Cardiac Troponin T and Cardiac Troponin I Levels in End Stage Renal Disease Patients Undergoing Hemodialysis : as Markers of Myocardial Injury / 대한신장학회잡지

BACKGROUND: The main cause of death in maintenance hemodialyzed patients is cardiovascular event. Serum cardiac troponin T(cTnT) and I(cTnI) are increased in the serum of patients with chronic renal failure. METHODS: We studied the incidence of increased serum cTnT and cTnI, the differences of their positivity, and the myocardial injury and cardiovascular risk factors in 56 maintenance hemodialyzed patients (30 males, 26 females). We investigated the patients about smoking, diabetes, hypertension and anginal pain. Blood was obtained from the patients immediately before hemodialysis. Samples were analyzed for myoglobin, CPK, LDH, total cholesterol, hemoglobin, PTH, cTnT and cTnI. Also, we evaluated the duration and adequacy(Kt/V(urea)) of dialysis and ECG. cTnT was measured by ECLIA(reference value

Pattern of Telomerase Activities in Acute Leukemias and Chronic Myeloid Leukemia / 대한혈액학회지

BACKGROUND: Telomerase has a leading role as a potential enzyme responsible for tumorigenesis and longevity. Telomerase is a ribonucleoprotein that synthesizes a specific repeating nucleotide sequence onto the ends of telomeres. This enzyme is normally present in immortalized cell lines, germ-line tissues, and tumor tissues. We intended to compare the telomerase activity among various types of leukemia to determine the association of telomerase activity and patients status and responsiveness of chemotherapy. METHODS: Specimens were collected from Jan. 1999 to Oct. 1999 and included the leukemic bone marrow (ALL, AML and CML) and the peripheral blood or bone marrow of normal persons or patients with iron deficiency anemia and immune thrombocytopenic purpura. Telomerase activity was measured by TRAP assay using Telomerase PCR ELISA kit. RESULTS: Telomerase activities were increased in acute leukemias and relapsed acute leukemia cases, whereas in the cases of complete remission state of acute leukemia, the activity was decreased. Telomerase activity was increased in leukemias which had high percentage of immature cells, especially more than 70% of blast. Also the activity was decreased in post-chemotherapeutic group, whereas increased in untreated group. There was no significant difference between prognosis of chromosomal abnormalities and telomerase activity. CONCLUSION: These results showed that telomerase activity was increased in acute phase of leukemia, high percentage of immature cells, and chemoresistant group of leukemia.

Evaluation of LG Malaria Anti-PvTM for Diagnosis of Plasmodium vivax Malaria in the Republic of Korea / 대한임상병리학회지

BACKGROUND: In the Republic of Korea, Plasmodium vivax malaria, which had disappeared since 1984, re-emerged in 1993. Currently, malaria is becoming a serious public health problem in the Republic of Korea. The diagnosis of malaria has relied on microscopic examination such as thin and thick blood smears. However, even for expert microscopists, this test is a laborious and time-consuming procedure. Therefore, the development of a reliable, easy, and convenient diagnostic test is crucial. Recently, the LG malaria anti-PvTM enzyme-linked immunosorbent assay (ELISA) kit for the detection of a specific antibody against the merozoite surface protein (MSP) of P. vivax was developed. The aim of this study was to evaluate the diagnostic kit for P. vivax malaria in the Republic of Korea. METHODS: To determine the usefulness of the LG malaria anti-PvTM as a diagnostic kit for vivax malaria, a total of 59 serum samples from patients with P. vivax malaria were tested. The patients were diagnosed microscopically and the parasitemia index of their blood was calculated. Sera from 203 uninfected healthy blood donors, which were microscopically negative for Plasmodium vivax, were used as negative controls. RESULTS: The sensitivity and specificity of the LG malaria anti-PvTM were 98.31% (58/59) and 98.03% (199/203), respectively. The false-positive and false-negative rates were 1.97% (4/203) and 1.69% (1/59), respectively. CONCLUSIONS: The diagnostic kit, LG malaria anti-PvTM, might be a useful tool for diagnosis and screening of P. vivax malaria in Korea.

