Identification of pulmonary paragonimiasis using Ziehl-Neelsen stain

Pulmonary paragonimiasis and tuberculosis are endemic in Asia, South America, and Africa. However, differential diagnosis among the diseases is difficult because they present with similar clinical symptoms and diagnostic features. Here, we report a case of pulmonary paragonimiasis that was identified using Ziehl-Neelsen stain after initially being assessed for pulmonary tuberculosis. Following anti-Paragonimus chemotherapy, the patient's symptoms, laboratory test results, and lung lesions improved. Thus, the identification of Paragonimus westermani using Ziehl-Neelsen stain can be considered in the diagnosis.

High-Resolution Melting Analysis for Genotyping Duffy Blood Group Antigens / 대한수혈학회지

BACKGROUND: Accurate typing of Duffy blood group is important because anti-Duffy antibodies cause hemolytic transfusion reaction and hemolytic disease of the newborn. The aim of this study was to evaluate a new genotyping method using high resolution melting (HRM) analysis, a rapid and inexpensive approach for high-throughput Duffy genotyping. METHODS: A total of 20 unrelated Korean blood samples were obtained and an African-black sample was used for GATA control. Phenotyping was performed by hemagglutination (DiaMed AG, Switzerland). GATA and FYA/B PCR products were obtained by PCR-restriction fragment length polymorphism (RFLP) using Taq DNA polymerase (Promega, WI) and enzymes BanI and StyI (New England Biolab, UK). For HRM, PCR amplification was performed using LightCycler 480 ResoLight Dye (Roche, USA) and Lightcycer 480 (Roche, USA). RESULTS: Phenotyping and genotyping data using PCR-RFLP and HRM analysis were compared. Different types of HRM curves were obtained according to genotypes, FYA/FYA, FYB/FYB, and FYA/FYB, and to GATA mutations, homozygote FYB-33T (T/T), heterozygote FYB-33T/33C (T/C), and homozygote FYB-33C (C/C). Phenotypes 18 Fy(a+b-), 1 Fy(a+b+), 1 Fy(a-b+), and 1 Fy(a-b-) showed complete concordance with genotyping methods. Fy(a-b-) sample was found to be a FYB-33C homozygote by both genotyping methods. CONCLUSION: Phenotyping and genotyping showed concordant results and both genotyping methods using PCR-RFLP and HRM analysis showed good agreement in finding mutation in GATA and FY gene coding regions. HRM analysis is suitable and reliable for high-throughput screening for Duffy genotyping.

A Case of Diphyllobothrium latum Infection in a Patient with Abdominal Pain / 대한소화기학회지

The growing popularity of eating raw fish has resulted in increase of certain human parasitic infection, such as diphyllobothriasis. Even though, upper and lower gastrointestinal endoscopy reveal no specific abnormality, if a patient complains of persistent abdominal pain, we should consider the possibility of parasitic infection. Careful history taking and stool examination can avoid further invasive study. We report a case of Diphyllobothrium latum infection in a patient with vague abdominal pain who showed normal finding on endoscopy.

The genotyping of Kell, Duffy, and Kidd System in Korean / 대한수혈학회지

BACKGROUND: Among human blood group antigens, the genes for Kell, Duffy, and Kidd antigens have been recently identified, and those can play an important role in unexpected acute and delayed hemolytic transfusion reactions or hemolytic disease of newborns. The determination of blood group polymorphism at the genomic level facilitates the resolution of clinical problems that cannot be addressed by hemagglutination. They are useful to determine antigen types for which currently available antibodies are weakly reactive, type patients who have been recently transfused, identify fetuses at risk for hemolytic disease of the newborn and to increase the reliability of repositories of antigen negative RBCs for transfusion. METHODS: Two hundred peripheral blood samples were collected from normal population. Primer sets were used with slight modification from Reid M.E, et al. Bsm I, Ban I, and Mnl I were used from digestion of 5 uL PCR products. 10 uL of each digested-PCR products were electrophoresed on agarose or polyacrylamide gel with ethidium bromide staining. Kell, Duffy, and Kidd phenotypes (serologic types) were compared with respective genotypes by PCR-RFLP. RESULTS: The concordance rate was 100%: between genotype and phenotype 0 case(0%) K, 187 cases(100%) k; 22 cases(11.4%) Fy(a+b+), 171 cases(88.1%) Fy(a+b-), 1 case(0.5%) Fy(a-b+), 0 case(0%) Fy(a-b-); 95 cases(50.8%) Jk(a+b+), 39 cases(20.9%) Jk(a+b-), 53 cases(28.3%) Jk(a-b+), 0 case(0%) Jk(a-b-). In this study, Fyb frequency was 11.9% and it was equal to that of Japan and China. We analyzed each digested PCR product from 200 patients; Kell(187 cases), Duffy(194 cases), and Kidd(187 cases). CONCLUSIONS: The PCR-RFLP method can be effectively used for the Kell, Duffy, and Kidd typing and is particularly useful in cases where serological typing method is difficult as in autoimmune hemolytic anemia or recently transfused red blood cells in their circulation. Also, it is useful in cases of hemolytic disease in newborns and hemolytic transfusion reaction.

