Annual Report on the External Quality Assessment Scheme for Blood Bank Tests in Korea (2015)

We report here the results of the external quality assessment scheme (EQA) of blood bank tests in Korea carried out in 2015. The proficiency testing specimens used in the survey were prepared at Ajou University Hospital. The response rates from participating laboratories for the first and second trials were 98.7% (542/549) and 98.2% (544/554), respectively. No answers to tests were considered incorrect, and the average accuracy rates for six different test items on the standard survey were as follows: ABO grouping, 99.4% to 100.0%; RhD typing, 99.4% to 100.0%; crossmatching, 93.6% to 99.0%; direct antiglobulin test (DAT) using a polyspecific reagent, 92.9% to 98.3%; DAT using an IgG monospecific reagent, 94.6% to 100.0%; DAT using a C3d monospecific reagent, 84.2% to 98.6%; unexpected antibody screening test, 94.5% to 100.0%; and antibody identification test, 93.8% to 100.0%. We performed a pilot survey on reactivities to A1 (54 responses) and H (50 responses); Rh C, c, E, and e antigen testing (47 responses); and ABO antibody titration (10-34 responses). We obtained excellent results for this EQA, and these results will be helpful for improving or maintaining the quality of the participating laboratories.

Analysis of Matrix Metalloproteinase Expression in the Recurrence of Superficial Low Grade Urothelial Bladder Cancer / 대한비뇨기과학회지

PURPOSE: Superficial bladder transitional cell carcinomas (TCCa) have high recurrence rates following endoscopic resection. Most of the parameters used for the prediction of a recurrence are associated with high grade TCCa. However, there are few valid parameters for prediction of the recurrence of low grade TCCa. We aimed to elucidate the prime factor of a recurrence of superficial low grade bladder TCCa. MATERIALS AND METHODS: Thirty cases of superficial low grade bladder TCCa were analyzed, 15 of which were recurred cases. Fresh frozen tumor and normal tissues were used for the analysis. Real-time reverse transcriptase polymerase chain reaction (RT-PCR) and Western blots analyses were subsequently performed to evaluate the validity of the molecules identified by a 0.12K cDNA array, including matrix metalloproteinase (MMP), oncogenes and cell-cycle-related genes. RESULTS: On cDNA microarray analysis, MMP-1, 2, 9, 12 and 15, and transforming growth factor beta1 (TGFbeta1), vascular endothelial growth factor (VEGF) and fos were found to be significantly upregulated in the recurred cases. From the real-time RT-PCR for the validation of those molecules, MMP-1 and 12, and TGFbeta1, VEGF and fos were significantly overexpressed in the recurred cases. Western blot showed significant overexpression of MMP-1 and 12, and TGFbeta1, VEGF and fos in the recurred cases. CONCLUSIONS: The overexpressions of MMP-1 and 12, and TGFbeta1, VEGF and fos may be associated with the recurrence of superficial low grade bladder TCCa.

Free Flow in Internal Thoracic Artery and Internal Thoracic Artery-Radial Artery Composite Graft / 대한흉부외과학회지

BACKGROUND: The Y-composite graft of internal thoracic artery and radial artery is commonly used in coronary bypass surgery. The aim of this study is to look for a way to raise the free flow of the internal thoracic graft and to see flow dynamics of the Y-graft. MATERIAL AND METHOD: In 15 patients undergoing coronary bypass surgery, free flow of the in-situ internal thoracic artery graft was measured using two different papaverine application methods; extraluminal papaverine spray in 7 patients and intraluminal papaverine injection in 8. In 18 other patients for whom the Y-graft was used, total free flow and flow changes from the two ends were measured. RESULT: The free flow of the in-situ internal thoracic artery graft almost doubled with internal papaverine injection than with external papaverine spray (47.7+/-9.6 mL/min vs. 100.8+/-26.3 mL/min, p<0.001). Total flow of the Y-composite graft was significantly more than either flow of the internal thoracic artery end or radial artery graft end (173.3+/-45.3 mL/min vs. 121.1+/-34.3 mL/min or 117.5+/-42.8 mL/min). When both ends of the Y-composite graft were opened, free flows from the two ends were similar (85.4+/-27.8 mL/min vs. 87.9+/-42.4 mL/min, p=0.772). The flow of one end of the Y-composite graft was increased significantly by clamping of the other-end than when both ends were opened. CONCLUSION: Intraluminal papaverine injection is very effective in raising free flow of the internal thoracic artery graft, and the free flow of the Y-composite graft of in-situ internal thoracic artery and free radial artery graft is more than that of the in-situ internal thoracic artery graft. The flow of one end flow of the Y-graft may be altered by the flow change of the other end.

