Analysis of HCV RNA Genotypes and Quantitative Values of Korean HCV NAT Reactive Blood Donors / 대한수혈학회지

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.

-D-/-D- Phenotype Frequency among Korean Donors / 대한수혈학회지

BACKGROUND: To improve Rh-related antigen negative blood supply effectively, the Korean Red Cross (KRC) blood centers have performed Rh phenotype screening tests of C, c, E and e antigens for all donors since April, 2013. Especially for rare ‘-D-/-D-’ blood supply and donor recruitment, we have implemented Rh phenotype confirmation test for all C, c, E and e antigen negative donors. In this study, we report the test results of 7 donors with ‘-D-/-D-’ phenotype. METHODS: All three KRC Blood Laboratory Centers performed Rh phenotype screening tests using the automatic machine, PK7300 (Beckman Coulter, Japan), for all 876,920 donors from January 1, 2018 to April 30, 2018. We then performed the Rh phenotype confirmation test using the tube method manually, at room temperature, 37℃ and antihuman globulin phase. RESULTS: Among 876,920 donors, 14 were Rh antigen C, c, E, e negative as results of Rh phenotype screening test. The results of Rh phenotype confirmation test of these 14 donors showed that 7 donors were Rh antigen C, c, E, e negative. The ratio of -D-/-D- phenotype for all donors was 0.000798%. CONCLUSION: Our data suggests that -D-/-D- phenotype is one of the rare blood groups among Koreans. Although ‘-D-/-D-’ phenotype was confirmed by serologic tests, it is necessary to re-confirm it by molecular genetic techniques.

A Case of Mild Hemolytic Disease of the Fetus and Newborn - The First Case of Anti-Di(b) Identified on Prescreening Test during Pregnancy - / 대한수혈학회지

The Di(a+b-) phenotype is extremely rare among Caucacians and mostly confined to mongoloids. The clinical significance of anti-Di(b) is incompletely recognized. The authors report here a mild case of hemolytic disease of the fetus and newborn (HDFN) due to anti-Di(b). The mother was Di(a+b-) with anti-Di(b), which was detected by antenatal screening. She delivered a Di(a+b+) infant with a positive direct antiglobulin test and mild hemolytic disease. The infant was treated by phototherapy and subsequently recovered without the need for exchange transfusion. We suggest that the screening program as routine prenatal care is necessary.

International Comparison of Blood Product Prices / 대한수혈학회지

BACKGROUND: Due to the slowing of population growth, population ageing, and more aggressive medical treatment, Korea will be faced with the challenge of blood shortage. One solution to the blood shortage problem is to take advantage of the multicomponent collection technique. However, clinical application is limited due to the low prices of blood products. In this study, we compared the prices of blood products in 6 major countries. METHODS: Prices of leukoreduced red blood cells (RBC), platelet concentrate (PC), fresh frozen plasma (FFP), cryoprecipitate (CRYO), and apheresis platelets (AP) were compiled from US, United Kingdom, Japan, Australia, Spain, and Korea. Adjusted prices using per capita gross domestic product (GDP) and purchasing power parity (PPP) were estimated and analyzed. RESULTS: The RBC price in Korea was only 30% of the mean RBC price of the other 5 countries. Considering per capita GDP and PPP, the RBC prices in Korea were estimated up to 41% and 46%, respectively. The PPP adjusted price of PC, FFP, and AP of Korea was 70%, 72%, and 70% of mean price of the other 5 countries. Price ratios of PC, FFP, and CRYO to RBC were 0.59, 0.63, and 0.57, which were higher than the means of the other 5 countries (0.38, 0.47, and 0.32). CONCLUSION: Considering per capita GDP and PPP, blood product prices in Korea were cheaper than the mean prices of the other 5 countries. For adoption of multicomponent collection, the prices of blood products should be raised, especially the price of RBCs.

