Iron in plasma cells has been described in patients with diseases characterized by iron overload. We observed iron-containing plasma cells in the bone marrow aspirates of 6 patients with anemia. In five of these 6 patients, there were alcoholic liver disease and in one there was abdominal aortic occlusion. Medical records of patients and previous reports were reviewed. Marrow storage irons were adequate or increased, but other morphologic changes of alcoholism such as erythroid vacuolization or ringed sideroblasts were not the features. The presence of iron-containing plasma cells is suggestive of alcoholism and its complications, and diseases associated with iron overload or inability of RBCs to utilize iron. The exact mechanism of entry of iron into plasma cells is controversial.
Alcoholism ; Anemia ; Bone Marrow ; Humans ; Iron Overload ; Iron* ; Liver Diseases, Alcoholic ; Medical Records ; Plasma Cells* ; Plasma*

No abstract available.
Licensure*

Thawing fresh frozen plasma(FFP) by waterbath(WB) requires about 30 minutes, which is too slow in emergency situations and carries the risk of bacterial contamination of FFP. To solve these problems, a new thawing method using a microwave oven(MWO) has been developed. Twenty units of equally divided plasma from 10 units of plasma were frozen, stored at -55 degrees C, and thawed in parallel using microwave oven or waterbath. Coagulation factors, plasma proteins and thawing time were measured. Except for antithrombin III(MWO: 85.2+/-6.94%, WB : 90.8+/-9.14%, p<0.05), no significant differences were observed in the 18 other coagulation parameters and the plasma proteins studied. Mean thawing time by MWO was 5.9 minutes per 1 unit, 10.4 minutes per 2 units and 12.5 minutes per 3 units; by WB, it was 19.0, 20.0 and 22.0 minutes, respectively. In conclusion, FFP can be thawed faster using a microwave oven than using 37 degrees C waterbath and the thawed plasma proteins were generally equivalent to those of FFP thawed by waterbath.
Blood Coagulation Factors ; Blood Proteins ; Emergencies ; Microwaves* ; Plasma*

No abstract available.
Anti-Bacterial Agents* ; Ascorbic Acid* ; beta Carotene* ; Tretinoin*

No abstract available.
Spinal Stenosis* ; Spondylolisthesis*

Peripheral cholangiocarcinoma (PCC) is defined as a malignancy of intrahepatic bile duct presenting as a focal liver mass, specifically, those located peripheral to the 2nd-order branchings of the bile duct. During the study period of 11 years from Jan. 1985 through Dec. 1995, a total of 12 patients underwent liver resection for PCC at the Department of Surgery, Inje University Paik Hospital, Seoul. This figure accounts for 8.3% of primary liver cancer. There were 9 men and 3 women with a ratio of 3:1, the mean age was 53.3 years with a range of 39 to 67 years. Twenty-five per cent of the patients had concomitant intrahepatic stone (IHS). HBsAg was positive in one case (8.3%) who had chronic hepatitis. No patient had liver cirrhosis. The accurate preoperative diagnosis of PCC in 3 cases was difficult because of the association with IHS. These 3 patients underwent surgery under the diagnosis of chronic cholangitis rather than PCC. CEA and CA 19-9 were elevated in 70% and 50% of the patients, respectively. In most cases concomitant measurement of CEA and AFP facilitated the differentiation between PCC and hepatocellular carcinoma. As to the tumor characteristics, 83% of the patients had tumors greater than 5 cm in diameter, indicating the advanced stage of the tumor at the time of resection. The site of origin of tumor mass was distributed more or less evenly between the hepatic lobes. The patients with mass-forming, expanding type of tumors made up 58% of the cases, infiltrating type 25%, and the remainder being the combination of both. A significant number of patients, 27%, had nodal metastasis. Two thirds of the patients underwent major hepatic resections. Segmentectomies here include the resection of lateral segment done as a treatment for IHS, which later proved to be cancer on histologic examination. There was no operative death among the 12 patients. The overall median survival time was 12 months. The overall survival rates at 1, 3, and 5 years were 42.4%, 42.4%, and 42.4%, respectively. Only the radicality of the resection was the statistically significant risk factor for survival by univariate analysis. The 5-year survival rate was 100% in 6 patients who had curative resection (no lymph node invasion, no peritoneal seeding, clear resection margin). The prognosis of patients with advanced PCC is unfavorable unless the tumor is entirely removed. In view of the association of IHS in a significant portion of the cases, the possible coexistence of the carcinoma should always be borne in mind when dealing with patients with IHS.
Bile Ducts ; Bile Ducts, Intrahepatic ; Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Cholangitis ; Diagnosis ; Female ; Hepatitis B Surface Antigens ; Hepatitis, Chronic ; Humans ; Liver ; Liver Cirrhosis ; Liver Neoplasms ; Lymph Nodes ; Male ; Mastectomy, Segmental ; Neoplasm Metastasis ; Prognosis ; Risk Factors ; Seoul ; Survival Rate

