BACKGROUND: Post-transfusion hepatitis B remains a risk for recipients of HBsAg negative bloods in Korea. The usefulness of anti-HBc screening for blood donors to reduce the risk of HBV transmission was evaluated in this study using LG Anti-HBc and LG Anti-HBs ELISA (LG Chemicals, Seoul, Korea) and HBV nucleic acid amplification test. METHOD: Sera from 2,274 HBsAg-negative blood donors were tested of anti-HBc and anti-HBs by LG Anti-HBc and LG Anti-HBs ELISA, respectively. Using 260 samples from HBsAg-negative blood donors and 62 FANA-positive samples, reactivity to LG Anti-HBc ELISA were compared with COBAS CORE Anti-HBc EIA (Roche Diagnostics, Basel, Switzerland). The precision of LG Anti-HBc was also tested. The nucleic acid amplification of 97 primary pools prepared from 2,274 samples was carried out, and then HBV presence was confirmed in individual samples. RESULT: Of 2,274 HBsAg-negative blood donors, 531 (23.4%) were positive for anti-HBc and 32 (1.4%) were anti-HBc positive/ anti-HBs negative. The concordance rate of LG Anti-HBc ELISA and COBAS was 97.8% (315/322). The intra-run and inter-run coefficient of variation was 4.7-10.2% and 2.5-11.4%, respectively. Thirteen pools showed initial positive in HBV PCR, but seven pools (53.8%) were finally found to be false positive. Of six true positive pools, seven samples were confirmed to have HBV DNA. The HBV detection rate was 6.3% (2/32) among donors whose results were anti-HBc positive/ anti-HBs negative. CONCLUSION: Among screen-negative blood donors, 6.3% of donors whose seroreactivity was anti-HBc positive/ anti-HBs negative were positive for HBV by nucleic acid amplification test, while donors showing such seroreactivity were only 1.4%. It is suggested that an introduction of anti-HBc and anti-HBs testing in Korean Blood Donation program be efficient to attain safety from HBV transmission.
Blood Donors* ; DNA ; Enzyme-Linked Immunosorbent Assay* ; Hepatitis B ; Hepatitis B Surface Antigens ; Humans ; Korea ; Mass Screening* ; Nucleic Acid Amplification Techniques* ; Polymerase Chain Reaction ; Seoul ; Tissue Donors

Although it is commonly appreciated that there is an inordinately large number of anormalies associated with the excretory ducts of the liver, comparatively little attention has been paid to the position of the orfice of the common bile duct into the duodenum. But, obiviously the site of entrance of the common bile duct into the duodenum becomes of great importance to the endoscopist, radiologist, and surgeon in diseases of the extra-hepatic biliary tract diag-nostically and therapeutically. We report 'a case of anomalous termination of the common bile duct into the duodenal bulb with the gall bladder empyema.
Biliary Tract ; Cholecystitis* ; Common Bile Duct* ; Duodenum ; Liver

No abstract available.
Bone Marrow Transplantation* ; Bone Marrow* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Recurrence*

BACKGROUND: Since the introduction of anti-HCV assay, post-transfusion hepatitis (PTH) by Hepatitis C Virus (HCV) was remakably reduced. Recently, based on the estimation of HCV seroincidence rate in blood donors, an investigator insisted that alanine aminotransferase (ALT) test be discontinued as a surrogate marker. This study was designed to determine the HCV seroincidence in Korean blood donors. METHODS: HCV seroincidence was calculated using repeat donors who had donated repeatedly during the 26 months from Nov. 1994 through Dec. 1996. To calculate the person-years according to ALT value, the computer database of the Korean National Red Cross (KNRC) was used in which results for anti-HCV by enzyme immunoassay (EIA) were filed up. To count the true incidence cases, who were defined as donors showing seroconversion by confirmatory test in two successive donation, seroconverted donors by EIA were individually reconfirmed whether they were true seroconverters. Finally, projected impact on HCV risk of discontining of ALT screening was calculated by using two important value previously known, such as periods of seroconversion window for anti-HCV and ALT preconversion window. RESULTS: HCV seroincidence was estimated to be 13.79/100,000 person-years. Seroincidences according to the ALT groups were as follows; 13.22 in the normal ALT group (< or = 64 IU/L), 34.15 in the elevated group (65-130 IU/L), 87.13 in the highly elevated group (> or =131 IU/L). By this study, investigators also could find seroconverted donors, whose result for anti-HCV by immunoblot was positive at the first donation and changed to negative by EIA at the next donation, as many as 100 donors. Among these falsely seroconverted persons, 16% of donors showed elevated ALT value. 8 units per 1 million donations were estimated to be discarded only by abnormal results of ALT testing in Korea. CONCLUSION: HCV seroincidence in Korean donors was 2.8 times as high as in American donors. HCV seroincidence calculated by this study seems to be somewhat lower than true rate because of the problem of summing-up the person-years. Considering that higher seroincidence results in more donors in seroconversion window phase, donor selection by careful history taking should be re-emphasized to reduce the seroincidence rate in Korean blood donation program.
Alanine Transaminase ; Biomarkers ; Blood Donors* ; Donor Selection ; Hepacivirus ; Hepatitis ; Humans ; Immunoenzyme Techniques ; Incidence ; Korea* ; Mass Screening ; Red Cross ; Research Personnel ; Tissue Donors

