Effects of Iron Dietary Supplements to Prevent Iron Deficiency in Repeat Blood Donors / 대한수혈학회지

Background@#The purpose of this study was to prepare data for the prevention and management of iron deficiency by analyzing the effects of taking iron supplements provided by blood centers for repeat blood donors. @*Methods@#The high-risk groups with a potential iron deficiency were defined as three or more whole blood donations within the previous year and were provided with iron supplements for three months. Their hemoglobin and ferritin levels were checked up once a month for six months. The effectiveness of the iron supplements was evaluated by analyzing the changes in the initial and monthly hemoglobin and ferritin results. @*Results@#At the time of recruitments, an average 50.4% (40.8% of men and 65.3% of women, respectively) of participants had ferritin levels of less than 15 ng/mL, the World Health Organization iron deficiency standard, but after three months iron supplementation, the results decreased to 10.9% (9.0% of men and 13.8% of women). The ferritin levels increased significantly after taking iron supplements for three months and showed significant increases in both men and women, particularly after two months (P＜0.05). @*Conclusion@#The dietary iron supplements containing low-dose iron were effective in preventing iron deficiency in repeat blood donors by increasing the ferritin levels.

Effects of Iron Dietary Supplements to Prevent Iron Deficiency in Repeat Blood Donors / 대한수혈학회지

Background@#The purpose of this study was to prepare data for the prevention and management of iron deficiency by analyzing the effects of taking iron supplements provided by blood centers for repeat blood donors. @*Methods@#The high-risk groups with a potential iron deficiency were defined as three or more whole blood donations within the previous year and were provided with iron supplements for three months. Their hemoglobin and ferritin levels were checked up once a month for six months. The effectiveness of the iron supplements was evaluated by analyzing the changes in the initial and monthly hemoglobin and ferritin results. @*Results@#At the time of recruitments, an average 50.4% (40.8% of men and 65.3% of women, respectively) of participants had ferritin levels of less than 15 ng/mL, the World Health Organization iron deficiency standard, but after three months iron supplementation, the results decreased to 10.9% (9.0% of men and 13.8% of women). The ferritin levels increased significantly after taking iron supplements for three months and showed significant increases in both men and women, particularly after two months (P＜0.05). @*Conclusion@#The dietary iron supplements containing low-dose iron were effective in preventing iron deficiency in repeat blood donors by increasing the ferritin levels.

Antiviral Activity of Corylus heterophylla Fisch Against Porcine Epidemic Diarrhea Virus Infection

The porcine epidemic diarrhea virus (PEDV) has recently been shown to cause huge economic losses in the global pork industry. Our results demonstrated that the extract dose-dependently inhibited the replication of PEDV and reduced the visible cytopathic effect (CPE). Treatment with C. heterophylla Fisch extract resulted in marked reduction of PEDVinduced cytokine and chemokine expression. The antiviral activity of C. heterophylla Fisch extract on PEDV replication was found to be primarily exerted at the early stages after infection. Taken together, our data indicate that C. heterophylla Fisch extract may be a good therapeutic agent for use against PEDV and also a potential candidate to be evaluated against other human and animal coronaviruses.

Effects of Block Bone Substitutes Loaded with Escherichia Coli-Produced Recombinant Human Bone Morphogenetic Protein-2 on Space Maintenance and Bone Formation in Rat Calvarial Onlay Model

We aimed to evaluate the effects of onlay-type grafted human freeze-dried corticocancellous bone block (FDBB) and deproteinized bovine bone with collagen (DBBC) loaded with Escherichia coli-produced recombinant human bone morphogenetic protein-2 (ErhBMP-2) on space maintenance and new bone formation in rat calvaria. Collagen sponge (CS), FDBB, or DBBC disks (8×4 mm) with ErhBMP-2 (2.5 µg) were implanted onto the calvaria of male Sprague-Dawley rats, whereas CS with buffer was implanted onto the calvaria as controls (n=20/carrier). Rats were killed at 2 or 8 weeks post-surgery for histologic and histomorphometric analyses; total augmented area, new bone area, and bone density were evaluated. At both time-points, all ErhBMP-2 groups showed significantly higher new bone area and bone density than the control group (p<0.05). ErhBMP-2/FDBB and ErhBMP-2/DBBC groups showed significantly higher total augmented area than ErhBMP-2/CS group (8 weeks), and ErhBMP-2/FDBB group showed significantly higher new bone area and bone density than ErhBMP-2/DBBC group (p<0.05). ErhBMP-2/CS group showed the highest bone density (p<0.05). Combining ErhBMP-2 with FDBB or DBBC could significantly improve onlay graft outcomes, by new bone formation and bone density increase. Moreover, onlay-grafted FDBB and DBBC with ErhBMP-2 could be an alternative to autogenous block onlay bone graft.

