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BACKGROUND: The previous performance tests of URiSCAN GEN 10SGL dipstick reagent strip (Yeongdong pharmaceutical Co., Seoul, Korea) were mainly done by comparison with the approved urine strips. However, adequate comparison was inavailable because the grading systems were different among the manufacturers. We evaluated the correlation of new generation URiSCAN GEN 10SGL urine strip with known quantitative, microscopic, and culture methods. METHODS: We used urine specimens which were collected for the urinalysis and culture from November 2000 to Mars 2001. We evaluated the correlation between the results of URiSCAN GEN 10SGL and the quantitative methods by comparing the mean of change of reflectance rate (change %R) with the result of the corresponding quantitative method for protein, glucose, bilirubin, urobilinogen, pH, and specific gravity. To calculate the sensitivity and specificity, we used microscopic examination for leukocytes and erythrocytes, and used urine culture for nitrite test. RESULTS: The correlation coefficients between the change %R of URiSCAN GEN 10SGL and the corresponding quantitative method exceeded 0.81, except bilirubin and specific gravity (P<0.01; respectively). The agreements of identical or neighboring concentration block were more than 90%, except urobilinogen and specific gravy. The sensitivity and specificity of URiSCAN GEN 10SGL were 63.6% and 94.2% for leukocytes; 92.8% and 74.1% for erythrocytes; 74.4% and 85.0% for nitrite producing organisms. CONCLUSTIONS: URiSCAN GEN 10SGL had acceptable accuracy and agreement compared with the corresponding quantitative methods and culture result. Also, it had improved sensitivity and specificity of leukocytes and erythrocytes detection compared with previous URiSCAN urine dipstick strip.
Bilirubin ; Erythrocytes ; Glucose ; Hydrogen-Ion Concentration ; Leukocytes ; Mars ; Reagent Strips ; Sensitivity and Specificity ; Seoul ; Specific Gravity ; Urinalysis ; Urobilinogen

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The Relationship of Insulin Resistance to High-Sensitivity C-Reactive Protein.

Rojin PARK ; Jeong Ho KIM ; Yong Seok YUN ; Young Duk SONG ; Kyung Rae KIM ; Kyung Soon SONG ; Oh Hun KWON ; Kap Bum HUH

Korean Journal of Clinical Pathology.2001;21(6):465-470.

BACKGROUND: Insulin resistance is known as the common denominator of risk factors of atheros-clerosis as well as the major pathogenic process of type 2 diabetes mellitus (DM). Recently some investigators indicated the relationship of chronic inflammatory reaction to atherosclerosis and insulin resistance. We examined the relationship between insulin resistance and high sensitivity CRP (hs-CRP) in Koreans. METHODS: Twenty-five patients with type 2 DM and eleven healthy men were examined. Glucose disposal rate (GDR, mg/kg/min) was determined as the index of insulin resistance by the euglycemic insulin clamp test with De Fronzo method. The serum hs-CRP level was determined by Behring nephelometric assay, fibrinogen by functional assay, and plasminogen activator inhibitor-1 (PAI-1) by ELISA. We also included 81 healthy subjects to determine the reference range of hs-CRP. RESULTS: The reference range (median) of hs-CRP was 0-5.20 (0.56) mg/L. The hs-CRP concentration was not significantly different between control and DM groups. The GDR of DM (3.8+/-1.7) showed significantly decreased value compared with normal (8.4+/-1.5) group (P<0.001). In all subjects, there was no significant correlation of GDR and hs-CRP. CONCLUSTIONS: There was no significant correlation of GDR and hs-CRP. We think the interventional prospective study with anti-inflammatory drug is warranted to elucidate the independent relationship between insulin resistance and hs-CRP.
Atherosclerosis ; C-Reactive Protein* ; Diabetes Mellitus, Type 2 ; Enzyme-Linked Immunosorbent Assay ; Fibrinogen ; Glucose ; Humans ; Inflammation ; Insulin Resistance* ; Insulin* ; Male ; Plasminogen Activators ; Reference Values ; Research Personnel ; Risk Factors

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Evaluation of Serum CTX and Osteocalcin Using Elecsys 2010.

Tong Kil JUNG ; Han Gil KIM ; Hyun Sik CHOI ; Nan Young LEE ; Sin Goo PARK ; Kyung Eun SONG

Korean Journal of Clinical Pathology.2001;21(6):459-464.

