BACKGROUND: The combination of Philadelphia chromosome (Ph) and monosomy 7(-7) was rarely observed in acute lymphoblastic leukemia (ALL). With the results from immunophenotyplc and molecular analysis, Philadelphia chromosome positive ALL with monosomy 7[Ph(+)/-7] has been considered that it may be derived from neoplastic transformation at the pluripotent stem cell level. We compared the clini-cal, laboratory, and hematological findings between 5 cases of Ph(+)/-7 and 5 cases of Ph(+) without monosomy 7 [Ph (+) /N7]. METHODS: During the period from January, 1995 to December, 1996, total 72 cases of ALL were confirmed among 259 cases of hematologic malignancy with bone marrow cytogenetic analysis. Among 72 ALL cases, 5 cases of Ph(+)/-7(monosomy 7 or 7q abnormalities) were compared with Ph only or Ph without monosomy 7(ph(+)/N7] on the hematological, immunophenotypic, other laboratory, clinical findings and event ree survival (EFS) The karyotyping of the bone marrow specimens was analysed byshort-term unsynchronized culture methods such as overnight colcemid treatment and 24 hours incubation following ethidium bromide treatment. RESULTS: The mean age of Ph(+)/-7 was 30.6+/-12.8 years, and it was significantly different from that of Ph(+)/N7 (p=0.009), Four cases of Ph(+)/-7 were classified as ALL L2 subtype, and 2 cases revealed CNS involvements. Immunophenotyping was positive in CD10, CDl9, CD2O, CD22 and HLA-DR. But one case revealed e-B-lymphoid lineage with positivity in CD34, CDl3, and CD33. The response to chemotherapy and EFS was very poor in Ph(+)/-7 group, and the mean EFS was 3.2+/-1.9 months(p=0.014). All of cases showed induction on failure in chemotherapy, relapsed with bone marrow, CNS and extramedullary involvements, and expired due to sepsis. CONCLUSIONS: Ph(+)/-7 ALL had very Poor clinical course with being resistant to chemotherapy and unfavorable prognosis, revealed L2 subtype by FAB classification, and was slightly older in ages compared with Ph(+)/N7 ALL.
Bone Marrow ; Classification ; Cytogenetic Analysis ; Demecolcine ; Drug Therapy ; Ethidium ; Hematologic Neoplasms ; HLA-DR Antigens ; Hydrogen-Ion Concentration ; Immunophenotyping ; Karyotyping ; Monosomy* ; Philadelphia Chromosome* ; Pluripotent Stem Cells ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Prognosis ; Sepsis

BACKGROUND AND OBJECTIVES: Human Troponin T & I (TnT, TnI) has several isoforms which have different functional property. This study was designed to describe the isoform expression of TnT & TnI in failing and hypertrophic human heart and during normal development. MATERIALS AND METHOD: Myocardium was attained from hypertrophic hearts (n=10) of TOF patients who underwent myomectomy, from failing hearts (n=10) of transplant recipients, from normal hearts (n=5) of patients in brain death and from aborted fetal hearts (n=5). After the extraction of RNA, RT-PCR was performed for TnT & TnI isoforms and GAPDH to evaluate the isoform expression qualitatively and quantitatively. RESULTS: In terms of TnI, slow skeletal TnI was expressed more than cardiac TnI in fetal hearts[ratio of Troponin over GAPDH (R)=1.3:0.5] but cardiac TnI was dominant in adult hearts (r=0.3:1.1) (p 0.05). Failing hearts showed similar pattern with adult hearts (r=0.3:1.2) and hypertrophic hearts showed the intermediate pattern (r=0.9:1.3). In terms of TnT, T1 and T3 were expressed in fetal hearts (r=0.04, 0.8) but only T3 was expressed in adult hearts (r=1.1). Failing hearts and hypertrophic hearts showed similar pattern with adult hearts and no differences in the amount of expression (r=1.4, 1.3). CONCLUSION: There is isoform switch from fetal to adult form during development and it might be responsible for the differences of myocardial functional property between fetal and adult heart. Failing and hypertrophic hearts showed no differences with normal hearts, which means the isoform switch of TnT & I might have no significant role in functional disturbances in these conditions.
Adult ; Brain Death ; Fetal Heart ; Heart* ; Humans* ; Myocardium ; Protein Isoforms ; RNA ; Transplantation ; Trinitrotoluene ; Troponin T* ; Troponin*

