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1.
Article in Korean | WPRIM | ID: wpr-713986

ABSTRACT

BACKGROUND: For effective blood usage and reduction of unnecessary workload at blood banks, we established the maximum surgical blood order schedule (MSBOS) for major elective surgeries and evaluated indicators, including the rate of returned red blood cells (RBCs). METHODS: During August 2016 and May 2017, MSBOS for neurosurgery, thoracic surgery, orthopedic surgery, and general surgery was established using two formulas: the mean units of transfusion per procedure (MSBOS 1) and the mean units of transfusion in transfused patients per procedure (MSBOS 2). The crossmatch to transfusion (C/T) ratio, transfusion probability, and rate of returned RBCs were calculated and analyzed. RESULTS: Based on MSBOS 1, type and screen can be applied to all elective surgeries of the general surgery department. MSBOS 2 was higher than MSBOS 1 in most surgeries ranging from 1 to 3 units. The C/T ratio and transfusion probability of surgery exhibited similar tendencies, and the general surgery department was over-prescribed compared to the actual transfusion requirement. The rate of returned RBCs was the highest in thoracic surgery (32/101, 32%), and the total number of returned RBC unit was the highest in orthopedic surgery (276 of 1131 units). CONCLUSION: MSBOS 1 was the formula corresponding to the purpose of the maximum blood application protocol. Application of an appropriate MSBOS protocol and concurrent utilization of C/T ratio, probability of transfusion, and rate and number of returned units of RBCs will further aid the efficiency of blood bank resources.


Subject(s)
Appointments and Schedules , Blood Banks , Erythrocytes , Humans , Neurosurgery , Orthopedics , Thoracic Surgery
2.
Article in Korean | WPRIM | ID: wpr-716935

ABSTRACT

BACKGROUND: The ABO blood group typing test (ABO test) is an initial pre-transfusion test based on hemagglutination. Although various factors affect hemagglutination strength, few studies have examined how these factors can be applied in clinical laboratories and their effects on hemagglutination. This study was conducted to analyze the factors affecting hemagglutination strength in the ABO test using a tube method applied in many laboratories. METHODS: We conducted a detailed questionnaire survey of 51 laboratories which use the ABO test with a tube method. We also analyzed the results of the ABO test (cell and serum typing) with 40 specimens using factors affecting hemagglutination at a tube method and applied differently in each laboratory. RESULTS: Each laboratory used various methods to prepare red cell suspensions as specimens or reagents and used different reagent to sample ratios, centrifugation protocols, and shaking test tubes before evaluating hemagglutination strength. By testing various combinations of these factors, direct sampling from the red cell layer of the original specimen was found to have the largest effect on lowering hemagglutination strength in cell typing tests. In serum typing tests, various factors influenced hemagglutination strength, including shaking the tube before analysis and the concentration of a home-made red cell suspension used as a reagent. CONCLUSIONS: To achieve accurate results in the ABO test by the tube method, detailed guidelines that include the factors affecting hemagglutination strength determined in this study should be established.


Subject(s)
Centrifugation , Hemagglutination , Indicators and Reagents , Methods , Suspensions
4.
Yonsei Medical Journal ; : 557-563, 2017.
Article in English | WPRIM | ID: wpr-188814

