High Frequency of Male Microchimerism in Peripheral Blood Mononuclear Cells of Korean Women with Scleroderma, Resembling Skin Manifestations of Chronic Graft Versus Host Disease / 임상소아혈액종양

BACKGROUND: Bidirectional traffic of cells at the feto-maternal interface has been shown during pregnancy and fetal cells have been found to persist in maternal peripheral blood for decades after childbirth. Fetal-microchimerism has been reported in women with scleroderma, which shares a number of characteristics with chronic graft versus host disease (GVHD), although its contribution to the disease pathogenesis remains unclear. We performed this study to determine the frequency of male microchimerism in peripheral blood of patients with scleroderma or normal healthy women with son.METHODS: PCR targeting the Y chromosome specific DYZ1 sequence was employed to test DNA extracted from peripheral blood mononuclear cells of 26 women with scleroderma and 10 healthy women who had given birth to at least one son.RESULTS: Male DNA was detected in 16 of 26 (61.5%) women with scleroderma. Whereas male DNA was not detected in any healthy women who had given birth to son.CONCLUSION: Although fetal microchimerism in women with scleroderma was documented, additional studies will be necessary to determine whether microchimerism plays a role in the pathogenesis of this or other autoimmune disease.

High Frequency of Male Microchimerism in Peripheral Blood Mononuclear Cells of Korean Women with Scleroderma, Resembling Skin Manifestations of Chronic Graft Versus Host Disease / 임상소아혈액종양

BACKGROUND: Bidirectional traffic of cells at the feto-maternal interface has been shown during pregnancy and fetal cells have been found to persist in maternal peripheral blood for decades after childbirth. Fetal-microchimerism has been reported in women with scleroderma, which shares a number of characteristics with chronic graft versus host disease (GVHD), although its contribution to the disease pathogenesis remains unclear. We performed this study to determine the frequency of male microchimerism in peripheral blood of patients with scleroderma or normal healthy women with son. METHODS: PCR targeting the Y chromosome specific DYZ1 sequence was employed to test DNA extracted from peripheral blood mononuclear cells of 26 women with scleroderma and 10 healthy women who had given birth to at least one son. RESULTS: Male DNA was detected in 16 of 26 (61.5%) women with scleroderma. Whereas male DNA was not detected in any healthy women who had given birth to son. CONCLUSION: Although fetal microchimerism in women with scleroderma was documented, additional studies will be necessary to determine whether microchimerism plays a role in the pathogenesis of this or other autoimmune disease.

Relationship between the Number of SPIO-labeled Macrophage and MR Signal Intensity

PURPOSE: For the in vivo imaging of macrophages using MRI, the feasibility of labeling macrophages with iron oxide and the number of SPIO-labeled macrophage detected in 1.5 T MR, were assessed. MATERIALS AND METHODS: The MR signal intensity was measured with variable concentrations of iron oxide, ranging from 112 to 2.384x10-7 μgFe/mL. The macrophages were incubated in SPIO solution (112 μgFe/mL) for 24 hours. The MR signal intensity was measured in variable numbers of SPIO-labeled macrophages. RESULTS: The MR image signal intensity gradually increased with decreasing SPIO concentration, and reached a plateau at a concentration of 0.219 μgFe/mL. After incubation with iron oxide, the compact uptake of SPIO was detected in the cytoplasm of the macrophages using Prussian blue staining. No susceptibility effect was detected in the tubes of more than 122 macrophages. CONCLUSION: The MR signal intensity was dependent on the number of macrophages. No susceptibility effect due to a cluster of SPIO-labeled macrophages was detected in more than 488 cells.