Relation of p53 Protein Overexpression to Subtypes of Acute Erythroleukemia / 대한임상병리학회지

BACKGROUND: Acute erythroleukemia (AEL), FAB-M6 is a rare heterogenous disorder diagnosed by myeloblasts more than 30% of nonerythroid cells (NEC). Pure erythroleukemia (Di Guglielmo disease) with an excess of proerythroblasts can be classified as MDS or M0. An aberration of the p53 gene in acute myelogenous leukemia is rare, but related to complex karyotypes with poor prognosis. METHODS: To evaluate heterogenous features, 32 cases of AEL or suspicious AEL were categorized as consisting of more than 50% erythroblasts and M6a with more than 30% myeloblasts of NEC, M6b with more than 30% proerythroblasts of all erythroblasts, and M6c with more than 30% both myeloblasts and proerythroblasts. The relation of the p53 protein overexpression and chromosomal abnormalities to AEL and these subtypes was investigated. RESULTS: There were 18 M6a, 6 M6b, and 8 M6c. The percentage of erythroblasts was M6a 58.7%, 77.7% M6b, and 67.2% M6c. The percentage of myeloblasts in NEC was M6a 53.6%, M6b 4.3%, and M6c 39.2%. The percentage of proerythroblasts in all erythroblasts was M6a 5.6%, M6b 56.2%, and M6c 34.1%. Survivals of M6b and M6c were significantly shorter than M6a (12.0 vs. 2.0 vs. 2.0 months, P=0.003). Five of 11 cases showed complex karyotypes (1 M6a, 2 M6b, 2 M6c), of -5, 5q-, -7, 7q-, -17 and/or 17p-, with shorter survival and poor response. The p53 protein overexpression was M6a 27.3%, M6b 100%, and M6c 83.3%. The p53 protein overexpression was positive in all 5 cases of multiple complex karyotype with frequent treatment failure or shorter survival, but was negative in 5 normal karyotypes. CONCLUSTIONS: The occurrence of complex karyotypes and aberration of the p53 gene frequently observed in M6b and M6c subtypes of acute erythroleukemia would be considered in establishing a new and innovative treatment to target neoplastic proerythroblasts that are resistant to standard therapy for acute myelogenous leukemia.

A Case of Delayed Hemolytic Transfusion Reaction Due to Anti-Jka Antibody / 대한수혈학회지

We report a case of delayed hemolytic transfusion reaction due to anti-Jka antibody. The patient was a 68-year-old women who was admitted for general weakness after subtotal thyroidectomy. She received two units of packed red cells because of anemia. On the fifteenth post-transfusion day, she developed a marked fall in hemoglobin and mild hyperbilirubinemia. Direct antiglobulin test was positive. Anti-Jka antibody was identified in her serum, and her phenotype of Kidd blood group was Jk(a-b+). Therefore the anti-Jka antibody was thought to be the possible offending antibody in this delayed hemolytic transfusion reaction.

A Case of CD5 Negative B-Cell Chronic Lymphocytic Leukemia / 대한내과학회지

A 67-year-old male visited Pusan Veterans Hospital due to general weakness and weight loss for 6 months. Physical examination showed non-tender 4 finger breaths sized splenomegaly and both inguinal and cervical lymphadenopathy. The white blood cell count was 25,300/uL with 91% morphologically mature lymphocytes. Bone marrow aspirate revealed hypercellularity with 74.5% lymphocytes morphologically similar to peripheral lymphocytes. The immunophenotpying study of lymphocytes displayed the phenotype of CD19(+), CD20(+), HLA-DR(+), sIg(+) but CD5(-). We concluded that this patients's diagnosis is CD 5 negative B-cell chronic lymphocytic leukemia.

