BACKGROUND: Detection of antibodies to extractable nuclear antigens (ENAs) and dsDNA is needed for the diagnosis of and predicting prognosis in systemic autoimmune diseases. Recently introduced line immunoassay (LIA) has the advantage of detecting several autoantibodies simultaneously, and we evaluated its usefulness in the diagnosis of autoimmune diseases in comparison with enzyme-linked immunosorbent assay (ELISA). METHODS: Samples were collected from 437 patients referred by rheumatologists. FANA (fluorescent antinuclear antibody) test and LIA for the detection of 13 different autoantibodies, including 6 ENAs and dsDNA were performed. LIA-positive samples for ENA or dsDNA antibodies were further tested with ELISA. Final diagnosis was made by rheumatologists according to the diagnostic criteria. Agreement of results between LIA and ELISA was analyzed in 53 selected patients with systemic autoimmune diseases. RESULTS: The LIA detected antibodies to ENA and dsDNA in 118 and 22 patients, respectively, and ELISA detected 70.3% (83/118) and 45.5% (10/22) of LIA positive samples. Especially, 60.2% (71/118) of patients with positive ENA antibody on LIA was diagnosed as systemic autoimmune diseases. Patients having strong FANA titer and homogenous/speckled pattern showed higher prevalence of autoantibodies, but a small proportion of FANA negative patients also showed positive reactivity (LIA 10.8%, ELISA 5.2%). LIA showed a good agreement with ELISA for the anti-ENA antibodies (> or =80%), and a lower agreement for the anti-dsDNA antibody (67.9%). CONCLUSIONS: LIA detecting several autoantibodies simultaneously might replace ELISA for anti-ENA antibodies, but not for anti-dsDNA antibodies. When LIA is performed considering clinical manifestations and FANA, it could contribute to the diagnosis of systemic autoimmune disease.
Antibodies, Antinuclear/*analysis ; Antigens, Nuclear/immunology ; Autoimmune Diseases/*diagnosis ; DNA/*immunology ; Enzyme-Linked Immunosorbent Assay ; Female ; Fluorescent Antibody Technique, Indirect ; Humans ; *Immunoassay ; Male ; Middle Aged ; Reagent Kits, Diagnostic ; Reproducibility of Results

BACKGROUND: The maximum surgical blood order schedule (MSBOS) is a viable option for reducing unnecessary crossmatching and achieving significant cost savings in the blood bank. In this study, we showed the process establishing MSBOS and through a prospective study, we evaluated the efficacy of MSBOS. METHODS: We organized task force team for transfusion management improvement composed of a director of the blood bank, surgeons and anesthesiologists in the Committee for Quality Improvement (CQI) of Asan Medical Center. In this team, we established MSBOS for most elective surgeries through the review of the previous transfusion and crossmatching data. We introduced MSBOS in April 1998 and prospectively analyzed surgeon's acceptance rate of MSBOS, crossmatch-to-transfusion ratio (C/T ratio), blood wastage rate, and cost savings. RESULTS: During the first 19 months after introducing MSBOS at our hospital, there was gradual increase in the surgeon's compliance rate of MSBOS from 30% to 94.0% through continuous education. The C/T ratio was changed from 3.5 to 1.6 and blood wastage rate was decreased from 4.0% to 1.9%. And also we could save more than 38,400,000 won through not performing the unnecessary crossmatches of 7,680 cases per year. CONCLUSION: Introduction of MSBOS can have a significant impact in reducing C/T ratio, blood wastage rate, and unnecessary crossmatches for the unused blood units. For successful application of MSBOS, cooperation with surgeons and anesthesiologists and continuous education is essential.
Advisory Committees ; Appointments and Schedules* ; Blood Banks ; Chungcheongnam-do ; Compliance ; Cost Savings ; Education ; Prospective Studies ; Quality Improvement

