Two Cases of Anti-M of Donated Bloods Confirmed at pH 6.5 / 대한수혈학회지

Anti-M is detected at room temperature and is often found in the sera of people who have never been exposed to human red cells. In a few cases, anti-M can be detected at 37 degrees C or at the antiglobulin phase, and these antibodies can cause hemolytic diseases in newborn or hemolytic transfusion reactions. Some examples of anti-M demonstrate stronger agglutination at low pH (pH 6.5), and when they react with the red blood cells of the MM type (dosage effect). An unexpected antibody test was carried out for the routine screening of donated blood and two cases that reacted to all panel cells at 5 degrees C were found, which indicated anti-M. We repeated the unexpected antibody identification test at pH 6.5 and confirmed the presence of anti-M. The reduction of the test system pH is a useful and simple method for detecting some cases of anti-M.

Cryopreservation and Thawing of Red Blood Cells Using Haemonetics ACP 215 / 대한진단검사의학회지

BACKGROUND: The FDA has approved the storage of frozen red blood cells (RBCs) at -80degrees C for 10 years. After deglycerolization, the RBCs can be stored at 4degrees C for no more than 24 hours, because open systems are currently being used. We evaluated Haemonetics ACP 215, an automated, functionally closed system, for both the glycerolization and deglycerolization processes. METHODS: Thirty packed RBCs that had been glycerolized and stored at -80degrees C for 2 weeks were thawed, deglycerolized and resuspended in AS-3. The RBCs were then stored at 4degrees C for 2 weeks. For the evaluation of the procedure, RBC recovery rate, osmolarity, specific gravity, LDH, K+, Hb-2, 3 DPG, Hb-ATP, and plasma hemoglobin were tested at day 0 and day 14. RESULTS: The recovery rate of RBCs was 83.7+/-2.6% (78.9-88.8%). The Hb ATP and 2, 3-DPG of RBCs were 5.16+/-1.0 mol/g Hb and 10.4+/-2.4 mol/g Hb, respectively, at day 0. The supernatant K+, specific gravity, osmolarity, LDH were 1.3+/-0.6 mmol/L, 1.008+/-0.001, 295.0+/-3.1 mOsm/kgH2O, 175.0+/-39.0 unit/L, respectively. All measurements were acceptable to allow the RBCs deglycerolized on ACP 215 to be stored at 4degrees C for 14 days. The blood cultures were negative at day 0 and day 14. CONCLUSIONS: Haemonetics ACP 215 provides a closed, automated system for RBC glycerolization and deglycerolization. This study showed that the RBCs that were glycerolized and deglycerolized in the automated instrument and stored in AS-3 at 4degrees C for 14 days are of an acceptable quality.

A Case of Anti-Wr(a) with Anti-E / 대한수혈학회지

Authors found a case of anti-Wr(a) with anti-E antibody in 67 years old female patient. Anti-Wr(a) in Korea was reported for the first time in 2005. Anti-Wr(a) has been associated with hemolytic transfusion reaction (HTR) and hemolytic disease of the newborn (HDN). It is necessary to study the incidence of Wr(a) antigen and anti-Wr(a) in Korea.

The Clinical Significance of Prenatal Antibody Screening Test / 대한수혈학회지

BACKGROUND: It is recommended that ABO, Rh typing and unexpected antibody screening should be tested during pregnancy in order to prevent hemolytic disease of the newborn (HDN). However, it is unclear that a routine prenatal antibody screening test predicts the occurrence of HDN. We performed a retrospective study to determine the frequency of unexpected antibody during pregnancy, antibody specificity, and the usefulness of prenatal antibody screening as a predictor of HDN. METHODS: All 6,293 prenatal antibody screening were tested at Eulji hospital from April 1997 to December 2002. The results of antibody screening and identification test were reviewed in laboratory sheet. The past transfusion and pregnant history and postnatal HDN evidence were reviewed in pregnant women with positive antibody screening. A commercial two cell panel, Selectogen I, II, and panel cell (Ortho Diagnostic Systems Inc., Raritan, USA) were used with tube method until March 1999. In April 1999, reagent cells were changed to a gel agglutination test with ID-Diacell I, II and ID-Dia Panel of DiaMed-ID Micro Typing System (DiaMed AG, Cressier, Switzerland). RESULTS: Positive results of antibody screening test were found in 52 cases (0.83%, 52/6,293). Only 28 cases of them were tested antibody identification. Antibody specificity was identified at 22 cases and 17 (77.3%, 17/22) women had unexpected antibodies which are not associated with HDN. They were 11 with anti-Lea , 3 with anti-Leb, and 3 with anti-P1. The others were 3 cases of anti-E, 1 of anti-M, and 1 of anti-S. However, no one had evidence of HDN. CONCLUSION: These results suggest that routine prenatal antibody screening may not be necessary for all pregnant women except Rh (D) negative women or those who have a history of HDN.