The Clinical Usefulness of the Venous Filling Time in Proliferative Diabetic Retinopathy

PURPOSE: To evaluate the clinical usefulness of venous filling time (VFT) in proliferative diabetic retinopathy (PDR) and the relation of VFT with PDR complications. METHODS: Retinal circulation time (RCT) such as ART (arm to retinal circulation time), AVP (arteriovenous passage time), and VFT (venous filling time) were obtained by video fluorescein angiogram using SLO (Scanning Laser Ophthalmoscope), after which PRP (panretinal photocoagulation) was performed. We performed two studies on 39 patients, (39 eyes), who had PDR. In the first study, according to the development of complication, patients were classified into 2 groups, stabilized and complicated groups. In the second study, according to the score of the risk factor by DRS (Diabetic Retinopathy Study), patients were classified into 4 groups, A (1 score), B (2 score), C (3 score), and D (4 score) groups. RCTs, especially VFT were analyzed with each group. RESULTS: In the Mann-Whitney test, the Z-values of ART, AVP and VFT were -1.92, -0.49, and -2.59, respectively. There was a significant difference only in VFT(P<0.05). According to the risk factor scores, VFTs were 7.48 +/- 1.36, 7.84 +/- 0.91, 9.15 +/- 1.10, and 10.94 +/- 0.44 sec in A, B, C, and D groups, respectively. In each group, there were significant differences, except between A and B. CONCLUSIONS: VFT was delayed in the complicated group. With increasing risk factor score, VFT was more delayed. We suggest that VFT is a predictable indicator of the progression and development of complication in PDR.

A Case of Squamous Cell Carcinoma Originating from the Lacrimal Sac

PURPOSE: The tumor of lacrimal sac is very rare. We report an experience of a 63-year-old female who had a squamous cell carcinoma of the lacrimal sac and discuss its diagnosis and overall management. METHODS: A 63-year-old woman came to our clinic with a 2-month history of a growing mass in the region of the left medial canthus, left eye tearing. Examination revealed left epiphora and swelling on the left medial canthus and the left lacrimal sac, which was firm. Lacrimal irrigation indicated an obstruction. A computed tomographic scan demonstrated a well enhancing soft tissue mass in medial aspect of left orbit and no evidence of invasion of rectus muscles and adjacent bony destruction. The mass was excised by dacryocystectomy and subsequently, required 200 cGy a day, 5 times a week, 6000 cGy of radiotherapy for 6 weeks. RESULTS: The patient was finally diagnosed with keratinizing, squamous cell carcinoma that was proven by histopathologic finding. There was no evidence of recurrence of the tumor in lacrimal sac throughout 24 months of follow-up period.

Genotype Analysis of Hepatitis B Virus Isolated from Korean Hepatitis Patients / 대한진단검사의학회지

BACKGROUND: Hepatitis B virus (HBV) is classified into 7 genotypes (A-G) that have distinct geographic distribution. Several studies have suggested that the HBV genotypic differences influence the severity of liver disease and clinical outcomes such that genotype C is associated with more advanced liver diseases and genotype B is associated with the earlier development of hepatocellular carcinoma. With the different genotypes of HBV reported in Shanghai, Taiwan and Japan, wetried to investigate the distribution of the HBV genotype and the utility of HBV genotyping tests in the Korea population. METHODS: A total of 51 HBV DNA positive serum from Korean hepatitis B patients were used for the genotyping. After PCR and sequencing, HBV genotypes were determined by phylogenetic analysis using the NCBI database (www.ncbi.nlm.nih.gov). RESULTS: By phylogenetic analysis in the Pre-S region, all the genotypes of HBV (100%) proved to be C. CONCLUSIONS: All patients in this study had genotype C. This result is consistent with previous studies reporting 96-100% distribution of genotype C in Korea. HBV genotyping in Korea is not informative in predicting individual variation of clinical outcome, so that it is meaningless to genotype HBV in routine laboratory genotyping.

