Current Status of Flow Cytometric Immunophenotyping of Hematolymphoid Neoplasms in Korea

Background@#Flow cytometric immunophenotyping of hematolymphoid neoplasms (FCIHLN) is essential for diagnosis, classification, and minimal residual disease (MRD) monitoring. FCI-HLN is typically performed using in-house protocols, raising the need for standardization. Therefore, we surveyed the current status of FCI-HLN in Korea to obtain fundamental data for quality improvement and standardization. @*Methods@#Eight university hospitals actively conducting FCI-HLN participated in our survey.We analyzed responses to a questionnaire that included inquiries regarding test items, reagent antibodies (RAs), fluorophores, sample amounts (SAs), reagent antibody amounts (RAAs), acquisition cell number (ACN), isotype control (IC) usage, positiveegative criteria, and reporting. @*Results@#Most hospitals used acute HLN, chronic HLN, plasma cell neoplasm (PCN), and MRD panels. The numbers of RAs were heterogeneous, with a maximum of 32, 26, 12, 14, and 10 antibodies used for acute HLN, chronic HLN, PCN, ALL-MRD, and multiple myeloma-MRD, respectively. The number of fluorophores ranged from 4 to 10. RAs, SAs, RAAs, and ACN were diverse. Most hospitals used a positive criterion of 20%, whereas one used 10% for acute and chronic HLN panels. Five hospitals used ICs for the negative criterion. Positiveegative assignments, percentages, and general opinions were commonly reported. In MRD reporting, the limit of detection and lower limit of quantification were included. @*Conclusions@#This is the first comprehensive study on the current status of FCI-HLN in Korea, confirming the high heterogeneity and complexity of FCI-HLN practices. Standardization of FCI-HLN is urgently needed. The findings provide a reference for establishing standard FCI-HLN guidelines.

Comparative Study on the Immunogenicity of COVID-19 mRNA Vaccines in Patients Receiving Adjuvant and Palliative Chemotherapy / 전남의대학술지

This study was conducted to investigate potential differences in vaccine efficacy between patients undergoing palliative chemotherapy and receiving adjuvant chemotherapy. Additionally, the study proved the influence of vaccination timing on vaccine efficacy during active chemotherapy. Anti-receptor-binding domain (RBD) IgG binding antibody assays and surrogate neutralizing antibody assays were performed after BNT162b2 or mRNA-1273 vaccination in 45 solid cancer patients (23 adjuvant and 22 palliative chemotherapy) and in 24 healthy controls before vaccination (baseline), at every two to four weeks after the first (post-dose 1) and the second vaccination (post-dose 2). The levels of anti-RBD IgG and neutralizing antibodies increased significantly from baseline through post-dose 1 to post-dose 2 in all three groups. At the post-dose 1, the anti-RBD IgG and neutralizing antibody levels were significantly lower in cancer patients than in healthy controls. However, by post-dose 2, the seropositivity of anti-RBD IgG and neutralizing antibodies uniformly reached 100% across all groups, with no significant disparity in antibody levels among the three groups. Moreover, the antibody titers were not significantly different between patients with a vaccine and chemotherapy interval of more than 14 days or those with less than 14 days. This study demonstrated that after second doses of mRNA COVID-19 vaccines, humoral immune responses in patients receiving chemotherapy were comparable to those of healthy controls, regardless of whether the purpose of the anti-cancer treatment was palliative or adjuvant. Furthermore, the timing of vaccination did not affect the level of humoral immunity after the second vaccination.