The Characteristics of Salivary alpha-Amylase Reactivity to Negative Affective Stimuli / 신경정신의학

OBJECTIVES: The aim of this study is to understand the characteristics of salivary ALPHA-amylase reactivity (sAA), as a biological maker of stress, by viewing negative affective pictures. METHODS: Forty six normal healthy subjects participated in this study. Prior to the experiment, the participants completed baseline psychological assessment including trait-dependent anxiety scales. On experiment, saliva samples were collected one time before and three times after exposure to 5-min stressor consisting 20 negative affective pictures. The state-related scales were measured before and just after exposure to stressor to assess the subjects' state anxiety. RESULTS: Overall, sAA was significantly decreased over time with the increase of negative affect score and state-anxiety. The Anxiety Scale Inventory scores were negatively correlated with the baseline as well as the other following sAA levels (all ps or =2, N=19) than in the lower counterpart (<2, N=27) in comparison between them (mean:46.6 vs. 76.5 U/mL, p=.024). After the exposure, the means of sAA levels significantly decreased over time in the lower susceptible group, whereas did not in the higher one (mean:-1.7 vs. -23.0 U/mL, p=.031). CONCLUSION: These findings suggest that the baseline level of sAA and its reactivity depend on individual trait of anxiety as well as state of reactivity to affective stress.

Measurement of Amylase in Saliva Collected by Salivette / 대한진단검사의학회지

BACKGROUND: Saliva is increasingly being used as a specimen for systemic disease as well as for oral health status. Especially, salivary amylase has been studied as an excellent index for psychological stress. Authors evaluated the measurement of salivary amylase activities collected by Salivettes (Sarstedt, Germany). METHODS: Saliva specimens were collected from 13 healthy adults between 10:00 and 11:00 a.m. Participants were asked to gently chew tampons of Salivettes for 1 min. Immediately after collection, all specimens were stored frozen. On the day of testing, they were centrifuged after thawing and diluted with distilled water. Amylase was measured by Dimension RxL Max (Dade Behring Inc., USA). We evaluated precision, linearity, and recovery rate of Salivette. Amylase activities between collection of saliva by Salivette and passive drool were compared, and also the changes of amylase by the storage temperature were evaluated. RESULTS: Intra-run CVs for three levels of amylase were excellent. Between-day CVs and total CVs were good only for mid and high levels. A good linear relationship was found at all diluted levels. Dosing Salivettes with 2 mL, 1.5 mL, and 1 mL yielded sample recovery 85.5+/-2.4%, 82.4+/-1.5%, and 72.2+/-3.1%, respectively and amylase recovery 78.9+/-10.9%, 74.1+/-13.7%, and 37.3+/-26.9%, respectively. Amylase by Salivette and passive drool were correlated well (r=0.757), although they showed a significant difference. Amylase activity was not affected by the storage temperature. CONCLUSIONS: Measurement of salivary amylase using Salivette could be a useful test having good intra-run CVs and linearity. More than 1.5 mL of saliva would be needed to have more than 70% recovery of Salivette.

The Frequency Unexpected Antibodies at Kyungpook National University Hospital / 대한수혈학회지

BACKGROUND: Unexpected antibody screening and identification tests are very important pre-transfusion tests for preventing transfusion reactions. Nowadays, the column agglutination test is widely used in Korea. The results of many studies that used this method showed the decreased frequency of nonsignificant cold antibodies and an increased frequency of warm antibodies when compared with other studies that used the tube test or the microplate test. This study was performed in order to determine the accurate frequency and distribution of unexpected alloantibody by using the column agglutination test. METHODS: We analyzed the results from 32,218 antibody screening tests with using LISS/Coombs cards and ID-DiaCell I and II for the transfusion candidates and patients with hemolytic anemia who were seen at Kyungpook National University Hospital during a recent eight-year period. RESULTS: According to the results of the antibody screening test, 188 samples (0.58%) out of all 32,218 samples, were shown to be positive. Unexpected alloantibodies were detected in 86 patients (0.27%) with using the antibody identification test. The antibodies that were detected most frequently were anti-E (29 samples), followed by anti-D (8 samples), anti-M (8 samples) and anti-c (7 samples). CONCLUSION: The frequency and distribution of unexpected antibodies at our hospital are similar with those obtained in other Korean studies. The detection rates of warm antibodies, including Rh antibodies, were high. The proportion of Rh antibodies in patients with a gestation history was significantly higher than that in the patients without a gestation history. This study shows once again that pregnancy affects the antibodies and this supports the relationship between pregnancy and antibody formation.