HLA-DQA1, HLA-DQB1 & HLA-DRB1 Alleles Distribution in Hepatitis B Vaccine Non-responder / 대한면역학회지

No abstract available.

Chemical Modification of RBC Surface Antigen with Methoxy Polyethylene Glycol / 대한임상병리학회지

BACKGROUND: Today, blood group antigens are a strong barrier of safe transfusion. We evaluated the change of agglutinability of antibody to RBC surface antigen before and after activated methoxy polyethylene glycol (mPEG) modification. METHODS: We collected blood from healthy volunteers and the blood were treated by activated mPEG (MW 5,000, Sigma, USA). Agglutinability of RBC was measured using anti-sera (Green Cross, Korea) in ABO and Rh(D) groups, and compared the agglutinability changes before and after mPEG treatment. RESULTS: The agglutinability of Rh(D) surface antigen (n=20) was disappeared after mPEG treatment. However, ABO antigens showed variable agglutinability against antisera, some of which showed no change at all. CONCLUSIONS: In the case of Rh(D) antigen, it would be useful to apply mPEG treated RBCs for clinical use, if the safety problem were solved. But in the case of ABO antigen, the more evaluation of the condition of reaction and the concentration of mPEG should be needed.

Removal of Yersinia enterocolitica from Packed RBCs with WBC-Reduction Filters / 대한임상병리학회지

BACKGROUND: Aseptic technique and cold storage of blood can reduce the incidence of transfusion-associated infections. But, none of these precautions eliminates the potential of drawing contaminated blood from an asymptomatic carrier with psychrophilic organisms such as Yersinia enterocolitica. We evaluated the ability of WBC-reduction filters to prevent the growth of bacteria in packed RBCs that are artificially inoculated with Y. enterocolitica. METHODS: Twenty units of packed RBCs donated from 20 healthy individuals were divided into 4 groups. Group A and B were inoculated with 10 CFU/mL of Y. enterocolitica and group C and D were inoculated with 100 CFU/mL of Y.enterocolitica. After 24 hours of cold storage, group A and C were filtered through WBC-reduction filter (Sepacell R 500A: Asai medical, Japan) and returned them to storage. Group B and D served as unfiltered controls. We collected blood weekly from day 1 to day 35 of storage. Bacterial growths were compared between 4 groups. RESULTS: The prefiltration WBC count was 8,880/ L (SD 1464.2/ L, n=20). After filtration residual WBC count was 210/ L (SD 99.8/ L, n=10). All cases of group B & D (10 & 100 CFU/mL inoculation without filtration) showed growth over 105 CFU/mL after 3 weeks storage. But in filtered groups, only 1/5 (20%) of group C (100 CFU/mL inoculation with filtration) and 4/5 (80%) of group A (10 CFU/mL inoculation with filtration) showed growth over 105 CFU/mL after 3 weeks. CONCLUSIONS: The use of WBC-reduction filter have ability to reduce the risk of transfusion transmitted bacteremia in packed RBCs.

