The observation of eosinophilic ascites is uncommon. They can be noted in parasitic disease, malignant condition, vasculitis, idiopathic hypereosinophilic syndrome or allergic disorders including eosinophilic gastroenteritis, which is a rare disease of unknown etiology characterized by massive tissue infiltration of eosinophils in the layers of any area of gastrointestinal[GI] tract. Clinical manifestations are related to the level of the histologic infiltration in the wall, and the segment of the GI tract involved. Mucosal involvement may result in abdominal pain, nausea, vomiting, diarrhea and weight loss. Muscle layer involvements have obstructive symptoms. Subserosal eosinophilic infiltration may result in the development of eosinophilic ascites. We experienced a case of eosinophilic ascites as manifestation of eosinophilic gastroenteritis in a 43-year old man who also had jejunal obstruction. High proportion of eosinophil count was noted in the ascites, however peripheral blood eosinophilia was not noted. Parasitologic studies were negative. Histologic examination of segment of jejunum showed heavy transmural infiltration of eosinophils which were extended to subserosal layer. Eosinophilic ascites noted in eosinophilic gastroenteritis, though not a common disease entity, had not been described in the laboratory medicine related papers in Korea. Therefore we report this case as an example of eosinophilic ascites.
Abdominal Pain ; Adult ; Ascites* ; Diarrhea ; Eosinophilia ; Eosinophils* ; Gastroenteritis* ; Gastrointestinal Tract ; Humans ; Hypereosinophilic Syndrome ; Jejunum ; Korea ; Nausea ; Parasitic Diseases ; Rare Diseases ; Vasculitis ; Vomiting ; Weight Loss

Although occasional patients with chronic myeloid leukemia (CML) have chromosomal changes other than Philadelphia chromosome early in the disease, in typical cases the 9;22 translocation remains the sole abnormality throughout the disease course in chronic phase. When disease progression occurs, however, 75-80% develop additional chromosome aberrations. These secondary changes sometimes precede the more aggressive manifestations hematologically and clinically and thus may serve as valuable prognostic indicators. ider (9) (q10)t (9;22) (q34;q11.2) is very rare and a recurrent chromosomal abnormality associated with acute lymphoblastic leukemias (ALL) and lymphoblastic crisis of CML. And ider (9) (q10)t (9;22) (q34;q11.2) is a lymphoid-specific rearrangement and the patients with this abnormality are of older age on average. They commonly show pre-B cell lineage immunophenotype and L2 morphology. We report a case of ider (9) (q10)t (9;22) (q34;q11.2) as secondary aberration in a patient with lymphoblastic crisis of CML.
Blast Crisis ; Chromosome Aberrations ; Disease Progression ; Humans ; Leukemia* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Philadelphia Chromosome ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Precursor Cells, B-Lymphoid

BACKGROUND: The evaluation of engraftment after BMT may be effectively accomplished by the analysis of genomic polymorphism, such as variable number of tandem repeat (VNTR). Discrimination potential (PD) and allelic profile of VNTR locus might be varied widely between races and geographic areas. Thus PCR-based VNTR loci to establish test panel useful in evaluating engraftment status of Korean patients after BMT were analyzed. MATERIAL AND METHODS: Thirty normal adults (15 males and 15 females), and each patient with acute lymphoblastic leukemia and severe aplastic anemia who had undergone allogeneic BMT were tested. Genomic DNAs extracted from peripheral blood lymphocytes or hair follicles were subjected to three PCR long tandem repeats (LTRs) and fifteen PCR short tandem repeats (STRs) loci analysis using silver-stain mode of detection. RESULTS: The PCR sensivity of VNTR system tested, and detection limit of minor component in mixing experiment, were 100 pg and 0.1%, respectively. The most informative marker was ACTBP2 with 93.2% of PD, and 98.0% of actual PD (APD). The most informative test panel was ACTBP2, D3S2386 and D1S1768 loci-combination with 99.6% of PD and 100.0% of combined APD. CONCLUSIONS: STRs, especially combination of ACTBP2, D3S2386, and D3S11768, were thought to be very useful screening markers for evaluating engraftment status in nonsibling allogeneic BMT. But most of allogeneic BMT are carried out between siblings, who have similar genetic marker each other, so further evaluation is need in sibling-BMT.
Adult ; Anemia, Aplastic ; Bone Marrow Transplantation* ; Bone Marrow* ; Continental Population Groups ; Discrimination (Psychology) ; DNA ; Genetic Markers ; Hair Follicle ; Humans ; Limit of Detection ; Lymphocytes ; Male ; Mass Screening ; Microsatellite Repeats ; Minisatellite Repeats ; Polymerase Chain Reaction ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Siblings ; Tandem Repeat Sequences

