Predictive Value of Maternal Serum Markers for Preeclampsia / 고신대학교의과대학학술지

The study performed a systematic review of screening for preeclampsia with the combination of vascular parameters and maternal serum markers in the first and early second trimester. We identified eligible studies through a search of Medline, and, for each included study, we focused on the relationship between the maternal serum markers and preeclampsia. In the selected literature, a combination of maternal serum markers was analyzed, also. Several tests suggested moderate or convincing prediction of early preeclampsia, but screening for late preeclampsia was poor. Literatures for serum markers were selected. Each serum marker was identified independently, and where relevant, a combination of these markers was analyzed. Encouraging results for the first trimester screening were observed when it was combined with other markers. Even in the first trimester of pregnancy, we can present the reliable results for the prediction of early preeclampsia. Detection rate for combination markers may yield higher detection rate and be promising to identify patients at high risk of developing preeclampsia.

Annual Report on External Quality Assessment in Diagnostic Genetics in Korea (2007) / 임상검사와정도관리

The importance of quality control for dramatically growing genetic tests continues to be emphasized with increasing clinical demands. Diagnostic genetics subcommitee of KSQACP performed two trials for cytogenetic study in 2007. Cytogenetic surveys were performed by 42 laboratories and answered correctly in most laboratories except some problems in karyotype nomenclature and the detection of complex cytogenetic abnormalities in hematologic neoplasias. The molecular genetics surveys included many kinds of tests: M. tuberculosis detection, hepatitis B (HBV) and C virus (HCV) detection and quantification, human papilloma virus (HPV) genotyping, gene rearrangement tests for leukemias and lymphomas, apolipoprotein E (APOE) genotyping, methylenetetrahydrofolate reductase (MTHFR) genotyping, hereditary breast and ovarian cancer genes (BRCA1 and BRCA2), and genetic tests for hereditary conditions such as Duchenne muscular dystrophy (DMD), Huntington disease, spinocerebellar ataxia, spinal muscular atrophy, and Prader-Willi/Angelman syndrome. Molecular genetic surveys showed excellent results in most of participants. External quality assessment program for genetic analysis in 2007 was proved to be helpful in continuous education and evaluation of quality improvement.

Annual Report on External Quality Assessment in Diagnostic Genetics in Korea (2007) / 임상검사와정도관리

The importance of quality control for dramatically growing genetic tests continues to be emphasized with increasing clinical demands. Diagnostic genetics subcommitee of KSQACP performed two trials for cytogenetic study in 2007. Cytogenetic surveys were performed by 42 laboratories and answered correctly in most laboratories except some problems in karyotype nomenclature and the detection of complex cytogenetic abnormalities in hematologic neoplasias. The molecular genetics surveys included many kinds of tests: M. tuberculosis detection, hepatitis B (HBV) and C virus (HCV) detection and quantification, human papilloma virus (HPV) genotyping, gene rearrangement tests for leukemias and lymphomas, apolipoprotein E (APOE) genotyping, methylenetetrahydrofolate reductase (MTHFR) genotyping, hereditary breast and ovarian cancer genes (BRCA1 and BRCA2), and genetic tests for hereditary conditions such as Duchenne muscular dystrophy (DMD), Huntington disease, spinocerebellar ataxia, spinal muscular atrophy, and Prader-Willi/Angelman syndrome. Molecular genetic surveys showed excellent results in most of participants. External quality assessment program for genetic analysis in 2007 was proved to be helpful in continuous education and evaluation of quality improvement.

Comparison of Two New Plastic Tubes (Sekisui INSEPACK and Green Cross Green Vac-Tube) with BD Vacutainer Tubes for 49 Analytes / 대한진단검사의학회지