Genotype Analysis of Hepatitis B Virus Isolated from Korean Hepatitis Patients / 대한진단검사의학회지

BACKGROUND: Hepatitis B virus (HBV) is classified into 7 genotypes (A-G) that have distinct geographic distribution. Several studies have suggested that the HBV genotypic differences influence the severity of liver disease and clinical outcomes such that genotype C is associated with more advanced liver diseases and genotype B is associated with the earlier development of hepatocellular carcinoma. With the different genotypes of HBV reported in Shanghai, Taiwan and Japan, wetried to investigate the distribution of the HBV genotype and the utility of HBV genotyping tests in the Korea population. METHODS: A total of 51 HBV DNA positive serum from Korean hepatitis B patients were used for the genotyping. After PCR and sequencing, HBV genotypes were determined by phylogenetic analysis using the NCBI database (www.ncbi.nlm.nih.gov). RESULTS: By phylogenetic analysis in the Pre-S region, all the genotypes of HBV (100%) proved to be C. CONCLUSIONS: All patients in this study had genotype C. This result is consistent with previous studies reporting 96-100% distribution of genotype C in Korea. HBV genotyping in Korea is not informative in predicting individual variation of clinical outcome, so that it is meaningless to genotype HBV in routine laboratory genotyping.

Evaluation of Cobas Integra 700 and Distribution of High Sensitivity C-reactive Protein Levels in Koreans / 대한진단검사의학회지

BACKGROUND: Prospective studies suggest that C-reactive protein (CRP) is a novel and indepen-dent risk factor of coronary heart disease. High-sensitivity methods for CRP (hs-CRP) measurement are needed for this purpose. In this study, we evaluated the performance of Cobas Integra 700 (Roche Diagnostics, Basel, Switzerland) and aimed to establish the distribution of serum CRP concentrations in healthy Koreans with the hs-CRP method. METHODS: The subjects of this study were 853 males (age; 45.9 +/- 9.8 years) and 546 females (age; 45.7 +/- 10.8 years) who visited the Health Promotion Center of the Asan Medical Center for routine health checks. Hs-CRP was measured with the Cobas Integra 700. The within-day precision, the between-day precision, the degree of correlation, the linearity, and the detection limit of hs-CRP were also analyzed with the Cobas Integra 700. RESULTS: The within-day coefficients of variation (CVs) were 0% and 1.3%. The between-day CVs were 4.0% and 3.0%. The percentage of relative nonlinearity was 0.78%. The correlation coefficient of the Cobas Integra 700 with the Behring Nephelometer was 0.994. The lower detection limit was 0.064 mg/L and the functional detection limit was 0.472 mg/L. The geometric mean concentration of CRP in Koreans was 0.69 mg/L. The mean CRP of the male population was 0.79 mg/L, which was higher than that of Korean females (0.54 mg/L) (P<0.0001). There was a significant trend to higher CRP values with increasing age (P<0.05). CONCLUSIONS: The linearity, the precision, the correlation, the detection limit of the Cobas Integra 700 were satisfactory. The age and sex-specific guidelines for hs-CRP would make the early intervention for coronary heart disease possible.

Total Antioxidant Status, Lipid Peroxidation and Autoantibody to Oxidized Low Density Lipoprotein in Diabetes Mellitus / 대한임상병리학회지

BACKGROUND: Oxidative stress, lipid peroxidation and immune response to oxidized low density lipoprotein(oxLDL) are important events in the progression of atherosclerosis in diabetes mellitus(DM). Though, many clinical studies used man-made reagents that the reproducibility of the tests was not reliable and showed controversial results in some aspects. We performed above three tests in DM patients by the commercial kits and compared our results with previous results. METHODS: Total 67 DM patients and sex- and age-matched healthy persons were tested about total antioxidant status(TAS), lipid peroxidation(LPO) and autoantibody to oxLDL(anti-oxLDL) by Total Antioxidant Status kit(RANDOX Labs., Crumlin, UK), BIOXYTECH LPO-586 kit(OXIS International Inc., Portland, OR, USA) and Ox-LDL IgG ELISA kit(BIODESIGN International, Kennenbunk, ME, USA) each. RESULTS: The intra-run and between-run coefficients of variation of TAS and LPO were 2.6/2.7% and 13.4/15.6% respectively. The intra-run coefficient of variation of anti-oxLDL was 1.8 to 6.9%. DM patients showed decreased TAS(1.31+/-0.15 mmol/L) when compared with normal controls(1.38+/-0.09 mmol/L, P <0.01). TAS was inversely correlated with HbA1c(r=-0.38, P <0.01). LPO and anti-oxLDL in DM patients did not differ significantly from normal controls. CONCLUSIONS: By commercial kits, we could get reproducible results of TAS and anti-oxLDL, but not LPO test. The results of TAS and HbA1c among the DM patients and normal controls suggested that poor glycemic control might be associated with decrease of TAS. We could not find significant difference in the results of LPO and anti-oxLDL between two groups.

