We report a case of B-cell chronic lymphocytic leukemia (CLL) with trisomy 12 detected by FISH using chromosome 12 alpha-satellite Probe (Oncor , USA) in uncultured interphase cells. Chromosome studies did not produce an analyzable metaphase by standard short term culture and revealed only normal female karyotype by B cell mitogen (phorbol 12-myristate 13-acetate) stimulated 96 hr culture. The patient, a 59-year-old female, did not have hepatomegaly, splenomegaly, lymphadenopathy and any other symptoms. The peripheral blood of the patient showed marked lymphocytosis (WBC : 28,300/microL, Lymphocyte: 80%) and the diagnosis by immunophenotyping was B cell CLL:CD5, CDl9, CD2O, SmIg, HLA-DR positive.
Chromosomes, Human, Pair 12 ; Diagnosis ; Female ; Fluorescence* ; Hepatomegaly ; HLA-DR Antigens ; Humans ; Immunophenotyping ; In Situ Hybridization* ; Interphase ; Karyotype ; Leukemia, Lymphocytic, Chronic, B-Cell* ; Lymphatic Diseases ; Lymphocytes ; Lymphocytosis ; Metaphase ; Middle Aged ; Splenomegaly ; Trisomy*

We report a case of B-cell chronic lymphocytic leukemia (CLL) with trisomy 12 detected by FISH using chromosome 12 alpha-satellite Probe (Oncor , USA) in uncultured interphase cells. Chromosome studies did not produce an analyzable metaphase by standard short term culture and revealed only normal female karyotype by B cell mitogen (phorbol 12-myristate 13-acetate) stimulated 96 hr culture. The patient, a 59-year-old female, did not have hepatomegaly, splenomegaly, lymphadenopathy and any other symptoms. The peripheral blood of the patient showed marked lymphocytosis (WBC : 28,300/microL, Lymphocyte: 80%) and the diagnosis by immunophenotyping was B cell CLL:CD5, CDl9, CD2O, SmIg, HLA-DR positive.
Chromosomes, Human, Pair 12 ; Diagnosis ; Female ; Fluorescence* ; Hepatomegaly ; HLA-DR Antigens ; Humans ; Immunophenotyping ; In Situ Hybridization* ; Interphase ; Karyotype ; Leukemia, Lymphocytic, Chronic, B-Cell* ; Lymphatic Diseases ; Lymphocytes ; Lymphocytosis ; Metaphase ; Middle Aged ; Splenomegaly ; Trisomy*

BACKGROUND: Propofol and lidocaine have been purported to attenuate bronchoconstriction induced by fentanyl administration during induction of anesthesia. The purpose of the present study was to study the synergic bronchodilation effect of propofol mixed with lidocaine. METHODS: Two hundred and thirty four patients were randomly allocated to five groups: Group 1 (n = 60, normal saline 0.25 ml/kg followed by fentanyl 3ng/kg), Group 2 (n = 30, propofol 2 mg/kg mixed with normal saline 0.05 ml/kg followed by normal saline 0.06 ml/kg), Group 3 (n = 50, propofol 2 mg/kg mixed with normal saline 0.05 ml/kg followed by fentanyl 3ng/kg), Group 4 (n = 33, propofol 2 mg/kg mixed with lidocaine 1 mg/kg followed by normal saline 0.06 ml/kg) and Group 5 (n = 61, propofol 2 mg/kg mixed with lidocaine 1 mg/kg followed by fentanyl 3ng/kg). All patients were injected with fentanyl or normal saline two minutes after administration of propofol premixed with lidocaine or normal saline, respectively. We checked the cough reflex, injection pain, oxygen desaturation and chest wall rigidity. RESULTS: There was a significant difference in the incidence of cough reflex between group 1 and 3 or 5. The incidience of group 5 was significantly lower than in group 3. CONCLUSIONS: This study suggests that a propofol-lidocaine mixture should be considered when patients require bronchodilation during induction of anesthesia.
Anesthesia ; Bronchoconstriction ; Cough* ; Fentanyl* ; Humans ; Incidence ; Lidocaine* ; Oxygen ; Propofol* ; Reflex* ; Thoracic Wall

