To evaluate correlation between the amount of oncogene products in tumor cell extracts and malignant potentiality in breast tumor, immunohistochemical staining for the ras Oncogene products was performed in the sections of benign and malignant lesions of the breast. The results obtained were as follows: 1) The positive reaction to ras Oncogene products was usually observed in the cytoplasm and cell membrane. 2) The ratio of positive reaction was 30.4% in epithelial hyperplasia of fibrocystic disease, 26.5% in fibroadenoma. 49.5% in intraductal carcinoma 71.6% in infiltrating ductal carcinoma, 85.2% in metastatic infiltrating ductal carcinoma, and 89.7% in relatively preserved neighboring lobules of infiltrating ductal carcinoma. In conclusion, the ras oncogene products are found by a significantly higher ratio in the more aggressive lesions, and the infiltrating ductal carcinoma might represent its potential of malignant transformation. 3) The expression of ras oncogene was heterogeneous in primary as well as metastatic mammary carcinomas.
Neoplasm Metastasis

BACKGROUND: Heat-treated erythrocytes have been reported to be undergone fragmentation and microspherocytes transformation in vitro. However, the changes for enzyme activity of WBCs is not well known. The purpose of this study is to investigate the effects of temperature on function and morphology of WBCs and platelets. And we also defined the relationship between temperature-induced changes in morphology of the erythrocytes and cholesterol level. METHODS: Peripheral blood specimens collected from 55 normal healthy subjects were assayed. CBC and biochemical test for heat-treated specimens were performed. Osmotic fragility was tested and echinocytes were counted using phase contrast microscope. DNA was extracted from heated WBCs with Wizard genomic DNA extraction kit(Promega Corp, USA) and applied on 1.5% agarose gel. After heating, plasma proteins were fractionated by sodium dodecyl sulfate-poly-acrylamide gel electrophoresis (SDS-PAGE) and compared according to changes of temperature. For the phagocytic function of WBCs, 1 x10(7) CFU/mL of gram-negative bacilli were incubated with specimens for 4 hours. Enzymatic activities for myeloperoxidase(MPO), alkaline phosphatase (ALP), and esterase (EST) were confirmed with cytochemical reaction. RESULTS: After incubation at 50 degrees C for 5 min, platelets were counted as 2,978.2 x 10(9)/L and the number of eosinophil was 5.58 x 10(9)/L. And blood glucose level was decreased from 92.4 mg/dL to 59.1 mg/dL, whereas the value of cholesterol was changed as follows; 201.3 mg/dL at 0 sec, 174.6 mg/dL at 60 sec, 151.2 mg/dL at 90 sec, and 197.6 mg/dL at 5 min. In the same temperature, the proportion of echinocytes was 94.1% at 90 sec and decreased to 2.3% at 5 min. In osmotic fragility test, the hemolysis of RBCs began at 0.74% of NaCl and completed at 0.35% of NaCl. Phagocytic function of leukocytes was lost at 52 degrees C, and enzyme activity was lost at following temperature ; MPO at 70t, EST at 70 degrees C, and ALP at 56 degrees C, respectively. SDS-PAGE patterns reveal individual differences of protein at same temperature condition. Aggregating function of platelets were lost, after incubation at 43 degrees C for 5 min. In EDTA-anticoagulated blood, temperature-induced platelelet aggregation was intensified, while in heparinized blood, platelet aggregation was not induced by heat. CONCLUSION: For morphological transformation of erythrocytes in vitro, 50 degrees C is critical point of temperature to induce fragmentation and microspherocytes. Plasma cholesterol appears to play some role to formation of echinocytes induced by heat. MPO is more stable for high temperature than EST and ALP. And sensitivity of RBCs to temperature is considered to be different individually.
Alkaline Phosphatase ; Blood Cells* ; Blood Glucose ; Blood Proteins ; Cholesterol ; DNA ; Electrophoresis ; Electrophoresis, Polyacrylamide Gel ; Eosinophils ; Erythrocytes ; Heating ; Hemolysis ; Heparin ; Hot Temperature* ; Individuality ; Leukocytes ; Osmotic Fragility ; Plasma ; Platelet Aggregation ; Sepharose ; Sodium