Evaluation of the Appropriateness of Platelet Transfusions at Two Tertiary Hospitals / 대한수혈학회지

Background@#Appropriate platelet transfusion is essential for patient blood management and allocating limited healthcare resources. Therefore, this study evaluated the appropriateness of platelet transfusion in two tertiary hospitals. @*Methods@#At Chonnam National University Hospital (Hospital A) and Chonnam National University Hwasun Hospital (Hospital B), 1,470 platelet transfusions (299 and 1,171 cases at Hospitals A and B, respectively) during a single month were reviewed retrospectively using the Korean Transfusion Guidelines (5th edition). @*Results@#The most common indications were therapeutic transfusion to ensure hemostasis (54.8%) at Hospital A and to prevent spontaneous bleeding in patients with hematologic/oncologic diseases (65.8%) at Hospital B. Overall, 87.3% and 76.3% of transfusions were appropriate at Hospitals A and B, respectively. According to the different transfusion indications, the therapeutic transfusions were appropriate in more than 80% of cases in both hospitals.The appropriateness of prophylactic transfusions against spontaneous bleeding was 80.7% and 69.3%, respectively, and those before surgery or invasive procedures were 72.0% and 66.2%, respectively. Of the 38 and 278 inappropriate transfusions in Hospitals A and B, respectively (as determined by pre-transfusion platelet counts), most cases had platelet counts between 50 and 100×109 /L in Hospital A (23 cases) and between 20 and 50×109 /L in Hospital B (198 cases). @*Conclusion@#The two hospitals differed in terms of transfusion indications, appropriateness, and cases of inappropriateness. The indications and appropriateness of platelet transfusion should be reviewed in real practice on a hospital-by-hospital basis to improve transfusion management.

Performance Evaluation of VITEK MS for the Identification of a Wide Spectrum of Clinically Relevant Filamentous Fungi Using a Korean Collection

The correct identification of filamentous fungi is challenging. We evaluated the performance of the VITEK MS v3.0 system (bioMérieux, Marcy-l’Étoile, France) for the identification of a wide spectrum of clinically relevant filamentous fungi using a Korean collection. Strains that were added to the upgraded v3.2 database were additionally identified by the VITEK MS v3.2 system. Of the 105 tested isolates, including 37 Aspergillus (nine species), 41 dermatophytes (seven species), and 27 other molds (17 species), 43 (41.0%) showed “no identification” or “multiple species identification” results at the initial VITEK MS testing; these isolates were retested using the same method. Compared with sequence-based identification, the correct identification rate using VITEK MS for Aspergillus, dermatophytes, other molds, and total mold isolates was 67.6%, 56.1%, 48.1%, and 58.1% at the initial testing and 94.6%, 78.0%, 55.6%, and 78.1% with retesting, respectively. Following retesting, 19 (18.1%) and two (1.9%) isolates showed “no identification” and “misidentification” results, respectively. VITEK MS reliably identified various filamentous fungi recovered in Korea, with a very low rate of misidentification

Attention-Deficit/Hyperactivity Disorder Symptom Characteristics in Korean Elementary School Children: Comparison with US Population

OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in elementary school children. The present study investigated the characteristics of ADHD in Korean elementary school children using the Korean version of the ADHD Rating Scale (K-ARS). The data was compared with those obtained from a comparable American population. METHODS: Participants included 29,914 elementary school children, aged 6–12 years, from a medium-sized city. The parents completed the home version of the K-ARS. The total and subscale-specific normative data and sex- and age-related mean score differences were analyzed. These data were compared with those obtained from the American population using independent t-tests. RESULTS: Mean total and subscale K-ARS scores were significantly higher among boys (vs. girls) and younger children aged equal to or less than 8 years old (vs. older children). Mean scores on the hyperactivity-impulsivity subscale were lower than those of American children, but similar to another Korean sample. CONCLUSION: Our data characterized ADHD symptoms in Korean children. However, further studies are needed to identify the cultural differences underlying ratings of ADHD symptom severity.

