BACKGROUND: The combination of Philadelphia chromosome (Ph) and monosomy 7(-7) was rarely observed in acute lymphoblastic leukemia (ALL). With the results from immunophenotyplc and molecular analysis, Philadelphia chromosome positive ALL with monosomy 7[Ph(+)/-7] has been considered that it may be derived from neoplastic transformation at the pluripotent stem cell level. We compared the clini-cal, laboratory, and hematological findings between 5 cases of Ph(+)/-7 and 5 cases of Ph(+) without monosomy 7 [Ph (+) /N7]. METHODS: During the period from January, 1995 to December, 1996, total 72 cases of ALL were confirmed among 259 cases of hematologic malignancy with bone marrow cytogenetic analysis. Among 72 ALL cases, 5 cases of Ph(+)/-7(monosomy 7 or 7q abnormalities) were compared with Ph only or Ph without monosomy 7(ph(+)/N7] on the hematological, immunophenotypic, other laboratory, clinical findings and event ree survival (EFS) The karyotyping of the bone marrow specimens was analysed byshort-term unsynchronized culture methods such as overnight colcemid treatment and 24 hours incubation following ethidium bromide treatment. RESULTS: The mean age of Ph(+)/-7 was 30.6+/-12.8 years, and it was significantly different from that of Ph(+)/N7 (p=0.009), Four cases of Ph(+)/-7 were classified as ALL L2 subtype, and 2 cases revealed CNS involvements. Immunophenotyping was positive in CD10, CDl9, CD2O, CD22 and HLA-DR. But one case revealed e-B-lymphoid lineage with positivity in CD34, CDl3, and CD33. The response to chemotherapy and EFS was very poor in Ph(+)/-7 group, and the mean EFS was 3.2+/-1.9 months(p=0.014). All of cases showed induction on failure in chemotherapy, relapsed with bone marrow, CNS and extramedullary involvements, and expired due to sepsis. CONCLUSIONS: Ph(+)/-7 ALL had very Poor clinical course with being resistant to chemotherapy and unfavorable prognosis, revealed L2 subtype by FAB classification, and was slightly older in ages compared with Ph(+)/N7 ALL.
Bone Marrow ; Classification ; Cytogenetic Analysis ; Demecolcine ; Drug Therapy ; Ethidium ; Hematologic Neoplasms ; HLA-DR Antigens ; Hydrogen-Ion Concentration ; Immunophenotyping ; Karyotyping ; Monosomy* ; Philadelphia Chromosome* ; Pluripotent Stem Cells ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Prognosis ; Sepsis

The t(3;21) (q26;q22) is associated with chronic myelogenous leukemia in blast crisis, leukemia evolving from therapy-related myelodysplasia, and with leukemia following other hematopoietic proliferative diseases. The t(3;21) is rare secondary aberration in blast crisis of Philadelphia(Ph)-positive chronic myeloid leukemia, which may be restricted to patients entering myeloid blast crisis. We report here in one case of chronic myeloid leukemia in blast crisis which reveals both t(9;22) (q34;q11), and t(3;21) (q26 ;q22). A 62-year-old male was diagnosed as chronic myeloid leukemia 5 years ago, received hydroxyurea therapy, and admitted because of gingival bleeding and fever. On examination, splenomegaly and leukocytosis with proliferated blasts(91%) in peripheral blood were noted. Bone marrow aspirate showed hypercellularity with severe blast proliferation(92.5%) which revealed all negative in peroxidase and PAS stain. Cytogenetic study of bone marrow cells showed the karyotype 46, XY, t(3;21) (q26;q22), t(9;22) (q34;q11), which might be suspected as myeloid blast crisis. Above finding was confirmed by the result of immunophenotyping(CD13 43.6%, CD34 68.2%, HLA-DR 91.6%). He received intensive chemotherapy, but still sustained proliferation of blasts was noted . The follow up cytogenetic study was as follows: 46, XY, 4(3;21) (q26:22), t(9;22) (q34;q11)/46, XY, t(3;21)(q26;q22), del(8) (q22), t(9:22) (q34,q11)/46, XY (16/3/1). He died soon from severe pancytopenia and sepsis.
Blast Crisis* ; Bone Marrow ; Bone Marrow Cells ; Cytogenetics ; Drug Therapy ; Fever ; Follow-Up Studies ; Hemorrhage ; HLA-DR Antigens ; Humans ; Hydroxyurea ; Karyotype ; Leukemia ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Leukocytosis ; Male ; Middle Aged ; Pancytopenia ; Peroxidase ; Sepsis ; Splenomegaly

