Pathology of Skin in a Patient with Scabies.
Laboratory Medicine Online.2012;2(4):240-241. doi:10.3343/lmo.2012.2.4.240
Laboratory Medicine Online
2011 to Present ISSN: 2093-6338
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Analysis of Comparability Test between Reagent Lots in Immunoassay.
Laboratory Medicine Online.2012;2(4):235-239. doi:10.3343/lmo.2012.2.4.235
Lot-to-lot reproducibility is an important issue in immunoassays and reagent lot-to-lot comparability test comparing the results of new reagent lot with those of used lot using patients' samples or controls is usually performed to detect the difference between lots. However, there are no universally used acceptability criteria regarding reagent lot-to-lot comparability test. We performed reagent comparability test between different lots of alpha-fetoprotein (AFP) reagents and tried to determine its comparability by several criteria. Both the commercialized controls and in-house controls for AFP made from pooled patients' sera were measured 10 times using the old and new lots of reagents, whenever a reagent lot was changed. The differences in the mean control values, the percent difference (% difference), and the difference to between-run standard deviation ratio (D:SD ratio) between successive lots were calculated. We compared the results of reagent comparability test to arbitrarily determined acceptability criteria suggested by CLSI C54-A. Although comparability between reagent lots was determined according to how strictly we set the criteria, some lot-to-lot differences between certain pairs of lots exceeded the criteria. We hope that the results of this study might be helpful to perform reagent lot-to-lot comparability test and set the criteria for reagent comparability test between lots in other laboratories.
alpha-Fetoproteins ; Immunoassay ; Indicators and Reagents
alpha-Fetoproteins ; Immunoassay ; Indicators and Reagents
Laboratory Medicine Online.2012;2(4):232-234. doi:10.3343/lmo.2012.2.4.232
Carbapenem resistance in Acinetobacter baumannii has increased rapidly worldwide. It is generally assumed that carbapenem prescription in a hospital has a significant impact on imipenem resistance in A. baumannii. However, there are few studies validating these assumptions with statistical data. We performed a surveillance study to investigate the relationship between carbapenem prescription trends and the imipenem resistance rate of A. baumannii in an ICU. Carbapenem prescription data in the WHO anatomical therapeutic chemical (ATC)/defined daily dose (DDD) format for the period from 2006 to 2010 were obtained from the hospital electronic pharmacy records. In the same period, microbiologic data for the ICU were extracted from the laboratory information system. Imipenem resistance rates of A. baumannii increased from 4.3% in 2006 to 83.8% in 2010 (P <0.05; r2=0.85). Carbapenem prescription had increased from 19.71 DDD per 1,000 inpatient-days in 2006 to 36.99 DDD per 1,000 inpatient-days in 2010 (P <0.05; r2=0.95). Carbapenem prescription rate correlated with the imipenem resistance rate in A. baumannii (P <0.05; R=0.9). The results of our study demonstrated a correlation between carbapenem prescription trends and imipenem resistance in A. baumannii.
Acinetobacter ; Acinetobacter baumannii ; Clinical Laboratory Information Systems ; Dichlorodiphenyldichloroethane ; Electronics ; Electrons ; Imipenem ; Critical Care ; Intensive Care Units ; Pharmacy ; Prescriptions
Acinetobacter ; Acinetobacter baumannii ; Clinical Laboratory Information Systems ; Dichlorodiphenyldichloroethane ; Electronics ; Electrons ; Imipenem ; Critical Care ; Intensive Care Units ; Pharmacy ; Prescriptions
Mycoplasma pneumoniae Pneumonia Unresponsive to Macrolide Treatment.
Laboratory Medicine Online.2012;2(4):226-231. doi:10.3343/lmo.2012.2.4.226
We present a case of community-acquired pneumonia (CAP) that developed in a previously healthy young woman. She was diagnosed with Mycoplasma pneumoniae pneumonia, but did not respond to macrolide treatment. The pathogens of CAP was examined using chest radiographs, computed tomography, and various laboratory tests including Mycoplasma IgG and IgM antibodies, blood and sputum cultures, and PCR for M. pneumoniae, Legionella pneumophila, and Chlamydophila pneumoniae. In this study, differential diagnosis of the pathogens and analysis of the mechanisms underlying their resistance to macrolide treatment were performed, and the results were discussed. After changing the antimicrobial to quinolone, the patients' clinical symptoms and radiographic findings improved, and she was discharged after 8 days.