Suppression of the ERK–SRF axis facilitates somatic cell reprogramming

The molecular mechanism underlying the initiation of somatic cell reprogramming into induced pluripotent stem cells (iPSCs) has not been well described. Thus, we generated single-cell-derived clones by using a combination of drug-inducible vectors encoding transcription factors (Oct4, Sox2, Klf4 and Myc) and a single-cell expansion strategy. This system achieved a high reprogramming efficiency after metabolic and epigenetic remodeling. Functional analyses of the cloned cells revealed that extracellular signal-regulated kinase (ERK) signaling was downregulated at an early stage of reprogramming and that its inhibition was a driving force for iPSC formation. Among the reprogramming factors, Myc predominantly induced ERK suppression. ERK inhibition upregulated the conversion of somatic cells into iPSCs through concomitant suppression of serum response factor (SRF). Conversely, SRF activation suppressed the reprogramming induced by ERK inhibition and negatively regulated embryonic pluripotency by inducing differentiation via upregulation of immediate early genes, such as c-Jun, c-Fos and EGR1. These data reveal that suppression of the ERK-SRF axis is an initial molecular event that facilitates iPSC formation and may be a useful surrogate marker for cellular reprogramming.

A Study on Prevalence and Risk Factors for Varicose Veins in Nurses at a University Hospital

BACKGROUND: Lower-limb varicose veins (VVs) are common and known to have a higher prevalence among people who work in occupations requiring prolonged standing. In the Republic of Korea, however, VV-related occupational factors have seldom been examined. This study was conducted to assess the prevalence of VVs among nurses, an occupational group considered to be at high risk of VVs, and determine the occupational risk factors of prolonged standing. METHODS: Between March and August 2014, a questionnaire survey coupled with Doppler ultrasonography was conducted on the nurses working at a university hospital. RESULTS: A total of 414 nurses participated in the survey and diagnostic testing. From the survey analysis and test results, the prevalence of VVs in nurses was estimated to be 16.18%. Significant factors for venous reflux were age [odds ratio (OR) = 1.06, 95% confidence interval (CI) = 1.03–1.10], pregnancy (OR = 2.15, 95% CI = 1.17–3.94), and delivery (OR = 2.02, 95% CI = 1.08–3.78). The statistical significance of these factors was verified after risk adjustment for sociodemographic factors (OR = 3.40, 95% CI = 1.27–9.09). CONCLUSION: Factors significantly associated with venous reflux were increasing age and prolonged working hours (≥ 4 hours) in a standing position (OR = 2.80, 95% CI = 1.08–7.25), even after risk adjustment for sociodemographic factors. This study is significant in that an objective diagnosis of VVs preceded the analysis of the risk factors for VV incidence, thus verifying objectively that VVs are associated with occupations requiring prolonged hours of working in a standing position.

STAT3 expression is associated with poor survival in non-elderly adult patients with newly diagnosed multiple myeloma

BACKGROUND: Signal transducer and activator of transcription 3 (STAT3) is not only a key signaling molecule in the regulation of growth but is also involved in malignant transformation. We investigated the prognostic significance of STAT3 expression in 94 non-elderly adult patients (aged 38 to 65 yr) with newly diagnosed multiple myeloma (MM). METHODS: Tumor cell-specific phosphotyrosine-STAT3 (PY-STAT3) expression at the time of diagnosis was evaluated with dual immunohistochemical (IHC) staining for PY-STAT3 and CD138. RESULTS: PY-STAT3 positivity was detected in 10 patients (10.6%), including three who showed strong expression. PY-STAT3-positive patients had higher serum C-reactive protein and calcium levels at diagnosis than did PY-STAT3-negative patients. PY-STAT3 positivity had predictive value for poor progression-free survival (PFS; P=0.001) and overall survival (OS; P=0.003). Among the 60 patients who received frontline autologous stem cell transplantation, PY-STAT3-positive patients had poorer PFS than did PY-STAT3-negative patients (4.2 vs. 19.2 mo, respectively; P=0.013). Multivariate analysis identified PY-STAT3 expression as an independent prognostic factor for PFS (relative risk [RR]=2.706, P=0.014) and OS (RR=3.091, P=0.044). CONCLUSION: These data show that PY-STAT3 positivity, as determined using dual IHC, is a marker of poor prognosis in non-elderly adult patients with MM.

