Microbial Contamination and Evaluation of Inoculum Volume in Umbilical Cord Blood Culture / 대한임상미생물학회지

BACKGROUND: Microbial screening tests of umbilical cord blood (UCB) are essential for stem cell transplantation. We analyzed the microbial contamination rate and distribution of isolated microorganisms over 10 years of samples from the MEDIPOST Cord Blood Bank. In addition, we studied the influence of inoculum volume microorganism culture and compared the yield and speed of microorganism detection. METHODS: Microbial screening tests were performed using a manual method, which includes using an inoculum of 2 mL of plasma, a byproduct of UCB processing from pediatric culture bottles. When positive blood culture was detected, each set was once again inoculated with 2 mL and 4 mL of plasma. RESULTS: From 2004 to 2013, a total of 133,610 UCB units were screened, of which 1,311 (0.9%) tested positive for contamination. The most frequently identified microorganism was Escherichia coli (34.6%), followed by Bacillus spp. (12.8%), Enterococcus faecalis (5.3%) and Klebsiella pneumoniae (4.4%). The total yield rate increased by 0.2% over this time period, although the yield rate of Bacillus spp. increased by 8.3%. CONCLUSION: The results of this study could be used in many ways with both domestic and international data regarding cord blood contamination. Also, other microbiology laboratories using culture conditions similar to ours could refer this study when preparing guidelines. Finally, by detecting low levels of bacteria, we have contributed to cord blood safety.

Allele and Haplotype Frequencies of Human Leukocyte Antigen-A, -B, and -DR Loci in Koreans: DNA Typing of 1,500 Cord Blood Units / 대한진단검사의학회지

BACKGROUND: The HLA system is known to be the most polymorphic genetic system in human, and HLA allele and haplotype distribution varies widely among different ethnic groups. This study was performed to examine the frequencies of HLA alleles and haplotypes in Koreans. METHODS: We examined HLA-A, -B, and -DR alleles at the serologic level in 1,500 cord blood units obtained from Koreans using the PCR-sequence specific oligonucleotide (SSO) method. Allele and haplotype frequencies were estimated by the maximum likelihood method using the computer program developed for the 11th International Histocompatibility Workshop. RESULTS: HLA alleles found in Koreans were 12 in A, 31 in B, and 13 in DR loci. Most frequent alleles with frequencies > or =10% in each locus in decreasing order of frequency were: A2, A24, A33, A11; B62; DR4, DR15, DR9, and DR13. Two-locus haplotypes with frequencies > or =0.1% were 104 A-B and 115 B-DR haplotypes, among which those with frequencies > or =1.0% showing significant positive linkage disequilibrium (P or =0.1% were identified. The results were similar to those of a previous study in 1,600 Koreans, although some differences were noted in the distribution of some less frequent alleles or haplotypes with frequencies < or =0.5%. CONCLUSIONS: We provided the allele and haplotype frequencies of HLA-A, -B, and -DR in cord blood units of Korean ethnicity defined by a DNA typing method, which can be used as basic data on Koreans for organ transplantation and disease association studies.

Changes of Symptoms and Serum Lithium Levels in Patient with Bipolar Disorder According to Menstrual Cycle / 신경정신의학

OBJECTIVES: It was reported that symptoms change according to menstrual cycles, aggravation of symptoms 3 to 7 days before menstruation in bipolar disorder for example. Therefore, this study was to investigate the correlation among the change of symptoms, serum lithium level, estradiol and progesterone levels. METHODS: For women with bipolar disorder, we divided by menstrual cycle into three groups; middle follicular phase, middle luteal phase and late luteal phase. We estimated serum lithiumlevel, estradiol and progesterone of each phase, and assessed the change of symptoms using Hamilton Rating Scale for Depression and Manic-State Rating Scale. Consequently they were divided into symptom changed group and not changed group. RESULTS: Serum lithium levels of patients with bipolar disorder were significantly decreased in middle luteal phase compared with in middle follicular phase, and it was sustained in low level to late follicular phase. Although there were no statistically significant differences, there was more decreased serum lithium level in symptom changed group than in symptom unchanged group. Serum lithium levels were not statistically correlated with both estradiol and progesterone levels. When symptom changed group was compared with symptom not changed group, there was a significant correlation between changes of symptom and estradiol level. CONCLUSION: The possible mechanism of the change of symptoms according to menstrual cycle in bipolar disorder may be in estrogen level and due to the effect of serum lithium level change according to menstrual cycle. The investigation of this mechanism will contribute to the treatment and the prevention of recurrence symptons in bipolar disorder.

Defense Mechanism of Professors and Residents: Comparison between Medicine and Surgery Groups / 신경정신의학

The purpose of this study was to explore the difference of defense mechanisms between medicine and surgery groups, and between residents and specialists who were professors of a medical school. The author evaluated the defense mechanisms by using Ewha Defense Mechanisms Test. The author compared the defense mechanisms of medicine and surgery specialist groups who are employed by Soonchunhyang university hospital as professors in 2000, and of medicine and surgery resident groups in 1999. First, there were significant differences in mean scores of the defense mechanisms ratings. In surgery specialist group, the rate of using projection and show-off were significantly higher than those of medicine group. In resident group, show-off, passive-aggression, dissociation, somatization, acting-out and regression were significantly higher than those of specialist group. In medicine group, residents were higher than specialists in show-off, passive-aggression, acting-out and regression. But for the specialist group, the score on anticipation was higher than in the resident group. In surgery group, residents were higher than specialists in identification, rationalization and regression. In the interaction, analysis by hierarchy and field anticipation and altruism have a significant interaction effect. Second, in comparison of maturity level between the field of speciality and level of hierarchies, surgery group used more neurotic and narcissistic defense than medicine group significantly. For the level of hierarchies, residents used more immature and neurotic defense than specialists. In medicine group, residents used immature defense more than specialists, but more mature defenses were used in specialists than residents significantly. In surgery group, residents used more immature and neurotic defenses than specialists. Mature defenses have more interaction effect. This results may reflect the fact that discipline in surgery have characteristic apprentices system and more dramatical therapeutic approach. The results seem to be useful in understanding the optimal character for each speciality. In the process of selecting spescialities evaluating one's defenses and matching with the characteristics and coping mechanisms of each specialty group can be helpful.