Chemical modification of RBC surface antigen with glutaraldehyde crosslinking / 대한수혈학회지

BACKGROUND: The chemical modification of RBC surface antigen has many advantages for safe transfusion practice. We evaluated the change of antibody reactivity to RBC surface antigen before and after glutaraldehyde crosslinking. MATERIALS AND METHODS: The 10 mL of blood were collected from 20 volunteers and were treated by 2-3% glutaraldehyde at 4degrees C. After 30 minute incubation, Agglutinability of various RBC surface antigen (ABO, Rh-C, c, D, E, e) was measured by titration using anti-sera (Green Cross, Korea, Dade, USA), and compared the agglutinability changes before and after glutaraldehyde crosslinking. RESLUTS: The agglutinability of Rh surface antigens (D, C, c, E, e) was disappeared after glutaraldehyde crosslinking. However, ABO antigens (n=20) still showed strong agglutinability against antisera with some decreased. CONCLUSIONS: It would be useful to apply glutaraldehyde crossliked RBCs for rare blood group transfusion practice, if the safety problem were solved.

The Characteristics of Residual Leukocyte in Sepacell PLS-5A Filtered Platelet Concentrates / 대한혈액학회지

BACKGROUND: We evaluated residual leukocytes characteristics of white cell(WBC) reduction filter in platelet concentrates. Differential count and lymphocyte subset changes were measured before and after leukocyte filtration in platelet concentrates. MATERIAL AND METHODS: Ten units of platelet concentrates were prepared and were filtered with WBC-reduction filter(Sepacell PLS 5A, Japan). After filtration of blood products, WBC and differential leukocyte count and lymphocyte subsets were counted by microscopic examination of Wright-Giemsa stained smear and Facscan(Becton-Dickinson, USA). Monoclonal antibodies used for lymphocyte subset test were CD3(FITC), CD4(FITC), CD8(PE), CDl4(PE), CDl6(PE), CDl9(PE), CD33(PE), CD56(PE), IgGl(FITC), IgG2(PE). RESULTS: The main population of residual leukocytes after filtration was mainly lymphocytes(96.7%), and CD3 positive T lymphocytes showed 23.8% positivity of residual leukocyctes and the next were NK cell(8.7%). B lymphocytes were rarely found(<0.01%) and CD4/ CD8 ratio was within normal limits. CONCLUSION: The leukocyte reduction filters(Sepacell PLS-5A) would be effective for prevention of platelet alloimmunization but not sure about the effect for prevention of TA GVHD.

Acute Leukemias with Unusual Immunophenotypes / 대한임상병리학회지

BACKGROUND: Although immunophenotyping of leukemias has improved diagnostic accuracy and reproducibility, it has also caused diagnostic confusion regarding the lineage of leukemic cells. So far, lots of papers about acute leukemias with coexpression of another lineage markers with different technical methodologies and different criteria have been published in Korea and other countries. The authors investigated the frequency and immunophenotypic characteristics of the leukemias with aberrant lineage markers from data obtained at Korea University Hospital by a retrospective study. METHODS: From Jan. 1993 to Feb. 1996, 179 leukemias had been requested for immunophenotypig and 28 cases among them with unusual immunophenotypes were retrieved according to their immunophenotyping results. For the final diagnosis all the slides stained with Wright-Giemsa, peroxidase, Periodic-Acid Schiff, Sudan black B, and nonspecific esterase were re-examined, and all the flow cytometric results were reanalyzed. RESULTS: Among 28 cases, 3 cases(10%) were acute biphenotypic leukemias(BP) one with B lymphoid and myeloid markers and the other two with T lymphoid and myeloid markers. One case of intralineage bilinear acute leukemia(ILBL) with two separate populations of megakaryocytic cells and monocytic cells was noted. 6 cases(21%) were acute myeloblastic leukemias expressing lymphoid associated markers(Ly+AMLs; CD19) and 8 cases(28%) were myeloid antigen-positive acute lymphoblastic leukemias(My+ALLs, four with CD13+ and three with CD33+ and one with blastic transformation of chronic myelogeneous leukemia). Because of the change in diagnostic criteria, lymphocyte contamination, or low setting of negative control, 10 cases (36%) were not included to be of unusual immunophenotypes. CONCLUSIONS: Frequency of acute hybrid leukemia was 2.2 % of all leukemias. Ly+AMLs was 3.4%, and My+ALL was 4.4%. In conclusion, first, quality control of the flow cytometry and careful interpretation especially in terms of positive cut-off value and gating, are needed. Secondly, national guidelines for the criteria of the hybrid leukemia and My+ALLs and Ly+AMLs are necessary for the elucidation of the prognostic implication of those leukemias.

