BACKGROUND: Dual antiplatelet therapy (aspirin and clopidogrel) is used to prevent adverse cardiac events in patients undergoing percutaneous coronary intervention (PCI). Some patients do not respond adequately to clopidogrel. Beta-thromboglobulin (beta-TG) and platelet factor 4 (PF-4) can act as markers to detect platelet activation. We investigated the relationship between clopidogrel response and the dynamics of beta-TG and PF4 concentrations. METHODS: This study included 36 myocardial infarction (MI) patients, who underwent PCI and was indicated for dual antiplatelet therapy. Platelet reactivity, using the VerifyNow P2Y12 assay, was measured on the 3rd day of PCI. At the time of admission, and on the 3rd and 10th day of PCI, the plasma beta-TG and PF4 concentrations were quantified. RESULTS: Ten patients (27.8%) were clopidogrel non-responders displaying >208 P2Y12 reaction units. At the time of admission, levels of beta-TG in patients were elevated than that in the healthy controls (P<0.001). A similar trend was observed on the 3rd and 10th day of PCI (P<0.001). The beta-TG levels on the 10th day were reduced than those at the time of admission and on the 3rd day of PCI. PF4 levels were not different between patients and controls, and were not significantly reduced after PCI. Higher beta-TG levels were observed in clopidogrel non-responders on the 10th day, but not significant. CONCLUSIONS: Clopidogrel therapy in MI reduce beta-TG concentration, but the beta-TG and PF4 levels before and after therapy are not associated with the response to clopidogrel. Platelet-derived markers may not be suitable for distinguishing clopidogrel non-responders.
beta-Thromboglobulin ; Blood Platelets* ; Humans ; Infarction* ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Plasma ; Platelet Activation* ; Platelet Factor 4

Pulmonary arteriovenous malformations (AVMs) are caused by abnormal vascular communications between the pulmonary arteries and pulmonary veins, which lead to the blood bypassing the normal pulmonary capillary beds. Pulmonary AVMs result in right-to-left shunts, resulting in hypoxemia, cyanosis, and dyspnea. Clinical signs and symptoms vary depending on the size, number, and flow of the AVMs. Transcatheter embolization is the treatment of choice for pulmonary AVMs. However, this method can fail if the AVM is large or has multiple complex feeding arteries. Surgical resection is necessary in those kind of cases. Here, we report the case of a patient with a 6-cm pulmonary AVM with multiple feeding arteries that was successfully treated by repeated coil embolization without surgery.
Anoxia ; Arteries ; Arteriovenous Malformations* ; Capillaries ; Cyanosis ; Dyspnea ; Embolization, Therapeutic* ; Humans ; Pulmonary Artery ; Pulmonary Veins

BACKGROUND: External quality assessment (EQA) uses a standard deviation index (SDI), based on a peer group, to evaluate laboratory performance. However, evaluations using peer group SDIs often have limited applicability, because they are not statistically valid unless the number of institutions in the same peer group is large. The present study proposes a statistical model for simultaneously evaluating the performance of all participating institutions, as well as the performance of instruments on the market. METHODS: By assuming that proficiency test results were affected by the manufacturer, the instrument, and the institution, the effects of those factors were estimated using a linear mixed model. We used these effect estimates to calculate manufacturer, instrument, and institution SDIs. Using simulation, we evaluated the false positive rates and efficiencies of the proposed linear mixed model. RESULTS: Simulations showed that the linear mixed model empirical type I error rates preserved the nominal significance level. This model was also more statistically efficient than the peer group SDI. Rates of unacceptability were lower when using institution SDI than they were when using peer group SDI. Additional outliers that could not be evaluated using the current system were detected by the institution SDI statistic. The instrument SDI statistic detected outliers among different instrument groups. CONCLUSIONS: Institution and instrument SDIs are robust and efficient tools for EQA, and they can replace the currently used system of peer group SDI.
Laboratory Proficiency Testing ; Models, Statistical ; Peer Group

No abstract available.
*Aneuploidy ; Bone Marrow/pathology ; Chromosomes, Human, Pair 21 ; Down Syndrome/*complications ; Female ; Humans ; Hyperplasia/pathology ; In Situ Hybridization, Fluorescence ; Infant ; Isochromosomes/*genetics ; Karyotype ; Leukemia, Megakaryoblastic, Acute/complications/*diagnosis ; Megakaryocytes/pathology

