Annual Report on External Quality Assessment in Immunoserology in Korea (2009) / 임상검사와정도관리

The followings are the results for external quality assessment (EQA) in immunoserology for 2009: Evaluation of EQA was done in 2 trials in April and November, about 99% of laboratories participating average 7.4 items. The results were collected via internet and about 98% of laboratories have sent their results via internet. Control materials used in EQA were pooled sera including commercial controls, MASR Immunology Control from Medical Analysis Systems (Camarillo, CA, USA), which were delivered refrigerated for stability of control materials, being received within 48 hours after sending. Latex agglutination tests for rheumatoid factor (RF) showed frequently false positive or false negative results especially in commercial controls, possibly due to matrix effect. False negative and positive results were frequently found in the laboratories using immunochromatography assay (ICA) for anti-HCV and anti-HIV. More careful quality control should be required for ICA tests. New tests measuring non-treponemal and trponemal antibody such as turbidoimmunoassay (TIA) and chemiluminescence immunoassay (CLIA) were introduced. Standardization of instruments and reagents including calibrators for quantitative results should be required for the harmonization of results.

Annual Report on External Quality Assessment in Immunoserology in Korea (2008) / 임상검사와정도관리

The followings are the results for external quality assessment (EQA) in immunoserology for 2008:1.Evaluation of EQA was done in 2 trials in May and November, about 99% of laboratories participating average 7.7 items. The results were collected via internet and about 99% of laboratories have sent their results via internet. 2.Control materials used in the External Proficiecny Testing were pooled sera including Commercial controls, MAS(R) Immunology Control from Medical Analysis Systems (Camarillo, CA, USA), which were delivered refrigerated for stability of control materials, being received within 48 hours after sending. 3.Latex agglutination tests for rheumatoid factor (RF) showed frequently false positive or false negative results especially in Commercial controls, possibly due to matrix effect.4.False negative and positive results were frequently found in the laboratories using immunochromatography assay (ICA) for anti-HCV and anti-HIV. More careful quality control should be required for ICA tests. 5.New tests measuring non-treponemal and trponemal antibody such as turbidoimmunoassay (TIA) and chemiluminescence immunoassay (CLIA) were introduced.6.Standardization of instruments and reagents including calibrators for quantitative results should be required for the harmonization of results.

Annual Report on External Quality Assessment in Immunoserology in Korea (2007) / 임상검사와정도관리

The followings are the results for external quality assessment (EQA) in immunoserology for 2007: 1. Evaluation of EQA was done in 2 trials in May and December, about 99% of laboratories participating average 7.8 items. The results were collected via internet for the first time and 96~98% of laboratories have sent their results via internet. 2. All the specimens for Immunoserology in EQA were delivered refrigerated, being received within 48 hours after sending. 3. Commercial controls, MASR Immunology Control from Medical Analysis Systems (Camarillo, CA, USA) were used to assure the quality of quantitative results of C-reactive protein (CRP), rheumatoid factor (RF) and anti- streptolysin O (ASO) tests, and the RF results of MASR Immunology Control were variable depending on the reagents used. 4. The laboratories using immunochromatography assay (ICA) were increased, however, many laboratories using ICA reported falsely negative for the positive specimens. The sensitivity of ICA test kits as well as various factors influencing the ICA results should be evaluated. 5. The HBsAg results of the ACCURUN 1R Multi-Marker Positive Control (Boston Biomedica Inc. USA) were falsely reported as negative in some laboratories using arbitrarily determined cutoff. 6. Standardization of methods including calibrators for quantitative results should be required for the harmonization of results.

Annual Report on External Quality Assessment in Immunoserology in Korea (2007) / 임상검사와정도관리

The followings are the results for external quality assessment (EQA) in immunoserology for 2007: 1. Evaluation of EQA was done in 2 trials in May and December, about 99% of laboratories participating average 7.8 items. The results were collected via internet for the first time and 96~98% of laboratories have sent their results via internet. 2. All the specimens for Immunoserology in EQA were delivered refrigerated, being received within 48 hours after sending. 3. Commercial controls, MASR Immunology Control from Medical Analysis Systems (Camarillo, CA, USA) were used to assure the quality of quantitative results of C-reactive protein (CRP), rheumatoid factor (RF) and anti- streptolysin O (ASO) tests, and the RF results of MASR Immunology Control were variable depending on the reagents used. 4. The laboratories using immunochromatography assay (ICA) were increased, however, many laboratories using ICA reported falsely negative for the positive specimens. The sensitivity of ICA test kits as well as various factors influencing the ICA results should be evaluated. 5. The HBsAg results of the ACCURUN 1R Multi-Marker Positive Control (Boston Biomedica Inc. USA) were falsely reported as negative in some laboratories using arbitrarily determined cutoff. 6. Standardization of methods including calibrators for quantitative results should be required for the harmonization of results.

