BACKGROUND: Autoimmune hemolytic anemias are characterized by autoantibodies recognizing antigens on the Individual's own red blood cells, resulting in immune- mediated hemolysis. Blood transfusions have been regarded as hazardous in patients with autoimmune hemolytic anemia (AIHA) because of potential intensification of hemolysis and a presumed high incidence of alloimmunization. METHODS: We examined the pretransfusion and posttransfusion hemoglobin levels in 6 patients with autoantibodies in their sera, which showed panagglutinations with all bloods tested in the compatibility testing. They received 'least' incompatible blood because of inability to find compatible blood. RESULTS: When we compared pretransfusion hemoglobin level with posttransfusion hemoglobin level, in 5 of 6 patients with AIHA, the hemoglobin levels were increased after red cell transfusion. 4 patient who did not respond to transfusion therapy initially had an increase in hemoglobin level after steroid treatment. Any signs or symptoms indicating hemolytic transfusion reaction were not observed ducting the transfusion period in all patients. CONCLUSIONS: The decision to transfuse in AIHA should consider multiple factors including the patient's clinical status, the potential benefit of transfusion, the potential response to other therapeutic modalities, but must never be regarded as contraindicated, even though the compatibility test may be strongly incompatible.
Anemia, Hemolytic* ; Anemia, Hemolytic, Autoimmune ; Autoantibodies ; Blood Group Incompatibility ; Blood Transfusion ; Erythrocyte Transfusion* ; Erythrocytes* ; Hemolysis ; Humans ; Incidence

BACKGROUND: Autoimmune hemolytic anemias are characterized by autoantibodies recognizing antigens on the Individual's own red blood cells, resulting in immune- mediated hemolysis. Blood transfusions have been regarded as hazardous in patients with autoimmune hemolytic anemia (AIHA) because of potential intensification of hemolysis and a presumed high incidence of alloimmunization. METHODS: We examined the pretransfusion and posttransfusion hemoglobin levels in 6 patients with autoantibodies in their sera, which showed panagglutinations with all bloods tested in the compatibility testing. They received 'least' incompatible blood because of inability to find compatible blood. RESULTS: When we compared pretransfusion hemoglobin level with posttransfusion hemoglobin level, in 5 of 6 patients with AIHA, the hemoglobin levels were increased after red cell transfusion. 4 patient who did not respond to transfusion therapy initially had an increase in hemoglobin level after steroid treatment. Any signs or symptoms indicating hemolytic transfusion reaction were not observed ducting the transfusion period in all patients. CONCLUSIONS: The decision to transfuse in AIHA should consider multiple factors including the patient's clinical status, the potential benefit of transfusion, the potential response to other therapeutic modalities, but must never be regarded as contraindicated, even though the compatibility test may be strongly incompatible.
Anemia, Hemolytic* ; Anemia, Hemolytic, Autoimmune ; Autoantibodies ; Blood Group Incompatibility ; Blood Transfusion ; Erythrocyte Transfusion* ; Erythrocytes* ; Hemolysis ; Humans ; Incidence

Among the causes of pure red cell aplasia, human parvovirus B19 has been shown to be cytotoxic to erythroid progenitor cells in the bone marrow associated with chronic hemolytic anemia with rapidly dividing erythroids and persistently to be suppression of erythropoiesis in immunocompromised individuals related with failure to produce neutralizing antibody to the virus. In a patient with hereditary spherocytosis presenting acute onset of reticulocytopenia during hospitalization, who had shown severe anemia and prodromal symptoms including fever, fatigue and dizziness, infection of parvovirus Bl9 was proven by the presence of IgM and IgG antibodies to parvovirus Bl9, the detection of viral DNA using PCR technique in her serum and the decreased erythroid cells, especially late normoblasts in bone marrow, Also in the other who was diagnosed as hereditary elliptocytosis and complained of fever, headache, abdominal pain and diarrhea, an episode of reticulocytopenia and the nearly absence of late normoblasts in the bone marrow were observed. IgM antibodies to parvovirus Bl9 and the viral DNA were detected in her serum, too.
Abdominal Pain ; Anemia ; Anemia, Hemolytic ; Antibodies ; Antibodies, Neutralizing ; Bone Marrow ; Diarrhea ; Dizziness ; DNA, Viral ; Elliptocytosis, Hereditary* ; Erythroblasts ; Erythroid Cells ; Erythroid Precursor Cells ; Erythropoiesis ; Fatigue ; Fever ; Headache ; Hospitalization ; Humans* ; Immunoglobulin G ; Immunoglobulin M ; Parvovirus B19, Human ; Parvovirus* ; Polymerase Chain Reaction ; Prodromal Symptoms ; Red-Cell Aplasia, Pure