PURPOSE: The aim of this study was to determine the role of the CT scan in blunt hepatic injury and the significance of CT degree of hepatic injury in the decision making of treatment plan. MATERIALS AND METHODS: We retrospectively analysed the CT findings of 22 patients with hepatic injury. We graded hepatic injury on CT scan into five according to the severity. Clinical records, type of management and clinical outcome of the patients were also reviewed. RESULTS: Of the 22 patients, 17 had conservative treatment and five had surgery. The numbers of patients treated conservatively were 0, 4, 11, 2 and 0 in the grade 1, 2, 3, 4 and 5, respectively and the numbers of surgically treated cases were 0, 0, 3, 2 and 0 respectively. There was no significant statistical difference between surgically and conservatively treated groups(p-value > 0.05). All patients with conservatively treated group were hemodynamically stable and had no complication during hospitalization. Hemoperitoneum was observed in 11 of 22 patients. CONCLUSION: In blunt hepatic injury, CT plays an important role in the demonstration of location and extent of the hepatic injury, size of hemoperitoneum and the post operative course. However, we believe that physiologic status of the patients may be more important than the extent of CT based hepatic injury for determining a mode of treatment.
Decision Making ; Hemoperitoneum ; Hospitalization ; Humans ; Retrospective Studies ; Tomography, X-Ray Computed

BACKGROUND/AIMS: In HCC with low AFP. we have to use repeated imaging study to evaluate residual viable rumor or recurrence after TACE ( transarterial chemoembolization). We performed the study to know that sICAM-1 in HCC can be a tumor marker of diagnosis and has cor relation with tumor size or clinical staging. The results were compared with PIVKA- , an another tumor marker of HCC. METHODS: Previously untreat ed 39 pat ients with HCC were evaluated. Serum sICAM- 1, AFP and PIVKA-II were measured by EIA, immunoradiometric assay and EIA, respectively. Tumor size were meas ured by abdominal CT and angiogr aphy. RESULTS: Range of sICAM- 1 levels with HCC patients were 189.0 to 983.6 ng/ mL, and mean value was 668.3+- 254.4 ng/ mL. Thirty four of the 39 patients (87.2%) with HCC showed sICAM- 1 levels higher than 306.4 ng/ mL (mean of 131 healt hy controls + 2SD level). Range of PIVKA-II level with HCC patients were 25.3 to 2,779.3mAU/nL, and mean value was 1,340.1+-1,091.1mAU/mL. seven of the 39 patients(94.9%) with HCC showde PIVKA-II levels higher than 40mAU/mL. Range of AFP levels with HCC patients were 4.2 to 57,520ng/mL, and mean value was 4,215.6+-10,807.2ng/mL. 10 patients (26%) showed AFP lower than 20ng/mL, and 17 patients(44%) were AFP lower than 100ng/mL. All of the 17 patients with alphaFP lower than 100ng/mL had s ICAM-1 levels more than reference range (mean of 131 healt hy cont r ols + 2 SD level), and PIVKA-II levels also more than reference range. Positive correlation was observed between PIVKA-II level and tumor size in 18 patients without vascular invasion. Accor ding t o HCC clinical staging, 10 patients (25.6%) belonged clinical stage II. 5 pat ients (12.8%) III, 24 pat ients (61.5%) IV. Both of PIVKA-II and sICAM-1 levels of stage showed significantly higher than stage II. PIVKA-II showed more positive correlation with tumor size and clinical stage than sICAM- 1. No correlation was found between AFP and sICAM-1, and positive correlation was AFP and PIVKA-II. CONCLUSION: In HCC patients with low AFP, sICAM-1 and PIVKA-II correlated with tumor size and clinical stage. sICAM-1 and PIVKA-II may be a useful marker of diagnosis. So, we need to further study to evaluate whether sICAM- 1 and PIVKA-II can be used as a marker of disease progression or prognosis.
Carcinoma, Hepatocellular* ; Diagnosis ; Disease Progression ; Humans ; Immunoradiometric Assay ; Intercellular Adhesion Molecule-1* ; Prognosis ; Recurrence ; Reference Values ; Tomography, X-Ray Computed