Primary hepatic sarcomas are uncommon, representing less than 1% of the primary malignant lesions of the liver. Three patients underwent resection for primary hepatic sarcoma at the Department of Surgery, Inje University Paik Hospital, Seoul: a 6 year-old girl with malignant mesenchmoma, a 74 year-old man with malignant fibrous histiocytoma and a 53 year-old man with rhabdomyosarcoma. Abdominal mass, fever with chills, and abdominal pain were the presenting symptoms, respectively. The patient with rhabdomyosarcoma was positive for HBsAg and had chronic active hepatitis. AFP level was elevated in this patient. CA 19-9 level was elevated in the patient with malignant fibrous histiocytoma. CEA levels were normal in all cases. All these tumors were hypodense on computed tomography. Malignant mesenchymoma was hypovascular and rhabdomyosarcoma was hypervascular on angiography. Immunohistochemical stains of the tumors were positive for vimentin but negative for epithelial markers, differentiating these lesions from other hepatic tumors. Electron microscopic examination was helpful in the diagnosis of the specific type of primary hepatic sarcoma. None had postoperative adjuvant chemotherapy or radiotherapy. The patient with malignant mesenchymoma, who underwent right hepatic trisegmentectomy, was disease free at 32 months. The patient with malignant fibrous histiocytoma, who underwent non-curative excision, died of the tumor at 2 months. The patient with rhabdomyosarcoma, who underwent posterior segmentectomy, was alive at 4 months. Resection of primary hepatic sarcoma should be executed if feasible, with potential survival measured in years, in view of the lack of other effective treatment modalities.
Abdominal Pain ; Aged ; Angiography ; Chemotherapy, Adjuvant ; Child ; Chills ; Coloring Agents ; Diagnosis ; Female ; Fever ; Hepatitis B Surface Antigens ; Hepatitis, Chronic ; Histiocytoma, Malignant Fibrous ; Humans ; Liver* ; Mastectomy, Segmental ; Mesenchymoma ; Middle Aged ; Radiotherapy ; Rhabdomyosarcoma ; Sarcoma* ; Seoul ; Vimentin

The purpose of this present study was to investigate the effect of autogenous bone with histological evaluation of regenerated bone after sinus elevation. The study involved genaral healthy 6 patients participated in this study and were treated with 2-stage sinus elevation procedures using a combination of demineralized freezeddried bone allograft (DFDBA) and coralline calcium carbonate with or without autogenous bone. At 6months after sinus elevation, bone specimens were obtained and stained with Hematoxylin-Eosin for light microscopic evaluation. The results of this study were as follows : 1. Autogenous bone grafts present trabecular patterns at 6 months in test groups, consist of woven bone and lamellar bone, but more compact than control groups. 2. Resorption of bone graft particles, osteoblast-like cells, newly formed osteoid tissue were observed at 6 months in test groups, but seems to be more frequently than control groups. 3. New osteoid tissue was formed from the surface of graft materials and gradually expanded around them. 4. The appearance of connective tissue around graft materials was densely formed, but more prominent in test groups than control groups. 5. Bone graft particles were resorbed incompletely and slight inflammatory infiltrate, newly formed capillaries, and adipocytes were observed. From the above results, autogenous bone is effective in bone regeneration after sinus elevation, could provide favorable conditions in implant placement.
Adipocytes ; Allografts ; Bone Regeneration* ; Calcium Carbonate ; Capillaries ; Connective Tissue ; Humans ; Transplants*

