BACKGROUND: The verse transcriptase polymerase chain reaction (RT-PCR) has been widely used to analyze the bcr/abl fusion mRNA in chronic myelogenous leukemia (CML). Fresh or cryopreserved cells may not always be available for molecular diagnosis. So we investigated the value of stored bone marrow aspirate smears as the sources of material for the detection of bcr/abl mRNA. METHODS: We extracted RNA using modified Chomczynski method, and amplified bcr/abl mRNA by RT-PCR from the 70 cases of bone marrow smear slides stored from 7 days to 7 years, which were comprised of 49 CML, 11 other chronic myeloproliferative disorders (CMPD) and 10 acute lymphoblastic leukemia (ALL). Sensitivity of RT-PGR was tested using the slide smears prepared with 10(0)-10(6) K562 cells, and RT-PCR results losing each fresh bone marrow cellular suspension and slide smears in 24 patients were compacted. For major bcr/abl rearrangement, RT-PCR was performed by nested PGR afters GDNA synthesis losing downward primer and beta2-microglobulin was used as RNA controls. RESULTS: The sensitivity of RT-PCR for detecting bcr/abl mRNA was l02 cells per slide. Sixty one cases (86%) of 70 bone marrow aspirate smears showed positive results of beta2-micyoglobulin cDNA as an indicator of intact RNA. Thirty nine cases of 42 beta2-microglobulin cDNA positive CML bone marrow aspirate smears showed 29 b3a2 type mRNA and 10 b2a2 type mRNA. Nine cases of 11 bone marrow aspirate smear with other CMPD showed negative results of bcr/abl mRNA. Two cases of 10 ALL bone mallow aspirate smears had b2a2 type mRNA and b3a2 type mRNA, respectively. The results for detection of bcr/abl mRNA with fresh cell suspensions of 24 patients were same as the bone marrow aspirate smears storied for 7 days to 1 year. CONCLUSIONS: These data indicated that RNA obtained from bone marrow smears storied for less than 1 year was valuable as the source of RT-PGR for the detection of bcr/abl mRNA in CML and the bone marrow smears stored for much longer period ould be assailable as the specimens for retrospective analysis of specific gene alter-ation in other hematologic malignancy.
Bone Marrow* ; Diagnosis ; DNA, Complementary ; DNA-Directed RNA Polymerases ; Hematologic Neoplasms ; Humans ; K562 Cells ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Myeloproliferative Disorders ; Polymerase Chain Reaction ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction* ; RNA ; RNA, Messenger* ; RNA-Directed DNA Polymerase* ; Suspensions

BACKGROUND: Soluble IL-2R, soluble CD8 and TNF-alpha are elevated in sera of some patients with hematological malignancies, and a marked elevation of these cytokines could be used to assess disease activity and prognosis in this malignancy group. METHODS: The serum levels of sIL-2R, sCD8 and TNF-alpha were assessed in 28 patients with myelodysplastic syndrome (MDS) and 32 patients with acute myeloid leukemia (AML), and 39 cases of healthy control subjects to define clinical usefulness as prognostic markers by sandwich enzyme immunoassay. RESULTS: In MDS patients, serum sIL-2R levels were significantly higher as compared with controls, and a more pronounced increase of serum sIL-2R levels was found in patients with RAEB RAEB-t and CMML as compared with RA and RARS. Serum sCD8 levels were higher as compared with controls, but not related with FAB classification. In patients with leukemic conversion. sCD8 levels tended to be higher as compared with patients with non-conversion. The sIL-2R levels of AML patients were significantly higher than controls, and a significant correlation was detected between the levels of sIL-2R and WBC counts. Higher sIL-2R levels( >2000 U/ml) tended to affect both complete remission rate and survival. Serum sCD8 levels were higher than controls, but not related to FAB classification. No differences of serum TNF-alpha levels were detected as compared with healthy controls. CONCLUSIONS: From these results, this study indicates that serum sIL-2R and sCD8 are significantly increased in some patients with MDS and AML, and increased levels of serum sIL-2R and sCD8 may be useful for predicting prognosis of these patients.
Anemia, Refractory, with Excess of Blasts ; Classification ; Cytokines ; Hematologic Neoplasms ; Humans ; Immunoenzyme Techniques ; Leukemia, Myeloid, Acute* ; Myelodysplastic Syndromes* ; Prognosis ; Tumor Necrosis Factor-alpha*

