No abstract available.
Humans ; Infant, Newborn* ; Intracranial Hemorrhages* ; Vitamin K* ; Vitamins*

No abstract available.
Dermatomyositis*

No abstract available.
Child* ; Endoscopy* ; Gastrointestinal Diseases* ; Humans

BACKGROUND: Human cancel can be induced by various environmental factors such as virus, chemicals, and radiations. However, susceptibility of host to these environmental factors is not well studied. The purpose of this study was to investigate the chromosomal vulnerability to gamma-1rradiation of peripheral blood lymphocytes in patients with luring, gastric, and liver cancer. METHODS: Micronuclei (MN) test was done in 15 patients with gastric cancer, 18 patients with lung cancer, and 20 normal controls. Sister chromatid exchange (SCE) test was done in 13 patients with hepatocellular cancer and 14 normal controls. RESULTS: The baseline frequency of MN before irradiation in patients with lung cancer and gastric cancel was significantly higher than in controls (47+/-8, 73+/-9, and 8+/-l, respectively; p<0.01). After gamma-irradiation, the frequency of MN was also significantly higher than in controls (223+/-19, 269+/-43, and 285+/-56, respectively; p<0.05). The frequency of SCE in Patients with hepatocellular cancer was significantly higher her than in controls (9.0+/-0.6, 4.3+/-0.7, respectively; p<0.001). CONCLUSIONS: From this preliminay data, we concluded that chromosomes of peripheyal blood lymphocytes in patients with various cancers were more vulnerable to gamma-irradiation as compared to normal controls.
Humans ; Liver Neoplasms ; Lung Neoplasms ; Lymphocytes* ; Sister Chromatid Exchange ; Stomach Neoplasms

BACKGROUND: We evaluated the Vitros 950 (Johnson & Johnson Clinical Diagnostics, Inc., NY, USA) in the measurement of digoxin and theophylline levels and compared its results to those of the TDxFLx II (Abbott Laboratories, IL, USA) used for therapeutic drug monitoring (TDM) world-widely in order to assess the utility of the Vitros 950 as a TDM instrument. METHODS: From June 1997 to August 1997, 125 and 135 candidates for TDM were randomly chosen to measure digoxin and theophylline, respectively, using the Vitros 950 and TDxFLx II. The relationship between its results and those of TDxFLx II were determined. The within-run and between-run precisions of the Vitros 950 were determined using two controls (Vitros Performance Verifier I and II; J & J Clinical Diagnostics, Inc., NY, USA). The high-concentration control (Vitros Performance Verifier II) was diluted in Vitros 7% BSA to 5 dilutions. And linearity for quantitative analysis of digoxin and theophylline were determined. RESULTS: The coefficients of variation (CV) for the within-run of the Vitro 950 were 0.8% - 4.4%. And the CV for between-run precision of the Vitro 950 were 1.7% - 12.3%. The linearity of digoxin and theophylline were relatively good. The correlations (r) of digoxin and theophylline levels with those determined by the Abbott TDxFLx II were 0.95 and 0.93, respectively (P <0.001). CONCLUSIONS: The recently developed dry slide method of the Vitros 950 proves to good precision and linearity for quantitative analysis of digoxin and theophylline. Its results correlate well with those of the TDxFLx II. The Vitros 950 does not require an elaborate preparatory protocol for the sample, and is easy to use and maintain.So it is considered a highly feasible instrument for stat test.
Digoxin* ; Drug Monitoring ; Theophylline*

