BACKGROUND: The maximal removal rate of indocyanine green (ICG Rmax), which has been used as a useful indicator of quantitative assessment of the hepatic function, has some disadvantages such as high cost, requirement of multiple sampling, and long turn-around time. This study was designed to clarify that the measurement of the lidocaine metabolite, monoethylglycinekylidide (MEGX) test, can replace the ICG Rmax. And in healthy adults, MEGX forma pion was measured and compared according to methods of measurement and serf. METHOD: In 18 patients to whom ICG Rmax test was requested, ICG Rmax test was carried out at two doses of 0.5 mg/kg and 5 mg/kg and MEGX formation after 15 minute of 1 mg/kg lidocaine Injection was measured by fluorescence polarization immunoassay (FPIA) method. The correlation between them was analyzed, To 25 healthy volunteers included in this study as normal control, lidocaine was given intravenously at, a dose of 1 mg/kg and MEGX forma pion was measured IS and 30 minute later (MEGX15, MEGX30) using both high performance liquid chromatography (HPLC) and FPIA methods. RESULT: Patient group resealed significant correlation between ICG Rmax and MEGX15 (r=0.7674, p<0.001) and also between ICG Rl5 and MEGX15 (r=0.5612, p=0.008). There was significant difference between MEGX15 of 9 patients with chronic liver diseases and those of normal controls (22.24+/- 13.18 and 35.40+/- 14.43 ng/mL, respectively) (p=0.01). In normal controls, the correlation between methods was significant (p=0.001) and the values measured by FPIA method was significantly higher than that by HPLG (p(0.001). Of the normal controls, male group had higher MEGX15 values than female group in both methods (in HPLC method 33.89+/-15.95 and 22.53+/- 8.36, and in FPIA method 41.48+/-16.61 and 28.81+/-7.88 ng/mL, respectively), and in female group MEGX30 values was significantly elevated compared to MEGX15 (p<0.001). CONCLUSION: Inferred from the fact that the correlation between ICG Rmax and MEGX was good, MEGX test can be considered a replacement for ICG Rmax. In healthy adults, it is considered that there is serf-related difference In the rate of lidocaine metabolism so we should pay attention to it in interpreting the MEGX results.
Adult ; Chromatography, High Pressure Liquid ; Chromatography, Liquid ; Female ; Fluorescence Polarization Immunoassay ; Healthy Volunteers ; Humans ; Indocyanine Green* ; Lidocaine ; Liver Diseases ; Male ; Mesons ; Metabolism

BACKGROUND: Heparin-induced thrombocytopenia/ thrombosis (HITT) is recognized as the most frequent and fatal symptom complexes in patients receiving heparin therapy. The antibodies of HITT are not directly bound to heparin but bound to complexes of heparin and platelet factor 4 (PF4) derived from platelet alpha-granules. That is, HITT IgG antibody-heparin-PF4 immune complexes are bound to FcgammaRII receptor of platelets, which induced thrombocytopenia. Some researches showed the antibodies reactive to platelets could be IgM or IgA as well as IgG. So in this study, the authors tried to explain the molecular basis of heparin-PF4-isoantibody complexes . METHODS: In HITT patients who had received long-term heparin therapy, we determined HITT isoantibodies and titers using heparin:PF4 ELISA. When fifteen HITT patients with high titer antibodies (more than 1 : 100) were selected, reaction patterns of isoantibodies with the platelets were examined through serotonin release test and flow cytometry. RESULTS: All patients showed one or more isotype antibodies and the most frequent isotype was IgGl (nine patients) . In the presence of optimal concentra pion of heparin and PF4, ten patients had antibodies which activated platelets, and all of them were positive in serotonin release test. Reactive plasmas had IgGl, IgG3, IgA or IgM antibodies, and each of them except one had IgGl. These platelet activations could be blocked in vitro by anti-IV.3 antibody. Non-reactive plasmas were negative In serotonin release assay nor had TgGl. The plasmas 4hat had two or more isoantibodies showed a similar pattern of the IgG antibody by flow cytometry. CONCLUSIONS: The HITT antibodies can be all kinds of antibody isotopes, but IgA and IgM may not bind to the platelets directly. It seems to be possible only after reacting with heparin-PF4-IgG complexes.
Antibodies ; Antigen-Antibody Complex ; Blood Platelets ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Heparin ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Isoantibodies ; Isotopes ; Mesons ; Plasma ; Platelet Activation ; Platelet Factor 4 ; Serotonin ; Thrombocytopenia ; Thrombosis*

