BACKGROUND: Human immunodeficiency virus (HIV) infection results in a selective CD4+ T cell depletion and an impairment of T cell regulation. Despite the immune depletion, the progression of HIV infection is accompanied by the stimulation of antibody synthesis. Thus, the prevalence and amplitude of the increase of total serum IgE level and the relationship between the IgE levels and the degree of immunodeficiency were evaluated in patients with HIV infection. METHOD: Twenty-six Korean adults infected with HIV, in different stages, were evaluated for serum IgE level and CD4+ T cell count. Serum IgG, IgM and IgA levels were also determined. All subjects enrolled in this study denied an individual and familial history of atopic diseases. The possibility of parasitic infestation was also excluded by history and stool examination. RESULTS: The mean serum IgE level was 473.5 IU/L with a standard deviation of 671.4 IU/L (range: 15.9~2000 IU/L) and increased serum IgE levels ( > 200 IU/L) were found in 38.5% of the study population. The mean serum IgG, IgA and IgM levels were 1,939.5 +/- 588.6 mg/dL (normal: 751~1,560 mg/dL), 388.9 +/- 216.7 mg/dL (normal: 82~453 mg/dL) and 153.6 +/- 75.3 mg/dL (normal: 46~304 mg/dL), respectively. The CD4+ T cell count was inversely correlated to the serum IgE level (r=-0.429, p < 0.05), but not to the other isotypes of immunoglobulin. CONCLUSION: Serum IgE levels are increased in adults with HIV infection and could be useful as a marker of disease progression. Further study is needed to elucidate the causes and clinical significance of these findings.
Adult ; CD4 Lymphocyte Count ; Eosinophils ; Female ; HIV Infections/*immunology/virology ; Human ; Immunoglobulin A/blood ; Immunoglobulin E/*blood ; Immunoglobulin G/blood ; Immunoglobulin M/blood ; Korea ; Leukocyte Count ; Male ; Middle Age ; RNA, Viral/blood

BACKGROUND AND OBJECTIVES: As human immunodeficiency virus (HIV) infection increases in prevalence and new medical therapies prolong the survival of HIV-infected patients, otolaryngologists will see a larger number of patients with head and neck manifestations of HIV infection. The aims of study were to evaluate the various otorhinolaryngologic diseases and to analyze the useful markers for predicting immune function in HIV-infected patients. SUBJECTS AND METHOD: Of 380 HIV-infected patients, 40 patients (10.5% ; 39 males and 1 female, age ranging from 23 to 55) were referred to otorhinolaryngologists. Spectrum of disease and correlation between various surrogate markers (HIV RNA, leukocyte count, neutrophil, lymphocyte, CD3, CD4, CD8 T cell percentage and count, CD4/CD8 ratio) and risk of infectious otorhinolaryngologic diseases were analyzed. RESULTS: Thirty-three patients (82.5%) were infectious, 6 patients (15.0%) had non-infectious diseases and 1 patient (2.5%) malignancy. In otologic diseases, acute otitis media and chronic otitis media were frequently found in the mentioned order. In rhinologic diseases, rhinosinusitis and vestibulitis were frequently found in the mentioned order, with one primary extra nodal non-Hodgkin's lymphoma. In laryngologic diseases, pharyngolaryngitis, oral candidiasis, stomatitis were frequently found. In the surrogate markers of immune function, CD4 percentage, CD4 count and CD4/CD8 ratio were found significantly lower in the infectious diseases than in the non-infectious disease. CONCLUSION: Of HIV-infected patients, 10.5% had seen an otolaryngologist, and the majority had infectious diseases. The risk of infectious diseases was strongly correlated with the CD4 percentage, count and CD4/CD8 ratio.
Biomarkers ; Candidiasis, Oral ; CD4 Lymphocyte Count ; Communicable Diseases ; Ear Diseases ; Female ; Head ; HIV ; HIV Infections ; Humans ; Leukocyte Count ; Lymphocytes ; Lymphoma, Non-Hodgkin ; Male ; Neck ; Neutrophils ; Otitis Media ; Otolaryngology ; Otorhinolaryngologic Diseases ; Prevalence ; RNA ; Stomatitis