Antibodies ; Chlamydial Pneumonia ; Chlamydophila pneumoniae ; Diagnosis, Differential ; Female ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Legionella pneumophila ; Mycoplasma ; Mycoplasma pneumoniae ; Pneumonia ; Pneumonia, Mycoplasma ; Polymerase Chain Reaction ; Sputum ; Thorax
Antibodies ; Chlamydial Pneumonia ; Chlamydophila pneumoniae ; Diagnosis, Differential ; Female ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Legionella pneumophila ; Mycoplasma ; Mycoplasma pneumoniae ; Pneumonia ; Pneumonia, Mycoplasma ; Polymerase Chain Reaction ; Sputum ; Thorax
Laboratory Medicine Online.2012;2(4):223-225. doi:10.3343/lmo.2012.2.4.223
Chemotherapy agents can induce chromosomal instability, including a variety of chromatid or chromosomal aberrations. However, only limited data is available on the effect of chemotherapy on the kinetics of chromosomal instability in peripheral blood lymphocytes. Here, we report the case of an ovarian cancer patient who showed chromosomal instability in peripheral blood lymphocytes while undergoing chemotherapy. Karyotypic analysis of peripheral blood 1 day after administration of cisplatin and etoposide showed chromosomal or chromatid aberrations, including gaps, breaks, and fragmentation. Chromosome study after completion of the first chemotherapy cycle showed normal karyotype. This finding suggests that chemotherapeutic agents can induce transient chromosomal instability in peripheral blood lymphocytes.
Chromatids ; Chromosomal Instability ; Chromosome Aberrations ; Cisplatin ; Etoposide ; Humans ; Karyotype ; Kinetics ; Lymphocytes ; Ovarian Neoplasms
Chromatids ; Chromosomal Instability ; Chromosome Aberrations ; Cisplatin ; Etoposide ; Humans ; Karyotype ; Kinetics ; Lymphocytes ; Ovarian Neoplasms
Laboratory Medicine Online.2012;2(4):215-222. doi:10.3343/lmo.2012.2.4.215
A new clinico-pathological entity in which isochromosome 17q is the sole abnormality has been reported in myelodysplastic syndrome and in myeloproliferative neoplasm with an aggressive course; In particular, myelodysplastic syndrome with the isolated i(17)(q10) chromosome has the unique features of male sex, severe anemia, dysmegakaryocytic hyperplasia, increased micromegakaryocytes, basophilia, eosinophila and high risk for progression to acute myeloid leukemia (AML). However, the isolated i(17)(q10) is occurring at a relatively low frequency in de novo AML, and only a few reports are available in the literature about the clinical features and molecular characteristics of the isolated i(17)(q10) in AML. Herein, we report both the clinico-pathological features and the results of high resolution single nucleotide polymorphism (SNP) array analysis in a case of AML with i(17)(q10) as the sole cytogenetic abnormality. This case showed marrow findings of basophilia and dysmegakaryocytic hyperplasia and aggressive clinical outcome and these findings were suggestive of the presence of underlying myelodysplastic syndrome. The breakpoint of i(17)(q10) was located within 17p11.2 sub-band, which is known as a genetically highly unstable region presenting a unique genomic architectural features of low copy repeats (LCRs); thus, LCRs within 17p11.2 might lead to genomic instability and facilitate somatic genetic rearrangements such as i(17) (q10) and could play an important pathogenetic role in presenting unique clinico-pathologic features as well as in tumor development and disease progression.
