Efficacy of the Measurement of 25-Hydroxyvitamin D2 and D3 Levels by Using PerkinElmer Liquid Chromatography-Tandem Mass Spectrometry Vitamin D Kit Compared With DiaSorin Radioimmunoassay Kit and Elecsys Vitamin D Total Assay

No abstract available.

Hemolytic Disease of the Newborn Caused by Anti-M in 2 Male Siblings / 대한주산의학회잡지

Hemolytic disease of the newborn (HDN) caused by anti-M is rare and clinical manifestations are variable ranging from mild anemia and hyperbilirubinemia to hydrops fetalis and intrauterine fetal death. There were few reports of HDN caused by anti-M in Korea but no case in siblings. We experienced a case of 2 male siblings, both of whom had anti-M induced HDN and prolonged anemia persisted for over a month. We report this case with a brief review of literature. This report documents the first case of HDN caused by anti-M in siblings in Korea.

Usefulness of a Rapid Real-time PCR Assay in Prenatal Screening for Group B Streptococcus Colonization

BACKGROUND: Group B streptococcus (GBS) infection is a leading cause of neonatal morbidity and mortality worldwide. Here, we present the analytical and diagnostic usefulness of a new real-time PCR-based assay (Xpert GBS; Cepheid, USA) for rapid and accurate prenatal GBS screening. METHODS: We enrolled 175 pregnant women who were between 35 and 39 weeks of gestation. The analytical performance of the Xpert GBS assay was first tested using a reference GBS strain. Next, to test diagnostic performance, rectovaginal swabs were obtained from pregnant women who visited the hospital for regular antenatal screening after 34 weeks of gestation. The results of the Xpert GBS assay were compared to those of standard culture for the detection of prenatal GBS colonization. RESULTS: When any positive result from Xpert GBS or culture was considered a true positive, the sensitivity of the Xpert GBS assay and culture were 91% (20/22; 95% CI [confidence interval], 72-98) and 68% (15/22; 95% CI, 47-84), respectively. The specificity of both methods was 100% (153/153; 95% CI, 97-100). The sensitivity and specificity of the Xpert GBS assay, using the culture results as a reference, were 86.7% and 95.6%, respectively. In the Xpert GBS assay, the median threshold cycle of vaginally colonized samples was significantly lower than rectally colonized samples (P<0.01). CONCLUSIONS: The Xpert GBS assay is an accurate, rapid, easy-to-use test for the detection of maternal GBS colonization in prenatal screening that might be especially useful in clinical settings where standard culture is not feasible.

Performance Evaluation of Method for Detecting Serum 25-Hydroxyvitamin D2 and 25-Hydroxyvitamin D3 by Using PerkinElmer MSMS Vitamin D Kit / 임상검사와정도관리

BACKGROUND: Determining the concentration profiles of serum 25-hydroxyvitamin D (25OHD) may aid in the clinical diagnosis and treatment of vitamin D deficiency. To date, the standardized liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay has been used for accurate and precise determination of 25-hydroxyvitamin D levels. Here, we evaluated the performance of the recently developed and introduced PerkinElmer Vitamin D kit and compared the measurements obtained by RIA and LC-MS/MS methods. METHODS: We evaluated the accuracy, precision, linearity, lower limit of quantification (LLOQ), recovery, and carry-over of the MSMS Vitamin D kit. Clinical specimens from 80 patients were used for the comparison between the MSMS Vitamin D kit (PerkinElmer, USA) and the RIA kit (DiaSorin, USA). RESULTS: The MSMS Vitamin D kit was found to produce intra-assay and inter-assay coefficients of variation (CVs) of less than 6% for precision and showed a bias of less than 5%. The MSMS Vitamin D kit displayed linearity within the range for total vitamin D levels of 4.5-150 ng/mL, and the lower limit of quantification for 25OHD was 0.38 ng/mL. The RIA measurements of 25OHD showed a correlation of y=0.9931x+0.2216 (r2=0.74) with the LC-MS/MS values. CONCLUSIONS: The LC-MS/MS assay of 25OHD3 and 25OHD2 showed excellent performance when using the MSMS Vitamin D kit and in terms of 4-phenyl-1,2,4-triazoline-3,5-dione (PTAD) derivatization. Further, the results obtained were well correlated with those obtained using the RIA method. Thus, assays using the MSMS Vitamin D kit are considered as more standardized, and they enable quicker and more accurate analysis and help reduce inter-laboratory variation than that by other existing methods.