BACKGROUND: In contrast with bone formation markers, most of available indices of bone resorption are urine markers and show relatively high degree of variability. The serum resorption assay has therefore been developed. We evaluated serum bone-derived degradation products of type I collagen C-telopeptide (s-CTX) and serum osteocalcin by Elecsys 2010 (Hitachi Boehringer Mannheim, Tokyo, Japan). METHODS: For 18 healthy controls, 15 osteopenic and 7 osteoporotic patients samples, serum CTX and serum osteocalcin were measured by Elecsys 2010 using -CrossLaps/serum (Roche Diagnostic Corp., Indianapolis, USA) kit and N-MID Osteocalcin (Roche Diagnostic Corp. kit, respectively. DPD by Immulite (Diagnostic Products Corp., LA, USA) using Pyrilinks-D(TM) (Diagnostic Products Corp.) kit and serum osteocalcin for correlation by Gamma counter (Hewlett Packard, Meriden, USA) using ELSA-OSTEO (CIS, Cedex, France) kit were measured. RESULTS: The within-run and between-run coefficient of variation (CV) values of s-CTX were 6.41% and 6% in low concentrations and 3.84% and 7% in high concentrations, respectively. The within-run and between-run CV values of serum osteocalcin were 2.21% and 6% in low concentrations and 1.25% and 3% in high concentrations, respectively. The dilution recovery of s-CTX and serum osteocalcin was 100-169% (mean, 134%) and 80-138% (mean, 104%), respectively. S-CTX and DPD (R=0.369, P=0.019), and serum osteocalcin by Elecsys 2010 and RIA (R=0.889, P<0.001) showed positive correlations, respectively. CONCLUSTIONS: S-CTX and serum osteocalcin by Elecsys 2010 exhibits good analytical performance and correlate with DPD and serum osteocalcin by RIA, respectively. Therefore, these may replace DPD and serum osteocalcin by RIA and can be used for bone resorption and formation markers, respectively.
Bone Resorption ; Collagen Type I ; Humans ; Osteocalcin* ; Osteogenesis

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Relation of p53 Protein Overexpression to Subtypes of Acute Erythroleukemia.

Tae Hee PARK ; Tae Sung PARK ; Seung Hwan OH ; Hyung Hoi KIM ; Eun Yup LEE ; Joo Seop CHUNG ; Myeong You KIM ; Jeong Nyeo LEE ; Kyeong Hee KIM ; Jin Yeong HAN

Korean Journal of Clinical Pathology.2001;21(6):451-458.

BACKGROUND: Acute erythroleukemia (AEL), FAB-M6 is a rare heterogenous disorder diagnosed by myeloblasts more than 30% of nonerythroid cells (NEC). Pure erythroleukemia (Di Guglielmo disease) with an excess of proerythroblasts can be classified as MDS or M0. An aberration of the p53 gene in acute myelogenous leukemia is rare, but related to complex karyotypes with poor prognosis. METHODS: To evaluate heterogenous features, 32 cases of AEL or suspicious AEL were categorized as consisting of more than 50% erythroblasts and M6a with more than 30% myeloblasts of NEC, M6b with more than 30% proerythroblasts of all erythroblasts, and M6c with more than 30% both myeloblasts and proerythroblasts. The relation of the p53 protein overexpression and chromosomal abnormalities to AEL and these subtypes was investigated. RESULTS: There were 18 M6a, 6 M6b, and 8 M6c. The percentage of erythroblasts was M6a 58.7%, 77.7% M6b, and 67.2% M6c. The percentage of myeloblasts in NEC was M6a 53.6%, M6b 4.3%, and M6c 39.2%. The percentage of proerythroblasts in all erythroblasts was M6a 5.6%, M6b 56.2%, and M6c 34.1%. Survivals of M6b and M6c were significantly shorter than M6a (12.0 vs. 2.0 vs. 2.0 months, P=0.003). Five of 11 cases showed complex karyotypes (1 M6a, 2 M6b, 2 M6c), of -5, 5q-, -7, 7q-, -17 and/or 17p-, with shorter survival and poor response. The p53 protein overexpression was M6a 27.3%, M6b 100%, and M6c 83.3%. The p53 protein overexpression was positive in all 5 cases of multiple complex karyotype with frequent treatment failure or shorter survival, but was negative in 5 normal karyotypes. CONCLUSTIONS: The occurrence of complex karyotypes and aberration of the p53 gene frequently observed in M6b and M6c subtypes of acute erythroleukemia would be considered in establishing a new and innovative treatment to target neoplastic proerythroblasts that are resistant to standard therapy for acute myelogenous leukemia.
Chromosome Aberrations ; Erythroblasts ; Genes, p53 ; Granulocyte Precursor Cells ; Karyotype ; Leukemia, Erythroblastic, Acute* ; Leukemia, Myeloid, Acute ; Prognosis ; Treatment Failure

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Analysis of Discrepancies Between G-banding and FISH in Hematologic Abnormalities.