ABSTRACT

PURPOSE: The aim of this study is to investigate the molecular characteristics of occult hepatitis B virus (HBV) infection in ‘anti-HBc alone’ subjects. MATERIALS AND METHODS: Twenty-four patients with ‘anti-HBc alone’ and 20 control patients diagnosed with HBV were analyzed regarding S and pre-S gene mutations. All specimens were analyzed for HBs Ag, anti-HBc, and anti-HBs. For specimens with an anti-HBc alone, quantitative analysis of HBV DNA, as well as sequencing and mutation analysis of S and pre-S genes, were performed. RESULTS: A total 24 were analyzed for the S gene, and 14 were analyzed for the pre-S gene through sequencing. A total of 20 control patients were analyzed for S and pre-S gene simultaneously. Nineteen point mutations of the major hydrophilic region were found in six of 24 patients. Among them, three mutations, S114T, P127S/T, M133T, were detected in common. Only one mutation was found in five subjects of the control group; this mutation was not found in the occult HBV infection group, however. Pre-S mutations were detected in 10 patients, and mutations of site aa58–aa100 were detected in 9 patients. A mutation on D114E was simultaneously detected. Although five mutations from the control group were found at the same location (aa58–aa100), no mutations of occult HBV infection were detected. CONCLUSION: The prevalence of occult HBV infection is not low among ‘anti-HBc alone’ subjects. Variable mutations in the S gene and pre-S gene were associated with the occurrence of occult HBV infection. Further larger scale studies are required to determine the significance of newly detected mutations.


Subject(s)
DNA , Hepatitis B virus , Humans , Point Mutation , Prevalence
5.
Yonsei Medical Journal ; : 1271-1275, 2016.
Article in English | WPRIM | ID: wpr-79764

ABSTRACT

Mycoplasma hominis (M. hominis) and Ureaplasma urealyticum (U. urealyticum) are important opportunistic pathogens that cause urogenital infections and complicate pregnancy. The aim of this study was to investigate the prevalence, effects on pregnancy outcomes, and antimicrobial susceptibilities of M. hominis and U. urealyticum. We tested vaginal swabs obtained from 1035 pregnant women for the presence of genital mycoplasmas between June 2009 and May 2014. The laboratory and clinical aspects of genital mycoplasmas infection were reviewed retrospectively, and the identification and antimicrobial susceptibility of genital mycoplasmas were determined using the Mycoplasma IST-2 kit. A total of 571 instances of M. hominis and/or U. urealyticum were detected. Of them, M. hominis was detected in two specimens, whereas U. urealyticum was detected in 472 specimens. The remaining 97 specimens were positive for both M. hominis and U. urealyticum. Preterm deliveries were frequently observed in cases of mixed infection of M. hominis and U. urealyticum, and instances of preterm premature rupture of membrane were often found in cases of U. urealyticum. The rates of non-susceptible isolates to erythromycin, empirical agents for pregnant women, showed increasing trends. In conclusion, the prevalence of M. hominis and/or U. urealyticum infections in pregnant women is high, and the resistance rate of antimicrobial agents tends to increase. Therefore, to maintain a safe pregnancy, it is important to identify the isolates and use appropriate empirical antibiotics immediately.


Subject(s)
Adolescent , Adult , Anti-Bacterial Agents/pharmacology , Female , Humans , Infant, Newborn , Microbial Sensitivity Tests , Middle Aged , Mycoplasma Infections/drug therapy , Mycoplasma hominis/drug effects , Pregnancy , Pregnancy Complications, Infectious/drug therapy , Pregnancy Outcome , Prevalence , Retrospective Studies , Ureaplasma Infections/drug therapy , Ureaplasma urealyticum/drug effects , Young Adult
6.
7.
Article in Korean | WPRIM | ID: wpr-180131

ABSTRACT

The standardization committee of the Korean Society for Laboratory Hematology sought to establish standardized testing guidelines for the diagnosis of hematologic malignancies. The guidelines were developed on the basis of survey results and international guidelines, including the National Comprehensive Cancer Network Guidelines and European LeukemiaNet recommendations. The committee expects that the diagnostic guidelines presented here will enhance diagnostic test standardization and clinical decision making and that the novel developments due to new molecular technologies will be integrated into the diagnostic algorithms through ongoing consensus initiatives.