Recently, according to the increase of adult patient, it is neccessory to understand the growth changes of adult after cessation of active pubertal growth in clinical orthodontics. The purpose of this study was to investigate the growth changes of craniofacial structure after active growth period(afult) in order to use reference in clinical orthodontics. Authors followed the 40 sample(male 25, female 15) from 24 to 31 years of age. By analyzing the serial cephalograms, authors could get the following findings. ? The mandible rotated clockwise in female, but not in male, and no incremental growth change in both genders. ? The anterior facial height and lower anterior facial height were increased in both genders, the increase of lower anterior facial height exceed the posterior facial height increase in famale. ? The cranial base was stable throughout observation period. ? The upper incisors uprighted slightly in female. ? There were quite great the individual variation in the growth change of ceaniofacial structure in adult.
Adult* ; Female ; Humans ; Incisor ; Male ; Mandible ; Orthodontics ; Skull Base

We investigated the anti-inflammatory effect of Pyunkang-tang extract (PGT), a complex herbal extract based on traditional Chinese medicine that is used in Korea for controlling diverse pulmonary diseases, on cigarette smoke-induced pulmonary pathology in a rat model of chronic obstructive pulmonary disease (COPD). The constituents of PGT were Lonicerae japonica, Liriope platyphylla, Adenophora triphilla, Xantium strumarinum, Selaginella tamariscina and Rehmannia glutinosa. Rats were exposed by inhalation to a mixture of cigarette smoke extract (CSE) and sulfur dioxide for three weeks to induce COPD-like pulmonary inflammation. PGT was administered orally to rats and pathological changes to the pulmonary system were examined in each group of animals through measurement of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) levels in bronchoalveolar lavage fluid (BALF) at 21 days post-CSE treatment. The effect of PGT on the hypersecretion of pulmonary mucin in rats was assessed by quantification of the amount of mucus secreted and by examining histopathologic changes in tracheal epithelium. Confluent NCI-H292 cells were pretreated with PGT for 30 min and then stimulated with CSE plus PMA (phorbol 12-myristate 13-acetate), for 24 h. The MUC5AC mucin gene expression was measured by RT-PCR. Production of MUC5AC mucin protein was measured by ELISA. The results were as follows: (1) PGT inhibited CSE-induced pulmonary inflammation as shown by decreased TNF-α and IL-6 levels in BALF; (2) PGT inhibited the hypersecretion of pulmonary mucin and normalized the increased amount of mucosubstances in goblet cells of the CSE-induced COPD rat model; (3) PGT inhibited CSE-induced MUC5AC mucin production and gene expression in vitro in NCI-H292 cells, a human airway epithelial cell line. These results suggest that PGT might regulate the inflammatory aspects of COPD in a rat model.
Animals ; Bronchoalveolar Lavage Fluid ; Campanulaceae ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells ; Epithelium ; Gene Expression ; Goblet Cells ; Humans ; In Vitro Techniques ; Inflammation ; Inhalation ; Interleukin-6 ; Korea ; Lonicera ; Lung Diseases ; Medicine, Chinese Traditional ; Models, Animal ; Mucins ; Mucus ; Necrosis ; Pathology ; Pneumonia ; Pulmonary Disease, Chronic Obstructive ; Rats ; Rehmannia ; Selaginellaceae ; Smoke ; Sulfur Dioxide ; Tobacco Products