The direct antiglobulin test (DAT) is used in investigating autoimmune hemolytic anemia, drug-induced antibodies, hemolytic diseases of newborn and alloimmune reactions to recently transfused red cells. We performed 3,033 DATs in our blood bank from 1985 to 1992. When using a polyspecific antihuman globulin reagent, the DAT was positive in 7.2% of all cases tested. In further studies using monospecific anti-IgG and anti-C3d reagents, three patterns of reactivity were founded: in 37% of cases, red cells are coated with IgG alone; in 18% of cases, the red cells are coated with both IgG and complement; and in 45% of cases only with complement. We evaluated clinical significance of DAT positive results with the 227 patients' medical records which can be available for reviewing among the positive DAT patients. The male to female ratio of DAT positive patient was 1:2 and 41% of cases were belong to the 20-30 years old age group. The most common underlying disorders were systemic lupus erythematosus (29.5%), idiopathic (10.1%), hematologic malignancy (8.8%), and liver disease (6.2%). Patients with warm reactive autoantibodies account for 60.4% of all DAT positive cases. Cold reactive autoantibodies were demonstrated in 11%, and the mixed-types were 2.6%. Drug-induced DAT positive findings were observed in 15.4% and the DAT positve caused with transfusion associated alloantibodies were 7.5%. IgG warm-reactive autoagglutinins were more commonly detected in patients with autoimmune hemolytic anemia and drug induced hemolysis. Definite hemolysis was present in 37% of all DAT positive patients and especially in all patients with mixed type autoagglutinin. Drugs caused a positive DAT were cephalosporin, penicillin, isoniazid, and rifampicin.
Anemia, Hemolytic, Autoimmune ; Antibodies ; Autoantibodies ; Blood Banks ; Complement System Proteins ; Coombs Test* ; Female ; Hematologic Neoplasms ; Hemolysis ; Humans ; Immunoglobulin G ; Indicators and Reagents ; Infant, Newborn ; Isoantibodies ; Isoniazid ; Liver Diseases ; Lupus Erythematosus, Systemic ; Male ; Medical Records ; Penicillins ; Rifampin

Balantidium coli is widely distributed in hogs, particularly in warm and temperate climates, and in monkeys in the tropics. B. coli is the only pathogenic ciliate and is the largest protozoan parasitizing humans. Some individuals with B. coli infections are totally asymptomatic, whereas others have symptoms of severe dysentery similar to those seen in patients with amebiasis. We report a 5-year-old girl with asymptomatic balantidiasis. The patient was suffering from herpes zoster for several days. She did not have symptoms of dysentery or urinary tract infection. Motile trophozoites of B. coli were observed in the urinary sediment. This is the first report of asymptomatic balantidiasis in Korea.
Amebiasis ; Balantidiasis ; Balantidium* ; Child, Preschool ; Climate ; Dysentery ; Female ; Haplorhini ; Herpes Zoster ; Humans ; Korea ; Trophozoites ; Urinary Tract Infections

The Di(a+b-) phenotype is extremely rare among Caucaclans and mostly confined to mongoloids. The incidences of Di antigen among Koreans were reported to be 6.1 to 14.5%, with an average of 9.6%; it can be calculated that the frequency of Di(a+b-) is 0.25% on the average. Authors report the first case of hemolytic disease of the newborn due to anti-Dib in Korea. The Diego phenotypes of the mother, baby and father were Di(a+b-), Di(a+b+) and Di (a-b+), respectively. The mother's serum and eluate from infant's erythrocytes contained anti-DP antibody active in the antiglobulin phase. After transfusions of Di-negative red cells from the mother and mother's relative, the patient was recovered from anemia and jaundice.
Anemia ; Erythrocytes ; Fathers ; Humans ; Incidence ; Infant, Newborn* ; Jaundice ; Korea ; Mothers ; Phenotype

