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: 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: Virologic diagnosis of hepatitis C virus (HCV) infection is based on the use of sero-logic assays detecting specific anti-HCV antibodies, and then definitive diagnosis is made by detecting HCV RNA. Recently, newly developed Track-C (total HCV core antigen) test using an enzyme immunoassay (EIA) can detect and quantify total HCV core antigen in the peripheral blood of HCV-infected patients. In this study, the usefulness of Track-C test for the detection of HCV viremia was investigated by comparing the results with those of the HCV RNA test. METHODS: The study group consisted of 159 sera including 72 anti-HCV positive sera. The Track-C test was performed by enzyme immunoassay (Ortho Clinical Diagnostics, USA) with pretreatment for the dissociation of antigen-antibody complex. HCV RNA test was performed by HCV in house RT-nested PCR method. Results were calculated for the sensitivity, specificity and efficiency by comparing to each other. RESULTS: The efficiency between HCV RNA and Track-C was 77.4% for the 72 anti-HCV positivesera. Comparing with the results of HCV RNA, Track-C assay showed the sensitivity and specificity of 56.0% and 96.4%, respectively. Track-C assay demonstrated a relatively good linearity (R2=0.9836) and reproducibility (CV=4.4%) at high concentrations. CONCLUSIONS: Although the sensitivity of Track-C assay was not as high as that of HCV RT-PCR, a positive Track-C assay suggests the presence of HCV viremia, especially at higher concentrations. Track-C assay, therefore, may be used as a simple and supplementary test for HCV viremia and for follow-up monitoring.
Antigen-Antibody Complex ; Diagnosis ; Follow-Up Studies ; Hepacivirus ; Hepatitis C Antibodies ; Humans ; Immunoenzyme Techniques ; Polymerase Chain Reaction ; RNA ; Sensitivity and Specificity ; Viremia

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*

BACKGROUND: Interphase fluorescence in situ hybridization (FISH) analysis following sex-mismatched bone marrow transplantation (BMT) is a sensitive and quantitative method to better assess the engraftment state and mixed chimerism. METHODS: Twelve patients (allogeneic 11 cases, unrelated 1 case) who underwent sex-mismatched BMT at Chonnam University Hospital from April 1996 through October 1998 were anlaysed chimerism employing FISH. Interphase FISH studies on peripheral blood cytospin slides were performed by using chromosome X alpha-satellite probe in early post-transplant periods at intervals of 3 days and in follow-up periods 6~15 months after BMT. RESULTS: In 11 engrafted patients, the mean percentage of host cells was 3.0% at the period of engraftment (15~25 days). Follow-up interphase FISH studies for ten patients with hematologic remission states after engraftment showed mixed chimerism with variable degree (mean, 4.7%: ranges, 0.5~19.0%). Although three of these patients showed host cells above 5.0% (13.2, 8.0 and 7.0%) transiently, they maintained hematologic remission states. One patient who showed 8.5% (344 days) and 14.5% (596 days) host cells proved to be an engraftement failure. CONCLUSION: Engrafted patients who obtained hematological remission showed variable mixed chimerism by FISH. When the host cells were low rate or increased transiently, mixed chimerism was not related to relapse. However, consecutive increasing host cells suggested engraftment failure or relapse. More sensitive long term follow-up FISH studies will help to evaluate and monitor engraftment status and degree of chimerism.
Bone Marrow Transplantation* ; Bone Marrow* ; Chimerism* ; Fluorescence* ; Follow-Up Studies* ; Humans ; In Situ Hybridization* ; Interphase ; Jeollanam-do ; Recurrence

BACKGROUND: In spite of active HIV/AIDS control and managements, UNAIDS estimate that 40 million people were living worldwide with HIV at the end of 2001. In Korea, The member of HIV- infected adults are continuously growing. For improvement of HIV screening and prevention, we analyzed over times the relationship between the changes in initial CD4+ T cell counts of newly HIV- diagnosed adults, sex, and exposure route. METHODS: We selected 1011 newly HIV-diagnosed adults whose initial CD4+ T cell count was determined within 6 months of HIV diagnosis between 1990 and June, 2002. Based on CD4+ T cell counts, the selected people were grouped into 4 as follows: <200 cells/mm3, 200-349 cells/mm3, 350-699 cells/mm3, and >700 cells/mm3. The relationship between initial CD4+ T cell counts, age, sex, and HIV risk category were studied by regression statistic methods. RESULTS: The median initial CD4+ T cell counts decreased over times (P<0.001). In each major group, over 50% of initial CD4+ T cell counts were below 350 cells/mm3. For homosexually infected adults, the median age did not statistically increase (P=0.062). However, in heterosexually infected adults, the median age increased throughout the time period examined (P<0.001) with an exception of female group (P=0.427). The multi-regression analyses revealed that older age (P<0.001) and male sex (P<0.001) were independently associated with lower initial CD4+ T cell counts, but not exposure group (P=0.483). For each year cohort of newly diagnosed adults, the median initial CD4+ T cell counts in subsequent years decreased until 1998 and then increased thereafter. CONCLUSION: These results show that a large proportion of HIV-infected adults are being diagnosed late in the course of HIV infection, particularly heterosexually infected male group. Therefore, we should continuously enforce screening, prevention and prompt diagnosis of high risk groups.
Adult ; Cell Count* ; Cohort Studies ; Diagnosis ; Female ; HIV ; HIV Infections ; Homosexuality ; Humans ; Korea ; Male ; Mass Screening

BACKGROUND: In spite of active HIV/AIDS control and managements, UNAIDS estimate that 40 million people were living worldwide with HIV at the end of 2001. In Korea, The member of HIV- infected adults are continuously growing. For improvement of HIV screening and prevention, we analyzed over times the relationship between the changes in initial CD4+ T cell counts of newly HIV- diagnosed adults, sex, and exposure route. METHODS: We selected 1011 newly HIV-diagnosed adults whose initial CD4+ T cell count was determined within 6 months of HIV diagnosis between 1990 and June, 2002. Based on CD4+ T cell counts, the selected people were grouped into 4 as follows: <200 cells/mm3, 200-349 cells/mm3, 350-699 cells/mm3, and >700 cells/mm3. The relationship between initial CD4+ T cell counts, age, sex, and HIV risk category were studied by regression statistic methods. RESULTS: The median initial CD4+ T cell counts decreased over times (P<0.001). In each major group, over 50% of initial CD4+ T cell counts were below 350 cells/mm3. For homosexually infected adults, the median age did not statistically increase (P=0.062). However, in heterosexually infected adults, the median age increased throughout the time period examined (P<0.001) with an exception of female group (P=0.427). The multi-regression analyses revealed that older age (P<0.001) and male sex (P<0.001) were independently associated with lower initial CD4+ T cell counts, but not exposure group (P=0.483). For each year cohort of newly diagnosed adults, the median initial CD4+ T cell counts in subsequent years decreased until 1998 and then increased thereafter. CONCLUSION: These results show that a large proportion of HIV-infected adults are being diagnosed late in the course of HIV infection, particularly heterosexually infected male group. Therefore, we should continuously enforce screening, prevention and prompt diagnosis of high risk groups.
Adult ; Cell Count* ; Cohort Studies ; Diagnosis ; Female ; HIV ; HIV Infections ; Homosexuality ; Humans ; Korea ; Male ; Mass Screening