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Performance Evaluation of the Hitachi 7600-110 Chemistry Autoanalyzer.

Sung Eun CHO ; Jun Woo NAM ; Ki Sook HONG

Korean Journal of Clinical Pathology.2001;21(5):331-337.

BACKGROUND: Hitachi 7600-110 (Hitachi, Tokyo, Japan) is an automated chemistry analyzer introduced in 1999. It consists of one dispensing type plus one pipetting type module and one electrolyte analyzer. We evaluated the performance of the analyzer in order to access the utility of the Hitachi 7600-110 autoanalyzer for the efficiency of routine chemistry work. METHODS: Within-day and between-day precision, accuracy, linearity, and recovery rates for albumin, ALP, ALT, AST, BUN, Ca, cholesterol, creatinine, r-GT, glucose, phosphorus, total bilirubin, TG, total protein, uric acid, CK, direct bilirubin, Fe, HDL-cholesterol, LD, Mg, Cl, K, and Na (24 items) were evaluated. Commercialized quality control material, Lyphochek (Bio-Rad, CA, USA) and patient sera for test specimens were used. Vitros 750 (Johnson & Johnson, Rochester, USA) was used as a control analyzer to evaluate the correlation. RESULTS: The within-day coefficients of variations (CVs) of almost all items were less than 3.0% except for direct bilirubin (7.71%), Mg (6.65%), and Fe (5.83%). The between-day CVs of almost all items were less than 5% except the direct bilirubin (13.16%). All items showed good linearity in the performance range (r>0.99, slope, 0.97-1.0). The results of ALT, AST, BUN, creatinine, glucose, CK, LD, Cl, K, and Na between Hitachi 7600-110 and the Vitros 750 revealed good correlation (r> or = 0.975) except Na and Cl. Hitachi data of Na and Cl showed significantly lower results (P<0.05) than did the Vitros 750 data. The recovery rates for BUN, creatinine, glucose, and uric acid were in the range of 100.00 to 101.78%. CONCLUSIONS: Hitachi 7600-110 showed acceptable performance in the "within-day" and "between-day" precision, linearity, and accuracy. The Hitachi 7600-110 that combines dispensing and pipetting modules can improve the speed and the efficiency of the workflow and can minimize the reagent consumption and the cost of system management. Therefore, it can be used both in large laboratories in general hospitals with many examinations and in small laboratories with relatively small numbers of cases.
Bilirubin ; Chemistry* ; Cholesterol ; Creatinine ; Glucose ; Hospitals, General ; Humans ; Phosphorus ; Quality Control ; Uric Acid

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Two Cases of Philadelphia Chromosome-negative Essential Thrombocythemia Manifested bcr-abl Gene Rearrangement.

Tong Kil JUNG ; Nan Young LEE ; Jang Soo SUH

Korean Journal of Clinical Pathology.2001;21(5):327-330.

Discrepant results have been reported in terms of detecting bcr-abl transcripts in patients with essential thrombocythemia that are Philadelphia (Ph) chromosome-negative. We present two cases of Ph chromosome-negative essential thrombocythemia in whom bcr-abl gene rearrangement was detected. In the diagnosis of both cases, they lacked the splenomegaly, anemia and basophilia, and had high platelet counts (948X10(3)/L and 1,329X10(3)/microL, respectively) and normal leukocyte alkaline phosphatase (LAP) scores on admission without any evidence of inflammation, infection, or therapy. They lacked the Philadelphia chromosome characteristic of classical chronic myelogenous leukemia (CML) and had b3a2 transcripts.
Alkaline Phosphatase ; Anemia ; Diagnosis ; Gene Rearrangement* ; Humans ; Hydrogen-Ion Concentration ; Inflammation ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukocytes ; Philadelphia Chromosome ; Platelet Count ; Splenomegaly ; Thrombocythemia, Essential*

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A Case of Acute Leukemia Complicated with Gastric Cancer.

Woo Jin KIM ; Woong Soo LEES ; Sung Joon KWON ; In Soon KIM

Korean Journal of Clinical Pathology.2001;21(5):323-326.

A 57-year-old man with a long history of smoking was admitted because of a history of abdominal pain lasting 2 weeks. An endoscopy revealed advanced gastric cancer. Four days after a subtotal gastrectomy, his peripheral blood count showed pancytopenia and five percent immature cells. Diagnosis of acute myelocytic leukemia was made by bone marrow examination, cytochemistry, and immunophenotyping. Induction chemotherapy was started and complete remission was achieved. Three months later, the patient suffered a relapse of leukemia and died of pulmonary hemorrhage during reinduction chemotherapy.
Abdominal Pain ; Bone Marrow Examination ; Diagnosis ; Drug Therapy ; Endoscopy ; Gastrectomy ; Hemorrhage ; Histocytochemistry ; Humans ; Immunophenotyping ; Induction Chemotherapy ; Leukemia* ; Leukemia, Myeloid, Acute ; Middle Aged ; Pancytopenia ; Recurrence ; Smoke ; Smoking ; Stomach Neoplasms*

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Why Should FISH Be Done in Patients with Acute Leukemias to Detect MLL Translocation?.