Annual Report on External Quality Assessment in Immunoserology in Korea (2005) / 임상검사와정도관리

The followings are the results for external quality assessment (EQA) in immunoserology for 2005: 1.Evaluation of EQA was done in 2 trials in May and December, about 99% of laboratories participating average 8.4 items. The results were collected via internet for the first time and 66~78% of laboratories have sent their results via internet. 2.Commercial controls, MASR Immunology Control from Medical Analysis Systems (Camarillo, CA, USA) and Immunology Control (Immuno-Q-sera I, SEIKEN, Japan) were used to assure the quality of quantitative results of C-reactive protein (CRP), rheumatoid factor (RF) and anti-streptolysin O (ASO) tests. All the specimens for Immunoserology in EQA were delivered refrigerated, being received within 48 hours after sending. 3.Commercial control for serologic tests for syphilis, Syphilis Control (Mediace RPR con, Sekisui, Japan) was newly introduced in 2005. 4.The laboratories using immunochromatography assay (ICA) were increased, however, many laboratories using ICA reported falsely negative for the positive specimens. The sensitivity of ICA test kits as well as various factors influencing the ICA results should be evaluated. 5.Standardization of methods including calibrators for quantitative results should be required for the harmonization of results.

Annual Report on External Quality Assessment in Immunoserology in Korea (2004) / 임상검사와정도관리

The followings are the results for external quality assessment (EQA) in immunoserology for 2004: 1. Evaluation of EQA was done in 2 trials in May and November, about 99% of laboratories participating average 8.4 items. EQA for anti-HBc test was newly started in 2004. 2. Commercial control, MASR Immunology Control from Medical Analysis Systems (Camarillo, CA, USA) was used to assure the quality of quantitative results of C-reactive protein (CRP), rheumatoid factor (RF) and anti-streptolysin O (ASO) tests in 2004. All the specimens for Immunoserology in EQA were delivered refrigerated for the first time, being received within 48 hours after sending. 3. EQA for detection of HBsAg mutants was tried for the first time, using the recombinant HBsAg mutant (Gly/Arg 145) kindly provided by Abbott Laboratories, USA. 4. The laboratories using immunochromatography assay (ICA) were increased, however, many laboratories using ICA reported falsely negative for the positive specimens. The sensitivity of ICA test kits as well as various factors influencing the ICA results should be evaluated. 5. Standardization of methods including calibrators for quantitative results should be required for the harmonization of results.

Investigation of Elevated Cardiac Troponin T in Chronic Renal Failure Patients Undergoing Hemodialysis / 대한진단검사의학회지

BACKGROUND: The aim of this study was to investigate the prevalence and clinical significance of abnormal values of cardiac markers, high sensitivity CRP (hsCRP) and homocysteine occurring in hemodialysis patients without clinical evidence of acute coronary ischemia. METHODS: We determined the concentrations of cardiac troponin T (cTnT), troponin I (cTnI), creatine kinase MB (CK-MB), myoglobin, hsCRP, homocysteine and other biochemical parameters 35 patients with chronic renal failure (CRF) and 22 healthy controls. All CRF patients were followed in for 3 years. RESULTS: All of the measured parameters except cholesterol were significantly elevated in the patients, comparing with controls (P0.05). A good association was present between cTnT and CK-MB, cTnT and myoglobin, myoglobin and creatinine, and BUN and creatinine. Inquiries about underlying diseases of CRF revealed that diabetes mellitus group showed significantly higher cTnT values than in hypertension group or inflammation group. cTnT was elevated above cutoff value in about 17% of patients, while cTnI was in none of them. During one-year follow-up period, 6 patients (18.2%) died and 3 of them had initially elevated cTnT values. Four patients had cardiac events, but none of them had any increase in the values of the cardiac markers. The patients with increased cTnT values above cutoff value (> or =0.1 ng/ mL) showed a significantly higher mortality rate than the patients with cTnT values below the cutoff value in 3-year follow-up (P<0.05). CONCLUSIONS: Mildly elevated cardiac markers, hsCRP and homocysteine are common in CRF patients undergoing hemodialysis. It is recommended that cTnI values be used for diagnosis of ischemic heart disease in CRF patients. The three-year follow-up outcome suggests that cTnT is a potential prognostic marker of mortality in CRF patients.