Vibrio metschnikovii is worldwidely distributed in the aquatic environment and human infections are very rarely associated, such as septicemia, urinary tract infection, wound infection, and peritonitis. V. metschnikovii is negative in nitrate reduction and oxidase reaction, and these findings are different from other vibrio species. V. metschnikovii was isolated from the ascitic fluid and blood of a patient with peritonitis, sepsis and renal insufficiency. This patient was a 41-year old man who suffered from post-necrotic liver cirrhosis, chronic hepatitis B, gastric ulcer, esophageal varix bleeding, and alcoholism. He had neither history of ingestion of seafoods nor exposure to seawater before onset of illness. He was successfully treated with antimicrobial agents. This is the first case report of septicemia and peritonitis by V. metschnikovii in Korea.
Adult ; Alcoholism ; Anti-Infective Agents ; Ascitic Fluid ; Eating ; Esophageal and Gastric Varices ; Hemorrhage ; Hepatitis B, Chronic ; Humans ; Korea ; Liver Cirrhosis ; Oxidoreductases ; Peritonitis* ; Renal Insufficiency ; Seafood ; Seawater ; Sepsis* ; Stomach Ulcer ; Urinary Tract Infections ; Vibrio* ; Wound Infection

No abstract available.
Chromosome Aberrations*

No abstract available.
Blood Coagulation Factors* ; Fibrinogen*

No abstract available.
Blood Coagulation Factors* ; Fibrinogen*

BACKGROUND: In spite of appropriate therapy and control for tuberculosis, the prevalence of tuberculosis is still frequent in Korea. Emerging infection and rapid detection of multidrug-resistant Mycobacterium tuberculosis (MDR-TB) are major interests in microbiologic laboratories. In this study, we evaluated the usefulness of random amplified polymorphic DNA (RAPD) genotyping for molecular epidemiological characteristics of MDR-TB. METHODS: We analyzed 64 clinical strains of M. tuberculosis including 35 strains which showed resistance to one or more antimycobacterial drugs and M. tuberculosis H37Rv (ATCC 27294), as a drug-sensitive control strain. RAPD genotyping analysis was carried out under eight reaction conditions and using ten random primers (A-1245, AP-50, B-1245, DKU-44, DKU-49, Leg-1, INS-2, IS-986-FP, PF-15 and MBR). RESULTS: RAPD patterns using six primers (IS-986-FP, DKU-44, DKU-49, INS-2, B-1245, and AP-50) showed marked polymorphisms that were easier to discriminate than those with other primers. RAPD patterns represented various polymorphisms among 64 strains. However, RAPD could not discriminate MDR-TB strains from drug-sensitive ones. CONCLUSIONS: RAPD genotyping is assumed a preferable technique for discrimination among clinical strains of M. tuberculosis but not for specifying MDR-TB strains.
Discrimination (Psychology) ; DNA* ; Korea ; Mycobacterium tuberculosis* ; Mycobacterium* ; Prevalence ; Tuberculosis