BACKGROUND: Several methods have been used to evaluate the engraftment and to monitor residual disease after bone marrow transplantation (BMT). Among them, karyotyping have been useful in gauging engraftment following opposite sex BMT. More recently, fluorescence in situ hybridization (FISH) has also been applied to determine engraftment and residual status. In order to establish the utility of this method in clinical practice, we have evaluated the data from FISH and several methods. METHODS: We performed FISH using chromosome X alpha-satellite probe (Oncor , USA) on twenty eight peripheral blood and nine bone marrow nuclear cells from eleven patients who underwent sex mis-matched transplant and from a patient who had a loss of X chromosome. RESULTS: In nine patients with well engrafted BMT, signals of host cells showed less than 5% in all patients, evaluated 21-210 days post-transplant. Mixed chimerism was detected in six patients; transiently in early post-transplant period in four, in a patient with engraftment failure, and in a patient with relapse, respectively. CONCLUSION: FISH using X probe is a rapid, quantitative and sensitive 'interphase cytogenetic method' for the evaluation of engraftment and monitoring of residual disease following sex mis-matched BMT or BMT in a patient with a loss of X chromosome; It is especially useful in early post-transplant period when ony a few cells are available during severe cytopenia.
Bone Marrow Transplantation* ; Bone Marrow* ; Chimerism ; Cytogenetics ; Fluorescence* ; Humans ; In Situ Hybridization* ; Karyotyping ; Recurrence ; X Chromosome

No abstract available.
Trisomy* ; Ultrasonography*

No abstract available.
Pregnancy*

BACKGROUND: Colonoscopy is a very effective and essential examination to diagnose colorectal cancer; however, many patients experience discomfort due to post-examination abdominal pain, which reduces colonoscopy compliance. This study was conducted to determine methods for reducing post-colonoscopic abdominal pain. METHODS: We conducted a randomized controlled study of 405 male and female adults who visited Hana General Hospital in Cheongju. We surveyed general characteristics, history of colonoscopy, and other related factors, then categorized examinees into 5 groups (0-5) according to the site of scope reinsertion. Pain was measured using a numeric rating scale (NRS). RESULTS: The mean age of examinees in this study was 47.8 years, and 210 participants had prior experience of colonoscopy. No significant difference was observed between variables, with the exception of reinsertion duration (P=0.005). Pain scores were different between performing physicians (P=0.006), and were higher when the subjective level of procedure difficulty was low (P=0.026) in univariate analysis. Pain scores decreased as the reinsertion site became closer to the proximal colon (P<0.001), but there was no significant difference between groups 3 and 4. The results of multiple logistic regression analysis, including univariate analysis, showed that group 1 had 0.48 times, group 2 had 0.38 times, group 3 had 0.09 times, and group 4 had 0.03 times odds ratio (moderate-to-severe pain, NRS ≥4) than control group 0. CONCLUSION: Air decompression by scope reinsertion is an effective way to reduce abdominal pain after colonoscopy. Removing air when the reinserted scope approaches the hepatic flexure seems to be the most effective method to reduce post-colonoscopic pain.
Abdominal Pain ; Adult ; Chungcheongbuk-do ; Colon ; Colonoscopy ; Colorectal Neoplasms ; Compliance ; Decompression* ; Female ; Hospitals, General ; Humans ; Logistic Models ; Male ; Methods ; Odds Ratio

BACKGROUND: Vancomycin-resistant enterococci (VRE) have been increasingly reported worldwide. The understanding of VRE dissemination in the hospital requires a molecular typing of the strains. VRE appeared recently in Chonnam University Hospital. The purpose of this study is to analyse the strains for their genetic relatedness. METHODS: Nine vancomycin-resistant E. faecium isolates, collected from six patients during 1995-1996 in Chonnam University Hospital, were typed using plasmid DNA and RAPD analyses. The plasmid DNA of the isolates was obtained by a alkaline lysis method. For RAPD, eight random primers were used. The cluster analysis was performed by NTSYS-pc (numerical taxonomy system and multivariate analysis system, version 1.50, Applied Biostatistics Inc., CA). RESULTS: Nine VRE isolates were separated into two different molecular types (group A and B) by the plasmid DNA patterns, which were agreed with the RAPD results: the isolates of each group showed the same plasmid DNA patterns and high similarity values in the RAPD analysis. Group A was consisted of two strains isolated from two patients who were admitted at the same room in May 1995. Seven strains of group B were isolated from four patients in the different wards during June 1995 to June 1996. CONCLUSIONS: Nine VRE isolates from six patients were typed to two groups by plasmid DNA or RAPD analysis. These results suggested the intrahospital spread of two clonal strains of vancomycin-resistant E. faecium.
Biostatistics ; Classification ; DNA* ; Enterococcus faecium* ; Enterococcus* ; Humans ; Jeollanam-do ; Molecular Typing ; Multivariate Analysis ; Plasmids*

