Recurred breast cancer presenting with autoimmune hemolytic anemia

No abstract available.

Del(5q) myelodysplastic syndrome combined with pure red cell aplasia

No abstract available.

Microangiopathic hemolytic anemia as initial presentation of recurrent colon cancer

No abstract available.

Small cell variant of T-cell prolymphocytic leukemia with atypical presentation

No abstract available.

Acute promyelocytic leukemia with normal karyotype initially diagnosed on bone marrow touch imprints

No abstract available.

Follicular lymphoma in leukemic phase with unusual morphology at diagnosis

No abstract available.

Multiple myeloma with spindle-like cell morphology

No abstract available.

Current routine practice and clinico-pathological characteristics associated with acute promyelocytic leukemia in Korea

BACKGROUND: Acute promyelocytic leukemia (APL) can be life threatening, necessitating emergency therapy with prompt diagnosis by morphologic findings, immunophenotyping, cytogenetic analysis, or molecular studies. This study aimed to assess the current routine practices in APL and the clinico-pathologic features of APL. METHODS: We reviewed the medical records of 48 Korean patients (25 men, 23 women; median age, 51 (20-80) years) diagnosed with APL in 5 university hospitals between March 2007 and February 2012. RESULTS: The WBC count at diagnosis and platelet count varied from 0.4 to 81.0 (median 2.0)x10(9)/L and 2.7 to 124.0 (median 54.5)x10(9)/L, respectively. The median values for prothrombin time and activated partial thromboplastin time were 14.7 (11.3-44.1) s and 29 (24-62) s, respectively. All but 2 patients (96%) showed a fibrin/fibrinogen degradation product value of >20 microg/mL. The D-dimer median value was 5,000 (686-55,630) ng/mL. The t(15;17)(q22;q12 and PML-RARA fusion was found in all patients by chromosome analysis and/or multiplex reverse transcriptase-polymerase chain reaction (RT-PCR), with turnaround times of 8 (2-19) d and 7 (2-13) d, respectively. All patients received induction chemotherapy: all-trans retinoic acid (ATRA) alone (N=11, 26%), ATRA+idarubicin (N=25, 58%), ATRA+cytarabine (N=3, 7%), ATRA+idarubicin+cytarabine (N=4, 9%). CONCLUSION: Since APL is a medical emergency and an accurate diagnosis is a prerequisite for prompt treatment, laboratory support to implement faster diagnostic tools to confirm the presence of PML-RARA is required.

Current routine practice and clinico-pathological characteristics associated with acute promyelocytic leukemia in Korea

BACKGROUND: Acute promyelocytic leukemia (APL) can be life threatening, necessitating emergency therapy with prompt diagnosis by morphologic findings, immunophenotyping, cytogenetic analysis, or molecular studies. This study aimed to assess the current routine practices in APL and the clinico-pathologic features of APL. METHODS: We reviewed the medical records of 48 Korean patients (25 men, 23 women; median age, 51 (20-80) years) diagnosed with APL in 5 university hospitals between March 2007 and February 2012. RESULTS: The WBC count at diagnosis and platelet count varied from 0.4 to 81.0 (median 2.0)x10(9)/L and 2.7 to 124.0 (median 54.5)x10(9)/L, respectively. The median values for prothrombin time and activated partial thromboplastin time were 14.7 (11.3-44.1) s and 29 (24-62) s, respectively. All but 2 patients (96%) showed a fibrin/fibrinogen degradation product value of >20 microg/mL. The D-dimer median value was 5,000 (686-55,630) ng/mL. The t(15;17)(q22;q12 and PML-RARA fusion was found in all patients by chromosome analysis and/or multiplex reverse transcriptase-polymerase chain reaction (RT-PCR), with turnaround times of 8 (2-19) d and 7 (2-13) d, respectively. All patients received induction chemotherapy: all-trans retinoic acid (ATRA) alone (N=11, 26%), ATRA+idarubicin (N=25, 58%), ATRA+cytarabine (N=3, 7%), ATRA+idarubicin+cytarabine (N=4, 9%). CONCLUSION: Since APL is a medical emergency and an accurate diagnosis is a prerequisite for prompt treatment, laboratory support to implement faster diagnostic tools to confirm the presence of PML-RARA is required.

Extramedullary blast crisis of secondary CML accompanying marrow fibrosis

No abstract available.

Large cell lymphoma as initial presentation of undetected chronic lymphocytic leukemia

No abstract available.

