• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9961-9966
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• 2014

Background: Some reports have suggested that chronic myeloid leukemia (CML) patients have a higher prevalence of M-bcr than acute lymphoblastic leukemia (ALL) patients, which show a higher prevalence of m-bcr. However, the relationship between BCR-ABL subtypes and progression of CML and ALL remains unclear. Materials and Methods: 354 CML chronic phase (CML-CP) patients, 26 CML blastic phase (CML-BP) patients and 72 ALL patients before treatment with BCR-ABL positive were recruited for blood routine examination and bone marrow smear cytology. Some 80 CML-CP and 32 ALL patients after imatinib (IM) treatment were followed-up for BCR-ABL relative concentrations detected after treatment for 3, 6 and 9 months and 1 year. Results: Before treatment, CML-CP patients showed lower BCR-ABL relative concentrations with a higher proportion of M-bcr (42.7%) compared to CML-BP and ALL patients while ALL patients had a higher BCR-ABL relative concentration with high expression of m-bcr (51.4%). Patients with M-bcr demonstrated higher WBC counts than those with m-bcr and the mixed group and higher PLT counts were noted in the CML-CP and ALL groups. After imatinib (IM) treatment, patients with m-bcr showed higher BCR-ABL relative concentrations in both CML-CP and ALL groups. Conclusions: This study identified the BCR-ABL gene as an important factor in CML and ALL cases. The M-bcr subtype was associated more with CML while the m-bcr subtype was associated more with ALL. Patients with m-bcr seem to have a poorer response to IM in either CML or ALL patients compared to M-bcr patients.

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.511-514
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• 2013

Background: A small but significant proportion of cases with atypical squamous cells of undetermined significance (ASCUS) may harbour CIN 2-3, or even invasive carcinoma. Although immediate colposcopy, HPV-DNA testing or expectant management are three recommended options in ASCUS triage, a consensus does not currently exist on which one of these approaches is the most efficient. In this study, we aimed to compare the performance and cost of immediate colposcopy and colposcopy based on the human papillomavirus (HPV) testing for detecting histologically confirmed high-grade cervical intraepithelial neoplasia (CIN) in women with ASCUS. Materials and Methods: Records of 594 women with an index Papanicolaou smear showing ASCUS were retrospectively analyzed. Women in the immediate colposcopy arm were referred directly to colposcopy (immediate colposcopy group, n=255) and those in the HPV triage arm were proceeded to colposcopy if the high-risk HPV (hrHPV) test was positive (HPV triage group, n=339). High grade CIN (CIN2+) detection rate and treatment costs were compared between the groups. Results: The detected rate of CIN2+ was higher in the HPV triage group compared to immediate colposcopy group (8% vs. 1.6%, p=0.011). In the HPV triage group, the total cost, cost per patient, and the cost for detecting one case of high grade CIN were higher than the immediate colposcopy group (p<0.001). Conclusions: In women with ASCUS cytology, HPV DNA testing followed by colposcopy is more costly than immediate colposcopy, but this approach is associated with a higher rate of CIN2+ detection. This findings suggest that HPV DNA testing combined with cervical cytology could reduce the referral rate to colposcopy.

• Tuberculosis and Respiratory Diseases
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• 제59권3호
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• pp.266-271
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• 2005

