PURPOSE: This study was undertaken to correlate the CT and histopathologic findings of abscess wall. MATERIALS AND METHODS: The CT findings of 12 patients with pathologically proven brain abscess were retrospectively analyzed with particular attention to the thickness, smoothness and uniformity of enhancing abscess wall, and the results were correlated with histopathologic findings. RESULTS: Two patients with acute cerebritis showed an isodense ring on non-contrast CT(NCCT), but a true capsule formation could not be identified at pathologic examination. Six other patients with isodense ring on NCCT consisted of early to late cerebritis(3 cases), late cerebritis to early capsule(1 case), early capsule(1 case), and late capsule(1 case). These 6 cases showed ring enhancement on contrast enhanced CT(CECT) and true capsule formation pathologically. There was no isodense ring on NCCT in the remaining four patients. They consisted of early to late cerebritis(2 cases), late cerebritis(1 case), and late cerebritis to early capsule formation(1 case). These also showed ring enhancement on CECT and true capsule formation pathologically. CONCLUSION: We found that it is difficult to predict the exact stage of brain abscess on preoperative CT findings. It is suggested that clinical findings and sequential dynamic CT may provide more detailed informations for evaluation of abscess staging.
Abscess ; Brain Abscess* ; Brain* ; Humans ; Retrospective Studies

Acute interstitial pneumonia is a fulminant disease of unknown etiology that usually occurs in a previously healthy person and produces the histologic findings of the organizing phase of diffuse alveolar damage. We experienced an autopsy case of acute interstitial pneumonia of unknown etiology. The patient was a 48 year old man who had been healthy and had not been exposed to organic dusts or other toxic materials. The chief complaints represented were dyspnea and a dry cough for several weeks before hospitalization, and the chest radiographs showed bilateral interstitial infiltrates. Patchy consolidation of air space was also identified and ground-glass attenuation similar to those described in ARDS was detected on high-resolution computed tomography. Steroid pulse therapy, mechanical ventilation, and antibiotics for superimposed bacterial infection were performed, but the symptoms did not improve and the patient died of generalized respiratory insufficiency and severe hypoxemia 2 1/2 months after hospitalization. At autopsy the macroscopic and microscopic findings were confined mainly to the lungs. On the whole, both lungs were firm in consistency and the external surface showed a cobblestone appearance. The cut surface showed almost complete replacement of the normal lung parenchyma with gray to yellow fibrous tissue with a little residual functional area remaining. The pathology of both open lung biopsy and autopsy tissue showed marked hyperplasia of type II pneumocytes, hyaline membrane formation, thickening of the alveolar wall due to extensive fibroblast proliferation, and relatively abundant young collagen deposition in the interstitium. An immunohistochemical stain for cytokeratin revealed epithelial hyperplasia and showed that the alveolar spaces were markedly shrunken by fibrous tissue.
Anoxia ; Anti-Bacterial Agents ; Autopsy* ; Bacterial Infections ; Biopsy ; Collagen ; Cough ; Dust ; Dyspnea ; Fibroblasts ; Hospitalization ; Humans ; Hyalin ; Hyperplasia ; Keratins ; Lung ; Lung Diseases, Interstitial* ; Membranes ; Middle Aged ; Pathology ; Pneumocytes ; Pulmonary Fibrosis ; Radiography, Thoracic ; Respiration, Artificial ; Respiratory Insufficiency

Mixed falciparum-vivax infection accounts for 5% of all malaria cases seen in endemic region. However, a larger proportion of mixed malaria cases develop cerebral complication. We report one case of mixed infection resulted in cerebral malaria.
Coinfection ; Malaria* ; Malaria, Cerebral

Tuberculosis can be superimposed on many hematologic disorders. Numerous hematologic abnormalities are also associated with tuberculosis, especially disseminated form. With this controversy, when the patient has tuberculosis and hematologic abnormalities, it is important to differentiate tuberculosis from primary hematologic disorder. Especially, most patients with tuberculosis and pancytopenia have been reported to have underlying hematologic disorder. We present two rare cases in which patients with myelodysplastic syndrome had disseminated tuberculosis involving the bone marrow.
Bone Marrow ; Humans ; Myelodysplastic Syndromes* ; Pancytopenia ; Tuberculosis*

