BACKGROUND: The usefulness of the alanine aminotransferase (ALT) test has been questioned after the introduction of anti-Hepatitis C virus (HCV) screening and the HCV nucleic acid test (NAT). A major proportion of the blood discarded according to a positive screening test is composed of ALT-high blood. This study was performed to investigate the usefulness of the ALT test. METHODS: The number of donors with a high ALT level was analyzed using the 2007 database of 2,028,684 donors. The HBsAg and anti-HCV positive donors were grouped into the ALT<65 group, the ALT=65~89 group and the ALT> or =90 IU/L group. Anti-HBc, anti-HBs and HBV DNA tests were performed for 402 high-ALT samples. RESULTS: A total of 30,077 (1.5%) donors had an ALT> or =65 IU/L, and 18,594 (61.8%) of them had an ALT of 65~89 IU/L. The mean ages of the groups with ALT<65, 65~89 and > or =90 IU/L were 24, 26 and 25 years, respectively and HBsAg was positive in 0.13, 0.36 and 0.88%, respectively, and anti-HCV was positive in 0.30, 0.39 and 0.52%, respectively. HBV DNA was not detected in the 402 samples with an ALT> or =65 IU/L and a negative HBsAg test. CONCLUSION: Based on an analysis of a donor databases, the HBV infection rates were higher in blood donors with high ALT. Although HBV DNA was not detected in the high-ALT samples with negative HBsAg, because of the high HBsAg positivity in the high-ALT samples, it would be desirable to retain the ALT screening test when considering the possibility of false negative reactions of the current hepatitis B screening test.
Alanine ; Alanine Transaminase ; Blood Donors ; DNA ; False Negative Reactions ; Hepatitis B ; Hepatitis B Surface Antigens ; Humans ; Mass Screening ; Tissue Donors ; Viruses

Anti-M antibody is usually a naturally occurring antibody reacting optimally 4 degrees C and is not considered to be clinically significant. Rarely has anti-M been implicated in hemolytic disease of the newborn(HDN) and the true incidence of HDN due to anti-M has not been well delineated. Authors report the second case of hemolytic disease of the newborn due to anti-M in Korea. A 3-days old baby boy was admitted due to jaundice and severe anemia which were developed at birth. The blood type of his mother was A, CcDEe, Ns, while the blood type of the infant of was A, CcDEe, MNs. The mother's serum had anti-M which wits strongnly positive in room temperature and albumin phase. The reaction was only weakly positive in the antiglobulin phase. Direct antiglobulin test of baby's red cells was negative, while the serum was weakly positive in polyethylene glycol-Coombs test. The antibody was found to be partially IgG through the treatment with dithiothreitol. After an exchange transfusion and phototherapy, the anemia and jaundice were corrected and and the patient discharged at the age of 16.
Anemia ; Coombs Test ; Dithiothreitol ; Humans ; Immunoglobulin G ; Incidence ; Infant ; Infant, Newborn* ; Jaundice ; Korea ; Male ; Mothers ; Parturition ; Phototherapy ; Polyethylene

BACKGROUND: A and B transferase are glycosyltransferase that transfer N-acetylgalactosamine and D- galactose to H antigen, respectively and lead to the expression of A and B phenotypes in ABO blood group system. Reduced or no activities of serum A and B transferase were observed in some A and B subgroup individuals. Determining the activities of serum A and B transferase can be useful in discriminating rare A and B subgroups. MATERIALS AND METHODS: ABO typing, saliva test, adsorption elution test and serum transferase assay were performed on samples from 12 individuals showing ABO discrepancy or weakened cell typing reactions which were referred to the Seoul National University Hospital to confirm their ABO blood types. Serum transferase activity was assayed by determining the ability of serum to convert group 0 RBCs into A or B cells. RESULTS: Determination of serum ABO transferase activity was useful in the identification of Ael (3 cases), B. (2 cases), Bm (1 case), Am (1 case), Bx (1 case), 0 with weakened anti-A or anti-B (3 cases), and A without anti-B due to hypogammaglobulinemia (1 case). CONCLUSION: Determining serum A and B glycosyltransferase activity was proven to be a simple and useful tool for the classification of several ABO subgroups.(Korean J Blood Transfusion 10(1): 27-33, 1999)
ABO Blood-Group System ; Adsorption ; Agammaglobulinemia ; B-Lymphocytes ; Blood Transfusion ; Classification* ; Galactose ; Phenotype ; Saliva ; Seoul ; Transferases