배 경 : 에탐부톨은 6개월 단기요법 중에 사용되는 1차 항결핵약제 중 하나이다. embB 유전자의 돌연변이는 에탐부톨의 내성과 관련이 있은 것으로 추측 되어왔다. 그러나 최근에 embB 유전자의 돌연변이는 에탐부톨 감수성인 균에서도 발견되어 이 유전자의 돌연변이가 에탐부톨 내성과 관련이 있는 것인지에 대한 논란이 있는 바, 이에 대한 이해를 높이고자 본 실험을 하게 되었다. 방 법 : 약제감수성검사에서 에탐부톨은 감수성이지만 타항결핵약제에 내성을 보인 36균주를 선택하였다. 이 균주들에서 embB 유전자에 대하여 중합효소연쇄반응를 실시한 후에 염기서열분석을 통해 돌연변이 여부를 조사하였다. 돌연변이가 있는 균주에 대하여 과거의 항결핵약제 감수성검사 결과를 비교하였다. 결 과 : 에탐부톨 감수성인 36균주 중에서 3균주(8.3%)만 이 embB 유전자의 codon 306과 codon 406에서 돌연변이를 나타냈다. 이 균주들은 적어도 아이소니아 짓에서도 내성을 가지고 있었고, 에탐부톨 1.0 mcg/ml를 함유한 LJ배지에서 모두 자랐다. 이 균주를 가진 결핵환자들은 꾸준히 치료를 하였음에도 불구하고 3년 동안이나 도말양성을 보였다. 또한 한 균주는 과거의 감수성검사에서 에탐부톨에 내성을 보인 경우도 있었다. 결 론 : 에탐부톨 감수성이지만 embB 유전자의 돌연변이를 가진 균주는 균주 자체의 특성이라기 보다는 일시적으로 생활력이 감소되어 약제 감수성으로 표현 될 수 있는 것으로 보인다.

• Tuberculosis and Respiratory Diseases
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• 제66권5호
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• pp.349-357
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• 2009

Background: The treatment success rates in patients with tuberculosis are known to be lower in the private sector compared to the public sector. To improve treatment outcomes in the private sector we developed a public-private collaboration model for strengthening health education and case holding activities with public health nursing in the private sector. Methods: We performed a prospective cohort study in new smear positive pulmonary tuberculosis patients treated at private hospitals, selected by non-randomization, with an intervention consisting of health education and case holding activities by specially trained public health nurses (intervention group) results were compared with cases treated without the intervention (conventional group). Physicians were asked to treat both groups routinely. The treatment outcomes of patients under treatment by the National Tuberculosis Programme were also analyzed for comparison. Results: There were 172 cases each in the intervention and conventional groups. The mean age was 48.9${\pm}$19.0 and 48.2${\pm}$19.7 in the respective groups (p=0.66). The PHN interacted with the cases in the intervention group by initial face to face interview and telephone calls an average of 7.1${\pm}$9.2 times during the initial six months. The intervention group showed a significantly higher treatment success rate, 91.6%, (Rate Ratio [RR]; 1.23, 95% Confidence Interval [CI]; 1.12-1.36), lower default, 3.6%, (RR; 0.31, 95% CI; 0.13-0.75) and transfer-out rate, 3.0%, (RR; 0.32, 95% CI; 0.12-0.86) than the conventional group where they were: 75.0%, 11.6%, 9.3%, respectively. The success rate was even higher than the rate (80.5%) of 1,027 cases treated in health centers (RR; 1.11, 95% CI; 1.05-1.17). Of the completed cases in the intervention group, 82.2% regarded the role of the public health nurse as very helpful. Conclusion: The treatment success rate, of tuberculosis patients in the private sector, was significantly improved by an intervention using a public-private collaboration model.

• Parasites, Hosts and Diseases
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• 제49권4호
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• pp.427-430
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• 2011

The aim of this study was to test the susceptibility of mice to Trypanosoma evansi treated with human plasma containing different concentrations of apolipoprotein L-1 (APOL1). For this experiment, a strain of T. evansi and human plasma (plasmas 1, 2, and 3) from 3 adult males clinically healthy were used. In vivo test used 50 mice divided in 5 groups (A to E) with 10 animals in each group. Animals of groups B to E were infected, and then treated with 0.2 ml of human plasma in the following outline: negative control (A), positive control (B), treatment with plasma 1 (C), treatment with plasma 2(D), and treatment with plasma 3 (E). Mice treated with human plasma showed an increase in longevity of $40.9{\pm}0.3$ (C), $20{\pm}9.0$ (D) and $35.6{\pm}9.3$ (E) days compared to the control group (B) which was $4.3{\pm}0.5$ days. The number of surviving mice and free of the parasite (blood smear and PCR negative) at the end of the experiment was 90%, 0%, and 60% for groups C, D, and E, respectively. The quantification of APOL1 was performed due to the large difference in the treatments that differed in the source plasma. In plasmas 1, 2, and 3 was detected the concentration of 194, 99, and 115 mg/dl of APOL1, respectively. However, we believe that this difference in the treatment efficiency is related to the level of APOL1 in plasmas.

