Hyperhomocysteinemia as a Risk Factor for Coronary Artery Disease / 대한진단검사의학회지

BACKGROUND: Hyperhomocysteinemia is considered as a risk factor for coronary artery disease (CAD). In this study, we investigated the relationship between plasma homocysteine concentration and coronary artery disease. METHODS: We measured plasma homocysteine concentration by fluorescent polarization immunoas-say (IMx, Abbott) in 58 healthy controls (39-72 years) and in 37 patients (42-84 years) who were diagnosed with stable angina (11), unstable angina (14), acute myocardial infarction (8), old myocardial infarction (1) and silent myocardial ischemia (3). RESULTS: The risk of CAD was independently associated with old age, decreased HDL cholesterol and hyperhomocysteinemia (P >or=12.8 nmol/L) and adjusted odds ratios were 2.8, 3.4, and 6.0, respec-tively. The risk for CAD in the upper two homocysteine quartiles (P >or=10.8 nmol/L and 8.1- 10.7 nmol/L) was 11.1 (95% CI, 2.5- 49.4) times and 6.3 (95% CI, 1.4- 27.7) times higher than in the lowest quar-tile (<6.9 nmol/L) (P=0.002 and 0.014, respectively). The mean plasma homocysteine values (M +/- SD) were higher in CAD patients (11.8 +/- 7.4 nmol/L) than in the control group (8.0 +/- 2.4 mol/L) (P=0.0006). In the control group, the mean plasma homocysteine concentration in men was signifi-cantly igher than in women (9.1 vs. 7.2 mol/L, P=0.002). Age and logarithmically transformed plasma homocysteine levels exhibited significant positive correlation in controls (r=0.43, P=0.001), ut no significant correlation in CAD patients (r=-0.024, P=0.9). Plasma homocysteine levels were significantly higher in the elderly, male subjects and smokers in the univariate analysis. CONCLUSIONS: Hyperhomocysteinemia is one of the independent risk factors for CAD.

Clinical Usefulness of the CK-MB Activity and Cardiac Troponin T as Markers for Detection of Acute Myocardial Infarction / 대한임상병리학회지

BACKGROUND: The goal of this study is to assess the clinical utility of cardiac troponin T(cTnT) and creatine kinase MB(CK-MB) activity and to determine optimum decision thresholds by using receiver operating characteristic(ROC) curve for cTnT and CK-MB. METHOD: We evaluated serum cTnT(Elecsys 2010, Boeringer Manheim, Germany) and CK-MB activity(XRC, Johnson & Johnson Clinical Diagnostics, USA) in 15 cases(124 samples) of acute myocardial infarction(AMI) and 64 cases(98 samples) of non-AMI patients from April 1998 to October 1998. RESULTS: CK-MB activity [cut-off value 16 U/L, relative index(CK-MB 100/total CK) 4-25%)] and cTnT(cut-off value 0.1 ng/mL) were detected in serum within 3 hours after onset of chest pain and cTnT was persistent to longer times than CK-MB activity. Sensitivity of cTnT(69.6%) is not statistically different from CK-MB activity(72.9%) within 24 hours of chest pain but more sensitive after 24 hours of symptom. Specificity(87.9%) and negative predictive value(91.2%) of cTnT were superior to that of CK-MB activity within 24 hours of chest pain. ROC curve analysis demonstrated the following decision cutoff, sensitivity, specificity: cTnT 0.13 ng/mL, 76.7%, 100%; CK-MB activity 14 U/L, 84.7% and 71.0%. CONCLUSION: Measurement of cTnT was useful for late admitted AMI and together with CK-MB could improve the detection of myocardial infarction.

Usefulness of column agglutination test for irregular antibody screening and identification / 대한임상병리학회지

BACKGROUND: Type and screen is recommended for efficient use of blood and reduction in workload in blood bank. Column agglutiation test is standardized and easy to perform, and provide clear and stable reactions that improve the interpretation of results. In this study, we compared column agglutination test(Ortho Diagnostic Systems Inc., USA) with conventional tube test and investigate its usefulness in irregular antibody screening and identification. METHODS: A total 182 samples were screened for irregular antibodies using column agglutination test and conventional tube test. And 18 patient's sera in which irregular antibodies previously screened by both tube and column agglutination tests were identified for irregular antibodies by tube and column agglutination tests. We compared the results of two tests. RESULTS: In the screening test, there was 96.7%(176/182) agreements between column agglutination test and conventional tube test. The column agglutination test showed stronger reactivity than tube test. In the irregular antibody identification, there was 88.8%(16/18) agreement between two tests and disagreement were seen in the identification of anti-P1 and anti-Leb antibodies. CONCLUSION: The results of column agglutination test are objective and superior to the conventional tube test in irregular antibody screening and identification tests. These results suggest that the column agglutination test will be useful and more convenient test in antibody screening and identification.