ABSTRACT
Porocarcinoma is a malignancy of the eccrine sweat gland. It may arise de novo or develop from pre-existing poroma and hidroacanthoma simplex. A 56-year-old woman was presented with a pinkish plaque on her left posterior thigh. She was diagnosed with hidroacanthoma simplex 6 years ago, and the same lesion had changed in size and shape. Histopathology revealed intraepidermal proliferation of small-sized basaloid cells, continuing to the proliferation of large polygonal tumor cells. This malignant transformation was consistent with the change in p53 expression pattern. The patient underwent wide excision with clear resection margin, and no evidence of recurrence was noted. We highlight this case in that the transition from hidroacanthoma simplex to porocarcinoma in situ was confirmed in the same tissue, as demonstrated by immunohistochemical staining.
ABSTRACT
Background@#Alopecia areata (AA) is a non-scarring, autoimmune, inflammatory hair loss on the scalp and/or the body. The disease affects both adults and children, but there are limited data on AA in children compared to AA in adults. @*Objective@#The purpose of this retrospective study was to evaluate the clinical characteristics and psychiatric dynamics of pediatric AA and its correlation with underlying diseases from 2007 to 2017. @*Methods@#A retrospective study was performed on 187 outpatients under 14 years of age who were diagnosed with alopecia areata in the Alopecia Clinic of the Department of Dermatology at Myongji Hospital from March 2007 to February 2017. @*Results@#The proportion of pediatric patients with alopecia areata was 16.8% (187/1112). Clinically, alopecia areata was found in 171 patients (91.4%); alopecia totalis, 10 patients (5.3%); and alopecia universalis, 6 patients (3.2%). The ratio of male (85; 45.5%) to female (102; 54.5%) patients was 1:1.2. Alopecia areata was observed most frequently in patients of school age (105 patients; 56.1%), and the duration was less than 1 year in most cases (75.9%). A family history of alopecia areata was observed in 11.2% of the patients (21/187). The patients most susceptible to the disease were only children, eldest children, those who were overloaded with school work, and those with deficient parent–child relationships, including familial discord. A single bald patch was observed in 50.3% of the patients, and the most commonly associated disease was atopic dermatitis (36 patients; 46.2%). @*Conclusion@#We analyzed several clinical features of pediatric AA, including epidemiology, clinical characteristics, and associated diseases. This study provides useful data for future research regarding AA in children.
ABSTRACT
There were 10 cases of transfusion-transmitted P. vivax malaria from 1990 to 2021. The Korean Centers for Disease Control and Prevention (KCDC) designated the areas showing a high frequency of malaria as a malaria-endemic area and has restricted whole blood donation from these areas. While the number of malaria infections has declined in recent years, the blood inventory has declined sharply due to the COVID-19 pandemic. Accordingly, the Ministry of Health and Welfare temporarily approved the donation of whole blood from malaria-endemic areas to secure the supply of blood products. In the present study, an anti-malaria screening and nucleic acid amplification test (NAT) was performed on samples collected from the malaria-endemic areas from May 20 to June 30, 2020. A total of 14,741 samples were collected and tested. NAT was performed for 1096 runs to test all the collected samples. The 117 (0.79%) samples showed initial reactive results due to the contamination of abnormal PCR results. Negative results were obtained for the samples showing initial reactive results using a duplicated re-test. From the NAT tests, no sample showed a true positive result. The results of the malaria antibody screening test were reactive in 10 out of the 14,741 samples. The malaria antibody screening needs to be reviewed through further study because of its insufficient sensitivity and specificity. According to this study, excluding the 10 reactive malaria antibodies, additional blood components could be secured from 14,731 blood donors for a stable blood supply.
