Coronavirus disease 2019 (COVID-19) emerged in December 2019 in Wuhan, China; it has since caused a pandemic, with more than 10,000 confirmed cases (> 800,000 tests) in Korea as of May 2020. Real-time reverse transcription polymerase chain reaction (RT-PCR) is currently the most commonly used method for the diagnosis of COVID-19 worldwide. The Korean Society for Laboratory Medicine and Korea Centers for Disease Prevention and Control regularly update the guidelines for COVID-19 diagnosis. Emergency use authorization for some laboratory diagnostic kits has been granted, enabling the timely diagnosis and treatment of COVID-19, and the isolation of infected patients. Due to the collective efforts of the government, medical professionals, local authorities, and the public, Korea’s response to the COVID-19 outbreak has been accepted widely as a model. Here, we summarize the currently available laboratory tests for COVID-19 diagnosis. Although RT-PCR tests are used widely to confirm COVID-19, antibody tests could provide information about immune responses to the virus.

Background: Acetylcholinesterase inhibitors (e.g., pyridostigmine bromide) are used for neuromuscular blockade (NMB) reversal in patients undergoing surgery under general anesthesia (GA). Concurrent use of anticholinergic agents (e.g., glycopyrrolate) decreases cholinergic side effects but can impede bowel movements. Sugammadex has no cholinergic effects; its use modifies recovery of gastrointestinal (GI) motility following laparoscopic cholecystectomy compared to pyridostigmine/glycopyrrolate. This study evaluated the contribution of sugammadex to the recovery of GI motility compared with pyridostigmine and glycopyrrolate. Methods: We conducted a prospective study of patients who underwent laparoscopic cholecystectomy. Patients were randomly allocated to the experimental group (sugammadex, Group S) or control group (pyridostigmine-glycopyrrolate, Group P). After anesthesia (propofol and rocuronium, and 2% sevoflurane), recovery was induced by injection of sugammadex or a pyridostigmine-glycopyrrolate mixture. As a primary outcome, patients recorded the time of their first passage of flatus (‘gas-out time’) and defecation. The secondary outcome was stool types. Results: One-hundred and two patients participated (Group S, 49; Group P, 53). Mean time from injection of NMB reversal agents to gas-out time was 15.03 (6.36–20.25) h in Group S and 20.85 (16.34–25.86) h in Group P (P = 0.001). Inter-group differences were significant. Time until the first defecation as well as types of stools was not significantly different. Conclusions Sugammadex after laparoscopic cholecystectomy under GA resulted in an earlier first postoperative passage of flatus compared with the use of a mixture of pyridostigmine and glycopyrrolate. These findings suggest that the use of sugammadex has positive effects on the recovery of GI motility.

BACKGROUND: Inorganic arsenic trioxide (As2O3) has emerged as a new drug of choice for refractory acute promyelocytic leukemia (APL). But, the curable disease spectrum and the arsenic resistance in association with the expression of multidrug resistance (MDR) proteins are not yet to be established. METHODS: Five de novo APL and 20 refractory acute leukemia cases were selected. Leukemic cells were cultured for 24 hr in media with various As2O3 concentrations. Apoptotic cells or damaged cells were measured by a morphologic examination after Wright stain and flow cytometry using annexin V/propidium iodide (PI) stain. The lowest concentration of As2O3 at which greater than 90% of leukemic cells were damaged morphologically was defined as the morphologic arsenic sensitivity of leukemic cells. MDR protein markers including multidrug resistance associated protein (MRP), lung resistance protein (LRP), P-glycoprotein (PGP) and glutathinoe-S-transferase (GST) were analyzed by flow cytometry. RESULTS: The leukemic cells from de novo APLs (in 3 of 5) were sensitive to arsenic trioxide, compared to refractory acute leukemia (only 1 of 20). Of the five MDR proteins examined, only PGP was expressed more in the arsenic resistant cases (in 8 of 21) than in the sensitive cases (none of 4) (P=.032). CONCLUSIONS: Refractory acute leukemia had a variable arsenic sensitivity, but were more resistant than de novo APL. The arsenic resistance seems to be related to PGP expression.
Arsenic ; Drug Resistance, Multiple ; Flow Cytometry ; Leukemia* ; Leukemia, Promyelocytic, Acute* ; Lung ; Multidrug Resistance-Associated Proteins ; P-Glycoprotein

OBJECTIVES: This study was conducted to develop a Personality Assessment Scale for Hospital Employees (PAS-HE). Most current personality scales for recruiting employees have focused on evaluating the negative aspects of mental health. The present study sought to develop a Self-Report Questionnaire that assessed not only mental health problems but also positive personality traits and character strengths, as well as capabilities for hospital work. METHODS: Initially, a preliminary item pool was constructed and administered to psychiatry outpatients (n=44), hospital employees (n=217), and normal adults matched to hospital employees (n=217). Using the data from the three groups, the final 250 items for the PAS-HE were selected. Next, using data from 637 normal adults, internal consistency, test-retest reliability, and factor structure were examined and age norms were calculated for each of four age groups (18–25, 26–35, 36–45, 46–55 years). RESULTS: The PAS-HE showed moderate to high internal consistency, good temporal stability, and good construct validity. Factor structure and t-score norms (mean=50, SD=10) for each age group were established. CONCLUSION: The results of this study indicated the reliability and validity of the developed PAS-HE, suggesting that the PAS-HE can be time- and cost-efficient when used for recruitment and human resource management in hospitals.
Adult ; Humans ; Mental Health ; Outpatients ; Personality Assessment* ; Reproducibility of Results ; Weights and Measures