Purpose: To evaluate the risk factors for the development of osteonecrosis in civilian professional divers by an epidemiologic study and to determine the correlation between osteonecrosis in divers and coagulopathy by analysis of serologic markers that are related to thrombophilia and hypofibrinolysis. Materials and Methods: Forty-two divers, who collected pen shells (Atrina pinnata), and among whom 10 had osteonecrosis (group 1), were compared with 32 divers without osteonecrosis (group 2). Both groups were evaluated based on the number of years of diving experience, number of dives per year, mean number of dives per day, mean diving time and depth, and diving methods. We determined any statistically significant differences among these variables. We measured the levels of serologic markers that were related to hyperlipidemia, thrombophilia, and hypofibrinolysis from the divers and a control group of 20 physicians (group 3). The levels of the serologic markers were compared between groups 1 and 2 and between the divers and the control group, in order to determine the relationship between the serologic markers and the development of dysbaric osteonecrosis. Results: None of the variables demonstrated any statistically significant differences, except for the mean diving time, in which group 1 had a mean diving time of 124 minutes and group 2 had a mean diving time of 62.1 minutes (P<0.05). In the analysis of the serologic markers, there were no statistically significant differences between groups 1 and 2; however, in comparison with the group 3, the divers demonstrated significantly decreased activity levels of proteins C and S (Protein C: P<0.05; Protein S: P<0.05), and an increase in the levels of plasminogen activator inhibitor-1 (PAI-1) (P<0.05). Conclusion: The divers with osteonecrosis had a longer mean diving time than did those divers without osteonecrosis. In the serologic marker analysis, the divers with osteonecrosis demonstrated significantly decreased activity levels of Proteins C, S and a significant increase in the levels of PAI-1, compared with the control group.
Biomarkers* ; Diving ; Epidemiologic Studies* ; Epidemiology ; Hyperlipidemias ; Osteonecrosis* ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Protein S ; Risk Factors ; Thrombophilia

BACKGROUND: P-glycoprotein (PGP) is capable of expelling cytotoxic drugs from cytosol and the overexpression mediates drug resistance. However not all resistant leukemic cells express PGP. High expression of glutathione S-transferasepie (GSTpie) is related to clinical outcome following chemotherapy. Topoisomerase IIalpha (topo IIalpha) is a major target of anthracyclines for the treatment of leukemia. METHODS: To evaluate the relation of PGP, GSTpie and topo IIalpha expression to treatment outcome, PGP, GSTpie and topo IIalpha expression were analysed by flow cytometry using mono clonal antibodies (anti-JSB1, anti-GSTpie and anti-topo IIalpha) in 33 cases of de novo acute myelogenous leukemia. RESULTS: In patients with AML, the frequency of patients with high expression of PGP was 57.6% (19/33). The complete remission (CR) rate and mean survival duration were significantly different between patients with high expression and those with low expression of PGP (31.6 vs 92.9%, P=0.001; 83 vs 341 days, P=0.011). The frequency of patients with high expression of GST pie was 60.6% (20/33). The CR rate and mean survival duration were significantly different between patients with high expression and those with low expression of GSTpie (40.0 vs 84.6%, P=0.011; 115 vs 343 days, P=0.021). The frequency of patients with high expression of topo IIalpha is 78.8% (26/33) and treatment outcome was not related to topo IIalpha expression. In multivariate analysis with age, WBC count, PGP and GSTpie, PGP expression was an independent prognostic factor for treatment outcome. CONCLUSION: The flow cytometric measurement of PGP and GSTpie expression can be useful for the prediction of treament outcome following chemotherapy and PGP can be used as aprognostic factor in AML.
Adult* ; Anthracyclines ; Antibodies ; Cytosol ; DNA Topoisomerases, Type II* ; Drug Resistance ; Drug Resistance, Multiple ; Drug Therapy ; Flow Cytometry ; Glutathione S-Transferase pi* ; Glutathione Transferase* ; Glutathione* ; Humans ; Leukemia ; Leukemia, Myeloid, Acute* ; Multivariate Analysis ; P-Glycoprotein* ; Treatment Outcome

