RESUMEN
Background@#Dietary Na+ or Na+/K+ ratio has been reported to be associated with bone mineral density (BMD). However, this remains unclear, and only a few studies have been reported on the Korean population. Therefore, this study aimed to determine the association between dietary Na+, K+, and Na+/K+ ratios and BMD in middle-aged Korean women. @*Methods@#This study used data from the Korea National Health and Nutrition Examination Survey 2008–2011. A total of 3,690 women aged >50 years were included. Study participants were classified into quartiles (lowest quartile Q1–highest quartile Q4) according to dietary Na+, K+, and Na+/K+ ratio, and we examined the association of these parameters with BMD. Total femur and lumbar spine BMD were measured using dual-energy X-ray absorptiometry. Multiple linear regression analyses were performed using IBM SPSS ver. 19.0. @*Results@#The mean age was 62 years, and a significant negative trend in the β-coefficient regarding dietary Na+ was only observed in the total femur BMD. However, the total femur and lumbar spine BMD decreased from Q1 to Q4 regarding the dietary Na+/K+ ratio (P-value for trend: 0.044 for total femur BMD and 0.002 for lumbar spine BMD). @*Conclusion@#A significant negative trend in the β-coefficient for both total femur and lumbar spine BMD was observed regarding the Na+/K+ ratio. Therefore, based on the results of this study, a higher dietary Na+/K+ ratio may be associated with a lower BMD.
RESUMEN
In Korea, the prevalence of obesity, morbid obesity with serious complications, and childhood obesity are rapidly increasing. To control the obesity pandemic, both prevention and treatment are essential strategic targets. While lifestyle modification is fundamental in obesity treatment, due to the complex appetite-controlling system in the body and the rapidly Westernizing environment, more effective treatment tools are required.Current Concepts: There are 4 types of drugs that have been approved for the treatment of obesity in Korea. They are (1) appetite suppressants for short-term therapy, (2) dietary fat absorption inhibitors, (3) glucagon-like peptide-1 (GLP-1) receptor agonists, and (4) fixed-dose combination drugs for appetite control. However, a large amount of weight reduction cannot be achieved with these drugs. The greatest amount of weight reduction of approximately 11% has been reported for phentermine/topiramate combination treatment. Recently, peptide agents have been under development and 2 of these agents, semaglutide, a second generation GLP-1 receptor agonist, and tirzepatide, a glucose-dependent insulinotropic polypeptide/GLP-1 receptor dual agonist, are expected to be available in the near future.Discussion and Conclusion: Both semaglutide and tirzepatide are more effective than currently available anti-obesity drugs. Semaglutide and tirzepatide reduced the body weight of people with obesity without diabetes by 14.9% and 20.9%, respectively. However, because of the mechanism of GLP-1 receptor agonism, gastrointestinal adverse events, including nausea, diarrhea, vomiting, and abdominal pain, were problematic in many patients, although these adverse events were generally acceptable. Both drugs will be excellent options for obesity treatment in the near future.
RESUMEN
Carbohydrate-restricted diets and intermittent fasting (IF) have been rapidly gaining interest among the general population and patients with cardiometabolic disease, such as overweight or obesity, diabetes, and hypertension. However, there are limited expert recommendations for these dietary regimens. This study aimed to evaluate the level of scientific evidence on the benefits and harms of carbohydrate-restricted diets and IF to make responsible recommendations. A meta-analysis and systematic literature review of 66 articles on 50 randomized controlled trials (RCTs) of carbohydrate-restricted diets and 10 articles on eight RCTs of IF was performed. Based on the analysis, the following recommendations are suggested. In adults with overweight or obesity, a moderately-low carbohydrate or low carbohydrate diet (mLCD) can be considered as a dietary regimen for weight reduction. In adults with type 2 diabetes mellitus, mLCD can be considered as a dietary regimen for improving glycemic control and reducing body weight. In contrast, a very-low carbohydrate diet (VLCD) and IF are recommended against in patients with diabetes. Furthermore, no recommendations are suggested for VLCD and IF in adults with overweight or obesity, and carbohydrate-restricted diets and IF in patients with hypertension. Here, we describe the results of our analysis and the evidence for these recommendations.