BACKGROUND: Most laboratories in Korea have been used kinetic Jaffe method for creatinine measurement. However, kinetic Jaffe method is interfered by hyperbilirubinemia, which causes creatinine decrement. In this study, we evaluated the usefulness of deproteinization by trichloroacetic acid (TCA) in eliminating negative interference of bilirubin for accurate creatinine measurement. METHODS: We evaluated the correction effect of serum creatinine levels by deproteinization using 0.55 mol/L TCA in 43 samples with various total bilirubin levels. For 26 samples of them we measured creatinine using the enzymatic method for evaluating accuracy of TCA correction. Creatinine was measured by using the Toshiba 200-FR automated analyzer and the HiSense CREA reagents. RESULTS: After TCA treatment, 22 to the total 43 samples with more than 10 mg/dL of total bilirubin, revealed statistically higher creatinine concentration (P=0.0002) and the difference of creatinine results is mean 0.53 mg/dL (0.15-1.92 mg/dL). Also, 19 of them (86.4%) revealed 20% or more difference of creatinine results before and after TCA treatment and the negative interference of bilirubin increased in proportion to the rise in total bilirubin concentration (r=0.870). There was no significant difference of creatinine results between kinetic Jaffe method with 0.55 mol/L TCA treatment and enzymatic method (P=0.216). CONCLUSIONS: TCA deproteinization is simple and very efficient method for estimating accurate creatinine level by using kinetic Jaffe method in a patient with hyperbilirubinemia.
Bilirubin ; Creatinine ; Humans ; Hyperbilirubinemia ; Korea ; Trichloroacetic Acid

BACKGROUND: Most laboratories in Korea have been used kinetic Jaffe method for creatinine measurement. However, kinetic Jaffe method is interfered by hyperbilirubinemia, which causes creatinine decrement. In this study, we evaluated the usefulness of deproteinization by trichloroacetic acid (TCA) in eliminating negative interference of bilirubin for accurate creatinine measurement. METHODS: We evaluated the correction effect of serum creatinine levels by deproteinization using 0.55 mol/L TCA in 43 samples with various total bilirubin levels. For 26 samples of them we measured creatinine using the enzymatic method for evaluating accuracy of TCA correction. Creatinine was measured by using the Toshiba 200-FR automated analyzer and the HiSense CREA reagents. RESULTS: After TCA treatment, 22 to the total 43 samples with more than 10 mg/dL of total bilirubin, revealed statistically higher creatinine concentration (P=0.0002) and the difference of creatinine results is mean 0.53 mg/dL (0.15-1.92 mg/dL). Also, 19 of them (86.4%) revealed 20% or more difference of creatinine results before and after TCA treatment and the negative interference of bilirubin increased in proportion to the rise in total bilirubin concentration (r=0.870). There was no significant difference of creatinine results between kinetic Jaffe method with 0.55 mol/L TCA treatment and enzymatic method (P=0.216). CONCLUSIONS: TCA deproteinization is simple and very efficient method for estimating accurate creatinine level by using kinetic Jaffe method in a patient with hyperbilirubinemia.
Bilirubin ; Creatinine ; Humans ; Hyperbilirubinemia ; Korea ; Trichloroacetic Acid

Background: Since the first case of severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) occurred in Wuhan in December 2019, the virus has spread globally. The World Health Organization declared the virus outbreak a pandemic on March 11, 2020. On January 19, 2020, a 35-year-old woman who returned from China was confirmed as the first SARS-CoV-2 infected case in Korea. Since then, it has spread all over Korea.Case: We report the first case of a SARS-CoV-2 positive woman delivering a baby through cesarean section at 37+6 weeks of pregnancy in the Republic of Korea. Conclusions This case suggested that negative pressure operating room, skillful medical team, and enhanced personal protective equipment including N95 masks, surgical cap, double gown, double gloves, shoe covers, and powered air-purifying respirator are required at the hospital for safe delivery in such a case.