Anemia ; Bone Marrow ; Chromosome Aberrations ; Cytogenetics ; Disease Progression ; Genomic Instability ; Humans ; Hyperplasia ; Isochromosomes ; Leukemia, Myeloid, Acute ; Male ; Myelodysplastic Syndromes ; Polymorphism, Single Nucleotide ; Segmental Duplications, Genomic
Anemia ; Bone Marrow ; Chromosome Aberrations ; Cytogenetics ; Disease Progression ; Genomic Instability ; Humans ; Hyperplasia ; Isochromosomes ; Leukemia, Myeloid, Acute ; Male ; Myelodysplastic Syndromes ; Polymorphism, Single Nucleotide ; Segmental Duplications, Genomic
Laboratory Medicine Online.2012;2(4):209-214. doi:10.3343/lmo.2012.2.4.209
BACKGROUND: Bacterial contamination of blood products, particularly of platelet concentrates (PCs), is a major risk factor for infections caused by blood transfusion. Various methods for the detection of bacterial contamination in PCs are available or are under investigation. We evaluated the usefulness of the Sysmex UF-1000i urine flow cytometer (Sysmex Medical Electronics Co, Japan) for screening of bacterial contamination in PCs. METHODS: The PCs were inoculated with various concentrations of bacteria (Staphylococcus aureus and Escherichia coli) and were analyzed with the urine flow cytometer for bacterial counts. All the samples were diluted with normal saline (1:10) before flow cytometric analysis in order to prevent interference by the turbidity due to platelets. RESULTS: For PCs inoculated with a high number (colony forming unit, CFU) of bacteria (105 CFU/mL), the bacterial counts were significantly higher than those for uninoculated PCs analyzed by the urine flow cytometer. However, bacterial counts for PCs inoculated with bacteria of 104 CFU/mL or less and those for uninoculated PCs were not significantly different. CONCLUSIONS: An automated urine flow cytometer evaluated in this study is easy to use, and the procedure is completed in less than 5 min. Moreover, the urine flow cytometer could detect approximately 105 CFU/mL of bacteria in PCs. Further validation studies are needed to assess the usefulness of this method for screening of bacterial contamination in PCs.
Bacteria ; Bacterial Load ; Blood Platelets ; Blood Transfusion ; Electronics, Medical ; Escherichia ; Mass Screening ; Risk Factors
Bacteria ; Bacterial Load ; Blood Platelets ; Blood Transfusion ; Electronics, Medical ; Escherichia ; Mass Screening ; Risk Factors
The Status of Use of Leukoreduced Blood Products in Korean Hospitals.
Laboratory Medicine Online.2012;2(4):204-208. doi:10.3343/lmo.2012.2.4.204
BACKGROUND: Leukoreduced blood components are recommended for prevention of non-hemolytic febrile transfusion reactions, HLA alloimmunization, platelet transfusion refractoriness, and transfusion-transmissible diseases. In addition, prestorage leukoreduction may be advantageous to poststorage leukoreduction. The authors investigated the current status of usage of leukoreduced blood components in Korea. METHODS: We surveyed 2,373 medical facilities, where blood components were supplied from Korean Red Cross blood centers and/or Hanmaeum blood center during one year period between January and December 2009. The survey was conducted about the current situation of usage of leukoreduction by web-based program (http://bms.cdc.go.kr), and 743 facilities answered and were analyzed. RESULTS: The leukoreduced RBC components comprised 10.3% (prestorage leukoreduction, 91,066 units, 5.7%; poststorage leukoreduction 73,192 units, 4.6%) of the total 1,593,098 units of RBC components used in 743 medical facilities. The leukoreduced platelet concentrates comprised 33.1% (458,552 units) of the total 1,386,184 units of platelet concentrates used in 397 medical facilities. If 1 single donor platelet is counted as 6 platelet concentrates, 48.9% of the total platelet components used were leukoreduced. CONCLUSIONS: The proportion of leukoreduced blood components to the total blood components used in Korea was much lower than that in Unites States of America, especially lower in the use of prestorage leukoreduction of RBC components. Further studies are required for cost-effectiveness and demand-supply amounts of leukoreduced blood components, and appropriate prestorage leukoreduction has to be performed in Korea based on these studies.
Americas ; Blood Group Incompatibility ; Blood Platelets ; Glycolates ; Humans ; Korea ; Platelet Transfusion ; Red Cross ; Tissue Donors
Americas ; Blood Group Incompatibility ; Blood Platelets ; Glycolates ; Humans ; Korea ; Platelet Transfusion ; Red Cross ; Tissue Donors
Laboratory Medicine Online.2012;2(4):197-203. doi:10.3343/lmo.2012.2.4.197
BACKGROUND: Alterations in blood cell count are well recognized features of bacteremia. The study objective was to determine the hematologic changes predictive of bacteremia. METHODS: We retrospectively studied febrile adult patients with neutrophilia and included patients were either bacteriologically proven cases or those who had clinically suspected bacterial infections. Hematologic findings derived from basic hematologic tests were compared between patients with and those without bacteremia. RESULTS: Of the 624 patients, 143 (22.9%) had significant bacteremia. The following items were significantly different between patients with and those without bacteremia by univariate analysis: absolute neutrophil count, neutrophil differential, absolute lymphocyte count, lymphocyte differential, platelet count and band-associated parameters such as absolute band neutrophil count (ABC). Multivariate analysis revealed platelet count, lymphocyte differential and ABC as independent predictors (P<0.0001, each). Platelet count, the most potent predictor of bacteremia, showed area under the curve (AUC) of 0.685. Analysis according to the primary diagnosis indicated that the most potent predictors of bacteremia in patients with respiratory tract, urinary tract and hepatobiliary system infections were platelet count (P=0.002, AUC=0.697), ABC (P=0.002, AUC=0.681) and neutrophil differential (P=0.0001, AUC=0.822), respectively. CONCLUSIONS: Simple variables obtained from basic hematologic tests were associated with bacteremia even in febrile patients with neutrophilia. In particular, very high neutrophil differential was highly predictive of bacteremia in patients with hepatobiliary system infections and its clinical usefulness needs to be elucidated in a prospective study.
