Subtype-Based Microbial Analysis in Non-small Cell Lung Cancer / 결핵및호흡기질환

Background@#The human lung serves as a niche for a unique and dynamic bacterial community related to the development and aggravation of multiple respiratory diseases. Therefore, identifying the microbiome status is crucial to maintaining the microecological balance and maximizing the therapeutic effect on lung diseases. Therefore, we investigated the histological type-based differences in the lung microbiomes of patients with lung cancer. @*Methods@#We performed 16S rRNA sequencing to evaluate the respiratory tract microbiome present in bronchoalveolar lavage fluid. Patients with non-small cell lung cancer were stratified based on two main subtypes of lung cancer: adenocarcinoma and squamous cell carcinoma (SqCC). @*Results@#Among the 84 patients analyzed, 64 (76.2%) had adenocarcinoma, and 20 (23.8%) had SqCC. The α- and β-diversities showed significant differences between the two groups (p=0.004 for Chao1, p=0.001 for Simpson index, and p=0.011 for PERMANOVA). Actinomyces graevenitzii was dominant in the SqCC group (linear discriminant analysis [LDA] score, 2.46); the populations of Haemophilus parainfluenza (LDA score, 4.08), Neisseria subflava (LDA score, 4.07), Porphyromonas endodontalis (LDA score, 3.88), and Fusobacterium nucleatum (LDA score, 3.72) were significantly higher in the adenocarcinoma group. @*Conclusion@#Microbiome diversity is crucial for maintaining homeostasis in the lung environment, and dysbiosis may be related to the development and prognosis of lung cancer. The mortality rate was high, and the microbiome was not diverse in SqCC. Further large-scale studies are required to investigate the role of the microbiome in the development of different lung cancer types.

The Association between Dietary Vitamin A and C Intakes and Cataract: Data from Korea National Health and Nutrition Examination Survey 2012

Oxidative stress in eye lens is one of the main causes of the cataract. Dietary antioxidants including vitamin A and C are therefore known to be associated with the risk of the disease. However, evidences are still lacking in Koreans. This study aimed to examine whether dietary vitamin A and C levels are associated with the cataract, using data of Korea National Health and Nutrition Examination Survey 2012. A total of 3,344 individuals (599 cases and 2,745 controls) were analyzed in the study. Dietary data was classified into 3 groups following Dietary Reference Intakes for Koreans 2015: 1) ≤ estimated average requirements (EAR), 2) EAR-recommended nutrient intake (RNI), and 3) ≥ RNI. Findings suggested normal subjects (controls) had better vitamin A and C nutritional status. Vitamin A and C intakes of normal subjects were significantly higher than those of cataract cases (p < 0.001, respectively). Ratio of subjects who consumed vitamin A and C lower than EAR was higher in cataract cases compared to normal subjects (p < 0.001, respectively). These antioxidant intake levels predicted that having lower level of vitamins lower than EAR increased the odd ratios (ORs) for cataract [for vitamin A: OR, 1.89; 95% confidence interval (CI), 1.55–2.31 and for vitamin C: OR, 2.06; 95% CI, 1.69–2.51]. However, such associations were not retained, when the subjects’ demographic and lifestyle factor were adjusted. In conclusion, vitamin A and C showed a protective effect against cataract. However, subjects' life style and demographic factors nullified the association. More studies are required to verify the true association between dietary antioxidants and risk of cataract in Koreans.

The Association between Dietary Vitamin A and C Intakes and Cataract: Data from Korea National Health and Nutrition Examination Survey 2012

Oxidative stress in eye lens is one of the main causes of the cataract. Dietary antioxidants including vitamin A and C are therefore known to be associated with the risk of the disease. However, evidences are still lacking in Koreans. This study aimed to examine whether dietary vitamin A and C levels are associated with the cataract, using data of Korea National Health and Nutrition Examination Survey 2012. A total of 3,344 individuals (599 cases and 2,745 controls) were analyzed in the study. Dietary data was classified into 3 groups following Dietary Reference Intakes for Koreans 2015: 1) ≤ estimated average requirements (EAR), 2) EAR-recommended nutrient intake (RNI), and 3) ≥ RNI. Findings suggested normal subjects (controls) had better vitamin A and C nutritional status. Vitamin A and C intakes of normal subjects were significantly higher than those of cataract cases (p < 0.001, respectively). Ratio of subjects who consumed vitamin A and C lower than EAR was higher in cataract cases compared to normal subjects (p < 0.001, respectively). These antioxidant intake levels predicted that having lower level of vitamins lower than EAR increased the odd ratios (ORs) for cataract [for vitamin A: OR, 1.89; 95% confidence interval (CI), 1.55–2.31 and for vitamin C: OR, 2.06; 95% CI, 1.69–2.51]. However, such associations were not retained, when the subjects’ demographic and lifestyle factor were adjusted. In conclusion, vitamin A and C showed a protective effect against cataract. However, subjects' life style and demographic factors nullified the association. More studies are required to verify the true association between dietary antioxidants and risk of cataract in Koreans.

