Multicenter Comparison of Four Automated Immunoassay Analyzers for Prostate Specific Antigen

No abstract available.

Intactness of Medical Nonsterile Gloves on Use of Alcohol Disinfectants

No abstract available.

Evaluation of HUBI-QUANPRO Point-of-Care Testing for Cardiac Markers / 임상검사와정도관리

BACKGROUND: Recently, quantitative point-of-care testing (POCT) for cardiac markers using colloidal gold particles was developed in Korea. We evaluated the analytical performance of the HUBI-QUANPRO (Humasis, Korea) assay in comparison with two other assays. METHODS: We evaluated the analytical precision and linearity of HUBI-QUANPRO creatine kinase (CK)-MB, cardiac troponin I (cTnI), and B-type natriuretic peptides (BNP). HUBI-QUANPRO assay was compared with ADVIA Centaur (Siemens, Germany) and Triage (Biosite Diagnostics, USA) assays by using 100 blood samples. In addition, we evaluated the interference of hemoglobin on the HUBI-QUANPRO assay. RESULTS: The coefficients of variation of HUBI-QUANPRO CK-MB, cTnI, and BNP were 7.5-9.7%, 12.0-17.4%, and 14.7-15.7%, respectively. The linearity ranges of HUBI-QUANPRO CK-MB, cTnI, and BNP were 4.7-27.8 ng/mL, 0.76-6.51 ng/mL, and 76.2-762.2 ng/mL, respectively. The comparison study showed no significant difference among them. When 0.5% hemolysis occurred, remarkable hemoglobin interference was found in the three markers resulting in underestimation of the concentrations. CONCLUSIONS: HUBI-QUANPRO CK-MB and BNP showed good analytical performances compared with the other two assays. Hemoglobin interference was noted in the HUBI-QUANPRO assay, especially more in BNP. Although the linearity range of cTnI was narrow, its agreement rate with ADVIA Centaur was good, thus the HUBI-QUANPRO assay could be useful as a quantitative POCT for cardiac markers in the emergency department.

The Comparison of Parathyroid Hormone Degradation Effect by Various Protease Inhibitors in Blood Specimen / 대한진단검사의학회지

BACKGROUND: The objective of this study was to evaluate the role of proteases on the degradation of parathyroid hormone (PTH) in blood samples. METHODS: Protease inhibitors with specificity against serine proteases (aprotinin), cysteine proteases (E-64), serine and cysteine proteases (leupeptin), metalloproteases (EDTA), or a protease inhibitor cocktail with a broad spectrum of inhibitory activity were added to blood samples. After storage at room temperature (0-48 hr), PTH levels were measured. RESULTS: PTH levels in samples with the protease inhibitor cocktail did not change significantly after 48 hr of storage at room temperature, but the average PTH levels decreased by 40.7% and 20.1%, in samples stored at room temperature and stored at 4degrees C without protease inhibitors, respectively. PTH levels in samples with leupeptin were stable for up to 24 hr. After 48 hr, the mean PTH levels decreased by 17.1%, 16.0%, 26.2%, and 32.1%, with 500 KIU/mL aprotinin, 100 micro mol/L leupeptin, 10 micro mol/L E-64, and 10 micro mol/L EDTA, respectively, in the samples stored at room temperature. CONCLUSIONS: The decrease in PTH levels in blood samples seemed to be due to the degradation of PTH by proteases. Various proteases, including especially serine proteases, would act together to degrade PTH in blood specimen. The PTH degradation may be inhibited in blood specimen with protease inhibitor cocktail.

Comparison of Quantitative Results among Two Automated Rapid Plasma Reagin (RPR) Assays and a Manual RPR Test / 대한진단검사의학회지

BACKGROUND: We compared two automated Rapid Plasma Reagin (RPR) assay kits with a manual RPR assay kit to evaluate the possibility of using the two automated RPR assays as an alternative to the manual RPR assay for a quantitative monitoring. METHODS: One hundred eighty-five samples were analyzed, including 16 sera from patients with primary, secondary, and latent syphilis. Measured RPR unit (R.U.) values of two automated RPR assay kits, Mediace RPR (Sekisui Chemical Co., Ltd, Japan) and HBi Auto RPR (HBI Co., Ltd, Korea), were compared with the RPR titers of Macro-Vue RPR card test (Becton Dickinson BD Microbiology systems, USA). As a confirmatory test, Anti-Treponema pallidum EUROLINE WB (IgG) and Anti-Treponema pallidum EUROLINE WB (IgM) (Euroimmun, Germany) were used. RESULTS: There was a prozone effect with Mediace RPR at RPR titer (card test) of 1:16, but not with HBi Auto RPR. The R.U. values of the two automated RPR assays did not show proportional increase to the RPR titer. Agreement between manual RPR and two automated RPR assay kits, Mediace RPR assay and HBi Auto RPR assay, were 83.8% and 83.2%, respectively. CONCLUSIONS: The two automated RPR assay kits could not be used as an alternative to manual RPR test for quantitative analysis of RPR titer. As Mediace RPR shows a prozone effect at relatively low RPR titer, caution is needed in the interpretation of the measured values.

