Clinical Evaluation of 10 Cases of Nontuberculous Mycobacteria Isolated from Sputum / 대한진단검사의학회지

Infections due to Nontuberculous Mycobacteria (NTM) have been recognized increasingly worldwide. We report 10 cases of nontuberculous mycobacteria isolated from sputa, being eight cases of M. szulgai, one of M. gordonae, and one of M. abscessus. All but one M. abscessus-isolating case was developed in the same period in one episode. Therefore, it is likely to be contaminated. NTM is a possible pathogen and infections due to NTM are clinically important. Thus, correct identification and determination of clinical significance should be verified.

A Case of Acquired Hemophilia A / 임상검사와정도관리

Acquired hemophilia is a rare acquired bleeding disorder. It occurs most frequently in elderly patients and in patients with associated underlying diseases such as autoimmune disorders, rheumatoid arthritis, malignancies, and so on. It is caused by autoantibodies to factor VIII which deplete circulating factor VIII. We report a 78-year-old man with acquired hemophilia A who underwent subtotal gastrectomy for stomach cancer 7 years ago with no current evidence of recurrence. He has no bleeding tendency in the past nor family history for bleeding. On admission he had blood clots in both renal pelvis and sustaining hematuria. Laboratory tests revealed prolonged activated partial thromboplastin time(aPTT), decreased activity of factor VIII and evidence of factor VIII inhibitor.

Efficacy of Therapeutic Plasma Exchange Using Post-Centrifugal Plasma Filtration / 대한진단검사의학회지

BACKGROUND: Therapeutic plasma exchange (TPE) removes pathogenic substances through a centrifugation or membrane filtration method. During the procedure for TPE, normal substances can be reduced with the removal of such pathogens. We evaluated a simple plasma exchange (SPE) and a modified technique called post-centrifugal plasma filtration (PCPF), and analyzed the degree of changes in substances between the two methods. METHODS: 14 chemical or serologic tests were performed on 129 samples from 16 patients and medical records were reviewed. Samples were divided into pre and post-apheresis measurements and delta values of pre and post-apheresis measurements were attained and compared for any statistical differences in the two methods. RESULTS: All post-apheresis concentrations were decreased compared to pre-apheresis levels in both methods. Two items revealed a statistical difference between the two methods. The IgG and rheumatoid factor, composed mainly of IgM, were reduced significantly in the SPE compared to the PCPF group (P=0.0009 P=0.02, respectively). CONCLUSIONS: Many factors, such as the size of the membrane pores and the patient's individual diagnosis played a very important role in the overall outcome of plasmapheresis. Although our study revealed a significant decrease in the IgG and RF in the SPE group, compared to the PCPF group, no other significance could be stated in the other substances measured. Therefore, such multivariable factors should be considered in the selection of the apheresis method.

Spontaneous Remission in a Patient with Acute Myelogenous Leukemia Involving the Skin Associated with Termination of Pregnancy / 대한임상병리학회지

Spontaneous remission of acute leukemia is a rare event and has been documented in cases of systemic infection and blood transfusion. Furthermore spontaneous remission in association with the termination of pregnancy is also rare and hormonal effects during the puerperium have been implicated. We report here a case of acute myelogenous leukemia (AML, M5) diagnosed in a young woman after Cesarean section delivery who acheived spontaneous remission and relapsed 2 weeks later with leukemia cutis.

Detection of Human Papillomavirus Type 16 and 18 in Cervical Specimens by Nested Polymerase Chain Reaction / 대한임상병리학회지

BACKGROUND: Some types of human papillomavirus (HPV) play a major role in the pathogenesis of cervical cancer. Several dozens of studies on the association of HPV with cervical neoplasm have been done since the first detection of HPV 16 and 18 directly from cervical cancer patients in 1983. Approximately 90 types of HPV have been identified so far and the number of oncogenic HPV types is still growing. In this study, we examined the occurrence of oncogenic HPV infections in patients with cervical lesions. Method : Two hundred twenty cervical swab specimens were collected during a 3 year period (1996-1999). Processed specimens were tested for HPV type 16 and 18 by polymerase chain reaction. RESULTS: HPV type 16 was detected in the cervical swab specimens as follows: 19 (51.4%) of 37 cervical cancer patients, 19 (30.2%) of 63 high-grade squamous intraepithelial lesions, 5 (9.6%) of 52 low-grade squamous intraepithelial lesion, none in 6 atypical squamous cells of undetermined significance and 3 (4.8%) of 62 normal cervices. Conclusion : The positive rate for HPV type 16 increased according to the degree of cervical malignancy.