BACKGROUND: To understand causes of abnormal reaction for the urinalysis, we analyze the interfering substances of clinical urine samples. We focused the effect of urinary vitamin C and fluorescein sodium to the urine chemistry especially glucose, hemoglobin, and leukocyte esterase. METHODS: Incidence of urinary vitamin C was determined for patients and people underwent a medical check–up. We decided dipstick results of glucose, hemoglobin, and leukocyte esterase as false negative based on urine sediment and serum glucose results. Dipstick urinalysis was tested by URiSCAN Pro III with URiSCAN 11 strip (YD Diagnostics, Korea). Urine sediments tests were performed by manual microscopic analysis or Sysmex UF–1000i (Sysmex Co., Japan). RESULTS: The incidence of vitamin C was 20.4% for all subjects. The positive rate of the medical check-up group (34.6%) was higher than others. When vitamin C was detected in clinical urine samples, 42.3%, 10.6%, and 8.2% were defined as false negative for glucose, hemoglobin, and leukocyte esterase dipstick tests, respectively. Fluorescein sodium also interfered on the results of hemoglobin and leukocyte esterase of the dipstick reagents. CONCLUSIONS: Vitamin C was frequently found in the clinical urine samples, and its incidence was higher in the people who underwent medical check-up. The urinary vitamin C and fluorescein sodium can cause interferences in urine dipstick results. Thus, it is expected that present study will give useful information to predict false negative rates of urine dipstick tests by vitamin C and fluorescein sodium.
Ascorbic Acid ; Blood Glucose ; Chemistry ; Fluorescein ; Glucose ; Humans ; Incidence ; Indicators and Reagents ; Leukocytes ; Urinalysis*

No abstract available.
Korea

No abstract available.
Anti-Bacterial Agents/therapeutic use ; Aorta/pathology ; Bacteremia/*complications/drug therapy/*microbiology ; Ceftriaxone/therapeutic use ; Female ; Gram-Positive Bacterial Infections/*complications/drug therapy/*pathology ; Hematoma/*complications ; Humans ; *Immunocompromised Host ; Middle Aged ; Phylogeny ; RNA, Ribosomal, 16S/analysis ; Sequence Analysis, DNA ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; Tomography, X-Ray Computed ; Weissella/classification/genetics/isolation & purification/*physiology

BACKGROUND: By conventional methods, the identification of anaerobic bacteria is more time consuming and requires more expertise than the identification of aerobic bacteria. Although the matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) systems are relatively less studied, they have been reported to be a promising method for the identification of anaerobes. We evaluated the performance of the VITEK MS in vitro diagnostic (IVD; 1.1 database; bioMerieux, France) in the identification of anaerobes. METHODS: We used 274 anaerobic bacteria isolated from various clinical specimens. The results for the identification of the bacteria by VITEK MS were compared to those obtained by phenotypic methods and 16S rRNA gene sequencing. RESULTS: Among the 249 isolates included in the IVD database, the VITEK MS correctly identified 209 (83.9%) isolates to the species level and an additional 18 (7.2%) at the genus level. In particular, the VITEK MS correctly identified clinically relevant and frequently isolated anaerobic bacteria to the species level. The remaining 22 isolates (8.8%) were either not identified or misidentified. The VITEK MS could not identify the 25 isolates absent from the IVD database to the species level. CONCLUSIONS: The VITEK MS showed reliable identifications for clinically relevant anaerobic bacteria.
Bacteria, Anaerobic/*genetics/isolation & purification ; Bacterial Typing Techniques/*instrumentation/*methods ; Body Fluids/microbiology ; Databases, Genetic ; Humans ; RNA, Ribosomal, 16S/*analysis/metabolism ; Sequence Analysis, DNA ; *Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

Plasma exchange performed with the aid of acid-citrate-dextrose formula A (ACD-A) is generally regarded as safe. However, unfractionated heparin (UFH) can serve as an anticoagulant for patients experiencing serious side effects such as anaphylaxis. No guidelines have currently been defined for the stand-alone UFH dosing during plasma exchange. We describe here two patients who developed anaphylaxis to ACD-A during plasma exchange, and we successfully used UFH as a standalone anticoagulant. The first patient was a 55-year-old man who required plasma exchange before ABO-incompatible kidney transplantation. During plasma exchange, he developed an allergic reaction. Thereafter, UFH was used as a standalone anticoagulant during four sessions of plasma exchange; the UFH (5,000 units) was added to a 500 mL normal saline bag and the UFH:whole blood ratio was maintained at 1:28. The second patient was an 80-year-old woman with steroid pulse-resistant neuromyelitis optica. She developed an allergic reaction during the first session of plasma exchange. The patient subsequently underwent five successful sessions of plasma exchange using UFH as a standalone anticoagulant. These findings may be useful when establishing a protocol for UFH as a standalone anticoagulant during plasma exchange in patients who develop an allergic reaction to citrate.

