The diagnosis of primary cutaneous lymphoma is based on a combination of clinical, histological, immunophenotypic and genetic criteria. Nineteen cases of primary cutaneous lymphomas were studied for clinicopathologic, immunophenotypic, and genetic features. Seventeen (89%) cases were T cell origin and two cases (11%) were B cell origin. CD30-positive cutaneous lymphoproliferative disorder was the most frequent subtype, occupying 42% (8 cases) of the cases. CD8 was positive in 5 cases consisting of 3 cutaneous T cell lymphomas and 2 anaplastic large cell lymphomas. CD4 was positive in 2 cases of mycosis fungoides and 3 cases of lymphomatoid papulosis. Six (67%) of 9 cases of cutaneous T cell lymphoma were positive for TIA-1. Ten (83%) out of 12 cases showed clonal rearrangements of TCR gamma genes, however, one T/NK cell lymphoma and one anaplastic large cell lymphoma did not. EBV association was detected only in T/NK cell lymphomas among 10 cases examined. In conclusion, our study showed higher proportion of CD30-positive lymphoproliferative disorders and less frequent mycosis fungoides in Korea compared to the incidences in Western countries. Our immunostaining results suggested that mycosis fungoides and lymphomatoid papulosis are CD4-positive T cell origin, however, the remaining primary cutaneous T cell lymphoma is predominantly CD8-positive cytotoxic T cell origin.
Diagnosis ; Genes, T-Cell Receptor gamma ; Herpesvirus 4, Human ; Incidence ; Korea ; Lymphoma* ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, T-Cell, Cutaneous ; Lymphomatoid Papulosis ; Lymphoproliferative Disorders ; Mycosis Fungoides

BACKGROUND: Pulmonary tuberculosis is affected by environmental factors, such as hygiene, nutrition, and socioeconomic status. Recently it has also been shown to be correlated with specific HLA types in foreign countries, although the mechanism underlying this association remains unknown. The aim of this study was to investigate the frequency and contribution of specific HLA alleles to pulmonary tuberculosis in Koreans. METHODS: HLA alleles of 97 patients whose illness was diagnosed as pulmonary tuberculosis by sputum acid-fast bacilli stain, culture, chest X-ray, and clinical evaluation at the Korean National Tuberculosis Association Department of Medical Operation were compared to those of 100 blood donors as controls. The polymerase chain reaction-sequence specific oligonucleotide probes (PCR-SSOP) method was used to define HLA-DQA1, HLA-DQB1, and HLA-DRB1 alleles. RESULTS: Among the patients analyzed by PCR- SSOP for HLA-DQA1 alleles, 63.9% were typed as HLA-DQA1*01, 50.5% HLA-DQA1*03, 22.6% HLA- DQA1*05, 8.2% HLA-DQA1*02, 7.2% HLA-DQA1* 06, and 4.1% HLA-DQA1*04. No difference in the distribution of HLA-DQA1 alleles between patients and healthy controls could be found, with the exception of HLA-DQA1*04, which was more common among controls. Regarding HLA-DQB1 alleles among the patients, 60% were typed as HLA-DQB1*03, 45% HLA-DQB1*06, 21.3% HLA-DQB1*04, 18.8% HLA- DQB1*05, and 11.3% HLA-DQB1*02. The allele distribution of HLA-DQB1 was not significantly different between patients and controls. For HLA-DRB1 alleles, 29.5% were typed as HLA-DRB1*02, 27.4% HLA- DRB1*08, 25.3% HLA-DRB1*04, 23.2% HLA-DRB1* 09, 20% HLA-DRB1*12, and 12.6% HLA-DRB1*13. There was also no difference between patients and controls in the allele distribution of HLA-DRB1. CONCLUSION: In Korea, where tuberculosis is relatively prevalent, pulmonary tuberculosis seems to be independent of HLA-DQA1, HLA-DQB1, and HLA- DRB1, although we found a statistically significant difference in HLA-DQA1*04 frequency between tuberculosis patients and controls.
Alleles ; Blood Donors ; HLA-DRB1 Chains* ; Humans ; Hygiene ; Korea ; Oligonucleotide Probes* ; Social Class ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary

BACKGROUND: Pulmonary tuberculosis is affected by environmental factors, such as hygiene, nutrition, and socioeconomic status. Recently it has also been shown to be correlated with specific HLA types in foreign countries, although the mechanism underlying this association remains unknown. The aim of this study was to investigate the frequency and contribution of specific HLA alleles to pulmonary tuberculosis in Koreans. METHODS: HLA alleles of 97 patients whose illness was diagnosed as pulmonary tuberculosis by sputum acid-fast bacilli stain, culture, chest X-ray, and clinical evaluation at the Korean National Tuberculosis Association Department of Medical Operation were compared to those of 100 blood donors as controls. The polymerase chain reaction-sequence specific oligonucleotide probes (PCR-SSOP) method was used to define HLA-DQA1, HLA-DQB1, and HLA-DRB1 alleles. RESULTS: Among the patients analyzed by PCR- SSOP for HLA-DQA1 alleles, 63.9% were typed as HLA-DQA1*01, 50.5% HLA-DQA1*03, 22.6% HLA- DQA1*05, 8.2% HLA-DQA1*02, 7.2% HLA-DQA1* 06, and 4.1% HLA-DQA1*04. No difference in the distribution of HLA-DQA1 alleles between patients and healthy controls could be found, with the exception of HLA-DQA1*04, which was more common among controls. Regarding HLA-DQB1 alleles among the patients, 60% were typed as HLA-DQB1*03, 45% HLA-DQB1*06, 21.3% HLA-DQB1*04, 18.8% HLA- DQB1*05, and 11.3% HLA-DQB1*02. The allele distribution of HLA-DQB1 was not significantly different between patients and controls. For HLA-DRB1 alleles, 29.5% were typed as HLA-DRB1*02, 27.4% HLA- DRB1*08, 25.3% HLA-DRB1*04, 23.2% HLA-DRB1* 09, 20% HLA-DRB1*12, and 12.6% HLA-DRB1*13. There was also no difference between patients and controls in the allele distribution of HLA-DRB1. CONCLUSION: In Korea, where tuberculosis is relatively prevalent, pulmonary tuberculosis seems to be independent of HLA-DQA1, HLA-DQB1, and HLA- DRB1, although we found a statistically significant difference in HLA-DQA1*04 frequency between tuberculosis patients and controls.
Alleles ; Blood Donors ; HLA-DRB1 Chains* ; Humans ; Hygiene ; Korea ; Oligonucleotide Probes* ; Social Class ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary

BACKGROUND: This was concerned with outbreak investigation of the epidemic keratoconjunctivitis (EKC) which occurred from April to May 1996 in the neonatal intensive care unit (NICU) of Seoul National University Hospital in Seoul, Korea. METHOD: We defined the cases by the clinical signs and symptoms and investigated the possible risk factors of this outbreak by case-control analysis. RESULTS: The number of total cases were 17, including neonates (10 cases) and health care workers (7 cases), The index case was thought to be infected by his family, while the other cases may have been transmitted through contact with nurses who cared for or fed the index case. There were no statistically significant differences between case and non-case (control) neonates. However, for nurses, the total amounts of time spent working in the hospital and in the NICU were identified as significant factors. And the incidence of EKC was higher in the nurses who contacted neonates with EKC more frequently. CONCLUSION: According to our contact precautions, we enforced cohort isolation and emphasized strict hand washing and aseptic technique to the health care workers. All of the equipment, especially eye dips used by the cases, was disinfected or sterilized. Fortunately this outbreak ended after about one week when we recognized and started to investigate this outbreak.
Case-Control Studies ; Cohort Studies ; Delivery of Health Care ; Hand Disinfection ; Humans ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal* ; Keratoconjunctivitis* ; Korea ; Risk Factors ; Seoul

A 23-year-old medical student showed a positive reaction on a skin test for Paragonimus westermani, and two Tarsonemus floricolus mites were subsequently found by sputum examination and identified morphologically. Our report is the first human case of Tarsonemus floricolus in Korea.
Adult ; Animals ; Female ; Humans ; Korea ; Male ; Mite Infestations/*parasitology ; Pyroglyphidae/anatomy & histology/*growth & development ; Sputum/*parasitology

