Delirium After Traumatic Brain Injury: Prediction by Location and Size of Brain Lesion

Objective@#To examine (1) the location of brain lesion that would predict post-traumatic delirium and (2) the association between volume of brain lesion and occurrence of delirium in patients with traumatic brain injury (TBI). @*Methods@#A retrospective study was conducted by reviewing medical records of 68 TBI patients, categorized into two groups: the delirious group (n=38) and non-delirious group (n=30). The location and volume of TBI were investigated with the 3D Slicer software. @*Results@#The TBI region in the delirious group mainly involved the frontal or temporal lobe (p=0.038). All 36 delirious patients had brain injury on the right side (p=0.046). The volume of hemorrhage in the delirious group was larger by about 95 mL compared to the non-delirious group, but this difference was not statistically significant (p=0.382). @*Conclusion@#Patients with delirium after TBI had significantly different injury site and side, but not lesion size compared to patients without delirium.

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.

Revision of Laboratory Testing Guidelines for Initial Diagnosis of Hematologic Neoplasms

Relationship between Alcohol Consumption and Ocular Pressure according to Facial Flushing in Korean Men with Obesity / 가정의학회지

BACKGROUND: This study aimed to examine the relationship between alcohol consumption and intraocular pressure (IOP) according to facial flushing in Korean men with obesity. METHODS: The study included 479 Korean men with a body mass index of ≥25 kg/m² (75 non-drinkers, 174 with drinking-related facial flushing, and 230 without facial flushing) who underwent health check-ups between October 1, 2016 and March 31, 2017. Multivariate logistic regression was used to assess the relationship between alcohol consumption and high IOP (≥21 mm Hg). RESULTS: Flushers consuming ≤16 drinks per week had a significantly higher risk of high IOP than non-drinkers, depending on alcohol consumption (≤8 standard drinks: odds ratio [OR], 4.49; 95% confidence interval [CI], 1.05–19.25; >8 but ≤16 standard drinks: OR, 8.14; 95% CI, 1.37–48.45). However, when the consumption was >16 drinks per week, the high IOP risk did not significantly increase (OR, 0.71; 95% CI, 0.05–10.69). In addition, there was no significant relationship between alcohol consumption and high IOP among non-flushers consuming ≤8 drinks per week (OR, 2.07; 95% CI, 0.52–8.19). However, a significantly increased risk of high IOP was observed among non-flushers consuming >8 drinks per week, depending on alcohol consumption (>8 but ≤16 standard drinks: OR, 4.84; 95% CI, 1.14–20.61; >16 standard drinks: OR, 4.08; 95% CI, 1.02–16.26). CONCLUSION: This study suggests that obese men with alcohol flush reactions may have an increased risk of high IOP with the consumption of smaller amounts of alcohol than non-flushers.

Molecular Genetic and Serologic Analysis of the O allele in the Korean Population / 대한수혈학회지

BACKGROUND: The recent expansion of knowledge about various ABO alleles has led to the need for a comprehensive measure to cover the numerous polymorphisms dispersed in the ABO gene. A few studies have examined the diversity of the O allele compared to A or B subgroup alleles, resulting in antigenic changes. This study investigated the relationship between the serologic and molecular genetic characteristics of the O alleles in the Korean population. METHODS: One hundred and five samples from healthy blood group O subjects were selected randomly. The isoagglutinin titer was measured using a tube agglutination and gel microcolumn assay. The ABO alleles were analyzed by sequencing exons 6 and 7 of the ABO gene. When the origin of a heterozygous nucleotide sequence was ambiguous, it was separated into a single allele using mono-allele amplification or cloning. RESULTS: The median IgM isoagglutinin titer was eight. In contrast, the median IgG anti-A and anti-B isoagglutinin titers were 64 and 32, respectively. The IgG isoagglutinin titer showed a significant increase with age (P<0.0001). Six O alleles were observed in 105 blood group O populations by sequencing. The O01 and O02 alleles were common (0.57, 0.36). Three rare O alleles (O04, O05, and O06) and one novel non-deletional O allele were found. CONCLUSION: The distribution of isoagglutinin titers of blood group O and the genetic frequency of O alleles in this study would form the basis of the development and interpretation of ABO genotyping and serologic workup in the Korean population.

Myelodysplastic syndrome with occult diffuse large B-cell lymphoma

No abstract available.

