BACKGROUND: Although immunophenotyping of leukemias has improved diagnostic accuracy and reproducibility, it has also caused diagnostic confusion regarding the lineage of leukemic cells. So far, lots of papers about acute leukemias with coexpression of another lineage markers with different technical methodologies and different criteria have been published in Korea and other countries. The authors investigated the frequency and immunophenotypic characteristics of the leukemias with aberrant lineage markers from data obtained at Korea University Hospital by a retrospective study. METHODS: From Jan. 1993 to Feb. 1996, 179 leukemias had been requested for immunophenotypig and 28 cases among them with unusual immunophenotypes were retrieved according to their immunophenotyping results. For the final diagnosis all the slides stained with Wright-Giemsa, peroxidase, Periodic-Acid Schiff, Sudan black B, and nonspecific esterase were re-examined, and all the flow cytometric results were reanalyzed. RESULTS: Among 28 cases, 3 cases(10%) were acute biphenotypic leukemias(BP) one with B lymphoid and myeloid markers and the other two with T lymphoid and myeloid markers. One case of intralineage bilinear acute leukemia(ILBL) with two separate populations of megakaryocytic cells and monocytic cells was noted. 6 cases(21%) were acute myeloblastic leukemias expressing lymphoid associated markers(Ly+AMLs; CD19) and 8 cases(28%) were myeloid antigen-positive acute lymphoblastic leukemias(My+ALLs, four with CD13+ and three with CD33+ and one with blastic transformation of chronic myelogeneous leukemia). Because of the change in diagnostic criteria, lymphocyte contamination, or low setting of negative control, 10 cases (36%) were not included to be of unusual immunophenotypes. CONCLUSIONS: Frequency of acute hybrid leukemia was 2.2 % of all leukemias. Ly+AMLs was 3.4%, and My+ALL was 4.4%. In conclusion, first, quality control of the flow cytometry and careful interpretation especially in terms of positive cut-off value and gating, are needed. Secondly, national guidelines for the criteria of the hybrid leukemia and My+ALLs and Ly+AMLs are necessary for the elucidation of the prognostic implication of those leukemias.
Carboxylesterase ; Diagnosis ; Flow Cytometry ; Immunophenotyping ; Korea ; Leukemia* ; Leukemia, Myeloid, Acute ; Lymphocytes ; Peroxidase ; Quality Control ; Retrospective Studies ; Sudan

No abstract available.
Nephrectomy*

Alveolar echinococcosis (AE) caused by infection with E. multilocularis metacestode, represents one of the most fatal helminthic diseases. AE is principally manifested with infiltrative, proliferating hepatic mass, resembling primary hepatocellular carcinoma. Sometimes metastatic lesions are found in nearby or remote tissue. AE diagnosis largely depends on imaging studies, but atypical findings of imaging features frequently require differential diagnosis from other hepatic lesions. Serological tests may provide further evidence, while obtaining reliable AE materials is not easy. In this study, alternative antigens, specific to AE were identified by analyzing E. granulosus protoscolex proteins. An immunoblot analysis of E. granulosus protoscolex showed that a group of low-molecular-weight proteins in the range from 14 kDa to 16 kDa exhibited a sensitive and specific immune response to AE patient sera. Partial purification and proteomic analysis indicated that this protein group contained myosin, tubulin polymerization promoting protein, fatty-acid binding protein, uncharacterized DM9, heat shock protein 90 cochaperone tebp P-23, and antigen S. When the serological applicability of recombinant forms of these proteins was assessed using enzyme-linked immunosorbent assay, DM9 protein (rEgDM9) showed 90.1% sensitivity (73/81 sera tested) and 94.5% specificity (172/181 sera tested), respectively. rEgDM9 showed weak cross-reactions with patient sera from the transitional and chronic stages of cystic echinococcosis (3 to 5 stages). rEgDM9 would serve as a useful alternative antigen for serodiagnosis of both early- and advanced-stage AE cases.