Therapeutic comparison between low-dose sustained-release theophylline dry syrup and capsule in children with mild persistent asthma / 소아과

PURPOSE: Theophylline has recently been reported to have concurrent anti-inflammatory effects at low therapeutic plasma concentrations which are below the doses at which significants, clinically useful bronchodilatation is evident. Sustained-release formulation in capsule and dry syrup forms were developed to reduce its adverse effects and improve its clinical effects. We compared the therapeutic effects of theophylline dry syrup and capsules in children with mild asthma. METHODS: Ninety children with mild asthma were randomized to receive either theophylline dry syrup (n=44) or theophylline capsules (n=46); 4 mg per kilogram of body weight, twice a day, for 12 weeks. Baseline and serial measurements of daytime and nighttime asthma symptom score were performed. Compliance scores, drug swallowing scores, and drug usability scores were measured every 4 weeks. Each scoring was rated on a scale of 0-4. Serum theophylline concentration were measured at 4 and at 12 weeks. To examine the anti-inflammatory effect of theophylline on asthma, Serum eosinophilic cationic protein as a marker of airway inflammation caused by eosinophil was measured 12 weeks pre- and post-administration. RESULTS: The daytime and nighttime asthma symptom scores of the two groups after 4 weeks significantly improved over the baseline score. Daytime and nighttime asthma symptom scores in the dry syrup group were statistically lower at all time points except for the nighttime symptom scores at 4 weeks. Compliance scores, drug swallowing scores, and drug usability scores in the dry syrup group were significantly higher at the end time point. Only in the dry syrup group was the serum ECP at the end time point statistically lower than baseline. CONCLUSION: Low-dose sustained-release theophylline may be safe and effective in bronchial asthma and this effect may be mediated by its anti-inflammatory action mechanisms. Especially, when used in children with asthma, dry syrup formulation is recommended because of its higher compliance than capsule formulation.

Comparison of Two Plastic Vacuum Tubes and Glass Tube for Use in Thyroid Hormone Tests / 임상검사와정도관리

BACKGROUND: Plastic tubes have recently been used for blood collection tubes in clinical laboratories. The silicone coated plastic tube is said to be very similar with the glass tube and to show no difference with the glass tube in routine blood test except for some tests such as hormone tests and drug monitoring. So, we investigated the influence of plastic tube on the thyroid hormone test using two types of plastic vacuum tubes. METHODS: A total of 105 cases for the total triiodothyronine (T3), total thyroxine (T4), and thyroid stimulating hormone (TSH) were studied. The glass tube was a plain glass tube, and the plastic tube was a serum separator tube with gel. The plastic vacuum tubes used in this study were the SST II plus tube (Becton Dickinson, Franklin Lakes, USA) and the Vacuette tube (Greiner Bio-One, Kremsmunster, Austria). An IMMULITE 2000 analyzer (Diagnostic Products Corporation, Los Angeles, USA) was used to measure the total T3, total T4 and TSH. RESULTS: Comparisons of the measured values within 1 hour of blood collection in the plastic tube with that in the glass tube are as follows. There was no difference between the Vacuette tube and the glass tube for the three tests, while there was statistically significant difference between the SST II plus tube and the glass tube for the total T3 and total T4. CONCLUSIONS: It might need more cautious interpretation of the results by a solid-phase, competitive chemiluminescent enzyme immunoassay, when the plastic vacuum tube is used as a blood collection tube instead of the glass tube.