Among the causes of pure red cell aplasia, human parvovirus B19 has been shown to be cytotoxic to erythroid progenitor cells in the bone marrow associated with chronic hemolytic anemia with rapidly dividing erythroids and persistently to be suppression of erythropoiesis in immunocompromised individuals related with failure to produce neutralizing antibody to the virus. In a patient with hereditary spherocytosis presenting acute onset of reticulocytopenia during hospitalization, who had shown severe anemia and prodromal symptoms including fever, fatigue and dizziness, infection of parvovirus Bl9 was proven by the presence of IgM and IgG antibodies to parvovirus Bl9, the detection of viral DNA using PCR technique in her serum and the decreased erythroid cells, especially late normoblasts in bone marrow, Also in the other who was diagnosed as hereditary elliptocytosis and complained of fever, headache, abdominal pain and diarrhea, an episode of reticulocytopenia and the nearly absence of late normoblasts in the bone marrow were observed. IgM antibodies to parvovirus Bl9 and the viral DNA were detected in her serum, too.
Abdominal Pain ; Anemia ; Anemia, Hemolytic ; Antibodies ; Antibodies, Neutralizing ; Bone Marrow ; Diarrhea ; Dizziness ; DNA, Viral ; Elliptocytosis, Hereditary* ; Erythroblasts ; Erythroid Cells ; Erythroid Precursor Cells ; Erythropoiesis ; Fatigue ; Fever ; Headache ; Hospitalization ; Humans* ; Immunoglobulin G ; Immunoglobulin M ; Parvovirus B19, Human ; Parvovirus* ; Polymerase Chain Reaction ; Prodromal Symptoms ; Red-Cell Aplasia, Pure

An epidermoid cyst of the cecum is extremely rare; only eight cases have been reported in the literature. A 63-year-old woman was admitted to Kyung Hee University Medical Center with a colonic mass that had been discovered incidentally during a regular health check-up. The radiographic impression was that this mass was a gastrointestinal stromal tumor. During surgery, an exophytic mass in the cecal wall was resected by using an ileocecectomy. Based on the macroscopic and the microscopic findings, this case was identified as an epidermoid cyst of the cecal wall. We report this case to discuss the origin of this entity and the unusual nature of our case.
Academic Medical Centers ; Cecum* ; Colon ; Epidermal Cyst* ; Female ; Gastrointestinal Stromal Tumors ; Humans ; Middle Aged

PURPOSE: The aim of this study was to determine the rate of lymph node (LN) micrometastasis in patients with stage I and II rectal cancer.METHODS: One hundred eighty patients with either stage I or II rectal carcinoma who underwent curative resection between 1995 and 2010 were included. Forty-eight patients received neoadjuvant chemoradiotherapy. Two sections from each LN were stained with hematoxylin and eosin (H&E) and with CK20 by immunohistochemistry (IHC), respectively.RESULTS: A total of 2,257 LNs with a median of 12.5 LNs per patient were examined. For IHC staining, CK20-positive neoplastic cells were found in 4 of the 2,257 LNs (0.2%) from 3 of the 180 patients (1.7%), and all corresponding H&E re-stained sections confirmed that these neoplastic cells were present. Three of four neoplastic cells were micrometastasis, and one was macrometastasis. All occult neoplastic cells were found in 3 of the 85 patients (3.5%) with stage II disease.CONCLUSION: We observed a 3.5% rate of occult neoplastic cells in stage II rectal cancer. Interestingly, the results of IHC staining corresponded with those of H&E re-stained sections, suggesting that the examination of H&E stained section by a competent pathologist may replace IHC staining.
Chemoradiotherapy ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Immunohistochemistry ; Lymph Nodes ; Lymphatic Metastasis ; Neoplasm Micrometastasis ; Rectal Neoplasms