BACKGROUND: Total T lymphocytes can be measured by CD3-fluorescein isothiocyanate (FITC)/CD4-phycoerythrin (PE) and CD3-FITC/CD8-PE. The difference in the CD3 percentages between these two determinations was evaluated. And, we characterized the CD3(+)CD4(-)CD8(-) T lymphocytes subset using the monoclonal antibody that detects gamma delta T lymphocytes receptors. METHODS: The T lymphocyte subset assay was performed on 221 samples. A two-color direct immunofluorescence flow cytometric assay was done using a Simultest IMK-Lymphocyte kit (Bec-ton- Dickinson, San Jose, CA, USA). If the difference between the CD3 determinations were greater than 3%, the entire procedure was reviewed and the flow cytograms were reanalyzed. In 71 among 221 samples the proportion of gamma delta T lymphocytes was determined. RESULTS: The difference between the CD3-FITC/CD4-PE tube and CD3-FITC/CD8-PE tube was 3.0%, 3.6%, 3.0%, 3.4%, and 2.4% in normal subjects, patients with chronic liver disease, patients with cancer, patients with other diseases, and children, respectively. The between-tube differences for CD3 exceeding 3% were found in 69 samples (31.2%). The proportion of gamma delta T lymphocytes was 0.81%, 2.46%, 2.50%, and 0.85% in normal controls, patients with chronic liver disease, patients with cancer and patients with other diseases, respectively. No correlation between gamma delta T lymphocytes and CD3(+)CD4(-)CD8(-) T lymphocytes was observed. CONCLUSIONS: The reproducibility of the total T lymphocytes should be improved because of the between-tube difference exceeding 3% in about one third of the cases. Additionally, CD3(+)CD4(-)CD8(-) T lymphocytes were composed of heterogeneous subsets including gamma delta T lymphocytes and their proportion might be considered to be related to individual variation.
Child ; Fluorescent Antibody Technique, Direct ; Humans ; Liver Diseases ; Lymphocyte Subsets* ; Lymphocytes* ; T-Lymphocytes

