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

PURPOSE: The purpose of the study was to identify the optimal cutoff values of indices for cardiometabolic risk in postmenopausal Korean women. Specifically, we intended to determine the cutoffs of waist circumference, waist-to-hip ratio (WHR), serum lipid profile, and homeostatic model of assessment-insulin resistance (HOMA-IR) for detecting metabolic syndrome (MetS), and metabolic obesity (MO). METHODS: The study participants were 397 postmenopausal women. We defined MetS and MO with the International Diabetes Federation criteria except for waist circumference. A receive operating characteristic curve analysis was used to assess the accuracy of diagnostic indices for identifying MetS and MO. Cutoff values were obtained both from the point on the receive operating characteristic curve which was closest to (0,1) and from the Youden's index. RESULTS: Among the participants, 34.5% and 73% were classified as having MetS and MO. The optimal cutoff of waist circumference and WHR were 81.9 cm [area under curve (AUC): 0.687, sensitivity: 61.7%, specificity: 68.9%], 0.87 (AUC: 0.660, sensitivity: 64.7%, Specificity: 60.2%) for MetS and 77.4 cm (AUC: 0.655, sensitivity: 65.6%, specificity: 57.8%), 0.86 (AUC: 0.680, sensitivity: 67.0%, specificity: 62.7%) for MO. Triglyceride to high-density lipoprotein ratio for MetS and MO were 2.11 (AUC: 0.838, sensitivity: 71.5%, specificity: 79.6%) and 1.59 (AUC: 0.725, sensitivity: 65.9%, specificity: 68.2%) respectively. The HOMA-IR for MetS was 1.36 (AUC: 0.773, sensitivity: 73%, specificity: 71.9%) and for MO was 1.17 (AUC: 0.713, sensitivity: 64.5%, specificity: 69.2%). CONCLUSIONS: For postmenopausal women, we suggest waist circumference of 81.9 cm and WHR of 0.87 as criteria of MetS. However, women with waist circumference over 77.4 cm and WHR over 0.86 should be monitored for the future development of MetS.
Female ; Humans ; Lipoproteins ; Menopause ; Obesity ; Obesity, Abdominal ; Sensitivity and Specificity ; Triglycerides ; Waist Circumference ; Waist-Hip Ratio

BACKGROUND: Chromosomal aberration observed only in a few metaphases may cause the cytogeneticists to have difficulties in making a decision whether it is due to in vivo mosaicism/multiple clones or due to in vitro artifact. This is especially important when the chromosome of concern has been associated with a classical chromosome syndrome, malignancy or its evolution. Therefore, we aimed to establish a range for random chromosomal aberrations among cells from PHA-stimulated blood(PB) and bone marrow(BM) cultures. METHODS: Among the cells from 449 PB and 472 BM specimens referred for chromosome studies from 1997 to 1998, we analyzed the frequency of random aneuploidy, structural abnormalities, and breaks/gaps. RESULTS: The number of cells analyzed was 5,904/4,488(1997/1998) in PB and 4,211/4,124(1997/1998) in BM. The frequency of metaphases with random chromosomal aberrations of BM(32.10%) was much higher than that of PB(5.90%). The most frequent aberration was chromsome loss. Autosome losses were inversely correlated with autosome size(correlation coefficient = -0.83 and -0.72, p<0.01), smaller chromosomes being lost more frequently while autosome breaks/gaps were correlated with autosome size(correlation coefficient = 0.69 and 0.85, p<0.01), in PB and BM. Comparing the data from 1998 to the data from 1997, the frequency of chromosome losses(<0.5% in PB, <2.25% in BM), gains(<0.1% in PB and BM), breaks/gaps(<0.1% in PB, <0.25% in BM), and structural aberrations( Aneuploidy ; Artifacts ; Bone Marrow* ; Chromosome Aberrations* ; Chromosomes, Human, 4-5 ; Clone Cells ; Metaphase ; Quality Control