PURPOSE: Spinal cord injuries can lead to varying degrees and patterns of neurologic deficits, which depend on the level of the injury, duration, completeness. So we analyzed the relationship between the types of neurogenic bladder and the level of injury in the spinal cord injury. MATERIALS AND METHODS: From June 1997 to August 2002, one-hundred twenty seven spinal cord injury patients were studied by neurological and urological examination and video-urodynamic evaluation. The neurogenic bladder in spinal cord injury were analyzed into five types according to the injured level. RESULTS: The 94 males and 33 females had a mean age of 45.7+/-15.1 years (range 15 to 92). Mean follow up interval after injury was 33.9+/-48.4 months. Injured level was classified into five levels; cervical, thoracic, lumbar, and sacral. Of the 127 patients 37 (29.1%) was cervical, 18 (14.2%) was thoracic, 33 (26.0%) was lumbar, and 39 (30.7%) was sacral. When all patients were divided suprasacral and infrasacral lesion. Typically, suprasacral lesions show detrusor hyperreflexia, and infrasacral lesions have detrusor areflexia. 30 (37.5%) of 88 suprasacral lesions and 12 (30.8%) of 39 infrasacral lesions were presented to atypical. 35.7% of patients have combine spinal lesion, but 47.6% of patients have no causes for atypical patterns. 3 (27.3%) of 11 patients were followed up, they changed neurogenic pattern. CONCLUSIONS: In our results, video urodynamic findings showed that about 30 percent patients had atypical patterns of neurogenic bladder, and they have underlying disease about 52.4%. And 27% of followed patients changed neurogenic pattern of bladder. So, urodynamic study have an important role in the spinal cord injury for diagnosis of neurogenic pattern and selection proper treatment, catching out the interval change and correction of treatment method, and evaluation of prognosis.
Diagnosis ; Female ; Follow-Up Studies ; Humans ; Male ; Neurologic Manifestations ; Prognosis ; Reflex, Abnormal ; Spinal Cord Injuries* ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urodynamics

BACKGROUND: The CD34+ cell dose and infused number of committed progenitor cells in transplantation are important factors in hematologic engraftment. However, the relationship between expansion potential of progenitor cells and hematologic engraftment remains controversial. We evaluated whether expansion potential of progenitor cells is a predictive factor of post-transplantation hematologic engraftment. METHODS: Mononuclear cells isolated from mobilized peripheral blood and bone marrow were cultured with cytokine cocktail for 7 days. Progenitor cells and committed progenitors were analyzed using stem cell markers (CD34 and CD133) and lineage specific markers. Hematologic engraftment was defined as neutrophil counts over 500/microliter and platelet counts over 20,000/microliter without transfusion. Acute and chronic graft-versus-host disease (GVHD) were investigated. RESULTS: There was inverse tendency between the number and fold expansion of progenitor cells or committed (granulocytic or megakaryocytic) progenitors and time to engraftment. Especially, fold expansion of CD34(+)/CD33(+) cells was significantly correlated with time to neutrophil engraftment in bone marrow transplantation (r=-0.56, P=0.04). The infused number and fold expansion of lymphoid progenitors were not related to the occurrence of acute or chronic GVHD. CONCLUSIONS: We could not prove that expansion potential of progenitor cells and committed progenitor cells is correlated to hematologic engraftment although there is a correlation between CD34(+)/ CD33(+) cells and time to neutrophil engraftment. But, a further study on the value of expansion potential is required because there is an inverse tendency.
Bone Marrow ; Bone Marrow Transplantation ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Neutrophils ; Platelet Count ; Stem Cells

BACKGROUND: The findings of dysplastic features in haemopoietic cells in de novo acute myeloid leukemia(AML) is defined as AML with trilineage myelodysplasia(AML/TMDS). These cases have been reported accounting for 10-5% of de novo AML. The rate of complete remission(CR) in AML/TMDS to conventional chemotherapy is poor and relapse occur much earlier than in patients without dysplastic features. TMDS features are also observed during remission and termed this de novo AML with myelodysplastic remission marrow(AML/MRM). Recent report described that TMDS during remission was more closely related to prognosis than dysplastic features at diagnosis. We investigated the incidence of AML/TMDS and AML/MRM and evaluated the impending role of dysplasia in prognosis. METHOD: Ninety-ive patients with de novo AML from March 1994 to December 1998 were enrolled according to the FAB classifiction. To determine AML/TMDS and AML/MRM, we used Brito-abapulle's criteria and Kazuhiro's criteria. Prognosis was aalysed by the means of disease free survival(DFS) and overall survival(OS). RESULTS: Nine(9.5%) patients had AML/TMDS and it was 7.7%, 17.2%, 50% of patients with M2, M4 and M6. CR rate was 44.4% for TMDS patients compared to 76.7% for patients without TMDS(p<0.05). AML/TMDS also showed significantly shorter DFS and OS. The incidence of AML/MRM was higher in the group of AML/TMDS(44.4%) compared to AML without TMDS(8.1%) but was not related to prognosis. CONCLUSION: We concluded that the presence of TMDS in de novo AML exerts a negative effect on the ability to achieve CR and in the prognosis. But the MRM has no significance to predict poor prognosis and early relapse.
Diagnosis ; Drug Therapy ; Humans ; Incidence ; Leukemia, Myeloid, Acute* ; Prognosis ; Recurrence