ABSTRACT
Analysis of HCV genotypes can help identify infection routes and the development of treatment methods. However, in some samples with a low titer of HCV RNA, it is difficult to analyze their genotypes. In our previous study about HCV genotyping, we could not identify 12 cases among the 175 HCV NAT reactive samples due to their low titer. In this study, we adopted three different kinds of virus concentration methods to identify the genotypes of the 12 unidentified cases and compared their efficacy. The three virus concentration methods were automatic nucleic acid extraction, polyethyleneimine-magnetic bead-based extraction, and sucrose cushion ultracentrifugation. After virus concentration using every three methods, we analyzed HCV RNA genotypes using the concentrated sample of the best efficacy. Among the 12 cases, six were identified as 1b, four as mixed types, and two were unidentified. Here we could validate that the sample concentration method is useful to identify the HCV genotypes, especially in samples with low HCV RNA titers. Furthermore, considering the convenience, high efficacy, and time-saving, automatic nucleic acid extraction is considered the most useful concentration method for samples with titer lower than 50 IU/mL.
ABSTRACT
There were 10 cases of transfusion-transmitted P. vivax malaria from 1990 to 2021. The Korean Centers for Disease Control and Prevention (KCDC) designated the areas showing a high frequency of malaria as a malaria-endemic area and has restricted whole blood donation from these areas. While the number of malaria infections has declined in recent years, the blood inventory has declined sharply due to the COVID-19 pandemic. Accordingly, the Ministry of Health and Welfare temporarily approved the donation of whole blood from malaria-endemic areas to secure the supply of blood products. In the present study, an anti-malaria screening and nucleic acid amplification test (NAT) was performed on samples collected from the malaria-endemic areas from May 20 to June 30, 2020. A total of 14,741 samples were collected and tested. NAT was performed for 1096 runs to test all the collected samples. The 117 (0.79%) samples showed initial reactive results due to the contamination of abnormal PCR results. Negative results were obtained for the samples showing initial reactive results using a duplicated re-test. From the NAT tests, no sample showed a true positive result. The results of the malaria antibody screening test were reactive in 10 out of the 14,741 samples. The malaria antibody screening needs to be reviewed through further study because of its insufficient sensitivity and specificity. According to this study, excluding the 10 reactive malaria antibodies, additional blood components could be secured from 14,731 blood donors for a stable blood supply.
ABSTRACT
Analysis of HCV genotypes can help identify infection routes and the development of treatment methods. However, in some samples with a low titer of HCV RNA, it is difficult to analyze their genotypes. In our previous study about HCV genotyping, we could not identify 12 cases among the 175 HCV NAT reactive samples due to their low titer. In this study, we adopted three different kinds of virus concentration methods to identify the genotypes of the 12 unidentified cases and compared their efficacy. The three virus concentration methods were automatic nucleic acid extraction, polyethyleneimine-magnetic bead-based extraction, and sucrose cushion ultracentrifugation. After virus concentration using every three methods, we analyzed HCV RNA genotypes using the concentrated sample of the best efficacy. Among the 12 cases, six were identified as 1b, four as mixed types, and two were unidentified. Here we could validate that the sample concentration method is useful to identify the HCV genotypes, especially in samples with low HCV RNA titers. Furthermore, considering the convenience, high efficacy, and time-saving, automatic nucleic acid extraction is considered the most useful concentration method for samples with titer lower than 50 IU/mL.
ABSTRACT
Background@#The Korean Red Cross adopted HIV NAT for blood donor screening in 2005 using a minipool assay. In June 2012, the NAT system was replaced with the individual assay. This study examined the characteristics of HIV NAT reactive blood donors to determine if there was any difference in their features between 10 years ago and later. @*Methods@#This study analyzed the HIV RNA quantitative values and the distribution of HIV subtypes using 118 HIV NAT positive blood donations (37 in 2007, 20 in 2008, 32 in 2017 and 29 in 2018). @*Results@#No significant variations of the quantitative values of HIV RNA and the distribution of HIV subtypes 10 years ago and later were observed. This study failed to produce quantitative values of three samples due to the low titer. The mean titer of HIV RNA of the remaining 115 samples were 5.14×10 4 IU/mL. The dominant HIV subtype of the HIV NAT reactive donors was B showing 54.2% (64/118). Approximately 5.9% (7/118) of the samples showed the HIV subtype C. Forty-seven samples (39.8%) showed the circulating recombinant form (CRF). @*Conclusion@#The rate of HIV subtype B in this study (54.2%) has decreased compared to the results of the past study (95.2%). Some of the cases showing CRF were identified as B in the past study because CRF3, 8, 9, 14, and 15 are recombinant forms, including subtype B.