Hee Jin KIM ; Dong Soon LEE ; Cha Ja SEE ; Eun Kyong KO ; Hee Young SHIN ; Hyo Seop AHN ; Seon Yang PARK ; Byoung Kook KIM ; Han Ik CHO

Korean Journal of Clinical Pathology.2001;21(5):315-322.

BACKGROUND: Translocations involving the MLL gene on the long arm of chromosome 11 (11q23) are frequently observed in acute leukemia. The detection of this genetic change has a unique significance due to its implication for poor prognosis. The aim of this study was to determine the utility of fluorescence in situ hybridization (FISH) method in detecting the MLL translocation. METHODS: We applied both conventional cytogenetic analysis (CC) and MLL FISH on 289 consecutive Korean patients (children and adults) with acute leukemia and analyzed the data, placing an emphasis on the discrepancies in the results. RESULTS: Twenty-two of 289 patients (7.6%) had the 11q23/MLL translocation. In 9 cases of 22 (41%), only FISH detected the translocation. In 8 among 22 patients, a total of 19 follow-up examinations were performed, of which FISH detected a significant level of leukemia cells harboring the MLL translocation in 5 (26%) without cytogenetic evidence. Besides the MLL translocation, FISH detected submicroscopic amplification, partial deletion of the MLL gene, and trisomy 11 in 12 cases without cytogenetic evidence. CONCLUSIONS: These results demonstrate that up to 41% of the MLL translocations at initial workups and 26% during follow-up were detected by FISH without cytogenetic evidence. Thus, we recommend that MLL FISH should be performed in the diagnosis and monitoring of acute leukemia in combination with CC.
Arm ; Asian Continental Ancestry Group ; Chromosomes, Human, Pair 11 ; Cytogenetic Analysis ; Cytogenetics ; Diagnosis ; Fluorescence ; Follow-Up Studies ; Humans ; In Situ Hybridization ; Leukemia* ; Prognosis ; Trisomy

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Hepatitis G Virus Infection Rate in Blood Donors, Hemodialysis Patients and Hepatitis C Infected Patients.

Ki Youn KIM ; Seong Chul KIM ; Won Kil LEE ; Jay Sik KIM ; Jang Soo SUH ; Kyung Eun SONG ; Dong Kyu CHO ; Jong Gyu KIM ; Dal Hyo SONG

Korean Journal of Clinical Pathology.1998;18(3):433-441.

BACKGROUND: A recently identified Flaviviridae-like agent, termed hepatitis G virus (HGV), has been recognized as a non A-E hepatitis agent, but its relation to liver disease and transmission mode are not well understood. We investigated HGV infection rate in Korea and tried to clarify its relation to the liver disease. METHODS: 145 blood donors, 39 hemodialysis patients and 22 hepatitis C virus (HCV) infected persons were investigated for the presence of HGV by nested reverse transcriptase polymerase chain reaction (nested RT-PCR) with primers from the 5' UTR of HGV and some liver function tests. In each PCR assay, one positive and two negative controls were included. RESULTS: HGV-RNA was detected in 11 (7.6%) of 145 young voluntary blood donors and in 5 (12.8%) of 39 hemodialysis patients and in 8 (36.4%) of 22 HCV infected patients. All HGV RNA positive hemodialysis patients have a past history of transfusion, but they had a remarkably shorter duration of hemodialysis than those of HGV-negative patients. HCV infected patients with HGV-RNA tended to be younger than those without HGV-RNA. In all 15 HGV-RNA infected individuals without hepatitis B and C infection, alanine amino transferase was not increased except in 2 cases. Liver function tests did not show a significant difference between HGV-RNA positive patients and negative patients. CONCLUSIONS: Hepatitis G virus infection rate was much higher in Korea than other countries, so we suggested that group life could be another transmission mode other than blood transfusion. But even in infected cases, HGV did not seem to cause hepatitis and a high proportion cleared the virus after a relatively short time.
5' Untranslated Regions ; Alanine ; Blood Donors* ; Blood Transfusion ; GB virus C* ; Hepacivirus ; Hepatitis B ; Hepatitis B virus ; Hepatitis C* ; Hepatitis* ; Humans ; Korea ; Liver Diseases ; Liver Function Tests ; Polymerase Chain Reaction ; Renal Dialysis* ; Reverse Transcriptase Polymerase Chain Reaction ; RNA ; Transferases

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Distribution of Hepatitis C Virus Serotypes of HCV RNA Positive Subjects in Korea.