The effect of prophylactic postoperative radiotherapy on peripheral lymphocyte count was determined for 20 cases of urogenital malignant tumors (bladder cancer-13 cases, prostatic cancer-4 cases, renal cancer-3 cases). The results were obtained as follows, l) Radiotherapy decreased the white blood cell count by a mean percentage of 16.7% (14.0% for bladder cancer, 16.4% for prostatic cancer. 36.8% for renal cancer, respectively) during the period of first month, but did not alter the granulocyte count. 2) Radiotherapy brought about high degree of decrease of peripheral lymphocyte count by a mean percentage of 47.9% (47. 3% for bladder cancer. 50.0% for prostatic cancer. 32.3% for renal cancer, respectively). 3) The recovery of the radiation-induced lymphocyte deficiency to pre-irradiation level was observed in 1-2 years after completion of radiation therapy (2 years for bladder cancer. 1 1/2 years for prostatic cancer. 1 year for renal cancer. respectively).
Granulocytes ; Kidney Neoplasms ; Leukocyte Count ; Lymphocyte Count ; Lymphocytes ; Prostatic Neoplasms ; Radiotherapy ; Urinary Bladder Neoplasms

OBJECTIVE: TNF-alpha related apoptosis inducing ligand (TRAIL) is a member of TNF superfamily that promotes apoptosis by binding to the transmembrane receptors. The effects of TRAIL in patients with rhematoid arthritis (RA) are still debatable. This study was performed to evaluate the effects of TRAIL on RA by measuring serum concentration of TRAIL in patients with RA and assessing relationships between the TRAIL concentration and various clinical parameters of RA. METHODS: A total of 105 patients with RA, 34 patients with osteoarthritis (OA), and 35 age- and gender-matched healthy controls were enrolled in this study. Data from the RA patients included subject's age, duration of disease, daily steroid doses, ESR, CRP, rheumatoid factor, leukocyte count, lymphocyte count, tender joint count, swollen joint count, and serum TRAIL concentration. Serum TRAIL concentration was measured by enzyme immunoassay (EIA) method. The serum concentration of TRAIL in RA patients was compared to those of OA patients and healthy controls. Relationships of TRAIL concentration with various clinical parameters were evaluated. RESULTS: Serum concentration of TRAIL in patients with RA was significantly decreased compared to that in healthy controls (RA: 42.60+/-26.39 pg/mL, control: 57.21+/-19.49 pg/mL, p=0.029). Serum concentration of TRAIL in patients with OA (50.79+/-15.92 pg/mL) was not different from that in normal controls (p=0.115). There were no significant differences in serum TRAIL concentration between patients with RA and those with OA (p=0.360). In patients with RA, serum TRAIL concentration showed no difference between high- and normal ESR subgroups, as well as high- and normal CRP subgroups. Serum TRAIL concentration correlated significantly with ESR (r=0.406, p<0.001). However, other clinical parameters, such as subject's age, duration of disease, daily steroid doses, CRP, leukocyte count, lymphocyte count, tender joint count, swollen joint count revealed no significant correlation with serum TRAIL concentration. CONCLUSION: Serum concentrations of TRAIL in RA patients were significantly lower than those in healthy controls, suggesting that apoptotic ability is decreased in the patients with RA. Serum TRAIL concentration does not seem to reflect disease activity of RA.
Apoptosis ; Arthritis ; Arthritis, Rheumatoid ; Humans ; Immunoenzyme Techniques ; Joints ; Leukocyte Count ; Lymphocyte Count ; Osteoarthritis ; Rheumatoid Factor ; Tumor Necrosis Factor-alpha

PURPOSE: The objective of this study was to explore the relationship between the circulating lymphocyte level during preoperative chemoradiotherapy (CRT) and pathologic complete response (pCR) in locally advanced rectal cancer. MATERIALS AND METHODS: From May 2010 to May 2013, 52 patients treated with preoperative CRT followed by surgery, were analysed. Patients received conventional fractionated radiotherapy (50-54 Gy) with fluorouracil-based chemotherapy. Surgical resection was performed at 4 to 8 weeks after the completion of preoperative CRT. Absolute blood lymphocyte counts and their relative percentage in total white blood cell counts were obtained from complete blood count tests performed prior to and after 4, 8, and 12 weeks of CRT. We analysed the association between achieving pCR and change in blood lymphocyte level during CRT, as well as clinical parameters. RESULTS: Among 52 patients, 14 (26.9%) had evidence of pCR. Sustaining the blood lymphocyte count during CRT (lymphocyte count at 4 weeks/baseline lymphocyte count > 0.35; odds ratio, 8.33; p=0.02) and initial carcinoembryonic antigen < 4.4 ng/mL (odds ratio, 6.71; p=0.03) were significantly associated with pCR in multivariate analyses. CONCLUSION: Sustaining blood lymphocyte count during preoperative CRT was predictive for pCR in rectal cancer. Further studies are warranted to investigate the association between pathologic responses and circulating lymphocyte count with its subpopulation during preoperative CRT.
Blood Cell Count ; Carcinoembryonic Antigen ; Chemoradiotherapy* ; Drug Therapy ; Humans ; Leukocyte Count ; Lymphocyte Count* ; Lymphocytes* ; Multivariate Analysis ; Neoadjuvant Therapy ; Odds Ratio ; Polymerase Chain Reaction ; Radiotherapy ; Rectal Neoplasms*