ABSTRACT
Background@#Dengue fever is considered one of the transfusion-transmissible emerging infectious diseases. Dengue fever has been reported every year by the Korea Disease Control and Prevention Agency (KDCA). Because a blood donor screening assay to detect the dengue virus (DENV) as an agent of dengue fever is not performed, the risk of transfusion-transmitted DENV infection needs to be assessed. @*Methods@#This study collected the data of DENV infected cases from the Infectious Disease Portal of the KDCA, the data of blood donors and blood components from the Blood Information Management System of the Korean Red Cross, and the data of travelers to major dengue outbreak countries from the Korean Tourism Organization.All data were from 2016 to 2018. A risk assessment was performed using European Up-Front Risk Assessment Tool (EUFRAT). @*Results@#The risk of DENV-infected red cells and platelet concentrate was higher than that of plasma and apheresis platelet. Nevertheless, the risk of the DENV infected blood component was shown to be less than one case per year for all kinds of blood components. @*Conclusion@#All the DENV infected cases in Korea were overseas travelers. Therefore, the risk of transfusiontransmissible DENV infection is very low. On the other hand, continuous observation and monitoring are required because Aedes albopictus as a vector of DENV is found in Korea, and the increase in reported cases may lead to domestic infections.
ABSTRACT
Background@#Dengue fever is considered one of the transfusion-transmissible emerging infectious diseases. Dengue fever has been reported every year by the Korea Disease Control and Prevention Agency (KDCA). Because a blood donor screening assay to detect the dengue virus (DENV) as an agent of dengue fever is not performed, the risk of transfusion-transmitted DENV infection needs to be assessed. @*Methods@#This study collected the data of DENV infected cases from the Infectious Disease Portal of the KDCA, the data of blood donors and blood components from the Blood Information Management System of the Korean Red Cross, and the data of travelers to major dengue outbreak countries from the Korean Tourism Organization.All data were from 2016 to 2018. A risk assessment was performed using European Up-Front Risk Assessment Tool (EUFRAT). @*Results@#The risk of DENV-infected red cells and platelet concentrate was higher than that of plasma and apheresis platelet. Nevertheless, the risk of the DENV infected blood component was shown to be less than one case per year for all kinds of blood components. @*Conclusion@#All the DENV infected cases in Korea were overseas travelers. Therefore, the risk of transfusiontransmissible DENV infection is very low. On the other hand, continuous observation and monitoring are required because Aedes albopictus as a vector of DENV is found in Korea, and the increase in reported cases may lead to domestic infections.
ABSTRACT
BACKGROUND@#Ever since the Korean Red Cross adopted HCV NAT for blood donor screening in 2005, HCV NAT reactive donors have been identified every year. The identification of the clinical features for these HCV NAT reactive donors may be helpful for the treatment and prevention of HCV infection.@*METHODS@#We analyzed HCV NAT reactive samples to examine the distribution of HCV RNA genotypes and the quantitative values of 128 and 47 HCV NAT reactive samples in 2007 and 2017, respectively.@*RESULTS@#The dominant genotype of the HCV NAT reactive donors was 1b showing 50.0% (64/128) in 2007 and 44.7% (21/47) in 2017. The genotype 2a was the second most dominant at 40.6% (52/128) in 2007 and 40.4% (19/47) in 2017. The mean titers of HCV RNA were 3.17×106 IU/mL in 2007 and 2.61×106 IU/mL in 2017. More than 90% of the donors showed a range of more than 1,000 IU/mL for the HCV RNA titer. There was no difference of quantitative values in the different genotypes.@*CONCLUSION@#In this study, the distribution of HCV RNA genotypes in Korean blood donors showed a similar pattern compared to that of the general population. There was no correlation between the quantitative values and genotypes in the HCV NAT reactive blood donors, and there was no significant variation in the distribution of HCV RNA genotypes of the HCV NAT reactive donors between 2007 and 2017. Yet it is thought that the characteristics of HCV NAT reactive samples in other years have to be analyzed to achieve more significant results.