Subject(s)
Consensus , Decision Making , Diagnosis , Diagnostic Tests, Routine , Hematologic Neoplasms , Hematology
9.
Yonsei Medical Journal ; : 1282-1284, 2013.
Article in English | WPRIM | ID: wpr-74271

ABSTRACT

Healthcare-associated infections caused by methicillin-resistant Staphylococcus aureus (MRSA) have recently become an important issue for healthcare facilities due to high rates of infection, mortality, and high treatment costs. We investigated the frequency of MRSA in healthcare workers (HCWs) via nasal carriage and assessed the performance of the LightCycler(R) MRSA Advanced test. We tested nasal swabs from the anterior nares of participating HCWs at an intensive care unit. Nasal swabs were identified as S. aureus, methicillin-sensitive or methicillin-resistant coagulase-negative staphylococci (MSCoNS or MRCoNS), or MRSA by using conventional culture and the LightCycler(R) MRSA Advanced test. Of the 142 HCWs who participated in this study, only 11 participants (7.8%) were MRSA-positive by conventional culture and MRSA ID, and 24 (16.9%) were positive for mecA by real time polymerase chain reaction (PCR). In terms of diagnostic performance, the LightCycler(R) MRSA Advanced test had a sensitivity of 100%, a specificity of 90.1%, a positive predictive value of 45.8%, and a negative predictive value of 100% compared with conventional culture method. The detection limit of the LightCycler(R) MRSA Advanced test was 103 colony/mL. We concluded that real-time PCR was able to rapidly and sensitively detect MRSA in HCWs. However, MRSA must be confirmed by culture due to false positivity.


Subject(s)
Bacterial Proteins/genetics , False Positive Reactions , Humans , Methicillin-Resistant Staphylococcus aureus/genetics , Nurses , Physicians , Real-Time Polymerase Chain Reaction/methods , Sensitivity and Specificity , Staphylococcal Infections/diagnosis
12.
Article in English | WPRIM | ID: wpr-162707

ABSTRACT

In this study, we report the first Korean case of an anti-Gerbich (Ge) alloantibody to a high-incidence antigen that belongs to the Ge blood group system. The alloantibody was detected in a middle-aged Korean woman who did not have a history of transfusion. Her blood type was B+, and findings from the antibody screening test revealed 1+ reactivity in all panels except the autocontrol. The cross-matching test showed incompatible results with all 5 packed red blood cells. Additional blood type antigen and antibody tests confirmed the anti-Ge alloantibody. While rare, cases of hemolytic transfusion reaction or hemolytic disease in newborns due to anti-Ge have been recently reported in the literature. Therefore, additional further studies on alloantibodies to high-incidence antigens, including anti-Ge, are necessary in the future.

13.
Article in English | WPRIM | ID: wpr-143970

ABSTRACT

Partial trisomy 3p results from either unbalanced translocation or de novo duplication. Common clinical features consist of dysmorphic facial features, congenital heart defects, psychomotor and mental retardation, abnormal muscle tone, and hypoplastic genitalia. In this paper, we report a case of partial trisomy 3p with rare clinical manifestations. A full-term, female newborn was transferred to our clinic. She had cleft lip-plate, dysgenesis of the corpus callosum, patent ductus arteriosus, pulmonary hypertension, and severe right-sided hydronephrosis, associated with ureteropelvic junction obstruction. Cytogenetic investigation revealed partial trisomy 3p; 46,XX,der(4)t(3;4) (p21.1;p16). The karyotype of her father showed a balanced translocation, t(3;4)(p21.1;p16). Therefore, the size of duplication can be an important factor.