• Parasites, Hosts and Diseases
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• 제52권6호
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• pp.661-666
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• 2014

In order to investigate the status of intestinal helminthic infections in Cambodia, epidemiological surveys were carried out on a national scale, including 19 provinces. A total of 32,201 fecal samples were collected from schoolchildren and adults between 2006 and 2011 and examined once by the Kato-Katz thick smear technique. The overall egg positive rate of intestinal helminths was 26.2%. The prevalence of hookworms was the highest (9.6%), followed by that of Opisthorchis viverrini/minute intestinal flukes (Ov/MIF) (5.7%), Ascaris lumbricoides (4.6%), and Trichuris trichiura (4.1%). Other types of parasites detected were Enterobius vermicularis (1.1%), Taenia spp. (0.4%), and Hymenolepis spp. (0.2%). The northwestern regions such as the Siem Reap, Oddar Meanchey, and Banteay Meanchey Provinces showed higher prevalences (17.4-22.3%) of hookworms than the other localities. The southwestern areas, including Koh Kong and Preah Sihanouk Provinces showed higher prevalences of A. lumbricoides (17.5-19.2%) and T. trichiura (6.1-21.0%). Meanwhile, the central and southern areas, in particular, Takeo and Kampong Cham Provinces, showed high prevalences of Ov/MIF (23.8-24.0%). The results indicate that a considerably high prevalence of intestinal helminths has been revealed in Cambodia, and thus sustained national parasite control projects are necessary to reduce morbidity due to parasitic infections in Cambodia.

• Asian Pacific Journal of Cancer Prevention
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• 제15권5호
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• pp.2051-2055
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• 2014

Background: To evaluate the performance of Siriraj liquid-based cytology (LBC) for cervical neoplasia screening after increasing use of this technology. Materials and Methods: Cytological reports of 103,057 Siriraj-LBC specimens obtained in 2007-2009 were compared with those of 23,676 specimens obtained in 2006. Results: Comparing with the year 2006, the 2007-2009 patients were slightly older ($43.4{\pm}12.yr$ vs $42.7{\pm}12.2yr$, p <0.001), and their specimens had much lower proportion of unsatisfactory slides (OR=0.06, 95%CI 0.04-0.09) with comparable detection rates (3.96% vs 3.70%, p=0.052) but different proportions of various cytological abnormalities (p<0.001). The 2007-2009 Siriraj-LBC had a negative predictive value (NPV) for cervical intraepithelial neoplasia 2+ (CIN2+) of 97.6% and an overall positive predictive value (PPV) of 43.9%. The PPV for CIN2+ varied with types of abnormal cytology, from 13.7% to 93.8% in atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL), atypical squamous cells cannot exclude HSIL (ASC-H), high-grade squamous intraepithelial lesion (HSIL), atypical glandular cells (AGC), to squamous cell carcinoma (SCC), respectively. The PPVs for CIN2+ in ASCUS and LSIL were comparable, but the PPV for CIN1 was higher for LSIL than for ASCUS (41.63% vs 16.32%). Conclusions: Siriraj-LBC has demonstrated a stable detection rate and NPV for CIN2+ of >95% since the first year of use. The comparable PPVs for CIN2+ of ASCUS and LSIL suggests that these two conditions may undergo similar management; other cytological abnormalities need immediate evaluation.

