A putative gamma herpesvirus, termed human herpesvirus 8 (HHV-8), discovered in recent years, has been implicated as a possible etiologic agent for Kaposi`s sarcoma (KS). In South Korea, the incidence of KS in HIV seropositive individuals is very low. The cause of its rarity as compared with other countries is unclear. The objective of this study was performed to determine the prevalence of infection with HHV-8 and to clarify the cause of low incidence of KS in Korean populations including HIV seropositive individuals. The study population was composed of 200 blood donors, 220 voluntary visitors for sexual transmitted infection (STI)-testing in the public health centers, and 214 HIV-seropositive individuals. For the detection of HHV-8 antibodies, all blood samples were tested using Advanced Biotechnologies Inc`s enzyme-linked immunosorbent assay (ELISA) kits and the reactive samples were retested using Biotrin International SARL`s immunofluorescent assay (IFA). Also, we investigated the seroprevalence of Cytomegalovirus (CMV), Varicella-Zoster virus (VZV) and Epstein-Barr Virus (EBV) in order to get more information of HHV-8 and other human herpesviruses transmission in Korea. The prevalence of specific IgG to HHV-8 among HIV seropositive individuals was 7.0% {95% confidential interval: 4.0-11.3%}. The specific antibody to HHV-8 could be detected only in HIV seropositive men. The prevalences of antibodies to other human herpesviruses unlike HHV-8 were very high even in blood donors. These observations strongly suggest that the rarity of KS in this country may be caused by very low prevalence of HHV-8.
Antibodies ; Biotechnology ; Blood Donors ; Cytomegalovirus ; Enzyme-Linked Immunosorbent Assay ; Herpesviridae ; Herpesvirus 3, Human ; Herpesvirus 4, Human ; Herpesvirus 8, Human* ; HIV ; Humans* ; Immunoglobulin G ; Incidence ; Korea* ; Male ; Prevalence ; Public Health ; Sarcoma* ; Sarcoma, Kaposi ; Seroepidemiologic Studies*

We present three cases of malignant solitary fibrous tumors of the pleura (SFTP) that produced recurrent hypoglycemia. Removal of the tumors produced normoglycemia. The tumors were well circumscribed and lobulated, and consisted of firm masses weighing 1,150 g to 1,450 g with the greatest diameter of 15 to 20 cm. The tumors were composed of spindle cells in fascicles or in a haphazard arrangement and were highly cellular and mitotically active (3-8 mitoses/10 high-power fields), showing histologically malignant features. Ultrastructurally, fibroblastic features of the tumor cells were present. Insulin-like growth factors (IGF) have been implicated in the presentation of hypoglycemia. The serum insulin and C-peptide levels were not elevated. Serum IGF-I levels were also low with values of 97.4, 157.1 and 51.9 ng/mL (ref. 125-317 ng/mL), respectively. However, tumor cells were strongly positive for IGF-I receptor on immunohistochemical analysis. It is tempting to speculate that IGF-I contributes to the hypoglycemia, even though the circulating levels were low.
Aged ; Blood Glucose ; Coin Lesion, Pulmonary/chemistry/*complications/pathology ; Female ; Human ; Hypoglycemia/*etiology ; Immunohistochemistry ; Male ; Middle Age ; Pleural Neoplasms/chemistry/*complications/pathology ; Receptor, IGF Type 1/*analysis ; Recurrence

