A case report of near-triploid in adult acute lymphocytic leukemia / 대한내과학회지

In addition to age, white cell count and immunophenotype, karyotype has been reported to be one of the important prognostic factors in acute lymphocytic leukemias.Furthermore 70 percent of patients with acute B lymphocytic leukemia presented chromosomal abnormalities, which is known to have a close relationship with the prognosis. Among the abnormalities, triploid is rare and known to have the worse prognosis. Structural chromosomal abnormality of the 11q23 band is more common in childhood acute lymphocytic leukemia and has been rarely reported in adult lymphocytic leukemia. We present a case of a 29 year - old male patient with acute lymphocytic leukemia, who had triploid and chromosomal translocation including 11q23 band along with the review of related literature.

Acute renal failure and delayed neuropathy due to anti-freeze ingestion / 대한내과학회지

Antifreeze contains ethylene glycol up to ninty five percent. Ethylene glycol is colorless, odorless, sweet-tasting and water-soluble compound and has been widely used as a chemical solvent. Ethylene glycol has been reported as a common cause of incidental poisoning all over the world because of its easy access. However, in Korea, it is not easy to find statistical references on incidences of ethylene glycol intoxication, except two reported cases. Ethylene glycol itself is not toxic substance. But, many other daughter metabolites are very toxic and lethal. Acid metabolites among them can cause metabolic acidosis. Oxalate, end-product of ethylene glycol, is quickly transformed to calcium oxalate crystals, which precipitate in body tissues such as brain, kidney, heart, liver, and pancreas. We report a case of acute renal failure and neuropathy due to ethylene glycol intoxication along with a review of toxic effects of ethylene glycol.

Transient Elliptocytosis Associated with Acute Lymphoblastic Leukemia / 대한혈액학회지

Elliptocytosis has been known to be a rare disease, especially in oriental people. Most of them are transmitted as an autosomal dominant trait but we experienced one case of transient elliptocytosis associated with acute lymphoblastic leukemia by morphologic examination of the peripheral blood and bone marrow biopsy. The results of the peripheral blood smears of the patient and his family are as follows : he showed about 50~60% of elliptocytes and anemia without hemolytic event; his family, however, showedno sign of elliptocytosis. The patient was treated for acute lymphoblastic leukemia. On follow-up check after one month, the peripheral blood showed almost normal RBC morphology. Therefore, we diagnosed this case as transient elliptocytosis associated with acute leukemia. So we report a case of transient elliptocytosis associated with acute leukemia with a brief review of the relevant literature.

Comparison of 67Ga planar imaging and SPECT for the evaluation of activity in undetermined minimal pulmonary tuberculosis / 결핵

BACKGROUND: We have studied the 67Ga SPECT to determine the activity of pulmonary tuberculosis, especially in patients with minimal extent of the disease on chest radiographs. Because active minimal pulmonary tuberculosis is sometimes difficult to diagnose by means of initial chest X-ray, sputum examination and 67Ga planar imaging, we compared 67Ga planar imaging with SPECT to evaluate minimal pulmonary tuberculosis activity. METHODS: 67Ga planar imagings and SPECTs of 69 patients suspected of minimal pulmonary tuberculosis by the initial chest X-ray were performed and compared to each other. Active pulmonary tuberculosis was defined by a positive AFB smear and/or culture in the sputum and changes shown on the serial chest X-ray findings. RESULTS: 1)67Ga planar imaging imagings showed positive uptakes in 24 patients and no uptakes in 13 patients, which confirms active pulmonary tuberculosis. But SPECT imagings showed positive uptakes in 25 patients and no uptakes in 12 patients. 2) Patients confirmed with inactive pulmonary tuberculosis showed no up-take on 67Ga planar imaging. Only one of the 32 patients confirmed as having inactive pulmonary tuberculosis showed positive uptake on 67Ga SPECT imaging. CONCLUSIONS: According to the results of our study, 67Ga planar imaging and SPECT are both sensitive in detecting the activity of minimal pulmonary tuberculosis. The difference between the two methods is not statistically significant, and the negative predictive value of the 67Ga SPECT is not higher than that of 67Ga planar imaging.

Effect of Propranolol on Portal Vein Pressure in Patients with Chronic Liver Disease: Evaluation by Perrectal Portal Scintigraphy / 대한핵의학회잡지

PURPOSE: Propranolol is known to decrease portal pressure by reducing blood flow of portal vein. Per-rectal portal scintigraphy with Tc-99m pertechnetate has been introduced to evaluate the portal circulation and early diagnosis of liver cirrhosis. We evaluated the effects of propranolol on portal circulation by using per-rectal portal scintigraphy. MATERIALS AND METHODS: We analyzed the portal hemodynamics by per-rectal portal scintigraphy in 51 patients with liver cirrhosis, 10 chronic hepatitis and 10 normal subjects. 38 patients with cirrhosis underwent per-rectal portal scintigraphy before and after propranolol medication. Per-rectal portal scintigraphy was performed after per-rectal administration of 370 MBq of Tc-99m pertechnetate. The shunt index was calculated as the ratio, expressed as a percentage of heart radioactivity to the sum of heart and liver radioactivity during the first 30 seconds. RESULTS: The shunt index in 40 patients with cirrhosis (59.8+/-27.2%) was significantly higher than that of normal control (5.0+/-1.2%, p<0.01) and chronic hepatitis (11.4+/-3.5%, p<0.01). Shunt index was significantly different according to Child's classification and the degree of esophageal varix (p<0.01). After propranolol medication, shunt index was significantly decreased from 59.9+/-27.3% to 51.3+/-15.3% (p<0.01) in 38 patients with liver cirrhosis. There was no significant difference of the amount of shunt index reduction after propranolol according to Childs' classification and the degree of esophgageal varix. CONCLUSION: The effect of propranolol on portal circulation was demonstrated as decreasing shunt index on per-rectal portal scintigraphy in patients with liver cirrhosis. Per-rectal portal scintigraphy may be useful to evaluate the portal circulation and to predict the effect of propranolol in patients with liver cirrhosis.

A seroepidemiological study of anti-HAV IgG in korean combat policemen / 대한내과학회지

BACKGROUND: Hepaitis A virus(HAV) infection occurs commonly during early childhood. Recent improvements in sanitation and hygiene have resulted in a decrease in HAV infection among children, while the clinical illness of hepatitis A and prevalence of antibody to HAV(anti-HAV IgG) have been increased, particularly in the 3rd decade of young male adults. We studied a seroepidemiology of anti-HAV IgG in combat policemen who were living together during their service in the combat police force. METHODS: We measured anti-HAV IgG(HAVAB, Abbott) from 1,009 healthy subjects with no history of transfusion of any blood products during the last 6 months. The mean age was 20.8 years. RESULTS: Overall, anti-HAV IgG was detected in 30.2% of study subjects. According to age, the positive rates of antibody were 15.7%, 25.9%, 31.5%, 38.1%, 43.5%, and 50.0% in 19, 20, 21, 22, 23, and 24 years respectively. The positive rates of anti-HAV IgG as to period of service were 17.3%, 28.1%, 40.9% in 0 month, 1-12 months, 13-24 months respectively. The positive rates of anti-HAV IgG were 27.0% in the urban group, 39.8% in the rural group. CONCLUSION: The positive rates of anti-HAV IgG in our data low compared with those of previous reports. We think that group living condition such as living in dormitories or barracks can be a risk factors for hepatitis A infection and that improvements to the sanitary system and active immunization would be necessary for prevention of it.

A comparative study of SPECT, q-EEG and CT in patients with mild, acute head trauma / 대한핵의학회잡지

No abstract available.