PURPOSE: To correlate SOhographic and pathologic findings of gallbladder adenoma, and to evaluate the clinical significance of sonographic findings. MATERIALS AND METHODS: Ultrasound findings of twenty gallbladder adenomas were retrospectively reviewed to evaluate the size, shape and echogenicity of the adenoma, and was correlated with the pathological finding. RESULTS: Among 14 patients, 11 patients had single lesion and 3 patients had multiple lesions. Three patients showed 2, 3 and 4 adenomas, respectively. Nine of 20 lesions showed focal dysplasia pathologically. Among the nine adenomas with dysplasia, two adenomas showed focal cancerous change. The nine adenomas showing focal dysplasia measured 25.6mm (14-35mm) in mean diameter, while the mean diameter of adenomas without dysplasia was 8.7 mm (3-13mm). The echogenicity of adenoma with focal dysplasia were hyperechoic in 8, isoechoic in 1. The echogenicity of adenomas without dysplasia were hyperechoic in 7, isoechoic in 4. Sessile(7/9) and papillary shape(6/9) were predominant in adenoma with dysplasia, but smooth shape(8/11) and stalked type(9/11) were predominant in adenoma without dysplasia. Two adenomas with focal cancerous change showed histological transition from cancer to dysplasia and to adenomatous tissue. In adenoma with dysplasia, the diameter more than 14 mm on sonography was statistically significant (p<0. 005). Also age of patient was significantly different between the two groups (p<0.01), while echogenicity and associated stone were not statistically significant. CONCLUSION: As gallbladder adenoma more than 14ram in diameter on US is suggestive of dysplasia on pathology, so, close follow up US or surgery is recommended.
Adenoma* ; Follow-Up Studies ; Gallbladder* ; Humans ; Pathology ; Retrospective Studies ; Ultrasonography

BACKGROUND: Following induction chemotherapy for AML, a sensitive determination of minimal residual disease (MRD) in patients achieving complete remission (CR) should enable the detection of early relapse. This study was designed to verify if quantitative assessment of the Wilms' tumor (WT1) gene by real time polymerase chain reaction (RQ-PCR) can be used as a marker for MRD detection during the monitoring of AML. METHODS: WT1 gene expression was quantified by RQ-PCR in 31 patients with AML at diagnosis (27 patients) and during follow-up (29 patients) relative to ABL control gene. In four patients, the WT1 gene expression was analyzed in comparison to a second PCR marker, PML-RARA fusion transcript. Prognostic significance of WT1 gene expression was analyzed at diagnosis and at the primary CR evaluation. Longitudinal WT1 gene analysis was performed in 17 AML patients. RESULTS: At diagnosis, WT1 gene expression exceeded the control level in all of the patients. Higher levels of WT1 gene expression were not associated with shorter event free survival or overall survival at diagnosis. Higher levels of WT1 gene expression were associated with shorter event free survival after induction chemotherapy. Relapse was observed in eight of 17 patients analysed longitudinally, and an increase of WT1 gene expression preceded morphologic relapse in four patients with the fusion transcript negative. Concomitant monitoring of PML-RARA fusion transcript reveals the lack of a significant correlation withWT1 gene expression. CONCLUSIONS: Quantitation of WT1 gene expression could be used for MRD monitoring of AML and for the early detection of relapse, especially in patients lacking specific molecular markers.
Adaptor Proteins, Signal Transducing/analysis ; Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Gene Expression ; *Genes, Wilms Tumor ; Humans ; Leukemia, Myelomonocytic, Acute/*diagnosis/mortality/therapy ; Male ; Middle Aged ; Neoplasm, Residual ; Polymerase Chain Reaction ; Prognosis ; Survival Analysis ; WT1 Proteins/*analysis/genetics