RESUMEN
Background@#Obesity is associated with increased mortality as a significant risk factor for chronic diseases, including cardiovascular diseases and cancer. Several people believe that weight gain is harmful, and weight loss helps maintain health. However, some studies have shown that weight loss, particularly among older adults, is more likely to increase the risk of mortality than weight gain. @*Methods@#We used data for the cohort of the Korean Longitudinal Study of Aging, which is a nationwide stratified multi-stage sample of adults aged 45 years. The all-cause mortality risk was assessed using the survival status and the number of months of survival calculated from 2006 (baseline year) to 2016. Cox proportional hazard regression were used to study the causal link between weight change and all-cause mortality risk. @*Results@#The results showed interactive associations between weight loss and mortality among middle-aged and older adults. The hazard ratio was 1.62 (95% confidence interval [CI], 1.10–2.40) for the participants aged 45–65 years with weight losses greater than 5 kg and 1.56 (95% CI, 1.29–1.89) for those older than 65 years with weight losses greater than 5 kg. The results for the group with weight gain above 5 kg were not significant. Middle-aged and older men showed an increase in all-cause mortality associated with weight loss of more than 5 kg, but only the older women showed significant results. @*Conclusion@#This large-scale cohort study in Korea showed a relationship between weight loss and all-cause mortality in middle-aged and older individuals.
RESUMEN
Background@#The prevalence of depression is much higher in people with chronic disease than in the general population. Depression exacerbates existing physical conditions, resulting in a higher-than-expected death rate from the physical condition itself. In our aging society, the prevalence of multimorbid patients is expected to increase; the resulting mental problems, especially depression, should be considered. Using a large-scale cohort from the Korean Longitudinal Study of Aging (KLoSA), we analyzed the combined effects of depression and chronic disease on all-cause mortality. @*Methods@#We analyzed 10-year (2006–2016) longitudinal data of 9,819 individuals who took part in the KLoSA, a nationwide survey of people aged 45–79 years. We examined the association between multimorbidity and depression using chi-square test and logistic regression. We used the Cox proportional hazard model to determine the combined effects of multimorbidity and depression on the all-cause mortality risk. @*Results@#During the 10-year follow up, 1,574 people (16.0%) died. The hazard ratio associated with mild depression increased from 1.35 (95% confidence interval [CI], 1.05–1.73) for no chronic disease to 1.25 (95% CI, 0.98–1.60) for 1 chronic disease, and to 2.00 (95% CI, 1.58–2.52) for multimorbidity. The hazard ratio associated with severe depression increased from 1.73 (95% CI, 1.33–2.24) for no chronic disease, to 2.03 (95% CI, 1.60–2.57) for 1 chronic disease, and to 2.94 (95% CI, 2.37–3.65) for multimorbidity. @*Conclusion@#Patients with coexisting multimorbidity and depression are at an increased risk of all-cause mortality than those with chronic disease or depression alone.
RESUMEN
Background@#Obesity is associated with increased mortality as a significant risk factor for chronic diseases, including cardiovascular diseases and cancer. Several people believe that weight gain is harmful, and weight loss helps maintain health. However, some studies have shown that weight loss, particularly among older adults, is more likely to increase the risk of mortality than weight gain. @*Methods@#We used data for the cohort of the Korean Longitudinal Study of Aging, which is a nationwide stratified multi-stage sample of adults aged 45 years. The all-cause mortality risk was assessed using the survival status and the number of months of survival calculated from 2006 (baseline year) to 2016. Cox proportional hazard regression were used to study the causal link between weight change and all-cause mortality risk. @*Results@#The results showed interactive associations between weight loss and mortality among middle-aged and older adults. The hazard ratio was 1.62 (95% confidence interval [CI], 1.10–2.40) for the participants aged 45–65 years with weight losses greater than 5 kg and 1.56 (95% CI, 1.29–1.89) for those older than 65 years with weight losses greater than 5 kg. The results for the group with weight gain above 5 kg were not significant. Middle-aged and older men showed an increase in all-cause mortality associated with weight loss of more than 5 kg, but only the older women showed significant results. @*Conclusion@#This large-scale cohort study in Korea showed a relationship between weight loss and all-cause mortality in middle-aged and older individuals.