BACKGROUND: Peripheral T cell lymphoma (PTCL), a prevalent form of non Hodgkin lymphomas in East Asia, can manifest fever, hepatomegaly, lymphadenopathy, pancytopenia and hemophagocytic histiocytosis (HPH). Similar clinicopathologic findings are also frequently encountered in reactive hemophagocytic syndrome (HPS) and malignant histiocytosis (MH) , thus diagnoses could be confused among them. With recent advancement of immunohistochemlal techniques, diagnostic accuracies have been improved and most cases of MH could have been reclassified as PTCL. In this study, we intended to delineate the lineage of atypical malignant cells in bone marrow of subjects which were previously diagnosed as MH or HPS with immunohlstochemical analysis and characterize clinlcophathologic findings of PTCL associated with HPH in the bone marrow. METHODS: Five cases dignosed as HPS, 3 as MH, 3 as presumed MH, and 7 as PTCL on bone marrow examination were enrolled in this study. We performed immunohistochemical stain for CD45, CD3, CD43, CD2O and CD68, then revised the diagnoses and summarized the clinical and morphologic features of PTCL associated with HPH. RESULTS: Eleven out of 18 cases were confirmed as PTCL which were previously diagnosed as MH(1), presumed MH(3) and PTCL(7). Eight cases of 11 PTCL showed HPH mimicking MH with infiltration of the atypical malignant cells, even if the proportion of atypical malignant cells was small on bone marrow aspirates. They manifested fever and hepatomegaly but didn't have lymphadenopathy at the early stage of disease. Subtypes of PTCL with HPH were PTCL, unspecifed (3), angioimmunoblastic T cell lymphoma (1) and undetermined (4). They showed poorer outcome in 3-month survival rate (25%) than in those with PTCL without HPH(100%). CONCLUSION: These results suggest that PTCL associated with HPH should be excluded from MH by immunohistochemical analysis. Considering that prognosis of PTCL with HPH is very poor, accurate and rapid diagnosis is needed for prompt treatment.
Bone Marrow ; Bone Marrow Examination ; Diagnosis ; Far East ; Fever ; Hepatomegaly ; Histiocytic Sarcoma* ; Histiocytosis* ; Lymphatic Diseases ; Lymphohistiocytosis, Hemophagocytic ; Lymphoma, Non-Hodgkin ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral* ; Pancytopenia ; Prognosis ; Survival Rate

Human parvovirus B19 is a single-strand DNA virus which causes erythema infectlosum, arthralgia, aplastic crisis in patients with red cell defect, chronic anemia in immunocompromised patients, and fetal hydrops in pregnant women . A 16-year-old women was referred to our hospital with pancytopenia and splenomegaly. In peripheral blood, spherocytosis and reitculocytopenia were observed. Many giant pronormoblasts with prominent inclusion bodies and deeply blue cytoplasm were observed but late erythroblasts were not observed in bone marrow smear. Osmotic fragility of patient's red cells was significantly increased. Human parvovirus Bl9 DNA was detected by polymerase chain reaction. Only with supportive therapy, pancytopenia was spontaneously resolved.
Adolescent ; Anemia ; Arthralgia ; Bone Marrow ; Cytoplasm ; DNA ; DNA Viruses ; Erythema ; Erythroblasts ; Female ; Humans* ; Hydrops Fetalis ; Immunocompromised Host ; Inclusion Bodies ; Osmotic Fragility ; Pancytopenia ; Parvovirus B19, Human ; Parvovirus* ; Polymerase Chain Reaction ; Pregnant Women ; Splenomegaly

