follow-up periods and recorded febrile events during follow-up periods. RESULTS: At the time of diagnosis and during febrile periods, the concentrations of ferritin were extremely high(927ng/ml to 96,650ng/ml normal 10-290.8 ng/ml). The values were unrelated to other manifestations of the disease or laboratory findings. The ferritin concentrations decreased rapidly after adequate treatment. Eleven febrile reattacks happened in 7 patients. Serum ferritin concentrations were increased in 8 febrile attacks, while leukocyte count, ESR, and CRP were increased in 5, 5, 6 febrile attacks respectively, There were 10 events of increased serum ferritin concentrations in 7 patients during follow-up periods and 8 events were related with fever. The increases of other laboratory tests were similar. CONCLUSIONS: In all patients, serum ferritin concentrations were increased at the time of diagnosis and closely related to fever. During follow-up periods, serum ferritin concentrations are helpful in monitoring disease activity and guiding decisions about treatment.
Adult* ; Diagnosis ; Ferritins* ; Fever ; Follow-Up Studies ; Humans ; Leukocyte Count ; Still's Disease, Adult-Onset*

Coronaviruses (CoVs) are single-stranded RNA viruses which contain the largest RNA genomes, and severe acute respiratory syndrome coronavirus (SARS-CoV), a newly found group 2 CoV, emerged as infectious disease with high mortality rate. In this study, we compared the synonymous codon usage patterns between the nucleocapsid and spike genes of CoVs, and C-type lectin domain (CTLD) genes of human and mouse on the codon basis. Findings indicate that the nucleocapsid genes of CoVs were affected from the synonymous codon usage bias than spike genes, and the CTLDs of human and mouse partially overlapped with the nucleocapsid genes of CoVs. In addition, we observed that CTLDs which showed the similar relative synonymous codon usage (RSCU) patterns with CoVs were commonly derived from the human chromosome 12, and mouse chromosome 6 and 12, suggesting that there might be a specific genomic region or chromosomes which show a more similar synonymous codon usage pattern with viral genes. Our findings contribute to developing the codon-optimization method in DNA vaccines, and further study is needed to determine a specific correlation between the codon usage patterns and the chromosomal locations in higher organisms.
Animals ; Codon/*genetics ; Humans ; Lectins, C-Type/*genetics ; Membrane Glycoproteins/*genetics ; Mice ; Nucleocapsid/*genetics ; Phylogeny ; SARS Virus/*genetics/pathogenicity ; Severe Acute Respiratory Syndrome/prevention & control ; Species Specificity ; Vaccines, DNA ; Viral Envelope Proteins/*genetics ; Virus Attachment

Liver function tests before treatment showed abnormalities of liver function tests during treatment, while 15(68. 2%) of 22 patients who had abnormal liver function tests before treatment showed abnormalities during treatment. In 12 of the 25 patients who showed abnormalities of liver function tests during treatment with allopurinol, allopurinol was stopped and all patients showed improvement of liver function tests. In remaining 13 patients, 10 patients were improved and other 2 patients showed only mild abnormalities of liver function tests despite of continuing allopurinol and 1 patient was lost during follow-up. CONCLUSION: Abnormalities of liver function tests were common during treatment with allopurinol. Most patiensts who had mild abnormalities of liver functions tests during treatment with allopurinol were improved regardless of continuing allopurinol.
Allopurinol* ; Follow-Up Studies ; Gout* ; Humans ; Liver Function Tests* ; Liver*

BACKGROUND: Despite of aggressive treatments, the long-term survival rate is about 30% in stage 4 neuroblastoma (NBL). Recently, dendritic cell (DC)-based immunotherapy is emerging as a promising tool in cancer treatment. But it is very difficult to get sufficient amount of autologous tumor as the source of tumor antigen in DC-based immunotherapy. The purpose of this study was to test whether DCs loaded with allogeneic NBL tumor antigens can prime effective anti-tumor immune responses. METHODS: Peripheral blood mononuclear cells (PBMCs) were differentiated into immature DCs in the presence of GM-CSF and IL-4. As the source of tumor antigens, human neuroblastoma cell lines, SK-N-MC, SK-N-SH, and IMR-32, were used after induction of apoptosis by UV irradiation. The immature DCs were loaded with apoptotic tumor cells, and then cultured with PBMCs for priming the tumor antigen-specific T lymphocytes. The tumor-specific cytotoxicity of T lymphocytes against NBL cells was analysed after coculture. RESULTS: Incubation of DCs with apoptotic tumor cells effectively loaded DCs with tumor antigens and induced maturation of DCs. The tumor antigen-challenged T lymphocytes effectively killed the NBL cells, which were used as tumor antigens. Furthermore, the T lymphocytes showed a broad ranged cytotoxicity to all of the NBL cell lines, which were not challenged as tumor antigens. CONCLUSION: This study showed that the apoptotic NBL tumor cells induced maturation of DCs and could be used as tumor antigens, and DCs loaded with apoptotic NBL tumor cells could induce effective anti-tumor specific cytotoxic T lymphocytes to allogeneic NBL tumors.
Antigens, Neoplasm ; Apoptosis ; Cell Line ; Coculture Techniques ; Dendritic Cells ; Granulocyte-Macrophage Colony-Stimulating Factor ; Humans ; Immunotherapy ; Interleukin-4 ; Neuroblastoma* ; Survival Rate ; T-Lymphocytes ; T-Lymphocytes, Cytotoxic