Objective: To assess the contrast-enhanced CT and ultrasonography (US) findings of intracholecystic papillary neoplasm (ICPN) and determine the imaging features predicting ICPN associated with invasive carcinoma (ICPN-IC). Materials and Methods: In this retrospective study, we enrolled 119 consecutive patients, including 60 male and 59 female, with a mean age ± standard deviation of 63.3 ± 12.1 years, who had pathologically confirmed ICPN (low-grade dysplasia [DP] = 34, high-grade DP = 35, IC = 50) and underwent preoperative CT or US. Two radiologists independently assessed the CT and US findings, focusing on wall and polypoid lesion characteristics. The likelihood of ICPN-IC was graded on a 5-point scale. Univariable and multivariable logistic regression analyses were performed to identify significant predictors of ICPN-IC separately for wall and polypoid lesion findings. The performances of CT and US in distinguishing ICPN-IC from ICPN with dysplasia (ICPN-DP) was evaluated using the area under the receiver operating characteristic curve (AUC). Results: For wall characteristics, the maximum wall thickness (adjusted odds ratio [aOR] = 1.4; 95% confidence interval [CI]: 1.1–1.9) and mucosal discontinuity (aOR = 5.6; 95% CI: 1.3–23.4) on CT were independently associated with ICPN-IC.Among 119 ICPNs, 110 (92.4%) showed polypoid lesions. Regarding polypoid lesion findings, multiplicity (aOR = 4.0; 95% CI: 1.6–10.4), lesion base wall thickening (aOR = 6.0; 95% CI: 2.3–15.8) on CT, and polyp size (aOR = 1.1; 95% CI: 1.0–1.2) on US were independently associated with ICPN-IC. CT showed a higher diagnostic performance than US in predicting ICPN-IC (AUC = 0.793 vs. 0.676; p = 0.002). Conclusion ICPN showed polypoid lesions and/or wall thickening on CT or US. A thick wall, multiplicity, presence of wall thickening in the polypoid lesion base, and large polyp size are imaging findings independently associated with invasive cancer and may be useful for differentiating ICPN-IC from ICPN-DP

Povidone-iodine (PVP-I, Betadine) has many advantages as a disinfectant solution for preoperative preparations, especially for oral surgery. It is widely used because of its low toxicity and excellent bactericidal effect. The authors report a case of pneumonia secondary due to the aspiration of PVP-I, which was used as an oral disinfectant. We present a case of aspiration pneumonia that resulted from the careless use of PVP-I during preoperative preparation. The patient was a 10-month-old female scheduled for elective surgery to correct a complete cleft of secondary palate. During the preparation of the oral cavity for that cleft palate patient, PVP-I was incidentally aspirated to the airway. The lung resistance was noted with positive pressure and pneumonic infiltration on chest radiograph was seen. The operation was postponed and the patient underwent respiratory care. Three months later, elective palatoplasty under general anesthesia was performed without complication. Based on the experiences of this case, the authors advise that throat-packing should be placed before oral preparation to prevent serious pulmonary complications.
Anesthesia, General ; Cleft Palate ; Female ; Humans ; Lung ; Mouth ; Palate ; Pneumonia ; Pneumonia, Aspiration ; Povidone-Iodine ; Surgery, Oral ; Thorax

PURPOSE: We conducted a phase II study of vinorelbine and ifosfamide combination chemotherapy in patients with advanced or recurrent non-small cell lung cancer (NSCLC) to evaluate response rate, response duration, and toxicities of this regimen. MATERIALS AND METHODS: From June 1998 to March 2000, twenty seven patients with advanced or recurrent non- small cell lung cancer (stage IIIB and IV) who had no prior systemic chemotherapy were enrolled in this study. All patients were treated with vinorelbine and ifosfamide combination chemotherapy (vinorelbine 25 mg/m2 i.v. days 1 & 8, and ifosfamide 2 g/m2 i.v. days 1~3 with Mesna 1600 mg/m2). Each cycle was repeated every 21 days. RESULTS: All twenty seven patients were eligible and assessable. Age ranged from 41 to 72 (median 57 years). 14 patients were male and 13 were female. Overall response rate was 33.3%. One complete response (3.7%) and 8 partial responses (29.6%) were observed. Stable disease was 15 (55.6%) and progressive disease was 3 (11.1%). Overall median survival duration was 7.8 months. The median progression-free and response durations were 6.6 months and 3.5 months respectively. World Health Organization grade 3 to 4 neutropenia occurred in 6.5%. Nonhematologic toxicities including nausea/vomiting, nephropathy and hepatopathy were generally grade 1 or 2. CONCLUSION: The combination chemotherapy with vinorelbine and ifosfamide in the patients with advanced or recurrent non-small cell lung cancer can be considered as an effective and safe treatment.
Carcinoma, Non-Small-Cell Lung* ; Drug Therapy ; Drug Therapy, Combination* ; Female ; Humans ; Ifosfamide* ; Male ; Mesna ; Neutropenia ; Small Cell Lung Carcinoma ; World Health Organization

No abstract available.
Cytogenetics* ; Leukemia* ; Phenotype*