A Case of Pediatric Acute Lymphoblastic Leukemia with Trisomy 5 as a Sole Chromosomal Anomaly: A Prognostic Significance / 임상소아혈액종양

We present a case of Korean pediatric patient with pre-B cell type acute lymphoblastic leukemia (ALL) with trisomy 5 as a sole cytogenetic anomaly. Here, we compare and describe the present case with previous pediatric case reports and provide a review of the literature. This case report may help elucidate the poor prognostic impact of trisomy 5 as a sole cytogenetic anomaly in pediatric patients with ALL. Additional studies are needed to confirm this hypothesis.

Prevalence of Fructose Malabsorption in Patients With Irritable Bowel Syndrome After Excluding Small Intestinal Bacterial Overgrowth

BACKGROUND/AIMS: Fructose malabsorption (FM) mimics symptoms of irritable bowel syndrome (IBS), and its prevalence has increased. Diagnosing FM in IBS is challenging because of its overlap with small intestinal bacterial overgrowth (SIBO). We assessed the prevalence of FM by comparing patients with IBS with asymptomatic control individuals after excluding SIBO using the glucose hydrogen breath test (HBT). METHODS: Patients diagnosed with IBS and asymptomatic control individuals were enrolled prospectively. Dietary habits were assessed with the Food Frequency Questionnaire. After excluding SIBO, participants underwent HBTs with both 15 g and 25 g of fructose. RESULTS: Thirty-five patients with IBS and 35 age- and sex-matched asymptomatic control individuals were enrolled. The 15-g fructose HBT yielded positive results in 7 of the 35 (20.0%) patients with IBS and in 2 of 35 (5.7%) controls (P = 0.070). The 25-g fructose HBT was positive in 16 of the 35 (45.7%) patients with IBS and in 8 of the 35 (22.9%) controls (P = 0.040). Analysis of the Food Frequency Questionnaire responses showed no significant differences between the 2 groups in dietary intake, although patients with IBS showed a significantly higher mean fiber intake than controls (21.24 ± 11.35 g vs 15.87 ± 7.07 g, respectively, P = 0.040). CONCLUSIONS: The 25-g fructose HBT identified FM in a significantly higher percentage of SIBO-negative patients with IBS than in asymptomatic control individuals, suggesting that FM may correlate with IBS. Education regarding dietary control of foods containing fructose may be useful for the management of patients with IBS.

Predictive Value of Endometrial Thickness for Anemia in Adolescent Girls with Abnormal Uterine Bleeding / 임상소아혈액종양

BACKGROUND: Immaturity of the endocrine system that controls the normal menstrual cycle frequently results in abnormal uterine bleeding (AUB) and elicits anemia in adolescent girls. This study was conducted to assess the predictive value of endometrial thickness (ET) for anemia in adolescent girls with AUB. METHODS: A retrospective chart review was performed for a cohort of adolescents (12–18 years old) with AUB who presented over a 10-year period. Complete blood count and ultrasonographic data of 115 adolescent girls with AUB were analyzed. Subjects were classified according to ET as group I (ET < 11 mm) and group II (≥11 mm), and the incidence of anemia was compared. Subjects were also classified according to age as group Y (12–15 years old of age) and group O (16–18 yr), and ET, hemoglobin (Hb), and incidence of anemia were compared. RESULTS: The incidence of anemia in all subjects was 67.8% and was significantly higher in group II than in group I (P < 0.001). The incidence of severe anemia was 56.9% in group II, which was higher than in group I (P=0.039). The incidence of anemia was not significantly different between groups Y and O. However, the incidence of severe anemia was significantly higher in group Y than in group O (P=0.001). CONCLUSION: AUB can result in severe anemia in adolescent girls particularly those who are close to menarche or have a thick endometrium. Early supervision of AUB is required in order to avoid anemia in adolescent girls with AUB.

Pharmacokinetic Study of Mycophenolic Acid in Korean Kidney Transplant Patients / 대한이식학회지

PURPOSE: Mycophenolate mofetil (MMF) given orally as 1000 mg twice daily has shown to be effective in the suppression of acute allograft rejection following renal transplantation. However, Korean transplant patients are usually administered with a lower dose of MMF (1~1.5 gm/day) than the recommended dose due to high incidence of gastrointestinal intolerance. The purpose of this study was to characterize the pharmacokinetic parameters of the mycophenolic acid (MPA), the active form of MMF, in Korean kidney transplant recipients. METHODS: The plasma MPA concentrations of 10 Korean kidney transplant recipients (7 men and 3 women) administered with a suboptimal dose of MMF (750 mg twice a day) were measured at 2 weeks of the MMF therapy by HPLC method. RESULTS: Plasma MPA concentration-time curve pattern of patients taking lower doses of MPA was consistent with previously reported profiles of patients taking the fully recommended doses. The plasma MPA concentration-time curve was characterized by an early sharp peak within 1 hour and a small second peak in some patients at 4~12 hours postdose. The mean ( SD) Cmax was 8.73 4.65micro gram/ml, and the mean MPA AUC was calculated as 18.45 4.25micro gram hr/ml. The mean fraction of free MPA, which is pharmacologically active, was 1.60 0.23% and this value seemed similar to previously reported data. The patient's age, weight, body surface area, and renal function did not influence the MPA AUC. However, a difference in AUC according to sex was statistically significant (P=0.0227). Free fraction of MPA appeared not to be affected by serum albumin and renal function when creatinine clearance was above 40 ml/min. Correlation analysis between each plasma concentration and AUC for the limited strategy of MMF therapeutic drug monitoring (TDM) resulted that the concentrations of predose, 1 hr post-dose, and 8 hr post-dose were positively related with AUC value, and their coefficients of correlation were 0.74545 (P=0.0133), 0.68485 (P=0.0289), and 0.63636 (P=0.0479), respectively. CONCLUSION: This study have shown that the pattern of the time-concentration profile of MPA was similar to the results of other studies performed with Caucasians, although there was interindividual variability of MPA AUC, Cmax, and Tmax.

The Experimental Effect of High Intensity Focused Ultrasound (HIFU) being Developed in Korea / 대한비뇨기과학회지

PURPOSE: This project aimed to determine the adequacy and accuracy of high-intensity focused ultrasound(HIFU) for ablating canine model of benign prostate hyperplasia and to assess the therapeutic results. MATERIALS AND METHODS: Using the developed transrectal type HIFU transducer, exposure time-temperature curves were obtained. In-vitro experiments were performed on calf muscle tissues and characteristics of coagulative lesions were observed. In-vivo experiments were performed on canine prostate, which were evaluated grossly, histologically, and ultrasonographically. Complications and side effects were assessed by blood chemistry and urinalysis. RESULTS: The peak temperature reached to 93.0+/-3.0degrees C within initial 11 seconds at the focused area. The mean thermal elevation was 56.0+/-3.0degrees C. In in-vitro HIFU experiments, the coagulative lesions were observed at the focused areas of muscle tissues. The lesions were ellipsoidal shaped, 5.0+/-2.0mm diameter, well delinated. In animal experiments, the affected canine prostates were shown definite lesions of coagulative necrosis which were confirmed grossly and histologically. Significant side effects or complications were not assessed. CONCLUSIONS: Transrectal HIFU treatment may be considered as safe, effective technique on prostate. It is neccessary to perform long-term animal experiments and clinical trials.

A clinical review of upper gastrointestinal bleeding

No abstract available.