BACKGROUND: Post remission therapy is one of the most important issues in the treatment of acute myelocytic leukemia (AML). Recently, autologous peripheral blood stem cell transplantation (PBSCT) has become an accepted procedure to support high dose chemotherapy in children with AML. But collection of PBSC from small pediatric patients provides many challenges not faced when collecting from adult patients. Therefore, the efficient procedures and optimal timing to perform the leukapheresis should be decided. The goal of the present study was to evaluate the practice of PBSC mobilization and collection and establish predictors of the leukapheresis in children with AML. METHODS: From November 1995 to February 1998, PBSC mobilizations were performed in 15 patients with AML. PBSCs were mobilized by high dose of cytosine arabinoside and etoposide plus G-CSF. CBC and peripheral blood smear were performed daily after WBC nadir. Leukapheresis was started when the WBC count recovered to 1,000/microliter from myelosuppression and monocytes appeared on the peripheral blood smear. Leukapheretic products were assayed for mononuclear cells, CD34+ cells and CFU-GM colonies. Correlations between the yields of leukapheresis and patients characteristics were evaluated by Wilcoxon rank sums test and Pearson correlation analysis. RESULTS: Eighteen mobilizations were done in 15 patients. The duration of absolute neutrophil count<0.5x103/microliter and platelet count<20x103/microliter were 6 days (0~10 days) and 8 days (5~21 days) after mobilization chemotherapy, respectively. Duration of fever was 1 day, but documented septicemia was not occurred in any of the patients. A median 5 leukaphereses (range : 3~6) were undergone per patient. The WBC on the first day of the leukapheresis was 1,640/microliter (850~16,840/microliter) and percentage of monocyte on the first day of the leukapheresis was 12% (4~36%). A median 5 leukaphereses yielded median of 11.02x108 (4.5~26.42x108) MNCs/kg, 7.63x106 (0.33~42.21x106) CD34+ cells/kg, and 8.46x104 (0.27~147.83x104) CFU-GM/ kg. The dose of 1x108 MNCs was harvested in 100% after 3 harvests and 1x106 CD34+ cells in 87% after 3 harvests. No serious adverse effects occurred in all patients during the leukapheresis procedures. A rapid rise in WBC count (> or = 3,000/microliter/day) during recovery was independent variable correlated to the peak MNCs, average MNCs, peak CD34+ cells and average CD34+ cells (P<0.01). CONCLUSIONS: Mobilization procedures using high dose cytosine arabinoside and etoposide plus G-CSF are tolerable and the leukapheresis can be initiated when WBC count recovers to 1,000/microliter from myelosuppression and monocytes appear on the peripheral blood smear. Sufficient numbers of PBSC can be obtained by three leukapheresis procedures without serious adverse effects in children with AML.
Adult ; Blood Platelets ; Child* ; Cytarabine ; Drug Therapy ; Etoposide ; Fever ; Granulocyte Colony-Stimulating Factor ; Granulocyte-Macrophage Progenitor Cells ; Humans ; Leukapheresis* ; Leukemia, Myeloid, Acute* ; Monocytes ; Neutrophils ; Peripheral Blood Stem Cell Transplantation ; Sepsis ; Stem Cells*