The accuracy of fine needle aspiration cytology(FNAC) of the lymph node was investigated through a review of 176 FNAC cases and the corresponding biopsies. We chose 157 FNAC cases after the exclusion of 19 inadequate ones. Sensitivity of malignancy was 94.0%, specificity 100%, false negativity 6.0%, and false positivity 0.0%. The overall diagnostic accuracy was 96.8%. Sensitivity of metastatic carcinoma was 98.0% and that of malignant lymphoma was 87.9%. False negative cases included one metastatic carcinoma and four malignant lymphomas. The aspirates of metastatic carcinoma with false negativity exhibited a diffuse smear of keratin debris without viable cells, which led to the difficulty in differentiation from benign epithelial cyst. The cases of malignant lymphoma with false negative diagnosis were two Hodgkin diseases, one Lennert's lymphoma, and one peripheral T cell lymphoma in the histologic sections. On the analysis of 39 cases of tuberculosis, 17 cases(43.6%) were diagnosed as tuberculosis, 4(10.3%) as granulomatous lymphadenitis, 3(7.7%) as necrotizing lymphadenitis, and 15(38.5%) as reactive hyperplasia or pyogenic inflammation. Sensitivity of tuberculosis was 53.9%. In conclusion, lymph node FNAC is an excellent non-invasive diagnostic tool for the diagnosis of metastatic carcinoma. The diagnostic accuracy of malignant lymphoma could be improved with flow cytometry or polymerase chain reaction for antigen receptor genes. For the FNAC diagnosis of tuberculosis, AFB stain, culture, and PCR would be helpful as adjuvant techniques.
Biopsy* ; Biopsy, Fine-Needle* ; Diagnosis ; Flow Cytometry ; Hyperplasia ; Inflammation ; Lymph Nodes* ; Lymphadenitis ; Lymphoma ; Lymphoma, T-Cell, Peripheral ; Polymerase Chain Reaction ; Receptors, Antigen ; Sensitivity and Specificity ; Tuberculosis

The patient was a 50-year-old woman who presented intermittent mild fever with elevated liver enzymes for 12 years. The liver biopsy showed diffuse portal and sinusoidal involvement of lymphoid cells with minimal atypia and epithelioid histiocytic granuloma formation. Subsequent bone marrow biopsy showed lymphomatous involvement. The lymphocytes infiltrating the liver were reactive for T-cell marker and showed TCR gamma gene rearrangement. The patient was diagnosed as primary peripheral T-cell lymphoma of the liver. Indolent clinical course and resemblance with hepatitis were considered to be a rare and unique feature of this case.
Case Report ; DNA, Neoplasm/analysis ; Female ; Gene Rearrangement ; Human ; Liver Neoplasms/radiography ; Liver Neoplasms/pathology* ; Liver Neoplasms/genetics ; Lymphoma, T-Cell/radiography ; Lymphoma, T-Cell/pathology* ; Lymphoma, T-Cell/genetics ; Middle Age ; Receptors, Antigen, T-Cell, gamma-delta/genetics ; Tomography, X-Ray Computed

Hematopoietic neoplasm coexpressing CD4 and CD56 includes a subset of acute myeloid leukemia with myelomonocytic differentiation, plasmacytoid monocyte tumor, and other immature hematopoietic neoplasms of undefined origin. Herein, we report a CD4+CD56+CD68+ hematopoietic tumor that was thought to be a tumor of plasmacytoid monocytes. This case is unique in the absence of accompanying myelomonocytic leukemia and the faint expression of cCD3 on the tumor cells. The patient was a 22-yr old man presented with multiple lymphadenopathy and an involvement of the bone marrow. Tumor cells were large and monomorphic with an angulated eosinophilic cytoplasm of moderate amount. Nuclei of most tumor cells were eccentric and round with one or two prominent nucleoli. Rough endoplasmic reticulum was prominent in electron microscopic examination. Tumor cells expressed CD4, CD7, CD10, CD45RB, CD56, CD68, and HLA-DR and were negative for CD1a, CD2, sCD3, CD5, CD13, CD14, CD20, CD33, CD34, CD43, CD45RA, TIA-1, S-100, and TdT. cCD3 was not detected in the immunostaining using paraffin tissue, but was faintly expressed in flow cytometry and immunostaining using a touch imprint slide. T-cell receptor gene rearrangement analysis and EBV in situ hybridization showed negative results. Cytochemically, myeloperoxidase, Sudan black B, and alpha naphthyl butyrate esterase were all negative.
Adult ; Antigens, CD/*biosynthesis ; Antigens, CD3/*biosynthesis ; Antigens, CD4/*biosynthesis ; Antigens, CD45/biosynthesis ; Antigens, CD56/*biosynthesis ; Antigens, Differentiation, Myelomonocytic/*biosynthesis ; Bone Marrow Cells/pathology ; Cell Nucleus/pathology ; Eosinophils/metabolism ; Flow Cytometry ; Gene Rearrangement ; Humans ; Immunohistochemistry ; In Situ Hybridization ; Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis/*metabolism ; Lymph Nodes/pathology ; Male ; Microscopy, Electron ; Monocytes/*metabolism ; Receptors, Antigen, T-Cell/metabolism