BACKGROUND: CSF can be leaked from the nose or ear due to fractures, tumors or surgical procedures in the skull base region, and the threat of impending meningitis necessitates early identification of it. Since 2-transferrin occurs practically in cerebrospinal fluid (CSF) and not in other body fluid, its detection from the rhinorrhea or otorrhea can be used for the diagnosis of CSF leakage. We carried out immunofixation-silver stain (IF-SS) method for detection of 2-transferrin in the CSF in order to know optimal identification condition of specific cerebrogenic marker. METHODS: The fresh CSF sample was collected by spinal tapping. 2-Transferrin was estimated by quantifying the total transferrin by nephelomertry (Behring, Germany). 2-Transferrin of CSF was identified by electrophoresis using Titan gel high resolution protein system (Beckman, USA), immunofixation with anti-human transferrin antibody (Dako, Denmark) and then stained with silver nitrate. Serial dilutions of CSF were performed to know the detection limit of 2-transferrin. To know the influence of blood mixing, tests for mixed specimen of serum and hemolysate in CSF were performed. To evaluate the specimen storage condition, tests for different temperature and storage time were performed . RESULTS: By IF-SS method, identification limit of 2-transferrin was 0.5 mg/dL in 1:4 diluted CSF with distilled water. And 2-transferrin could be detected in condition of mixing serum protein (7.5 g/dL) or hemoglobin (13 g/dL) with CSF up to 6 : 4. At various sample storage condition, such as 37degrees C, room temperature, and 4degrees C, band intensity decreased abruptly after 1 day, and it was not detected 5 days later. Mean while, in -20degrees C and -70degrees C, 2-transferin band was detected after 10 days. CONCLUSIONS: IF-SS method was sufficiently sensitive and specific for invalidation by blood contamination, and seems to be used as effective identification of 2-transferrin in the CSF without sample concentration, less diagnostic test for CSF leakage.
Body Fluids ; Cerebrospinal Fluid* ; Diagnosis* ; Diagnostic Tests, Routine ; Ear ; Electrophoresis ; Limit of Detection ; Meningitis ; Nose ; Saturn ; Silver Nitrate ; Skull Base ; Spinal Puncture ; Transferrin* ; Water

Ewing's sarcoma is a highly malignant, small, round cell tumor that usually affects long bones. The acral part of the extremities is a very rare primary site for this neo plasm. A fifteen-year-old girl was seen for a lobulated, dome-shaped, 2.7cm diameter, denuded mass on the distal phalanx of the right middle finger which had increased in size over a 14-month period. The radiological featuies of the hand showed a cortical brick of distal phalanx and surrounding soft tissue mass. Histologically, the biopsy specimen showed sheets of small round to oval cells with scanty cytoplasm, that were closely packed and separated into lobules by trands of fibrous tissue. A periodic acid-Schiff stain demonsirated glycogen in the cytoplasm of the tumor cells. Electron microscopy showed large aggregates of glycogen in the cytoplasm of the neoaplastic cells. Immunohistochemical stains revealed positive staining for vimentin, glial fibrillary acid potein, and neuron specific enolase, stains for S-100, Factor VIII, and cytokeratin were negative.
Biopsy ; Coloring Agents ; Cytoplasm ; Extremities ; Factor VIII ; Female ; Fingers ; Glycogen ; Hand ; Humans ; Keratins ; Microscopy, Electron ; Phosphopyruvate Hydratase ; Sarcoma* ; Sarcoma, Ewing ; Vimentin

Ewing's sarcoma is a highly malignant, small, round cell tumor that usually affects long bones. The acral part of the extremities is a very rare primary site for this neo plasm. A fifteen-year-old girl was seen for a lobulated, dome-shaped, 2.7cm diameter, denuded mass on the distal phalanx of the right middle finger which had increased in size over a 14-month period. The radiological featuies of the hand showed a cortical brick of distal phalanx and surrounding soft tissue mass. Histologically, the biopsy specimen showed sheets of small round to oval cells with scanty cytoplasm, that were closely packed and separated into lobules by trands of fibrous tissue. A periodic acid-Schiff stain demonsirated glycogen in the cytoplasm of the tumor cells. Electron microscopy showed large aggregates of glycogen in the cytoplasm of the neoaplastic cells. Immunohistochemical stains revealed positive staining for vimentin, glial fibrillary acid potein, and neuron specific enolase, stains for S-100, Factor VIII, and cytokeratin were negative.
Biopsy ; Coloring Agents ; Cytoplasm ; Extremities ; Factor VIII ; Female ; Fingers ; Glycogen ; Hand ; Humans ; Keratins ; Microscopy, Electron ; Phosphopyruvate Hydratase ; Sarcoma* ; Sarcoma, Ewing ; Vimentin