Evaluation of BD Lab Reagents for Chemistry Analyzers / 임상검사와정도관리

BACKGROUND: Many modern chemistry analyzers are open systems and they can use reagents other than those supplied by the manufacturer of the analyzer. There are many generic reagents for use in open systems. The objective of this study was to evaluate the analytical performance of the BD Lab reagents (BD Lab co., Korea) which were generic reagents. METHODS: Sixteen kinds of reagents of total protein, albumin, blood urea nitrogen (BUN), creatinine, glucose, uric acid, aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin, alkaline phosphatase (ALP), lactate dehydrogenase (LD), gamma glutamyl transferase (GGT), calcium, inorganic phosphorus, total cholesterol, triglycerides were tested for precision, linearity and correlation according to the NCCLS guidelines (EP5-A, EP6-A, EP9-A2). Toshiba 200-FR Neo (Toshiba Medical Systems Co., Japan) was used in this evaluation. RESULTS: All reagents showed acceptable precision with total coefficients of variation less than 7%. Comparison of BD Lab reagents with the current reagents by regression analysis resulted in slopes ranging from 0.86 to 1.06 and correlation coefficients more than 0.975. Fifteen of sixteen reagents showed good linearity in broad range. CONCLUSIONS: BD Lab reagents showed good precision, linearity, and correlation. Therefore, we conclude that the BD Lab reagents can be an alternative of currently used reagents in chemistry analyzers.

Comparison of Common Clinical Chemistry Analyte Levels between Greiner Bio-One Vacuette Tube and Glass Tube / 임상검사와정도관리

BACKGROUND: Serum separator tubes were introduced 25 years ago and are widely used in the clinical laboratory for collection of blood. Recently, the plastic serum separator tube has become available for blood collection for lightening and flexibility and suitability for automation. However few studies have been reported on stability of the common analytes in this tube. METHODS: We evaluated the concentrations of seventeencommonly ordered analytes: aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), total protein, albumin, sodium, chloride, calcium, phosphorus, triglyceride, low density lipoprotein (LDL)-cholesterol, potassium, uric acid, blood urea nitrogen (BUN), total cholesterol, glucose, creatinine in sera separated in plain glass tubes (no gel) and in sera separated in the plastic Greiner Bio-One Vacuette tubes containing serum separator gel (Greiner Bio-One, Kremsm?nster, Austria) by Toshiba 200-FR Neo. RESULTS: Results were analyzed using two-tailed paired t-tests and Bland-Altman plots. Results from 9 common analytes (glucose, total cholesterol, BUN, potassium, LDL-cholesterol, inorganic phosphorus, calcium, sodium, chloride) were statistically different between glass tube and plastic Greiner Bio-One Vacuette tube, but the differences were not considered to be clinically significant. CONCLUSIONS: We conclude that the plastic Greiner Bio-One Vacuette tubes are suitable for collection of blood and storage of serum for common analytes.

The Influence of Anticoagulants and Time of Measurements on D-Dimer Determinations / 대한진단검사의학회지

BACKGROUND: We evaluated the effects of anticoagulants used in blood sampling and time of mesurements after blood collection on D-dimer determinations. METHODS: A total of 32 samples of sodium citrated plasma, and 23 samples each of serum and ethylene diamine tetraacetic acid (EDTA) plasma, were studied. D-dimer was measured by enzyme linked fluorescent assay using a VIDAS analyzer. RESULTS: The mean+/-SD (median) of D-dimer titers in citrated plasma, serum, and EDTA plasma samples immediately after blood collection were 282.7+/-201.1 (224.6) microgram/L, 255.1+/-206.8 (197.3) microgram/L, and 313.3+/-230.8 (246.4) microgram/L respectively. The results obtained for the three different sample groups were well correlated. While the upper limit of the reference range for D-dimer for citrated plasma has been set at 500 microgram/L, the cut-off values for serum and EDTA plasma were 400 microgram/L (100%sensitivity and specificity), and 585 microgram/L (100% sensitivity and 94.7% specificity), respectively CONCLUSIONS: In addition to citrated plasma, both serum and EDTA plasma can be used for D-dimer assay. A delay in the time of measurements after blood collection does not influence the results significantly.

False Susceptibility to Imipenem by Vitek GPS Card in Enterococcus faecium / 임상검사와정도관리

BACKGROUND: Enterococcus faecium (E. faecium) is potential pathogens of mixed infections for which a broad-spectrum antimicrobial agents such as imipenem has a therapeutic role. But controversy continues concerning testing imipenem versus enterococci. The purpose of this study were 1) to investigate the ability of penicillin and ampicillin minimum inhibitory concentration (MIC) to predict in vitro susceptibility of E. faecium versus imipenem. and 2) to compare MICs of ampicillin, penicillin and imipenem by the Vitek system with those by agar dilution method. METHODS: Fifty-two isolates of E. faecium between April 2002 and May 2002 were tested. Each isolate was tested versus penicillin, ampicillin and imipenem. MICs were determined by Vitek system and agar dilution method according to NCCLS guidelines. Imipenem MIC determinations were repeated by E-test. RESULTS: MIC of Vitek system tends to be lower than that of agar dilution method, but there was good concordance between MICs of penicillin and ampicillin by Vitek system and agar dilution method. But for imipenem, the MICs by the agar dilution method did not correspond with the Vitek results. Of the 52 E. faecium isolates tested, in vitro activity of penicillin and ampicillin accurately predicts that of imipenem. CONCLUSIONS: MICs of ampicillin and penicillin are reliable, but imipenem MIC is not reliable for E. faecium by Vitek system. In vitro activity of penicillin and ampicillin versus E. faecium accurately predicts that of imipenem.