Evaluation of a Multiplex Real-time PCR Assay for the Detection of Respiratory Viruses in Clinical Specimens

BACKGROUND: In this study, we evaluated the analytical performance and clinical potential of a one-step multiplex real-time PCR assay for the simultaneous detection of 14 types of respiratory viruses using the AdvanSure RV real-time PCR Kit (LG Life Sciences, Korea). METHODS: Three hundred and twenty clinical specimens were tested with the AdvanSure RV real-time PCR Kit and conventional multiplex reverse transcription (RT)-PCR assay. The assay results were analyzed and the one-step AdvanSure RV real-time PCR Kit was compared with the conventional multiplex RT-PCR assay with respect to the sensitivity and specificity of the detection of respiratory viruses. RESULTS: The limit of detection (LOD) was 1.31 plaque-forming units (PFU)/mL for human rhinoviruses (hRVs), 4.93 PFU/mL for human coronavirus HCoV-229E/NL63, 2.67 PFU/mL for human coronavirus HCoV-OC43, 18.20 PFU/mL for parainfluenza virus 1 (PIV)-1, 24.57 PFU/mL for PIV-2, 1.73 PFU/mL for PIV-3, 1.79 PFU/mL for influenza virus group (Flu) A, 59.51 PFU/mL for FluB, 5.46 PFU/mL for human respiratory syncytial virus (hRSV)-A, 17.23 PFU/mL for hRSV-B, 9.99 PFU/mL for human adenovirus (ADVs). The cross-reactivity test for this assay against 23 types of non-respiratory viruses showed negative results for all viruses tested. The agreement between the one-step AdvanSure multiplex real-time PCR assay and the conventional multiplex RT-PCR assay was 98%. CONCLUSIONS: The one-step AdvanSure RV multiplex real-time PCR assay is a simple assay with high potential for specific, rapid and sensitive laboratory diagnosis of respiratory viruses compared to conventional multiplex RT-PCR.

Evaluation of Seeplex(TM) Pneumobacter Multiplex PCR Kit for the Detection of Respiratory Bacterial Pathogens in Pediatric Patients / 대한진단검사의학회지

BACKGROUND: Rapid identification of the causative agent among potential bacterial and viral pathogens is important for the management of acute respiratory disease. In this study, we evaluated the analytical performance and clinical usefulness of a recently-introduced multiplex PCR assay, Seeplex(TM)Pneumobacter detection kit (Seegene Inc., Korea) for the identification of respiratory bacterial pathogens. METHODS: One hundred and eighty one nasopharyngeal aspirates were collected from pediatric patients with respiratory symptoms and analysed by multiplex PCR for the detection of Streptococcus pneumoniae (S.P), Haemophilus influenzae (H.I), Mycoplasma pneumoniae (M.P), Chlamydophila pneumoniae (C.P), Bordetella pertussis (B.P) and Legionella pneumophila (L.P). A comparison of multiplex PCR with conventional culture for the isolation of S.P and H.I was performed on 112 specimens. The cross reactivity of multiplex PCR was also evaluated. RESULTS: Of 181 cases, 81 cases were positive by multiplex PCR (44.8%): 52 cases for S.P (28.7%), 47 cases for H.I (26.0%), 9 cases for M.P (5.0%), 3 cases for B.P (1.7%) and 1 case for C.P (0.6%) including multiple infection cases. The agreement rates between multiplex PCR and culture for S.P and H.I were 92.9% (kappa index=0.84, P<0.001) and 91.1% (kappa index=0.75, P<0.001), respectively. There was no cross reactivity with common bacterial and viral pathogens. CONCLUSIONS: Seeplex(TM) Pneumobacter detection kit could be a useful screening tool for the rapid detection of respiratory bacterial pathogens. Further studies with lower respiratory tract specimens would be needed for the clinical evaluation of S. pneumoniae and H. influenzae detected by multiplex PCR.

Evaluation of iQ200 Automated Urine Microscopy Analyzer / 대한진단검사의학회지

BACKGROUND: Microscopic examination of urine sediment is one of the most commonly performed tests in the clinical laboratory. However, manual microscopic sediment examination is labor-intensive, time-consuming and imprecise. In this study, we evaluated the analytical performance and clinical usefulness of a recently introduced image-based automated urinalysis system, Iris iQ200 (Iris Diagnostics, USA). METHODS: We assessed the iQ200 for linearity, precision and carryover rate using patient's samples and quality control materials. On 337 urine samples, urine sediment analyses performed by the iQ200 were compared with manual microscopy results. RESULTS: The iQ200 showed a good linearity (r2>0.99) for all cellular components analyzed. Within-run and total CVs on urine specimens and quality control samples were less than 10% except for within-run CV for the samples with low concentration of the squamous epithelial cells. The carryover rates were 0.21% for RBCs and 1.92% for WBCs. The agreement rates within one grade between the iQ200 and manual microscopy for RBCs, WBCs, and squamous epithelial cells were 93.8%, 94.2% and 96.9%, respectively. CONCLUSIONS: Since the iQ200 showed a reliable analytical performance and good concordance with manual microscopy, it could be useful in the clinical practice as a screening procedure.