BACKGROUND: Diabetes mellitus (DM) is characterized by impaired glucose regulation and various complications. It is known that chronic inflammation and platelet activation play a role in development of insulin resistance or diabetic complications. This study investigated whether hematologic parameters are useful for monitoring blood glucose regulation or complications in DM patients. METHODS: Total 90 diabetic patients were divided into two groups according to their hemoglobin A1c (HbA1c) levels: 59 regulated DM patients with HbA1c levels<7% and 31 unregulated DM patients with HbA1c levels≥7%. RESULTS: White blood cell counts (P=0.021), neutrophil counts (P=0.005), monocyte counts (P=0.040), neutrophil % (P=0.042) and the neutrophil lymphocyte ratio (NLR) (P=0.032) were significantly higher in the unregulated DM group compared to that in the regulated DM group. There were no differences in lymphocyte counts, lymphocyte %, monocyte %, mean neutrophil volume, mean monocyte volume, platelet count, and mean platelet volume between groups. Neutrophil counts and NLR were higher in unregulated DM patients with complications than in the regulated DM group. A positive correlation was observed between HbA1c and white blood cell count (r=0.389, P<0.001) and neutrophil count (r=0.361, P<0.001). CONCLUSIONS: In DM patients, neutrophil counts and NLR were related to glycemic control and the presence of complications. Additionally, neutrophil counts showed a positive correlation with HbA1c. Therefore, neutrophil counts and NLR can be used as related markers for diabetic regulation and complications during the follow-up of diabetic patients.
Blood Glucose ; Diabetes Complications ; Diabetes Mellitus ; Follow-Up Studies ; Glucose ; Humans ; Inflammation ; Insulin Resistance ; Leukocyte Count ; Lymphocyte Count ; Lymphocytes ; Mean Platelet Volume ; Monocytes ; Neutrophils ; Platelet Activation ; Platelet Count

BACKGROUND: Diabetes mellitus (DM) is characterized by impaired glucose regulation and various complications. It is known that chronic inflammation and platelet activation play a role in development of insulin resistance or diabetic complications. This study investigated whether hematologic parameters are useful for monitoring blood glucose regulation or complications in DM patients. METHODS: Total 90 diabetic patients were divided into two groups according to their hemoglobin A1c (HbA1c) levels: 59 regulated DM patients with HbA1c levels<7% and 31 unregulated DM patients with HbA1c levels≥7%. RESULTS: White blood cell counts (P=0.021), neutrophil counts (P=0.005), monocyte counts (P=0.040), neutrophil % (P=0.042) and the neutrophil lymphocyte ratio (NLR) (P=0.032) were significantly higher in the unregulated DM group compared to that in the regulated DM group. There were no differences in lymphocyte counts, lymphocyte %, monocyte %, mean neutrophil volume, mean monocyte volume, platelet count, and mean platelet volume between groups. Neutrophil counts and NLR were higher in unregulated DM patients with complications than in the regulated DM group. A positive correlation was observed between HbA1c and white blood cell count (r=0.389, P<0.001) and neutrophil count (r=0.361, P<0.001). CONCLUSIONS: In DM patients, neutrophil counts and NLR were related to glycemic control and the presence of complications. Additionally, neutrophil counts showed a positive correlation with HbA1c. Therefore, neutrophil counts and NLR can be used as related markers for diabetic regulation and complications during the follow-up of diabetic patients.
Blood Glucose ; Diabetes Complications ; Diabetes Mellitus ; Follow-Up Studies ; Glucose ; Humans ; Inflammation ; Insulin Resistance ; Leukocyte Count ; Lymphocyte Count ; Lymphocytes ; Mean Platelet Volume ; Monocytes ; Neutrophils ; Platelet Activation ; Platelet Count

