Plasma col1 leukemia with motility-related morphological behavior is rarely studied. The plasma cells have variable degrees of cytoplasmic morphologies as dairy Projections, long extensions and pseudopods. These morphological evidences show the papa bility of wide spread and dissemination of disease itself. We present a case of a 38 year old woman who had back pain for 4 months and was diagnosed as a solitary plasmacytoma of the third lumbar vertebra. In spite of resection of the tumor and chemotherapy, the plasmacytoma was disseminated into both breasts and ovaries within less than a year. On her blood examination, we counted 34% of plasma cells in peripheral blood and 91.6% of plasma cells in bone marrow aspiration. Most of them resealed hairy projections and pseudopods of the cytoplasm.
Adult ; Back Pain ; Bone Marrow ; Breast ; Cytoplasm ; Drug Therapy ; Female ; Humans ; Leukemia ; Leukemia, Plasma Cell* ; Ovary ; Plasma Cells* ; Plasma* ; Plasmacytoma ; Spine

PURPOSE: To evaluate the incidence and CT findings of the medial depression and bony dehiscence of lamina papyracea as an anatomic variation. MATERIAL AND METHODS: 1472 PNS CTs of the patients with symptoms of chronic sinusitis were retrospectively evaluated. RESULTS: The total incidence of depressed lamina papyracea as an anatomic variation was 3.5%(52/1472) on PNS CT. There was a statistically significant correlation between the increasing age and the incidence of delamina papyracea. Depression of lamina papyracea anterior to the basal lamella were more common those of the posterior depression. Associated findings were herniation of adjacent fatty tissue in all cases and the roedial bowing and hypertrophied configuration of the medial rectus muscle without significant herniation in 19 cases(34%). CONCLUSION: Nontraumatic, asymptomatic depression with bony dehiscence of lamina papyracea as an anatomic variation is not uncommon with the incidence of 3.5%. Recognition of its existence and degree may helpful in avoiding various ocular complication during ethmoid surgery.
Adipose Tissue ; Anatomic Variation* ; Depression* ; Humans ; Incidence ; Retrospective Studies ; Sinusitis

No abstract available.
Mycobacterium*

BACKGROUND: T lymphocytes that bear CD3 but lack CD4 and CD8 (Double negative T cells, DN T cells) are normally present early in ontogeny in the fetal thymus, but constitute only a small proportion of adult thymocytes and peripheral blood. Since DN T TCR alpha beta+ cells have been found to accumulate in the lymphoid organs of lpr and gld mice and to be expanded in patients with autoimmune diseases, their functional properties are now of considerable interest. METHOD: Sixty four rheumatoid arthritis (RA) patients and 24 healthy volunteers were studied from Jan 1997 to Feb 1998. The whole blood from the patients and controls were analyzed by flow cytometry (Elite ESP, Coulter, USA) and XL-II software after the cells were stained with trifluorochrome monoclonal antibodies (anti-CD4-FITC/anti-CD8-PE/anti-CD3-PE-Cy5, anti-CD3-FITC/anti-CD19-PE/anti-CD45-PE-Cy5, anti-CD3-FITC/ CD16+56-PE) (Immunotech, Coulter, USA). We reviewed patient records to find out the inflammatory parameters and Ritchie index. RESULTS: We confirmed the presence of DN T cells in peripheral blood of healthy volunteers and RA patients. DN T cells were lower in RA patients (mean+/-SD; 6.44%+/-4.46), when compared to healthy volunteers (mean+/-SD; 9.97%+/-4.50) (p=0.001). There was no clinical correlations between DN T cells and inflammatory parameters. CONCLUSION: Our study showed that the DN T cells in normal control were about 10% of CD3 positive T cells and the cells were significantly lower in RA patients. Although we did not identify whether these cells have either TCR alpha beta or TCR gamma delta, we could conclude that these cells are not expanded in RA patients. We would like to continue this study further 1) to identify TCR the DN T cells have and 2) to monitor the changes after treatment.
Adult ; Animals ; Antibodies, Monoclonal ; Arthritis, Rheumatoid* ; Autoimmune Diseases ; Flow Cytometry ; Healthy Volunteers ; Humans ; Mice ; Receptors, Antigen, T-Cell, alpha-beta ; Receptors, Antigen, T-Cell, gamma-delta ; T-Lymphocytes* ; Thymocytes ; Thymus Gland