BACKGROUND: A key to successful peripheral blood stem cell transplantation is to harvest a sufficient amount of hematopoietic stem cells. A method of quickly detecting hematopoietic stem cells in peripheral blood with simple procedures using the SE-9000TM IMI channel (TOA Medical Electronics Co., Ltd., Kobe, Japan) was developed. In this study, usefulness of determining the optimal time for peripheral blood stem cell harvest using IMI channel was investigated. METHODS: Seventy nine peripheral blood stem cell collections were performed from thirteen patients with hematologic malignancy and nineteen patients with solid organ malignancy. In 13 cases, G-CSF was administrered following chemotherapy. In 19 cases only G-CSF was used to mobilize the peripheral blood stem cells. The counts of leukocytes, mononuclear cells, CD34 positive cells, and IMI in peripheral blood and leukapheresis products were determined. RESULTS: The CD34 positive cell count in harvested PBSC showed positive correlation with leukocyte cell, mononuclear cell, CD34 positive cell, and IMI in peripheral blood, with correlation coefficients of 0.48, 0.27, 0.63, 0.66, respectively. Positive correlation was presented between IMI and CD34 positive cell in peripheral blood and harvested PBSC, with a correlation coefficient, 0.83 and 0.74, respectively. CONCLUSIONS: As the SE-9000TM enables determination of the number of PBSC easily and rapidly, within approximately 85 seconds, whereas CD34 assays is expensive and needs skilled operator, the measurement of IMI positive cells is clinically useful for monitoring the peripheral blood stem cell mobilization.
Cell Count ; Drug Therapy ; Electronics, Medical ; Granulocyte Colony-Stimulating Factor ; Hematologic Neoplasms ; Hematology* ; Hematopoietic Stem Cell Mobilization ; Hematopoietic Stem Cells ; Humans ; Leukapheresis ; Leukocytes ; Leukocytes, Mononuclear ; Peripheral Blood Stem Cell Transplantation ; Stem Cells*

BACKGROUND: The Diego blood group system consists of two independent pairs of antigens, Dia and Dib. Immunization to Dia or Dib is clinically significant, because anti-Dia and anti-Dib may cause hemolytic transfusion reactions of transfused incompatible red cells or hemolytic disease of the newborn. At the nucleotide level, the difference between the Di a and Di b alleles is a single-base change of exon 19 that results in the substitution of leucine (CTG) for proline (CCG) at position 854. METHODS: Peripheral blood was collected from 116 patients. DNA was isolated from 50 L of blood. PCR was performed with previously described primers by Bruce et al (S22: 5'-GTC ACGTCGCTCAGCGG, AS13: 5'-GACCTTCCTCCTCATCAA). The 5 L of PCR products were digested by Nae I. We analyzed 10ul of each digested PCR product by electrophoresis on 1.5 % agarose gel with ethidium bromide staining. RESULTS: A concordance rate of 100 percent was observed between genotyping and phenotyping (105 Di (a-b+), 11 Di (a+b+)). CONCLUSIONS: This method can be effectively used for the Diego typing and is particularly useful in cases where the serological typing method is difficult as in autoimmune hemolytic anemia.
Alleles ; Anemia, Hemolytic, Autoimmune ; Blood Group Incompatibility ; DNA ; Electrophoresis ; Ethidium ; Exons ; Humans ; Immunization ; Infant, Newborn ; Leucine ; Polymerase Chain Reaction* ; Proline ; Sepharose