BACKGROUND: The findings of dysplastic features in haemopoietic cells in de novo acute myeloid leukemia(AML) is defined as AML with trilineage myelodysplasia(AML/TMDS). These cases have been reported accounting for 10-5% of de novo AML. The rate of complete remission(CR) in AML/TMDS to conventional chemotherapy is poor and relapse occur much earlier than in patients without dysplastic features. TMDS features are also observed during remission and termed this de novo AML with myelodysplastic remission marrow(AML/MRM). Recent report described that TMDS during remission was more closely related to prognosis than dysplastic features at diagnosis. We investigated the incidence of AML/TMDS and AML/MRM and evaluated the impending role of dysplasia in prognosis. METHOD: Ninety-ive patients with de novo AML from March 1994 to December 1998 were enrolled according to the FAB classifiction. To determine AML/TMDS and AML/MRM, we used Brito-abapulle's criteria and Kazuhiro's criteria. Prognosis was aalysed by the means of disease free survival(DFS) and overall survival(OS). RESULTS: Nine(9.5%) patients had AML/TMDS and it was 7.7%, 17.2%, 50% of patients with M2, M4 and M6. CR rate was 44.4% for TMDS patients compared to 76.7% for patients without TMDS(p<0.05). AML/TMDS also showed significantly shorter DFS and OS. The incidence of AML/MRM was higher in the group of AML/TMDS(44.4%) compared to AML without TMDS(8.1%) but was not related to prognosis. CONCLUSION: We concluded that the presence of TMDS in de novo AML exerts a negative effect on the ability to achieve CR and in the prognosis. But the MRM has no significance to predict poor prognosis and early relapse.
Diagnosis ; Drug Therapy ; Humans ; Incidence ; Leukemia, Myeloid, Acute* ; Prognosis ; Recurrence

BACKGROUND: Factor VII:C (FVII:C) has been shown to be a risk factor of ischemic heart disease (IHD) and plasma levels are reported to be associated with polymorphisms of the FVII gene. Cerebrovascular disease (CVD) shares many of the risk factors associated with IHD but few studies about the relationship between FVII and CVD have been investigated. In this study, we sought to determine the relationship between FVII gene polymorphisms and cerebral infarct in the population below 50 years old. METHODS: The subjects were 78 patients with cerebral infarct who had been admitted between March and December 1999 and 70 controls, matched with age and sex. FVII R353Q and hypervariable region 4 (HVR4) polymorphisms were analyzed with allele specific PCR and restriction enzyme treatment. FVII:C assay was performed on the STAGO Compact analyzer. Total cholesterol and triglycerides were also measured. RESULTS: There was no significant difference in FVII:C, total cholesterol and triglycerides between patients and controls. The distribution of the FVII R353Q genotype and the HVR4 genotype also showed no differences in patients, compared to controls. But both polymorphisms were significantly associated with FVII:C levels in the patients and controls. CONCLUSIONS: The level of FVII:C was related to FVII gene polymorphisms but there is no significant difference of FVII gene polymorphisms in the cerebral infarct population, compared to controls. Our study supports that neither FVII:C levels nor FVII genotypes are independently involved in the pathogenesis of cerebral infarct. In conclusion, the FVII genotype is a major predictor of plasma FVII:C levels but may not play an important role in the development of cerebral infarct.
Alleles ; Cholesterol ; Factor VII* ; Genotype ; Humans ; Middle Aged ; Myocardial Ischemia ; Plasma ; Polymerase Chain Reaction ; Risk Factors ; Stroke* ; Triglycerides

BACKGROUND: The recent advances in flow cytometric technology and the development of monoclonal antibodies have led to the important insights into the cell lineage and maturation stage of leukemia. The increased use of immunophenotyping in acute leukemia revealed the unusual anigen expression and biclonal or biphenotypic acute mixed lineage leukemia (AMLL). However, the data on their frequency and prognostic significance are still conflicting. METHODS: The immunophenotyping of leukemic cells (HLA-DR, CD10, CD19, CD20, CD22, CD3, CD5, CD7, CD13, CD33, CD61, TdT, cytoplasmic Ig, surface Ig) was performed by flow cytometry in 115 cases of acute leukemia between January 1994 and August 1996. Double-color immunofluorescent staining was performed in the cases expressing unusual antigens. RESULTS: 51 cases (44.3%) of 115 acute leukemias showed unusual antigens expression. These included 27 cases (38.6%) of 70 AML, 13 cases (43.3%) of 30 B-lineage ALL, 4 cases (50%) of 8 T-LL and 7 AMLL cases (6.1%) of 115 acute leukemias. CD7 (28.6%) and CD19 (11.4%) are expressed in AML, and CD13 (36.7%) and CD33 (26.7%) are expressed in ALL. Among 7 cases of AMLL, we could obtain the clinical data of 5 cases. The 4 cases of 5 AMLL failed to respond to induction chemotherapy or died before or during induction chemotherapy, and only one case showed partial remission. CONCLUSION: The unusual antigen expressions of acute leukemic cells are frequently observed, and the identification of relatively rare AMLL is very important, because AMLL showed poor response to the chemotherapy.
Antibodies, Monoclonal ; Cell Lineage ; Cytoplasm ; Drug Therapy ; Flow Cytometry ; Immunophenotyping ; Induction Chemotherapy ; Leukemia*