BACKGROUND: Peripheral blood stem cell transplantation (PBSCT) has been widely used as a substi-tute of bone marrow transplantation for the treatment of various solid tumors or hematologic malig-nancies. The success of PBSCT is correlated with peripheral blood CD34+ cell count per kilogram of the recipient body weight. Standardization of flow cytometric CD34+ cell enumeration was improved by the modified International Society of Hematotherapy and Gene Engineering (ISHAGE) protocol. The purpose of this study was to evaluate the peripheral parameters (WBCs, mononuclear cells, the CD 34+ cells) that may predict the total CD34+ cell count in the harvest product, using the Stem-Kit (Beck-man Coulter Inc., Fullerton, CA, USA). METHODS: The study tested 88 PBSC harvests and peripheral blood (PB) on the day before collection from 26 patients. The CD34+ cells were analyzed using the Stem-Kit. The WBC and MNC count were measured by Coulter STKS (Beckman Coulter Inc.). The correlation and regression analysis between peripheral parameters (WBCs, MNCs, CD34+ cells) and the total CD34+ cell count in the harvest product were performed. RESULTS: The CD34+ cell count per weight (kg) of 88 PBSC harvests was 1.59 +/- 2.61 (0.01 -17.35). The mean number of WBC, MNC, and CD34+ cell in PB prior to harvest were 10.57 +/- 8.36 (1.50 - 32.50) X 10(3)/micro L, 1.85 +/- 1.28 (0.39- 7.43) X 10(3)/micro L, and 17.21 +/- 33.19 (0.12-239.19)/micro L, respectively. With the CD34+ cells numbering under 3/micro L in peripheral blood (PB), we could not harvest more than 0.5 X 10(6) /kg PBSC. With the cells numbering 3-6/micro L (59%) and 10- 20/micro L (89%), however, we could harvest more than 0.5 X 10(6) /kg and 1.0 X 10(6) /kg, respectively. More than 2.0 X 10(6)/kg of PBSC was collected with 10-20/micro L (31%). The peripheral blood CD34+ cell count prior to harvest significantly correlated with the total CD34+ cell count in the harvest product (r=0.97, P<0.05). CONCLUSIONS: Peripheral blood CD34+ cell enumeration using the Stem-Kit was an efficient predictor of when to harvest peripheral blood stem cells after mobilization therapy. We could not collected the CD34+ cell in harvest product of more than 0.5 X 10(6)/kg if the peripheral blood CD34+ cell count was less than 3/micro L.
Body Weight ; Bone Marrow Transplantation ; Cell Count* ; Humans ; Peripheral Blood Stem Cell Transplantation ; Stem Cells*

BACKGROUND: Optimal use of tricyclic antidepressants (TCAs) requires serum monitoring to determine if the appropriate therapeutic range has been attained and to assess possible side effects. This study was to evaluate the resolution capacity of the following four mobile phases which were previously reported; mobile phase I (methanol, acetonitrile and 5 mmol/L Na2HPO4: 41/15/44 by volume), II (methanol, acetonitrile and 5 mmol/L Na2HPO4,: 15/60/25 by volume), III (acetonitrile and 2-propanol: 95/5 by volume) and IV (methanol and n-butylamine: 99.5/0.5 by volume). METHODS: Amitriptyline (AT), nortriptyline (NT), imipramine (IMI) and doxepin (DOX) were used for the selection of appropriate mobile phase in high performance liquid chromatographic (HPLC) determination. TCAs were extracted from serum with hexane, isoamyl alcohol (99:1). The drug was re-extracted into 0.1 N HCl and an aliquot was injected into the HPLC. The analytical column was C-18 reversed phase column (3.9 mm x 30 cm; Waters, USA) with the flow rate of 1.5 mL/min. The UV detector signal was monitored at 254 nm. RESULTS: Mobile phase I disclosed 9.8-15.8 retention time (min), 5.1-8.8 capacity ratio and 1.0-2.2 resolution factors for the above four TCAs. Precision studies using this mobile phase demonstrated a coefficient variation of 2.4-4.7% in the concentration range of 500-125 ng/mL. Analytical recovery of AT and IMI was 85-90% at a concentration of 125 ng/mL and 250 ng/mL. CONCLUSIONS: Mobile phase I provided a reliable and excellent resolution of TCAs in the use of HPLC with the C-18 reversed phase column and UV absorbance detector.
2-Propanol ; Amitriptyline ; Antidepressive Agents, Tricyclic* ; Chromatography, High Pressure Liquid ; Doxepin ; Imipramine ; Nortriptyline

Cryptococcus laurentii is one of several non-neoformans cryptococci that have rarely been associated with human infection. Candida zeylanoides, an unusual Candida species, is also infrequently reported as a human pathogen. We report a case of mixed fungemia with C. laurentii and C. zeylanoides in a 12-year-old girl. The patient with acute myelogenous leukemia was receiving intensive remission induction chemotherapy through a central venous catheter (CVC) and was severely neutropenic. She had been treated with oral fluconazole prophylaxis since admission. C. laurentii and C. zeylanoides were simultaneously isolated from the peripheral blood cultures collected on days 29 and 31 of her hospital stay. The culture of the removed catheter tip grew >15 CFU of both C. laurentii and C. zeylanoides. In vitro susceptibility testing of the strains showed that the MIC of fluconazole for C. laurentii and C. zeylanoides were 8 microgram/mL and 4 microgram/mL, respectively. The patient was successfully treated by CVC removal and by treatment with amphotericin B intravenously. To our knowledge, this represents the first report of C. laurentii and C. zeylanoides fungemia in Korea.
Amphotericin B ; Candida* ; Catheters ; Central Venous Catheters ; Child ; Cryptococcus* ; Drug Therapy ; Female ; Fluconazole ; Fungemia* ; Humans ; Korea ; Length of Stay ; Leukemia, Myeloid, Acute ; Remission Induction