RESUMEN
Background@#The prevalence of depression is much higher in people with chronic disease than in the general population. Depression exacerbates existing physical conditions, resulting in a higher-than-expected death rate from the physical condition itself. In our aging society, the prevalence of multimorbid patients is expected to increase; the resulting mental problems, especially depression, should be considered. Using a large-scale cohort from the Korean Longitudinal Study of Aging (KLoSA), we analyzed the combined effects of depression and chronic disease on all-cause mortality. @*Methods@#We analyzed 10-year (2006–2016) longitudinal data of 9,819 individuals who took part in the KLoSA, a nationwide survey of people aged 45–79 years. We examined the association between multimorbidity and depression using chi-square test and logistic regression. We used the Cox proportional hazard model to determine the combined effects of multimorbidity and depression on the all-cause mortality risk. @*Results@#During the 10-year follow up, 1,574 people (16.0%) died. The hazard ratio associated with mild depression increased from 1.35 (95% confidence interval [CI], 1.05–1.73) for no chronic disease to 1.25 (95% CI, 0.98–1.60) for 1 chronic disease, and to 2.00 (95% CI, 1.58–2.52) for multimorbidity. The hazard ratio associated with severe depression increased from 1.73 (95% CI, 1.33–2.24) for no chronic disease, to 2.03 (95% CI, 1.60–2.57) for 1 chronic disease, and to 2.94 (95% CI, 2.37–3.65) for multimorbidity. @*Conclusion@#Patients with coexisting multimorbidity and depression are at an increased risk of all-cause mortality than those with chronic disease or depression alone.
RESUMEN
BACKGROUND: Several studies have shown that negative mental health increases risky health behavior and mortality risk. We investigated the relationship between mental health and health behavior, and the causal association between mental health and mortality risk. METHODS: We used data from the 8-year (2006–2014) Korean Longitudinal Study of Aging with a cohort of 10,247 individuals (whom we divided into a younger group aged <65 years and an older group aged ≥65 years). Mental health was assessed with the following factors: depression, social engagement, and satisfaction of life. Health behavior was assessed with smoking, alcohol use, and regular exercise. Mortality risk was calculated using survival status and survival months as of 2014. Multiple logistic regression and Cox proportional hazard analysis were performed. RESULTS: Negative mental health was associated with current smoking and sedentary life style, but not with alcohol consumption. In addition, it was associated with an increase in all-cause mortality risk. The increase in mortality risk in the highest quartile (vs. lowest) was 1.71 times (hazard ratio [HR], 1.71; 95% confidence interval [CI], 1.12–2.62) and 2.07 times (HR, 2.07; 95% CI, 1.60–2.67) for the younger and older group, respectively. CONCLUSION: Our results show that mental health affects health behavior and mortality risk. A key inference from this study is that improving mental health can lead to positive changes in health behavior and reduce the risk of mortality.
Asunto(s)
Envejecimiento , Consumo de Bebidas Alcohólicas , Estudios de Cohortes , Depresión , Conductas Relacionadas con la Salud , Estilo de Vida , Modelos Logísticos , Estudios Longitudinales , Salud Mental , Mortalidad , Humo , FumarRESUMEN
No abstract available.
Asunto(s)
Índice de Masa Corporal , Ecocardiografía , Circunferencia de la CinturaRESUMEN
BACKGROUND: Obesity is associated with a variety of diseases and increases cardiovascular morbidity and mortality. The purpose of this study is to examine the relationship between the obesity index and diastolic function parameters of the left ventricle. We use body mass index (BMI) and waist circumference (WC) as the obesity index. METHODS: From January 2010 to December 2012, 390 cases (283 men, 109 women) were enrolled in this study. The blood pressure, height, weight, blood test, personal habits questionnaire, and echocardiographic indices were obtained. We analyzed the echocardiographic indices of left ventricular diastolic function with BMI and WC. RESULTS: The left ventricle (LV) mass index (P=0.007), LV dimension (P<0.01), A (P<0.01), A' (P=0.030), and E/E' (P=0.006) were higher, and E (P=0.003), E' (P<0.01), E/A (P<0.01) were lower in the overweight and obese groups than in the normal group. On multiple linear regression analysis, E/E' correlated positively with age, gender, BMI and systolic blood pressure. In men, E/E' correlated positively with age and BMI or WC. In women, only age had a positive correlation with E/E'. CONCLUSION: In men, increased BMI or waist circumference are associated with an increase in E/E', which surrogates left ventricular diastolic dysfunction. In women, obesity and abdominal obesity have no correlation with E/E'.