Characteristics of occupational musculoskeletal disorders of five sectors in service industry between 2004 and 2013

BACKGROUND: ‘Work related musculoskeletal disorders (WRMSDs)' have been mostly reported in the manufacturing industry but recently the occurrence of industrial injuries has been constantly increasing in the service industry. This research is going to analyze the data about workers' compensation for WRMSDs in five different service sectors and identify characteristics of occupations with the highest approved occupations. METHODS: According to the data released from the Korea Worker's Compensation & Welfare Service, the overview of 12,730 cases of workers' compensation for WRMSDs in five service sectors from 2004 to 2013 is going to be analyzed and the source data is going to be classified by the Korean Standard Classification of Occupations to select the top five occupations that have the highest number of approval. RESULTS: After selecting each five occupations from the service sector that have work related musculoskeletal disorders, the result showed that the occupation with the highest number of approval in the health and social care sector were the early childhood educators, cooks in the school canteens in education services sector, garbage collectors in the sanitation and similar services sector, deliverymen in wholesale and retail, consumer goods repair and building cleaners in general management businesses such as those in building maintenance. The major event observed in the top five occupations was the overexertion and reaction as a cause of WRMSDs. The day when the WRMSDs mostly occurred was on Monday and the most likely time was 10 am. The median days away from work and lost working days are 29–90 days and 0–50 days respectively. The difference in each occupation was observed in year of service, age, and gender. CONCLUSIONS: 83.21% of the approved cases of workers' compensation for WRMSDs occurred in the top 25 occupations in all of the five service sectors, which meant that the approval of workers' compensation is concentrated in specific occupations. This research is going to suggest preventive measures for work related musculoskeletal disorders in the service industry and to help prioritize the preventive measures. TRIAL REGISTRATION: Not applicable.

Constitutional Chromosomal Abnormality Identified in a Sibling Donor After Bone Marrow Stem Cell Transplantation in a Pediatric Patient with Acute Megakaryoblastic Leukemia

No abstract available.

Alteration of the SETBP1 Gene and Splicing Pathway Genes SF3B1, U2AF1, and SRSF2 in Childhood Acute Myeloid Leukemia

BACKGROUND: Recurrent somatic SET-binding protein 1 (SETBP1) and splicing pathway gene mutations have recently been found in atypical chronic myeloid leukemia and other hematologic malignancies. These mutations have been comprehensively analyzed in adult AML, but not in childhood AML. We investigated possible alteration of the SETBP1, splicing factor 3B subunit 1 (SF3B1), U2 small nuclear RNA auxiliary factor 1 (U2AF1), and serine/arginine-rich splicing factor 2 (SRSF2) genes in childhood AML. METHODS: Cytogenetic and molecular analyses were performed to reveal chromosomal and genetic alterations. Sequence alterations in the SETBP1, SF3B1, U2AF1, and SRSF2 genes were examined by using direct sequencing in a cohort of 53 childhood AML patients. RESULTS: Childhood AML patients did not harbor any recurrent SETBP1 gene mutations, although our study did identify a synonymous mutation in one patient. None of the previously reported aberrations in the mutational hotspot of SF3B1, U2AF1, and SRSF2 were identified in any of the 53 patients. CONCLUSIONS: Alterations of the SETBP1 gene or SF3B1, U2AF1, and SRSF2 genes are not common genetic events in childhood AML, implying that the mutations are unlikely to exert a driver effect in myeloid leukemogenesis during childhood.

Immature Teratoma and Subsequent Acute Promyelocytic Leukemia in a Pediatric Patient With XYY Syndrome

No abstract available.