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

BACKGROUND: Because specific chromosomal abnormalities are associated with certain hematologic disorders, cytogenetic studies can help classifing the diseases, providing the clues of disease progression and being used to monitor remission after chemotherapy. In this study, cytogenetic analysis was performed. In acute and chronic leukemic patients in Korea and the results were compared with foreign cytogenetic reports, and the typical acute lymphocytic leukemia (ALL) and acute myelocytic leukemia (AML) associated chromosome aberrations were analysed by some calculated parameters to clarify if the specific chromosomal abberations in the specific types or subtypes of leukemias had diagnostic value or not. METHOD: Chromosome studies were done in bone marrow or peripheral blood samples by high resolution banding technique. Sensitivity, specificity, and positive and negative predictive values of finding or not finding a given aberration were calculated for followings : for the differential diagnosis between ALL and AML when a patient is known to have acute leukemia, for the differential diagnosis among AML and ALL FAB subtypes in a patient with known AML and ALL. RESULTS: The high positive predictive values (1.0) in the AML versus ALL comparison were found for -7, del(7) (q11-34q22-36), +8s, t(8;21) (q22;q22), t(15;17) (q22;q11), inv (16) (q13;q22) and -Y. Among the AML subtypes, the highest sensitivity, positive and negative predictive values were 0.85, 0.97, 0.94 for t(15;17) (q22;q11) in M3, respectively. The high positive predictive values and specificity in the ALL versus AML comparison were found for t(1;19) (q23;p13) ,t(4;11) (q21 ;23) and t(8; 14) (q24;q32) Among the ALL subtypes, the highest negative predictive value was 0.99 for t (8;14) (q24;q32) in L3. Among 398 CML cases, Philadelphia chromosome positive CML were shown in 81.9% that were classic t(9;22) (q34;all) (94.5%), complex variant traslocation(1.8%) and additional secondary chromosome aberrations (3.7%) . CONCLUSION: Total chromosomal aberration rate in acute and chronic leukemia in Korea was lower than that in foreign reports, but the patterns of chromosome aberrations were similar except for t(15;17) (q22;q11) in AML patients. Quantitativly calculated data of sensitivity, specificity and positive and negative predictive values in the specific chromosomal aberration might be used for diagnostic markers of acute leukemia.
Bone Marrow ; Chromosome Aberrations ; Cytogenetic Analysis ; Cytogenetics* ; Diagnosis, Differential ; Disease Progression ; Drug Therapy ; Humans ; Korea* ; Leukemia ; Leukemia, Myeloid, Acute ; Philadelphia Chromosome ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Sensitivity and Specificity

BACKGROUND: The characteristic t(15; 17) of acute promyelocytic leukemia (APL) fuses the retinoic acid receptor alpha (RARA) gene on chromosome 17 to the PML gene on chromosome 15. The test of PML-RARA rearrangement is essential for diagnosis and therapy of APL. We analyzed breakpoints of the PML gene as a basic study for PML-RARA rearrangement test. METHODS: PML-RARA rearrangements, breakpoints of the PML gene and junction sequences were analyzed in 41 patients with APL using RT-PCR and direct sequencing. RESULTS: Forty out of 41 cases revealed PML-RARA rearrangement, of which results coincided with cytogenetic data. Breakpoint distribution was 26 cases in burl (65%), one in bcr2 (2.5%), and 13 in bcr3 (32.5%). Sequencing data showed invariable joining of exon 3 of the RARA gene and exon 6 (bcrl type) or exon 3 (bcr3 type) of the PML gene. One case with bcr2 type had breakpoint in exon 6 of the PML gene with 57 bp deletion. CONCLUSIONS: Bcrl Is the most common breakpoint site of APL in Koreans, and bcy1+2/bcr3 ratio is approximately 2.1. PML-RARA junctions were continuous and joined by a correct splicing event. Breakpoint analysis would be useful in quality control of PML-RARA rearrangement test and the fused protein analysis.
Chromosomes, Human, Pair 15 ; Chromosomes, Human, Pair 17 ; Cytogenetics ; Diagnosis ; Exons ; Humans ; Leukemia, Promyelocytic, Acute* ; Quality Control ; Receptors, Retinoic Acid

No abstract available.

No abstract available.
Hepacivirus* ; Hepatitis C Antibodies* ; Hepatitis C* ; Hepatitis*

No abstract available.
Busan* ; Cytogenetics*