Over-expression of the human epidermal growth factor receptor-2 (HER2/neu) has been observed in many cancers, and is associated with a poor prognosis. Recent adjuvant treatment with anti-HER2 monoclonal antibodies in breast cancer has increased the demand for an evaluation of the HER2/neu status in breast cancer. The aim of this study was to investigate the HER2/neu status in breast cancer by a real-time quantitative polymerase chain reaction (PCR) method using LightCycler (Roche Diagnostics, Mannheim, Germany). DNA samples from the fresh tumor tissues of 27 patients with breast cancer were analyzed in parallel using immunohistochemistry (IHC) and the other prognostic parameters including estrogen receptor, progesterone receptor, cytokeratin, and DNA ploidy. Ten (37%) out of 27 cases tested were positive for HER2/neu, while 16 (73%) out of 22 tested positive through an IHC study. The correlation between the DNA aneuploidy and the positive results for HER2/neu were only observed using the real-time PCR method (p < 0.05). There was no significant correlation between the HER2/neu status and the S-phase fractions of the DNA ploidy or other parameters. This study demonstrated that there is marked discordance in the results for the HER2/neu status according to the various methods used. Real-time quantitative PCR for HER2/neu appears to be clinically useful due to its simplicity and ability to produce rapid results.
Breast Neoplasms/*metabolism ; Female ; Human ; Protein Isoforms/metabolism ; Receptor, Epidermal Growth Factor/*metabolism ; *Reverse Transcriptase Polymerase Chain Reaction

BACKGROUND: Numerous disinfectants are available for disinfection and sterilization in the hospital environment but it is difficult to select an appropriate one. Biospot(R) is a chlorine-based disinfectant that consists of sodium dichloroisocyanurates. We evaluated the bactericidal effect of Biospot(R) against clinical isolates and compared it with that of other disinfectants. METHOD: Biospot(R), Wydex(R), HiCLO-S(R), Vipon(R), 70% ethanol, and 3% boric acid were evaluated. Clinical isolates were cultured from the patients in Kangnam St. Mary's hospital. There were two strains of Escherichia coli, methicillin-susceptible Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, Klebsiella pneumoniae, vancomycin-resistant Enterococcus faecium, Pseudomonas aeruginosa, coagulase-negative staphylococcus, Streptococcus pneumoniae, and Bacillus subtilis. One strain of Candida albicans was included. Each strain was exposed to disinfectants for 0.5, 1, 2, 4, 8, and 15 minutes. RESULTS: All the non-spore forming bacteria were killed within 30 seconds in Biospot(R) (30 ppm of sodium dichloroisocyanurate). Wydex(R) (2% glutaraldehyde), HiCLO-S(R) (hypochlorous add 30ppm and electrolyzed oxidized water), Vipon(R) (50ppm of sodium hypochlorite), and 70% ethanol, but not in boric acid. Candida albicans were killed in 30 seconds with 100 ppm of BiOSpot(R) and all of disinfectants except boric acid. Bacillus subtilis, the spore forming bacteria, was killed in 4 minutes with 50 ppm, 2 minutes with 100 ppm of Btospot. Other disinfectants such as Vipon(R) killed Bacillus subtilis in 8 minutes. But Wydex(R), HiCLO-S(R), 70% ethanol, and boric acid could not kill the strain until 15 minutes. CONCLUSIONS: Biospot(R) was an effective and useful disinfectant against most common clinical isolates including fungus and spore forming bacteria.
Bacillus subtilis ; Bacteria ; Candida albicans ; Disinfectants ; Disinfection ; Enterococcus faecium ; Escherichia coli ; Ethanol ; Fungi ; Humans ; Klebsiella pneumoniae ; Methicillin-Resistant Staphylococcus aureus ; Pseudomonas aeruginosa ; Sodium ; Spores ; Staphylococcus ; Staphylococcus aureus ; Sterilization ; Streptococcus pneumoniae