Changes in biochemical markers of bone turnover and bone mineral density during pregnancy and postpartum in korean women / 대한산부인과학회지

OBJECTIVE: To show the patterns of changes in biochemical markers of bone turnover and ultrasound bone mineral density (BMD) during pregnancy and postpartum in Korean women. METHODS: We conducted a prospective study between February 2004 and February 2005. Forty-one healthy singleton pregnant women were included. We used quantitative ultrasonography for BMD measurement which is advantageous to pregnant women because it is radiation-free and it provides very accurate BMD that correlates highly with BMD measured by conventional dual energy x-ray absorptiometry. We measured marker of bone resorption (beta-Crosslaps), bone formation [total alkaline phosphatase (ALP), osteocalcin (OC)], total calcium, phosphorus and parathyroid hormone (PTH) during and after pregnancy. RESULTS: During pregnancy, BMD slightly decreased in the third trimester. Bone resorption marker (beta-Crosslaps) increased steadily during pregnancy and immediate postpartum. Markers of bone formation (ALP, osteocalcin) increased from late pregnancy. Total calcium decreased slightly as bone resorption peaks in second trimester. PTH and phosphorus increased steadily throughout pregnancy and postpartum. CONCLUSION: Pregnancy is characterized by high bone turnover in Korean women with resorption preceding formation.

Clinical Implication of Air Stacking Exercise in Patients with Neuromuscular Diseases

OBJECTIVE: To evaluate the effect of the air stacking exercise on maximal insufflation capacity (MIC) and peak cough flow (PCF) in patients with neuromuscular diseases. METHOD: Two hundred twenty nine neuromuscular patients with vital capacity (VC) below 50% of the predicted normal value were initially evaluated for VC, MIC, PCF, and assisted PCF (APCF). After the first evaluation, these patients were instructed to carry out air stacking exercise periodically, and were re-evaluated after one year. RESULTS: Forty seven patients were capable of performing air stacking exercise on regular basis, at least twice a day for one year. Among these patients, MIC increased in 28 patients from 1345.4 ml to 1572.9 ml on average (p<0.05), while it decreased in 19 patients from 1740.0 ml to 1325.3 ml on average (p<0.05). In the increasing MIC group APCF increased from 244.6 L/min to 278.1 L/min (p<0.05). In the decreasing MIC group, every value decreased significantly. CONCLUSION: Air stacking exercise was shown to be capable of increasing MIC and APCF despite the reduction in VC and PCF in patients with neuromuscular diseases.

Change in Forced Vital Capacity with Postures according to Neuromuscular Disease

OBJECTIVE: To evaluate the difference in forced vital capacity (FVC) between sitting and supine position in patients with amyotrophic lateral sclerosis (ALS), cervical spinal cord injury (SCI) and Duchenne muscular dystrophy (DMD). METHOD: FVC was measured in sitting and supine position for 32 patients with DMD, 32 patients with cervical SCI and for 28 patients with ALS. The highest value in three or more attempts in each position was chosen. RESULTS: FVCs measured in cervical SCI and ALS patients in the sitting and supine position were 1612.8+/-291.0 ml, 1393.2+/-286.7 ml and 2054.7+/-545.8 ml, 1104.3+/-425.4 ml respectively. Cervical SCI patients showed significantly higher value in the supine position (p<0.05). And ALS patients showed significantly higher value in the sitting position (p<0.05). FVCs measured in DMD patients were 1311.6+/-260.7 ml and 1213.8+/-378.9 ml respectively. There was no statistically significant difference between the measurements in both positions. CONCLUSION: Difference in postural change of FVC was observed in patients with different types of neuromuscular disorders. Such difference in FVC suggest that postural change of FVC should be considered in management of neuromuscular disease with respiratory muscle weakness.

