Comparison of Hematopoietic Stem Cell Activity in Normal Bone Marrow, in vivo G-CSF Stimulated Bone Marrow, and G-CSF-Mobilized Peripheral Blood / 대한수혈학회지

BACKGROUND: Classically, bone marrow (BM) has been the sole source of hematopoietic stem cell transplantation, but limitations of conventional bone marrow transplantation have stimulated a search for alternative sources of stem cells. METHODS: We compared hematopoietic stem cell activity of normal bone marrow (BM), in vivo G-CSF-stimulated bone marrow (G-CSF BM), and G-CSF-mobilized peripheral blood (G-CSF PB) by immunophenotyping, clonogeneicity, and long-term culture-initiating cell (LTC-IC) analysis. RESLUTS: The average numbers of CD34+/HLA-DR- cells after CD34+ cells isolation from each stem cell source were 59.64 +/- 8.70%, 91.39 +/- 1.98%, and 95.75 +/- 2.08% in normal BM, G-CSF BM, and G-CSF PB, respectively (normal BM vs. G-CSF BM, normal BM vs. G-CSF PB, p<0.0001). And the average numbers of CD34+/CD38- cells were 66.23 +/- 9.33%, 95.08+/- 2.09%, and 91.76 +/- 4.59% in normal BM, G-CSF BM, and G-CSF PB, respectively (normal BM vs. G-CSF BM, normal BM vs. G-CSF PB, p<0.0001). The numbers of CFU-GM was significantly higher in G-CSF PB (53.2 +/- 4.05) and G-CSF BM (52.5 +/- 3.63) than that of normal BM (31.3+/- 5.50) (p<0.0001). Also the numbers of CFU-GEMM and CFU-Mk were also significantly higher in G-CSF PB (110.3 +/- 8.79 and 13.3 +/- 1.49) and G-CSF BM (109.7 +/- 10.78 and 11.2 +/- 1.69) than that of normal BM (48.8 +/- 1.48 and 8.5 +/- 1.72) (p<0.05). Comparison of LTC-IC in the three sources of stem cells showed that G-CSF PB and G-CSF BM were superior to normal BM at five weeks of culture (p<0.05). CONCLUSIONS: These data suggest that the amount of both early progenitor cells and late progenitor cells in G-CSF PB and G-CSF BM are higher than that of normal BM. And our results further support that the higher stem cell transplantation using G-CSF-mobilized PB and in vivo G-CSF-stimulated BM can lead to more rapid and sustained engraftment even in cases of high risk of rejection.

Hepatosplenic Tuberculosis Mimicking Disseminated Candidiasis in Patients with Acute Leukemia / 감염

The intensive chemotherapy for acute leukemia is often associated with profound, protracted neutropenia and increases the risk of serious infections. In general, the duration of neutropenic period correlates with the increased risk of fungal infection and multiple hepatosplenic microabscesses following neutropenic periods has been one of the major problems in patients with acute leukemia, often attributed to fungal infections such as hepatosplenic candidiasis or disseminated candidiasis. But recently we experienced two cases of hepatosplenic tuberculosis in patients with acute leukemia during or after chemotherapy following prolonged neutropenia. Tuberculosis should be considered as one of causes of hepatosplenic abscesses during prolonged neutropenia, especially in countries, where the disease is endemic.

Three Cases of the Gastric Carcinoid Tumor Combined with the Gastric Adenoma / 대한소화기내시경학회지

Carcinoid tumor in the stomach is neuroendocrine tumor originated from enterochromaffin cells in submucosa in the stomach. It is very rare, account for 0.3% of gastric tumor. It is likely to be demonstrated with other tumor in the stomach simultaneously, such as adenocarcinoma. According to paper published in Korea, it is only 4 cases that gastric carcinoid combined with other gastric tumors have been reported. But there has been no reports of gastric carcinoid combined with gastric adenoma, such as our cases. We report 3 cases of gastric carcinoid tumor combined with atypical adenoma, with review of paper presented.

A case of Klebsiella pneumonia & Bacteremia Following Flexible Fiberoptic Bronchoscopy / 병원감염관리

Flexible fiberoptic bronchoscopy is a useful tool for the diagnosis and management for diseases of the airway. Although it has been known to be a relatively safe procedure; in some cases, mild complications can occur after fiberoptlc bronchoscopy. However, fatal complications such as bacteremia, pneumonia, myocardial infarction, severe obstruction of the airways, respiratory failure or death have been reported. Among them, infectious complications following flexible fiberoptic bronchoscopy occur sometimes, although most of them are self-limited. We recently experienced a case of severe Klebsiella pneumoniae pneumonia in a patient presenting with fever following flexible fiberoptic bronchoscopy, We report this case to discuss the potential complications of fiberoptic bronchoscopy with a review of literature.