BACKGROUND: The testes are one of the most common extramedullary sites of relapse in boys with acute lymphoblastic leukemia(ALL). The reported incidence of isolated testicular relapse varies from 3 to 40%. If these patients are treated exclusively with testicular irradialion, a systemic relapse occurs within a few months. Recently, the use of intensive chemotherapy and testicular irradiation improved the survival rate for boys with testicular leukemia. So, we performed this study to identify clinical manifestations, disease free survival and prognostic factors of testicular leukemia in children. METHODS: We reviewed 33 patients of testicular leukemia among total 410 boys with ALL diagnosed at the Department of Pediatrics, Seoul National University Children's Hospital from Jan. 1970 to Aug. 1996. Testicular leukemia was confirmed by testicular biopsy in all 33 patients. These patients were treated with combined local testicular irradiation(2,400~2,500 cGy/8~12fractions) and systemic chemotherapy. Two patients, in whom testicular relapse was diagnosed before 1979, unilateral orchiectomy of the involved site and testicular irradiation of the opposite site were performed. Probability estimates of disease free survival (DFS) were calculated by the method of Kaplan and Meier, and the relationship of prognostic factors to DFS was compared using the chi-square test in survival analysis. RESULTS: In 410 boys with ALL, testicular leukemia occurred in 33 patients(8%). Of 33 patients, 6 patients presented with testicular involvement at initial diagnosis, 16 patients had testicular relapse while still receiving chemotherapy and 11 patients had testicular relapse 3 to 57 months(median : 15 months) after cessation of chemotherapy. The median age of 33 patients was 7.4 yrs(9 months~18 yrs) and median WBC count 7,600/ L(2,700~270,000/L). All patients presented with painless testicular enlargement and testicular leukemia was confirmed by testicular biopsy. Among 33 patients, 2 had prior CNS relapse and 11 had concomitant bone marrow and/or CNS relapse. Twenty nine patients were treated with combined local testicular irradiation and systemic chemotherapy. Eleven had second relapse(6 bone marrow, 3 CNS, 2 opposite testis). Seventeen have been followed until now: 6 patients on chemotherapy and 11 patients(37.9%) in complete remission for 48.5+/-22.3 months(19~86 months). The 3 year DFS for 29 patients was 55.3%+/-10.1%. The following prognostic factors showed no significant association with DFS in testicular relapse : age and WBC count at initial diagnosis, age at testicular relapse, and concomitant relapse. Whether testicular relapse occurred on initial therapy or off initial therapy has prognostic value in predicting DFS. The 3 year DFS for boys with testicular relapse on and off initial therapy were 40.0%+/-12.9% and 78.8%+/-13.4%, respectively(P: 0.046). CONCLUSION: With the use of chemotherapy and testicular irradiation, prolonged second re mission can be achieved in many patients with testicular leukemia. The patients with testicular relapse off initial therapy fared significantly better than patients on therapy. So, to improve the DFS for boys with testicular leukemia, a better understanding of its biology and prognostic factors is needed.
Biology ; Biopsy ; Bone Marrow ; Child ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Humans ; Incidence ; Leukemia ; Missions and Missionaries ; Orchiectomy ; Pediatrics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence ; Seoul ; Survival Rate ; Testis

Acarapis mites, including Acarapis woodi, Acarapis externus, and Acarapis dorsalis, are parasites of bees which can cause severe damage to the bee industry by destroying colonies and decreasing honey production. All 3 species are prevalent throughout many countries including UK, USA, Iran, Turkey, China, and Japan. Based on previous reports of Acarapis mites occurring in northeast Asia, including China and Japan, we investigated a survey of Acarapis mite infestations in honey bees in Korean apiaries. A total of 99 colonies of Apis mellifera were sampled from 5 provinces. The head and thorax of 20 bees from each colony were removed for DNA extraction. PCR assays were performed with 3 primer sets, including T, A, and K primers. Results indicated that 42.4% (42/99) of samples were Acarapis-positive by PCR assay which were sequenced to identify species. Each sequence showed 92.6-99.3% homology with reference sequences. Based on the homology, the number of colonies infected with A. dorsalis was 32 which showed the highest infection rate among the 3 species, while the number of colonies infected with A. externus and A. woodi was 9 and 1, respectively. However, none of the Acarapis mites were morphologically detected. This result could be explained that all apiaries in the survey used acaricides against bee mites such as Varroa destructor and Tropilaelaps clareae which also affect against Acarapis mites. Based on this study, it is highly probable that Acarapis mites as well as Varroa and Tropilaelaps could be prevalent in Korean apiaries.
Animals ; Bees/*parasitology ; Mites/classification/*genetics/physiology ; Molecular Sequence Data ; Phylogeny ; Prevalence ; Republic of Korea

In systemic lupus erythematosus (SLE), besides immunosuppressive therapy, the immunological abnormalities such as impaired phagocytosis and deficiency of cell-mediated immunity contribute to the increased risk of infection. Most of all, the incidence of tuberculous infection is higher and the pattern tends to be more extensive and extrapulmonary than in general population. Therefore the contributory role of tuberculous infection in mortality of SLE should be emphasized, especially in areas endemic for Mycobacterium tuberculosis like Korea. When tuberculous infection involves central nervous system, it can mimic lupus myelitis, showing the clinical manifestations like paraplegia, sensory impairment and bladder dysfunction. Tuberculous myelitis should be differentiated with lupus myelitis as early as possible for proper treatment and better prognosis. We report a 52 year-old woman with SLE presented with paraplegia and urinary incontinence, who were initially suspected as lupus myelitis. But the AFB smear and culture of cerebrospinal fluid were compatible with tuberculosis myelitis.
Central Nervous System ; Cerebrospinal Fluid ; Female ; Humans ; Immunity, Cellular ; Incidence ; Korea ; Lupus Erythematosus, Systemic ; Middle Aged ; Mortality ; Mycobacterium tuberculosis ; Myelitis* ; Paraplegia ; Phagocytosis ; Prognosis ; Tuberculosis ; Urinary Bladder ; Urinary Incontinence