BACKGROUND: Although immunophenotyping of leukemias has improved diagnostic accuracy and reproducibility, it has also caused diagnostic confusion regarding the lineage of leukemic cells. So far, lots of papers about acute leukemias with coexpression of another lineage markers with different technical methodologies and different criteria have been published in Korea and other countries. The authors investigated the frequency and immunophenotypic characteristics of the leukemias with aberrant lineage markers from data obtained at Korea University Hospital by a retrospective study. METHODS: From Jan. 1993 to Feb. 1996, 179 leukemias had been requested for immunophenotypig and 28 cases among them with unusual immunophenotypes were retrieved according to their immunophenotyping results. For the final diagnosis all the slides stained with Wright-Giemsa, peroxidase, Periodic-Acid Schiff, Sudan black B, and nonspecific esterase were re-examined, and all the flow cytometric results were reanalyzed. RESULTS: Among 28 cases, 3 cases(10%) were acute biphenotypic leukemias(BP) one with B lymphoid and myeloid markers and the other two with T lymphoid and myeloid markers. One case of intralineage bilinear acute leukemia(ILBL) with two separate populations of megakaryocytic cells and monocytic cells was noted. 6 cases(21%) were acute myeloblastic leukemias expressing lymphoid associated markers(Ly+AMLs; CD19) and 8 cases(28%) were myeloid antigen-positive acute lymphoblastic leukemias(My+ALLs, four with CD13+ and three with CD33+ and one with blastic transformation of chronic myelogeneous leukemia). Because of the change in diagnostic criteria, lymphocyte contamination, or low setting of negative control, 10 cases (36%) were not included to be of unusual immunophenotypes. CONCLUSIONS: Frequency of acute hybrid leukemia was 2.2 % of all leukemias. Ly+AMLs was 3.4%, and My+ALL was 4.4%. In conclusion, first, quality control of the flow cytometry and careful interpretation especially in terms of positive cut-off value and gating, are needed. Secondly, national guidelines for the criteria of the hybrid leukemia and My+ALLs and Ly+AMLs are necessary for the elucidation of the prognostic implication of those leukemias.
Carboxylesterase ; Diagnosis ; Flow Cytometry ; Immunophenotyping ; Korea ; Leukemia* ; Leukemia, Myeloid, Acute ; Lymphocytes ; Peroxidase ; Quality Control ; Retrospective Studies ; Sudan

No abstract available.
Alleles* ; Hepatitis B Vaccines* ; Hepatitis B* ; Hepatitis* ; HLA-DRB1 Chains*

BACKGROUND: The prevalence of pulmonary tuberculosis among the elderly is increasing in Korea and in the developed countries due to the increased elderly population and their predispositions to chronic disease, poverty and decreased immunity. To define the characteristics of pulmonary tuberculosis in the elderly, we evaluated the clinical spectrum of pulmonary tuberculosis. METHODS: We analyzed 92 patients retrospectively that were diagnosed as active pulmonary tuberculosis over the age of 65. The analysis involved patient's profiles, clinical manifestations, coexisting diseases, diagnostic methods, anti-TB medications and their side effects, and treatment outcomes. RESULTS: The results were as follows:- 1) The ratio of male to female was 2.1:1(62:30 cases) 2) Chief complaints were a cough (47.8%),dyspnea(40.2%), sputum(38.0%), chest pain(12.0%), anorexia(10.9%), and fever(9.8%). 3) 38(41.3%) of cases had a past history of pulmonary tuberculosis. 4) The coexisting diseases were:-COPD, 25 cases(27.2%);pneumonia, 17 cases(18.5%);DM, 13 cases(14.1%);and malignancy, 10 cases(10.9%). 5) The positivity of Mantoux test(5 TU, PPD-S) was 82.7%. 6) Pulmonary tuberculosis was diagnosed using the following methods : sputum AFB (Acid Fast Bacillus) smear 42.4%, sputum TB(M.Tuberculosis) culture 15.2%, sputum TB PCR (Polymerase Chain Reaction) 10.9%, bronchial washing AFB smear 2.1%, chest radiology only 25.0%. 7) Locations of radiologic lesions were RULF, 50 cases;RLLF, 50 cases, mostly, then LLLF;26 cases were leastly involved. 8) The coexisting tuberculosis were endobronchial TB(8.7%), TB pleurisy(7.6%) miliary TB(5.4%), intestinal TB(2.2%), renal TB(1.1%) 9) The proportion of treatment regimen with 1st line drug and 2nd line drug were 92.3% and 7.6%, respectively. 10) The outcome of treatment were as follows:cured 31.5%, expired 13.0%, no return 47.8%, follow-up now 7.6%. CONCLUSION: The pulmonary tuberculosis in the elderly has atypical patterns with chronic coexisting diseases. Therefore, the possibility of pulmonary tuberculosis should be considered in elderly patients with pulmonary symptoms.
Aged* ; Chronic Disease ; Cough ; Developed Countries ; Female ; Follow-Up Studies ; Humans ; Korea ; Male ; Polymerase Chain Reaction ; Poverty ; Prevalence ; Retrospective Studies ; Sputum ; Thorax ; Tuberculosis* ; Tuberculosis, Pulmonary