Determination of Early Graft Patency Using CT Angiography after Coronary Artery Bypass Surgery / 대한흉부외과학회지

BACKGROUND: CT angiography is now available to evaluate the early graft patency after coronary bypass surgery. We investigated whether patency or occlusion of the bypass grafts can be visualized by CT angiography and what factors effect the visuality. MATERIAL AND METHOD: Fifty patients underwent scanning with a 4-slice computed tomographic scanner (Somatom Volume ZoomTM; Siemens, Germany) before being discharged after coronary artery bypass grafting. To evaluate graft patency and relationship between the quality of graft image and the characteristics of the diseased coronary vessels, 50 internal thoracic artery grafts, 18 radial artery grafts, and 56 vein grafts were included in this study. RESULT: All vein grafts (24 grafts; 32 anastomoses) to left coronary artery system were well visualized, but 3 grafts (4.7%) of 30 vein grafts (35 anastomoses) to right coronary artery system were not visualized. The latter was also occluded in invasive coronary angiographic study. Thirty-nine (78%) internal thoracic artery grafts were well visualized, 8 (16%) faintly visualized, and 3 (6%) not visualized, but all the internal artery grafts were well patent in invasive coronary angiographic study. CONCLUSION: Unvisualized vein grafts in CT angiography means occlusion of the grafts, but unvisualized arterial grafts in CT angiography may not mean occlusion of the graft but result from competitive flow between the graft and coronary artery. To confirm patency of the unvisualized arterial grafts, invasive coronary angiography is needed.

Ozon-induced airway hyperresponsiveness of rat tracheal smooth muscle / 천식및알레르기

BACKGROUND: Ozone (03) induces airway inflammation and hyperresponsiveness which are characteristic features of asthma. There have been few studies observing O3-induced increase in responsiveness of rat airway muscle. Objectives: The aims of this study were to develop an O3-induced nonallergic asthma model using rat tracheal smooth muscle (TSM) and to evaluate the role of airway epithelium on the modulation of muscle responsiveness. METHOD: Five groups of 20 male Sprague-Dawley(SD) rats were exposed to filtered air including 0.12, 0.5, 1.0, or 2.0 ppm 03 for 1 hour. Thirty minutes after the exposure, bronchoalveolar lavage (BAL) and isometric contractile responses of the isolated tracheal ring segments to KCI, acetylcholine (ACh), and electrical field stimulation (EFS) were measured. RESULTS: The percent age of neutrophils was significantly higher and that of alveolar macro-phages in BAL fluid was significantly lower in 2.0 ppm O3-exposed rats than in the control. There were no significant differences in the maximal contractile responses of TSM to KC1, ACh, EFS and in the sensitivity to ACh (ACh-EC50) and EFS (EFS-EC50) between the control group and the ozone exposed group. ACh-EC50 and EFS-EC50 were correlated positively with the percent age of neutrophils and inversely with that of macrophages. Removal of epithelium significantly increased the sensitivity to ACh in O3-exposed group, but not in the control group. CONCLUSION: These findings indicate that O3 induces neutrophilic airway inflammation, but not an increased sensitivity of TSM to ACh or EFS in SD rats. However, O3-induced epithelial damage may be associated with increased muscle response.