BACKGROUND: Screening of high-risk patients using bladder tumor markers can offer an advantage of early detection and saving medical costs. For these purpose many tumor markers have been developed to supplement invasive cystoscopy. Our study evaluated the NMP22 point-of-care test (NMP22 POCT), which is one of the tumor makers, comparing with the standard urine cytology for the diagnosis of bladder cancer. METHODS: From January to September 2005, 232 patients who had undergone a cystoscopy due to bladder cancer associated symptoms including hematuria and dysuria were enrolled in this study. Urine specimens were collected for NMP22 POCT and cytology. NMP22 POCT and urine cytology were compared for sensitivity and specificity. In addition, we evaluated urine stick test and microscopy to explain some false-positive results in NMP22 POCT. RESULTS: Superficial transitional cell carcinoma was diagnosed in 10 patients. The sensitivity of NMP22 test was 60% (95% confidence interval [CI], 26.2-87.8%), whereas that of cytology was 33.3% (95% CI, 7.5-70.1%); however, the difference was not significant. The specificity of NMP22 test was 69.8% (95% CI, 63.3-75.8%), compared with 99.0% (95% CI, 96.5-99.9%) for cytology (P<0.001). The presence of microscopic RBCs in urine specimen was significantly associated with the lower specificity of NMP22 POCT (P=0.02). CONCLUSIONS: NMP22 POCT was significantly less specific than urine cytology. To be useful as a bladder cancer screening test, the NMP22 test should have a higher specificity.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Nuclear Proteins/*urine ; Point-of-Care Systems ; Sensitivity and Specificity ; Tumor Markers, Biological/*urine ; Urinary Bladder/pathology ; Urinary Bladder Neoplasms/*diagnosis/urine ; Urine/cytology

PURPOSE: Cytogenetic and genetic alterations of tumors are closely related with progressian and promotion of cancers. Comparative genomic hybridization (CGH) has known to be a novel tool for the detection of genetic alteration in solid cancers. We performed CGH for the detection of new genetic alterations of bladder tumors. MATERIALS AND METHODS: Biotin-labeled tumor DNA and digoxigenin-labeled normal DNA were hybridized to normal metaphase cells. The fluorescence signals were captured by fluorescence microscope after detection by avidin FITC and antidigoxigenin rhodamin. Then, the ratio of fluorescence was calculated by an image analyzer. RESULTS: CGH results showed amplifications on chromosomes 1q, 3q, 4q, 5p, 6pq, 7p, 8q, 11q, 12q, 13q, 17q, 18q and 20pq (more than 20% of cases). Deletions were on chromosome 2q21-qter, 4q13-q23, 5q, 8p12-p22, 9pq, 11p13-p15 (more than 20% of cases). High level amplifications were noted on chromosomes 1q31-qter, 3p21, 3q24, 4q26, Sq21-qter, llq14-qter, 12q15-q21, 12q21-q24, 13q21-q31, 17q22, 18q22. CONCLUSION: We considered that the amplification on chromosome 4q26, 11q14-qter, 12q21-q24, 18q12 and deletion on 4qll-4q13 as a novel genetic alterations of bladder cancer. Our results revealed different pattem of amplifications that affect other regions from previous study on chromosome 7, llq, 12q, 13q, and 18q. CGH was very useful for the screening of genetic alterations of solid tumors.
Avidin ; Chromosomes, Human, Pair 7 ; Comparative Genomic Hybridization* ; Cytogenetics ; DNA ; Fluorescein-5-isothiocyanate ; Fluorescence ; Mass Screening ; Metaphase ; Urinary Bladder Neoplasms* ; Urinary Bladder*