Tuberculomas in the spine are estimated to be 15 to 50 times less common than those occurring in the cranium. We experienced a case of intramedullary spinal tuberculoma and brain tuberculoma associated with pulmonary tuberculosis. A 39-year-old male was referred to the National Medical Center via emergency room because of urinary difficulty and lower limb weakness for 3 days. He had been treated with anti-tuberculosis regimens against pulmonary tuberculosis for 20 days. Spinal MRI revealed intradural intramedullary tuberculoma at T5. On the 21st day at the hospital, a generalized seizure attacked him. Brain MRI revealed multiple tuberculoma in both hemispheres, brainstem and cerebellum. He was treated anti-tuberculosis regimens and corticosteroids for 9 months. His condition improved clinically and radiologically. We report this case with a review of the literature.
Adrenal Cortex Hormones ; Adult ; Brain Stem ; Brain* ; Cerebellum ; Emergency Service, Hospital ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Male ; Seizures ; Skull ; Spine ; Tuberculoma* ; Tuberculosis, Pulmonary*

No abstract available.
Nephrotic Syndrome* ; Venous Thrombosis*

A 24 year-old Korean male, has had an eruption on the Lt. foot for 3 years. The lesion consists of single large macule of reddish purplish brown coloration scattered over the great toe, dorsum and inner part of the Lt. foot. Recently, there is no new lesions and lymphadenopathy on any part of the body. Laboratory tests were all negative, including serology. X-ray findings of the chest and Lt. foot showed normal limits but, angiographic findings which was performed under the local anesthesia through the femoral artery showed the arterio-venous plexus and markedly increased vascularity on the inner side of Lt foot area. Biopsy of a macule on the inner part of the Lt. foot was confirmed as Kaposi's sarcoma. X-ray therapy (100Kv at 50cm distance with 2 mm of AL. filter) was directed to the involved sites daily for 6 days to a total of 1,800 roentogens, after lesion was progressively improved day by day.
Anesthesia, Local ; Biopsy ; Femoral Artery ; Foot ; Humans ; Lymphatic Diseases ; Male ; Sarcoma, Kaposi* ; Thorax ; Toes ; X-Ray Therapy ; Young Adult

No abstract available.
Cardiomyopathies* ; Peripartum Period*

The author investigated the allergic contact dermatitis patients which visited our out-patient skin dispensary during 1969 and 1970. The patients were evaluated arcording to age, sex and cause of the disease. Furthermore, the patients were analysed as to the causative allergic contact factors by clinical inspection and history. The causes were confirmed by the patch test which was done on 88 of the allergic contact dermatitis patients. It is believed that patch test is clinically a most reliable procedure for the determination of responsible antigenic substance in allergic contact dermatitis and the positive reactions may be labelled as latent or potential hypersensitivity(Hjorth et al, 1968; Maibach, 1965). There is a group of chemicals used on the so-called routine screening patch test tray, which have proved to be frcquent causes of allergic contact dermatitis. Many diagnostic groups of chemicals and therapeutic trays, shoe trays, metal trays, etc., in addition to the standard routine screening patch test tray are used. Certain allergens seem to cause dermatitis in all countries hut many sensitizers vary from one country to anothcr (Calnan, 1955), The author has tried to establish a standard routine screening patch test tray fitted to our country according to the basic consideration used with standard routine patch test trays of the Skin and Cancer Unit, New York University Hospital. Paraphenylene diamine, ammoniated mercury, mercury bichloride, formalin, crude coal tar, potassium dichromate and mercaptobenzothiazole were the most potent sensitizers. These chemicals must be included in our standard screening routine patch test tray. However, the patch test results and the present clinical dermatitis (i.e. cosmetic dermatitis and rubber or leather dermatitis) did not coincide. Further investigation for the establishment of a proper stanard patch test tray for Korea should be carried out.
Allergens ; Coal Tar ; Dermatitis ; Dermatitis, Allergic Contact ; Formaldehyde ; Humans ; Korea* ; Mass Screening ; Mercuric Chloride ; Outpatients ; Patch Tests ; Potassium Dichromate ; Rubber ; Shoes ; Skin

No abstract available.
Pregnancy*

Borderline malignant ovarian tumor are characterized as neoplasrns exhibiting cellular priliferative changes greater than those seen in the benign form, but not showing destnictive invasion of the ovarian strama. We reviewed 14 cases of borderline ovarian tumor who had been diagnosed and treated at Kyung Pook university hospital from 1987 to 1992. We nnalysed the clinical features, treatment and prognosis which were compared to 24 cases of the epithelial ovarian cancer at the same period The most common histological thpe of boderline tumnr was mucinous type (1 l cases, 79%), the next one was serous type (3 cases, 21%). In FIGO stage of Borderline tumor, 11 caseS weve stage I a, 1 with stage II c, 1 with stage gb and 1 with stage lV, and the FIGO stage of 24 cases of ovarian cancer was 8 cases with stage I a, 1 with stage I b, 2 with stage I c, 1 with II c, 2 with stage III a, 1 with stage III b, 7 with stage III c and 2 with stage 1V. The mean age of borderline and malignant tumor was 37.1 and 47.6 years.. 3 cases were being pregnant on the operatian. In the 14 cases of borderline turnor, 7 cases were managed by conservative operation, but 1 case recurred 4 years later so extirpative operation and pastoperative chemotherapy were given. The other 4 cases were managed by extirpative operation but postoperative chemotherapy was given in only 1 patient. Follow up ranged from 7 to 72 months. 12 cases were alive. 2 cases died, one was stage III b, the other was atage IV. This atudy suggeat, that it is neceasary to follow up carefully even the early stage of botderline tumor and manage as oyarian carcinama in the advanced stage.
Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Mucins ; Ovarian Neoplasms ; Ovary* ; Prognosis