Detection of M. tuberculosis by LCx M. tuberculosis Assay / 대한임상병리학회지

BACKGROUND: Mycobacterial culture is a confirmatory test to detect the Mycobacterium tuberculosis, but it requires considerable time and the diagnosis and treatment may be delayed. The recently developed LCR (ligase chain reaction) is a more rapid and more specific test for the detection of M. tuberculosis. In this study, we compared the LCR results with those of the culture and AFB smear. METHODS: Mycobacterial culture was performed on 3% Ogawa media for 8 weeks. For LCR, we used LCx Mycobacterium tuberculosis assay kit (Abbott Laboratories, North Chicago, Ill.). The specimens for LCR were resuspended to LCx respiratory specimen resuspension buffer, and then separated mycobacterial DNA by ultrasonicator (Abbott LCx Lysor). Then the samples were mixed in amplification vial containing DNA polymerase and DNA ligase and amplified. For the detection, we used LCx analyzer from Abbott laboratories. RESULTS: The sensitivity, specificity, and positive and negative predictive values of the LCx M. tuberculosis assay were 95, 100, 100, 60%, respectively; 90, 100, 100, 42.9%, for culture; and 62.5, 100, 100, 16.7%, for acid-fast staining, respectively. The agreements between culture and LCx, smear and LCx, and culture and AFB smear were 86%, 65% and 60%, respectively. CONCLUSIONS: LCx was confirmed as a more rapid and sensitive test than the culture test and AFB smear.

Expression of Ki-67/MIB-1 in Bone Marrow Biopsies from Patients with Myelodysplastic Syndromes and Aplastic Anemia / 대한임상병리학회지

BACKGROUND: Sometimes myelodysplastic syndrome (MDS) is especially difficult to distinguish from acquired aplastic anemia (AA) because of the clinical, cytologic, and histologic similarities of these two disorders. The proliferative activity of the hematopoietic cells is very different in various hematologic disorders and Ki-67 expression in the bone marrow cells is an useful cell proliferation marker. We tried to evaluate the significance of Ki-67/MIB-1 immunoreactivity in the discrimination of MDS and AA. METHODS: Bone marrow biopsy specimens from 56 individuals, 7 controls, 21 with MDS, 16 with AA and 12 with acute leukemia were obtained in Pusan Paik Hospital. Immunohistochemial staining for Ki-67 antigen was assessed by the MIB-1 monoclonal antibody using a microwave oven-based antigen retrieval technique. RESULTS: The mean values (+/-SD) of Ki-67 positive cells was as follows: control group, 16.8+/-3.6%; MDS, 25.3+/-10.1%; AA, 5.1+/-2.9%; acute leukemia, 30.5+/-10.4%. MDS cases showed statistically higher values of Ki-67 than did those of AA cases and control group (P<0.001) but no significance in Ki-67 frequencies was observed between the cases of MDS and acute leukemia. CONCLUSIONS: In the bone marrows of MDS cases the Ki-67 positive cells were frequently observed, suggesting high proliferative activity even in the nonleukemic state, while most of the bone marrows in AA showed very low proliferative activity. Thus immunohistochemical staining with Ki-67/MIB-1 would be useful in the discrimination of AA and MDS by the difference of Ki-67 positive cell percentage in the bone marrow.

A Case of Ael: First report in Korea / 대한수혈학회지

We found a case of Ael for the first time in Korea. The patient was 28-year-old woman admitted for the delivery of her first baby. Patient's red cells were typed as O, while the serum typing was A. The red cells were agglutinated by anti-H, but not agglutinated by anti-A1 or anti-AB. Adsorption of anti-A by patient's RBC was confirmed on the adsorption-elution test. In the saliva, only H substance was demonstable. A substance was not demonstrated either in the serum or in the saliva. A transferase was not demonstrated in patient's serum. One of the patient's sister and her daughter, and the patient's son also had same Ael phenotype.