Subject(s)
Agenesis of Corpus Callosum , Chromosomes, Human, Pair 3 , Corpus Callosum , Cytogenetics , Ductus Arteriosus, Patent , Fathers , Female , Genitalia , Heart Defects, Congenital , Humans , Hydronephrosis , Hypertension, Pulmonary , Infant, Newborn , Intellectual Disability , Karyotype , Muscles , Trisomy
14.
Article in English | WPRIM | ID: wpr-143963

ABSTRACT

Partial trisomy 3p results from either unbalanced translocation or de novo duplication. Common clinical features consist of dysmorphic facial features, congenital heart defects, psychomotor and mental retardation, abnormal muscle tone, and hypoplastic genitalia. In this paper, we report a case of partial trisomy 3p with rare clinical manifestations. A full-term, female newborn was transferred to our clinic. She had cleft lip-plate, dysgenesis of the corpus callosum, patent ductus arteriosus, pulmonary hypertension, and severe right-sided hydronephrosis, associated with ureteropelvic junction obstruction. Cytogenetic investigation revealed partial trisomy 3p; 46,XX,der(4)t(3;4) (p21.1;p16). The karyotype of her father showed a balanced translocation, t(3;4)(p21.1;p16). Therefore, the size of duplication can be an important factor.


Subject(s)
Agenesis of Corpus Callosum , Chromosomes, Human, Pair 3 , Corpus Callosum , Cytogenetics , Ductus Arteriosus, Patent , Fathers , Female , Genitalia , Heart Defects, Congenital , Humans , Hydronephrosis , Hypertension, Pulmonary , Infant, Newborn , Intellectual Disability , Karyotype , Muscles , Trisomy
15.
Article in English | WPRIM | ID: wpr-125849

ABSTRACT

An 87-yr-old woman was diagnosed with AML with myelodysplasia-related changes (AML-MRC). The initial complete blood count showed Hb level of 5.9 g/dL, platelet counts of 27x10(9)/L, and white blood cell counts of 85.33x10(9)/L with 55% blasts. Peripheral blood samples were used in all the tests, as bone marrow examination could not be performed because of the patient's extremely advanced age and poor general health condition. Flow cytometric analysis, chromosome analysis, FISH, and reverse transcriptase-PCR (RT-PCR) results indicated AML-MRC resulting from t(3;21) with the RUNX1-MECOM fusion gene. To our knowledge, this is the second most elderly de novo AML patient associated with t(3;21) to be reported.


Subject(s)
Aged, 80 and over , Blood Cells/pathology , Chromosomes, Human, Pair 21 , Chromosomes, Human, Pair 3 , Female , Humans , Karyotyping , Leukemia, Myeloid, Acute/complications , Multiplex Polymerase Chain Reaction , Myelodysplastic Syndromes/complications , Oncogene Proteins, Fusion/genetics , Sequence Analysis, DNA , Translocation, Genetic
17.
Yonsei Medical Journal ; : 276-281, 2011.
Article in English | WPRIM | ID: wpr-68180

ABSTRACT

PURPOSE: Procalcitonin (PCT) is a current, frequently used marker for severe bacterial infection. The aim of this study was to assess the ability of PCT levels to differentiate bacteremic from nonbacteremic patients with fever. We assessed whether PCT level could be used to accurately rule out a diagnosis of bacteremia. MATERIALS AND METHODS: Serum samples and blood culture were obtained from patients with fever between August 2008 and April 2009. PCT was analyzed using a VIDAS(R) B.R.A.H.M.S PCT assay. We reviewed the final diagnosis and patient histories, including clinical presentation and antibiotic treatment. RESULTS: A total of 300 patients with fevers were enrolled in this study: 58 with bacteremia (positive blood culture) (group I); 137 with local infection (group II); 90 with other diseases (group III); and 15 with fevers of unknown origin (group IV). PCT levels were significantly higher in patients with bacteremia than in those with non-bacteremia (11.9 +/- 25.1 and 2.5 +/- 14.7 ng/mL, respectively, p < 0.001). The sensitivity and specificity were 74.2% and 70.1%, respectively, at a cut-off value of 0.5 ng/mL. A serum PCT level of < 0.4 ng/mL accurately rules out diagnosis of bacteremia. CONCLUSION: In febrile patients, elevated PCT may help predict bacteremia; furthermore, low PCT levels were helpful for ruling out bacteremia as a diagnosis. Therefore, PCT assessment could help physicians limit the number of prescriptions for antibiotics.