OBJECTIVE: A number of disease-modifying anti-rheumatic drugs (DMARDs) have been shown to be more effective than placebo in the management of rheumatoid arthritis (RA). However, most course of DMARDs, except methotrexate, are discontinued after 2 or 3 years, because of toxicity, lack of efficacy or escape from control. The multi-drug resistance (MDR) is a phenomenon in which cells develop cross-resistance to many agents such as anthracyclin, vinca alkaloids and colchicine. In our hypothesis, MDR phenomenon could be implicated in acquired resistance to DMARDs in RA. We have established a mdr1 cell line and tested whether DMARDs are substrate for P-glycoprotein (P-gp). METHODS: The mdr1-cDNA was cloned into retroviral vector, and the recombinant retroviral vector was transfected into PA317 cells. The target cells, NIH3T3, were infected with recombinant retroviruses. A colony most resistant to vinblastin was selected for the following experiments; expression of mdr1 gene in NIH3T3 cells was confirmed by RT-PCR, and biological function of mdr1 gene product, P-gp, was tested using Rhodamine-123 (Rh123) efflux assay. Resistance of the target cells expression P-gp which can survive against hydroxychloroquine (HCQ) and methotrxate (MTX) were measured by MTT assay. RESULTS: RT-PCR for mdr1 gene showed successful transfer of the gene into the NIH3T3 cells. Rh123 assay revealed expression of P-gp on the selected cells as follows; Rh123 efflux activity of uninfected NIH3T3 cells was 6%, that of PLXSN was 0.2%, and that of selected cells was 44%. The 50% proliferation inhibitory capacity of the selected cells were twice for HCQ but there was no difference of that for MTX. CONCLUSION: We established a mdr1 cell line and using the cell line, HCQ was a substrate of MDR, but MTX was not related to MDR.
Antirheumatic Agents* ; Arthritis, Rheumatoid ; Cell Line ; Clone Cells ; Colchicine ; Drug Resistance, Multiple ; Hydroxychloroquine ; Methotrexate ; P-Glycoprotein ; Retroviridae ; United Nations ; Vinca Alkaloids ; Zidovudine

PURPOSE: To analyse the results of treatment of unstable intra-articular distal radius fractures using the percutaneous K-wire reduction-fixation and external fixator. MATERIALS AND METHODS: A retrospective follow-up study of 22 cases was carried out. With use of the system of AO classification 9 cases were in C1 and 7 in C2, and 6 in C3. The average duration of follow-up for all fractures was 35 months. We evaluated the radiologic results, the functional results according to clinical evaluation scoring system by Green and O'Brien and osteoarthritis grade according to arthritic grading system by Knirk and Jupiter. RESULTS: Excellent and good results were rated in 17 cases (77%) of all cases. At last follow-up the mean loss of radial length, radial inclination and volar tilt were 1.4 mm, 1.0o, and 1.4o respectively. Also 7 patients had grade I, 1 patient grade II, and 1 patient grade III arthritis. CONCLUSION: We think that percutaneous K-wire reduction-fixation and external fixation is useful treatment method for the unstable intra-articular distal radius fracture. But severely comminuted AO type C3 fractures would need additional treatments such as open reduction and bone graft to acquire and maintain the articular reduction for better results.
Arthritis ; Classification ; External Fixators* ; Follow-Up Studies ; Humans ; Osteoarthritis ; Radius Fractures* ; Radius* ; Retrospective Studies ; Transplants

BACKGROUND: The UF-100 flow cytometer (Sysmex Co., Japan) and the Iris iQ200 (Iris Diagnostics, USA) are widely used for routine urinalysis in Korea. We compared the diagnostic accuracy of these two automated systems based on the microscopic finding, and evaluated the clinical performance of the automated systems. METHODS: A total of 323 fresh urine samples were selected and analyzed by conventional microscopy and the automation systems, the UF-100 and the iQ200. Quantification for RBCs, WBCs, and bacteria were also evaluated using both automated systems. RESULTS: For 158 of urine sample classified as normal urines, the agreement rate for the UF-100 and the iQ200 was 84.8% (N=134) and 89.9% (N=142), respectively. For 165 of urine samples classified as abnormal urines, the agreement rate for the UF-100 and the iQ200 was 90.9% (N=150) and 81.8% (N=135), respectively. The UF-100 showed a good linearity in the quantitative measurements of RBCs and WBCs. For both systems, false-negative value for WBCs and bacteria were about 30% in abnormal urines. Both systems showed inaccurate results for pathologic casts and bacteria. CONCLUSIONS: We compared the microscopic finding and the primary results of automated systems without user reclassification, and the agreement rate was about 85%. The agreement rate will be improved by deliberating "Review" comments of the instruments.
Automation ; Bacteria ; Iris ; Korea ; Microscopy ; Urinalysis