Asunto(s)
Femenino , Humanos , Masculino , Presión Sanguínea , Índice de Masa Corporal , Ecocardiografía , Ventrículos Cardíacos , Pruebas Hematológicas , Modelos Lineales , Mortalidad , Obesidad , Obesidad Abdominal , Sobrepeso , Circunferencia de la CinturaRESUMEN
BACKGROUND: The objective of this study was to investigate the relationship between smoking and metabolic syndrome in men. METHODS: This cross-sectional study included 1,852 men over age 40 who underwent health screening from April 2009 to December 2010. We classified them into three smoking levels as non-, intermediate-, and heavy-smoker, considering their smoking status (non, ex, current) and amount (0, 1-29, > or =30 pack year [PYR]). The relationship between smoking level and metabolic syndrome was analyzed by logistic regression analysis, after covariates (age, body mass index, education, house income, alcohol intake, and physical activity) were controlled. RESULTS: The proportions of non-, intermediate-, and heavy-smokers were 31.8%, 56.2%, and 12.0%, respectively. Odds ratios (ORs) and 95% confidence intervals (95% CIs) for metabolic syndrome were 1.0, 1.58 (1.09-2.23), 1.92 (1.29-2.81) in non-, intermediate-, and heavy-smokers, respectively. For heavy-smokers compared with non-smokers, ORs and 95% CIs of a lower high density lipoprotein cholesterol, higher triglyceride, and higher fasting glucose were 2.47 (1.63-3.74), 1.71 (1.17-2.52), and 1.43 (1.02-2.00), respectively. In current-smokers, we divided into three subgroups according to PYR, and compared with 1-19 PYR, ORs and 95% CIs of 20-29 PYR and > or =30 PYR for metabolic syndrome were 2.07 (1.14-3.74) and 3.06 (1.66-5.62), respectively. CONCLUSION: This study showed a positive dose-response relationship between smoking level and metabolic syndrome in men.
Asunto(s)
Humanos , Masculino , Índice de Masa Corporal , HDL-Colesterol , Estudios Transversales , Educación , Ayuno , Glucosa , Modelos Logísticos , Tamizaje Masivo , Síndrome Metabólico , Oportunidad Relativa , Humo , Fumar , TriglicéridosRESUMEN
BACKGROUND: This study aimed to investigate the relationship between leisure time physical activities (LTPA) and metabolic syndrome (MS). METHODS: Five thousand seven hundred and thirty two adults 40 years old or older were enrolled in the study from April 2009 to December 2010. National Cholesterol Education Program's Adult Treatment Panel III was used for the criteria of MS, and Minnesota Leisure Time Physical Activity Questionnaire was used to measure LTPA. After adjusted covariates (age, hypertension, smoking, drinking, education level, household income level, work time physical activities, and menopause for females), the relationship between LTPA and MS was analyzed using logistic regression analysis. RESULTS: The prevalence of MS was 22.8% in men, and 14.1% in women. Average LTPA was 1,498 kcal/wk in men, and 1,308 kcal/wk in women. After adjustment for covariates, the odds ratios of middle and low LTPA compared with high LTPA were 1.06 (0.87-1.34), 1.54 (1.08-1.75), for women, this same association was not seen in men. The prevalence of MS was 22.8% in men and 14.1% in women, and their LTPA burned 1,498 and 1,308 kcal/wk, respectively. When the odds ratio of MS for the high LTPA group was set at 1.0, the odds ratio of MS was 1.06 (0.87-1.34) in the middle LTPA group and 1.54 (1.08-1.75) in the low LTPA group in women, which showed that the MS risk increased when the LTPA was lower. This same association was not seen in men. CONCLUSION: LTPA was independently associated with metabolic syndrome, but only for women.