Anterior Knee Pain after Intramedullary Nailing for Tibial Shaft Fractures

PURPOSE: To analyze the possible causes and incidence of the chronic anterior knee pain follow after closed intramedullary nailing for the tibial shaft fractures, in a retrospective aspect. MATERIALS AND METHODS: 52 patients who treated with intramedullary nailing for the tibial shaft fractures from January 2001 to October 2008 were reviewed. We analyzed the relationship between knee pain and the variables (sex, age, types of fracture, protrusion extent of intramedullary nailing on proximal tibia). The aspects of pain, its onset and relieving time, and how much it influences on daily living were analyzed retrospectively. For categorical variables, group variences were estimated using Chi-square test. RESULTS: 34 patients of 52 (65%) complaint of anterior knee pain followed after intramedullary nailing, and there were no statistical differences between pain and sex/age (p>0.05). Incidence of anterior knee pain becomes higher as the severity of fracture increases, but there was no statistical difference between pain and intramedullary nailing protrusion. Pain severity was mostly not influencing on daily living, and it mostly responded to conservative treatment. CONCLUSION: The incidence of anterior knee pain followed after intramedullary nailing was 65%, and its severity was mostly not influencing on daily living. There were no significant differences between pain and sex, age, protrusion extent of intramedullary nailing on proximal tibia, but as the severity of frature increases, the incidence of anterior knee pain became higher.

Serum Lipid Analysis Using Biphasic Electrophoresis / 임상검사와정도관리

BACKGROUND: Recently biphasic agarose gel electrophoresis method using Chol/Trig ComboTM for simultaneous detection of cholesterol and triglyceride on lipoprotein fractions has been developed to facilitate the classification and interpretation of abnormal lipoprotein patterns of patients with hyperlipidemia. The author analysed serum lipid profiles using Chol/Trig ComboTM in the patients of OPD in Department of Internal Medicine. METHODS: Measurement of serum cholesterol and triglyceride using enzymatic method was performed in the sera of 415 patients from April, 2006 to July, 2006. Simultaneously, we electrophoresed serum cholesterol and triglyceride using Chol/Trig ComboTM with analysis software (ED BANK, Helena Laboratories, Saitama, Japan). RESULTS: According to ATP III guideline, we set up standard cholesterol as 200 mg/dL and triglyceride as 150 mg/dL, respectively, and the patients were classified into control, hypercholesterolemic, hypertriglyceridemic and hypercholesterolemic/hypertriglyceridemic groups, respectively. Hypercholesterolemic group had higher HDL and LDL, hypertriglyceridemic group had higher HDL, VLDL and the rates of positive modified LDL, hypercholesterolemic/hypertriglyceridemic group have higher VLDL and the rates of positive modified LDL than the control. Otherwise, the rates of positive modified LDL were 19.8% in the control, 23.6% in the hypercholesterolemic group, 50.9% in hypertriglyceridemic group, and 39.3% in hypercholesterolemic/hypertriglyceridemic group. CONCLUSIONS: The frequency of the rates of positive modified LDL and VLDL was higher in the hypertriglyceridemic group than those in the control.

Serum Lipid Analysis Using Biphasic Electrophoresis / 임상검사와정도관리

BACKGROUND: Recently biphasic agarose gel electrophoresis method using Chol/Trig ComboTM for simultaneous detection of cholesterol and triglyceride on lipoprotein fractions has been developed to facilitate the classification and interpretation of abnormal lipoprotein patterns of patients with hyperlipidemia. The author analysed serum lipid profiles using Chol/Trig ComboTM in the patients of OPD in Department of Internal Medicine. METHODS: Measurement of serum cholesterol and triglyceride using enzymatic method was performed in the sera of 415 patients from April, 2006 to July, 2006. Simultaneously, we electrophoresed serum cholesterol and triglyceride using Chol/Trig ComboTM with analysis software (ED BANK, Helena Laboratories, Saitama, Japan). RESULTS: According to ATP III guideline, we set up standard cholesterol as 200 mg/dL and triglyceride as 150 mg/dL, respectively, and the patients were classified into control, hypercholesterolemic, hypertriglyceridemic and hypercholesterolemic/hypertriglyceridemic groups, respectively. Hypercholesterolemic group had higher HDL and LDL, hypertriglyceridemic group had higher HDL, VLDL and the rates of positive modified LDL, hypercholesterolemic/hypertriglyceridemic group have higher VLDL and the rates of positive modified LDL than the control. Otherwise, the rates of positive modified LDL were 19.8% in the control, 23.6% in the hypercholesterolemic group, 50.9% in hypertriglyceridemic group, and 39.3% in hypercholesterolemic/hypertriglyceridemic group. CONCLUSIONS: The frequency of the rates of positive modified LDL and VLDL was higher in the hypertriglyceridemic group than those in the control.