BACKGROUND: Despite modern advances in laboratory automated medicine, work-process in the blood bank is still handled manually. Several automated immunohematological instruments have been developed and are available in the market. The IH-1000 (Bio-Rad Laboratories, Hercules, CA, USA), a fully automated instrument for immunohematology, was recently introduced. In this study, we evaluated the performance of the IH-1000 for ABO/Rh typing and irregular antibody screening. METHODS: In October 2011, a total of 373 blood samples for ABO/Rh typing and 303 cases for unexpected antibody screening were collected. The IH-1000 was compared to the manual tube and slide methods for ABO/Rh typing and to the microcolumn agglutination method (DiaMed-ID system) for antibody screening. RESULTS: For ABO/Rh typing, concordance rate was 100%. For unexpected antibody screening, positive results for both column agglutination and IH-1000 were observed in 10 cases (four cases of anti-E and c, three of anti-E, one of anti-D, one of anti-M, and one of anti-Xg) and negative results for both were observed in 289 cases. The concordance rate between IH-1000 and column agglutination was 98.7%. Sensitivity and specificity were 90.9% and 99.3%, respectively. CONCLUSION: The automated IH-1000 showed good correlation with the manual tube and slide methods and the microcolumn agglutination method for ABO-RhD typing and irregular antibody screening. The IH-1000 can be used for routine pre-transfusion testing in the blood bank.
Agglutination ; Automation ; Blood Banks ; Isoantibodies ; Mass Screening ; Sensitivity and Specificity

BACKGROUND: Recently, a new automated inoculating instrument, Previ Isola(R) (bioMerieux, France) was introduced. Although there are many evaluation reports about the inoculation of urine and body fluid samples using Previ Isola(R), no evaluation has been reported for blood samples. The objectives of this study were to evaluate this instrument for the inoculation of blood samples and to compare the microbiological results with the manual loop-to-plate method. METHODS: From March 2014 to July 2014, a total of 296 non-duplicate blood samples showing positive signals on the BacT/Alert 3D system were obtained, and both manual and automated methods were used for sample inoculation. Results of the two methods were compared according to five aspects: the culture result, number of single colonies, morphology of colonies, number of re-inoculations, and time required for inoculation. RESULTS: The sensitivity and specificity of Previ Isola(R) were 98.9% and 96.6%, respectively. The positive and negative predictive values were 99.6% and 90.3%, respectively, and the total concordance rate was 98.6%. For Previ Isola(R) and the manual methods, the number of average usable single colonies per plate was 25 and 16, the number of re-inoculations was 60 and 62, and the inoculation time for 15 blood samples was 30 min and 75 min, respectively. The morphology of colonies showed no differences between the two methods. CONCLUSIONS: The automated inoculation instrument, Previ Isola(R), showed relative good concordance with manual method, with high sensitivity and high specificity for blood sample inoculation. Previ Isola(R) may be useful for inoculating specimens including blood samples.
Automation ; Body Fluids ; Evaluation Studies as Topic ; Sensitivity and Specificity

BACKGROUND: Biodegradable microneedle technology is a recently developed method to deliver medical and pharmaceutical medications into the skin, and is expected to yield better treatment results than topical application methods. OBJECTIVE: To evaluate the efficacy of hyaluronic acid (HA)-based microneedle patches and epidermal growth factor (EGF)-containing microneedle patches on periorbital wrinkle improvement. METHODS: A 20-week randomized, double-blind study was performed. Twenty-five Korean patients with periorbital wrinkles and a wrinkle severity rating scale (WSRS) score above 2 were enrolled into the study. The patients completed the study using the two different types of patches on each side of the designated periorbital wrinkles area every other day for 8 weeks. Patients were requested for an additional 12-week follow up. Wrinkle improvements were assessed by WSRS score, subjective patient satisfaction score, and imaging analysis using the visiometer, corneometer, cutometer, and mexameter, respectively (Courage&Khazaka, Cologne, Germany). RESULTS: Both the HA-based microneedle patch and EGF-containing HA-based microneedle patch had positive effects on WSRS score, patient satisfaction levels, and corneometer result with statistically significant differences. No significant side effects were noticed. CONCLUSION: With respect to efficacy, no statistical difference between the two groups were noted, indicating that the anti-wrinkle effects of the microneedle patch may solely be due to the HA rather than the EGF.
Double-Blind Method ; Epidermal Growth Factor ; Follow-Up Studies ; Humans ; Hyaluronic Acid ; Patient Satisfaction ; Skin