• 한국임상수의학회지
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• 제30권4호
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• pp.315-319
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• 2013

5년령의 중성화된 암컷 말티즈가 1개월 동안 지속된 전신적 발적, 탈모 및 소양감으로 내원하였다. 피부조직구증으로 진단되어 면역억제치료를 1개월 간 지속하였지만 다발성의 발적된 반 및 판 병변들이 새롭게 발생하였다. 피부병변에 대한 압박도말검사에서 림프종을 지시하는 원형세포들이 관찰되었다. 조직학적 검사에서는 종양세포들의 외피 및 부속구조물에 대한 친화성이 나타났다. 면역염색결과 종양세포들은 CD3에 대하여 양성, CD79a에 대해서는 음성반응을 나타내어 피부 상피친화성 T-세포 림프종으로 확진하였다. $70mg/m^2$의 lomustine을 2-3주 간격으로 총 2회 투여하였으며 부분적인 치료반응이 관찰되었다. 피부병변의 악화와 lomustine의 이용제한으로 gemcitabine ($500mg/m^2$, 1주일당 1회 30분간 혈관주입)을 이용한 화학치료를 시작하였다. 총 3회 치료가 실시되었으나 질병의 진행을 억제하지 못하였으며, 최초 lomustine 치료 69일 후 안락사 되었다.

• 한국임상수의학회지
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• 제32권2호
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• pp.191-195
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• 2015

7년령, 중성화 수컷 고양이가 무기력과 식욕부진으로 내원하였다. 실험실 검사는 말초혈액 호중구에서 중등도의 퇴행성 변화, free 및 total thyroxine의 농도 감소 및 혈액배양에서 세균증식이 관찰되었다. 16S ribosomal RNA 및 heat shock protein 60 유전자 검사 결과 세균은 Enterobacter cloacae로 확인되었다. 항생제 최소억제농도 평가결과 16개 항생제에 대한 다약제 내성이 관찰되었다. 중합효소연쇄반응 및 시퀀싱 결과 $bla_{TEM-1}$, $bla_{CTX-M-15}$ 및 플라스미드 유래 $bla_{ACT-1}$ 유전자에 대한 양성 반응이 관찰되었으며, 결과적으로 확인된 세균이 광범위 beta-lactamase 및 ampC beta-lactamase를 합성하는 플라스미드를 보유한 것을 확인하였다. 환자는 1개월 간 항생제와 levothyroxine 치료를 받은 후 증상이 호전되었고, 치료 후 갑상선 기능검사와 혈액배양 결과 이상소견은 소실되었다. 이 증례는 고양이의 지역사회획득 다약제내성 E. cloacae에 의한 정상 갑상샘 질환 증후군의 첫 예이다. 신속한 진단과정과 적절한 항생제 선택에 의해 이환된 고양이는 패혈증으로부터 회복되었다.

• 대한임상검사과학회지
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• 제36권2호
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• pp.144-152
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• 2004

With technological advances in automatic hematology analyzers, primary and screening differential counts of white blood cells (WBC) are done with automatic hematology analyzers. They are using different measurement and analysis principles, so differences in WBC differentials and WBC morphology flag exist. This study was carried out to analyze WBC differential counts and WBC morphology flags comparing them with the manual method. Patient EDTA samples in Vacutainer requested for WBC differentials were analyzed with XE-2100. And those samples with suspect flags messages index over 100 were selected and were analyzed with ADVIA-120. Peripheral blood smear film was subsequently made. Three investigators counted 200 cells each (600 cells) in 111 Wright-Giemsa stained blood films. Between two automatic hematology analyzers, neutrophil, lymphocyte, eosinophil, and monocyte showed good correlations, but basophil had moderate correlation. Among automatic hematology analyzers and manual count, neutrophil, lymphocyte, and eosinophil had good correlations, but monocyte had moderate correlation. XE-2100 had higher monocyte, which was due to atypical lymphocyte and myeloblast. LUC in ADVIA-120 was not due to monocyte in XE-2100. Morphology flagging rates were 146.9% in XE-2100 and was 93.2% in ADVIA-120. Positive predictive values of morphology flag were 58.2% in XE-2100 and 54.4% in ADVIA-120. Flags such as atypical lymphocyte, immature granulocyte, and left shift had higher predictive values and those such as N-RBC, platelets clump, and blast had lower ones. Between automatic hematology analyzers, WBC differentials showed good correlations. Predictive values for morphology flags can be variable with changing criteria. Reviewing criteria for WBC differentials and morphology flags should be established in each laboratory with regards to size of laboratory and patients it serves.