Natural killer (NK) cell neoplasms are a group of rare but highly malignant tumors. We report here one case of NK cell leukemia. A 54-yr-old woman presented with a 2-month history of progressive left neck mass. Based on the positive result of tissue PCR for Mycobacterium tuberculosis, she was at first diagnosed with tuberculous lymphadenopathy. After two weeks, she developed generalized lymphadenopathy, hepatosplenomegaly, fever and anemia. Subsequent evaluation was performed including bone marrow aspiration and biopsy. Peripheral blood smear showed leukoerythroblastic features with 31% blasts. Bone marrow was packed with agranular blastoid cells, which were periodic acid-Schiff (PAS) positive and myeloperoxidase (MPO) negative. Immunophenotyping showed that these cells were positive for CD45 and HLA-DR, whereas negative for CD3, CD5, CD7, CD10, CD13, CD14, CD19, CD20, CD22, CD33, CD34, and CD61. Because of the absence of the markers of T-cell, B-cell, and myeloid lineage-specific antigens, we added CD16/56 for the immunophenotyping and the blasts were positive (94%). The tumor cells of biopsied lymph node were only positive for CD56, consistent with NK cell lymphoma. Epstein-Barr virus (EBV) was not detected by RNA in situ hybridization. Culture for M. tuberculosis was negative. Thus this patient was diagnosed with blastic NK cell lymphoma/leukemia involving bone marrow and lymph node.
Antigens, CD45/metabolism ; Bone Marrow/pathology ; Female ; HLA-DR Antigens/metabolism ; Humans ; Killer Cells, Natural/immunology/*pathology ; Leukemia/*diagnosis/immunology/pathology ; Middle Aged ; Tuberculosis, Lymph Node/diagnosis

OBJECTIVE: Multipotent bone marrow stromal cells have the ability to differentiate toward a variety of connective tissue lineages including cartilage. The future use of adult mesenchymal stem cells (MSCs) for human therapies depends on the establishment of preclinical studies. Therefore, in this preclinical study we demonstrated the expression of MSC surface markers CD29, CD105, and CD44 on human bone marrow derived stromal cells during chondrogenic differentiation. METHODS: Adult human bone marrow was collected from the iliac crest of 7 donors following informed consent. Mononuclear cells were isolated, incubated in monolayers, and embedded in alginate beads for three-dimensional cultures. Cellualr viability was assessed by MTT assay. Flow cytometry of alginate bead cultures was performed on days 0, 7, 14, 21, and 28 using monoclonal antibody against surface molecules, CD105, CD29, CD44, CD34 and CD45. Total contents of collagen and glycosaminoglycan (GAG) of the alginate beads was measured. SPSS 11.0 was used for data analysis. RESULTS: After 7 days of culture, 89% of the cells expressed the human integrin beta 1 antibody, CD29. The CD29-positive cells remained elevated at 83% on days 28. However, while only 18% expressed the type II TGF-beta receptor endoglin, CD105 on day 7, the CD105-positive cells increased abruptly 65% on day 14 remaining elevated up to day 28. The expression of CD44 was maximal in the first passage cell (63%). High concentration of TGF-beta 3 (10 ng/mL) was more favorable for sustaining cell viability than a low concentration (0.5 ng/mL)(n=4, p= 0.002, day 21). The total contents of collagen and GAG in the MSC-alginate beads increased during the three-dimensional culture (n=4, p=0.02, p=0.006) suggesting its differentiation into a chondrogenic lineage. CONCLUSION: CD29 was expressed earlier than CD105 during chondrogenic differentiation of human bone marrow MSC. CD44 expression was highest in the first passage cells and gradually decreased afterwards.
Adult ; Bone Marrow* ; Cartilage ; Cell Survival ; Collagen ; Connective Tissue ; Flow Cytometry ; Humans* ; Informed Consent ; Mesenchymal Stromal Cells ; Receptors, Transforming Growth Factor beta ; Statistics as Topic ; Stromal Cells* ; Tissue Donors ; Transforming Growth Factor beta

BACKGROUND: Nasal colonization with methicillin-resistant Staphylococcus aureus (MRSA) is a known risk factor for nosocomialtransmission and infection. In an effort to mitigate this problem, topical mupirocin has been widely used for clearing nasal carriage of MRSA. However, mupirocin resistance has become a worldwide concern due to increased use of the antibiotic. The aims of this study were to evaluate the clinical characteristics and prevalence of mupirocin resistance among clinical isolates of staphylococci and to investigate antimicrobial susceptibility. METHODS: A total of 175 S. aureus specimens recovered over a 4-month period from various body sites were tested for resistance to mupirocin and other antibiotics using the Vitek2 automated system. The presence of the mupA gene was assessed in isolates exhibiting resistance to mupirocin and in other selected organisms. The clinical characteristics of the isolates were also reviewed. RESULTS: Of the 175 S. aureus isolates, 9.1% (16/175) were resistant to mupirocin, with 1.7% (3/175) having high-level resistance (HR) and 7.4% (13/175) having low-level resistance (LR). Patients with HR-mupirocin-resistant S. aureus had a longer duration of hospitalization (P=0.026). Of the 13 LR-mupirocin-resistant S. aureus strains, 11 had identical antibiogram patterns. The mupA gene was detected only among HR isolates. CONCLUSION: The rate of mupirocin resistance in the S. aureus isolates was high. The spread of mupirocin-resistant S. aureus may be due to nosocomial infection.
Anti-Bacterial Agents ; Colon ; Cross Infection ; Drug Resistance ; Hospitalization ; Humans ; Methicillin-Resistant Staphylococcus aureus ; Microbial Sensitivity Tests ; Mupirocin ; Prevalence ; Risk Factors ; Staphylococcus ; Staphylococcus aureus