BACKGROUND: The Rheumatoid Factor (RF) is the only serological marker in the diagnosis of rheumatoid arthritis (RA), but its sensitivity and specificity are not satisfactory for the diagnosis of RA. Therefore, we investigated the diagnostic performance of a new anti-cyclic citrullinated peptide antibodies test (anti-CCP) by the enzyme-linked immunosorbent assay (ELISA) in RA. METHODS: A cyclic peptide variant that contains citrulline was used as an antigenic substrate in ELISA. We performed the RF and anti-CCP in 324 RA patients, 251 non-RA patients (rheumatic diseases other than RA), and 286 normal individuals. Diagnostic performances such as sensitivity and specificity were evaluated by the receiver-operator characteristics (ROC) curve at optimal cut-off values. The optimal cut-off values were determined at the maximal point of the area under the curve. RESULTS: The sensitivity and specificity of anti-CCP were 72.8% and 92% at 3.8 U/mL. The sensitivity and specificity of RF were 80.6% and 78.5% at 9 U/mL. The sensitivity and specificity of anti-CCP and RF were 67%, 95.2% and 63.3%, 90% at 8.4 U/mL, 20 U/mL, respectively. A combination of anti-CCP with RF increased the sensitivity and specificity to 79.3%, 96.4%, respectively. Anti-CCP was positive in 23.8% among 63 sero-negative RA patients. CONCLUSIONS: We considered that the anti-CCP might be useful as another new serological marker for the diagnosis of a RA combination with RF, or not, because the anti-CCP has a higher diagnostic specificity than the RF and was an easy, convenient ELISA method in performance.
Antibodies* ; Arthritis, Rheumatoid* ; Citrulline ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Humans ; Rheumatoid Factor ; Sensitivity and Specificity

The World Health Organization declared that a new strain of novel swine-origin influenza A (H1N1) virus was responsible for the pandemic infection in June 2009. We report a case of encephalitis diagnosed as the H1N1 virus infection. We describe a 17-year-old patient who had a seizure attack, diagnosed with a H1N1 virus infection via real time reverse-transcriptase polymerase chain reaction (RT-PCR). The H1N1 virus infection can be causative of the encephalitis, as with other influenza virus infections. Careful monitoring is essential for reducing complications.
Adolescent ; Animals ; Encephalitis, Viral/*diagnosis/*virology ; Humans ; Influenza A Virus, H1N1 Subtype/*pathogenicity ; Male ; Swine/*virology

Karyotype analysis by G-anding is the standard method for identifying numerical and structural chromosomal aberrations in cytogenetic laboratories. However, the origins of marker chromosomes, subtle translocations, or complex chromosomal rearrangements are often difficult to identify with certainty. Cross-pecies color banding is a new FISH-ased screening technique that enables the generation of a specific color banding pattern for each human chromosome based on the genomic homologies between man and various species of apes. We report application of Cross-pecies color banding (RxFISH) to characterize the chromosomal rearrangements of one leukemia sample the G-and karyotype of which were incomplete. The combination of G-anding and RxFISH in this case study yielded additional information beyond that obtained by either technique used alone in determining the precise breakpoints in complex chromosomal rearrangements.
Chromosome Aberrations ; Chromosomes, Human ; Cytogenetics ; Hominidae ; Humans ; Karyotype ; Leukemia ; Mass Screening

Karyotype analysis by G-anding is the standard method for identifying numerical and structural chromosomal aberrations in cytogenetic laboratories. However, the origins of marker chromosomes, subtle translocations, or complex chromosomal rearrangements are often difficult to identify with certainty. Cross-pecies color banding is a new FISH-ased screening technique that enables the generation of a specific color banding pattern for each human chromosome based on the genomic homologies between man and various species of apes. We report application of Cross-pecies color banding (RxFISH) to characterize the chromosomal rearrangements of one leukemia sample the G-and karyotype of which were incomplete. The combination of G-anding and RxFISH in this case study yielded additional information beyond that obtained by either technique used alone in determining the precise breakpoints in complex chromosomal rearrangements.
Chromosome Aberrations ; Chromosomes, Human ; Cytogenetics ; Hominidae ; Humans ; Karyotype ; Leukemia ; Mass Screening