Aspirin(ASA) and NSAIDs can induce bronchoconstriction in 10~20% of adult asthmatics patients. Inhalation of lysine-ASA(L-ASA) has been described as an alternative method for diagnosis of ASA-sensitive asthma. To further understand the characterlstics of ASA-sensitive asthmas. we studied 38 asthmatic patients with ASA -sensitivity (36 intrinsic and 2 extrinsic asthma) proven by L-ASA bronchoprovocation test (BPT). Most were female (male to female ratio was 27:73). Twenty (53%) of them had no previous history of adverse reactions when exposed to ASA. Twenty nine (79%) had rhino-sinusitis symptoms. Early asthmatic response was observed in 16 (42%) patients, late only response in 16(42%), and dual response in 6(16%) patients. The threshold of L-ASA to provoke a positive response ranged from 11.2 to 180 mg/ml and most (68.3%) had a positive response after the inhalation of 180 mg/ml. Concurrent sensitivity to sulfite was noted in 14 (36%) patients, followed by sensitivity to tartrazine in one (3%) patient. None showed a positive response to sodium benzoate. After the avoidance from ASA/ NSAIDs with administration of anti-asthmatic medications, symptom and medication scores reduced in 26(87%) patients among 30 followed patients. They were classified into the improved group: four (13%) patients belonged to the not-improved group. There were no significant differences in clinical characteristics between the improved and not- improved group (p>0.05). In conclusion, L-ASA BPT could be considered as a useful method to diagnose ASA -sensitive asthma and be used to screen the causative agent for asthmatic patients with intrinsic type, especially in female patients with rhino-sinusitis and/or nasal polyp, even though they do not have arty history of adverse reactions. Cessation of exposure and proper treatment may allow to reduce symptom and medication scores.
Adult ; Anti-Inflammatory Agents, Non-Steroidal ; Asthma* ; Bronchoconstriction ; Diagnosis ; Female ; Humans ; Inhalation ; Nasal Polyps ; Sodium Benzoate ; Tartrazine

No abstract available.

Between December 18, 1985 and May 31, 1986 at the VD Clinic, Choong-ku Public Health Center, in Seoul, 274 male patients with uncomplicated gonococcal infection, including 124 penicillinase producing Neisseria gonorrhoeae(PPNG) infection, were entered into the study. They were divided randomly into the group A and the group B. In the group A, treated with kanamycin 2g, im regimen, 126 of 137 patients were followed and 86 patients(68.3%) were cured. In the group B, treated with gentamicin 240mg, im regimen, 125 of 137 patients were followed and 78 patients(62.4%) were cured. The cure rates in PPNG urethritis were 63.9%(39/61) in the group A and 50.9%(29/57) in the group B. The cure rates in non PPNG urethritis were 72.3%(47/65) in the group A and 72.1% (49/68) in the group B. No significant difference was observed in cure rates between two groups. It is suggested that. both kanamycin 2g, im regimen and gentamicin 240mg, im regimen is not suitable for a first line treatment for uncomplicated gonococcal urethritis.
Gentamicins* ; Humans ; Kanamycin* ; Male* ; Neisseria ; Penicillinase ; Public Health ; Seoul ; Urethritis*

Crohn's disease, a chronic relapsing, multisystemic, inflammatory disorder, may involve any part of the gastrointestinal tract and shows a cobblestone-like appearance on intestinal mucosa. There are also extraintestinal features, including lesions of the skin, eye, and joints. Ulcers, fissures, sinus tracts, abscesses, and vegetant plaques have been reported for the perianal skin lesions of Crohn's disease. We experienced a case of Crohn's disease in a 21-year-old Korean female showing a skin lesion with a cobblestone-like appearance in the perianal region.
Abscess ; Crohn Disease* ; Female ; Gastrointestinal Tract ; Humans ; Intestinal Mucosa ; Joints ; Skin* ; Ulcer ; Young Adult

Lentigo maligna, a precancerous tumor arising from abnormal melanocytes, is a chronic, slowly progressive, pigmented lesion with a range of colors from pale tan to black and an irregular shape, The commonest location of lentigo maligna is the face during the sixth and seventh decades of life. Less frequently, the lesion occurs on an extrafacial area such as the hand or lower leg. In the late stage, lentigo maligna transforms into invasive malignant melanoma. A 50-year-old male patient had a well-defined, black pigmented patch on the right sole for 30 years. The histopathologic examination revealed numerous vacuolated melanocytes clusters at the dermo-epidermal junction with invasion of the epidermis. There was no evidence of dermal invasion by atypical melanocytes.
Epidermis ; Hand ; Humans ; Hutchinson's Melanotic Freckle* ; Leg ; Lentigo* ; Male ; Melanocytes ; Melanoma ; Middle Aged ; Triacetoneamine-N-Oxyl

Unstable microsatellite repeat sequences or DNA replication errors(RER) due to defective mismatch repair genes have been reported in a subset of sporadic colorectal tumors and in most tumors of patients of hereditary nonpolyposis colorectal carcinoma(HNPCC). To elucidate the clinicopathological correlation of these RER-positive cancers, we examined 16 cases of colorectal carcinoma of different histologic subtypes(6 cases of carcinoma with no gland formation, 5 cases of mucinous carcinoma and 5 cases of gland forming carcinoma). We detected RER in five cases. The patients with RER-positive cancers had a marked preponderance of carcinoma with no gland formations out of 6 carcinomas with no gland formation were RER-positive cancers) and of cancers proximal to splenic flexure(all of the RER-positive cases were proximal colon carcinomas). We conclude that RER-positive cancers have wiique pathologic features that may be useful for the screening and counselling of patients with hereditary colon cancers.

No abstract available.
Korea* ; Tuberous Sclerosis*