BACKGROUND: This study investigated the effectiveness of reinforced contact precautions and active surveillance cultures (ASCs) in reducing the incidence of methicillin-resistant Staphylococcus aureus (MRSA) and other healthcare-associated infections (HAIs). METHODS: A before- and after-experimental study was performed at the intensive care unit (ICU) in a university-affiliated hospital. Reinforced contact precautions were applied to all patients, and ASCs for MRSA were performed for newly admitted patients at the time of admission and once a week thereafter. The HAIs were investigated in accordance with the National Nosocomial Infections Surveillance (NNIS) definitions and compared before and after the interventions. The data were analyzed using descriptive statistics. RESULTS: The number of HAIs caused by MRSA decreased from 2.2 to 0.5 per 100 patients discharged (P=0.02) and from 3.6 to 1.0 per 1,000 patient-days (P=0.032). The number of overall HAIs decreased from 7.6 to 4.0 per 100 patients discharged (P=0.011) and from 12.7 to 7.3 per 1,000 patient-days (P=0.034). The invasive device-associated infections caused by MRSA and other pathogens decreased, but the decrease was not statistically significant. CONCLUSION: Reinforced contact precautions and ASCs were effective in decreasing both MRSA infections and overall HAIs in the ICU. Further, it was assumed that the incidence of device-associated infections would have decreased if the intervention period was extended.
Cross Infection ; Humans ; Incidence ; Critical Care ; Intensive Care Units ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus

BACKGROUND: HLA-B5102 is a newly approved antigen at the meeting of the WHO Nomenclature Committee held after the Eleventh International Histocompatibility Workshop. It had been called B5l.35 because it was defined by both B5l and B35 antisera. HLA-B5102 antigen cannot be accurately determined by current commercial HLA typing trays. This study was carried out to assess the frequency of HLA-B5102 antigen in Koreans and serological reaction patterns of HLA-B5102 on commercial HLA trays. METHODS: We performed HLA-A, B, C serological typing for 2,000 Koreans registered for KMDP (Korean Marrow Donor Program) donors using the Terasaki Oriental Tray (One Lambda, USA). Selected samples (17/2000) which showed atypical B5 reaction patterns were tested against Japan Central Block HLA Workshop tray to detect the presence of HLA-B5102. RESULTS: HLA-B5102 showed a phenotype (antigen) frequency of 0.45% (9/2000) and an allele frequency of 0.23%. Two locus HLA haplotype and linkage analysis showed that HLA-B5102 was in linkage disequilibrium with HLA-A3l (p<0.01). The serological patterns of HLA-B5102 on Terasaki Oriental Tray were 1) Lot 14, 15 : B5(+), 2) Lot 15 B : B5(+), B35+53(+), and 3) Lot 16 : B5(+), B5l(+), B35+53(+), and therefore could be identified as HLA-B5, B5l, B52, B35 or B53. CONCLUSIONS: The frequency of HLA-B5102 in the Korean population (antigen frequency 0.45%, allele frequency 0.23%) is similar to that of Japanese. The presence of HLA-B5102 can be suspected when atypical BS reaction patterns are encountered in commercial HLA typing trays, and B5 or BSI had better been assigned to these cases when additional confirmatory typing is not available.
Asian Continental Ancestry Group ; Bone Marrow ; Education ; Gene Frequency ; Haplotypes ; Histocompatibility ; Histocompatibility Testing ; HLA-A Antigens ; Humans ; Immune Sera ; Japan ; Linkage Disequilibrium ; Phenotype ; Tissue Donors