BACKGROUND: Becton Dickinson (BD) Vacutainer tubes are the most widely used vacuum system for collection of blood in clinical laboratories. We compared the performance of two new tubes, Sekisui INSEPACK tube and Green Cross Green Vac-Tube, with the existing BD Vacutainer tubes for 49 common analytes. METHODS: A total of 20 apparently healthy volunteers were recruited for this study. For rountine chemistry and thyroid function tests, we compared the results of two new vacutainer tubes and BD Vacutainer tubes with those of BD glass tubes at t =0 hr by student paired t test. Hematology and coagulation test results of the two new vacutainer tubes were compared with those of BD Vacutainer tubes at t =0 hr. To study the stability of each analyte, results at t =24 +/- 2 hr, t =72 +/- 2 hr, and t =168 +/- 2 hr were compared with those at t =0 hr for each tube. RESULTS: Although paired t test analysis revealed statistically significant differences between two tested tubes and existing BD Vacutainer tube in several tests (total protein, total bilirubin, alkaline phosphatase, glucose, uric acid, calcium, inorganic phosphorus, direct bilirubin, triglyceride, HDL-cholesterol, LDL-cholesterol, lactate dehydrogenase, triiodothyronine, and thyroxine), these differences were not considered clinically significant. Stability of two new vacuum tubes for each analyte was similar to that of the BD Vacutainer tube. CONCLUSIONS: Sekisui INSEPACK tube and Green Cross Green-Vac Tube showed a satisfactory analytical performance compared with existing BD Vacutainer tubes. We conclude that these two new plastic vacutainer tubes are acceptable for the commonly ordered laboratory tests.

Evaluation of Serologic Markers for HBV Infection Using Roche Modular Analytics E170 / 임상검사와정도관리

BACKGROUND: Hepatitis B virus (HBV) infection is the leading cause of liver disease in Korea and, is usually diagnosed with serologic testings. The automated immunoassay analyzer, Roche Modular Analytics E170 (Roche Diagnostics, Mannheim, Germany; E170) tests HBV serologic markers based on electrochemiluminescence (ECL) method. We would like to evaluate analytical performances of E170 for HBV serologic markers. METHODS: We evaluated the precision of E170 for 6 serologic markers (HBsAg, anti-HBs, HBeAg, anti-HBe, IgG anti-HBc, IgM anti-HBc) with positive pooled serum. A comparison study with the AxSym immuoassay analyzer (Abbott Laboratories, Abbott Park, IL USA) was performed using patient's sera. HBsAg confirm test was evaluated using the specimens with cutoff index (COI) between 1 and 10 for HBsAg. RESULTS: The total coefficients of variations were below 5% for all of the 6 serologic markers. Method comparisons between E170 and AxSYM showed a good concordance rate; the rates of positive and negative agreements were more than 90% for almost all the serologic markers. HBsAg confirm tests for 84 samples with COI between 1 and 10 revealed that only 36 samples (43%) were true positive for HBsAg. Among 36 true positive samples, 9 samples (25%) were anti-HBs positive concurrently, but these showed low antibody titer (<50 IU/L). CONCLUSIONS: The E170 showed good precision for all HBV serologic markers and a high concordance rate with the AxSYM. Therefore, E170 can be used as a routine immunoassay analyzer for the testing of HBV serologic markers. In addition, HBsAg confirmatory test might be useful to confirm the true positivity when a specimen has low cut-off index (1-10).

Cold Agglutinin Disease due to Anti-Pr Cold Autoantibody in a Patient with Bone Marrow Transplantation / 대한수혈학회지

Cold agglutinin disease (CAD) is a most common autoimmune hemolytic anemia (AIHA) induced by cold antibody. CAD represents approximately 16-32% of AIHA cases and causative cold autoantibodies commonly show specificity against the I antigen. We report a case of cold agglutinin disease with anti-Pr cold autohemolysin. A 20 year old woman with a history of bone marrow transplantation was admitted with nausea, vomiting, and pallor. Direct antiglobulin tests were positive with IgG and C3d specific AHG reagents. Cold agglutinin titer was as high as 1:1024 at 4degrees C, 1:16 at room temperature, negative at 37degrees C. The agglutinin titer was diminished after treatment with protease, ficin and immunohematologic results of cold agglutinin was compatible with anti-Pr specificity. In unexpected antibody identification test, anti-M which showed reactivity at anti-human globulin phase was identified. Washed and prewarmed 16 units of A+, M antigen negative red blood cells were transfused. After two weeks, patient was improved with steroid therapy and experienced relief of fever and hemolysis, and she was discharged.