Seon Ho LEE ; Sung Ryul KIM ; Chul Hun CHANG ; Han Chul SON ; Soon Ho KIM

Korean Journal of Clinical Pathology.1998;18(3):425-432.

BACKGROUND: The geographical prevalence of the genotypes of hepatitis C virus (HCV) is variable, with which the response to therapy is associated. The HCV genotypes based on PCR and serological genotypes (serotypes) are known to be highly correlated with each other. In spite of the ease of the test, there was no reported data of HCV serotypes in Korean. So, the serotypes in Korean was evaluated for the construction of the basic data. METHODS: The HCV serotypes were tested by Murex HCV serotyping 1-6 Assay kit in persons with normal or high ALT. At the same time, anti-HCV and HCV RNA were detected. RESULTS: Positive rates of anti-HCV were 6.0% in persons with high ALT, with increasing tendency in aging process, which were higher than 1.4% in normal persons. HCV RNA was positive in 49% of persons with anti-HCV positive. The serotypes were detectable in 92.4% of persons with HCV RNA positive, of which type 1 and 2 were 51.6% and 40.8%, respectively. CONCLUSIONS: Serotype 1 and 2 were the major type in Korean, which data would be useful for the further study on the correlation of the serotypes with the genotypes and the relationship of the serotypes and the responses to therapy.
Aging ; Genotype ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Korea* ; Polymerase Chain Reaction ; Prevalence ; RNA* ; Serotyping

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Diagnostic Availability of the Soluble Transferrin Receptor in RA Patients.

Lae Hee CHUN ; Think You KIM ; Hye Rim LEE ; Woong Soo LEE

Korean Journal of Clinical Pathology.1998;18(3):420-424.

BACKGROUND: The transferrin receptor (TfR) is expressed on almost all cellular surfaces and is shedded into the blood to form the soluble transferrin receptor (sTfR). The sTfR has been known to be a good marker to reflect cellular iron status and to differentiate between iron deficiency anemia (IDA) and anemia of chronic disease (ACD) without the need for a bone marrow aspiration in rheumatoid arthritis (RA) patients. So we aimed to evaluate the diagnostic availability of sTfR in patients with RA and degenerative joint disease (DJD). METHODS: Eighty-seven outpatients visiting the Department of Rheumatology at HYUH were studied and divided into anemic and non-anemic groups according to their Hb levels (female< 12 g/dL, male< 14 g/dL). The sTfR was measured by ELISA method (Quantikine IVDTM, R&D system). To differentiate whether the anemia was due to iron deficiency or other causes, we used the RBC parameters and a discriminant index which was calculated from serum iron, ferritin and TIBC instead of a bone marrow aspiration, an invasive procedure of which interpretation can be subjective. RESULTS: The median was higher (31.09 nM) than the normal reference values (9-28 nM) only in the anemic group of RA. The medians were within normal limit in all the other groups. sTfR levels were high in 15 of the 28 RA anemic patients which were composed of 10 patients with IDA, 4 with non-anemic RA and 1 with non-anemic RA & DJD. CONCLUSIONS: In the present study, sTfR was increased not only in IDA but also in ACD of RA patients and also in non-anemic patients, which showed that sTfR cannot be used to differentiate these two types of anemia by itself and the further tests are needed. We conclude that the expression of TfR in RA patients was dependent not only on iron deficiency but also on the disease itself.
Anemia ; Anemia, Iron-Deficiency ; Arthritis, Rheumatoid ; Bone Marrow ; Chronic Disease ; Enzyme-Linked Immunosorbent Assay ; Ferritins ; Humans ; Iron ; Joint Diseases ; Outpatients ; Receptors, Transferrin* ; Reference Values ; Rheumatology ; Transferrin*

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Comparison of the Hybrid Capture Assay and Polymerase Chain Reaction for the Detection of Hepatitis B Virus DNA.

So Young KIM ; Moon Hee CHOI ; Mi Ae LEE ; Wha Soon CHUNG

Korean Journal of Clinical Pathology.1998;18(3):414-419.