PURPOSE: We investigated to identify factors related to thrombocytosis and clinical data for thrombopoiesis in children with iron deficiency anemia (IDA). METHODS: We retrospectively analyzed clinical and laboratory data for 85 children admitted for acute infection or inflammation. Seventy patients of 85 children were diagnosed as IDA. The others were clinically suspected as IDA but they were not diagnosed. We divided three groups: group 1 included severe anemia below hemoglobin (Hb) 8.0 g/dL, group 2 mild to moderate anemia (Hb: 8.0~10.0 g/dL), and group 3 (control) were clinically suspected but without IDA. RESULTS: There are no differences among groups except age at diagnosis. The age at diagnosis in group 1 are higher than other groups. In control group, there are not any factors correlated with thrombocytosis. In group 1, the white blood cell and lymphocyte counts are significantly related to the platelet counts. However, serum iron level is only correlated with platelets in group 2. In multiple regression analysis, we found significantly correlation between white blood cell counts and serum iron level and thrombocytosis in IDA including group 1 and 2. CONCLUSION: We suggest that white blood cell counts and serum iron level in IDA may be related with increased platelet counts, as a reactive thrombocytosis. We need further study for correlation between acute phase reactants and thrombocytosis in IDA.
Acute-Phase Proteins ; Anemia ; Anemia, Iron-Deficiency* ; Child* ; Diagnosis ; Humans ; Inflammation ; Iron* ; Leukocyte Count ; Leukocytes ; Lymphocyte Count ; Platelet Count ; Retrospective Studies ; Thrombocytosis* ; Thrombopoiesis

Today's automated hematology analyzers capable of performing a full CBC and a differential leukocyte count (DLC) on whole blood, particularly in a closed tube system, using cytochemistry or impedance-based flow cytometry technology coupled with laser light scattering, conductivity and/or differential cell lysis, are here to stay. Their need and popularity among at least the large, cost and quality-conscious clinical laboratories have been growing for the past few years and will continue to do so in the years ahead. The efficiency and reliability of several of these analyzers in performing complete CBCD (CBC and DLC) and in flagging significant abnormalities have been tested and found acceptable with the need to review a stained blood smear or perform a manual DLC to confirm or obtain additional information on selected cases.
Automation ; Human ; Leukocyte Count/*methods

BACKGROUND: Proper gating is important in flow cytometric assays of lymphocyte subsets. Forward light scatter (FSC)/side light scatter (SSC) gating requires application of a lymphocyte purity correction when lymphocyte purity is less than 95%. We compared 3 different gating methods to establish an accurate gating method appropriate for a T-lymphocyte subset assay of bronchoalveolar lavage (BAL) fluid. METHODS: Leukocyte numbers and subtypes in 31 BAL fluid samples were assessed manually and by using an automatic hematology analyzer. T-lymphocyte subsets (T cells, T helper/inducer cells [Th], and T suppressor/cytotoxic cells [Tc]) were assessed by flow cytometry. We compared 3 methods of lymphocyte gating: CD45/SSC gating (reference method), FSC/SSC gating, and FSC/SSC gating with application of a lymphocyte purity correction. Lymphocyte purity was determined by CD45/CD14 staining of BAL fluid. RESULTS: We observed a significant correlation between lymphocyte percentage and lymphocyte purity (r = 0.453, P = 0.011). T-cell results obtained using the reference method were not correlated with the results of the other 2 gating methods (r = 0.189 each, P = 0.308 for FSC/SSC gating and P = 0.310 for FSC/SSC gating with purity correction). Mean differences between the reference method and FSC/SSC gating (T cells: 14.4%, P = 0.002; Th cells: 7.7%, P = 0.006; Tc cells: 7.1%, P = 0.001) were greater than those between the reference method and FSC/SSC gating with purity correction (T cells: 12.1%, P = 0.004; Th cells: 1.7%, P = 0.608; Tc cells: 0.2%, P = 0.957). CONCLUSIONS: Lymphocyte purity correction after FSC/SSC gating improved the accuracy of Th- and Tc-cell measurements, but not T-cell measurements. CD45 is essential for lymphocyte gating in T-lymphocyte subset assays of BAL fluid.
Bronchoalveolar Lavage ; Bronchoalveolar Lavage Fluid ; Flow Cytometry ; Hematology ; Leukocyte Count ; Light ; Lymphocyte Subsets ; Lymphocytes ; T-Lymphocyte Subsets ; T-Lymphocytes