Effect of Interrupted Agitation and Removal of Leukocyte on Platelet Quality during the Storage of Platelet Concentrates / 대한진단검사의학회지

BACKGROUND: This study aimed to analyze the influence of the interruption of agitation and removal of leukocytes on platelet concentrates (PCs), and determine the maximum amount of time the agitation could be interrupted without impairing PCs' effectiveness during the storage period. METHODS: Four ABO-identical random donor platelets agitated for 24 hr were pooled, and divided into 4 units, and 2 units of them were leukoreduced. Then 52 pooled units were categorized into 4 groups, non-leukoreduced continuous agitation (Non-LRCA), non-leukoreduced interrupted agitation (Non-LRIA), leukoreduced continuous agitation (LRCA), and leukoreduced interrupted agitation (LRIA), and preserved for 6 days (total 7 days). Mean platelet volume (MPV), pH, HCO3-, pO2, pCO2, CD62P, CD61, glucose, lactate, ammonia and free fatty acid were measured during the period. RESULTS: Starting from the Day 4, the pH and HCO3- of Non-LRIA group begun to decrease while the amount of lactate production, glucose consumption, and MPV increased compared to the Non- LRCA group (P<0.01). An increase in pO2 level was observed in the interrupted agitation groups as the storage period prolonged (P<0.01). The pH levels of all the units in the agitation groups remained higher than 6.4 up to Day 7, while those of the non-leukoreduction group did so only up to Day 2, but those of leukoreduction in the interrupted agitation groups did so up to Day 4. CONCLUSIONS: The interruption of agitation reduced the platelet's capacity to utilize oxygen, increasing lactate amount and reducing pH level. However, the in vitro parameters of the Non-LRIA and Non-LRCA groups on Day 2 were similar to each other and the pH level remained at 6.4 or higher, making one day of agitation interruption possible after 24 hr of agitation. With leukocytes removed, the effective agitation interruption period may become longer.

A Case of Thrombotic Thrombocytopenic Purpura Associated with Escherichia coli O26 / 대한진단검사의학회지

Escherichia coli O26 is the most common serotype among the non-O157 E. coli strains producing shiga-toxin (ST) and the cases infected by ST-producing E. coli O26 has been reported with increasing frequency. The infection of ST-producing E. coli O26 can manifest mainly as an acute gastroenteritis and a hemorrhagic colitis, but rarely a hemolytic uremic syndrome or a thrombotic thrombocytopenic purpura (TTP). We reported the first case of TTP associated with E. coli O26 in Korea.

Clinical Significance of Escherichia coli O26 Isolated from Clinical Specimens / 대한임상미생물학회지

BACKGROUND: Non-O157 human isolates among enterohemorrhagic Escherichia coli (EHEC) serogroup have been reported with increasing frequency in recent years; the serotype O26 is the most common among the non-O157 isolates. We performed serotyping of E. coli isolates with O157, O26, and O111 antisera at Ulsan University Hospital and identified 27 isolates of O26. The purpose of this study was to investigate the clinical significance of E. coli O26 isolates. METHODS: During the 24-month period from January 2002 to December 2003, E. coli isolates were serotyped when requested by the physician because of bloody diarrhea or when blood was noted in the stool specimen at the laboratory. The isolates were identified biochemically by Vitek 1 (BioMerieux Vitek Inc., Mo., USA) and serotyped using diagnostic antisera of O157, O26, and O111 (NIH, Korea). When a positive agglutination reaction was shown, the patient's was reviewed retrospectively. RESULTS: Of 4,921 isolates of E. coli during the 2-year period, 200 isolates were serotyped and 27 (13.5%) were identified as serotype O26. These were isolated from stool (13 isolates), urine (9), pus (1), blood (1), and bile (1). Among the 13 patients whose stool specimens grew E. coli O26, 12 had watery diarrhea and 7 bloody diarrhea; two patients had thrombocytopenia and purpura simultaneously. Two patients with watey diarrhea, two with bloody diarrhea, and one with TTP were among the 7 patients with E. coli O26 in the urine. Finally, one patient each with blood isolate and bile isolate of E. coli O26 both had acute gastroenteritis. CONCLUSIONS: Most of the patients infected with E. coli O26 had clinical manifestations consistent with EHEC infections. E. coli isolates from patients with boody diarrhea should be serotyped with O157 and O26 antisera.

Comparison of Mycobacterial Culture by Mycobacterium Growth Indicator Tube and Ogawa Media / 대한임상미생물학회지

BACKGROUND: Mycobacterial disease is still greatly concerned in the developing and industrialized countries. Ogawa media has been used to diagnose mycobacterial disease in Korea in spite of a low sensitivity and long incubation time. Mycobacterium Growth Indicator Tube (MGIT) 960 system has been developed to overcome the pitfalls of Ogawa media. So, we investigated improvement in dectection rate and the detection time of mycobacteria using the MGIT 960 system along with 3% Ogawa media. METHODS: A total of 8,045 clinical specimens referred to the department of laboratory medicine in Ulsan University Hospital from January in 2001 to June in 2002 were cultured for mycobacteria. Specimens were processed with the NALC-NAOH (final concentration of NaOH: 1%) and inoculated into both MGIT and Ogawa media. Mycolic acid in the cultured products were analyzed by High performance liquid chromatography to discriminate between Mycobacterium tuberculosis and nontuberculous mycobacteria. RESULTS: Of 8,045 clinical specimens cultured, mycobacteria grew in 957 (11.9%) specimens, 840 (87.8%) M. tuberculosis and 117 (12.2%) nontuberculous mycobacteria. Mycobacteria were detected in 939 specimens (98.1%) by MGIT and 771 (80.6%) specimens by Ogawa media; 753 (78.7%) were detected by both media, 186 (19.4%) by MGIT only, and 18 (1.9%) by Ogawa media only. Mycobacteria were detected in 11.7 days by MGIT 960 and 28.4 days by Ogawa media. CONCLUSIONS: The detection rate and detection time of mycobacteri are improved considerably by the MGIT system; however a combined use of MGIT system and Ogawa media is the most ideally recommended for increasing the detection rate and shortening the detection time.

A case of heterotopic pregnancy / 대한산부인과학회잡지

Heterotopic pregnancy occurs when there are coexisiting intrauterine and ectopic pregnances. It occure, more often, due to assisted reproductive technology such as IVF-ET, GIFT and increased pelvic inflammatory diseases. We present a case of heterotopic pregnancy confirmed by surgical removal of ruptured left ovarian pregnancy and sonographic finding of the intrauterine pregnancy following natural conception.