CD56/CD16 Expression on Mononuclear Cells and Concentration of Serum TNF-alpha in Recurrent Spontaneous Abortion / 대한진단검사의학회지

BACKGROUND: Recurrent spontaneous abortion (RSA) is defined as the occurrence of three or more consecutive spontaneous abortion before 20 gestational weeks. But, 40-50% of RSA still remain "unex-plained". Cytokines seem to play a critical role in the pathogenesis of unexplained RSA, and Th1 cytokines have been shown to exert deleterious effects on pregnancy. NK cytotoxicity has been reported to be predictive of subsequent abortion in women who had unexplained recurrent abortions. The aim of this study was to investigate immunophenotypic characteristics of peripheral blood mononu-clear cells and evaluate Th1 cytokine (TNF-alpha) production in women with RSA. METHODS: The study group comprised 93 women with RSA, and the control group consisted of 40 healthy pregnant women. The population of CD56/CD16 cells was observed by using a two-color scattergram in FACScan (Becton Dickinson, San Jose CA, USA). Concentration of TNF-alpha was measured by an enzyme-linked immunoabsorbant assay (ELISA) using commercial kits (NEOGEN corporation, Lexington KY, USA). RESULTS: The percentage of CD56+/CD16-cells were significantly higher (P<0.05) in the patients with RSA (13.40+/-7.95%) than in the pregnant control group (9.12+/-3.93%). We observed a significantly higher level of TNF-alpha (medians: 85.59+/-8.29 pg/mL versus 44.80+/-9.78 pg/mL; P<0.05) in RSA women compared to controls. CONCLUSIONS: This study indicates that an increased proportion of CD56+/CD16-mononuclear cells and increased level of serum TNF-alpha are related to RSA. Thus, the two factors could be used as an indicator of subsequent successful implantation and maintenance of gestation.

Meaning of the DR-70(TM) Immunoassay for Patients with the Malignant Tumor

BACKGROUND: The DR-70(TM) immunoassay is a newly developed cancer diagnostic test which quantifies the serum fibrin degradation products (FDP), produced during fibrinolysis, by antibody reaction. The purpose of this study was to evaluate the potential of DR-70(TM) immunoassay in screening malignant tumor. METHODS: Sample subjects were 4,169 adults, both male and female, who visited the health promotion center of a general hospital from March 2004 to April 2005 and underwent the DR-70(TM) immunoassay test and other tests for cancer diagnosis. The patient group was defined as 42 adults out of the sample subjects who were newly diagnosed with cancer during the same time period when the DR-70(TM) immunoassay test was performed. Final confirmation of a malignant tumor was made by pathological analysis. RESULTS: The mean DR-70(TM) level was 0.83+/-0.65 microgram/ml (range: 0.00 (0.0001)~7.42 microgram/ml) in the control group (n=4,127) as opposed to 2.70+/-2.33 microgram/ml (range: 0.12 ~ 9.30 microgram/ml) in the cancer group (n=42), and statistical significance was established (p<0.0001, Student t-test). When categorized by the type of malignant tumor, all cancer patients with the exception of the subgroups of colon and rectal cancer showed significantly higher mean DR-70(TM) levels compared with the control group (p<0.0001, Kruscal-Wallis test). The receiver operating characteristic (ROC) curve analysis revealed < or = 1.091 microgram/ml as the best cut-off value. Using this cut-off value, the DR-70(TM) immunoassay produced a sensitivity of 71.4%, a specificity of 70.1%, a positive predictability of 69.4%, and a negative predictability of 69.2% (1). CONCLUSION: A significant increase in the mean DR-70(TM) value was observed in the cancer group (thyroidal, gastric, breast, hepatic and ovarian) compared with the control group. In particular, the specificity and sensitivity of the DR-70(TM) immunoassay was relatively high in the subgroups of breast, gastric, and thyroidal cancer patients. There is need for further studies on a large number of malignant tumor patients to see how the DR-70(TM) level might be changed according to the differentiation grade and postoperative prognosis of the malignant tumor.