Background: Bronchoscopy is recommended for patients with suspected nontuberculous mycobacterial pulmonary disease (NTM-PD) whose sputum culture results are consistently negative or from whom adequate sputum samples cannot be obtained. Post-bronchoscopy sputum (PBS) collection is recommended for patients with suspected tuberculosis who undergo bronchoscopy. However, it remains unclear whether PBS collection can increase the diagnostic yield of NTM-PD. Methods: Patients with suspected NTM-PD who underwent diagnostic bronchoscopy from January 1, 2017 to June 30, 2020 at the Seoul National University Hospital were included in the study. They were divided into the sputum culture-negative and scanty sputum groups.The results of mycobacterial cultures from bronchial washing specimens and PBS were compared between these groups. Results: In total, 141 patients were included in the study; there were 39 and 102 patients in the sputum culture-negative and scanty sputum groups, respectively. Nontuberculous mycobacteria were cultured from bronchial washing specimens collected from 38.3% (54/141) of all patients (30.7% [12/39] patients in the sputum culture-negative group and 41.2% [42/102] patients in the scanty sputum group; P = 0.345). Nontuberculous mycobacteria were exclusively cultured from PBS collected from 3.5% (5/141) of all patients (7.7% [3/39] patients in the sputum culture-negative group and 2.0% [2/102] patients in the scanty sputum group; P = 0.255). Conclusions Additional PBS collection improved diagnostic yield marginally in patients with suspected NTM-PD who undergo bronchoscopy.

Background: Bronchoscopy is recommended for patients with suspected nontuberculous mycobacterial pulmonary disease (NTM-PD) whose sputum culture results are consistently negative or from whom adequate sputum samples cannot be obtained. Post-bronchoscopy sputum (PBS) collection is recommended for patients with suspected tuberculosis who undergo bronchoscopy. However, it remains unclear whether PBS collection can increase the diagnostic yield of NTM-PD. Methods: Patients with suspected NTM-PD who underwent diagnostic bronchoscopy from January 1, 2017 to June 30, 2020 at the Seoul National University Hospital were included in the study. They were divided into the sputum culture-negative and scanty sputum groups.The results of mycobacterial cultures from bronchial washing specimens and PBS were compared between these groups. Results: In total, 141 patients were included in the study; there were 39 and 102 patients in the sputum culture-negative and scanty sputum groups, respectively. Nontuberculous mycobacteria were cultured from bronchial washing specimens collected from 38.3% (54/141) of all patients (30.7% [12/39] patients in the sputum culture-negative group and 41.2% [42/102] patients in the scanty sputum group; P = 0.345). Nontuberculous mycobacteria were exclusively cultured from PBS collected from 3.5% (5/141) of all patients (7.7% [3/39] patients in the sputum culture-negative group and 2.0% [2/102] patients in the scanty sputum group; P = 0.255). Conclusions Additional PBS collection improved diagnostic yield marginally in patients with suspected NTM-PD who undergo bronchoscopy.

BACKGROUND: Tumor-infiltrating lymphocytes, which form a part of the host immune system, affect the development and progression of cancer. This study investigated whether subsets of lymphocytes reflecting host-tumor immunologic interactions are related to the prognosis of patients with acute myeloid leukemia (AML). METHODS: Lymphocyte subsets in the peripheral blood of 88 patients who were newly diagnosed with AML were analyzed by quantitative flow cytometry. The relationships of lymphocyte subsets with AML subtypes, genetic risk, and clinical courses were analyzed. RESULTS: The percentages of T and NK cells differed between patients with acute promyelocytic leukemia (APL) and those with AML with myelodysplasia-related changes. In non-APL, a high proportion of NK cells (>16.6%) was associated with a higher rate of death before remission (P=0.0438), whereas a low proportion of NK cells (≤9.4%) was associated with higher rates of adverse genetic abnormalities (P=0.0244) and relapse (P=0.0567). A multivariate analysis showed that the lymphocyte subsets were not independent predictors of survival. CONCLUSION: Lymphocyte subsets at diagnosis differ between patients with different specific subtypes of AML. A low proportion of NK cells is associated with adverse genetic abnormalities, whereas a high proportion is related to death before remission. However, the proportion of NK cells may not show independent correlations with survival.
Diagnosis ; Flow Cytometry ; Humans ; Immune System ; Killer Cells, Natural ; Leukemia, Myeloid, Acute* ; Leukemia, Promyelocytic, Acute ; Lymphocyte Subsets* ; Lymphocytes* ; Lymphocytes, Tumor-Infiltrating ; Multivariate Analysis ; Prognosis ; Recurrence