Background: Detection of anti-human leukocyte antigen (HLA) antibodies is important during the selection of an appropriate donor prior to organ transplantation and also for monitoring the patients after transplantation. In this study, we compared antibodies detected via C3d assays, which monitors C3d complement-binding activities of HLA antibodies with those detected via single antigen bead (SAB) assays. Methods: A total of 66 serum samples were tested in parallel by SAB assays (Immucor Transplant Diagnostics, USA) and C3d assays (Immucor) for the detection of HLA class II antibodies. The relationship between these two methods was analyzed based on the types, numbers, median fluorescent intensity (MFI) values, and positivity of the antibodies using MATCH IT! Antibody (Immucor) program. Results: The number of antibodies obtained based on SAB and C3d assays was the highest with 24 samples (36.4%) in the 11–20 range and 23 (34.8%) in the 2–5 range detected via each assay. Among the SAB-positive antibodies, only 28 (6.4%) of the 440 antibodies with MFI ≤3,000 were C3d-positive, and 341 (61.3%) of the 556 antibodies with MFI ≥3,001 were C3d-positive. Whereas, among the 442 C3d-positive antibodies, SAB assays were positive except for 32 (7.2%) and 41 (9.3%) antibodies in the sections of MFI ≤500 and 1,001 ≤MFI ≤10,000, respectively. C3d-positive samples had higher maximum MFI values based on SAB assays, compared with C3d-negative samples. Conclusions MFI values of HLA class II antibodies detected through SAB assays in C3d-positive samples were higher than those in C3d-negative samples.

No abstract available.
Cannibalism ; Urinary Bladder

Background: Detection of anti-human leukocyte antigen (HLA) antibodies is important during the selection of an appropriate donor prior to organ transplantation and also for monitoring the patients after transplantation. In this study, we compared antibodies detected via C3d assays, which monitors C3d complement-binding activities of HLA antibodies with those detected via single antigen bead (SAB) assays. Methods: A total of 66 serum samples were tested in parallel by SAB assays (Immucor Transplant Diagnostics, USA) and C3d assays (Immucor) for the detection of HLA class II antibodies. The relationship between these two methods was analyzed based on the types, numbers, median fluorescent intensity (MFI) values, and positivity of the antibodies using MATCH IT! Antibody (Immucor) program. Results: The number of antibodies obtained based on SAB and C3d assays was the highest with 24 samples (36.4%) in the 11–20 range and 23 (34.8%) in the 2–5 range detected via each assay. Among the SAB-positive antibodies, only 28 (6.4%) of the 440 antibodies with MFI ≤3,000 were C3d-positive, and 341 (61.3%) of the 556 antibodies with MFI ≥3,001 were C3d-positive. Whereas, among the 442 C3d-positive antibodies, SAB assays were positive except for 32 (7.2%) and 41 (9.3%) antibodies in the sections of MFI ≤500 and 1,001 ≤MFI ≤10,000, respectively. C3d-positive samples had higher maximum MFI values based on SAB assays, compared with C3d-negative samples. Conclusions MFI values of HLA class II antibodies detected through SAB assays in C3d-positive samples were higher than those in C3d-negative samples.

We report a case of CTX-M-55-type extended-spectrum beta-lactamase (ESBL)-producing Shigella sonnei infection in a 27-year-old Korean woman who had traveled to China. The patient was admitted to the hospital due to abdominal pain, watery diarrhea, and fever (39.3degrees C). S. sonnei was isolated from her stool specimens, and the pathogen was found to be resistant to cefotaxime due to CTX-M-55-type ESBL. Insertion sequence (IS)Ecp1 was found upstream of the blaCTX-M-55 gene. The blaCTX-M-55 gene was transferred from the S. sonnei isolate to an Escherichia coli J53 recipient by conjugation. Pulsed-field gel electrophoresis and Southern blotting revealed that the blaCTX-M-55 gene was located on a plasmid of approximately 130 kb.
Adult ; Anti-Bacterial Agents/pharmacology ; Asian Continental Ancestry Group ; Cefotaxime/pharmacology ; China ; Drug Resistance, Bacterial/drug effects ; Dysentery, Bacillary/diagnosis/*microbiology ; Electrophoresis, Gel, Pulsed-Field ; Escherichia coli/metabolism ; Feces/microbiology ; Female ; Humans ; Plasmids/chemistry/genetics ; Republic of Korea ; Shigella sonnei/enzymology/*isolation & purification ; Travel ; beta-Lactamases/genetics/*metabolism

BACKGROUND: Recently, myeloproliferative leukemia (MPL) W515 mutations have been reported to be molecular markers for myeloproliferative neoplasms (MPNs). We studied the association between MPL W515 mutations and the clinico-hematological features of patients with MPNs. METHODS: Our study included 154 consecutive patients diagnosed with MPNs (31 had polycythemia vera [PV]; 106, essential thrombocythemia [ET]; and 17, primary myelofibrosis [PMF]). MPL W515 mutations were detected by real-time PCR and direct sequencing methods. RESULTS: The MPL W515L mutation was found in 4 patients and the MPL W515A mutation was detected in 1 patient. These 5 patients were diagnosed with JAK2 V617F-negative ET, and they accounted for 12.5% of patients with JAK2 V617F-negative ET. The patients with MPL W515-positive ET showed significantly lower hemoglobin levels and WBC counts than did patients with MPL W515-negative ET or JAK2 V617F-positive ET. CONCLUSIONS: MPL W515 mutation is a useful diagnostic marker for JAK2 V617F-negative MPNs and it is associated with specific hematologic characteristics such as lower hemoglobin levels and WBC counts.
Humans ; Janus Kinase 2 ; Leukemia ; Polycythemia Vera ; Primary Myelofibrosis ; Real-Time Polymerase Chain Reaction ; Thrombocythemia, Essential