BACKGROUND: HLA-B5102 is a newly approved antigen at the meeting of the WHO Nomenclature Committee held after the Eleventh International Histocompatibility Workshop. It had been called B5l.35 because it was defined by both B5l and B35 antisera. HLA-B5102 antigen cannot be accurately determined by current commercial HLA typing trays. This study was carried out to assess the frequency of HLA-B5102 antigen in Koreans and serological reaction patterns of HLA-B5102 on commercial HLA trays. METHODS: We performed HLA-A, B, C serological typing for 2,000 Koreans registered for KMDP (Korean Marrow Donor Program) donors using the Terasaki Oriental Tray (One Lambda, USA). Selected samples (17/2000) which showed atypical B5 reaction patterns were tested against Japan Central Block HLA Workshop tray to detect the presence of HLA-B5102. RESULTS: HLA-B5102 showed a phenotype (antigen) frequency of 0.45% (9/2000) and an allele frequency of 0.23%. Two locus HLA haplotype and linkage analysis showed that HLA-B5102 was in linkage disequilibrium with HLA-A3l (p<0.01). The serological patterns of HLA-B5102 on Terasaki Oriental Tray were 1) Lot 14, 15 : B5(+), 2) Lot 15 B : B5(+), B35+53(+), and 3) Lot 16 : B5(+), B5l(+), B35+53(+), and therefore could be identified as HLA-B5, B5l, B52, B35 or B53. CONCLUSIONS: The frequency of HLA-B5102 in the Korean population (antigen frequency 0.45%, allele frequency 0.23%) is similar to that of Japanese. The presence of HLA-B5102 can be suspected when atypical BS reaction patterns are encountered in commercial HLA typing trays, and B5 or BSI had better been assigned to these cases when additional confirmatory typing is not available.
Asian Continental Ancestry Group ; Bone Marrow ; Education ; Gene Frequency ; Haplotypes ; Histocompatibility ; Histocompatibility Testing ; HLA-A Antigens ; Humans ; Immune Sera ; Japan ; Linkage Disequilibrium ; Phenotype ; Tissue Donors

BACKGROUND: We have performed questionnaire surveys of HLA laboratories in 1993 and 1995 and here we report the results of a survey performed in 1997. METHODS: The questionnaires were distributed to 39 HLA laboratories enrolled in the HLA quality assessment (QA) program (started in 1996) in Korea. The questionnaire items were slightly modified from those of the previous survey. RESULTS: Most of the HLA laboratories (31/39, 80%) belonged to the specialties of clinical pathology. Most of the HLA laboratories were of small scale in the number of HLA technicians and the annual number of HLA tests. The methods used for HLA crossmatch were quite improved compared to those of the previous survey (1995). The number of laboratories using sensitive methods such as T-AHG and/or T-long methods has markedly increased (31/34 laboratories, 91%) compared to that of the previous survey (5/29 laboratories, 17%). DNA typing methods for HLA-DR were used in 27 (69%) laboratories, among which 25 laboratories used commercial kits. Some laboratories stored complement at inappropriate temperature, which could adversely affect the test results. As for external QA programs for HLA tests, 7 laboratories were participating in international programs. Most of the laboratories responded that the domestic HLA QA program was of much help for HLA tests, especially for HLA crossmatch tests, and 21 laboratories changed the HLA crossmatch test methods after participating in the QA program. CONCLUSIONS: In recent 2 years, the most prominent changes in domestic HLA laboratories were increased use of HLA-DR DNA typing methods and improvement and standardization of HLA crossmatch test methods. The domestic HLA QA program was considered to be very helpful for quality improvement and standardization of HLA test.
Complement System Proteins ; DNA Fingerprinting ; Histocompatibility Testing ; HLA-DR Antigens ; Korea* ; Pathology, Clinical ; Quality Improvement ; Surveys and Questionnaires

BACKGROUND: We evaluated the efficacy of two chemiluminescence immunoassays that detect treponemal antibodies, Centaur Syphilis and Immulite Syphilis, in comparison with Mediace Treponema pallidum latex agglutination (TPLA). METHODS: The study was conducted in two phases. In the first phase, we tested 1,147 serum samples that were sequentially submitted for routine syphilis serology. In the second phase, we tested a panel of 119 frozen serum samples that had previously tested positive by Mediace RPR. The kappa value, total agreement percentage, and sensitivity and specificity were analyzed. RESULTS: Of the 1,147 random samples, 24 (2.09%) tested positive with Centaur Syphilis, 16 (1.39%) with Immulite Syphilis, and 19 (1.66%) with Mediace TPLA. Of the 119 Mediace RPR-positive samples, 103 (86.6%) tested positive with Centaur Syphilis, 101 (84.9%%) with Immulite Syphilis, and 105 (88.2%) with Mediace TPLA. The percent agreements (kappa values) were 98.8% (0.934) between Centaur Syphilis and Mediace TPLA, 99.0% (0.94) between Immulite Syphilis and Mediace TPLA, and 99.2% (0.955) between Centaur Syphilis and Immulite Syphilis. To measure the sensitivity and specificity of each treponemal test, samples showing agreement in three or four of the tests (three treponemal tests and Mediace-RPR) were regarded as true positive (n=117) or true negative (n=1,142). The respective values for sensitivity and specificity were 100% and 99.6% for Centaur Syphilis, 98.3% and 100% for Immulite Syphilis, and 99.2% and 99.7% for Mediace TPLA. CONCLUSIONS: Results from the three treponemal assays were in good agreement. Greater sensitivity of Centaur Syphilis and greater specificity of Immulite Syphilis were suggested.
Agglutination ; Antibodies* ; Immunoassay ; Latex ; Luminescence ; Sensitivity and Specificity ; Syphilis* ; Treponema pallidum