BACKGROUND: The purpose of this study is to evaluate the diagnostic usefulness of the quantitation of D-dimer, thrombin-antithrombin III complex (TAT) and prothrombin fragment 1 2 (F1 2) in patients with DIC or venous thrombosis. METHODS: The quantitation of D-dimer, TAT and F1 2 by ELISA (Behring, Germany) were done with the specimens from eighty eight patient plasma. The patients were classified as DIC, probable DIC and non-DIC based on the DIC criteria by reserach committee in Japan, and the patients with deep vein thrombosis (DVT) or pulmonary embolism (PE) were included. RESULTS: All eighteen DIC patients showed the increased D-dimer ELISA and fourteen patients showed the increased TAT and F1 2. According to the results of quantitative D-dimer, TAT and F1 2 tests, probable DIC and the group with increased results of above three tests among non-DIC were considered as DIC. Two patients with PE showed increased results of above three tests. Among nine DVT patients, eight patients showed increased results of D-dimer ELISA and F1 2, but TAT was increased in only six patients. Among forty six patients with negative results of D-dimer semiquantitation (latex agglutination), twenty seven patients (59%) revealed increased results of D-dimer quantitation (ELISA). CONCLUSIONS: D-dimer quantitation by ELISA is the most sensitive test in the diagnosis of DIC and venous thrombosis. The quantitation of D-dimer, TAT and F1 2 can increase the diagnostic rate of DIC and venous thrombosis, and the developement of the new quatitating reagents with more rapid and individual procedures will contribute to the accurate and rapid diagnoses of them.
Dacarbazine ; Diagnosis ; Disseminated Intravascular Coagulation* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Indicators and Reagents ; Japan ; Plasma ; Prothrombin* ; Pulmonary Embolism ; Venous Thrombosis*

BACKGROUND: Rapid and accurate identification of Mycobacterium tuberculosis complex is important in the diagnosis, treatment, and assessment of prognosis of tuberculosis. But, the conventional identification procedures such as niacin test usually requires considerable time. In this study, we compared the diagnostic value of a gene probe method with that of the niacin test for the differentiation of M. tuberculosis complex from mycobacteria other than tuberculosis (MOTT). METHODS: Commercially available gene probe kit(AccuProbeTM, Gen-Probe, Inc. , San Diego, Calif.) and Niacin test strip were used to identify 78 strains of mycobacteria isolated from patients at Asan Medical Center. One ATCC strain (M. tuberculosis complex) and one MOTT strain were used as controls. Polymerase chain reaction(PCR) was used when the above two tests yielded discordant results. RESULTS: Fifty isolates were identified as M. tuberculosis complex by both gene probe method and niacin test. Likewise 25 isolates were identified as MOTT by the both methods. For the remaining 5 isolates, the results of the two tests differed from each other: M. tuberculosis complex by gene probe and MOTT by niacin test. By PCR, however. these strains were identified as M. tuberculosis. The time required for identification was 1 to 2 hours by gene probe method and 1 to 3 weeks by niacin test. CONCLUSION: Gene probe is simple, rapid and reliable and is a very practical diagnostic tool that can be used in any clinical laboratory.
Chungcheongnam-do ; Diagnosis ; Genes, vif* ; Humans ; Mycobacterium tuberculosis* ; Mycobacterium* ; Niacin ; Polymerase Chain Reaction ; Prognosis ; Tuberculosis