BACKGROUND: Hyperleukocytic acute myelogenous leukemia (H-AML) is a relatively rare disease found in adults and it should have different characteristics from those of non-hyperleukocytic acute myelogenous leukemia (non-H-AML). We analyzed adult patients with H-AML whose peripheral WBC count was over 100, 000/ L, and compared laboratory and clinical findings of H-AML with those of non-H-AML cases. METHODS: This study included 19 patients with H-AML who were diagnosed between July 1994 and February 2001 at Chonnam University Hospital. The laboratory data, including peripheral blood smear, bone marrow study, immunophenotyping and cytogenetic study, were reviewed and the clinical out-comes of the patients were assessed. The results were compared with those of 127 non-H-AML cases. RESULTS: Of all adult AML cases, 13.1% (19/146) were H-AML. In H-AML, the subtypes were in the order of M5 (36.8%), M4 (21.1%) and M2 (21.1%), while in non-H-AML were in the order of M2 (40.9%), M3 (28.3%) and M4 (11.0%), respectively. HLA-DR and CD14 were more frequent in H-AML than in non-H-AML (83.3% vs. 47.2%, P=0.005; and 23.5% vs. 56.4%, P=0.042; respectively). H-AML had a tendency for low complete remission and short overall survival. Disease-free survival of H-AML was significantly shorter than that for the non-H-AML (6.0 vs 22.1 months, P=0.006). CONCLUSIONS: It suggests that hyperleukocytosis could be a predictor of unfavorable clinical out-comes and survival in acute myelogenous leukemia.
Adult ; Bone Marrow ; Cytogenetics ; Disease-Free Survival ; HLA-DR Antigens ; Humans ; Immunophenotyping ; Jeollanam-do ; Leukemia, Myeloid, Acute* ; Rare Diseases

OBJECTIVES: There are much controversy about the duration of antibody persistence, necessity and time of booster for hepatitis B vaccine(HB vaccine). The long term follow-up study is lack in Korea. Therefore this study is designed for evaluating the long-term immunogenicity of HB vaccine, necessity and time of booster vaccination. METHODS: The plasma derived HB vaccine (He-pavax-B(R)) was administered to healthy volunteers (28cases) as usual method. Secondary booster immunization was done at the 2nd year after primary vaccination in 6 cases(anti-HBs<10 mIU/ml). The serum transaminase levels, the HBsAg and anti-HBs were checked at the 9th month, 1st, 2nd, 3rd, 5th and 10th year after primary vaccination. RESULTS: 1) The positivity of anti-HBs (over 10mIU/ml) was 93%, 96%, 92% at the 3rd, 5th, 10th year respectively. In the children under 20 years old, it was 94Yo at the 3rd, 5th and 10th year without the secondary booster. 2) The good responders(anti-HBs>or=100mIU/ml) at the 9th month after primary vaccination are 21 cases (7%), low responders(anti-HBs: 10-100mIU/ml) 5 cases (18%), and non-responders(anti-HBs Adult ; Child ; Follow-Up Studies* ; Healthy Volunteers ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis B Vaccines ; Humans ; Immunization, Secondary ; Korea ; Plasma* ; Vaccination ; Young Adult

Background: The increasing prevalence of cementless total knee arthroplasty (TKA) necessitates a reliable assessment of bone quality. Central bone mineral density (BMD), measured by dual-energy x-ray absorptiometry (DEXA) in the lumbar spine and hip, is conventionally used to estimate bone quality. However, its effectiveness in predicting the actual bone strength at the knee, which is crucial for cementless TKA, is under scrutiny. This study investigated the relationship between central BMD and actual bone strength at the knee. Methods: This prospective study included 191 knees undergoing standard posterior-stabilized TKA between November 2021 and March 2023. Central BMD was assessed 3 months before TKA, and the failure load of bone fragments collected during box preparation was directly measured using an indentation test. Relationships between central BMD and failure load as a measure of the actual bone strength at the knee were analyzed. Results: Linear regression analysis revealed a weak correlation between central BMD and the actual bone strength at the knee (R 2= 0.146 in all patients; < 0.001 in osteoporosis group; 0.126 in non-osteoporosis group). The correlation suggested by the regression models was particularly insignificant in the osteoporosis subgroup, showing that central BMD is not a reliable predictor of bone strength for cementless TKA. Conclusions Central BMD measurements have limited utility in accurately predicting the real bone strength at the knee for cementless TKA. This study highlights the need for more specific and direct methods of assessing bone quality at the knee to ensure the success of cementless TKA.