Clinical Effectiveness of Urinary Human Chorionic Gonadotropin Related Protein (hCGRP) Quantification for Diagnosis of Ectopic Pregnancy

We detected pregnancy related new molecule, human chorionic gonadotropin related protein (hCGRP) in the urine of a pregnant women by using a monoclonal antibody against the human chorionic gonadotropin (hCG). This study examined the effectiveness of urinary hCGRP quantification in diagnosing ectopic pregnancy. This study included 40 normal pregnant women and 25 patients with ectopic pregnancy. Patients' serum and urinary intact whole hCG (i-hCG) and hCGRP concentrations were measured using sandwich ELISA and the ratio of hCGRP to i-hCG was calculated. Statistical analysis was performed using statistical package for social sciences (SPSS) 10.0. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the cut-off value to discriminate ectopic pregnancies from normal intrauterine pregnancies. Urinary hCGRP and hCGRP/i-hCG ratio in ectopic pregnancy group (14 +/- 6.6 ng/mL, 4.6 +/- 1.9%, respectively) were significantly lower than those of normal pregnancy group (149 +/- 10.2 ng/mL, 29.7 +/- 1.9%, respectively; p<0.001). Based on ROC curve analysis, a cut-off point of urinary hCGRP/i-hCG ratio <16.2% discriminated between ectopic pregnancy and normal pregnancy with a sensitivity, specificity, positive predictive value and negative predictive value of 92.0%, 90.0%, 32.6%, and 99.5%, respectively. Urinary hCGRP/i-hCG ratio measurement may be effective in diagnosing ectopic pregnancy.

Effectiveness of Intravenous Immunoglobulin Therapy in Women with Recurrent Spontaneous Abortions and Elevated Pre-conceptional Peripheral Blood CD56+ Natural Killer Cell Percentage / 대한불임학회지

OBJECTIVE: The aim of present study was to evaluate the effectiveness of low-dose intravenous immunoglobulin (IVIg) therapy in women with recurrent spontaneous abortions (RSA) and elevated pre-conceptional peripheral blood CD56+Natural Killer (NK) cell percentage. STUDY DESIGN: Retrospective case control study. MATERIALS AND METHODS: Thirty three women with RSA and elevated pre-conceptional peripheral blood CD56+NK cell percentage who had received low-dose IVIg therapy (400 mg/kg per day, every 4 week, until 20 gestational weeks) were included in this study. Controls were nine women with RSA and elevated pre-conceptional peripheral blood CD56+ Natural Killer (NK) cell percentage who had not received IVIg therapy were included in this study. Medical records of study and control groups were retrospectively analyzed and we compared the successful pregnancy outcomes between two groups. Successful pregnancy outcome was defined as pregnancy ongoing beyond 25 gestational weeks. RESULTS: Age, number of previous abortions, pre-conceptional CD56+NK cell percentage and type of RSA were not statistically different between two groups. Otherwise, twenty-five women who received IVIg therapy (25/33, 75.8%) but, only three women who had not received (3/9, 33.3%) had a successful pregnancy outcome and the rate difference between two groups was statistically significant. CONCLUSION: Based on our study, low-dose IVIg therapy have a effective role in treatment of RSA patients with elevated pre-conceptional peripheral blood CD56+ Natural Killer (NK) cell percentage, but more larger scaled prospective study is needed for available of conclusive evidence.