BACKGROUND: Various molecular methods such as polymerase chain reaction (PCR) and DNA hybridization have been introduced to diagnose the hepatitis B more accurately. Recently, Hybrid Capture Assay (HCA) was developed, which uses the signal amplification solution hybridization capture assay with chemiluminescent detector. So we evaluated the sensitivity and clinical utility of the HCA and PCRs for the detection of hepatitis B virus DNA (HBV DNA) and compared these results with serologic markers. METHODS: We analysed the 50 samples from the hepatitis B patients using enzyme immunoassay, HCA and nested PCRs with two different primer sets. The primers of PCR I and PCR II were targeted to pol and core region respectively. RESULTS: In 18 cases, HBV DNA were detected by HCA in which the positive rates by PCR I and PCR II were 55.6%, and 88.9%, respectively. And in 32 cases in which HBV DNA by HCA was negative, the positive rates by PCR I and PCR II were 6.2% and 31.3%, respectively. In 44 cases which were positive for HBsAg, the positive rates for HBV DNA were 38.6% by HCA, 27.3% by PCR I, and 56.8% by PCR II. In cases positive for HBeAg, the positive rates were 93.3% by HCA, 60.0% by PCR I and 80.0% by PCR II. In cases positive for anti-HBe and negative for HBeAg, the positive rates were 10.3% by HCA, 10.3% by PCR I, and 44.8% by PCR II. CONCLUSIONS: Both HCA and PCR compensated each other yet as to the accurate investigation of the viral replication in patients with hepatitis B and the sensitivity was better in HBV PCR with primers to core region than to pol region.
DNA ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Immunoenzyme Techniques ; Polymerase Chain Reaction*

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Early Detection of Human Cytomegalovirus DNA by PCR-ELISA.

Min KIM ; Myung YOON ; Woo Hyun LIM ; Jong Hee SHIN ; Soon Pal SUH ; Dong Wook RYANG

Korean Journal of Clinical Pathology.1998;18(3):407-413.

BACKGROUND: Human cytomegalovirus (CMV) infections are common and occasionally severe in newborns, immunocompromised hosts, cancer patients, and recipients of organ transplant. Consequently, sensitive and rapid methods for CMV detection are of great diagnostic value since antiviral drugs have become available, which might be more effective upon early administration. We evaluated a polymerase chain reaction and enzyme-linked immunosorbent assay (PCR- ELISA) to detect human CMV infection as an aid in making a prompt diagnosis and a determination of therapeutic efficacy. METHODS: CMV DNA was amplified by single PCR, using primers chosen from genomic regions (major immediate-early [MIE] protein coding region), and the microwell plate hybridization assay was performed for specific detection of 5'-biotinylated PCR products using CMV-specific probes labeled with digoxigenin. A total of 35 clinical specimens from 14 patients who were suspected CMV infectious state was analyzed by PCR-ELISA and its results were compared with those of serum anti-CMV IgM, shell vial culture assay and PCR. RESULTS: The sensitivity for detection of PCR-amplified CMV DNA by the ELISA was 102 copies, which was ten-fold greater than ethidium bromide staining of agarose gels. The positive rates of 35 clinical specimens by serology, shell vial culture assay, PCR and PCR-ELISA were 37.9%, 40.0%, 60.0% and 68.6%, respectively. The OD ranges of 24 positive specimens by PCR-ELISA were from 0.042 to above 2.5. In follow-up studies of two patients with bone marrow transplantation, positive CMV results by PCR-ELISA earlier than by other methods including serologic method, shell vial culture assay and PCR. CONCLUSIONS: These results reveal that PCR-ELISA may show higher sensitivity and positive rate than serologic method, shell vial culture assay and conventional PCR. PCR-ELISA can be useful to manage CMV infection rapidly in patients at risk.
Antiviral Agents ; Bone Marrow Transplantation ; Clinical Coding ; Cytomegalovirus* ; Diagnosis ; Digoxigenin ; DNA* ; Enzyme-Linked Immunosorbent Assay ; Ethidium ; Follow-Up Studies ; Gels ; Humans* ; Immunocompromised Host ; Immunoglobulin M ; Infant, Newborn ; Polymerase Chain Reaction ; Sepharose ; Transplants

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Unusual Morphology of Aberrant Forms of Bacteria in Urine: Presented with Grotesque-Giant Form with Central Emptiness and Fusiform Ends.

Ae Seek KIM ; Jong Chan KANG ; Sun Hwa LEE

Korean Journal of Clinical Pathology.1998;18(3):403-406.

Unusual morphology of aberrant forms of bacteria, presented with grotesque-giant form, 15 m 3 m, with central emptiness and fusiform ends was observed in urine Gram stain from a 26-year-old woman who was admitted with the symptoms of acute urinary tract infection. On wet smear, these bacilli were markedly swollen, yeast-like organisms. In addition to normal shaped bacilli, various shapes of another aberrant bacteria, such as long bacilli, filamentous form, filamentous form with central bulge, and bipolar staining with central emptiness were also observed in the same specimen. The morphologic characteristics of these unusual aberrant bacilli were more distinct on Papanicolaou stain than on Gram stain. In Korea, where antimicrobial agents are overused and disused, the frequency of observing the aberrant bacteria would be much higher than cases reported. Here we report unusual morphology of aberrant forms of Escherichia coli with the emphasis on awaring of the potential appearance of such bacilli in clinical specimen and avoiding confusion with fungi and other naturally filamentous organisms.
Adult ; Anti-Infective Agents ; Bacteria* ; Escherichia coli ; Female ; Fungi ; Humans ; Korea ; Urinary Tract Infections

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