Background: The increasing prevalence of cementless total knee arthroplasty (TKA) necessitates a reliable assessment of bone quality. Central bone mineral density (BMD), measured by dual-energy x-ray absorptiometry (DEXA) in the lumbar spine and hip, is conventionally used to estimate bone quality. However, its effectiveness in predicting the actual bone strength at the knee, which is crucial for cementless TKA, is under scrutiny. This study investigated the relationship between central BMD and actual bone strength at the knee. Methods: This prospective study included 191 knees undergoing standard posterior-stabilized TKA between November 2021 and March 2023. Central BMD was assessed 3 months before TKA, and the failure load of bone fragments collected during box preparation was directly measured using an indentation test. Relationships between central BMD and failure load as a measure of the actual bone strength at the knee were analyzed. Results: Linear regression analysis revealed a weak correlation between central BMD and the actual bone strength at the knee (R 2= 0.146 in all patients; < 0.001 in osteoporosis group; 0.126 in non-osteoporosis group). The correlation suggested by the regression models was particularly insignificant in the osteoporosis subgroup, showing that central BMD is not a reliable predictor of bone strength for cementless TKA. Conclusions Central BMD measurements have limited utility in accurately predicting the real bone strength at the knee for cementless TKA. This study highlights the need for more specific and direct methods of assessing bone quality at the knee to ensure the success of cementless TKA.

Background: The increasing prevalence of cementless total knee arthroplasty (TKA) necessitates a reliable assessment of bone quality. Central bone mineral density (BMD), measured by dual-energy x-ray absorptiometry (DEXA) in the lumbar spine and hip, is conventionally used to estimate bone quality. However, its effectiveness in predicting the actual bone strength at the knee, which is crucial for cementless TKA, is under scrutiny. This study investigated the relationship between central BMD and actual bone strength at the knee. Methods: This prospective study included 191 knees undergoing standard posterior-stabilized TKA between November 2021 and March 2023. Central BMD was assessed 3 months before TKA, and the failure load of bone fragments collected during box preparation was directly measured using an indentation test. Relationships between central BMD and failure load as a measure of the actual bone strength at the knee were analyzed. Results: Linear regression analysis revealed a weak correlation between central BMD and the actual bone strength at the knee (R 2= 0.146 in all patients; < 0.001 in osteoporosis group; 0.126 in non-osteoporosis group). The correlation suggested by the regression models was particularly insignificant in the osteoporosis subgroup, showing that central BMD is not a reliable predictor of bone strength for cementless TKA. Conclusions Central BMD measurements have limited utility in accurately predicting the real bone strength at the knee for cementless TKA. This study highlights the need for more specific and direct methods of assessing bone quality at the knee to ensure the success of cementless TKA.

Background: The increasing prevalence of cementless total knee arthroplasty (TKA) necessitates a reliable assessment of bone quality. Central bone mineral density (BMD), measured by dual-energy x-ray absorptiometry (DEXA) in the lumbar spine and hip, is conventionally used to estimate bone quality. However, its effectiveness in predicting the actual bone strength at the knee, which is crucial for cementless TKA, is under scrutiny. This study investigated the relationship between central BMD and actual bone strength at the knee. Methods: This prospective study included 191 knees undergoing standard posterior-stabilized TKA between November 2021 and March 2023. Central BMD was assessed 3 months before TKA, and the failure load of bone fragments collected during box preparation was directly measured using an indentation test. Relationships between central BMD and failure load as a measure of the actual bone strength at the knee were analyzed. Results: Linear regression analysis revealed a weak correlation between central BMD and the actual bone strength at the knee (R 2= 0.146 in all patients; < 0.001 in osteoporosis group; 0.126 in non-osteoporosis group). The correlation suggested by the regression models was particularly insignificant in the osteoporosis subgroup, showing that central BMD is not a reliable predictor of bone strength for cementless TKA. Conclusions Central BMD measurements have limited utility in accurately predicting the real bone strength at the knee for cementless TKA. This study highlights the need for more specific and direct methods of assessing bone quality at the knee to ensure the success of cementless TKA.