A 36 year old infertile was diagnosed endometrial adenocarcinoma by endometrial biopy due to vaginal bleeding. She was characterized by obesity, hirsutism and infertility. Diagnosis was confirmed endometrial adenocarcinoma(Geade I) associated with polycystic ovarian disease postoperatively. We experienced this case and so report this case with a brief review of literatures.
Adenocarcinoma* ; Adult ; Diagnosis ; Female ; Hirsutism ; Humans ; Infertility ; Obesity ; Ovarian Diseases* ; Uterine Hemorrhage

Neonatal alloimmune thrombocytopenia(NAIT) is a rare disease caused by maternal alloimmunization against fetal platelet surface antigen, which is mainly platelet specific alloantigen or human leukocyte antigen(HLA). During routine hemotology, we accidentally discovered thrombocytopenia in a female fullterm newborn admitted due to jaundice. We excluded NAIT due to human platelet alloantigen(HPA), because the HPA of the mother and baby were the same on PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism). Mother's serum was tested for lyrnphocytotoxity against 36 donor lymphocytes, and anti-HLA A2, A24 and B58 were found. HLA typing of the father and baby revealed A2 antigen which was not present on the mothers lymphocytes. The patient received concentrated platelet and intravenous globulin. Her platelet count increased to 222,000/mm from 3,000/mm on the 11th day of life. We described a case of NAIT due to anti-HLA A2 antibody with a detailed clinical feature. (J Korean Pediatr Soc 1999;43:861-865)
Antigens, Surface ; Blood Platelets ; Fathers ; Female ; Histocompatibility Testing ; Humans ; Infant, Newborn ; Isoantigens ; Jaundice ; Leukocytes ; Lymphocytes ; Mothers ; Platelet Count ; Rare Diseases ; Thrombocytopenia ; Thrombocytopenia, Neonatal Alloimmune* ; Tissue Donors

No abstract available.

OBJECTIVES: The objective of this study was to evaluate the thermic effects, the macronutrient oxidation rates and the satiety of medium-chain triglycerides (MCT). METHODS: The thermic effects of two meals containing MCT or long-chain triglycerides (LCT) were compared in ten healthy men (mean age 24.4 +/- 2.9 years). Energy content of the meal was 30% of resting metabolic rate of each subject. Metabolic rate and macronutrient oxidation rate were measured before the meals and for 6 hours after the meals by indirect calorimetry. Satiety was estimated by using visual analogue scales (VAS) at 8 times (before the meal and for 6 hours after meal). RESULTS: Total thermic effect of MCT meal (42.8 kcal, 8.0% of energy intake) was significantly higher than that (26.8 kcal, 5.1% of energy intake) of the LCT meal. Mean postprandial oxygen consumption was also significantly different between the two types of meals (MCT meal: 0.29 +/- 0.35 L/min, LCT meal: 0.28 +/- 0.27 L/min). There were no significant differences in total postprandial carbohydrate and fat oxidation rates between the two meals. However, from 30 to 120 minutes after consumption of meals, the fat oxidation rate of MCT meal was significantly higher than that of the LCT meal. Comparison of satiety values (hunger, fullness and appetite) between the two meals showed that MCT meal maintained satiety for a longer time than the LCT meal. CONCLUSIONS: This study showed the possibility that long-term substitution of MCT for LCT would produce weight loss if energy intake remained constant.
Calorimetry, Indirect ; Energy Intake ; Humans ; Male ; Meals ; Oxygen Consumption ; Triglycerides* ; Weight Loss ; Weights and Measures

