BACKGROUND: The VITROS 3600 (Ortho Clinical Diagnostics, Johnson & Johnson, Buckinghamshire, UK), which uses the enhanced chemiluminescence immunoassay, has recently been introduced; however, it has not been evaluated for detection of HBsAg in Korea. We evaluated the ability of the VITROS 3600 for detection of HBsAg, compared with the ARCHITECT i2000 (Abbott Laboratories, Abbott Park, IL, USA), which is used widely in Korea to help in selection of an analyzer for detection of HBsAg. METHODS: A total of 800 samples were tested randomly for HBsAg and 150 samples with positive HBV DNA detected by real-time PCR were used in this study. Precision, agreement, and Pearson correlations between two analyzers were evaluated. RESULTS: The total standard deviations (SD) were 0.016 and 0.183 for the negative and positive HBsAg controls, respectively; the precision met the criteria suggested by the manufacturer. There were 100% agreements for the 800 random samples (positive 33, negative 767) and 150 samples with HBV DNA (positive 148, negative 2) between two analyzers. In addition, good correlation was observed between two analyzers for the 767 HBsAg negative samples (r=0.691, P=0.004), and 148 HBV DNA positive samples (r=0.763, P<0.001). CONCLUSION: The VITROS 3600 showed good precision and agreement. And, correlation between the VITROS 3600 and the ARCHITECT i2000 was excellent. Therefore, this result will be helpful in selection of an analyzer for detection of HBsAg.
DNA ; Enzyme-Linked Immunosorbent Assay ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Immunoassay ; Korea ; Luminescence ; Real-Time Polymerase Chain Reaction

Accurate D antigen blood typing is needed owing to the clinical importance of the Rh blood group. We describe a female infant who was suspected to suffer from Rh incompatible hemolytic disease of the newborn, and who showed a strong positive direct antiglobin test (DAT) result and false red blood cell (RBC) agglutination in D typing. Using chloroquine dissociation of IgG, we confirmed that the antibodies coating her RBCs were of anti-D type. D typing with 0.8% RBC suspensions in saline using saline gel cards showed 2+ RBC agglutinations. After increasing the incubation time of dissociation by chloroquine for up to 4 hr, the dissociated RBCs began to show agglutination in both the tube technique (2+) and the gel card technique (4+) for D typing, although the DAT rest was still positive. Therefore, in order to prevent mistyping as a false-negative D blood group, whenever the D blood typing of a patient with a strong positive DAT rest does not show RBC agglutination, retesting of the D blood typing is recommended by using saline-suspended RBCs or dissociated RBCs.
Agglutination ; Antibodies ; Blood Grouping and Crossmatching ; Chloroquine ; Erythrocytes ; Female ; Humans ; Immunoglobulin G ; Infant ; Infant, Newborn* ; Phenotype* ; Suspensions

The endoscopic diagnosis of gastric carcinoid has been considered difficult. Reported cases of this tumor diagnosed by endoscopic examination are rare. And the gastric carcinoid with massive upper gastrointestinal bleeding is a rare disease entity. We experienced a case of gastric carcinoid admitted to the hospital because of hematemesis, melena and syncope. And it was diagnosed by endoscopic biopsy, although it resembled type IIa+IIc early gastric cancer at endoscopic examination. To our knowledge, this is the first case report of gastric carcinoid tumor mimicking early gastric cancer. So we report this case with a review of relevant literatures.
Biopsy ; Carcinoid Tumor* ; Diagnosis ; Hematemesis ; Hemorrhage ; Melena ; Rare Diseases ; Stomach Neoplasms* ; Syncope

Hemophagocytic lymphohistiocytosis (HLH) is a rare disorder characterized by fever, pancytopenia, hyperferritinemia, and phagocytosis of hematopoietic cells in bone marrow, liver, or lymph nodes. HLH can occur during the course of systemic lupus erythematosus (SLE), but can also be a presenting manifestation. Because development of pancytopenia occurs in less than 10 percent of SLE cases, investigation for HLH is necessary when otherwise unexplained pancytopenia persists despite adequate treatment. We experienced three cases of secondary HLH associated with SLE. Among the three patients, two patients developed HLH during the clinical course of SLE. The other patient who presented with pancytopenia was first diagnosed with HLH, and later with SLE. In her case, HLH turned out to be a presenting manifestation of SLE. We report on three successfully treated cases, and discuss the prevalence, characteristics, treatments, and prognosis of secondary HLH associated with SLE.
Bone Marrow ; Fever ; Humans ; Liver ; Lupus Erythematosus, Systemic ; Lymph Nodes ; Lymphohistiocytosis, Hemophagocytic* ; Pancytopenia ; Phagocytosis ; Prevalence ; Prognosis

BACKGROUND: Emphysematous pyelonephritis (EPN) is a rare and potentially life-threatening condition that requires prompt evaluation and management. However, its clinical presentation and outcomes vary widely. This study was conducted to ascertain the clinical features and prognostic factors regarding EPN. METHODS: All patients diagnosed with EPN radiologically and treated at the emergency department in the university-affiliated, tertiary-referral center, from January 1999 to December 2009 were evaluated. The patients' demographic and clinical characteristics, computed tomographic findings, treatment, and outcomes were analyzed retrospectively. RESULTS: Overall 14 patients diagnosed with EPN were admitted. There were 12 females and 2 males. A history of diabetes was found in 12 (85.7%) patients and was the most common comorbidity. The chief complaint among patients was flank pain (42.9%). Severe sepsis or septic shock was noted in 10 (71.4%) patients. Thirteen cases had unilateral involvement and one case had bilateral involvement. More than half of patients had Escherichia.coli in culture. Mean serum levels of HbA1c, creatinine, C-reactive protein (CRP) were 9.4 +/- 2.7, 2.4 +/- 1.4 mg/dl, and 22.4 +/- 13.1 mg/dl. Eight (57.1%) patients received antibiotic treatment alone and four (28.6%) patients received the concurrent percutaneous drainage as well as antibiotics. Hospital mortality was 7.1%. A higher initial serum CRP level (20.3 vs. 49.8 mg/dl, p = 0.02) and HbA1c level (8.7 vs. 16.4, p = 0.01) was associated with hospital mortality. CONCLUSIONS: Antibiotics alone provide a high success rate for the treatment of EPN. Higher serum CRP and HbA1c level was associated with a higher mortality rate in patients with EPN.
Anti-Bacterial Agents ; C-Reactive Protein ; Comorbidity ; Creatinine ; Diabetes Mellitus ; Drainage ; Emergencies ; Female ; Flank Pain ; Hospital Mortality ; Humans ; Male ; Pyelonephritis ; Sepsis ; Shock, Septic