ABSTRACT
BACKGROUND: The risk of transfusion-transmissible infections (TTIs) of HBV, HCV, and HIV in Korea has been reduced significantly by strengthening the blood safety policies. On the other hand, the risk of TTI still exists due to the diagnostic window period or viral variants. METHODS: The residual risks of TTI of HBV, HCV, and HIV were calculated from July 1, 2012 to June 30, 2018 by dividing the data into two year sets. The residual risk was conducted by separating the donors who donated only once and those who donated more than once during each period. RESULTS: In the first two years, the residual risks of HBV, HCV, and HIV were calculated to be 17.54/106, 0.42/106, and 0.30/106 respectively. The residual risk of HBV and HCV over the last two years was calculated to be 9.41/106 and 0.27/106, showing a tendency to decrease with time. On the other hand, the residual risk of HIV over the last two years was calculated to be 0.29/106, showing no significant difference. The residual risk in the donors who donated only once was higher than that in the donors who donated more than once during each period. CONCLUSION: The real transfusion-transmitted infection can be different from the estimated residual risk in this study because this study was based on the thesis that all NAT-reactive blood components cause infection. Because the residual risk of HBV is higher than HCV and HIV, it was considered that the safety measures for the HBV need to be improved continuously.
Subject(s)
Humans , Blood Safety , Hand , HIV , Korea , Tissue DonorsABSTRACT
HBV core antibody and surface antibody test are currently conducted for those donors showing non-discriminated reactive (NDR) results on a nucleic acid amplification test (NAT) as a blood donor screening assay. It is necessary to investigate the relationship with HCV or HIV in the donors showing NDR results. From June 12th, 2012 to December 31st, 2018, 0.05% (9,020/17,798,461) donors showed NDR results on a NAT. Among the donors showing NDR results, 17 and 18 donors showed positive results on serological assay of HCV and HIV, respectively. 23 donors with NDR results showed positive results on the serological assay or NAT for HCV or HIV on the following donation. Further study and more accumulated data are required because it may be difficult to find the cause of NDR results by the current serological assay that is used for screening blood donors.
Subject(s)
Humans , Blood Donors , HIV , Mass Screening , Nucleic Acid Amplification Techniques , Tissue DonorsABSTRACT
Corrections of author names are needed.
ABSTRACT
BACKGROUND: Since December 15 2017, donors showing a non-discriminated reactive (NDR) result in the nucleic acid amplification test (NAT) have been temporarily deferred and anti-HBc and anti-HBs assays as additional tests were performed. Donors with an anti-HBc reactive result and less than 100 IU/L of anti-HBs could not be released and can request a reentry test after more than six months. This study considered the effects of additional tests for NDR donors by analyzing the reentry test results in donors not released in the additional test. METHODS: This study examined the results of the additional test for NDR donors from January 2017 to September 2018 and the reentry test of the donors not released in the additional test. RESULTS: NAT was conducted on 4,706,051 blood donors over the period and 2,545 (0.05%) of them showed NDR. A total of 656 (25.8%) of the NDR donors were not released in the additional test. Among them, 246 donors requested a reentry test; 222 (90.2%) donors were not reentered, and 23 (10.4%) showed HBV NAT reactive results in the reentry test. Among the remaining 24 reentered donors, 2 donors (8.3%) showed anti-HBc nonreactive results in the reentry test and 22 donors (91.7%) showed higher than 100 IU/L of anti-HBs. CONCLUSION: The follow-up of NDR donors may be significant because some donors showed different results between screening test and reentry test. In addition the effectiveness of the introduction of additional tests for the NDR donors has been proved to be effective.