BACKGROUND: Growth retardation (GR) has literally hundreds of causes that have differences in prognoses, complications, and responses to treatments. Especially, growth retarded patients resulting from chromosomal disorders should be genetically counseled. To focus the cytogeneticist's attention on specific chromosomal regions, it is important to understand cytogenetic aberrations associated with GR prior to chromosomal analysis. So, we attempted to figure out the cytogenetic findings of patients with GR and support the effective application of cytogenetic studies, accurate diagnosis and genetic counseling. METHODS: Of 203 cases referred for GR, the positive rate and pattern of chromosomal aberrations were retrospectively analyzed with review of associated clinical features. Cytogenetic studies were performd by high resolution banding technique after peripheral T lymphocyte culture and, if necessary, Ag-NOR stain, C-banding and fluorescence in situ hybridization. RESULTS: Forty two (20.7%) patients had abnormal karyotypes. Thirty one (15.2%) patients had well-recognized chromosomal syndromes including Turner, Cri-du-chat, Edward, 13q- and 18p-/ 18q- syndromes. In addition to those, the sporadic chromosomal aberrations of 11 cases were partial monosomy of 11q23, partial trisomy of 1q32, 4p, 9p, and 14q, and ring chromosome 4 and 18, etc. which were not literally established in view of the correlation with phenotype. CONCLUSIONS: The various results of definite or debating chromosomal disorders associated with GR could be used as the data for diagnosis, management, prognosis, and genetic counseling in growth retarded patients. Furthermore, these may provide the background for prospective study to define the new chromosomal disorders.
Abnormal Karyotype ; Chromosome Aberrations* ; Chromosome Deletion ; Chromosome Disorders ; Cytogenetics* ; Diagnosis ; Fluorescence ; Genetic Counseling ; Humans ; In Situ Hybridization ; Lymphocytes ; Phenotype ; Prognosis ; Retrospective Studies ; Ring Chromosomes ; Trisomy

A 47-day-old male infant presented with fever, poor oral intake, irritability, and right-sided bluish buccal swelling. Contrast-enhanced computed tomography of the neck showed a round mass lesion of about 2.0x1.5 cm that suggested abscess formation in the right masticator space. Ultrasound-guided extraoral aspiration of the abscess at the right masseter muscle was successful. Staphylococcus aureus was identified in the culture from the aspirated pus and blood. Appropriate antibiotics were given and the patient recovered. The patient underwent follow-up ultrasonography that showed an improved state of the previously observed right masseter muscle swelling at about 1 month after hospital discharge. A masticator space abscess usually originates from an odontogenic infection in adults. We report a case of masticator space abscess in a 47-day-old infant in whom septicemia without odontogenic infection was suspected.
Abscess ; Adult ; Anti-Bacterial Agents ; Bacteremia ; Fever ; Follow-Up Studies ; Humans ; Infant ; Male ; Masseter Muscle ; Neck ; Sepsis ; Staphylococcus aureus ; Suppuration

PURPOSE: The study examined the effects of early enteral nutrition on the patients' length of stay in an intensive care unit (ICU), length of stay and mortality rate. METHODS: A retrospective design was employed with a total of 461 patients (mean age=69.9±15.6 years; 253 males; 208 females). They were divided into two groups according to when they received enteral feeding: an "early enteral nutrition" (EEN) group of 148 patients (32.1%) who received enteral feeding within 48 hours of their arrival at the hospital and a "delayed enteral nutrition" (DEN) group of 313 patients (67.9%) who received enteral feeding at some point after 48 hours of their arrival at the hospital. The EEN group and control group were similar in terms of age, sex, body mass index, and underlying diseases. RESULTS: The EEN group's total length of stay in hospital was shorter (23.29±27.19 days) than that of the control group (36.74±32.24 days); the difference was significant (P<0.001). The EEN group also showed a shorter length of stay in the ICU (13.67±22.77 days) than the DEN group (17.46±21.02 days) and a lower mortality rate (17.6%) than the control group (18.8%), but these differences were not significant. CONCLUSION: The study found that early enteral nutrition treatment reduced total length of stay in hospital significantly. The findings suggest that early enteral nutrition treatment plays an important role in the patients' recovery and prognosis.
Body Mass Index ; Enteral Nutrition* ; Humans ; Intensive Care Units ; Length of Stay ; Male ; Mortality ; Nutritional Support ; Prognosis ; Retrospective Studies