ABO Gene Analysis of Discrepant ABO Blood Group in Blood Donors / 대한수혈학회지

BACKGROUND: An exact ABO blood group is essential for prevention of transfusion accident and safe transfusion therapy. It is known that one of causes of ABO discrepancies is ABO subgroup caused by genetic polymorphism. Therefore, we analyzed ABO genotype of ABO discrepancies in blood donors and studied the distribution and cause of ABO discrepancies. METHODS: This study examined 118 samples showing ABO discrepancies of ABO blood typing between May 2003 and Dec 2003. ABO genotyping using the polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) method was performed on 118 samples. Restriction enzymes including BssH II, Kpn I and Alu I were used for PCR-RFLP. RESULTS: The genotypes of 118 cases were composed of 43 cases of A/B, 12 cases of A/O, 10 cases of B/O, 1 case of B/B, 37 cases of cis-AB/O, 4 cases of cis-AB/A, 11 cases of cis-AB/B. The genotype of cis-AB/O showed 32 cases with phenotype A2 B3 , 2 cases with phenotype A2 B, 2 cases with phenotype A1 B3 , 1 case with phenotype Ael B. The genotype of cis-AB/B showed 11 cases with phenotype A2 B, and cis-AB/A showed 2 cases with phenotype A2 B3 , 1 case with phenotype A1 Bx and 1 case with phenotype A1 Bel. CONCLUSION: These data demonstrated that the most frequent genotype of ABO discrepancies in our study is cis-AB. The most predominent phenotype of cis-AB/O is A2 B3 . ABO genotyping is useful in resolving ABO discrepancies, and determination of ABO subgroups.

Evaluation of HLC-723 G7 Hemoglobin A1c Autoanalyzer / 임상검사와정도관리

BACKGROUND: We evaluated the performance and analysis time of HLC-723 G7 (Tosoh corp. Tokyo, Japan) hemoglobin (Hb) A1c autoanalyzer. It utilizes cation exchange high performance liquid chromatography (HPLC) method and has a reduced analysis time compared with that of an earlier model HLC-723GHb V A1c 2.2(TM) (HLC-723GHb V, Tosoh corp. Tokyo, Japan). METHODS: We evaluated linearity, precision and comparison with HLC-723GHb V following NCCLS guidelines and counted the number of tests per hour to estimate analysis time. RESULTS: Linearity through the range from 5.8% to 13.9% was good (r2=0.9930, relative nonlinearity <2.5%). The within-run coefficients of variation (CVs) for groups of low, middle, and high level were 1.09%, 0.76%, and 0.68% and total CVs for each group were 1.60%, 0.91%, and 1.00%, respectively. Correlation equation between HLC-723 G7 and HLC-723GHb V was HLC-723 G7=1.0308 (HLC-723GHb V)-0.2896 %Hb A1c (r=0.9992, P<0.0001). Analysis time of HLC-723 G7 was 1.2 minutes per test compared with 2.1 minutes of HLC-723GHb V. CONCLUSIONS: HLC-723 G7 showed the acceptable performance and shortening analysis time therefore, it was suitable for reducing turn around time of Hb A1c assay.