It hae been well established that, specifi alterations in members of the ras gene family, H-ras, K-ras and N-ras, can convert them into active oncogenes. These alterations are either point mutations occurirg in either codon 12, 13 or 61, or alternatively, a 5- to 50-fold amplification of the wfld-type gene. Activated ras oncogenes have been found in a significant proportion of all turnors, but the incidence varies considerably with the tumor type : it is frequent (20~40%) in colarectal eancer and acute myeloid leukemia, but absent or preaent rarely in breast and atomach cancer. But the role of c-K-ras point mutatio in the development of cancers in the female genital tract has not been extensively studied. Polymerase chain reaction followed by gel electrophoresis was performed respectively using wild-type normal and specific point mutation primers{GGT->GAT, GGT->AGT, GGT->TGT and GGT->GTT) to detect, point, mutation of codon 12 of c-K-ras oncogene. The c-K-ras oncogene point mutation was confirmed by Southern blot hybridization using synthetic oligonucleatide probe. 3'-end Iabelled with digoxigenin -dUTP. With this method, the frequency of point mutation on codon 12 of c-K-ras oncogene was examined the tissues in 37 casea of ovarian cancer, 7 cases of endometrial cancer, 36 cases of the gestational trophoblastic tumor, 60 cases of cervical cancer. The relationship between the presence of a c-K-ras point mutation and clinicopathological characteristics of the female genital tract cancers were also analysed. The results were as follows; 1. The incidence of four point mutations on codon 12 of c-K-ras oncogene in 37 ovarian cancers was 45.9% (17/37) and distribution were 43.2% (16/37), 2.7% (1/37) and 0% (0/37) in GGT-->GAT, GGT-->AGT, GGT-->TGT, and GGT-->GTT, respectively. According to histological type, in ovarian cancers, The point mutation of K-ras oncogene waspositive in 45 % (10/22) of serous cystadenocarcinomas. The incidence of four point mutations on codon 12 among 37 patients with ovarian cancer according to histological type was 45.5 % (10/22) with serous cystadenocarcinoma, 57.1% (4/7) of mucinous cystadenocarcinoma. Comparing the positive rate of point mutations of K-ras oncogen among 37 patients with ovarian cancer with the clinical stage, point mutation was detected in 28.5% (2/7) of patients with stage I, 40.0% (2/5) with stage II, and 52.0% (13/25) with stage III/IV. There was no statistically significant increasement of point mutations with the advance of the clinical stage of ovarian cancer. Comparing the positive rate of point mutations of K-ras oncogen among 37 patients with ovarian cancer according to the histologic grade point mutation was detected in 50.0 % (2/4) 0f patients with grade I, 451.7 % (5/12) with grade II and 47.6 % (10/21) with grade III. 2. The incidence of point mutations of K-ras oncogen among 33 patients with ovarian cancer who were performed pelvic lymph node dissection was 57.1 % (12/21) of the patients with pelvic lymph node metastases and 16.7% (2/12) of the patients without pelvic lymph node metastases. There was statistically significant difference between the positive rate of c-K-ras point mutations and the pelvic lymph nodal status(P<0.05). 3. In 7 cases of endometrial cancer, positive rate of K-ras point was 42.8 % (3/7). Point mutations were also detected in 2 cases from 4 choriocarcinomas, but, the point mutation was only detected in 1 case from 60 cervical carcinomas. From these results, we may suggest that the point mutation on codon 12 c-K-ras oncogene are considered to be one of the important genetic change in the tumor formation and progression of ovarian of c-K-ras oncogene seems to be the one stop in the multistep process of tumor formation in ovarian cancer. Furthermore, the point mutation of c-k-ras gene could occur more frequently in the patients of ovarian cancer with pelvic lymph node metastases than in those without pelvic metastases, suggesting the orle in tumor progression. And we concluded that point mutation on codon 12 is comparable frequent in uterine endometrial carcinomas and have significance as an event that contributes to progrssion of endometrial cancers and choriocarcinoma, but cervical carcinoma do not appear to have c-K-ras point mutation in general. More studies will be necessary, but the detection of c-k-ras point mutation as the possibility of biological tumor marker to predict clinical outcome may be utilized in female malignancies.
Blotting, Southern ; Breast ; Choriocarcinoma ; Codon ; Cystadenocarcinoma, Mucinous ; Cystadenocarcinoma, Serous ; Digoxigenin ; Electrophoresis ; Endometrial Neoplasms ; Female* ; Genes, ras ; Humans ; Incidence ; Leukemia, Myeloid, Acute ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Oncogenes* ; Ovarian Neoplasms ; Point Mutation* ; Polymerase Chain Reaction ; Pregnancy ; Trophoblastic Neoplasms ; Biomarkers, Tumor ; Uterine Cervical Neoplasms

To investigate resistance to lamivudine (3TC), we examined the incidence of M184V in 20 HIV-1 patients treated with 3TC for 13.1 +/- 9 months. Fourteen of 20 patients had been exposed to zidovudine (ZDV) or didanosine (ddl) prior to 3TC therapy. Nested PCR targeting to reverse transcriptase (RT) and direct sequencing were performed for peripheral blood mononuclear cells sampled serially. There were resistance mutations to ZDV in at least 9 patients at baseline, although there was no resistance mutation to 3TC. We could detect M184V in 6 (30%) out of 20 patients. The incidence of M184V increased as the duration of therapy prolongs (13% in samples<12 months; 47% in samples gtoreq 12 months). The frequency of mutation M184V was higher in patients with previous mutation to ZDV than in patients with wild type. Resistance mutation was not detected in 7 patients. This study shows that resistance to 3TC tends to develop rapidly in patients with baseline mutations or two drugs combination therapy than in those treated simultaneously with triple drugs. This report is the first on resistance to 3TC in Korean AIDS patients.
Didanosine ; HIV-1* ; Humans ; Incidence ; Lamivudine* ; Polymerase Chain Reaction ; RNA-Directed DNA Polymerase ; Zidovudine