Prevalence of Hepatitis C Virus Infections and Distribution of Hepatitis C Virus Genotypes among Korean Blood Donors

BACKGROUND: Hepatitis C virus (HCV) remains a worldwide health-care burden. Prevalence rates vary and the distribution of genotypes depends on geographical location. Here, the recent prevalence of HCV infections and distribution of HCV genotypes among Korean blood donors were studied. METHODS: Between February 2005 and December 2009, a total of 11,064,532 donors were screened for anti-HCV and 11,412,690 donors were screened for HCV RNA. HCV genotyping was conducted for 748 blood donors with HCV RNA by using the line probe assay (VERSANT HCV Genotype 2.0 Assay, Bayer Healthcare, USA) after amplification of the 5'-untranslated and core regions of the genome. RESULTS: The anti-HCV prevalence was 0.16% (17,250/11,064,532). HCV RNA was detected in 959 out of the 11,412,690 donors (8.4/100,000). HCV RNA was more prevalent among women, donors who resided at harbor sites, and first-time donors. In addition, the prevalence of HCV RNA increased with age. The genotypes of 740 out of the 748 tested donors (98.9%) were identified. HCV genotype 1b (47.7%) and 2a/2c (35.0%) were dominant. Genotypes 2 (7.6%), 2b (2.3%), 3a (1.6%), 1a (1.3%), 1 (0.9%), 2v (0.5%), 1v (0.1%), and 3 (0.1%) were also identified. Genotype 4a/4c/4d (0.1%) was detected for the first time in one Korean blood donor. CONCLUSIONS: The distribution of HCV genotypes in Korea has not changed remarkably, with the exception of genotype 4a/4c/4d. A periodic study to monitor the prevalence of HCV infections and the distribution of HCV genotypes is required to identify emerging genotypes in Korea.

Determining the Cause of Discrepant Results in HCV NAT Comparative Tests / 대한수혈학회지

BACKGROUND: The Korean Red Cross blood laboratory centers have been performing comparative tests for NAT reactive specimens since February 2005. However, five discrepant specimens were found in HCV-diluted specimens between 2007 and 2008 and the reasons for this has been investigated. METHODS: For the five discrepant specimens, the HCV RNA concentration was measured in 5 tubes for each speciment. Subsequently, in order to compare the sensitivity of the low titer specimens measured by RT-PCR and TMA, comparative tests of diluted samples were examined six times per sample. Finally, the genotype was tested in order to determine the characteristics of the discrepant samples. RESULTS: Result of the quantitative tests for HCV RNA demonstrated that aliquots of the plasma bag were homogenous in term of viral load quantitation. As a result of the comparative test, all samples were found to contain over 1.0x10(1) IU/mL as detected by the two analytical systems. In contrast, those less than 1.0x10(1) IU/mL were not entirely detected by the two systems. CONCLUSION: It was impossible to completely detect using the two NAT system and the detection rates for both systems were equivalent for the samples examined. In particular, with respect to HCV, it may be undetectable on the NAT test because viral load decreases rapidly before and after sero-conversion. This result indicates that anti-HCV and NAT should be performed together as an HCV screening test prior to blood donation.

Apoptosis Gene Expression Pattern Analysis of Jurkat Cells Treated with FK506

PURPOSE: FK506 (tacrolimus) is a widely used immunosuppressive agent in the treatment of various medical conditions, including autoimmune disease, bone marrow and organ transplantations. Previously FK506 was known to cause apoptotic death of human Jurkat T cells. METHODS: The current study was designed to analyze the gene expression pattern of Jurkat T cells after FK506 application by using cDNA microarray. Treatment of Jurkat T cells with FK506 resulted in a decrease of cell viability in a time- and dose-dependent manner. Next, total RNA of Jurkat T cells was extracted by using TRIzol reagent and used to carry out a confirmation test for the purity and integrity of total RNA. RESULTS: Gene expression levels related to apoptosis and cell cycle process were mainly focused to analyze in FK506-treated Jurkat T cells. According to the inhibition of calcineurin activity, MARCKS in PKC substrates and Sp3 transcription factor was markedly increased in FK506-treated cells. Also, cell cycle control gene Id1 and Id3 were induced in expression from FK506-treated Jurkat T cells. However, FK506 decreased the expression of Src homology 2, G protein, and MEK 2 genes in bioactive peptide induced signaling pathway. It also reduced the expression level of the insulin receptor, DRPLA and Bai1-associated protein 2 genes, which are involved in the regulation of cell motility and morphology control. CONCLUSION: The author will continue to pursue the exact functional roles of genes that are markedly changed in expression by FK506 in human Jurkat T cells in vitro and in vivo experimental models.

