The t(3;21) (q26;q22) is associated with chronic myelogenous leukemia in blast crisis, leukemia evolving from therapy-related myelodysplasia, and with leukemia following other hematopoietic proliferative diseases. The t(3;21) is rare secondary aberration in blast crisis of Philadelphia(Ph)-positive chronic myeloid leukemia, which may be restricted to patients entering myeloid blast crisis. We report here in one case of chronic myeloid leukemia in blast crisis which reveals both t(9;22) (q34;q11), and t(3;21) (q26 ;q22). A 62-year-old male was diagnosed as chronic myeloid leukemia 5 years ago, received hydroxyurea therapy, and admitted because of gingival bleeding and fever. On examination, splenomegaly and leukocytosis with proliferated blasts(91%) in peripheral blood were noted. Bone marrow aspirate showed hypercellularity with severe blast proliferation(92.5%) which revealed all negative in peroxidase and PAS stain. Cytogenetic study of bone marrow cells showed the karyotype 46, XY, t(3;21) (q26;q22), t(9;22) (q34;q11), which might be suspected as myeloid blast crisis. Above finding was confirmed by the result of immunophenotyping(CD13 43.6%, CD34 68.2%, HLA-DR 91.6%). He received intensive chemotherapy, but still sustained proliferation of blasts was noted . The follow up cytogenetic study was as follows: 46, XY, 4(3;21) (q26:22), t(9;22) (q34;q11)/46, XY, t(3;21)(q26;q22), del(8) (q22), t(9:22) (q34,q11)/46, XY (16/3/1). He died soon from severe pancytopenia and sepsis.
Blast Crisis* ; Bone Marrow ; Bone Marrow Cells ; Cytogenetics ; Drug Therapy ; Fever ; Follow-Up Studies ; Hemorrhage ; HLA-DR Antigens ; Humans ; Hydroxyurea ; Karyotype ; Leukemia ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Leukocytosis ; Male ; Middle Aged ; Pancytopenia ; Peroxidase ; Sepsis ; Splenomegaly

To find out the good visual environment for reading, the methods of illumination were studied using Arden Contrast Sensitivity System. Among various factors for comfortable reading condition such as air condition, temperature, humidity, noise and light, the intensity and characters of illumination were the most important factors for eye health. If the character of illuminations are fairly good, to make the brighter condition is better for eye hdalth. But in artificial illumination, there are so many limitations for supplying light of good characters. So we set the luminosity on the desk to 500 lx in which tbe best visual acuity presented, and checked the contrast sensitivity by changing the luminosity of the room. The results suggested that the condition in which luminosity on the desk was higher twice than the room was favorable for reading.
Contrast Sensitivity* ; Humidity ; Lighting* ; Noise ; Visual Acuity

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

This study was performed to determine whether peripapillary atrophy can be helpful in diagnosis of glaucoma and to investigate the correlation between peripapillary atrophy and optic disc head configuration in patients with primary open-angle glaucoma and normal-tension glaucoma. For all eyes, color polaroid optic disc photographs had been taken with Topcon retinal camera and reviewed. 93 eyes of normal subjects, 47 eyes of 47 patients with primary open-angle glaucoma and 47 eyes of 47 patients with normal-tension glaucoma were analyzed. Zone beta was detected more often in patients with normal-tension glaucoma and primary open-angle glaucoma (P<0.05). There was no significant difference in frequency of peripapillary atrophy between in patients with normal-tension glaucoma and primary open-angle glaucoma (P=0.071). In primary open-angle glaucoma,total,nasal and temporal neuroretinal rim area and total, inferior, nasal and temporal neuroretinal rim area/disc area ratio were smaller in patients with zone beta than without zone beta (P<0.05). The presence of zone beta was associated with neural tissue loss and progression of visual field in primary open-angle glaucoma (P<0.05). In conclusion,peripapillary atrophy, especially zone beta, is associated with glaucoma. Therefore, evaluation of peripapillary atrophy can be help-ful in diagnosing glaucoma. The presence of zone beta is associated with functional and structural optic nerve damage and is of predictive value in the future glaucomatous damage in primary open-angle glaucoma.
Atrophy* ; Diagnosis* ; Glaucoma ; Glaucoma, Open-Angle* ; Head ; Humans ; Optic Nerve ; Retinaldehyde ; Visual Fields

Vibrio metschnikovii is worldwidely distributed in the aquatic environment and human infections are very rarely associated, such as septicemia, urinary tract infection, wound infection, and peritonitis. V. metschnikovii is negative in nitrate reduction and oxidase reaction, and these findings are different from other vibrio species. V. metschnikovii was isolated from the ascitic fluid and blood of a patient with peritonitis, sepsis and renal insufficiency. This patient was a 41-year old man who suffered from post-necrotic liver cirrhosis, chronic hepatitis B, gastric ulcer, esophageal varix bleeding, and alcoholism. He had neither history of ingestion of seafoods nor exposure to seawater before onset of illness. He was successfully treated with antimicrobial agents. This is the first case report of septicemia and peritonitis by V. metschnikovii in Korea.
Adult ; Alcoholism ; Anti-Infective Agents ; Ascitic Fluid ; Eating ; Esophageal and Gastric Varices ; Hemorrhage ; Hepatitis B, Chronic ; Humans ; Korea ; Liver Cirrhosis ; Oxidoreductases ; Peritonitis* ; Renal Insufficiency ; Seafood ; Seawater ; Sepsis* ; Stomach Ulcer ; Urinary Tract Infections ; Vibrio* ; Wound Infection