Identification of Anti-Gerbich Antibody in an Emirati Marrow Hematopoietic Progenitor Cell Donor with Fy(a−b−) Phenotype

In this study, we report a case of anti-Gerbich (Ge) alloantibody to a high-prevalence Ge antigen in a donor with Fy(a−b−) phenotype. The alloantibody was detected in an Emirati boy who was admitted to a Korean tertiary hospital for marrow hematopoietic progenitor cell donation. He did not have a history of transfusion. His blood type was A, RhD+, and findings from the antibody screening and identification test showed 2+ reactivity in all panel cells except autologous cells. We concluded that it would be very difficult to find compatible blood components for the donor and requested further tests from external laboratories. Anti-Ge2 was identified by additional tests in a foreign reference laboratory, and the Duffy genotype of the donor was FY*02/FY*02N.01 based on the Korean Rare Blood Program. Although the donor was not a Korean, as the number of foreign patients visiting Korea increases annually, there is growing interest in patients with rare blood types in the Korean population. However, there has been very little research on rare or high prevalence blood type antigen and antibody in the Korean population. Therefore, additional research in Korea is needed on rare blood group antibodies and antigens, including Ge cases.

Intake of fruits and vegetables may modify the risk of cataract in Korean males: data from Korean National Health and Nutrition Examination Survey 2012 / 한국영양학회지

PURPOSE: Cataract is a major cause of a loss of eye sight, and is a critical health issue in an aging society. The oxidative stresses to the lens due to various exterior/interior stimuli leads to degenerative changes of the visual system, resulting in cataract. Therefore, reducing the level of oxidative damage is critical in the prevention of the disease. This study examined the association between the risk of cataract and intake of fruits and vegetables, the major dietary source of antioxidants. METHODS: Using the data of Korean National Health and Nutrition Examination Survey 2012, the intake of fruits and vegetables of 1,332 males (222 cases) and 2,012 females (377 cases) were analyzed, taking into account the cataract phenotype. Their dietary intake was categorized in 6 groups: TV (total vegetables), F (fruits), TVF (TV+F), SV (salted vegetables), NSV (Non-SV), and NSVF (NSV+F). The level of intakes were evaluated referring to the recommendation level of various dietary guidelines. RESULTS: The presence of cataract was associated with some type of fruit and vegetable intake. In males, the controls had more TVF (p < 0.001), TV (p = 0.001), SV (p = 0.012), NSV (p = 0.007), and NSVF (p < 0.001) intake than the cases, and the lower intake of TVF (< 500g), TV (300g), NSV (< 100g), and NSVF (< 400g) increased the risk of cataract by up to 1.7 fold [95% confidence interval: 1.06–2.71]. In females, the controls also had a higher intake of TVF (p < 0.001), TV (p = 0.042), and NSVF (p < 0.001), but the intake of such fruits and vegetables did not predict the meaningful risk of cataract. The intake of SV and F was not associated with the cataract phenotype in either males or females. CONCLUSION: The intake of fruits and vegetables can modify the risk of cataract in Korean males and a sufficient intake of those could be effective in the prevention of cataract.