Asunto(s)
Adulto , Femenino , Humanos , Masculino , Quemaduras , Colesterol , Ingestión de Líquidos , Educación , Composición Familiar , Conductas Relacionadas con la Salud , Hipertensión , Actividades Recreativas , Modelos Logísticos , Menopausia , Minnesota , Actividad Motora , Oportunidad Relativa , Prevalencia , Encuestas y Cuestionarios , Humo , FumarRESUMEN
BACKGROUND: The purpose of this study was to examine the association of metabolic syndrome (MS) coronary heart disease (CHD) with socioeconomic status (SES). METHODS: The participants were 2,170 (631 men and 1,539 women), aged over 40 years who had visited for health screening from April to December in 2009. We classified them into three SES levels according to their education and income levels. MS was defined using the criteria of modified National Cholesterol Education Program Adult Treatment Panel III and CHD risk was defined using Framingham risk score (FRS) > or = 10%. RESULTS: High, middle, and low SES were 12.0%, 73.7%, and 14.3%, respectively. The prevalence of MS was 18.1%. For high, middle, and low SES, after adjusted covariates (age, drinking, smoking, and exercise), odds ratios for MS in men were 1.0, 1.41 (confidence interval [CI], 0.83 to 2.38; P > 0.05), and 1.50 (CI, 0.69 to 3.27; P > 0.05), respectively and in women were 1.0, 1.74 (CI, 1.05 to 3.18; P or = 10% was 33.5% (adjusted covariates were drinking, smoking, and exercise) and odds ratios for FRS > or = 10% in men were 1.0, 2.86 (CI, 1.35 to 6.08; P or = 10% risk in men, and an inverse relationship between SES and both risk of MS and FRS > or = 10% in women.
Asunto(s)
Adulto , Anciano , Femenino , Humanos , Masculino , Colesterol , Enfermedad Coronaria , Ingestión de Líquidos , Tamizaje Masivo , Oportunidad Relativa , Prevalencia , Humo , Fumar , Clase SocialRESUMEN
Few cases of macrophage activation syndrome (MAS) or reactive hemophagocytic lymphohistiocytosis (HLH) during the acute febrile phase of Kawasaki disease (KD) have been reported. We report on a case of a 19 month-old girl with MAS or reactive HLH during the course of KD. Despite immunoglobulin and steroid therapy, she showed persistent fever with hepatosplenomegaly and evidence of hemophagocytosis in the bone marrow. A high index of suspicion for clinical features associated with MAS is necessary for KD patients in order to provide appropriate treatment.
Asunto(s)
Humanos , Médula Ósea , Fiebre , Inmunoglobulinas , Linfohistiocitosis Hemofagocítica , Activación de Macrófagos , Síndrome de Activación Macrofágica , Macrófagos , Síndrome Mucocutáneo Linfonodular , Compuestos OrgánicosRESUMEN
Thrombotic complications in iron-deficiency anemia (IDA) are rare. We now report a case of deep vein thrombosis following iron deficiency anemia in cerebral palsy. A 20 year old male was admitted to our hospital? due to a pale appearance. He was diagnosed as having spastic cerebral palsy. On admission, a complete blood cell count showed IDA with thrombocytosis. Prothrombin time and activated partial thromboplastin time were within the normal range. We observed swelling and edema on the left thigh and ankle without tenderness. We performed Doppler sonography and computed tomography. Thrombi were located in the left common iliac vein and left superficial femoral vein with elevated D-dimer levels. We started heparin therapy. We excluded intravascular hemolysis or a hypercoagulable state when we found that Ham's test, anti-cardiolipin antibody, and lupus anticoagulant were negative. The patient died due to hypoxemia and cardiac failure despite ventilator care with anti-coagulant therapy.