In Vitro Susceptibilities of Clinical Isolates of Aspergillus Species against Echinocandins / 감염과화학요법

BACKGROUND: Echinocandins are a new class of antifungal agents with potent in vitro and in vivo activities against Aspergillus species. We investigated the in vitro activity of caspofungin and micafungin against Korean clinical Aspergillus isolates. MATERIALS AND METHODS: A total of 100 clinical isolates of Aspergillus species (32 A. fumigatus, 26 A. flavus, 22 A. niger and 20 A. terreus) were tested. The susceptibilities of caspofungin, micafungin, amphotericin B and itraconazole were established by means of the Clinical and Laboratory Standards Institute (CLSI) M38-A microdilution methods. The results for caspofungin and micafungin were evaluated by using the end points of minimum inhibitory concentrations (MIC) and minimum effective concentration (MEC, the lowest concentration that produces short and aberrant hyphal branchings microsopically). RESULTS: The MEC ranges of caspofungin and micafungin against 100 isolates of Aspergillus species were 0.06 to 0.5 microgram/mL and 16 microgram/mL unexpectedly, in 5% (5/100) and 4% (4/100) of isolates, respectively, which resulted in the loss of a consistent correlation between the two endpoint readings. The MEC50 of all Aspergillus isolates for caspofungin and micafungin were 0.25 and < or =0.03 /mL, respectively, and the MIC50 for amphotericin B and itraconazole were 0.5 and 0.25 microgram/mL, respectively. There were no species-related differences in caspofungin and micafungin MECs for Aspergillus species. CONCLUSION: This data demonstrates excellent in vitro activity of echinocandins against clinical strains of Aspergillus species.

In Vitro Susceptibilities of Clinical Isolates of Aspergillus Species against Echinocandins / 감염과화학요법

BACKGROUND: Echinocandins are a new class of antifungal agents with potent in vitro and in vivo activities against Aspergillus species. We investigated the in vitro activity of caspofungin and micafungin against Korean clinical Aspergillus isolates. MATERIALS AND METHODS: A total of 100 clinical isolates of Aspergillus species (32 A. fumigatus, 26 A. flavus, 22 A. niger and 20 A. terreus) were tested. The susceptibilities of caspofungin, micafungin, amphotericin B and itraconazole were established by means of the Clinical and Laboratory Standards Institute (CLSI) M38-A microdilution methods. The results for caspofungin and micafungin were evaluated by using the end points of minimum inhibitory concentrations (MIC) and minimum effective concentration (MEC, the lowest concentration that produces short and aberrant hyphal branchings microsopically). RESULTS: The MEC ranges of caspofungin and micafungin against 100 isolates of Aspergillus species were 0.06 to 0.5 microgram/mL and 16 microgram/mL unexpectedly, in 5% (5/100) and 4% (4/100) of isolates, respectively, which resulted in the loss of a consistent correlation between the two endpoint readings. The MEC50 of all Aspergillus isolates for caspofungin and micafungin were 0.25 and < or =0.03 /mL, respectively, and the MIC50 for amphotericin B and itraconazole were 0.5 and 0.25 microgram/mL, respectively. There were no species-related differences in caspofungin and micafungin MECs for Aspergillus species. CONCLUSION: This data demonstrates excellent in vitro activity of echinocandins against clinical strains of Aspergillus species.