An Outbreak of Astrovirus Infection of Newborns with Hemorrhagic Diarrhea in a Neonatal Unit / 대한임상미생물학회지

BACKGROUND: We investigated the causative agents of hemorrhagic diarrhea which occurred in newborn babies in a hospital nursery in July, 2002. Rotavirus was not confirmed as the cause because only a few patients were positive for rotavirus test while most others with hemorrhagic diarrhea were negative. Therefore, patients with bloody stool were tested for Salmonella, Shigella, rotavirus, adenovirus, enterovirus, astrovirus, and enterohemorrhagic Escherichia coli (EHEC). METHODS: Bloody stools from 12 newborns with hemorrhagic diarrhea were tested. Polymerase chain reaction (PCR) of shiga-toxin gene was performed for EHEC. Rotavirus and adenovirus were tested with latex agglutination kit (Orion Diagnostica). Reverse transcription (RT)-PCR was performed for enterovirus. To detect astrovirus, RNA was extracted with Viral RNA Mini Kit (QIAGEN), reverse-transcribed with random hexamer, and PCR-amplified with specific primers. RESULTS: Of the 12 patients tested, seven (58%) were positive for astrovirus RT-PCR while all were negative for Salmonella, Shigella, EHEC, rotavirus, adenovirus, and enterovirus. CONCLUSIONS: Although diarrhea caused by astrovirus is known to be milder than that caused by rotavirus, our cases showed that astrovirus could cause serious bloody diarrhea in newborn babies.

Postural Change of Vital Capacity in Patients with Neuromuscular Disease

OBJECTIVE: To evaluate the difference in vital capacity (VC) between sitting and supine position in patients with amyotrophic lateral sclerosis (ALS) and Duchenne muscular dystrophy (DMD). METHOD: VC was measured in the sitting and supine position for 30 patients with DMD and for 30 patients with ALS. The highest value in three or more attempts in each position was chosen. RESULTS: VCs measured in ALS patients in the sitting and supine position were 1591.7+/-634.6 ml and 1290.0+/-580.3 ml respectively. The VC in the sitting position showed significantly higher value than the VC in the supine position (p<0.05). VCs measured in DMD patients were 903.7+/-518.1 ml and 795.3+/-505.6 ml respectively. There was no statistically significant difference between the measurements in both positions. CONCLUSION: Difference in postural change of VC was observed in patients with different types of neuromuscular disorders. Such difference in VC suggest that postural change of VC should be considered in management of neuromuscular disease with respiratory muscle weakness.

Non-invasive Intermittent Positive Pressure Ventilation Apply to Complete Tetraplegia due to C1 Spinal Cord Injury: A case report

The patients who have high cervical cord injury with paralysis of diaphragm are not able to live without mechanical ventilatory support. In conventional concept, tracheostomy is necessary for long-term use of mechanical ventilation. We reported a 33-year-old man diagnosed with complete tetraplegia due to C1 spinal cord injury. He had used intermittent mechanical ventilation via tracheostomy tube. He had no movement of diaphragm and showed hypercapnia and hypoxemia without ventilatory support for several hours. He showed 400 ml of vital capacity and un-obtainable peak cough flow level but it could be obtained 300 L/min of assisted peak cough flow. Noninvasive intermittent positive pressure ventilation (NIPPV) was applied from invasive method and decannulation and tracheostomy closure was performed successfully. He had no pulmonary complications for six months. This case could be a good model for the indication of NIPPV application and decannulation.

Changes of bone mineral density after 2-yrs treatment with HRT and alendronate in osteoporotic Korean women