Plasma Exchange in a Patient with Antineutrophil Cytoplasmic Antibody-associated Vasculitis / 대한수혈학회지

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis is a systemic autoimmune disease with a poor prognosis in untreated patients, and combination therapy with steroidsand cyclophosphamide is the current standard treatment. Treatment with immunosuppressive agents results in high remission rates; however, there is a considerable morbidity related to the immunosuppressive state, such as life-threatening infections. To reduce serious immunosuppressant-related adverse effects, potentially promising treatment options, including plasma exchange, cytapheresis, administration of intravenous immunoglobulin and TNF-alpha blocking agents have been developed. We performed plasma exchange with steroid pulse therapy for a 52 year-old female patient with pulmonary hemorrhagewith ANCA-associated crescentic glomerulonephritis. After combination therapy, the pulmonary hemorrhage and renal function recovered and myeloperoxidase (MPO)-ANCA decreased.

Changes in the Physical Properties of Irradiated Red Blood Cells / 대한수혈학회지

BACKGROUND: Irradiation of cellular blood products is the current method used for the prevention of transfusion-associated graft-versus-host disease. However, irradiation has been shown to cause biochemical changes in stored red blood cells (RBCs) and to generate reactive oxygen species (ROS). Irradiation-induced biochemical changes and oxidation damage of the RBCs is closely related to the deformability of these cells. Furthermore, deformation of the RBCs may lead to alterations in the post-transfusion viability of stored RBCs. In this study, we evaluated the physical properties of irradiated RBCs. METHODS: Citrate phosphate dextrose adenine-1 preserved RBC concentrates were irradiated with a minimum dose of 25 Gy and stored at 4oC for 28 days. The deformation of the RBCs was measured by a microfluidic ektacytometer (RheoScan-D). To examine the effect of oxidative stress, the RBC concentrates were exposed to oxidative stress using FeSO4 and ascorbic acid. RESULTS: The deformability threshold of the irradiated RBCs was significantly lower than that of the control RBCs on day 21 of storage and later (P<0.05). The deformability threshold of the RBCs exposed to oxidative stress was lower than that of control RBCs, and the difference was significant on day 21 of storage and later (P<0.05). For up to 21 days of storage, the deformability of control and irradiated RBCs were maintained; however, they were significantly decreased at 28 days of storage compared with 1 day of storage (P<0.05). CONCLUSION: Irradiation reduced the threshold of RBC deformability during storage. In accordance with the effect of irradiation, oxidative stress affected the RBC deformability. Therefore, a ROS scavenger may play a protective role against deformation of irradiated RBC concentrates. Further evaluation will be required for confirmation and clarification of these findings.

The Effect of Verapamil on the Specific Activity of Na+-K+-activated Adenosine Triphosphatase in Rabbit Renal Medulla / 대한마취과학회지

The Na+ -K+ -activated ATPase is required to maintain osmotic balance and stabilize cell volume. The Na+ -K+ -ATPase has a more direct role in regulating cell volume; it controls the solute concentrations inside the cell, thereby regulating the osmotic forces that can make a cell swell or shrink. The impotance of the Na+ -K+ -ATPase in controlling cell volume is indicated by the observation that animal cells swell, and may burst, if they are treated with ouabain, which, inhibits the Na+ -K+ -ATPase. The present experiment was designed and carried out to determine the effect of verapamil, a calcium blocker, on the activity of Na+ -K+ -ATPase prepared from renal medulla in the normal rabbit. It was reported that verapamil, a well known coronary vasodilator, possessed negative inotropic effects. The mechanism of action of verapamil was initially thought to be due to coronary vasodilation and blockade of myocardial B-adrenergic receptors. 1t was termed such agent calcium antagonist. A derivative of verapamil, D-600, was subsequently shown to block the movement of calcium through the slow channel and thereby after the plateau phase of the cardiac action potential. Verapamil do not directly antagonize the effects of calcium. Rather, it inhibit the entry of ealcium into cells or its mobilization form intracellular stores and, as such, have been termed a calcium channel blocker.