No abstract available.
Fetus* ; Humans ; Pregnancy, Twin* ; Twins*

No abstract available.
Fetus* ; Humans ; Pregnancy, Twin* ; Twins*

No abstract available.
Tetralogy of Fallot*

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: 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*

Esophageal schwannoma is a very rare neoplasm. The differentiation of schwannoma from the other submucosal tumors such as GISTs or leiomyoma is very difficult to do on the preoperative examination with performing esophagoscopy and computed tomography. The diagnosis is generally not confirmed until the histologic and immunohistochemical tests of the tumor are performed. A 38- year-old man presented to us with neck discomfort. The endoscopy showed a middle esophageal submucosal tumor that measured 12 mm in size and there were no mucosal changes. The endoscopic ultrasonography showed a tumor in the muscluaris mucosa layer without lymphadenopathy. After band ligation of the lower part of the tumor, it was removed by performing endoscopic mucosal resection and using a snare. A definitive diagnosis of esophageal benign schwannoma was made from the pathologic findings, which included positive immunohistochemical staining for S-100 protein and negative staining for C-kit, CD34 and actin. We report here on an esophageal benign schwannoma that was removed by endoscopic mucosal resection.
Actins ; Endoscopy ; Endosonography ; Esophagoscopy ; Leiomyoma ; Ligation ; Lymphatic Diseases ; Mucous Membrane ; Neck ; Negative Staining ; Neurilemmoma ; S100 Proteins ; SNARE Proteins

BACKGROUND: CD56 is generally considered to be a natural killer (NK) cell marker, but it is also found in various tissues including acute leukemia. Recently, some reports have showed that positive CD56staining by blast cells is associated with an unfavorable outcome in AML with either t(8;21) or t(15;17)and in some ALL. This study investigated the characteristics of morphology, immunophenotype and cytogenetics and correlated the expression of CD56 of blast cells in 262 acute leukemia patients. METHODS: We analyzed 153 AML and 109 ALL, who underwent flow cytometry for CD56 at diagnosis at Chonnam National University Hospital between January 1999 and May 2003, for morphology, immunophenotype, and cytogenetics, retrospectively. RESULTS: The CD56 antigen was positive in 47 out of 163 AML cases (28.8%) and in 4 out of 109 ALL cases (3.7%). There were no statistically significant differences in the hematological parameters between the CD56+ and CD56- groups in ALL. However, the CD56 expression in AML was significantly high (81.8%) in AML-M2 with t(8;21) and low (5%) in AML-M3 with t(15;17) and was associatedwith the frequent expression of CD34 and HLA-DR. CONCLUSIONS: In conclusion, the CD56 expression in AML is associated with specific translocation, FAB subtype, some antigens CD34 and HLA-DR, and is significantly higher than in ALL.
Antigens, CD56 ; Cytogenetics* ; Diagnosis ; Flow Cytometry ; HLA-DR Antigens ; Humans ; Immunophenotyping ; Jeollanam-do ; Leukemia* ; Retrospective Studies

BACKGROUND: After a zealous advocates of granulocyte transfusion therapy (GTX) in the 1970s and early 1980s, the use of GTX has diminished strikingly because of the several problems of GTX and the introduction of new antimicrobial agents and recombinant hematopoietic growth factors. Recently, GTX offers renewed interest because several investigators reported the transfusion efficacy of granulocytes collected by stimulating normal donors with recombinant human granulocyte-colony stimulating factor (G-CSF). METHODS: To evaluate the safety and efficacy of GTX, thirteen patients with neutropenia- related infections at Chonnam University Hospital from March 1997 to February 1998 were treated with dexamethasone- or G-CSF-stimulated granulocyte transfusions apheresed from normal donor. RESULTS: Patients received a mean number of 2.4 transfusions (range, 1-7) and a mean dose of 5.5x1010 granulocytes (range, 0.2-19.6). Six patients (46.2%) had favorable responses. Favorable responses occurred among patients with more fungal infection than bacterial infection (71.4 vs 28.6%, P<0.05) and more increment of absolute neutrophil count at 1 hour after transfusion (P<0.05). Adverse reactions of GTX were pulmonary edema in 2 patient (15.4%) and transient hypoxia in 1 patient (7.7%). One patient (7.7%) with pulmonary edema died of severe pulmonary reaction. Two of 20 donors received by G-CSF complained of mild myalgia and bone pain. CONCLUSION: G-CSF- or dexamethasone-stimulated GTXs were well tolerated and may be clinically beneficial for neutropenia-related infection, particularly in fungal infection, that is refractory to antimicrobial therapy.
Anoxia ; Anti-Infective Agents ; Bacterial Infections ; Granulocyte Colony-Stimulating Factor ; Granulocytes* ; Humans ; Intercellular Signaling Peptides and Proteins ; Jeollanam-do ; Myalgia ; Neutropenia ; Neutrophils ; Pulmonary Edema ; Research Personnel ; Tissue Donors