BACKGROUND: Using the classical serological methods, the HLA-Cw typing resulted in a high frequency of Cw blank because of the lack of suitable antisera coupled with low cell surface expression. Recent data on association between graft-versus-host disease and serologically undetectable HLA-Cw mismatches in bone marrow transplantation (BMT) facilitate the investigations into the biological role of HLA-Cw and more reliable HLA-Cw typing. METHODS: We performed the HLA-Cw DNA typing using PCR-SSP technique with sequence-specific primers of 22 pairs in 150 Koreans (79 organ transplant recipients, 71 healthy potential donors). These results were compared with those of serological HLA-Cw typing, which had been performed by complement-dependent microlymphocytotoxicity technique using Terasaki Tissue typing tray. RESULTs: Comparison between serological and PCR-SSP typing revealed a discrepancy rate of 24.0% (36/150). The majority of total discrepancies (29/36, 80.6%) were due to antigens that were not detected serologically and these antigens consisted of mainly Cw*12 and Cw*15. In five cases, no Cw allele was detected by DNA typing, whereas serological typing showed antigens and different antigen assignments between two methods were found in three cases. Of 66 individuals typed serologically with one blank, 66.6% (44 cases) were confirmed to be homozygous, whereas an additional Cw allele was found in remaining 22 cases using the PCR-SSP technique. In the case of the serologically undetectable HLA-Cw blank antigens, the gene frequencies of Cw*12 and Cw*15 were 6.4% and 2.8%, respectively. CONCLUSIONS: These results indicated that serological typing is insufficient for accurate HLA-Cw typing. DNA typing using PCR-SSP technique appears a reliable and practical method for accurate HLA-Cw typing which can contribute to the evaluation of the biological role of the HLA-Cw in transplantation.
Alleles ; Bone Marrow Transplantation ; DNA Fingerprinting ; Gene Frequency ; Graft vs Host Disease ; Histocompatibility Testing ; Immune Sera ; Transplantation ; Transplants

BACKGROUND: The Fas/Fas ligand (FasL) system plays an important role in apoptosis by involvement in various immunologic functions, especially the removal of autoreactive and activated T-cells. sFas is a variant of the Fas receptor molecule, which lacks the transmembrane domain by alternative splicing of Fas mRNA and has an inhibitory effect in apoptosis by inhibition of the Fas/FasL pathway. sFasL is a coverted form of FasL by metalloproteinase and is increased in various malignant and autoimmune diseases. In this study, we investigated the expression of sFas and sFasL in systemic lupus erythematosus (SLE) and evaluated their usefulness as markers of disease activity. MATERIALS AND METHODS: The concentration of sFas and sFasL in sera from 43 patients with SLE, 17 with rheumatoid arthritis (RA) and 15 normal healthy persons were measured using sFas (S) ELISA Kit and sFas Ligand ELISA Kit (MBL Co., LTD., Nagoya, Japan), respectively. Twenty of 43 SLE sera were paired samples of 10 patients obtained on admission and discharge. RESULTS: The concentration of sFas in SLE (3.12 +/- 2.28 ng/mL) was significantly higher than in RA (2.23 +/- 0.37 ng/mL) and in the normal control (2.12 +/- 0.33 ng/mL). In particular, the concentration of sFas in sera on admission (4.35 +/- 3.68 ng/mL) was significantly higher than in the sera on discharge (2.89 +/- 0.66 ng/mL), but, the concentration of sFasL among the 3 groups was not statistically different. CONCLUSIONS: These results suggest that apoptosis is involved in the pathogenesis of SLE and sFas might be a useful marker as a predictor of disease activity. Further study on the correlation between sFas and other disease activity markers, such as CRP, CH50, CD4 cell count and autoantibody titer is needed. Also, the evalution of sFas as a predictor of disease progression on follow-up studies of these patients is needed.
Alternative Splicing ; Antigens, CD95 ; Apoptosis ; Arthritis, Rheumatoid ; Autoimmune Diseases ; CD4 Lymphocyte Count ; Disease Progression ; Enzyme-Linked Immunosorbent Assay ; Fas Ligand Protein* ; Follow-Up Studies ; Humans ; Lupus Erythematosus, Systemic* ; RNA, Messenger ; T-Lymphocytes

BACKGROUND: A two-dose measles vaccination schedule is recommended routinely for either school entry or 11 to 13 years of age in America since 1989. But, several studies were performed on measles antibody in Korea and it remains controversial whether a second dose measles vaccine after 15 months is necessary. To generate baseline data, measles antibody prevalence and its levels according to different age groups in children and young adults in Taejon area were studied. METHODS: A total of 261 subjects at 3 to 21 years of age, who had received a single dose of measles vaccine, were tested for measles antibody by quantitative alpha enzyme immunoassay. The subjects were divided into five age-groups based on the educational system (preschool, elementary school, middle school, high school, young-adult). RESULTS: The seropositivity rates were 97.7% and not significantly different among groups. The expected tendency of declining antibody levels with advancing age, as reported by other studies, was not observed in this study. Except for between Group I and Group II, no significant difference was noted in the antibody levels among the five age groups. Group II showed significantly higher antibody levels than those of Group I (P=0.0025). CONCLUSIONS: No declining tendency of measles antibody levels with advancing age is different from many other studies and contradicts the current recommendations for supplementary vaccinations after 15 months. These might reflect the regional characteristics of the study population in Taejon area and current vaccination rate. Therefore, futher studies with larger population in different geographic regions by quantitative EIA would be needed.
Americas ; Appointments and Schedules ; Child ; Daejeon ; Humans ; Immunoenzyme Techniques ; Korea ; Measles Vaccine ; Measles* ; Prevalence ; Vaccination* ; Young Adult