Pre-existing arterial pathologic changes affecting arteriovenous fistula patency and cardiovascular mortality in hemodialysis patients

The radiocephalic arteriovenous fistula (AVF) provides optimal vascular access for hemodialysis; it has a higher long-term patency rate and fewer complications than other vascular access methods. However, the AVF has a high primary failure rate. The presence of small-diameter vessels at anastomosis sites is an important risk factor for AVF failure. However, in a recent study, despite selecting an adequate artery and vein for creating an AVF by routine preoperative vascular mapping, AVF maturation and primary failure occurred. Thus, pre-existing arteriosclerosis at AVF anastomosis sites likely contributes to AVF failure. In this review, we discuss the relationship between pathologic changes and AVF patency in hemodialysis patients. Because arteriosclerosis of the major arteries such as the coronary and carotid arteries is associated with cardiovascular mortality, we also review the impact of arteriosclerosis of upper arm arteries at AVF anastomosis sites on cardiovascular mortality in hemodialysis patients.

Chemopreventive and Chemotherapeutic Effects of Fish Oil derived Omega-3 Polyunsaturated Fatty Acids on Colon Carcinogenesis

Colorectal cancer is the third most common cause of cancer related death in the world. Multiple lines of evidence suggest that there is an association between consumption of dietary fat and colon cancer risk. Not only the amount but also the type and the ratio of fatty acids comprising dietary fats consumed have been implicated in the etiology and pathogenesis of colon cancer. Omega-3 (n-3) polyunsaturated fatty acids (PUFAs), such as docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), have been known to inhibit development of colon cancer by downregulating the expression of genes involved in colon carcinogenesis and also by altering the membrane lipid composition. Data from laboratory, epidemiological, and clinical studies substantiate the beneficial role of n-3 PUFAs in preventing colitis and subsequent development of colon cancer. In addition, recent studies suggest that some n-3 PUFAs can be effective as an adjuvant with chemotherapeutic agents and other natural anticancer compounds in the management of colon cancer. In this review, we discuss chemopreventive and therapeutic effects of fish oil derived long chain n-3 PUFAs, particularly EPA and DHA, with focus on synergetic effects of which they exert when combined with chemotherapeutic agents and other natural compounds.

The Characteristic Doppler Pattern of the Left Ventricular Outflow Tract in a Patient with Orthostatic Hypotension

No abstract available.

A Case of Hemolytic Transfusion Reaction Attributable to Anti-Jk(b) Abolished in the Enzyme Phase Reaction / 대한수혈학회지

We report a case of an intravascular hemolytic reaction attributable to anti-Jk(b) antibodies that were not detected using an enzyme phase antibody identification test. A 61-year-old male who had received two units of red blood cells was admitted to the emergency room because his urine was dark. LISS/Coombs gel column agglutination tests suggested the presence of anti-Jk(b) and anti-E antibodies. However, his serum was negative for the Jk(b) antigen when an enzyme phase test was performed. A positive reaction was evident, however, when EDTA-treated plasma was tested; this excluded any possible complement-mediated reaction. The patient was diagnosed with an intravascular hemolytic transfusion reaction, caused by anti-Jk(b), and was later discharged without specific complications after receiving antigen-negative blood transfusions.

Analysis of Effect and Prognostic Factors Associated with Catheter Intervention on Ascites in Terminal Cancer Patient / 한국호스피스완화의료학회지

PURPOSE: alignant ascites is a common complication in terminal cancer patients. Less-invasive pigtail catheter insertion is the most frequent procedure in patients who need repeated ascites drainage. This study investigated effects and adverse events associated with catheter insertion for ascites drainage and evaluated prognostic outcomes. METHODS: We reviewed medical records between 2010 and 2013 of hospice and palliative care institutions in Seoul, South Korea. Among 2,608 inpatients, 67 patients received ascites pigtail catheter drainage. We reviewed demographic data, palliative performance scale, laboratory data, duration of catheter insertion, prevalence and type of complications, use and duration of antibiotics, and survival time. Univariate and multivariate Cox regression models were used to evaluate prognostic outcomes related with catheter insertion. RESULTS: Ascites drainage was performed most commonly in hepatobiliary and gastric cancer patients. Ascites symptoms improved in 55 patients after the catheter drainage. Adverse events included pain (19.4%), leakage (14.9%), disconnection (7.5%), catheter occlusion (6%) and fever (4.5%). In Cox regression analysis, survival time from the catheter insertion was significantly associated with Palliative Performance Scale (PPS) (HR 0.73; P value 0.045) and serum sodium level (HR 2.77; P value 0.003) in a multivariate model. CONCLUSION: Patients' PPS and serum sodium level should be considered before making a decision of pigtail catheter insertion.