Effects of Delayed Test, Hemolysis and Turbidity on Measurement of PT and aPTT / 대한임상병리학회지

BACKGROUND: Sometimes we receive specimens collected several hours ahead, hemolyzed, or turbid. To decide to analyze the samples or not, the influence of storage time, hemolysis, and turbidi-ty on PT and PTT were studied. METHODS: Total of 198 cases for PT and 192 for aPTT were studied to clarify the effect of storage time on PT and aPTT. We performed the tests of PT and aPTT at 0, 2, 4, and 8 hours after collection of specimens. For the hemolysis effect study, we used 31 cases. Slightly, moderately, and severely hemolyzed plasma were obtained by adding hemolysate to plasma. For the turbidity effect study, we used 30 cases. Slightly, moderately, and severely turbid plasma were obtained by adding Intrali-pos (20% soybean oil) to plasma. RESULTS: Delayed test time affected the aPTT results after 8 hours. Hemolysis affected the PT and aPTT results. Turbidity did not affect the PT and aPTT results; however, the Coagrex-100s rejected to analyze the severely turbid samples. CONCLUSIONS: It is recommended that specimens be evaluated immediately or within 4 hours and that hemolysed or severely turbid specimens for PT and aPTT tests not be used.

Primary Choriocarcinoma of the Stomach: A Case Report

A case of primary gastric choriocarcinoma with multiple liver metastases is described. A 54-year-old man underwent gastrectomy for an advanced cancer. An ulcerofungating tumor with extensive hemorrhagic necrosis was found in the anterior wall of the prepyloric antrum. The histologic examination revealed a biphasic pattern composed of uninucleated cyto or intermediate trophoblasts and syncytiotrophoblasts. A small area of the adenocarcinoma forming glandular structures and poorly differentiated solid sheets was also noted on the superficial portion of the tumor. Immunohistochemical staining for the beta human chorionic gonadotropin (-hCG) and the human placental lactogen (hPL) showed strong immunoreactivity, particularly in the cytoplasms of the syncytiotrophoblasts and intermediate trophoblasts, respectively. A diagnosis of the choriocarcinoma was made. Multiple hepatic nodules consistent with metastases were noted on the abdominal sonogram. The serum -hCG level of the patient was significantly increased.

Juxtaglomerular cell tumor of the kidney: a case report

We report a case of renin-secreting juxtaglomerular cell tumor which developed in a hypertensive 47-yr-old Korean man. Presumptive clinical diagnosis was made before surgery based on the high level of plasma renin and the radiologic evidence of renal mass. Grossly, a round, bulging, well-encapsulated mass of 3x3 cm was located in the mid-portion of the right kidney. On microscopic examination, the tumor was composed of ovoid to polyhedral cells with bland nuclei, indistinct nucleoli and light eosinophilic cytoplasm. The immunostaining for renin showed strong positivity in the cytoplasm of tumor cells. The characteristic rhomboid shaped renin protogranules were observed in ultrastructural analysis.

Epidermoid Cyst of the Sole: A report of two cases positive for human papillomavirus

Epidermoid cysts occur rarely on the palms and soles, where hair is not present. These cysts have long been assumed to arise from traumatic implantation of epidermal fragment, but the pathogenesis is still controversial. Recently, with microscopic findings, immunohistochemical features, and molecular studies, the epidermoid cysts of the sole may be induced by the human papillomavirus. We report two cases of epidermoid cysts of the sole with the discussion of the pathogenesis.