Develpoment of allergic asthma model using rat airway smooth muscle / 알레르기

Airway hyperresponsiveness is a consistent feature of asthma. Since the airway smooth muscle is hyperresponsive to a number of different stimuli operating through many different mechanisms, it is attractive to speculate that the abnormality may reside in the airway smooth muscle itself. Animal model of asthma is needed to unravel possible mechanisms underlying airway hyperresponsiveness and also to develop new therapeutic approaches. However, there are few reports showing that airway smooth muscle from animal asthma model is indeed hyperresponsive. In addition, sensitizing and provoking doses of allergen were different each other ambng the studies on animal asthma model. The aim of this study was to determine an appropriate sensitizing and provoking dose of allergen to induce a maximum airway hyperresponsiveness. Eighty-four male Sprague-Dawley rats were actively sensitized with a subcutaneous injection of 0, 10, or 1000/gg ovalbumin(OA) and 14 days later they were provoked with 0, 1, or 5 % OA aerosols. One day after the provocation, serum levels of OA-specific IgE, cell numbers in bronchoalveolar lavage fluid (BALF), and in vitro isometric contractile responses of the isolated tracheal smooth muscle(TSM) to 120 mM KC1, acetylcholine(ACh, 0.1~ 1000/micro meter), electrical field stimulation (EFS, 0.5~100Hz), serotonin(5-HT, 0.014 100/micro meter), and OA(10, 50, or 250 micro gram/ml) were measured. The results were as follows; 1) When 38 OA-sensitized rats were exposed to OA aerosols in vivo early asthmatic responses(EAR) were observed in 20(52.6%) rats. In vitro isometric contractile forces of TSM from rats with EAR were stronger than those from rats without EAR. 2) The maximal contractile responses to KC1 and EFS were significantly higher in rats only sensitized with OA compared with those in controls. The maximal response to ACh was significantly related to OA-specific serum IgE level(r=0.40, p%0.05), and the latter was in turn significantly related to the BALF eosinophil count(r=0.67, p<0.01). 3) When 10 microgram OA-sensitized rats were analyzed, the maximal response to KC1, ACh, EFS, and 250 micro gram/ml OA were lower in OA-provoked rats compared to those in saline-provoked control rats, in which 5% OA-provoked rats had a lower response than 1% OA-provoked rats. 4) The sensitivity of TSM to ACh was significantly higher in 10/micro gram OA-sensitized & OA-provoked rats, and the sensitivity to EFS was also significantly higher in 10/~g OA-sensitized & 5% OA-provoked rats compared to that in controls(p<0.05). 5) There was a significant correlation between the sensitivity of TSM to EFS and the counts of eosinophil or of lymphocytes in BALF(for eosinophil, r=-0.30; p<0.05, for lymphocyte, r=-0.35; p<0.05), or OA-specific serum IgE level(r=-0.46, p<0.01) in OA-sensitized & OA-provoked rats. This relationship was maintained in the data obtained only from 10 micro gram OA-sensitized & 5% OA-provoked rats. 6) The ratio of EFS-sensitivity to ACh-sensitivity was significantly lower in OA-sensitized & OA-provoked rats compared to that in controls or rats only sensitized with OA(p%0.05). 7) The Schultz-Dale phenomenon occurred in an in vitro dose-dependent manner. However, the inhaled provocation with OA in vivo resulted in a decrease in the contractile response to OA in vitro. There was a significant correlation between OA-specific serum IgE level and isometric response to 250 micro gram/ml OA(r=0.36, p<0.01). These results suggest that sensitization and provocation in vivo with OA in rats induces hypersensitivity of airway smooth muscle to cholinergic stimuli through an allergic inflammatory mechanism. The sensitivity was highest when sensitized to 10 micro gram OA and exposed to 5% OA aerosols.

A report of hypercarbia during general anesthesia / 대한구급학회지

No abstract available.

Occupational asthma and IgE antibodies to reactive dyes

Reactive dyes have been widely used in recent years. This paper reports nine cases of immediate type occupational asthma to reactive dyes in one dye industry. All patients had had asthmatic symptoms, four had had rhinitis and they had worked for 6 to 25 months. Skin prick tests with reactive dyes were positive and bronchoprovocation tests also produced immediate or dual types of bronchoconstriction. We used the radioallergosorbent test (RAST) technique with nitrocellulose filter paper as a solid phase to detect specific IgE to four reactive dye-human serum albumin conjugates. High specific IgE binding was found in eight asthmatic workers compared with 13 negative controls. The RAST inhibition test revealed that there was no immunological cross-reactivity between 4 reactive dyes. These results suggested that the mechanism of their asthmatic symptoms was immunological, mostly an IgE-mediate reaction.

Occupational asthma and IgE antibodies to reactive dyes

Reactive dyes have been widely used in recent years. This paper reports nine cases of immediate type occupational asthma to reactive dyes in one dye industry. All patients had had asthmatic symptoms, four had had rhinitis and they had worked for 6 to 25 months. Skin prick tests with reactive dyes were positive and bronchoprovocation tests also produced immediate or dual types of bronchoconstriction. We used the radioallergosorbent test (RAST) technique with nitrocellulose filter paper as a solid phase to detect specific IgE to four reactive dye-human serum albumin conjugates. High specific IgE binding was found in eight asthmatic workers compared with 13 negative controls. The RAST inhibition test revealed that there was no immunological cross-reactivity between 4 reactive dyes. These results suggested that the mechanism of their asthmatic symptoms was immunological, mostly an IgE-mediate reaction.