Test Guidelines for Initial Diagnosis of Hematologic Neoplasms

The standardization committee of the Korean Society for Laboratory Hematology sought to establish standardized testing guidelines for the diagnosis of hematologic malignancies. The guidelines were developed on the basis of survey results and international guidelines, including the National Comprehensive Cancer Network Guidelines and European LeukemiaNet recommendations. The committee expects that the diagnostic guidelines presented here will enhance diagnostic test standardization and clinical decision making and that the novel developments due to new molecular technologies will be integrated into the diagnostic algorithms through ongoing consensus initiatives.

Mixed-phenotype acute leukemia treated with decitabine

No abstract available.

Optic Fracture of the Preloaded Intraocular Lens during Insertion

No abstract available.

Comparison of the Clinical Performance of Binax NOW RSV Versus Multiplex RT-PCR for Detection of Respiratory Syncytial Virus

BACKGROUND: Respiratory syncytial virus (RSV) is one of the most important causes of lower respiratory tract infection. The rapid antigen test is a simple, cheap, and quick method for RSV detection, however, it has an acknowledged low sensitivity. The aim of this study is to evaluate the diagnostic performance of the rapid antigen test by comparing it with a multiplex reverse transcription-PCR (RT-PCR). METHODS: A total of 557 nasopharyngeal aspirates or swabs that were submitted for both a rapid antigen test, Binax NOW RSV (Binax; Alere Scarborough, Inc., USA) and multiplex RT-PCR, Seeplex RV7 (Seegene Inc., Korea) were included in this study. We performed both tests according to the manufacturer's recommendations and analyzed the diagnostic performances of a rapid antigen tests based on the results of multiplex RT-PCR. RESULTS: Among the 557 specimens, the positive rates determined from the rapid antigen test and multiplex RT-PCR were 12.2% (N=68) and 25.1% (N=140), respectively. The relative sensitivity and specificity of the rapid antigen test were 46.4% and 99.3% based on the multiplex RT-PCR, respectively. Positive and negative predictive values were 95.6% and 84.7%, respectively. The diagnostic sensitivity was lower (28.6%) in children >36 months compared with children < or =36 months of age. Test sensitivity declined when RSV infection was accompanied by infection with other respiratory viruses. CONCLUSIONS: Binax NOW RSV exhibited good diagnostic performance, easy handling, and rapidity. However, it does have the possibility of false-negative results, and additional tests are needed when there is clinical suspicion of RSV infection.

Comparative Analysis of Clinical Outcome in Penetrating Keratoplasty Using Domestic or Imported Cornea

PURPOSE: To compare the survival of corneal grafts and the changes in endothelial cell density in penetrating keratoplasty using domestic or imported corneas. METHODS: Medical records of 236 eyes of 211 patients who underwent penetrating keratoplasty from November 2004 to August 2011 in Seoul National University Hospital and were followedup at least 1 year were retrospectively reviewed. After excluding the patients who received the combined surgeries with other surgeries except cataract surgery, the eyes were divided into 2 groups depending on the origin of donor tissue resulting in a domestic cornea group (108 eyes) and an imported cornea group (128 eyes). Recipient demographics, preoperative diagnosis, donor age, death-to-preservation time, death-to-operation time and pre-and postoperative visual acuities were compared between the 2 groups. Kaplan-Meier survival and changes in endothelial cell density were analyzed at 3, 6 and 12 months and then every year. RESULTS: The most common preoperative diagnoses were regraft and corneal opacity in the domestic and imported cornea groups, respectively, without statistical difference. Death-to-preservation time was 8.9 hours and 8.0 hours in the domestic and imported cornea groups, respectively, without statistical difference. However, death-to-operation time was longer in the imported cornea group (4.98 days) than in the domestic cornea group (2.18 days). There were no differences in pre- and postoperative visual acuities, decrease in annual changes in endothelial densities and survival up to 3 years between the 2 groups. In addition, the survival and decreased annual changes in endothelial densities were not different from each other in penetrating keratoplasty combined with cataract surgery or in penetrating keratoplasty for a corneal edema. CONCLUSIONS: Our study results suggest that clinical outcomes of the penetrating keratoplasty using imported corneas are comparable in efficacy when compared with the clinical outcomes using domestic corneas.