Subject(s)
Bacteremia/blood , Biomarkers/blood , C-Reactive Protein/analysis , Calcitonin/blood , Early Diagnosis , Female , Fever/blood , Fever of Unknown Origin/blood , Humans , Male , Middle Aged , Protein Precursors/blood , Sensitivity and Specificity , Young Adult
18.
Article in English | WPRIM | ID: wpr-152848

ABSTRACT

We present a rare case of microgranular variant acute promyelocytic leukemia (APL) associated with ider(17)(q10)t(15;17)(q22;q12) of an old-age patient. The initial chromosome study showed a 46,XX,del(6)(?q21q25),der(15)t(15;17)(q22;q12),ider(17)(q10)t(15;17)[10]/47,sl,+ider(17)(q10)t(15;17)[3]/46,XX[16]. FISH signals from a dual color dual fusion translocation PML-RARA probe were consistent with the results of conventional cytogenetics. Because of the rarity of ider(17)(q10)t(15;17) in microgranular APL, further studies on both gene dosage effect of this chromosomal abnormality and the influence of ider(17)(q10)t(15;17) on clinical features such as prognosis, survival, and treatment response of APL cases are recommended.


Subject(s)
Bone Marrow Cells/pathology , Chromosomes, Human, Pair 15 , Chromosomes, Human, Pair 17 , Female , Humans , In Situ Hybridization, Fluorescence , Karyotyping , Leukemia, Promyelocytic, Acute/diagnosis , Middle Aged , Oncogene Proteins, Fusion/genetics , Translocation, Genetic
19.
Article in Korean | WPRIM | ID: wpr-96804

ABSTRACT

Four trials of external quality assessment in diagnostic hematology were performed in 2009 with average 946 participating laboratories in Korea. We performed quality assessment for white blood cell count, hemoglobin, hematocrit, red blood cell count, platelet count, blood cell morphology, prothrombin time and activated partial thromboplastin time. The response rate was more than 98.2%. The coefficients of variation in hemoglobin, hematocrit and RBC count were stable but variable in platelet count and WBC count according to measuring cell counters. Test results of blood cell morphology showed variation among various cell morphologies.


Subject(s)
Blood Cells , Cell Count , Erythrocyte Count , Hematocrit , Hematology , Hemoglobins , Korea , Leukocyte Count , Partial Thromboplastin Time , Platelet Count , Prothrombin Time
20.
Article in English | WPRIM | ID: wpr-164239

ABSTRACT

Factor VIII inhibitors are produced during or after coagulation factor VIII (FVIII) therapy in hemophilia A patients. These inhibitors are usually detected by a modified Bethesda assay or an enzymelinked immunosorbent assay (ELISA). In this study, we used the Bethesda assay to determine the incidence of FVIII inhibitors in 75 fresh plasma samples obtained from 50 hemophilia A patients, and then used ELISA and the Bethesda assay to determine the titres of these inhibitors after the samples had been frozen and thawed. The samples from the screening Bethesda assay were centrifuged and stored at -70degrees C in accordance with the assay guidelines. Subsequently, these samples were thawed and analyzed using ELISA and the Bethesda assay. The incidence of inhibitors in hemophilia A patients was 20.0%. Among the 35 inhibitor-positive samples identified in the screening Bethesda assay, 16 were positive in ELISA while only 4 were positive in the repeated Bethesda assay. In this study, the ELISA technique showed a higher sensitivity than the Bethesda assay in the detection of FVIII inhibitors in samples that were subjected to freezing and thawing procedures; this was because the Bethesda assay could not identify the FVIII inhibitors that were degraded after freezing and thawing.


Subject(s)
Blood Coagulation Factor Inhibitors/analysis , Enzyme-Linked Immunosorbent Assay , Factor VIII , Hemophilia A/blood , Humans , Immunologic Tests , Male
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