Evaluation of the Level of Minimum Hemoglobin Trigger for Red Blood Cell Transfusion according to Clinical Departments / 대한수혈학회지

BACKGROUND: Red blood cell (RBC) transfusion is one of the major treatments for correcting anemia, but its use should be carefully considered because of adverse transfusion reactions and inappropriate usage. Therefore, individual health care facilities have self evaluated their use of transfusion in an attempt to decrease unnecessary procedures. In this study, we evaluated the differences in the minimum hemoglobin (Hb) trigger for RBC transfusion among clinical departments in Severance Hospital. METHODS: We analyzed the electronic medical records of RBC transfusion episodes that were conducted at a Hb level above 8 g/dL from July 2014 to September 2015. We classified these data by clinical department, and considered the overall medical conditions of the patients. The minimum Hb trigger level in this study was defined as the lowest Hb level within 24 hours prior to RBC transfusion. RESULTS: A total of 4,953 RBC transfusion episodes that were conducted at Hb levels above 8 g/dL were analyzed over that period. In general, the minimum Hb trigger level was higher in the operation group than the hemorrhage group. When compared among clinical departments, the department of orthopedic surgery, neurosurgery, rehabilitation medicine, and anesthesiology showed high levels of minimum Hb trigger equal to or greater than 10 g/dL. CONCLUSION: The minimum Hb trigger level differed among clinical departments, with the operation group showing a much higher level of minimum Hb trigger. We hope that these data will be practically applied to establish plans and strategies for managing the appropriateness of RBC transfusions in Korea. In addition, continuous evaluation and transfusion education for clinical departments should be performed.

The Clinical Significance of Implementing Concurrent Direct Antiglobulin Test and Antibody Elution Test in Diagnosing Hemolytic Disease of the Fetus and Newborn / 대한수혈학회지

BACKGROUND: Hemolytic disease of the fetus and newborn (HDFN) is a condition in which immune hemolytic anemia occurs in fetuses or newborns as a result of maternal alloimunized antibodies transfer. Antibody elution test and direct antiglobulin test (DAT) can be performed to diagnose HDFN; maternal originated antibodies cannot be confirmed if DAT is utilized alone. In this study, we analyzed the clinical significance of implementing concurrent DAT and antibody elution test in diagnosing HDFN. METHODS: We retrospectively analyzed the DATs and antibody elution tests that were simultaneously conducted in a period of 11 years, between 2005 and 2015, in newborns that received hemoglobin, reticulocyte, and total bilirubin tests. According to the results of these tests, the number of newborns diagnosed with HDFN was measured. Furthermore, the sensitivity and specificity of DAT and antibody elution test were compared. RESULTS: Among 325 newborns, the results of DATs and antibody elution tests were both negative in 208 (64.0%), negative and positive, respectively, in 80 (24.6%), positive and negative in 10 (3.1%), both positive in 27 (8.3%). When this was compared to the clinical diagnosis of HDFN, more sensitive and specific diagnoses were possible when implementing DAT and antibody elution test together (sensitivity of 76.9% for antibody elution test and specificity of 90.3% for DAT). Twenty-six (8.0%) newborns suspected for HDFN showed clinically significant hemolytic anemia. CONCLUSION: It is necessary to conduct both DAT and antibody elution test when HDFN is suspected. The severity of hemolysis in HDFN can be indirectly anticipated using an antibody elution test confirming maternal originated alloantibodies.

Disc-Type Hyaline Cartilage Reconstruction Using 3D-Cell Sheet Culture of Human Bone Marrow Stromal Cells and Human Costal Chondrocytes and Maintenance of Its Shape and Phenotype after Transplantation

In this study, we developed the disc-type bio-cartilage reconstruction strategies for transplantable hyaline cartilage for reconstructive surgery using 3D-cell sheet culture of human bone marrow stromal cells and human costal chondrocytes. We compared chondrogenesis efficiency between different chondrogenic-induction methods such as micromass culture, pellet culture, and 3D-cell sheet culture. Among them, the 3D-cell sheet culture resulted in the best chondrogenesis with the disc-type bio-cartilage (>12 mm diameter in size) in vitro, but sometimes spontaneous curling and contraction of 3D-cell sheet culture resulted in the formation of bead-type cartilage, which was prevented by type I collagen coating or by culturing on amniotic membrane. Previously, it was reported that tissue-engineered cartilage reconstructed in vitro does not maintain its cartilage phenotype after transplantation but tends to transform to other tissue type such as bone or connective tissue. However, the disc-type bio-cartilage of 3D-cell sheet culture maintained its hyaline cartilage phenotype even after exposure to the osteogenic-induction condition in vitro for 3 weeks or after the transplantation for 4 weeks in mouse subcutaneous. Collectively, the disc-type bio-cartilage with 12 mm diameter can be reproducibly reconstructed by the 3D-cell sheet culture, whose hyaline cartilage phenotype and shape can be maintained under the osteogenic-induction condition as well as after the transplantation. This disc-type bio-cartilage can be proposed for the application to reconstructive surgery and repair of disc-type cartilage such as mandibular cartilage and digits.