The Effect of Microdose Gonadotropin-releasing Hormone Agonist on Secretion of Gonadotropins and Estradiol in Normally Menstruating Women / 대한산부인과학회잡지

OBJECTIVES: The microdose of gonadotrophin-releasing hormone agonist (GnRHa) has been suggested as a beneficial method of ovulation induction for poor responders. However, the effect of microdose of GnRHa itself has not been evaluated yet. We performed a prospective sutdy to assess the effect of microdose of GnRHa (5 microgram of triptorelin acetate) on the luteinizing hormone (LH) and follicle stimulating hormone (FSH). Secondary objective of this study is to assess how long the down-regulation of gonadotrophin secretion by microdose GnRHa persists. METHODS: Five microgram of triptorelin was injected daily into five normally menstruating women for 7 days starting from cycle day 3. The blood sample was drawn for 12h with 4h interval, then for 6days with 4 h interval and once a day for 14days, In next cycle, same amount of triptorelin was injected into the same subjects daily for 3 days. The blood sample was drawn twice a day for 20days. Serum FSH, LH and extradiol level was measured. RESULTS: The serum LH and FSH level increased rapidly after injection of first GnRHa. The FSH level reached peak (27.53+/-6.34 IU/l) in 5h while LH level reached peak (34.35+/-7.18 IU/l) in 4h. The flare of gonadotrophins persisted even after second and third day injection of GnRHa, although the peak levels were not as high as first injection. The down regulation of gonadotrophin was established in 4-5 days. The estradiol level increased for 4-5 days then decreased. When GnRHa was given for 7days, the estradiol level began to rise 7-8 days after last injection; when given for 3days, the estradiol level began to rise 3-6 days after last injection. CONCLUSION: Even with ultra-low dose of GnRHa, the down-regulation of gonadotrophin could be achieved. The flare-up of gonadotrophin would persist for 3days with this dose. The duration of down regulation was influenced by the duration of GnRHa administration.

CT Findings of Diffuse Pneumocephalus due to Bacterial Meningitis: A Case Report

We report a case of diffuse pneumocephalus due to infection. Brain CT revealed diffuse brain swelling and diffuse pneumocephalus in the ventricular system, subarachnoid space, subdural/epidural space and superior sagittal sinus. CSF disclosed the presence of a yellowish-green pus-like liquid. Polymerase chain reaction was positive for Haemophilus influenza Ag.

Evaluation of VARIANTTM II Hemoglobin A1c Autoanalyzer / 대한임상병리학회지

BACKGROUND: We evaluated newly introduced VARIANTTM II(Bio-Rad Laboratories, CA, USA) hemoglobin(Hb) A1c autoanalyzer, including bar code reading, cap-piercing system and automatic hemolyzing. It utilizes ion-exchange high performance liquid chromatography(HPLC) method. METHODS: Linearity, precision, comparison with Hi-AUTOA1cTM HA-8121(Kyoto Daiichi, Kagaku Co. Ltd, Kyoto, Japan) and analysis time were evaluated. The reference range was determined by VARIANTTM II from 120 healthy subjects. RESULTS: Linearity through the range from 5.8% to 14.7% was good(r2=0.9909). The within-run coefficients of variation(CVs) for groups of low, middle and high level were 3.07%, 1.96% and 2.14% and between-day CVs for each group were 2.35%, 3.09% and 2.10%, respectively. Correlation equation between VARIANTTM II and Hi-AUTOA1cTM HA-8121 was VARIANTTM II = 1.0886(Hi-AUTOA1cTM HA-8121) + 0.4760% Hb A1c(r=0.9906). Two instruments were also compared by Altman and Bland's method and mean bias was 1.20. Analysis time of VARIANTTM II was 15.6 tests per hour compared with 14.8 tests of Hi-AUTOA1cTM HA-8121. The reference range in this study was 2.8-5.9% Hb A1c. CONCLUSIONS: VARIANTTM II showed the acceptable performance and advantage of calibration, and it was suitable for routine use in the clinical laboratory.

Bacteremia Diagnosed on Peripheral Blood Smear before Blood Cultures become Positive:A case report / 대한임상병리학회지

In a 49-year-old man admitted due to dyspnea, epistaxis and loss of consciousness, disseminated intravascular coagulation with petechiae and ecchymosis was presented. Bacteria within monocytes and neutrophils were observed in the peripheral blood smear of this patient, and, also, prominent toxic changes, such as marked granulation, vacuolation, and Dohle bodies, were noted in leukocytes. These bacteria could be confirmed by Gram stain of peripheral blood smear and blood cultures as Klebsiella pneumoniae, at 48 hours after bacteremia was diagnosed by the blood films. We believe that this report is the first case of bacteremia diagnosed by a Wright's stained peripheral blood smear in Korea. Despite intensive treatment with respiratory support, associated with broad spectrum antibiotherapy, he died on the second day of the admission and before getting the result of blood cultures. Therefore, direct examination of peripheral blood smears could be a valuable tool for the early diagnosis and management of high-level bacteremia.