BACKGROUND: Helicobacter pylori(H. pylori) is an important etiologic agent for chronic active gastritis and plays a role in the pathogenesis of peptic ulcer and stomach cancer and recently lymphomas occurring in mucosa associated lymphatic tissue. At present, H. pylori infection associated gastritis was estimated about 80% among the cause of chronic gastritis. In this study, we tested Polymerase Chain Reaction (PCR) assay to detect H. pylori infection in gastric biopsy specimens. This results were compared with results obtained by other tests. METHODS: A total of 70 patients with dyspepsia were evaluated for H. pylori infection through the use of PCR, culture and serologic tests. The study population had an age of 12 to 80 years(median 46.4), there were 31 males and 39 females. We tested PCR using H. pylori detection kit(TM) (Bioneer, Korea) and anti-H. pylori anti-body EIA using GAP test IgG and IgM(TM)(BIO-RAD, USA). We used anaerobic jar without catalyst for the microaerophilic condition. RESULTS: The positive result by PCR assay for diagnosis of H. pylori infection in gastric specimens was 71.4% in total of 70 patients, which the gastritis, peptic ulcer and gastric cancer were 63.2%, 77.8% and 85.7%, respectively. Among 10 gastrectomy specimens of stomach cancers, the detection rate of H. pylori infection by culture was 50% and the PCR assay was 100%. The detection rate of If pylori IgG and IgM antibodies by commercially available GAP test IgG and IgM EIA were 64.3%, respectively, and IgG or IgM were 85.7%. CONCLUSIONS: The serologic study was sensitive but it was appeared that the high false positive (75%) and false negative (25%) rate and could not confirm current infection. The PCR assay was shown to be more sensitive, rapid and easy to treat specimen for the detection of H. pylori infection than conventional methods such as culture and serologic test in dyspeptic patients.
Antibodies ; Biopsy ; Diagnosis ; Dyspepsia ; Female ; Gastrectomy ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Lymphoid Tissue ; Lymphoma ; Male ; Mucous Membrane ; Peptic Ulcer ; Polymerase Chain Reaction* ; Serologic Tests ; Stomach Neoplasms

BACKGROUND: Helicobacter pylori(H. pylori) is an important etiologic agent for chronic active gastritis and plays a role in the pathogenesis of peptic ulcer and stomach cancer and recently lymphomas occurring in mucosa associated lymphatic tissue. At present, H. pylori infection associated gastritis was estimated about 80% among the cause of chronic gastritis. In this study, we tested Polymerase Chain Reaction (PCR) assay to detect H. pylori infection in gastric biopsy specimens. This results were compared with results obtained by other tests. METHODS: A total of 70 patients with dyspepsia were evaluated for H. pylori infection through the use of PCR, culture and serologic tests. The study population had an age of 12 to 80 years(median 46.4), there were 31 males and 39 females. We tested PCR using H. pylori detection kit(TM) (Bioneer, Korea) and anti-H. pylori anti-body EIA using GAP test IgG and IgM(TM)(BIO-RAD, USA). We used anaerobic jar without catalyst for the microaerophilic condition. RESULTS: The positive result by PCR assay for diagnosis of H. pylori infection in gastric specimens was 71.4% in total of 70 patients, which the gastritis, peptic ulcer and gastric cancer were 63.2%, 77.8% and 85.7%, respectively. Among 10 gastrectomy specimens of stomach cancers, the detection rate of H. pylori infection by culture was 50% and the PCR assay was 100%. The detection rate of If pylori IgG and IgM antibodies by commercially available GAP test IgG and IgM EIA were 64.3%, respectively, and IgG or IgM were 85.7%. CONCLUSIONS: The serologic study was sensitive but it was appeared that the high false positive (75%) and false negative (25%) rate and could not confirm current infection. The PCR assay was shown to be more sensitive, rapid and easy to treat specimen for the detection of H. pylori infection than conventional methods such as culture and serologic test in dyspeptic patients.
Antibodies ; Biopsy ; Diagnosis ; Dyspepsia ; Female ; Gastrectomy ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Lymphoid Tissue ; Lymphoma ; Male ; Mucous Membrane ; Peptic Ulcer ; Polymerase Chain Reaction* ; Serologic Tests ; Stomach Neoplasms