Annual Report on External Quality Assessment in Immunoserology in Korea (2003) / 임상검사와정도관리

The followings are the results for external quality assessment (EQA) in immunoserology for 2003: 1.Evaluation of EQA was done in 2 trials in May and November, about 99% of laboratories participating average 8.2 items. 2.In C-reactive protein (CRP), rheumatoid factor (RF) and anti-streptolysin O (ASO) tests, about 63%, 49% and 44% of the participating laboratories respectively have used quantitative assays. Because the laboratories using quanitiative assays were on the increase annually, commercial control, Liquicheck(TM) Immunology Contol from Bio-Rad Laboratories (Irvine, CA, USA) was used to assure the quality of quantitiavie results in 2003. A few laboratories reproted the outlier results, comparing with the reference ranges presented by the company. 3.Over 92% of participating laboratoreis have used imunoassays including enzyme immunoassay (EIA), microparticle EIA (MEIA), chemiluminescence immunoassay (CIA), immunochromatography assay (ICA) or radioimmunoassay (RIA) for detedting viral antigens or antibodies. Especially for anti-HCV, over 98% of participating laboratoreis have used various kind of imunoassays. Laboratories using ICA increased and about 24% of participating laboratoreis have used ICA for anti-HCV and anti-HIV. However, many laboratories using ICA for detecting anti-HCV reported false negative results, suggesting lower sensitivity of ICA than those of other immunoassays. 4.The criteria of interpretation were considered to be evaluated in Widal test and laboratories using ICA increased in serological tests for syphilis.

Annual Report on External Quality Assessment in Immunoserology in Korea (2002) / 임상검사와정도관리

The followings are the results for external quality assessment (EQA) in immunoserology for 2002: 1. Evaluation of EQA was done in 2 trials in May and November, about 96% of laboratories participating average 8.3 items. 2. In C-reactive protein (CRP), rheumatoid factor (RF) and anti-streptolysin O (ASO) tests, about 40%, 53% and 52% of the participating laboratories respectively have used qualitative assays, mainly latex agglutination. And about 55%, 43% and 40% of the participating laboratories have used quantitative assays, turbidimetric immunoassay (TIA) or nephelometry in CRP, RF and ASO tests respectively. Laboratories using TIA increased and those using nephelometry decreased. The instruments which were the most frequently used in nephelometry were BN series (Dade Behring Inc., Germany). The instruments of Hitachi series (Hitachi Ltd., Japan), Cobas Integra and Mira series (Roche Diagnostics GmbH, Germany), Toshiba series (Toshiba Corporation, Japan) and Olympus AU series (Olympus Optical Co., Ltd., Japan) were frequently used in TIA. The quantitative results were quite variable according to the methods or reagents, especially in RF and ASO. 3. Over 90% of participating laboratoreis have used imunoassay including enzyme immunoassay (EIA), microparticle EIA (MEIA), chemiluminescence immunoassay (CIA), immunochromatography assay (ICA) or radioimmunoassay (RIA). Laboratories using CIA and ICA increased. Sensitivities of ICA were lower than those of other immunoassays in the results of HBsAg and anti-HCV. The sensitivity of SD HCV (Standard Diagnostics, Inc., Korea) was especially lower in anti-HCV results. Sensitivities of CIA and ICA were also lower than those of EIA including MEIA in the results of anti-HIV. 4. The criteria of interpretation were considered to be evaluated in Widal test and laboratories using ICA increased in serological tests for syphilis.

Early Detection of Mycobacterium Tuberculosis and Determination Rifampin-Resistance by PCR-Reverse Hybridization (Line Probe Assay) v / 감염

BACKGROUND: Recent worldwide increase of tuberculosis has been mainly caused by opportunistic infections in the patients with AIDS. Emergence of multidrug- resistant Mycobacterium tuberculosis has been also posing serious problems on the treatment of tuberculosis. The purpose of this study was to evaluate the usefulness of the PCR-reverse hybridization method (line probe assay, INNO-LIPA; Innogenetics, Belgium) for the identification of M. tuberculosis and detection of rifampicin- resistant M. tuberculosis. METHOD: Identification of 37 isolates was performed by both conventional method and line probe assay. Detection of rifampin resistance by line probe assay was based on the reaction of amplified gene products of isolates with either wild type probes (S1, S2, S3, S4, and S5) specific for rpoB gene or mutant type probes (R2, R4a, R4b, and R5) specific for the mutation sequence in the rpoB region, and the results were compared with those by the absolute concentration method. RESULTS: All of the 37 isolates were identified as M. tuberculosis by both line probe assay and conventional method. Eight isolates susceptible to rifampin by absolute concentration method showed no mutation by line probe assay. Twenty seven of 29 isolates resistant to rifampin by absolute concentration method showed the following mutations in rpoB gene: 11, S5-R5+(loss of S5 with R5); 7, S4-R4a; 1, S4-R4b+; 4, S2-R2+; 1, S1-S2+: 1; S2-S4-; 1, S4-; and 1, R5+. The sensitivity of rifampin resistance by line probe assay was 95%. CONCLUSION: Line probe assay is a useful tool for the early identification of M. tuberculosis as well as determination of its rifampin resistance, especially in cases of emergent need for rapid treatment for tuberculosis before getting the final of conventional antituberculous drug susceptibility test.