BACKGROUND: Despite proposing clonal depletion, anergy, and alternation of cytokines in peripheral tolerance, the precise mechanism for the immunosuppressive effect of blood transfusion remains unknown. Here, we evaluated the effect of transfusion on the immune system indirectly via quantitation of leukocyte cytokine mRNA expression before and after allogeneic transfusion. METHODS: Samples were obtained from eight patients, being ordered one to four units of leukocytefree erythrocytes, before, 1, and 7 days after transfusion, from November to December, 2002 at Inha University Hospital. We explored the changes in mRNA expression of interleukin-2 (IL-2), IL-4, IL-10, tumor necrosis factor alpha (TNF-alpha) and interferon gamma (IFN-gamma). RESULTS: In four patients who received blood transfusions among eight, significant changes were observed in the blood mRNA levels of INF-gamma and IL-10. The amounts of IFN-gamma mRNA were significantly decreased a day after transfusion to 78.5% and then recovered to 110.9% 7 days later (P=0.032), whereas, that of IL-10 was increased to 151.5% a day after and recovered to 119.1% 7 days later (P=0.034). mRNA expressions of IL-2, IL-4, and TNF-alpha were not detected in all patients. CONCLUSIONS: We observed a significant decrease in leukocyte IFN-gamma mRNA expression and an increase in IL-10 mRNA after transfusion. These findings indirectly represent that down-regulation of the Th1 cells and the up-regulation of the Th2 cells could be caused by allogeneic transfusion.
Blood Transfusion ; Cytokines ; Down-Regulation ; Erythrocytes ; Humans ; Immune System ; Interferons ; Interleukin-10 ; Interleukin-2 ; Interleukin-4 ; Leukocytes ; Peripheral Tolerance ; RNA, Messenger* ; Th1 Cells ; Th2 Cells ; Tumor Necrosis Factor-alpha ; Up-Regulation

BACKGROUND: Serum transferrin receptor (sTfR) level has been reported to be a sensitive indicator of tissue iron deficiency and also reflects the erythropoietic activity in bone marrow. As little is known about the difference of sTfR between adults and children in Korea, authors tried to determine the changes of sTfR level according to the age in apparently healthy subjects. And we also defined the correlation between sTfR and iron parameters. METHODS: A total of 522 healthy population without anemia was investigated for the sTfR level and the evidence of iron deficiency. The population was divided into 4 groups according to age, i.e., adults aged 23 to 58 years (n=110), adolescents aged 14 to 19 years (n=125), young children aged 3 to 7 years (n=136), and infants aged 4 to 24 months (n=151). CBC, iron parameters, and sTfR were tested and analyzed. Serum transferrin receptor was assayed by IDeATMsTfR IEMA (soluble transferrin receptor immunoenzymometric assay, Orion Diagnostica, Finland) test kits. RESULTS: The mean values of sTfR were 2.41+/-0.99 mg/L in adults and 2.10+/-1.07 mg/L in adolescents aged 17 to 19 years (P=0.214). The sTfR level in infants was 5.49+/-1.81 mg/L and significantly higher than in young children of 3.12+/-1.45 mg/L (P<0.001). The level of sTfR in male infants aged 4-24 months was 5.89 mg/L and that of female infants with same age was 5.11 mg/L (P =0.019). The sTfR level was significantly correlated with mean corpuscular volume (r=-0.67, P <0.01), total iron binding capacity (r=0.52, P <0.01), and transferrin saturation (r=-0.45, P <0.01), however ferritin level showed poor correlations with hemoglobin (r=0.11, P=0.06), serum iron (r=0.01,P =0.97), and transferrin saturation (r=0.18, P <0.01). CONCLUSIONS: The mean value of sTfR is different according to the age and appears to reach adult level at the period of adolescent. On the basis of correlation study, sTfR is a more correlative indicator of iron status than ferritin. The prevalence rate of iron deficiency is still high and sufficient iron supplement is needed even in infants without anemia.
Adolescent ; Adult* ; Anemia ; Bone Marrow ; Child* ; Erythrocyte Indices ; Female ; Ferritins* ; Humans ; Infant ; Iron ; Korea ; Male ; Prevalence ; Receptors, Transferrin* ; Statistics as Topic ; Transferrin*