Adult ; Bacteremia ; Bacterial Infections ; Blood Cell Count ; Hematologic Tests ; Humans ; Lymphocyte Count ; Lymphocytes ; Multivariate Analysis ; Neutrophils ; Platelet Count ; Respiratory System ; Retrospective Studies ; Urinary Tract
Adult ; Bacteremia ; Bacterial Infections ; Blood Cell Count ; Hematologic Tests ; Humans ; Lymphocyte Count ; Lymphocytes ; Multivariate Analysis ; Neutrophils ; Platelet Count ; Respiratory System ; Retrospective Studies ; Urinary Tract
Laboratory Medicine Online.2014;4(4):218-221. doi:10.3343/lmo.2014.4.4.218
Approximately 60-70% of small cell lung carcinoma (SCLC) cases are diagnosed at extensive stage, thus tumor markers for its early detection are needed. Autoantibodies associated with malignancy are present before radiographic detection. Autoantibodies detected using the autoimmune target (AIT) test in patients with some tumors have shown the possibility of autoantibodies to be used as a tumor marker. To overcome the limitations of antinuclear antibody (ANA) test using HEp-2 cell line, the AIT test was developed using human macrophage cell line, IT-1, as a substrate, which showed positive identification of various autoantibodies with a higher level of sensitivity. We report a case of SCLC with autoantibodies against proliferating cell nuclear antigen (PCNA) and centriole in a 70-yr-old man who had a history of heavy alcohol consumption and a 50 pack-yr history of smoking. Results of computed tomography of the chest and abdomen showed a lung mass and multiple metastases. Extensive stage SCLC was confirmed using sputum cytology and lymph node aspiration biopsy. Anti-PCNA (1:1,280) and anti-centriolar (1:320) patterns were detected using the AIT test. Neuron-specific enolase was elevated (38.2 ng/mL). There was no evidence of systemic autoimmune rheumatic disease or chronic hepatitis. This is the first case report in which coexisting autoantibodies against PCNA and centriole associated with SCLC were detected using the AIT test. This case provides some evidence that autoantibodies may be used as a tumor marker for SCLC.
Abdomen ; Alcohol Drinking ; Antibodies, Antinuclear ; Autoantibodies* ; Biopsy, Needle ; Cell Line ; Centrioles* ; Hepatitis, Chronic ; Humans ; Lung ; Lymph Nodes ; Macrophages ; Neoplasm Metastasis ; Phosphopyruvate Hydratase ; Proliferating Cell Nuclear Antigen* ; Rheumatic Diseases ; Small Cell Lung Carcinoma* ; Smoke ; Smoking ; Sputum ; Thorax ; Biomarkers, Tumor
Abdomen ; Alcohol Drinking ; Antibodies, Antinuclear ; Autoantibodies* ; Biopsy, Needle ; Cell Line ; Centrioles* ; Hepatitis, Chronic ; Humans ; Lung ; Lymph Nodes ; Macrophages ; Neoplasm Metastasis ; Phosphopyruvate Hydratase ; Proliferating Cell Nuclear Antigen* ; Rheumatic Diseases ; Small Cell Lung Carcinoma* ; Smoke ; Smoking ; Sputum ; Thorax ; Biomarkers, Tumor
Country
Republic of Korea
Publisher
Korean Society for Laboratory Medicine
ElectronicLinks
http://labmedonline.org/index.phpEditor-in-chief
Chulhun Chang
kscp1@kams.or.kr
Abbreviation
Lab Med Online
Vernacular Journal Title
ISSN
2093-6338
EISSN
Year Approved
2012
Current Indexing Status
Currently Indexed
Start Year
2011
Description
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