A Case of Deep Vein Thrombosis Associated with Myositis due to Streptococcus pyogenes / 소아감염

A 5-year-old boy was admitted to the hospital with a high fever and abnormal gait. Magnetic resonance imaging showed extensive swelling of the quadriceps and adductor muscles around the right hip and anterior thigh. A duplex scan demonstrated a thrombus from the external iliac vein to below the popliteal vein. The blood culture revealed Streptococcus pyogenes. The patient was immediately treated with antibiotics and anticoagulants. Follow-up sonography demonstrated complete disappearance of the venous thrombosis. We report a case of streptococcal myositis complicated by deep vein thrombosis.

A Study to Verify the Stability of Currently Stored Blood Donor Samples (A First Year Study) / 대한수혈학회지

BACKGROUND: The Korean Red Cross (KRC) has stored blood donor samples for 10 years under -20degrees C since 2004. These samples have been used for investigating transfusion related infections and for Look-back studies. We designed an experimental scheme to verify the stability of stored blood samples. METHODS: We collected and prepared samples such as blood donor samples (HBV, HCV, HIV nucleic acid positive; n=90), the HIV infected patient samples (n=20), the WHO nucleic acid international standards serologic positive samples (HBsAg, anti-HCV, anti-HIV; n=120) and the negative samples (n=20). The samples were aliquoted in cryo tubes with volumes of 0.5~5 mL and they were stored at -20~-30degrees C and -70~-80degrees C. We used enzyme immunoassay, chemiluminescence immunoassay and quantitative PCR for the base line and the follow up studies. The linear mixed statistical model using SAS 9.1 for windows was used for statistical analysis. RESULTS: The results of the baseline test of the stored samples showed a variable range of viral load (10(1)~10(7) IU/mL or copies/mL) and optical density (S/CO 3.0~500). The results of the stored samples after 6 month (n=82) did not show any significant differences compared to the baseline data for the viral loads (P>0.05) and the qualitative serologic tests. CONCLUSION: We established an experimental scheme to verify the stability of the stored blood donor samples. From now on, the stability of the stored samples is going to be monitored by every 6 month for 10 years.

The effect of ketamine as adjuvant to opioid for intractable cancer pain / 대한내과학회지

BACKGROUND: There has been growing evidence of the importance of the N-methyl-D- aspartate (NMDA) receptor in intractable pain. There is good evidence from experimental animal models and clinical trials that ketamine as a NMDA receptor antagonist relieves neuropathic pain. We evaluated whether ketamine in low doses as an adjuvant to opioid treatment improves analgesia with tolerable adverse effects. METHODS: 58 patients with intractable cancer pain received ketamine for 3 days. Each pain type was classified as a somatic, visceral, or neuropathic pain. We assessed pain at 6 hourly intervals with vital signs using a numeric rating scale. Data on opioid doses, ketamine dose, and adverse effects were recorded daily on an assessment chart. To be designated as a responder, a patient had to show a 50% or greater reduction in the mean pain scale. RESULTS: The overall response rate was 34.5%. The results according to the type of pain mechanism showed that 47% (15/32) patients with neuropathic and 25% (5/20) patients with somatic pain responded. In 24 cases (41.4%), the requirement for an opioid dose was reduced after infusion of ketamine. The most common adverse effects were nausea and vomiting. Eleven patients complained of drowsiness or transient hallucination. However, most adverse effects were mild to moderate and were easily relieved by treatment. CONCLUSIONS: This study demonstrates that the infusion of ketamine in low doses may have an effect on intractable cancer pain and in reducing opioid requirements, especially neuropathic pain with acceptable toxicities. Therefore, ketamine may be useful as an adjuvant to opioid treatment in cancer patients who are receiving palliative care.

Characteristics of Human Immunodeficiency Virus Type 1 Reactive Blood Donors Following Nucleic Acid Amplification Test Screening / 대한수혈학회지

BACKGROUND: The Korean Red Cross has established three nucleic acid amplification test (NAT) centers, and the organization has begun NAT screening for human immunodeficiency virus type 1 (HIV-1) and hepatitis C virus (HCV) for domestic blood donors commencing from February 2005. As a result, between February 2005 and July 2006, it was found that 80 of a total of 3,481,972 donors that were screened were positive for HIV-1 as determined by the NAT. This report will describe the characteristics of the HIV-1 positive reactive donors. METHODS: We attempted to determine the number of HIV-1 positive reactive donors for each NAT center, and attempted to characterize the donors by gender, age, RNA viral load, and the distribution of HIV-1 subtype. RESULTS: Among the 80 HIV-1 positive reactive donors determined by the NAT, 57.5% of the donors were in their twenties and all but one of the donors was male. Of all of the donors, 82.5% were repeated donors and four donors showed antibody negative window periods. The average quantity of HIV-1 RNA for 78 donors was 1.12x105 copies/mL and for the four donors that showed the antibody negative window periods was 2.68x105 copies/mL. The HIV-1 subtypes of 76 cases were all B of group M. CONCLUSION: NAT screening contributes to the safety of the domestic blood supply. Therefore, it is necessary to continue to study the characteristics of the blood that was found to show HIV positivity by the NAT.