Asunto(s)
Animales , Humanos , Masculino , Anemia Ferropénica , Tobillo , Hipoxia , Recuento de Células Sanguíneas , Parálisis Cerebral , Edema , Vena Femoral , Productos de Degradación de Fibrina-Fibrinógeno , Insuficiencia Cardíaca , Hemólisis , Heparina , Vena Ilíaca , Hierro , Inhibidor de Coagulación del Lupus , Tiempo de Tromboplastina Parcial , Tiempo de Protrombina , Valores de Referencia , Muslo , Trombocitosis , Trombosis de la Vena , Ventiladores MecánicosRESUMEN
BACKGROUND: The class I major histocompatibility complex (MHC) antigen, HLA-B27 appears to be the major genetic susceptibility factor for ankylosing spondylitis (AS), anterior uveitis, and reactive arthritis, but the mechanism underlying the association remains unknown. HLA-B27 consists of eleven closely related alleles (B*2701-B*2711) which differ in a restricted number of nucleotide substitutions. The aim of this study was to investigate the frequency and the contribution of the HLA-B27 subtypes to AS. METHODS: Forty-six patients (36 AS, 4 anterior uveitis, and 2 psoriatic arthritis, 2 reactive arthritis, 1 erythema nodosum, 1 rheumatic valvular disease) were analysed. The polymerase chain reaction with sequence-specific primers (PCR-SSP) method was used to define B27 allele subtypes. The primers were specifically designed for the discrimination of HLA-B*2701-B*2711. RESULTS: Thirty-two out of forty-six patients were typed. Among them, 27 AS patients were typed. Only two subtypes were identified : 88.9% (24 out of 27) were typed as B*2705 and 11.1% (3 out of 27) were typed as B*2704. Other 5 non-AS patients ( 4 anterior uveitis & 1 psoriatic arthritis) were also typed as B*2705. CONCLUSIONS: No difference in the distribution of HLA-B27 subtypes between patients and healthy controls could be found (Fisher's exact test : P= 0.867, P>0.05). Any specific B27 subtypes don't appear to contribute to AS susceptibility.
Asunto(s)
Humanos , Alelos , Artritis Psoriásica , Artritis Reactiva , Discriminación en Psicología , Eritema Nudoso , Predisposición Genética a la Enfermedad , Antígeno HLA-B27 , Complejo Mayor de Histocompatibilidad , Reacción en Cadena de la Polimerasa , Espondilitis Anquilosante , Uveítis AnteriorRESUMEN
BACKGROUND: The flowcytometric analysis of HLA-B27 gives more objective results and is performed more rapidly than traditional serologic methods. We have used a flowcytometric method using only anti-HLA-B27 monoclonal antibody, but it gave frequently borderline mean fluorescence intensity (MFI) results. The authors compared the method using anti-HLA-B27 antibody (HLA- ABC-m3, Serotec) with the Becton Dickinson (BD) method which uses different HLA-B27 antibody (GS145.2) with CD3 antibody. METHODS: The 59 patients that requested HLA-B27 testing were measured by two methods. In the former method, the mononuclear cells were stained with HLA-B27-FITC and the MFIs were determined in lymphocytes. In the BD method, the whole blood was directly stained with CD3-PE and HLA-B27-FITC. The MFIs were determined in the CD3+ cells, and compared with the MFI of the standard. For the cases showing discrepancy in the two methods or borderline values, the HLA-ABC typing was done. RESULTS: Of 21 showing discrepancy, 10 samples had undergone HLA typing. Among nine samples that were positive by the Serotec method but negative by the BD method, four samples were B7, one B40, one B54 and three B7 CREG negative. One that was negative by the Serotec method but positive by the BD method was confirmed as HLA-B27. CONCLUSIONS: The Serotec method showed significant overlap between the MFIs of HLA-B27 and non B27 samples that resulted in a relatively low efficiency compared with the BD method. The discrepant results of the two methods seem to be due to maily the specificity of the antibody used.