BACKGROUND: Alendronate is one of the anti-resorptive drugs for the treatment of osteoporosis and results in a decrease of bone turnover. HRT is also known to decrease the bone turnover. Combination therapy with HRT and alendronate has made significant increase of BMD in postmenopausal women. But there were no available long-term results about combination therapy of HRT and alendronate on Korean osteoporotic women. METHODS: Eighty postmenopausal women with osteoporosis who visited the Climacteric clinic in Samsung Cheil Hospital & Women's Health Care Center from Apil to July 1999 were subjects. Randomized open labeled case control study was made. We evaluated 37 postmenopausal osteoporotic Korean women who were treated for 2 years after enrollment. Subjects in Group I were treated with HRT only, and group II had HRT with alendronate 10 mg daily. Subjects also were measured BMD at lumbar spine and markers of bone turnover before, one and two year after treatment. RESULTS: Common reasons for dropouts were side effects of HRT such as breast tenderness, irregular vaginal bleeding, economic problems, long distance from clinic etc. BMD in lumbar spine was increased 10.1% in the first year, and 12.0% in the second year in subjects treated with HRT and alendronate. But in HRT only group BMD increased to 6.4% in the first year and 7.8% at second year. Markers of bone turnover were decreased significantly in both groups compared with baseline value, but the percent changes of markers after 1 year and 2 years between the two groups were not significant. CONCLUSION: This study demonstrated that, in postmenopausal Korean women with osteoporosis, 2 years of combination therapy with HRT and alendronate resulted in a significant and sustained increase in spinal BMD than HRT only group.

A common mutation in cholesteryl ester transfer protein gene and plasma HDL cholesterol level before and after hormone replacement therapy in Korean postmenopausal women

BACKGROUND: Plasma cholesteryl ester transfer protein (CETP) functions to transfer cholesteryl ester from HDL to triglyceride-rich lipoproteins and regulates plasma HDL cholesterol level. A common mutation, the exon 15 A to G substitution at codon 442 (D442G) results in reduced plasma CETP activity and increased plasma HDL cholesterol level. Meanwhile, hormone replacement therapy (HRT) in postmenopausal women increases plasma HDL cholesterol level. METHODS: We investigated the frequency of D442G mutation and its effect on plasma HDL cholesterol level in Korean women. We also examined if the mutation has any effect on an increase in plasma HDL cholesterol level during HRT. RESULTS: Two hundred and twenty eight women aged over 40 years were recruited in this study. Of 228 women, 22 (9.6%) were identified as having the D442G mutation; 21 heterozygotes and 1 homozygote. The subjects with the mutation had higher plasma HDL cholesterol levels than those without the mutation (61.6 +/- 17.3 vs. 55.1 +/- 14.0 mg/dL, p < 0.05). After 12 month HRT, HDL cholesterol increased by 6.4% (3.6 +/- 13.2 mg/dL, p < 0.05) and D442G mutation did not have any significant effect on the change of plasma HDL cholesterol level. CONCLUSION: D442G mutation is common in Korean postmenopausal women and it is associated with increased plasma HDL cholesterol level. HRT for postmenopausal women increased plasma HDL cholesterol level in similar amounts regardless of the presence or absence of D442G mutation.

Metabolic Characteristics and Prevalence of Osteoporosis among Women in Tae-An Area

Understanding the metabolic changes in women is one of the important ways to prevent and treat osteoporosis. To reveal the metabolic characteristics of 289 healthy women aged between 35-65 yr in Tae-An, Korea we evaluated the association between bone mass assessed by broadband ultrasound attenuation (BUA) using quantitative ultrasound 2 (QUS2) and various parameters such as age, body mass index, serum levels of alkaline phosphatase, calcium, phosphorus, parathyroid hormone, 25(OH)D, and urinary ratios of calcium/creatinine and deoxypyridinoline (Dpyd)/creatinine. Among the subjects, 3.0% were osteoporotic, and 40.9% were osteopenic. When the subjects were classified according to their years since menopause (YSM) and age, the prevalence of osteoporosis increased along with an increase of YSM and age. Bone turnover markers such as serum alkaline phosphatase and fasting urinary Dpyd/creatinine were significantly higher in the group with low bone mass than in the normal group. In summary, this study shows, by use of biochemical markers of bone turnover and QUS2, the prevalence of osteoporosis in women aged between 35-65 in Tae-An was 3.0% and the risk of low bone mass increased with the bone turnover markers.