Evaluation of the Usefulness of Kobias HBsAg and Anti-HBs / 대한진단검사의학회지

BACKGROUND: The analysis of serological markers for hepatitis B virus (HBV) is a useful tool for the prevention and diagnosis of HBV infection. In this work, we evaluated a newly improved domestic rapid assay, Kobias HBsAg and anti-HBs Window kits (Kobias, Korea) for the detection of HBsAg and anti-HBs in serum. METHODS: A total of 360 sera screened by enzyme immunoassay (EIA) (Enzygnost, DADE Behring, Germany) were included in this study. Each specimen was tested for HBsAg and anti-HBs by Kobias Window kits and Genedia Rapid device (Green Cross, Korea), conventional one step test kits. The results were compared with those of EIA. RESULTS: The sensitivity and specificity of Kobias HBsAg were 99.2% and 96.7%, and those of Kobias Anti-HBs were 95.8% and 96.7%, respectively. The concordance rates between EIA and Kobias HBsAg and Kobias Anti-HBs were 98.3% and 96.1%, and those between Kobias kits and Genedia kits for HBsAg and anti-HBs were 97.8% and 93.9%, respectively. CONCLUSIONS: Kobias HBsAg/Anti-HBs kits are simple, rapid, and low-cost methods for detecting HBsAg and anti-HBs. With comparable results with EIA, the Kobias HBsAg/Anti-HBs kits could be suitable for screening purposes or in emergency situations.

Relationship of Free Fatty Acid/Albumin Molar Ratio with Indicators of Erythrocyte Injury in Clinical Conditions with Hypoalbuminemia / 대한임상병리학회지

BACKGROUND: Free fatty acids are well known as an energy source. However, theoretically it could be destructive through oxygen free radical chain reactions unless they are bound to albumin in blood. Recently, the toxicity of oxidative agents in several diseases, and additionally the behavior of antioxidants including albumin against this have been suggested. Therefore, we investigated the relationship between free fatty acid/albumin molar ratio and erythrocyte injury in this study. METHODS: Free fatty acid and albumin were analysed in thirty-eight hypoalbuminemia patients and fifty-six healthy controls. To measure the erythrocyte injury, hemoglobin, absolute and relative reticulocyte counts, and lactate dehydrogenase (LD) were also examined. In addition, glutathione peroxidase (GPX) and superoxide dismutase (SOD) were determined in both fifteen patients and fifteen controls, respectively. RESULTS: The albumin levels in study group (3.06+/-0.28 g/dL) were significantly lower than those of control group (4.94+/-0.21 g/dL). The hemoglobin, reticulocyte counts, and LD levels in study group were significantly different from those of control group (P<0.01), but the free fatty acid concentrations showed no difference between two groups. The free fatty acid/albumin molar ratio in study group was significantly higher than control values. In study group, there were significant correlations between the free fatty acid/albumin molar ratio and (a) LD (r=0.43, P< 0.05), (b) relative reticulocyte count (r=0.39, P<0.05), and (c) hemoglobin (r=-0.31, P<0.01), respectively. The GPX and SOD activities in study group were not statistically different from the control values. There was an inverse correlation between albumin and GPX concentrations in study group (r=-0.36, P<0.01). CONCLUSIONS: These results suggest that toxic effect of unbound free fatty acid with decreased albumin activity as antioxidant may be involved in the cellular injury in hypoalbuminemia patients. Further studies for the correlation of free fatty acid/albumin molar ratio with individual antioxidant status are needed.

An Analysis of Nicotine and its Metabolites in Plasma and Urine Samples of Tobacco Smokers and Nonsmokers by High Performance Liquid Chromatographic Method / 대한임상병리학회지

