MRI Finding of a Case of Relapsed Acute Mixed Type Leukemia with Bone Marrow Necrosis

Bone marrow necrosis is a rare complication of a variety of diseases affecting the marrow. The cause and incidence are unknown, and reports of treatment response are rare. We describe a case of relapsed acute mixed type leukemia with bone marrow necrosis. The patient was a 10 year old female diagnosed with acute mixed type leukemia four years ago. She had been on second remission state for 1 year, presented with severe back pain, tenderness in lower extremities, low-grade fever and general weakness. Her level of serum lactic dehydrogenase on admission was increased. Bone marrow aspiration from both posterior iliac crest showed marrow necrosis. Subsequent examination showed the same feature. Hip MRI showed heterogenous low signal intensity in both iliac bone on T-1 weighted image and heterogenous high signal intensity on T-2 wieghted image. Remission induction therapy was started but she expired on 59th hospital day due to the complication of sepsis.

Viability and Colony Forming Capacity of Hematopoietic Stem Cells after Cryopreservation / 대한소아혈액종양학회지

PURPOSE: Cryopreservation of hematopoietic stem cells is one of the essential components in autologous and peripheral blood stem cell transplantation. Cryopreservation of hematopoietic stem cell, the conventional method involves controlled-rate freezing by a programmed freezer in medium that contains 10% dimethyl sulfoxide (DMSO) as cryoprotectant, followed by storage in liquid nitrogen freezer. We compared the differences between different methods of cryopreservation and cryoprotectants on viability and colony forming capacity of hematopoietic stem cells. METHODS: Mononuclear cells separated using Ficoll-Hypaque from cord blood, peripheral blood and bone marrow were frozen with programmed freezer at 196degrees C or placed in a 70degrees C freezer without programmed freezer in both 10% and 20% DMSO. We measured cell viability using trypan blue dye exclusion method and colony forming capacity with methyl cellulose media at 7, 30 and 90 days after thawing. RESULTS: Cell viability of cord blood, peripheral blood and bone marrow was higher in the groups with programmed freezer compared with rapid freezing and storing in a 70degrees C freezer. Also as the storage time passed, the decrease in viability of hematopoietic cells was much less in the groups of controlled-rate freezing by a programmed freezer. The number of colony in cord blood and bone marrow was higher with programmed freezer and that of peripheral blood was higher with rapid freezing and storage in a 70degrees C freezer. Comparing the differences between different concentraions of DMSO, cell viability was similar or slightly higher in 20% DMSO groups than 10% DMSO groups, but the number of colony was higher in 10% DMSO groups. CONCLUSION: These results suggested that conventional cryopreservation method using programmed freezer with 10% DMSO was more effective in the cryopreservation of hematopoietic stem cells.

CD68 Positive Histiocytic Necrotizing Lymphadenitis / 대한소아혈액종양학회지

Histiocytic necrotizing lymphadenitis (Kikuchi's disease) is a cause of benign lymphadenitis, most commonly affecting young women and usually presenting as a painless or painful cervical lymphadenopathy sometimes associated with fever and leukopenia. Less frequent symptoms include weight loss, nausea, vomiting, and night sweats. We experienced two cases of histiocytic necrotizing lymphadenitis in an 11-year-old boy and a 13-year-old boy. They presented cervical lymphadenopathy with fever in one patient and without fever in the other patient. Lymph node enlargement did not respond to antibiotics. We performed surgical biopsy of cervical lymph node which was consistent with histiocytic necrotizing lymphadenitis. In one patient CD8 T cells and CD68 histiocytes were shown in immunohistochemical stain. So we report two cases of histiocytic necrotizing lymphadenitis with brief review of the related literature.

Comparision of IGF-I Level in Children with Short Stature / 대한소아내분비학회지

PURPOSE: Nowadays pharmacologic provocation tests and physiologic tests are usually used to determine growth hormone(GH) deficiency in short stature. But this method has many problems. We know GH stimulates the release and synthesis of insulin-like growth factor-I(IGF-I) and measuring the level of IGF-I is relatively simple. So we measured plasma IGF-I to watch the correlation with the GH levels and to determine it may replace the complicated stimulation tests. METHODS: At the department of Pediatrics in Dong San Hospital from Dec. 1996 to Aug. 1998, childrens who visited for evaluation of short stature and measured GH and IGF-I simultaneously were reviewed. After clonidine and insulin administration, exercise and sleep, we measured their peak GH level and IGF-I level by the immunoradiometric assay(IRMA) kit. RESULTS: The ratio of boys and girls were 22 to 31 and the cases below 3 rd percentile were 26 which was the most. With phamacologic provocation test, there were 43 cases whose level of peak GH below 7 ng/mL(group I) but with combined phamacologic provocation and physiologic tests there were 27 cases of group I. The mean IGF-I level showed correlation with aging in both male and female(r=0.53, P<0.05). The relationship between peak GH and IGF-I level are found when we tested both phamacologic and physiologic combined tests. The mean IGF-I level did not correlate with height percentile. CONCLUSION: Measuring the IGF-I value was useful to detect GH deficient children but combined tests were more helpful.