BACKGROUND: The effect of opioids on nitric oxide (NO)- and peroxynitrite-induced neuronal cell death is largely unknown. In the present study, we examined the effect of morphine on NO- and peroxynitrite-induced cell death using a human neuroblastoma SH-SY5Y cell line, which abundantly expresses micro, delta, kappa-opioid receptors. METHODS: The cultured cells were pretreated with morphine and exposed to 3-morpholinosydnonimine (SIN-1) that simultaneously generates NO and superoxide, thus possibly forming peroxynitrite. The cell damage was assessed by using MTT assay and crystal violet staining. Morphological nuclear changes and enzymatic evidences of apoptosis of the cells after exposure to SIN-1 for 24 hours were evaluated by using 4', 6-diamidino-2-phenylindole (DAPI) staining and the measurement of pro-apoptotic protease (caspase-3) activity, respectively. Levels of reduced glutathion (GSH) were measured by monochloronimane (MCB) assay. RESULTS: Pretreatment of SH-SY5Y with morphine significantly inhibited the apoptotic cell death. Morphine also inhibited SIN-1-induced caspase-3 (pro-apoptotic protease) activity in a dose-dependent manner. However, naloxone (20 microM) could not antagonize completely the effect of morphine in SIN- 1-induced cell death. Pre-administered GSH and N-acetylcysteine (NAC) have been found to protect SIN-induced apoptosis, and the neuroblastoma cells treated with morphine had significantly elevated the levels of GSH. CONCLUSIONS: The present study shows that morphine protects the human neuroblastoma cell line SH- SY5Y from peroxynitrite-induced apoptotic cell death through elevated GSH levels. The protective actionof morphine seems to be associated with inhibition of the apoptotic pathway. However, it is suggested that morphine protects the cells possibly via other unknown mechanisms in addition to the activation of opioid receptors.
Acetylcysteine ; Analgesics, Opioid ; Apoptosis* ; Caspase 3 ; Cell Death ; Cell Line ; Cells, Cultured ; Gentian Violet ; Humans* ; Morphine* ; Naloxone ; Neuroblastoma* ; Neurons ; Nitric Oxide ; Peroxynitrous Acid ; Receptors, Opioid ; Superoxides

The purpose of this study was to evaluate the relationship between umbilical coiling index and Doppler velocimetry in umbilical artery. The umbilical coiling index was calculated by dividing the total number of helices by the entire cord length(in centimeter) postnatally between December 1995 and March 1996. Doppler flow velocities were obtained from the umbilical artery bifore delivery( within 3 days). The mean umbilical coiling index was 0.17 +/- 0.09 )n=186). The subjects with umbilical coiling indices below the tenth percentile(0.08), above the 90th percentile(0.3), and between the tenth and 90th percentile were defined as hypocoiled, hypercoiled, and normocoiled. The subjects with hypocoiled and hypercoiled cords did not differ from those with normocoiled cords in perinatal outcomes. The correlations between umbilical coiling index and umnilical artery systolic-diastolic ratio were not significang(r=0.015, p < 0.05). The subjects with umbilical artery systolic-diastolic ratio above 90th percentile(3.0) differed from those with below 90th percentile in several ways : fetal heart rate disturbances, birth weight, intrauterine growth retardation and admission to intensive care unit were higher in high S-D ratio group. This study suggest that the umbilical coiling level dose not interfere umbilical aretery flow.
Arteries ; Birth Weight ; Female ; Fetal Growth Retardation ; Heart Rate, Fetal ; Intensive Care Units ; Pregnancy ; Rheology* ; Umbilical Arteries