A Case of Panagglutination on Antibody Identification in a Multiple Myeloma Patient Receiving Daratumumab / 대한수혈학회지

Herein, we report a patient showing panagglutination in the unexpected antibody identification test after the administration of daratumumab. The patient was a 66-year-old woman who had undergone multiple cycles of chemotherapy and autologous peripheral blood stem cell transplantation for treating multiple myeloma; however, despite treatment, she had relapsed. Therefore, daratumumab, on clinical trials in Korea, started to be administered. After administration of daratumumab, the result of antibody screening test was positive, on the contrary to the result prior to the administration. Moreover, all positive reactions were shown in the antibody identification to the panel cells. After destroying CD38 antigens on the surface of RBCs using DTT, negative results were obtained. Daratumumab—a novel therapeutic human CD38 monoclonal antibody that can be used as targeted immunotherapy—is an FDA-approved drug for treating multiple myeloma. Because CD38 is expressed not only on myeloma cells, but also on red blood cells (RBCs), the use of daratumumab might lead to RBC agglutinations, and thereby resulting in false-positive results on the pre-transfusion tests. Therefore, caution is needed in case of a patient receiving daratumumab. Furthermore, additional test using DTT is required, especially when panagglutination was shown in the antibody identification test, as in this case.

A Case Report of Anti-f(ce) Identified in a Patient with Pancreatic Cancer / 대한수혈학회지

Anti-f(ce) is a rare unexpected antibody against the ce(f) antigen. The aim of this study is to report a second case of anti-f(ce) identified in a patient. A 66-year-old-male with pancreatic cancer received percutaneous transhepatic biliary drainage. During pretransfusion tests, anti-f(ce) was identified. He had a history of multiple transfusions and was transfused with 2 units of antiglobulin crossmatch compatible RBCs without any adverse reactions. To confirm that the antibody was specific for ce(f) antigen, we crossmatched the patient's serum with RhD-positive red cells of Rh phenotype DcE, DCcEe, DCce, and DCe; all results were negative. Conversely, a crossmatch with RhD-negative red cells of Rh phenotype ce, Cce, and cEe, showed positive results for Rh phenotype ce and cEe red cells. Among the four reports that confirmed anti-e, we discovered the possibility of co-existence of anti-C or misidentification of anti-Ce as anti-e. Therefore, when antibodies against Rh antigens are identified, the possibility of co-existence of antibodies against compound antigens should be considered. Using unexpected antibody identification panel that ce(f) antigen positive red cells are marked is recommended for sensitive detection of anti-f(ce).

Preventive effects of imperatorin on perfluorohexanesulfonate-induced neuronal apoptosis via inhibition of intracellular calcium-mediated ERK pathway

Early life neuronal exposure to environmental toxicants has been suggested to be an important etiology of neurodegenerative disease development. Perfluorohexanesulfonate (PFHxS), one of the major perfluoroalkyl compounds, is widely distributed environmental contaminants. We have reported that PFHxS induces neuronal apoptosis via ERK-mediated pathway. Imperatorin is a furanocoumarin found in various edible plants and has a wide range of pharmacological effects including neuroprotection. In this study, the effects of imperatorin on PFHxS-induced neuronal apoptosis and the underlying mechanisms are examined using cerebellar granule cells (CGC). CGC were isolated from seven-day old rats and were grown in culture for seven days. Caspase-3 activity and TUNEL staining were used to determine neuronal apoptosis. PFHxS-induced apoptosis of CGC was significantly reduced by imperatorin and PD98059, an ERK pathway inhibitor. PFHxS induced a persistent increase in intracellular calcium, which was significantly blocked by imperatorin, NMDA receptor antagonist, MK801 and the L-type voltage-dependent calcium channel blockers, diltiazem and nifedipine. The activation of caspase-3 by PFHxS was also inhibited by MK801, diltiazem and nifedipine. PFHxS-increased ERK activation was inhibited by imperatorin, MK801, diltiazem and nifedipine. Taken together, imperatorin protects CGC against PFHxS-induced apoptosis via inhibition of NMDA receptor/intracellular calcium-mediated ERK pathway.