Subject(s)
Humans , Blood Donors , Follow-Up Studies , Mass Screening , Nucleic Acid Amplification Techniques , Tissue DonorsABSTRACT
BACKGROUND: A nucleic acid amplification test was adopted to detect transfusion-transmitted infectious agents. In the case of HTLV, however, there was no internal control (IC) because the laboratory developed polymerase chain reaction (laboratory-developed PCR) was used. In this study, noncompetitive IC was constructed for the laboratory-developed PCR of HTLV and the effectiveness was compared with the competitive test that was constructed in a previous study. METHODS: As a competitive IC, plasmid DNA, including the primer recognition sequence for the amplification of the HTLV pX region, was constructed. As a noncompetitive IC, an additional primer was constructed for the amplification of the housekeeping gene, the glyceraldehyde 3-phosphate dehydrogenase (GAPDH) gene. The performance of the competitive and noncompetitive IC was verified and compared using 10 HTLV positive samples and 10 negative samples. In addition, the detection limits in the assay adopting competitive IC and noncompetitive IC were compared. RESULTS: In the case of competitive IC applications, all 10 positive samples were positive and all 10 negative samples were negative. In the case of noncompetitive IC applications, however, one positive sample was not detected. The detection limit of the assay using competitive IC was 100 pg and that of the assay using noncompetitive IC was 1 ng. CONCLUSION: Although the manufacturing processes is not required using noncompetitive IC, the adoption of competitive IC is more effective to ensure the assay results because the ability of detection of the assay adopting competitive IC was better than that using noncompetitive IC.
Subject(s)
DNA , Genes, Essential , Glyceraldehyde 3-Phosphate , Limit of Detection , Nucleic Acid Amplification Techniques , Oxidoreductases , Plasmids , Polymerase Chain ReactionABSTRACT
BACKGROUND: If donors who were deferred due to the reactivity or grey zone in HBV surface antigen (HBsAg) assay want to donate blood again, they need to pass reentry tests. On the other hand, approximately half of the donors who are subject to the reentry tests cannot be reentered. This study examined the association between the sample to cutoff (S/Co) value of the HBsAg assay and the final results of the reentry test. METHODS: This study analyzed the S/Co values of the HBsAg assay and the final results of the reentry tests for the 3,947 donors from January 2008 to December 2017 using the database of Blood Information Management System of the Korean Red Cross. RESULTS: 1,767 donors (44.8%) were not reentered among 3,947 deferred donors. Among 1,585 donors showing ≥10 of the S/Co value in the HBsAg screening test, 1,542 donors (97.3%) were not reentered. The additional reentry tests were performed on 120 donors who were not reentered in the first reentry test; 98 donors (81.7%) were still not reentered. Overall, 4.6% of the donors showing a grey zone in the HBsAg assay were not reentered. CONCLUSION: The reentry test needs to be restricted for the deferred donors showing a more than 10 S/Co value. The application of the grey zone of current HBsAg assay will need to be continued to enhance the HBV-related blood safety.