Dong Young LEE ; Cha Ja SEE ; Chi Dae HWANG ; Han Ik CHO ; Dong Soon LEE

Korean Journal of Clinical Pathology.2001;21(6):445-450.

BACKGROUND: The effective treatment of hematologic malignancies depends upon application of different therapeutic strategies by selecting patients known as the high risk group and the detection of malignant cells that can not be distinguished during following-up. We compared the results of G-banding and fluorescence in situ hybridization (FISH), which are used most frequently in detecting genetic changes, with the respect to investigating the discrepancies between these methods. METHODS: G-banding and FISH were performed on 919 consecutive specimens from 304 patients with hematologic malignancies. As for FISH, we covered most of the more frequent gene-tic changes, using 18 types of FISH probe. RESULTS: The average discrepancy between G-banding and FISH was 8.6% with a discrepancy at initial diagnosis of 6.0% and at follow-up of 11.9%, indicating greater discrepancy at follow-up after treatment. The chromosomal changes with especially large discrepancies were TEL/AML1, BCR/ABL & del(5q) (22.4%, 18.1%, and 16.2%, respectively). According to each disease, the discrepancies in acute biphenotypic leukemia (33.3%), acute lymphoblastic leukemia (14.7%), and chronic myelogenous leukemia (9.6%) were larger than average discrepancy. CONCLUSTIONS: We concluded that application of FISH is effective for detecting genetic changes in hematologic malignancies. Once genetic changes are detected, follow-up with FISH would be especially effective for making an accurate assessment of the likelihood of complete remission and recurrence.
Diagnosis ; Fluorescence ; Follow-Up Studies ; Hematologic Neoplasms ; Humans ; In Situ Hybridization ; Leukemia, Biphenotypic, Acute ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Recurrence

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Mantle Cell Lymphoma/Leukemia in Bone Marrow: Lacking Evidence of t(11;14).

Myung Hyun NAM ; Hee Yeon WOO ; Quehn PARK ; Sun Hee KIM ; Young Hyeh KO ; Howe J REE ; Won Seog KIM ; Hong Gee LEE ; Keun Chil PARK

Korean Journal of Clinical Pathology.2001;21(6):437-444.

BACKGROUND: Mantle cell lymphoma/leukemia (MCL) is a distinctive disease entity that has been characterized by specific histopathologic, immunologic, and cytogenetic features. The characteristic cytogenetic abnormality of MCL is t(11;14)(q13;q32), that results in cyclin D1 overexpression. We have experienced 12 MCL cases with bone marrow involvement that were lacking evidence of t(11;14). We tried to review the cases. METHODS: We reviewed the bone marrow findings, immunophenotypic, cytogenetic studies including fluorescent in situ hybridization (FISH) analysis using IGH/CCND1 probes and medical records of 12 patients that were diagnosed with MCL based on immunophenotypic results during the period 1997 to 2001. RESULTS: The patients had a median age of 63 (50-70) years with male-to-female ratio of 3:1. All patients showed hepatosplenomegaly with varying degrees of peripheral blood involvement (2-93%), and lymphocytosis was found in 7 cases. Other presenting features were palpable lymph nodes (83%) and B symptoms (25%). The malignant cells were quite heterogenous in morphology from centrocytic to blastic variants. Most cases showed typical immunophenotypes-expression of CD19, bright CD20, FMC7, CD5 and bright-light chains with negative CD23. Immunohistochemical staining with cyclin D1 on marrow biopsies showed mostly negative results. Among the eleven cases in which cytogenetic studies were possible, four cases showed complex karyotypes, and three that involved 14q32. Strikingly, no one showed t(11;14) in G-banding analysis and only 2 cases showed IGH/CCND1 rearrangement by FISH. CONCLUSTIONS: Most MCL cases with typical immunophenotypic findings did not show evidence of specific cytogenetic features. Although further workups for molecular pathogenesis and clinical follow-up of the above cases need to be done, we suggest a new disease entity, t(11;14)-negative MCL.
Biopsy ; Bone Marrow* ; Chromosome Aberrations ; Cyclin D1 ; Cytogenetics ; Follow-Up Studies ; Humans ; In Situ Hybridization, Fluorescence ; Karyotype ; Lymph Nodes ; Lymphocytosis ; Lymphoma, Mantle-Cell ; Medical Records