Asunto(s)
Humanos , Fluorescencia , Prueba de Histocompatibilidad , Antígeno HLA-B27 , Linfocitos , Sensibilidad y EspecificidadRESUMEN
BACKGROUND: Although immunophenotyping of leukemias has improved diagnostic accuracy and reproducibility, it has also caused diagnostic confusion regarding the lineage of leukemic cells. So far, lots of papers about acute leukemias with coexpression of another lineage markers with different technical methodologies and different criteria have been published in Korea and other countries. The authors investigated the frequency and immunophenotypic characteristics of the leukemias with aberrant lineage markers from data obtained at Korea University Hospital by a retrospective study. METHODS: From Jan. 1993 to Feb. 1996, 179 leukemias had been requested for immunophenotypig and 28 cases among them with unusual immunophenotypes were retrieved according to their immunophenotyping results. For the final diagnosis all the slides stained with Wright-Giemsa, peroxidase, Periodic-Acid Schiff, Sudan black B, and nonspecific esterase were re-examined, and all the flow cytometric results were reanalyzed. RESULTS: Among 28 cases, 3 cases(10%) were acute biphenotypic leukemias(BP) one with B lymphoid and myeloid markers and the other two with T lymphoid and myeloid markers. One case of intralineage bilinear acute leukemia(ILBL) with two separate populations of megakaryocytic cells and monocytic cells was noted. 6 cases(21%) were acute myeloblastic leukemias expressing lymphoid associated markers(Ly+AMLs; CD19) and 8 cases(28%) were myeloid antigen-positive acute lymphoblastic leukemias(My+ALLs, four with CD13+ and three with CD33+ and one with blastic transformation of chronic myelogeneous leukemia). Because of the change in diagnostic criteria, lymphocyte contamination, or low setting of negative control, 10 cases (36%) were not included to be of unusual immunophenotypes. CONCLUSIONS: Frequency of acute hybrid leukemia was 2.2 % of all leukemias. Ly+AMLs was 3.4%, and My+ALL was 4.4%. In conclusion, first, quality control of the flow cytometry and careful interpretation especially in terms of positive cut-off value and gating, are needed. Secondly, national guidelines for the criteria of the hybrid leukemia and My+ALLs and Ly+AMLs are necessary for the elucidation of the prognostic implication of those leukemias.
Asunto(s)
Carboxilesterasa , Diagnóstico , Citometría de Flujo , Inmunofenotipificación , Corea (Geográfico) , Leucemia , Leucemia Mieloide Aguda , Linfocitos , Peroxidasa , Control de Calidad , Estudios Retrospectivos , SudánRESUMEN
BACKGROUND: Cord blood transplantation has generated much enthusiasm because of the low incidence of GVHD(graft-versus-host disease), even in HLA(Human Leukocyte Antigen) mismatched situations, owing to intrinsic defects in mature T cell functions, and human cord blood is a constantly and easily obtainable source for hematopoietic stem cell. This study was undertaken to elucidate the possible mechanisms of low GVHD incidence observed when cord blood is used for stem cell transplantation. Based on current knowledge of the phenotypic correlates with functional subtypes of peripheral blood lymphocytes, we evaluated lymphocyte subpopulation in cord blood. METHODS: The 25 cord blood and 20 peripheral blood of adult control were included in this study. Monoclonal antibodies(MAb) conjugated with fluorescein-isothiocynate(FITC), phycoerythrin(PE) were used in this study. Heparinized whole blood was stained with mAbs using the whole blood lysis method. We used FACScan flow cytometer with argon laser tuned at 488 nm. Analysis was done by either Simulset or lysis II research software. RESULT: 1) The means of WBC and lymphocyte content were higher in cord blood than in adult blood(p<0.05). 2) The overall percentages of cord blood T(CD3+) cells, B(CD19+) cells, NK(natural killer)(CD16+/CD56+) cells were not different from adult controls. 3) The CD4+ : CD8+ ratio of cord blood was higher than thar of adult controls(2.7 in cord bloods versus 1.8 in adults). 4) The majority of the cord blood cells, both CD4+ and CD8+, co-expressed the CD45RA+ (naive) molecule. 5) The CD57, an antigen present on a subpopulation of NK cells, is absent in cord blood. CONCLUSION: We determined that cord blood contained mainly naive T lymphocytes to be predominantly suppressor cells. We found reduced alloproliferative, allostimulatory and allocytotoxic capacity of cord blood lymphocytes. Therefore, the GVHD may be less readily induced in cord blood transplantation, even in the face of HLA difference.