In Vitro Susceptibilities to Caspofungin and Micafungin of Clinical Isolates of Candida Species / 대한진단검사의학회지

BACKGROUND: Caspofungin and micafungin are echinochandins with potent activities against Candida species. However, in vitro susceptibility to these agents of clinical Candida isolates in Korea has not been fully surveyed. We determined minimum inhibitory concentrations (MICs) of caspofungin and micafungin against clinical isolates of Candida species. METHODS: A total of 107 blood isolates of Candida species (24 C. albicans, 25 C. tropicalis, 24 C. glabrata, 20 C. parapsilosis, 8 C. krusei, and 6 other Candida species) were tested by using the National Committee for Clinical Laboratory Standards M27-A2 broth microdilution methods. The in vitro antifungal activities and spectrum of caspofungin and micafungin were compared with those of amphotericin B, fluconazole, and itraconazole. RESULTS: Caspofungin and micafungin exhibited a broad-spectrum activity against Candida species: caspofungin MIC ranged from 0.125 to 1 microgram/mL and micafungin MIC from < or =0.03 to 1 microgram/mL. C. albicans, C. tropicalis and C. glabrata showed high susceptibility to caspofungin (MIC90, 0.25 to 0.5 microgram/mL) and micafungin (MIC90 , < or =0.03 microgram/mL), whereas C. parapsilosis was less susceptible to both echinocandins (MIC90, 1 microgram/mL). The MIC50 for caspofungin, micafungin, amphotericin B, fluconazole, and itraconazole were 0.25, < or =0.03, 0.5, 1, and 0.125 microgram/mL, respectively. Caspofungin MIC50 of C. glabrata and C. krusei isolates with decreased susceptibility to azoles were 0.25 and 0.5 microgram/mL, respectively, and micafungin MIC50 were < or =0.03 and 0.125 microgram/mL, respectively. CONCLUSIONS: These data showed an excellent in vitro activity of caspofungin and micafungin against clinical strains of Candida species, including isolates with reduced susceptibility to azoles.

Biphenotypic Acute Leukemia with BCR-ABL mRNA Transcript b3a2 Type: A Case Report with Review of the Literature / 대한진단검사의학회지

Biphenotypic acute leukemia (BAL) is a subtype of leukemia of ambiguous lineage in the World Health Organization classification system. About one third of the cases have the Philadelphia chromosome, and some cases are associated with other structural abnormalities involving 11q23. BAL is known to have a poor prognosis in both children and adults. According to the previously reported BAL cases with positive BCR-ABL fusion gene, most of the BCR-ABL mRNA transcript type was e1a2. So, we describe here a 30-year-old adult BAL case with the karyotype 46,XY,t(9;22)(q34;q11.2) resulting in a very rare b3a2 type of BCR-ABL mRNA transcript.

A Patient with RhD(el) (1227G>A) Failed to Produce Detectable Anti-D after Transfusion of RhD Positive Red Blood Cells / 대한수혈학회지

Only 0.15% of all donors in Korea are RhD negative, which has led to a chronic shortage of RhD negative blood. Most physicians are aware of the potential for RhD alloimmunization after transfusing RhD+ red blood cells into RhD- patients. Hence, the undertransfusion of RhD- patients might be occurring in Korea. A 66-year-old man without a history of transfusion tested negative for anti-D in his serum. In an emergency situation where RhD- blood was unavailable, the patient received two units of RhD+ RBCs. Anti-D was not detected over three months after the transfusion. The red cells of the patient showed no agglutination with the anti-D reagent and a negative result by the standard weak D test. The polymerase chain reaction-sequence specific primers (PCR-SSP) and sequencing revealed D(el) (1227G>A) in the patient.