Ehlers-Danlos Syndrome(EDS) is an inherited disorder of the connective tissue disease that is usually transmitted as autosomal dominant trait. The defect in the biogenesis of collagen results in varying degree of skin hyperextensibility, joint hypermobility, skin fragility and bruising. There have been several reports of cardiac or great vessel abnormalities in patients with the EDS. A 45-year-old Woman was admitted to Maryknoll hospital because of orthopnea, palpitation and epigastric discomfort. Physical examination reveals multiple variable sized bruises and increased hyperelasticity on skin, and hypermobile joint in knee and proximal interphalanges of both hands. Mitral valvular prolapse and atrial septal defect were detected by echocardiography. We report a case of EDS accompanied by mitral valvular prolapse and ostium secundum atral septal defect with brief review of literature.
Organelle Biogenesis ; Collagen ; Connective Tissue Diseases ; Contusions ; Echocardiography ; Ehlers-Danlos Syndrome* ; Female ; Hand ; Heart Septal Defects, Atrial* ; Humans ; Joint Instability ; Joints ; Knee ; Middle Aged ; Physical Examination ; Prolapse* ; Skin

Autoimmune diseases are occasionally associated with other autoimmune diseases in the same patients. Autoimmune Graves' disease has been associated with systemic rheumatic diseases including systemic lupus erythematosus (SLE). And Graves' disease associated with idiopathic thrornbocytopenic purpura (ITP) has been reported many times in Korea. There is a special relationship between SLE and ITP, both of which are autoimmune diseases. Some patients with thrombocytopenic purpura, labeled as idiopathic at the onset, later develop a classical course of SLE, suggesting that ITP may be an early manifestation of SLE. The relationships among these three conditions and their pathogenesis are poorly undemtood, and the coexistence of these diseases at the same time has been reported very rarely, but it may be very probable that there are some relationships among them. We report a case of SLE associated with Graves' disease and ITP treated well by imunosup-pressive agent who had been suffering from recurrence by conventional treatments (antithyroid medication, corticosteroid, subtotal thyroidectomy and splenectomy).
Autoimmune Diseases ; Graves Disease ; Humans ; Korea ; Lupus Erythematosus, Systemic ; Purpura ; Purpura, Thrombocytopenic ; Purpura, Thrombocytopenic, Idiopathic* ; Recurrence ; Rheumatic Diseases ; Thyroidectomy

No abstract available.
Uterine Cervical Neoplasms*

OBJECTIVE: Anorexia nervosa carries the highest mortality of any psychiatric disorder with largely attributed to a cardiovascular etiology. The aim of this study was to evaluate QT alteration and the factors to influence the QT alteration. METHODS: We evaluated a hospital cohort of patients with anorexia nervosa (n=78) and age-matched healthy women (n=89). The QT, QT dispersion and U wave were measured from electrocardiograms in both patients and controls, and QT was corrected for heart rate using Bazett's formula. We also gathered the data for serum electrolytes, cholesterol, uric acid, creatinine, thyroid hormone, and bone mineral density. RESULTS: QT dispersion was significantly greater in patients with anorexia nervosa whereas corrected QT interval did not differ between groups. U wave tended to appear more frequently in patients with anorexia nervosa. QT dispersion was influenced by lowest ever body mass index and serum thyroid hormone. CONCLUSION: QT dispersion and U wave look to be more reliable index than heart rate-corrected QT, which may reflect arrhythmia potential in patients with anorexia nervosa. Lowest ever body mass index and current metabolic status could be predictive factors to cardiac arrhythmia in anorexia nervosa. Longitudinal follow-up study to evaluate risk as well as protective factors to cardiac mortality is warranted.
Anorexia Nervosa* ; Arrhythmias, Cardiac ; Body Mass Index ; Bone Density ; Cholesterol ; Cohort Studies ; Creatinine ; Electrocardiography ; Electrolytes ; Female ; Heart ; Heart Rate ; Humans ; Mortality ; Thyroid Gland ; Uric Acid

PURPOSE: To report a case of Chrysosporium parvum endophthalmitis after trauma. METHODS: A 42-year-old healthy woman visited our hospital complaining of ocular pain after trauma sustained with a wire used to tie grapes. She showed corneal laceration and iris prolapse of the right eye on slit lamp examination. She underwent primary suture of the corneal laceration. Two days later, she presented with hypopyon of the anterior chamber. She was treated with topical antibiotics and a topical steroid. On follow-up examination, she again presented with hypopyon of the anterior chamber. She was admitted for microbiologic examination and was again treated with topical antibiotics and a topical steroid. Unfortunately, no organisms were identified by culture. Later, she reported a recurrent history of the inflammation. After 9 months, she presented with increased hypopyon of the anterior chamber and was treated with anterior chamber irrigation and intracameral antibiotics injection on two different occasions. But, still no organisams were identified. After one year, the patient visited our clinic with ocular pain and decreased visual acuity. Her intraocular pressure was 72 mmHg and there was whitish infiltration and hypopyon around 360 degrees of the anterior chamber and angle. At the same time, the intraocular pressure and inflammation were uncontrolled. Ultimately, microscopic examination of specimens obtained directly from tissue after enucleation identified the organism as Chrysosporium parvum. CONCLUSIONS: We experienced a case of Chrysosporium parvum endophthalmitis after trauma. To our knowledge, this was the first report of a case of Chrysosporium parvum endophthalmitis in the world.
Adult ; Anterior Chamber ; Anti-Bacterial Agents ; Chrysosporium* ; Endophthalmitis* ; Female ; Follow-Up Studies ; Humans ; Inflammation ; Intraocular Pressure ; Iris ; Lacerations ; Prolapse ; Sutures ; Visual Acuity ; Vitis