The study of RHD gene mutation in weak D / 대한수혈학회지

BACKGROUND: The weak D is characterized serologically by a weak or negative agglutination reaction with polyclonal anti-D in an immediate-spin test and agglutination is enhanced in the indirect antiglobulin test. Weak D has a lower number of D antigen or weaker antigen density than are normal D positive red cells. Here we studied the cause of weak D antigenicity at genetic level and compared to that of normal D RBCs. METHODS: The amplification of RHD gene and RHCcEe gene site was done in normal D(n=20), weak D(n=8), D negative group(n=20) by polymerase chain reaction and by based on D typing in these individuals compared to that of serologic D typing. In addition, to detect RHD gene mutation and nucleotide sequence difference of weak D group compared to normal D RBCs, single stranded conformational polymorphism PCR was simultaneuosly perfomed in two group by RHD amplified product(189 bp). We analysis the correlation RHD genotyping and serological phenotyping, and also analysis the difference of nucleotide sequence between two group in genetic level. RESULTS: The RHD genotyping was completely matched normal D(n=20), D negative group(n=20) but weak D group(n=8) showed same genotype of normal D RBCs. In single stranded conformational polymorphism PCR, weak D phenotypes does not show any abnormalities at the genomic level when compared to the RHD gene in normal D phenotypes. CONCLUSIONS: RHD PCR showed good correlation with conventional serologic test but weak D genotype was same as that of normal D RBCs. The weaker immunogenicity of weak D is not explained by genomic DNA difference itself.

Nocardia asteroides complex Isolated from Cerebrospinal Fluid and Surgical Wound Site: Three Case Reports / 대한임상병리학회지

Nocardia is an aerobic gram-positive, weak acid-fast, branching, filamentous bacteria causing various clinical infections such as pulmonary nocardiosis, systemic nocardiosis, extrapulmonary nocardiosis, cutaneous nocardiosis and nocardial mycetoma. They are most commonly caused by N. asteroides complex. Humans become infected by inhaling contaminated air-borne dust particles or by traumatic implantation of the bacterium into the subcutaneous tissues. We isolated Nocardia asteroides complex from the hemo-vac of trauma patient and CSFs of two hydrocephalus patients. Nocardia asteroides complex has been isolated less commonly in Korea than in other countries. We think that it is important to extend an incubation time of culture plate when we find the gram positive, branched, beaded filaments and coccoid cells.

Experience of Concurrent Collection of Plosrno During a Ploteletpheresls / 대한수혈학회지

BACKGROUND: There has been rapid increase in demand for fresh frozen plasma and its derivatives in Korea. It may be due to active therapy by the clinicians especially hematologic and coagulopathy areas. So, now, the plasma is lack of supply of full demand. So, We studied the concurrent collection procedure of plasma during a plateletpheresis for the purpose of plasma supply. METHODS: Over three month period from January 1996 to March 1996, we introduced a program of concurrent collection of plasma (CCP) during plateletpheresis at Korea University Guro Hospital, in which the additional plasma are collected for preparation of FFP. Donors were enrolled in our 62 volunteer plateletpheresis. The 31 volunteers (group I) were done plateletphersis only, another volunteers (group II) were done CCP. We compared the platelet concentrate volume, to the characteristics of donor's condition and the adverse reaction during plateletpheresis between two groups. RESULTS: Before the plateletpheresis, there were no differences in the age, weight, height, pre-platelet count between the two groups. Also there were no adverse reactions through the procedure, such as perioral paresthesia, hypotension, hyperventilataion, chills, nausea and vomiting. The mean platelet count per unit did not show significant differences between two groups. In group 1, the mean platelet concentrate volume was 300 mL, yield was 4.5 x 1011 and group II, the volume was 315 mL, the yield was 5.1 x 1011 and the fresh plasma volume was 223 mL. CONCLUSION: We have experienced the concurrent collection procedure of plasma during a plateletpheresis from 31 volunteers without main adverse reactions.

Mondini dysplasia and recurrent meningitis / 대한이비인후과학회지

No abstract available.