Evaluation of the Automated Immunohematology Analyzer ORTHO VISION for ABO Antibody Titration / 대한수혈학회지

BACKGROUND: ABO antibody titration is important in cases such as ABO incompatible hemolytic disease of the fetus and newborn (HDFN), ABO incompatible bone marrow, or solid organ transplantation. This study was conducted in order to evaluate usability of ORTHO VISION (Ortho Clinical Diagnostics, Raritan, USA) designed automated ABO antibody titration equipment. METHODS: The isoagglutination titers were determined in 80 subjects (20 A, 20 B, 40 O (anti-A 20, anti-B 20)) using a conventional tube technique, including a 30 minute room temperature phase (CTT), Dithiothreitol treated manual column agglutination technique (MCAT), and automated column agglutination technique (ACAT) by ORTHO VISION. The concordance of titer was compared within one dilution step between the two methods. RESULTS: The isoagglutinin titers measured by the ACAT with anti-human globulin poly cassette (ACAT_Poly) and anti-human globulin IgG cassette (ACAT_IgG) were the highest and the isoagglutinin titer measured by the MCAT was also higher than that by the CTT. The isoagglutinin titer measured by the ACAT with reverse diluents cassette (ACAT_Reverse) was similar to that measured by the CTT. The concordance of anti-A and anti-B titers between CTT and ACAT_Reverse was 83% and 68%. The concordance of anti-A and anti-B titers between MCAT and ACAT_Poly was 100% and 83%. The concordance of anti-A and anti-B titers between MCAT and ACAT_IgG was 98% and 88%. CONCLUSION: Automated isoagglutinin titration using ACAT_Poly or ACAT_IgG without DTT showed reliable concordance with DTT treated MCAT, and it appears to be a possible replacement for the conventional MCAT method.

Imperatorin Suppresses Degranulation and Eicosanoid Generation in Activated Bone Marrow-Derived Mast Cells

Imperatorin has been known to exert many biological functions including anti-inflammatory activity. In this study, we investigated the inhibitory effects of imperatorin on the production of inflammatory mediators in mouse bone marrow-derived mast cells (BMMC). Imperatorin inhibited degranulation and the generation of eicosanoids (leukotriene C4 (LTC4) and prostaglandin D2 (PGD2)) in IgE/antigen (Ag)-stimulated BMMC. To elucidate the molecular mechanism involved in this process, we investigated the effect of imperatorin on intracellular signaling in BMMC. Biochemical analyses of the IgE/Ag-mediated signaling pathway demonstrated that imperatorin dramatically attenuated degranulation and the production of 5-lipoxygenase-dependent LTC4 and cyclooxygenase-2-dependent PGD2 through the inhibition of intracellular calcium influx/phospholipase Cgamma1, cytosolic phospholipase A2/mitogen-activated protein kinases and/or nuclear factor-kappaB pathways in BMMC. These results suggest that the effects of imperatorin on inhibition of degranulation and eicosanoid generation through the suppression of multiple steps of IgE/Ag-mediated signaling pathways would be beneficial for the prevention of allergic inflammation.

Britanin Suppresses IgE/Ag-Induced Mast Cell Activation by Inhibiting the Syk Pathway

The aim of this study was to determine whether britanin, isolated from the flowers of Inula japonica (Inulae Flos), modulates the generation of allergic inflammatory mediators in activated mast cells. To understand the biological activity of britanin, the authors investigated its effects on the generation of prostaglandin D2 (PGD2), leukotriene C4 (LTC4), and degranulation in IgE/Ag-induced bone marrow-derived mast cells (BMMCs). Britanin dose dependently inhibited degranulation and the generations of PGD2 and LTC4 in BMMCs. Biochemical analyses of IgE/Ag-mediated signaling pathways demonstrated that britanin suppressed the phosphorylation of Syk kinase and multiple downstream signaling processes, including phospholipase Cgamma1 (PLCgamma1)-mediated calcium influx, the activation of mitogen-activated protein kinases (MAPKs; extracellular signal-regulated kinase 1/2, c-Jun NH2-terminal kinase and p38), and the nuclear factor-kappaB (NF-kappaB) pathway. Taken together, the findings of this study suggest britanin suppresses degranulation and eicosanoid generation by inhibiting the Syk-dependent pathway and britanin might be useful for the treatment of allergic inflammatory diseases.