The t(3;3)(q21;q26.2) is known to be mainly observed in hematologic myeloid malignancies, as a form of 3q21q26 syndrome. Cytogenetic abnormalities of 3q21q26 syndrome result in RPN1-EVI1 fusion transcripts involving ecotropic viral integration site-1 (EVI1) at 3q26.2 and ribophorin I (RPN1) at 3q21, and the fusion transcripts play an important role in leukemogenesis and disease progression. They are usually associated with dysplasia, especially of megakaryocytes. Patients with these cytogenetic abnormalities show extremely poor prognosis even with aggressive anti-leukemic therapy. We report a case of blastic crisis of CML with both t(3;3)(q21;q26.2) and t(9;22)(q34;q11.2) and associated severe multilineage dysplasia. The patient showed a poor response to imatinib, dasatinib and aggressive induction therapy. When both t(3;3)(q21;q26.2) and t(9;22)(q34;q11.2) are observed in cases of leukemia with increased blasts, they are best considered as aggressive phases of CML with t(3;3)(q21;q26.2), rather than AML with t(9;22)(q34;q11.2) by 2008 WHO classification.
Adolescent ; Antineoplastic Agents/therapeutic use ; Blast Crisis/*diagnosis ; Bone Marrow Cells/pathology ; *Chromosomes, Human, Pair 3 ; Drug Resistance, Neoplasm ; Humans ; Karyotyping ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/*diagnosis/drug therapy/genetics ; Male ; Piperazines/therapeutic use ; Pyrimidines/therapeutic use ; Thiazoles/therapeutic use ; *Translocation, Genetic

BACKGROUND: In vitro serum allergen-specific IgE tests have been routinely used in the clinical diagnosis of allergic diseases. We evaluated the clinical usefulness of a newly introduced multiple antigen screen test, Advansure Allergy Screen (LG Life Science, Korea) (LG-Screen) for the detection of allergen specific IgE. METHODS: A total of 180 sera (80 for inhalant and 100 for food panels) were tested by LG-Screen and RIDA Allergy Screen (R-biopharm, Germany) (RIDA-Screen) assays. According to the 58-60 specific allergens or allergen groups, the positive rates and agreement rates were analyzed using the cut off levels of class 2. For the quantitation of total IgE and specific IgE, nephelometry and ImmunoCAP test were performed in the sera showing discrepant results between the two allergy screen assays. RESULTS: The agreement rate and kappa value (k) of total IgE between the two allergy screen assays was 73.9% and 0.333. LG-Screen showed higher agreement rate with nephelometry than RIDA-Screen. The positive rates to common outdoor inhalant and food allergens were significantly higher in RIDA-Screen. Overall agreement rate of specific IgE between the two allergy screen assays for 58 allergens was 86.7% (6,086/7,020) (k, 0.293). In samples showing discrepant results between the two allergy screen assays, concordance rate of allergy screen assay with ImmunoCAP assay was 70.9% (449/633) for LG-Screen (k, 0.585) and 29.1% (184/633) for RIDA-Screen (k, -0.303). CONCLUSIONS: LG-Screen showed a favorable agreement with RIDA-Screen and ImmunoCAP assays, and it could be used for the detection of allergen specific IgE in the clinical laboratory.
Adolescent ; Adult ; Aged ; Allergens/diagnostic use/*immunology ; Child ; Child, Preschool ; Female ; Humans ; Hypersensitivity, Immediate/diagnosis ; Immunoglobulin E/*blood ; Immunologic Tests/methods ; Infant ; Male ; Middle Aged ; Reagent Kits, Diagnostic

BACKGROUND: In acute lymphoblastic leukemia (ALL), the importance of argyrophilic nucleolar organizer regions (AgNOR) is not established. METHODS: NOR silver staining was carried out in 74 ALL patients. We analyzed the AgNOR parameters ; counting parameters including number of AgNOR per cell, percentage of cells with one cluster, and area parameters including mean AgNOR area, total AgNOR area, and its percentage of nuclear area by morphometry. Cyclin A index was evaluated by immunohistochemical stain. We compared the AgNOR parameters with cyclin A index and evaluated the differences of AgNOR parameters in accordance with FAB classification, immunophenotype, a new classification of ALL (ALL with maturation), and response to induction chemotherapy. RESULTS: A positive correlation was found between cyclin A index and AgNOR area parameters and a significant negative correlation was found between mean AgNOR area and number of AgNOR per cell (r=-0.433, P=0.000). AgNOR area parameters revealed the highest value in L3. The number of AgNOR per cell in T cell ALL was higher than non-T cell ALL (P=0.011), and the percentage of cells with one cluster was lower (P=0.002). The number of AgNOR per cell in ALLm was lower (P=0.004) and the percentage of cells with one cluster was higher than in typical ALL (P=0.002). In cases achieved complete remission (CR) after induction chemotherapy, the number of AgNOR per cell was higher (P=0.005) and the percentage of cells with one cluster was much lower than in cases failed to achieve CR (P=0.013). CONCLUSIONS: Our study indicates that the AgNOR area parameters are helpful to predict the proliferating activity of leukemic blasts in ALL. It is suggested that the number of AgNOR per cell and the percentage of cells with one cluster provide a valuable information to estimate the response to chemotherapy in ALL.
Classification ; Cyclin A ; Drug Therapy ; Humans ; Induction Chemotherapy ; Nucleolus Organizer Region* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Silver Staining