Subject(s)
Humans , Antigens, Surface , Blood Safety , Hand , Hepatitis B Surface Antigens , Immunoassay , Information Management , Mass Screening , Red Cross , Tissue DonorsABSTRACT
BACKGROUND: For donor samples showing reactive results in a human T-cell lymphotropic virus (HTLV) antibody test along with indeterminate results in Western blot assay, HTLV nucleic acid amplification test using laboratory-developed polymerase chain reaction (PCR) was performed. It is necessary to construct an adequate internal control (IC) to evaluate the accuracy of the results since we did not use an IC in the laboratory-developed PCR. METHODS: As a competitive IC, plasmid DNA containing the primer recognition sequence for amplification of the HTLV pX region was constructed. We determined the adequate concentration of the IC, which was added to the samples to evaluate the accuracy of the test results. RESULTS: When the plasmid DNA was added to the HTLV-positive samples, the amplified product of IC (400 bp) was detected with the HTLV gene (230 bp). The adequate concentration of plasmid DNA added as an IC was 1 pg. CONCLUSION: The construction of plasmid DNA as a competitive IC is an efficient method to evaluate accuracy of the test results. However, the production process for the competitive IC must be further developed. Therefore, it is necessary to compare with the performance of a non-competitive IC.
Subject(s)
Humans , Blotting, Western , DNA , Methods , Nucleic Acid Amplification Techniques , Plasmids , Polymerase Chain Reaction , T-Lymphocytes , Tissue DonorsABSTRACT
BACKGROUND: A leukoreduction filter was recently developed in Korea to reduce various kinds of adverse transfusion reactions. The objective of this study was to propose a domestic evaluation system for leukoreduction filters and to apply this evaluation system to assess the newly developed leukoreduction filter. METHODS: We prepared packed red blood cells from 60 units of whole blood (400 mL) collected from 60 normal individuals and evaluated the efficacy of the newly developed filter (FINECELL, KOLON INDUSTRIES, Gumi, Korea) and a control filter (RCM1, Haemonetics, MA, USA). To verify the evaluation system, we assessed the filtration time, residual leukocyte count, RBC recovery, RBC hemolysis, hemoglobin concentration, and hematocrit using a control filter RCM1 and compared the results with those of an evaluation performed by the American Red Cross (ARC) in 2013. We then evaluated the efficacy of the test filter FINECELL using the methods established in this study and compared the results with those of the control filter RCM1. RESULTS: The results of the current study were similar to those of the ARC with the control filters. The test filters developed in Korea were not inferior to commonly used control filters regarding residual leukocyte count, RBC recovery, and RBC hemolysis at 35 days after filtration. All of the results in the evaluation satisfied the international standards. CONCLUSION: These results of this study showed that the efficacy of the newly developed domestic leukoreduction filter were satisfactory and will contribute to improvement of quality of blood components in Korea.
Subject(s)
Erythrocytes , Filtration , Hematocrit , Hemolysis , Korea , Leukocyte Count , Methods , Red Cross , Transfusion ReactionABSTRACT
BACKGROUND: Transfusion transmissible emerging infectious diseases (EIDs) is a potential risk to the safety of blood transfusions due to the lack of donor screening assays. To prevent the spread of EIDs through blood transfusions, we attempted to predict the possibility of blood donations from people with EIDs using a public database. METHODS: We used the Disease Web Statistics System of the Korean Centers for Disease Control and Prevention and Korean Statistical Information Service. We estimated the possibility of blood donations from people with EIDs using the public database combined with the database made available by the Blood Information Management System of the Korean Red Cross. RESULTS: Among the transfusion transmissible EIDs, Babesiosis, Leishmaniasis, West Nile fever, Chikungunya, and Dengue fever were reported in Korea. All of them were cases imported from abroad. Although the number of reported cases of Babesiosis, Leishmaniasis, West Nile fever, and Chikungunya were less than 10 per year until 2016, the reported cases of Dengue fever gradually increased from 2001, and there were 318 cases of Dengue fever in 2016. CONCLUSION: The possibility of blood donation from people with transfusion-transmissible EIDs was low because all reported transfusion-transmissible EIDs in Korea were from foreigners and blood donation from Koreans who returned from abroad was restricted for a period of a month. Nonetheless, preventive strategy for donation from people is necessary given the recent increase in Dengue fever.