BACKGROUND: Antibody screening for donated blood is not yet being performed in Korea. Positive rate of irregular antibodies in Korean patients or blood donors has been thought to be much lower than that of foreign contries. We studied to know the actual frequency of irregular antibodies in blood donors with history of parturition using gel card, which was recently introduced in the field of blood banking and considered to be easy to standardize and sensitive to detect irregular antibodies. METHODS: 706 samples were collected from four blood centers in Seoul for 4 months. Antibody screening and identification were done by two kinds of Gel Card (DiaMed-ID corp, DiaMed, Murten, Switzerland) such as Nacl/Enzyme and LISS/Coombs' card. Adsorption- elution test was done in samples of which we could know the antibody specificity. RESULTS: Irregular antibodies were identified in 24 cases among 706 samples, therefore the overall frequency was 3.4% (95% CI: 3.4% +/- 1.3%). Only 4 cases, however, showed positive reaction in both enzyme and Coombs' phase, therefore frequency of clinically significant antibodies was 0.57% (95% CI: 0.57% +/- 0.55%). The identified irregular antibodies were anti-Lea (8 cases), Anti-Rh (3 cases) and Anti-P1 (1 case). Adsorption-elution test showed positive reaction only in 3 cases with anti-Rh antibodies. CONCLUSION: Considering that blood donors with history of parturition comprize just little proportion of total donors in Korea and frequency of irregular antibody is relatively lower than that of foreign countries in same group (0.57% vs 3.8%), it can be concluded that antibody screening be not urgent problem in Korean blood donation program.
Antibodies ; Antibody Specificity ; Blood Banks ; Blood Donors* ; Female ; Humans ; Korea ; Mass Screening ; Parturition* ; Seoul ; Tissue Donors

Enterococcus gallinarum carrying both vanA and vanC1 genes were detected from a surveillance culture from a patient staying at the surgical intensive care unit for a few years. E. gallinarum, SI04, was highly resistant to vancomycin (MIC of >or=256ng/mL) and teicoplanin (MIC of >or=256ng/mL). Multiplex PCR for vanA, vanB, vanC1 and vanC2/3 genes revealed SI04 to be positive for both vanA and vanC1 genes. This finding supports the fact that genotyping is needed to classify vancomycin-resistant enterococci (VRE). This is the first report on VanC VRE accompanying vanA gene in Korea.
Enterococcus* ; Humans ; Critical Care ; Korea ; Multiplex Polymerase Chain Reaction ; Teicoplanin ; Vancomycin

BACKGROUND: The specificity of HBsAg enzyme immunoassay (EIA) has been previously reported between 95% and 100% for blood donor screening in Korea. Considering that Korea is highly endemic in HBV infection, it is highly recommended that blood donors showing true positive for HBsAg were permanently deferred from donation. Identification of false-positive results by a confirmation assay would be a necessary step for this purpose. This study was intended to evaluate LG HBsAg Confirm (LG Chemicals Corp., Seoul, Korea) kit as a confirmation test and know the positive predictive value for HBsAg screening results. METHODS: LG HBsAg Confirm reactivities were evaluated in 279 patients and 185 blood donor samples, all of which were positive in HBsAg EIA. Patients samples were positive in both HBsAg EIA and HBV DNA. Confirm positive was determined according to the following 2 step criteria: (1) the percent neutralization is 50% or more (first-step neutralization), or (2) if not, the percent neutralization after 1:1,000 dilution of original sample is 50% or more (second-step neutralization). RESULTS: LG HBsAg Confirm kit confirmed all 279 patients~ sera as positive. All of 185 blood donor samples showed true positive results. First-step neutralization confirmed 157 sera (33.8%) as positive and second-step neutralization confirmed 307 sera (66.2%) among 464 samples. CONCLUSION: Performance of LG HBsAg Confirm was so excellent that all the samples showing positive in both HBsAg EIA and HBV DNA tests could be determined as confirm positive.
Blood Donors ; DNA ; Hepatitis B Surface Antigens* ; Humans ; Immunoenzyme Techniques ; Korea ; Mass Screening ; Neutralization Tests ; Sensitivity and Specificity ; Seoul