Diabetes-related Characteristics in Men with Diabetes for the Glucose Control Group and Noncontrol Group / 기본간호학회지

PURPOSE: This study was done to identify factors related to glycemic control in men with diabetes. METHODS: Data from the Korean National Health and Nutrition Examination Survey 2007, 2008 collected by the Korean Center for Disease Control were analyzed using chi-square test and t-test. RESULTS: There was a difference in glycemic control according to the individual factor of economic status. Differences in glycemic control according to health related factors were as follows: fasting blood sugar, cholesterol, triglyceride, sleep duration, experience of depression and suicidal thoughts. CONCLUSION: The results of this study will contribute to improvements in management for men with diabetes through comprehensive identification of factors related to glycemic control.

Flowers of Inula japonica Attenuate Inflammatory Responses

BACKGROUND: The flowers of Inula japonica (Inulae Flos) have long been used in traditional medicine for the treatment of inflammatory diseases. In the present study, we investigated the anti-inflammatory properties of Inulae Flos Extract (IFE). METHODS: The anti-inflammatory effects of IFE against nitric oxide (NO), PGE2, TNF-alpha, and IL-6 release, as well as NF-kappa B and MAP kinase activation were evaluated in RAW 264.7 cells. RESULTS: IFE inhibited the production of NO and the expression of inducible nitric oxide synthase (iNOS) in LPS-stimulated RAW264.7 cells. In addition, IFE reduced the release of pro-inflammatory cytokines, such as TNF-alpha and IL-6. Furthermore, IFE inhibited the NF-kappa B activation induced by LPS, which was associated with the abrogation of I kappa B-alpha degradation and subsequent decreases in nuclear p65 and p50 levels. Moreover, the phosphorylation of ERK, JNK, and p38 MAP kinases in LPS-stimulated RAW 264.7 cells was suppressed by IFE in a dose-dependent manner. CONCLUSION: These results suggest that the anti-inflammation activities of IFE might be attributed to the inhibition of NO, iNOS and cytokine expression through the down-regulation of NF-kappa B activation via suppression of I kappa B alpha and MAP kinase phosphorylation in macrophages.

A Study about the Factors Affecting the Suicidal Thought in Korean Elders / 정신간호학회지

PURPOSE: This study was done to identify the risk factors influencing suicidal ideation in Korean elders. METHODS: Data from the Korean national health & nutrition examination survey 2007 collected by the Korean Center for Disease Control were analyzed using chi2 test and t-test. RESULTS: Differences in suicidal ideation according to individual factors were as follows: gender, education status, recognition of stress, experience of depression, and smoking. Differences in suicidal ideation according to health related factors were as follows: subjective health status, EQ-5D (EuroQoL-5 Dimensions), and restriction of activity. Differences in suicidal ideation according to family related factors were as follows: spouse, and status of dietary life. CONCLUSION: The findings suggest that board intervention programs should be provided to prevent problems of suicidal ideation. It is also recommended that programs be developed that can help control the variables identified in this study along with follow up study to verify the model.

Comparison of Two Commercial Real-time Nucleic Acid Amplification Methods for Detecting the Viral Load of Human Immunodeficiency Virus Type 1 / 대한수혈학회지

BACKGROUND: Detection of the viral load of Human Immunodeficiency Virus type 1 (HIV-1) RNA is important for clinical decision making and for determining the prognosis of HIV-infected patients. The aim of the study is to compare the performance of real-time RT-PCR (COBAS AmpliPrep/COBAS TaqMan HIV-1, CAP/CTM, Roche Diagnostics) and the Nucleic Acid Sequence Based Amplification (NucliSens EasyQ HIV-1, NucliSens, BioMerieux) methods for testing Korean HIV-infected patients. METHODS: Among the specimens that were requested to undergo HIV-1 RNA viral load detection from 2005 to 2006, 153 specimens were selected based on the status of the specimens. The CAP/CTM and NucliSens tests were performed according to the manufacturer's instruction. RESULTS: HIV-1 RNA was detected by both tests in 93 specimens. Among the remainder, CAP/CTM detected HIV-1 RNA in 10 specimens, while the same specimens showed results lower than the detection limit with using the NucliSens. Though the results were appropriately correlated (r=0.85, P<0.0001), the mean differences between the two test results were -0.1321 log(10) IU/mL on the Bland-Altman test. CONCLUSION: The methodologic difference or the presence of a HIV subtype may affect the agreement between the two tests. The standardization of methods and the establishment of a linear range for the individual laboratory results may be helpful to obtain accurate test results.