A Case of TypeI Glanzmann's Thrombasthenia Diagnosed by Flow Cytometry

Glanzmann's thrombasthenia is a rare autosomal recessive hemorrhagic disorder of platelet function with missing or abnormal platelet plasma membrane glycoprotein IIb-IIIa, which functions as a receptor for fibrinogen. We have experienced a case of thrombasthenia in a 6-year-old female whose chief complaints were easy bruising, frequent epistaxis, arthralgia and swelling of the right ankle joint. Bleeding time was prolonged in the presence of normal platelet levels and the platelet aggregation test showed lack of aggregation after exposure to ADP, epinephrine and collagen, but showed an aggregation response to ristocetin. Platelet analysis by flow cytometry is a successful alternative rapid diagnostic technique for Glanzmann's thrombasthenia patients as well as for carriers of this disease. Flow cytometry technique provides an effective tool for investigating platelet function defects caused by altered expression or deficiency of platelet surface proteins.

A Case of TypeI Glanzmann's Thrombasthenia Diagnosed by Flow Cytometry

Glanzmann's thrombasthenia is a rare autosomal recessive hemorrhagic disorder of platelet function with missing or abnormal platelet plasma membrane glycoprotein IIb-IIIa, which functions as a receptor for fibrinogen. We have experienced a case of thrombasthenia in a 6-year-old female whose chief complaints were easy bruising, frequent epistaxis, arthralgia and swelling of the right ankle joint. Bleeding time was prolonged in the presence of normal platelet levels and the platelet aggregation test showed lack of aggregation after exposure to ADP, epinephrine and collagen, but showed an aggregation response to ristocetin. Platelet analysis by flow cytometry is a successful alternative rapid diagnostic technique for Glanzmann's thrombasthenia patients as well as for carriers of this disease. Flow cytometry technique provides an effective tool for investigating platelet function defects caused by altered expression or deficiency of platelet surface proteins.

Serum Immunoglobulins in Childrens with Recurrent Sinusitis / 대한이비인후과학회지

BACKGROUND: Sinusitis is a common and frequently recurrent illness in children. Respiratory allergy has been recognized as a major factor that predisposes children to recurrent and chronic sinusitis. Another important causative factors of recurrent sinusitis in children is immunodeficiency diseases. Among them, humoral immunodeficient disease especially is associated with recurrent sinusitis. Most common immune defect in recurrent sinusitis is immunoglobulin deficiency. OBJECTIVES: The aim of this study is to obtain a quantitative data of serum immunoglobulins in children with recurrent sinusitis, to investigate a relationship between recurrent sinusitis and immunoglobulin deficiency. MATERIALS AND METHODS: 30 childrens were selected who had been diagnosed as recurrent sinusitis at Nowon Eulji hospital in 1996. The serum immunoglobulins were evaluated by Latex agglutination immunoassay and ELISA. RESULTS: The serum IgG was within normal limits and IgA deficiency appeared in 1 patient but serum IgM appeared higher than normal value over 3 years patients. The serum IgG subclass deficiency appeared in 3 patients for IgG(1), 7 patients for IgG(2), 14 patients for IgG(3), 10 patients for IgG(4). The combined serum IgG subclass deficiency appeared in 4 patients for IgG(2) and IgG(3), 1 patient for IgG(2) and IgG(4), 4 patient for IgG(3) and IgG(4), 1 patient for IgG(1) and IgG(2) and IgG(3). CONCLUSION: Immunoglobulin deficiency is approved to be closely associated with recurrent sinusitis in children.

A case of neonatal alloimmune thrombocytopenia due to anti-HLA B44 / 대한수혈학회지

No abstract available.

A case of neonatal alloimmune thrombocytopenia due to anti-HLA B44 / 대한수혈학회지

No abstract available.

Prevalence of antibody to hepatitis C virus in blood donors in Incheon area / 대한임상병리학회지

No abstract available.