BACKGROUND: Smoking has been suggested to invoke many health problems. Nicotine, one of the effective major components of tobacco smoke, has a half-life less than 2 hours and is oxidized to its major metabolite, cotinine. This study was conducted to establish the measurement system of nicotine and cotinine by high performance liquid chromatographic method (HPLC) and to set reference range in Korean population. METHODS: Fifteen nonsmokers (25-66 years old, 37.9 average) and 30 smokers (22-63 years old, 27.9 average) were investigated. We modified the methods from Kyerenmaten, et al. and from Hariharan, et al. Urine and heparinized plasma samples were pretreated. Pretreated samples were injected into Waters u-Bondapak C18 reverse column (3.9 mm 30 cm) of Waters HPLC system unit with flow rate of 2 mL/min. Absorbance was monitored at 254 nm of wavelength. RESULTS: The retention times of the NNX (nicotine-1'-N-oxide), cotinine, and nicotine peaks were 2.9, 3.7, 5.1 min, respectively, and readily delayed with increase of pH in the mobile phase. Nicotine and cotinine levels in plasma and urine samples by a modified HPLC method showed high linearity from 0 to 1000 ng/mL for both compounds. Intra- and inter-assay coefficients of variation were 7.49% and 6.54%, respectively for nicotine assay and 5.71% and 14.20%, respectively for cotinine assay. The averages and standard deviations for plasma cotinine, nicotine, urine cotinine, and nicotine in nonsmokers (N=15) were 277.8+/-313.9, 0.7+/-2.4, 382.0+/-273.7, and 17.2+/-27.5 ng/mL, respectively, and in smokers (N=30) were 312.9+/-267.1, 26.3+/-50.1, 1,049.2+/-556.2, and 555.7+/-895.1 ng/mL, respectively (P=0.351, 0.009, 0.0026, 0.000004). CONCLUSIONS: A modified HPLC method for nicotine and cotinine measurement showed a high precision and accuracy. Nicotine and cotinine levels in plasma and urine samples of smokers were significantly higher than those of non-smokers, except for plasma cotinine in passive smokers of nonsmoker group. And this method can be used as a routine test for detection of passive smoking and managing of smoking habit. Reference values of nicotine and cotinine measured in Korean nonsmokers and smokers were suggested.

RBC Sorbitol Analysis in Diabetes Mellitus / 대한임상병리학회지

BACKGROUND: Red blood cell (RBC) sorbitol has been implicated in the pathogenesis of organic complications of diabetes mellitus. W8 investigated RBC sorbitol level as an indicator of glucose control or diabetic complications, and also evaluated whether RBC sorbitol/plasma glucose ratio is an indicator of diabetic complications. METHODS: RBC sorbitol levels were measured in 43 healthy persons and 133 diabetes mellitus (DM) patients by enzymatic method. We also tested linearity, inter- and intra- assay precisions. Plasma glucose and Hb Alc were measured by hexokinase method and HPLC, respectively. Hospital records were reviewed. RESULTS: The intra- and inter-assay coefficients of variation of RBC sorbitol test are 8.7% and 28.5%, respectively. Linearity is good. The RBC sorbitol level(3.60+/-1.00 ug/mL) and RBC sorbitol/plasma glucose ratio (2.37+/-0.98%) in diabetic patients are significantly higher than those in normal control (1.69+/-0.43 ug/mL, 1.85+/-0.49 per mill), respectively(p<0.0001). We can't observe correlation between RBC sorbitol and Hb Alc in BM patients, but observe that in non-treatment DM patients. We also observed correlation between Hb Alc and glucose and reverse correlation between RBC sorbitol ratio and Hb Alc. We can't find significant relation between diabetic complications and RBC sorbitol or RBC sorbitol/plasma glucose. CONCLUSIONS: We suggest that the reference range of normal RBC sorbitol level and RBC sorbitol/plasma glucose ratio by enzymatic method are 1.69+/-0.86 ug/mL and 1.85+/- 0.98%,. These Ire significantly different from DM patients and may be useful in diagnosis of DM.

RBC Sorbitol Analysis in Diabetes Mellitus / 대한임상병리학회지

BACKGROUND: Red blood cell (RBC) sorbitol has been implicated in the pathogenesis of organic complications of diabetes mellitus. W8 investigated RBC sorbitol level as an indicator of glucose control or diabetic complications, and also evaluated whether RBC sorbitol/plasma glucose ratio is an indicator of diabetic complications. METHODS: RBC sorbitol levels were measured in 43 healthy persons and 133 diabetes mellitus (DM) patients by enzymatic method. We also tested linearity, inter- and intra- assay precisions. Plasma glucose and Hb Alc were measured by hexokinase method and HPLC, respectively. Hospital records were reviewed. RESULTS: The intra- and inter-assay coefficients of variation of RBC sorbitol test are 8.7% and 28.5%, respectively. Linearity is good. The RBC sorbitol level(3.60+/-1.00 ug/mL) and RBC sorbitol/plasma glucose ratio (2.37+/-0.98%) in diabetic patients are significantly higher than those in normal control (1.69+/-0.43 ug/mL, 1.85+/-0.49 per mill), respectively(p<0.0001). We can't observe correlation between RBC sorbitol and Hb Alc in BM patients, but observe that in non-treatment DM patients. We also observed correlation between Hb Alc and glucose and reverse correlation between RBC sorbitol ratio and Hb Alc. We can't find significant relation between diabetic complications and RBC sorbitol or RBC sorbitol/plasma glucose. CONCLUSIONS: We suggest that the reference range of normal RBC sorbitol level and RBC sorbitol/plasma glucose ratio by enzymatic method are 1.69+/-0.86 ug/mL and 1.85+/- 0.98%,. These Ire significantly different from DM patients and may be useful in diagnosis of DM.