BACKGROUND: Human cytomegalovirus (CMV) infections are common and occasionally severe in newborns, immunocompromised hosts, cancer patients, and recipients of organ transplant. Consequently, sensitive and rapid methods for CMV detection are of great diagnostic value since antiviral drugs have become available, which might be more effective upon early administration. We evaluated a polymerase chain reaction and enzyme-linked immunosorbent assay (PCR- ELISA) to detect human CMV infection as an aid in making a prompt diagnosis and a determination of therapeutic efficacy. METHODS: CMV DNA was amplified by single PCR, using primers chosen from genomic regions (major immediate-early [MIE] protein coding region), and the microwell plate hybridization assay was performed for specific detection of 5'-biotinylated PCR products using CMV-specific probes labeled with digoxigenin. A total of 35 clinical specimens from 14 patients who were suspected CMV infectious state was analyzed by PCR-ELISA and its results were compared with those of serum anti-CMV IgM, shell vial culture assay and PCR. RESULTS: The sensitivity for detection of PCR-amplified CMV DNA by the ELISA was 102 copies, which was ten-fold greater than ethidium bromide staining of agarose gels. The positive rates of 35 clinical specimens by serology, shell vial culture assay, PCR and PCR-ELISA were 37.9%, 40.0%, 60.0% and 68.6%, respectively. The OD ranges of 24 positive specimens by PCR-ELISA were from 0.042 to above 2.5. In follow-up studies of two patients with bone marrow transplantation, positive CMV results by PCR-ELISA earlier than by other methods including serologic method, shell vial culture assay and PCR. CONCLUSIONS: These results reveal that PCR-ELISA may show higher sensitivity and positive rate than serologic method, shell vial culture assay and conventional PCR. PCR-ELISA can be useful to manage CMV infection rapidly in patients at risk.
Antiviral Agents ; Bone Marrow Transplantation ; Clinical Coding ; Cytomegalovirus* ; Diagnosis ; Digoxigenin ; DNA* ; Enzyme-Linked Immunosorbent Assay ; Ethidium ; Follow-Up Studies ; Gels ; Humans* ; Immunocompromised Host ; Immunoglobulin M ; Infant, Newborn ; Polymerase Chain Reaction ; Sepharose ; Transplants

BACKGROUND: Despite the recognized increase of frequency of candiduria due to Candida tropicalis, little was known of its molecular epidemiology. We applied PFGE and RAPD assay for urinary C. tropicalis isolates and evaluated the utilities of PFGE and RAPD for the epidemiological typing of C. tropicalis isolates. METHODS: A total of urinary 57 isolates of C. tropicalis from 40 patients at two hospitals was analyzed. PFGE analysis were performed by electrophoretic karyotyping (EK) and restriction endonuclease analysis of genomic DNA (REAG) using two restriction enzymes (BssHII and SfiI). For RAPD, a total of 31 primers (30 random 10-mer primers and M13 primer) were used. RESULTS: EK and RAPD analysis showed the same or similar patterns among the isolates. REAG with BssHII separated 57 isolates into 28 distinct types. Six patterns were generated by REAG with using SfiI. By combining the two REAG, a total of 31 different DNA types were identified among 57 isolates from 40 patients. Three strain types were common to 23 isolates from 12 patients of a University Hospital, which suggested possible nosocomial transmission. In 19 patients with serial urinary isolates, the sequential strains from each patient exhibited the same REAG pattern. CONCLUSION: These suggest that REAG with BssHII and SfiI is useful for the investigation of molecular epidemiology of C. tropicalis isolates. In addition, some clusters of C. tropicalis isolates with the same DNA type suggest that nosocomial transmission may occur.
Candida tropicalis* ; Candida* ; DNA Restriction Enzymes ; DNA* ; Electrophoresis, Gel, Pulsed-Field* ; Humans ; Karyotyping ; Molecular Epidemiology ; Molecular Typing*