Owing to in-hospital transmission of coronavirus disease 2019 (COVID-19), Uijeongbu St.Mary’s Hospital, a university-affiliated hospital in South Korea, was temporarily closed for disinfection in March 2020. This study aimed to investigate the impact of both the hospital shutdown and the prolonged COVID-19 pandemic on short-term outcomes of colorectal cancer (CRC) patients. We retrospectively reviewed the clinicopathologic data of 607 patients who were surgically treated for CRC from May 2018 to September 2021. Nodal upstaging, higher lymphatic invasion and abdominoperineal resection rates for 3 months after the hospital resumed surgery following the shutdown in the first wave of the COVID-19 pandemic were detected, without worse short-term morbidity or mortality. The incidence of adverse pathologic features of CRC such as lymphatic, venous, and perineural invasion was higher throughout the COVID-19 pandemic era. Further follow-up of CRC patients treated in the pandemic era for long-term oncologic outcomes is needed.

PURPOSE: To evaluate the effectiveness and safety of the modified pulse-spray method using Urokinase (UK) in subacute and chronic thrombotic arterial occlusion. MATERIALS AND METHODS: Modified pulse-spray methods using UKwere performed in seven patients with subacute (1week-1month) to chronic (1 month-5years) occlusive sysmptoms suchas limb pain, claudication and impotence. Angiographic examination revealed thrombotic occlusion of the aorta, common iliac arteries, brachial arterio-venous hemodialysis graft and femoro-popliteal bypass graft. The patients underwent thrombolysis using modified pulse-spray and additional constant infusion of UK. In the presence of underlying stenosis or organized clots, balloon angioplasty or stent placement was performed. RESULTS: Completelysis was obtained in five of seven patients. For initial lysis, the mean dose of UK was 420,000 units, and the mean modified pulse-spray time was 50 minutes. Mean total dose of UK and mean total time for complete lysis were 800,000 units and 161 minutes, respectively. Thrombolysis of the femoro-popliteal bypass graft failed due to severe occlusion of the distal anastomosis. Partial lysis was achieved in one patient with aorto-iliac occlusion, but further thrombolysis was stopped due to bleeding at the puncture site. CONCLUSION: The modified pulse-spraymethod using UK is effective in treating subacute and chronic arterial thrombotic occlusion. It augments the speed, safety and efficacy of thrombolysis. When underlying stenosis or organized clots remain after thrombolysis, balloon angioplasty or stent placement would be helpful.
Angioplasty ; Angioplasty, Balloon ; Constriction, Pathologic ; Erectile Dysfunction ; Extremities ; Hemorrhage ; Humans ; Iliac Artery ; Male ; Punctures ; Renal Dialysis ; Stents ; Transplants ; Urokinase-Type Plasminogen Activator*

Anterior diastemas are common esthetic problems. One of the challenges in clinical esthetic dentistry is closing anterior diastemas without creating “black triangles” between the teeth. The success of a restorative treatment in anterior teeth depends on the esthetic integration between soft tissues and hard tissues. This report describes the successfully accomplished diastema closure case by producing the emergence profile with natural contours at the gingival-tooth interface and then generating of gingival recontouring process.
Dentistry ; Diastema* ; Tooth

Congenital cystic duplications of the alimentary tract are rare, but can occur anywhere along the GI tract. Ileal duplication cysts account for the majority of diagnosed cases. Symptoms generally develop during infancy or childhood, with diverse presentations. Common manifestations include abdominal pain, an abdominal mass, vomiting, occasional intussusception, perforation, bleeding, and obstructive symptoms. In this report, we present the case of a 20-year-old man with an ileal duplication cyst with obscure lower gastrointestinal bleeding. The patient underwent cyst excision with a primary end to end anastomosis. The patient was discharged on the postoperative 7th day without any complications.
Abdominal Pain ; Adult* ; Gastrointestinal Tract ; Hemorrhage* ; Humans ; Intussusception ; Vomiting ; Young Adult