A Report of Pseudomembranous Colitis caused by Clostridium glycolicum / 대한임상미생물학회지

The major cause of pseudomembranous colitis is known to be Clostridium difficile (C. difficile). There are few reports that Clostridium species other than C. difficile has caused pseudomembranous colitis. We report a case of pseudomembranous colitis caused by clostridium glycolicum(C. glycolicum). A 47-year-old woman who had operational history for rectal cancer 3 months ago, was readmitted with diarrhea of 3 days duration. Seven weeks before admission, she had received ornidazole and ceftriaxone due to diarrhea and abdominal pain, and her symptoms were improved. She had received additional radiation therapy for rectal cancer during six weeks before the recent onset of diarrhea. On admission, she complained of watery diarrhea ten times a day and abdominal pain. She had tenderness on both lower abdomen. Pseudomembrane was observed by colonoscopic and histologic examination. VIDAS C. difficile toxin A II assay was positive and C. glycolicum was isolated in the stool. She recovered after receiving oral metronidazole treatment.

Classification and Prognostic Significance of Immunophenotypic Subgroups in Non-T-ALL(I) / 대한임상병리학회지

BACKGROUND: Recently, the importance of immunologic subclassification based on surface marker expression of acute lymphoblastic leukemia (ALL) has been emphasized. The importance of immunophenotypic analysis of ALL has been documented by numerous studies, but study for survival rate of subgroups in the non-T-ALL was rarely documented in Korea. The aim of this study was to classify the non-T-ALL immunologically, and to compare the survival rates among the subgroups. MATERIALS AND METHODS: From April, 1987 to October, 1997, 142 patients diagnosed as non-T- ALL by immunophenotyping were classified into 6 subgroups, group I to group VI. Review of medical records were undertaken in 130 patients and analysed for survival rates. For the cases in whom CD20 not tested, classification was also undertaken into 4 groups. The survival analysis of immunophenotypic subgroups was carried out by Kaplan-Meier method and differences in survival rates were tested by the log-rank test. RESULTS: The 142 patients, which included patients in whom CD20 was not tested, were assigned into 4 groups as follows: Group I (2 cases, 1%), Group II (24 cases, 17%), Group III-V (110 cases, 78%), Group VI (6 cases, 4%). On the other hand, 113 patients in whom CD20 was tested, were assigned into 6 groups as follows: Group I (0 cases, 0%), Group II (22 cases, 20%), Group III (59 cases, 52%), Group IV (23 cases, 21%), Group V (3 cases, 3%), Group VI (5 cases, 4%). The result showed that median survival time was higher in Group III and Group III-V, and lower in Group VI. However, statistic difference was not seen for 6 subgroups, while in the study for 4 subgroups, statistic difference was seen (p=0.04). And in children, study for 6 subgroups and 4 subgroups showed statistic differences in survival rate. CONCLUSIONS: We conclude that immunophenotypic subclassification of Non-T-ALL is a valuable prognostic marker in children.

A Case of Septicemia Caused by Moraxella lacunata / 감염

Moraxella lacunata is part of the normal flora of the mucosal surface and skin. It is considered to have low pathogenic potential and has been known to cause eye infection but rarely systemic infection. We experienced a case of septicemia due to M. lacunata in a 28-year-old man who was admitted to our hospital due to high fever. He had been well untill 3 weeks earlier when he experienced fever. Physical examination revealed no audible heart murmur and echocardiogram revealed no remarkable abnormalities. Culture of blood revealed M. lacunata. The patient expired due to subdural hemorrhage, 12th days after admission. We report the case with a brief review of related literature.