BACKGROUND: We evaluated the efficacy of two chemiluminescence immunoassays that detect treponemal antibodies, Centaur Syphilis and Immulite Syphilis, in comparison with Mediace Treponema pallidum latex agglutination (TPLA). METHODS: The study was conducted in two phases. In the first phase, we tested 1,147 serum samples that were sequentially submitted for routine syphilis serology. In the second phase, we tested a panel of 119 frozen serum samples that had previously tested positive by Mediace RPR. The kappa value, total agreement percentage, and sensitivity and specificity were analyzed. RESULTS: Of the 1,147 random samples, 24 (2.09%) tested positive with Centaur Syphilis, 16 (1.39%) with Immulite Syphilis, and 19 (1.66%) with Mediace TPLA. Of the 119 Mediace RPR-positive samples, 103 (86.6%) tested positive with Centaur Syphilis, 101 (84.9%%) with Immulite Syphilis, and 105 (88.2%) with Mediace TPLA. The percent agreements (kappa values) were 98.8% (0.934) between Centaur Syphilis and Mediace TPLA, 99.0% (0.94) between Immulite Syphilis and Mediace TPLA, and 99.2% (0.955) between Centaur Syphilis and Immulite Syphilis. To measure the sensitivity and specificity of each treponemal test, samples showing agreement in three or four of the tests (three treponemal tests and Mediace-RPR) were regarded as true positive (n=117) or true negative (n=1,142). The respective values for sensitivity and specificity were 100% and 99.6% for Centaur Syphilis, 98.3% and 100% for Immulite Syphilis, and 99.2% and 99.7% for Mediace TPLA. CONCLUSIONS: Results from the three treponemal assays were in good agreement. Greater sensitivity of Centaur Syphilis and greater specificity of Immulite Syphilis were suggested.
Agglutination ; Antibodies* ; Immunoassay ; Latex ; Luminescence ; Sensitivity and Specificity ; Syphilis* ; Treponema pallidum

The very rare D--/D-- phenotype lacks C, c, E, e antigens with strong expression of the D antigen. A 31-year-old woman delivered her second baby, 3.6 kg girl at 38+4 weeks' gestation through repeat-Cesarean section. Her parents were not consanguineous. She had one artificial abortion, one Cesarean section with red blood cell transfusion and two spontaneous abortions. Her red cells were typed as O, D+C-c-E-e- and did not react with anti-Hr(o) (Rh 17). Her serum reacted with all of the screening cells and identification panel cells with strength of (++)~(+++). The baby was mildly jaundiced 12 hours after delivery. At 1 day after delivery, total bilirubin was 17.7 mg/dL, and direct and indirect antiglobulin tests were both positive. Phototherapy was immediately given for the baby but jaundice and anemia were worsened. Twenty six milliliter of the mother's whole blood was given twice to the baby after plasma depletion and leukocyte reduction. The baby showed improvement of jaundice and anemia, and discharged at hospital day 14. As far as we know, this is the third reported case of hemolytic disease of the newborn occurred in the D--/D-- mother with anti-Hr(o) in Korea, and the first case that was neither fatal nor treated with intensive medical care.
Abortion, Spontaneous ; Adult ; Anemia ; Bilirubin ; Cesarean Section ; Coombs Test ; Erythrocyte Transfusion ; Female ; Hepatitis B e Antigens ; Humans ; Infant, Newborn* ; Jaundice ; Korea ; Leukocytes ; Mass Screening ; Mothers ; Parents ; Phenotype* ; Phototherapy ; Plasma ; Pregnancy