Neuroblastoma, which originates in the sympathetic division of the autonomic nervous system, is the most common extracranial solid malignancy in childhood but rarely occurs in adulthood. Only one case of neuroblastoma has been reported in Korean adult. Authors recently experienced a case of neuroblastoma originating from the retroperitoneal cavity with metastasis to the bone marrow and neck. A 29-year-old male was admitted at Inha University Hospital because of abdominal pain and back pain. The patient had a past history of chemotherapy for retroperitoneal tumor in a general hospital 4 years ago. In biochemical test, neuron specific enolase(NSE) was above 260 ng/mL and urine vanillylmandelic acid(VMA) was positive. Immunohistochemical stainings of bone marrow sections, showed positive reactions for NSE, chromogranin, and synaptophysin, however, revealed negative reactions for MIC2, vimentin, and mixed keratin. Pathologic examination showed the characteristic findings of neuroblastoma. We report this case with a review of literature.
Abdominal Pain ; Adult* ; Autonomic Nervous System ; Back Pain ; Bone Marrow* ; Drug Therapy ; Hospitals, General ; Humans ; Male ; Neck ; Neoplasm Metastasis ; Neuroblastoma* ; Neurons ; Synaptophysin ; Vimentin

Autoimmune hemolytic anemia(AIHA) is characterized by the production of Coombs antibodies, which are responsible for the destruction of RBCs. The antibody specificity of warm A1HA(WAIHA) is very complex while all cells tested are usually reactive in routine test. Although some autoantibodies have broad specificity to the Rh system, apparent specificity for simple Rh antigen(D, C, E, c, e) is rare. A 63 year-old farmer was admitted at Inha University Hospital for evaluation of anemia. He had no history of blood transfusion. He presented overt anemia with decreased Hb (6.6g/dL) and increased reticulocyte count(18.5%, corrected reticulocyte count 8.4%). The direct antiglobulin test(DAT) was strongly positive for IgG and negative for C3d while indirect antiglobulin test(IAT) was weakly positive. Both two different antibody identification test kits identified this antibody as anti-e. His Rh phenotype was CDe. Although the eluted antibody from his own RBCs failed to show specificity against e but agglutinated all the reagent RBCs, we diagnosed this case as WAIHA induced by IgG anti-Rh(e) because his serum agglutinated all e-positive RBCs while it was non-reactive with e-negative RBC in the cross- matching test. Drugs(loxoprofen, cimetidine) couldn' t be ruled out as causative agent. (Korean J Blood Transfusion 10(1): 61-67, 1999)
Anemia ; Anemia, Hemolytic, Autoimmune* ; Antibodies ; Antibody Specificity ; Autoantibodies ; Blood Transfusion ; Humans ; Immunoglobulin G ; Middle Aged ; Phenotype ; Reticulocyte Count ; Reticulocytes ; Sensitivity and Specificity

Cold agglutinins are serum autoantibodies activated at reduced body temperatures to produce red blood cell agglutination and hemolysis. They are commonly found in the sera of healthy people but rarely become clinically important, because most of them exist at very low titers, and exert their greatest effect at low temperatures. By contrast, during open heart surgery, systemic hypothermia and cold cardioplegia are commonly used, and cold agglutinins can be a appreciable threat. This report describes a patient with documented cold agglutinins who successfully underwent atrial septal defect closure and patent ductus arteriosus ligation by normothermic cardiopulmonary bypass in an effort to avoid the adverse effects of hypothermia.
Agglutination ; Agglutinins ; Anemia, Hemolytic, Autoimmune* ; Autoantibodies ; Body Temperature ; Cardiopulmonary Bypass ; Ductus Arteriosus, Patent ; Erythrocytes ; Heart Arrest, Induced ; Heart Septal Defects, Atrial ; Heart* ; Hemolysis ; Humans ; Hypothermia ; Ligation ; Thoracic Surgery*