BACKGROUND: Although HIV is introduced relatively late into Asia, the amount of HIV-positive population has been continuously growing in this area. UNAIDS/WHO estimate that 6.5 million people are living with HIV in the Asia/Pacific region at the end of 1999. To expect the HIV/AIDS epidemic in the 21st century in Korea, it is necessary to monitor the changes of the number of newly found HIV-infected individuals and their immune status by year including their epidemiological data. METHODS: We have selected 591 HIV-infected individuals whose first CD4 count was checked within 6 months from the time of diagnosis of HIV infection from 1990 to 1999. For the measurement of CD4+T and CD8+T cells, blood samples of HIV-1 infected individuals were collected into three potassium ethylene diamine tetra-acetic acid (K3EDTA)-treated tubes and stained within at least 24 hours after drawing and analysed by flow cytometer (FACStar or FACScount). The immune status were classified into 4 groups as follows: group I (> or =500 CD4+T cells/mm3), group II (201~499 CD4+T cells/mm3), group III (51~200 CD4+T cells/mm3), and group IV (< or =50 CD4+T cells/mm3). RESULTS: The mean of number of CD4+T cells of HIV-infected individuals at the time of HIV diagnosis was 677 cells/mm3 and the percentage of CD4+T cells was 22.5% in 1990~1991 but 350 cells/mm3 and 14.7% in 1999, respectively. The number of newly found HIV-infected individuals belong to Group III increased rapidly from 1997 to 1999. Also, the proportion of newly found HIV-infected individuals having the CD4+T cell counts of < or =50 cells/mm3 increased slowly by the time of diagnosis of HIV infection. The proportion of newly found HIV-infected individuals who were found in general hospitals increased during the second half of the 1990s. CONCLUSION: These results show that not only the number of newly found HIV-infected individuals has increased annually but also their immune status at the time of HIV diagnosis have been more depressed by the year. Therefore, we should enforce education for prevention of HIV/AIDS about general population as well as high risk groups.
Asia ; Blood Cells ; CD4 Lymphocyte Count ; Cell Count ; Diagnosis ; Education ; HIV Infections ; HIV* ; HIV-1 ; Hospitals, General ; Korea ; Potassium

BACKGROUND: Vibrio vulnificus sepsis requires a rapid and accurate bacteriological diagnosis for optimal management of the patient because of its high mortality. We evaluated two automated bacteriological identification systems, Microscan (WalkAway 96, Dade Behring, West Sacramento, CA, USA) and Vitek II (bioMerieux, Durham, NC, USA), for their ability to identify V. vulnificus strains isolated from clinical specimens. METHODS: A total of 60 V. vulnificus strains isolated from clinical specimens in Chonnam University Hospital during 1993-2003 were tested. For the identification of the isolates by the Microscan, Neg Combo type 32 was used and four different panel inoculation methods were evaluated for accuracy. Identification by the Vitek II system was carried out using Vitek ID-GNB cards in accordance with the manufacturers, instruction using 0.45% saline media. RESULTS: With the Microscan, the most accurate identification result was obtained after a modified inoculation method of the panel with a bacterial suspension prepared in 0.85% saline; the identification rate was 100%. The identification rate of Vitek II system was 96.7%; two strains of V. vulnificus were misidentified as V. harveyi and V. alginolyticus. CONCLUSIONS: These results indicate that both Microscan and Vitek II are adequate for the identification of clinical isolates of V. vulnificus, but for the identification by the Microscan a modified inoculation method should be used by suspending the organisms in 0.85% saline.
Diagnosis ; Humans ; Jeollanam-do ; Mortality ; Sepsis ; Vibrio vulnificus*