Three Cases of Bacteremia by Capnocytophaga spp / 대한임상병리학회지

Capnocytophaga spp. are thin, spindle-shaped, gram-negative bacilli, similar to fusobacteria. We isolated Capnocytophaga from the blood of three patients with fever: two acute myelogenous leukemia patients and one chronic osteomyelitis patient. The patients showed mild course of disease without hypotension or the change of mental status. As Capnocytophaga spp. are slow growing bacteria, there were difficulties in the isolation and susceptibility test of bacteria. More concerns should be given to the uncommonly isolated bacteria such as Capnocytophaga.

Trend in the Isolation of beta-Hemolytic Streptococci and Current Infection Status of Group B Streptococcus / 대한임상병리학회지

BACKGROUND: Group B Streptococcus (GBS) is known to be the leading cause of severe neonatal infections and also causes infections in pregnant women and adults with chronic underlying diseases. The frequency of GBS infections has increased recently. This study was aimed to determine the cultural results of beta-hemolytic streptococci and the clinical significance of the patients who had GBS infections during recent years. METHODS: This study has analyzed the isolation results and clinical importance of beta-hemolytic streptococci and GBS isolated from clinical specimens, except for stools, obtained from the patients in the Severance Hospital in Seoul from 1991 to 1999. RESULTS: Of 2,242 isolated beta-hemolytic streptococci, clinical records of 2,078 were available. GBS was found in 790 cases (38.0%). The isolation rate of group A Streptococcus was considerably high in pus and respiratory specimens while GBS was most commonly isolated from urogenital specimens. The isolation rate of GBS was much higher in females than males. GBS was the most common in patients under the age of one year or over age twenty. Especially, in newborn babies, GBS accounted for 72.7% of the total isolates. Of the 790 GBS isolates, 35.6% were considered to have definite infections. Of the 283 GBS infected patients, 56.2% had chronic diseases such as diabetes and malignancies. CONCLUSIONS: GBS is, two-fold, more commonly isolated than group A Streptococcus and the isolation rate is on the rise. GBS is more common in adult patients with chronic underlying diseases and remarkably high in newborn babies and the neonatal infections are severe. Therefore, microbiological diagnosis of GBS infections is necessary for proper treatment.

Clinicial Outcome of Pregnancies with Positive or Equivocal Anti-rubella IgM Antibody and Comparison of the Results Performed by 4 Different Enzyme Immunoassays / 대한임상병리학회지

BACKGROUND: The test for the anti-rubella IgM Ab (R-IgM) is important in early pregnancies because therapeutic termination may be considered depending on the results. METHODS: The subjects consisted of 52 pregnant women with positive or equivocal R-IgM by Cobas Core Anti-Rubella IgM EIA test (Roche, Basel, Swiss) between January 1997 and July 2000. Three different EIA methods such as the Enzygnost Anti-Rubella-virus/IgM test (DADE Behring, Marburg, Germany), the AxSYM Anti-Rubella IgM test (Abbott, USA), and the IMx Anti-Rubella IgM test (Abbott, USA) were simultaneously performed on 44 specimens as well as the Cobas Core Anti-Rubella IgM EIA test. RESULTS: Among 52 pregnancies, 9 (17%) experienced an artificial abortion due to positive or equivocal R-IgM result. The clinical symptoms associated with rubella infection were observed in 3 cases and the persistent R-IgM positivity was noted for more than 1 year in 4 cases. The concordance rate between 4 different EIAs was 41%. When performed with serial diluted pool and 3 sera, the results of Cobas Core were similar to those of AxSYM, IMx and Enzygnost. The R-IgM were detected one titre higher in diluted sera performed by IMx and Enzygnost than those of Cobas Core and AxSYM. CONCLUSIONS: For pregnancies with positive or equivocal R-IgM, it is recommended that results should be interpreted with caution, considering the possibilities, such as a persistent R-IgM response and discrepant R-IgM depending on the different EIA methods.