Evaluation of Diagnostic Efficiency of Troponin T Measurement in Acute Myocardial Infarction and Ischemic Heart Disease / 대한임상병리학회지

BACKGROUND: Troponin T(TnT), a 37 kDa polypeptide subunit of contractile protein, is part of the troponin complect in striated muscle, where it binds to tropomyosin. TnT is not usually found in circulating blood, but increase in serum by cytoplasmic damage. Because the amino acid sequence is unique to cardiac muscle, one can immunologically differentiate skeletal muscle and cardiac protein isoforms. METHODS: We evaluated serum cardiac TnT (ELISA, Troponin-T, Boehringer Mannheim, Germany) versos CK-MB mass (IMX CK-MB, Abbott Laboratories, USA) in 46 cases (173 samples) of acute myocardial infarction, 28 cases (94 samples) of ansi na pectoris, 23 cases (62 samples) of other cardiac disease, and 32 cases of non-cardiac disease from September 1994-June 1996. RESULTS: TnT was detected in serum(cutoff value 0.20 ng/ml) within 6 hours after onset of chest pain, slightly earlier than CK-MB mass (cutoff value 5.0 ng/ml). Sensitivity of TnT (81%) is not statistically different from CK-MB mass (84%) within 24 hour of cutest pain but more sensitive after 24-72 hours of symptom, Specificity (79.5%) and positive predictive value (70.7%) of TnT were superior to that of CK-MB mass within 24 fours of cutest pain, and persistent to 6 days, which was longer than that of Cl4-MB mass. More patients show increment of TnT in unstable angina pectoris(40.0%) than stable angina pectoris(15.4%), No difference in detection rate of TnT between angina pectoris(28.6%) and other cardiac disease patients(34.8%). Only 3.1 % of non-cardiac disease patients show TnT increment. CONCLUSIONS: We concluded that TnT Is not detected In most of non-cardiac disease patients, and is an early and later marker with very wide diagnostic time win-dow. Also, TnT can be used as a valuable masker for ischemic myocardial damage in any underlying causes.

A case of malignant lymphoma with CNS involvement / 대한혈액학회지

No abstract available.

Transitional myelomonocytic variant of AMML / 대한임상병리학회지

No abstract available.

Microgliomatosis: A case report with literature review

In 1929, Bailey first described an intracranial sarcomatous tumor as a term of perithelial sarcoma. The term of microgliomatosis was introduced by Benedek and Juba, 1941. In recent period, malignant lymphoma was widely used rather than many other terms such as reticulum cell sarcoma, malignant reticulosis, etc. An autopsy case of microgliomatosis was presented. She was a 33-year-old woman with headache, ataxia, memory disturbance, defecation and micturition difficulty. She was relatively well until 3 months earlier before admission. She visited first St. Vincent Hospital due to memory disturbance, and a tumor was found in her left frontal lobe by CT scanning of her brain. She was transferred to Kang Nam Sacred Heart Hospital for further evaluation of the tumor mass. She ws given steroid therapy and somewhat improved in her symptoms. By follow-up CT scannings, the tumor could not be found. Her general conditions were progressively deteriorated and died on 85th day of her admission. Brain limited autopsy was performed. The external features of her brain were grossly unremarkable. Cut surfaces revealed multiple ill-defined grayish white masses, especially on deep white matter of left frontal lobe, left cingulate gyrus and white matter together with medial side of basal ganglia. The definite size was not able to be measured, but the largest one in left frontal lobe was about 2.5cm in diameter. Microscopically, the tumors have many characteristics of microgliomatosis, such as perivascular arrangement of tumor cells and concentric reticulin condensation. These microscopic features were seen not only in grossly visible masses but also in other areas, almost all cerebral hemispheres. Literature review on microgliomatosis and a case report were done.