Effects of Active Hexose Correlated Compounds on Drug Induced Liver Injury in Mice

AHCC (Active Hexose Correlated Compounds), which was at first extracted from cultured broth of Basidiomycotina, is known to be one of the Biological Response Modifiers (BRM). We examined the protective effects of AHCC on carbon tetrachloride (CCl4) and thioacetamide (TAA)-induced liver injury in mice. The AHCC pretreatment prevented the suppression of several physiological and biochemical parameters in the mice injected with CCl4 or TAA for 5 days. The liver weights and serum ALT and AST levels were increased by CCl4 or TAA, the degree of which was significantly reduced with the AHCC pretreatment. The AHCC pretreatment induced increasing activity of GST (glutathione s-transferase) and showed an increasing tendency of P450 and EROD (ethoxyresorufin o-dealkylation). The AHCC pretreatment also showed negative effects against the suppression of drug metabolizing enzymes, such as P450, EROD, and GST induced by CCl4 or TAA. AHCC pretreatment showed protective effects with significant inhibition of fatty change, inflammation, and necrosis in CCl4 and TAA intoxicated mice liver. The present study suggests that the protective effect of AHCC pretreatment might be related to the protection of liver from the drug induced liver injury in mice model.

Nasal angiocentric lymphoma with hemophagocytic syndrome

OBJECTIVES: Hemophagocytic syndrome (HS) is a fatal complication of nasal angiocentric lymphoma (AL) and difficult to distinguish from malignant histiocyosis. Epstein-Barr virus (EBV)-associated HS is frequently observed in lymphoma of T-cell lineage and EBV is highly associated with nasal AL. Clinicopathologic features of 10 nasal ALs with HS were reviewed to determine the clinical significance and the pathogenetic association with EBV. METHODS: Ten patients of HS were identified from a retrospective analysis of 42 nasal ALs diagnosed from 1987 to 1996. Immunohistochemical study and in situ hybridization were performed on the paraffin-embedded tumor specimens obtained from 10 patients. Serologic study of EBV-Ab was performed in 3 available patients. RESULTS: Five patients had HS as initial manifestation, 3 at the time of relapse and 2 during the clinical remission of AL. Four patients were treated by combination chemotherapy (CHOP) and others had only supportive care. The median survival of all patients with HS was 4.1 months (range 2 days-36.5 months) and all had fatal outcome regardless of the treatment-modality. All cases were positive for UCHL1 (CD45RO) and EBV by EBER in situ hybridization. The data of serologic tests indicated the active EBV infection. CONCLUSIONS: HS is a fatal complication of nasal AL and has a high association with EBV. Reactivation of EBV may contribute to HS and further investigation of predictive factors and effective treatment of HS should be pursued in the future.

Fine Needle Aspiration Cytology of Pulmonary Lesions in Wegener's Granulomatosis: A Case Report / 대한세포병리학회지

We described the findings of fine needle aspiration cytology of the lung from a patient with Wegener's granulomatosis. Early diagnosis and prompt treatment of the patients with Wegener's granulomatosis is essential for a better prognosis. However, the variety of clinical presentations and nonspecific radiologic infiltrates of Wegener's granulomatosis frequently make the diagnosis difficult. Although an open lung biopsy is required for a firm diagnosis, fine needle aspiration cytology & biopsy preparation can also provide an adequate tissue sample, when the findings of fine needle aspiration are considered with clinical manifestations and ANCA value in the serum. The cytologic smears showed scattered necrotic tissue fragments entrapping many neutrophils and occasional epithelioid cells. Multinucleated giant cells were infrequently observed. Ziehl-Neelsen stain for acid fast bacilli was negative. All the cytologic features recapitulated the histopathologic findings of purulent and necrotizing granulomatous inflammation seen in Wegener's granulomatosis.

A Case of Factor VII Deficiency with Normal Factor VII Antigen Level / 대한혈액학회지

Factor VII (FVII) deficiency is a rare hereditary disorder with a reduced FVII:C activity, which is transmitted by an autosomal recessive gene with variable expressions and a high penetrance. FVII deficiency has different antigen levels, normal or reduced, and has various symptoms. We report on a 26 year-old male patient with pleurisy who showed hematuria and prolonged prothrombin time. FVII:C was 4% and FVII:Ag level was 80% (within normal range). The inheritance of this case is unclear. The FVII:C, FVII:Ag, and prothrombin time of his father and mother's sister were within normal ranges. This is the first proven case of FVII deficiency with normal FVII:Ag level in Korea.

Meningioma with Multiple Recurrences and Malignant Transformation Differences in expression of MIB1, p53 and progesterone receptor

We describe herein a case of meningioma showing three recurrences and in the end malignant transformation. To compare the differences of MIB1, p53 and progesterone receptor expressions in benign, recurrent and malignant meningiomas of the same patient, we performed immunohistochemical stainings for those markers. MIB1 and p53 reactivities were increased in proportion to histologic aggressiveness. By contrast, the progesterone receptor expression was noted in benign meningioma but not in malignant meningioma.