BACKGROUND: Mutations of p53 gene, rarely found in leukemia, result in accumulation of mutated p53 protein in the nuclei of tumor cells, which can be detected by immunohistochemistry. Lately, anti-p53 antibodies were found in the sera of patients who had solid tumors as a result of immune response to accumulation of mutated p53 protein in tumor cells. METHODS: For investigation of the clinical implication of cellular p53 protein overexpression and serum p53 antibody, immunohistochemical staining for p53 protein of B-5 fixed paraffin embedded bone marrow biopsies and enzyme immunoassay for the presence of anti-p53 antibodies of sera were performed simultanously; in 58 cases of AML, 34 cases of ALL, 11 cases of acute leukemia at relapse, 13 cases of CML in chronic phase and 5 cases of CLL. RESULTS: Overexpression of p53 protein was found in 9.1%(11/121) of all leukemias, with 8.6% of AML with predominance of M6, 5.9% of ALL, 18.2% of acute leukemia at relapse and 40% of CLL, but not found in CML. Serum anti-p53 antibodies were found in 5.8%(7/121) of all leukemias, with 6.9% of AML and 5.9% of ALL, 9.1% of acute leukemia at relapse, but not found in chronic leukemias. In AML and ALL, age, sex, hemoglobin, leukocyte count, platelet count and blast % were not related with p53 protein expression. The AML patients with p53 protein overexpression have more unfavorable karyotypes(complex karyotype, -5, -7 and t(10;11)), with shorter overall survival as compared to those without p53 protein overexpression. The presence of serum anti-p53 antibodies was not related with clinical findings of leukemias. CONCLUSIONS: The indications are that p53 gene alterations will contribute to disease development and progression in some specific patients with leukemia, due to the rare frequency of overexpression of p53 protein and serum anti-p53 antibodies in leukemia. Analysis of the p53 protein and serum p53 antibodies could screen p53 gene mutation and predict prognosis for some leukemias.
Antibodies* ; Biopsy ; Bone Marrow ; Genes, p53 ; Humans ; Immunoenzyme Techniques ; Immunohistochemistry ; Karyotype ; Leukemia* ; Leukocyte Count ; Paraffin ; Platelet Count ; Prognosis ; Recurrence

OBJECTIVES: To evaluate the factors that limit post-cochlear implantation (CI) speech perception in prelingually deaf children. METHODS: Patients with CI were divided into two groups according to Category of Auditory Performance (CAP) scores 3 years post-CI: the poor performance group (poor performance group, CAP scores≤4, n=41) and the good performance group (good performance group, CAP scores≥5, n=85). The distribution and contribution of the potential limiting factors related to post-CI speech perception was compared. RESULTS: Perinatal problems, inner ear anomalies, narrow bony cochlear nerve canal (BCNC), and intraoperative problems was significantly higher in the poor performance group than the good performance group (P=0.010, P=0.003, P=0.001, and P=0.045, respectively). The mean number of limiting factors was significantly higher in the poor performance group (1.98±1.04) than the good performance group (1.25±1.11, P=0.001). The odds ratios for perinatal problems and narrow bony cochlear nerve canal in the poor performance group in comparison with the good performance group were 4.878 (95% confidence interval, 0.067 to 0.625; P=0.005) and 4.785 (95% confidence interval, 0.045 to 0.972; P=0.046). CONCLUSION: This study highlights the comprehensive prediction of speech perception after CI and provides otologic surgeons with useful information for individualized preoperative counseling of CI candidates.
Child ; Cochlear Implantation ; Cochlear Implants* ; Cochlear Nerve ; Counseling ; Deafness* ; Ear, Inner ; Hearing Loss, Sensorineural ; Humans ; Language Development ; Odds Ratio ; Prognosis ; Speech Perception ; Surgeons

PURPOSE: Previous study revealed that 90% of benign bone tumor of hand is enchondroma. In soft tissue tumor, 36% of glomus tumor and less than 5% of giant cell tumor of tendon sheath are revealed as bone involving lesions. However, primary bone tumor and soft tissue tumor are not reported frequently at the distal phalanx. We aimed to assess the specific characters of the distal phalangeal mass. MATERIALS AND METHODS: Fourteen cases of distal phalangeal masses with bony lesions were included, and clinical and radiologic review were done. RESULTS: Fourteen cases out of eighteen distal phalangeal mass cases were bony lesions of the distal phalanx. Chief complaints of patients were pain (ten cases), palpable mass (four cases), and both (one case). Six cases were benign bone tumor, eight were soft tissue tumor involving the bone. In eight soft tissue mass, four glomus tumors, two epidermoid cysts, two giant cell tumors of tendon sheath were diagnosed. Nail involvement was found in four cases, and three of them were diagnosed as glomus tumor. CONCLUSIONS: The high rates of bone involvement and nail deformity of the distal phalangeal mass must be considered.
Chondroma ; Congenital Abnormalities ; Epidermal Cyst ; Fingers ; Giant Cell Tumors ; Glomus Tumor ; Hand ; Humans ; Nails ; Tendons

No abstract available.
Cardiac Catheterization* ; Cardiac Catheters* ; Child* ; Cineangiography* ; Heart Diseases* ; Heart* ; Humans ; Statistics as Topic*