BACKGROUND: Routine typing for HLA-B27 has been usually accomplished by the microcytotoxicity assay in Korea because it does not require special equipment and is easily reproducible. Recently, an immunofluorescence method and the polymerase chain reaction have also been applied for HLA-B27 testing. However, the current economic crisis in Korea have led domestic manufacturers to develop a Korean HLA-B27 typing kit. The aim of this study was to assess the advantages and disadvantages of this kit and to assess the possibility of replacing the currently used foreign-made kits with this domestic one. METHODS: HLA-B27 testing by the microcytotoxicity test was performed on 116 patients during a period of 3 months in 1998. The Biotest typing tray and the Chongkundang typing tray were tested simultaneously. Results: There was no difference in results in 116 samples (positive: 39, negative: 77). The Korean typing tray showed high false positivity of the negative control well (8 point: 1 case, 6 point: 33 cases, 4 point: 47 cases, 2 point: 17 cases, 1 point: 18 cases) and 6 of the HLA-B27 negative cases showed false positivity in one of the four HLA-B27 wells. Typing of HLA-Bw4 and Bw6 revealed an inconsistency in five and six cases, respectively. CONCLUSIONS: Despite of the false positivity of the negative control in Korean panel, we believe that Korean typing tray can replace the foreign-made tray due to its low cost and adequate performance. Because placenta of Korean multiparous women was used for the kit, Chongkundang typing tray seems to correlate better with Korean HLA-B27 subtypes.
Cytotoxicity Tests, Immunologic ; Female ; Fluorescent Antibody Technique ; HLA-B27 Antigen* ; Humans ; Korea ; Placenta ; Polymerase Chain Reaction

BACKGROUND: Widal test has been one of the most important diagnostic tests for typhoid and is still widely used. Widal test has been useful diagnostic tool for typhoid in endemic areas, while it has been largely abandoned in developed countries. Since 1990, occurrance of typhoid has been markedly decreased in Korea, we studied diagnostic usefulness and criteria of Widal test from 1990 to 1997. METHODS: Using rapid slide titration method (Stained Salmonella suspensions, Murex Biotech Ltd., Dartford, England), the Widal test was done in 116 nontyphoid salmonellosis patients, 75 patients with proven typhoid fever, and 173 cases of clinically suspected typhoid fever patients. Stastical analysis was done with discriminant analysis in culture proven salmonellosis. RESULTS: Fifty-four culture proven cases of Salmonella paratyphi (S. paratyphi) A and S. paratyphi B showed no significant cutoff value in O antibodies. Salmonella typhi (S. typhi) O titer at the 1:160 and above showed lower sensitivity (37.3% vs. 69.3%) and specificity (91.4% vs. 93.1%) compared to S. typhi H titer at the 1:320 and above in diagnosis of culture proven cases of typhoid. We applied D (0.01xH titer+0.001xO titer-1.635) score which result from discriminant analysis. Positive D score (> or =0.21) showed sensitivity of 72% and specificity of 92.2% in culture proven cases of typhoid. In clinically suspected patients, positive D score showed 39.3% of sensitivity. CONCLUSIONS: We concluded that the Widal test for O antibodies of S. paratyphi A and S. paratyphi B is not useful for diagnosis of paratyphoid fever. In the present study S. typhi H antibodies are more diagnostic than S. typhi O antibodies. We appled D score and positive D score showed increased sensitivity of Widal test than application of O antibody titer.
Antibodies ; Developed Countries ; Diagnosis ; Diagnostic Tests, Routine ; Humans ; Korea ; Paratyphoid Fever ; Salmonella ; Salmonella Infections ; Salmonella paratyphi A ; Salmonella typhi ; Sensitivity and Specificity ; Suspensions ; Typhoid Fever