Stereotactic radiosurgery for brain metastasis in non-small cell lung cancer

PURPOSE: Stereotactic radiosurgery (SRS) has been introduced for small-sized single and oligo-metastases in the brain. The aim of this study is to assess treatment outcome, efficacy, and prognostic variables associated with survival and intracranial recurrence. MATERIALS AND METHODS: This study retrospectively reviewed 123 targets in 64 patients with non-small cell lung cancer (NSCLC) treated with SRS between January 2006 and December 2012. Treatment responses were evaluated using magnetic resonance imaging. Overall survival (OS) and intracranial progression-free survival (IPFS) were determined. RESULTS: The median follow-up was 13.9 months. The median OS and IPFS were 14.1 and 8.9 months, respectively. Fifty-seven patients died during the follow-up period. The 5-year local control rate was achieved in 85% of 108 evaluated targets. The 1- and 2-year OS rates were 55% and 28%, respectively. On univariate analysis, primary disease control (p or =65 years; p = 0.036) were significant predictive factors for OS. Primary disease control (p = 0.041) and ECOG status (p = 0.017) were the significant prognostic factors for IPFS. Four patients experienced radiation necrosis. CONCLUSION: SRS is a safe and effective local treatment for brain metastases in patients with NSCLC. Uncontrolled primary lung disease and ECOG status were significant predictors of OS and intracranial failure. SRS might be a tailored treatment option along with careful follow-up of the intracranial and primary lung disease status.

Evaluation of the Automated Hematology Analyzer Sysmex XN-2000 and the Accuracy of Differential Leukocyte Counts Using the Low WBC Mode

BACKGROUND: The XN-series (Sysmex, Japan) is the new hematology analyzer from Sysmex, with new channels to improve the accuracy of differential leukocyte count and platelet count in the low cell count range. We evaluated the analytical performance and low white blood cell (WBC) mode of the XN-2000. METHODS: Precision, linearity, and carryover were evaluated for the analyzer. We analyzed the accordance of complete blood count (CBC), reticulocyte count, and differential leukocyte count between the XN-2000 and XE-2100 (Sysmex), using 200 samples from normal controls and patients. For 80 samples with a WBC count 0.9800 for all CBC parameters except mean corpuscular hemoglobin concentration, mean platelet volume, and platelet distribution width, and >0.9900 for differential leukocyte count except monocytes and basophils. The low WBC mode provided accurate counts for neutrophils and lymphocytes, with r>0.9300 for samples with a WBC count of 0.1-1.5x10(9) cells/L. CONCLUSIONS: The XN-2000 showed good analytical performance and correlation with the existing model, the XE-2100. The XN-2000 provided accurate results for differential leukocyte count in samples with a WBC count of 0.1-1.5x10(9) cells/L, and reduced manual slide reviews.

Comparison of the Results among Automated Treponema pallidum Latex Agglutination, Rapid Plasma Regain and Treponema pallidum Particle Agglutination, Rapid Plasma Regain Card Test in Blood Donors / 대한수혈학회지

BACKGROUND: The Korean Red Cross blood laboratory centers use Treponema pallidum particle agglutination assay on the PK7300 instrument as a primary donor screening test for syphilis, and semi-quantitative TPPA and RPR card as supplementary tests. We compared the results of Treponema pallidum latex agglutination and RPR tests on the automated analyzer with those of TPPA and RPR card tests. METHODS: A total of 1,000 samples with negative TPPA results and 103 samples with positive TPPA results (> or =1:80 titers) were evaluated in this study. HiSens Auto TP, RPR (HBI, Anyang, Korea) and Mediace TPLA, RPR (Sekisui, Tokyo, Japan) reagents were used on the automated analyzer. FTA-ABS test was performed as a confirmatory test to evaluate the sensitivity and specificity of HiSens Auto TPLA, RPR and Mediace TPLA, RPR reagents. RESULTS: The concordance rate between HiSens Auto TP, Mediace TPLA and TPPA was 95.5% and 95.4%, respectively. The concordance rate between HiSens Auto RPR, Mediace RPR and RPR card was 79.6% and 80.6%, respectively. Sensitivity of HiSens Auto TP and Mediace TPLA was 87.7% and 90.8%, respectively, and specificity was 99.5% and 99.0%, respectively. CONCLUSION: Despite the high concordance rate between TPLA and TPPA, there were negative TPLA results which were positive for both TPPA and FTA-ABS tests. Therefore, changing the primary donor screening test for syphilis from current TPPA to TPLA on the automated analyzer requires further investigation.