Characteristics and Follow-up Results of the Window Period Blood Donors for Hepatitis C Virus / 대한수혈학회지

BACKGROUND: To improve the safety of the blood supply in Korea, nucleic acid amplification testing (NAT) for HCV and HIV-1 as a blood screening test has been used by the Korean Red Cross since February 1st, 2005. Until October 31st 2006, a total of 4,037,618 donor samples had been tested and 436 cases showed reactivity for HCV RNA. Only 10 of these cases showed serologically negative antibody results. METHODS: We investigated the characteristics and the follow-up results of the ten donors who showed HCV RNA reactivity and serologically negative results. RESULTS: All the ten donors were identified to be "window period" blood donors with confirmation of their seroconversion by follow-up testing. The average RNA titer of the donors was 9.21x106 IU/mL. Five donors showed high levels of ALT. One donor showed the reversed pattern on the test results for antibody and RNA. CONCLUSION: By detecting five cases of HCV "window period" infection, NAT has increased the safety of the Korean blood supply. But it is considered that NAT can not be a substitute serological test and an adequate follow-up strategy is required for verification of the accurate seroconversion time.

The Analysis of the Effect of Mixing of Anticoagulant on Nucleic Acid Amplification Tests for Donated Blood / 임상검사와정도관리

BACKGROUND: In the process of implementing the nucleic acid amplification tests (NAT) for the blood screening, it was needed to change plain tube to EDTA tube for the sampling. Because the sample is taken from the CPDA-1 anticoagulated whole blood, the EDTA of tube could be mixed with the CPDA-1. So, we studied the effect of the mixing of two anticoagulants on the NAT. METHODS: Using HIV-1 and HCV RNA standards, we made the qualitative and quantitative test panels for the EDTA anticoagulant and the EDTA/CPDA-1 anticoagulant containing blood. The reverse transcription-polymerase chain reaction of Roche and transcription-mediated amplification of Chiron were used for the RNA qualitative and quantitative test. RESULTS: On the qualitative HIV-1 and HCV RNA tests for the EDTA, CPDA-1 alone and the CPDA-1/EDTA mixture, false negative and false positive reactions were not observed. On quantitative test, viral loads were not different statistically. CONCLUSIONS: Since there were no statistically significant differences between CPDA-1 alone and EDTA/CPDA-1 mixture in both qualitative and quantitative tests for HIV-1 and HCV RNA, it was concluded that mixing of anticoagulants, EDTA and CPDA-1, would not cause an significant effect on the NAT for the donated blood.

A case of AILD associated with pure red cell aplasia / 대한임상병리학회지

No abstract available.

Clinical Study of Acute Diarrhea in Infants and Children

Diarrhea is one of the most common symptoms evaluated by pediatrician. In a study of 671 children admitted to the diarrhea from Jan. 1970 to Dec. 1976. The results are summarized as follow 1) Diarrhea patients were total 671 cases(7.7%) among 8711 children who were admitted during last 7 years from Jan. 1970 to Dec. 1976. There was no significant difference in annual incidence. 2) Monthly incidence revealed in summer(Jun. July) and autumn (sep.Oct) frequently. 3) Age incidence showed the highest rate between 6 month to 2 year of age(52.2%). 4) Sex incidence showed that male to female in a proportion of 1.5:1. 5) potential etiologic agents were identified 332 of 671 children with diarrhea: E. coli 21.0%, shigella 7.0%, ameba 7%. In the majority of cases(31.89%) the etiologic agents were not found. 6) Infection in other parts of the body were recorded in 123 cases(18.64%) including common cold, bronchits, pneumonia measles, tonsillits. 7) Initial symptoms of the diarrhea patients were fever, vomiting, abdominal pain, tenesmus, neurologic symptoms. 8) The nature of stool was blood tinged mucoid in shigella, watery and granular stool are associated with enteropathogenic E.coli of Parenteral diarrhea. 9) Most effect chemotherpeufic agent of shigella was ampicillin, and gentamycin was considerable effectiveness against E.coli, with 76.2% showing susceptibility to gentamycin.