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Measurement of Thrombus Precursor Protein in the Diseases Associated with Thrombosis and Changes after Heparin Therapy.

Nan Young LEE ; Tae Yeob KIM ; Dong Kil JUNG ; Jang Soo SUH

Korean Journal of Clinical Pathology.2001;21(6):431-436.

BACKGROUND: The relationship between thrombosis and atherosclerosis has long been recognized. It is important to diagnose them earlier and utilize thrombolytic agents earlier in the clinical diseases associated with thrombosis and atherosclerosis. So we measured the thrombus precursor protein (TpP) in these diseases and intended to investigate the changes after heparin therapy. METHODS: TpP concentration was measured in 17 patients with acute myocardial infarction (AMI), 7 patients with unstable angina (UA), 2 patients with aortic dissection (AD), 10 patients with other chest pain, and 9 patients with cerebral infarction and 18 healthy controls. We divided AMI into two groups, early presenters (n=10) who presented to the emergency room (ER) within 6 hours and late presenters (n=7) who presented to the ER after 6 hours of the onset of chest pain. Among the patients, in 24 patients treated with unfractionated heparin, the level of TpP was measured from plasma at 8 hours after therapy. We used the microtiter plate ELISA procedure. RESULTS: TpP was significantly increased in AD (mean+/-SD; 51.21+/-8.08 microgram/mL), AMI (12.07+/-9.62 microgram/mL), early AMI (11.39+/-9.25 microgram/mL), late AMI (13.05+/-10.78 microgram/mL), cerebral infarction (7.34+/-4.67 microgram/mL), and UA (7.05+/-4.72 microgram/mL) compared with healthy controls (3.03+/-1.48 g/ mL). Abnormal concentrations of TpP were observed in 2 of 2 patients (100%) with AD, 12 of 17 patients (70.6%) with AMI, 8 of 10 patients (80.0%) with early AMI, 4 of 7 patients (57.1%) with late AMI, 5 of 9 patients (55.6%) with cerebral infarction, 3 of 7 patients (42.9%) with UA, and 2 of 10 patients (20.0%) with other chest pain. Among the 24 patients following heparin therapy, the level of TpP did not show significant decrease after heparin therapy in the group of UA and AMI with increased TpP above the upper limit of normal (n=14). CONCLUSTIONS: TpP appears to be a sensitive marker of the clinical diseases associated with thrombosis and atherosclerosis. But, TpP measurement does not allow for the accurate monitoring in the treatment with unfractionated heparin.
Angina, Unstable ; Atherosclerosis ; Cerebral Infarction ; Chest Pain ; Emergency Service, Hospital ; Enzyme-Linked Immunosorbent Assay ; Fibrinolytic Agents ; Heparin* ; Humans ; Myocardial Infarction ; Plasma ; Thrombosis*

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Spontaneous Remission in a Patient with Acute Myelogenous Leukemia Involving the Skin Associated with Termination of Pregnancy.

Sui Yon PARK ; Kyung Sam CHO ; Jin Tae SUH ; Hee Joo LEE

Korean Journal of Clinical Pathology.2001;21(6):427-430.

Spontaneous remission of acute leukemia is a rare event and has been documented in cases of systemic infection and blood transfusion. Furthermore spontaneous remission in association with the termination of pregnancy is also rare and hormonal effects during the puerperium have been implicated. We report here a case of acute myelogenous leukemia (AML, M5) diagnosed in a young woman after Cesarean section delivery who acheived spontaneous remission and relapsed 2 weeks later with leukemia cutis.
Blood Transfusion ; Cesarean Section ; Female ; Humans ; Leukemia ; Leukemia, Myeloid, Acute* ; Postpartum Period ; Pregnancy* ; Remission, Spontaneous* ; Skin*

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