Prostate cancer (CaP) is the most common cancer diagnosed among men in the United States and the fifth most common cancer among men in Korea. Unfortunately, the early stages of CaP may have no symptoms. Thus, early detection is very important and physicians managing voiding dysfunction must have awareness about CaP. The traditional tests used for early detection of CaP are the prostate-specific antigen (PSA) blood test and digital rectal examination. However, a high PSA level is not specific for CaP. Benign prostatic hyperplasia, prostatitis, urinary tract infection, and urinary retention can all cause a high PSA level. Thus, no test shows sufficient accuracy to truly be useful for screening men for CaP. A prostate biopsy is the only method that yields a definitive diagnosis of CaP; however, this test is invasive and uncomfortable. Recently, new biomarkers for CaP detection have been proposed to improve the accuracy of the PSA test. In this review, we summarize our knowledge of various new biomarkers, including PSA-associated biomarkers (the prostate health index and 4Kscore), molecular biomarkers (PCA3, TMPRSS2: ERG fusion gene, and various miRNAs), and proteomics-associated biomarkers, and the ways in which they may improve the detection rate of CaP. Accordingly, this review can raise awareness about CaP to physicians managing voiding dysfunction and be a good reference for them.
Biomarkers ; Biopsy ; Diagnosis ; Digital Rectal Examination ; Discrimination (Psychology) ; Early Detection of Cancer ; Hematologic Tests ; Humans ; Korea ; Male ; Mass Screening ; Methods ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Prostatitis ; United States ; Urinary Retention ; Urinary Tract Infections

PURPOSE: Patients with Turner syndrome (TS) have increased risk of morbidities and mortality related to cardiovascular complications. Cardio-ankle vascular index (CAVI) is a novel method of evaluating arterial stiffness independent of changes in blood pressure. We compared arterial stiffness using CAVI between TS patients and healthy control subjects. METHODS: Nineteen young women with TS (mean, 26.8 years; range, 20.0–35.1 years) and 23 healthy women matched for age and body mass index (BMI) were recruited for CAVI measurements at Seoul National University Hospital between 2010 and 2013. Anthropometric parameters, fasting blood testing and measurements of CAVI were compared between the 2 groups. RESULTS: TS patients were significantly shorter (mean: 150.1 cm vs. 160.7 cm, P<0.001) and had lower body weight (mean: 47.0 kg vs. 55.5 kg, P=0.014) than healthy controls, without difference in BMI. CAVI (6.5±0.6 vs. 6.1±0.6, P=0.039) was significantly higher in TS patients compared to healthy controls. Age was positively associated with CAVI (r=0.403, P=0.008) in univariate analysis. After adjusting for age, TS was associated with CAVI (P=0.006). CONCLUSION: Young women with TS showed increased arterial stiffness measured by CAVI compared to healthy women after adjusting for age, suggesting inherent vasculopathy in TS patients.
Blood Pressure ; Body Mass Index ; Body Weight ; Cardiovascular Abnormalities ; Fasting ; Female ; Hematologic Tests ; Humans ; Methods ; Mortality ; Seoul ; Turner Syndrome ; Vascular Stiffness

BACKGROUND AND OBJECTIVES: Dizziness is not uncommon in children. The etiology of dizziness varies according to different studies due to different methods of examination or characteristics of the dizziness center. To assess meaningful causes of dizziness in children, a multidisciplinary approach would be needed. The purpose of this study was to analyze the main pathologies associated with vertigo and dizziness in children, paying particular attention to recent diagnostic advances with a multidisciplinary approach. SUBJECTS AND METHOD: A total of 73 children, aged between 4-18 years, who visited the Pediatric Dizziness Clinic of the University Hospital from January 2016 to June 2016 were included in this study. Medical records were reviewed retrospectively. All of the subjects were examined by history, questionnaires, physical examinations, electrocardiogram, hematologic tests, brain MRI scan, audiogram and vestibular function tests. Patients who had orthostatic symptoms additionally underwent a tilt table test, and in selective cases, a caloric and vestibular evoked myogenic potential tests as well. RESULTS: Vestibular migraine (VM) and benign paroxysmal vertigo of childhood (BPVC) were found in 35.6% and 27.4% of the children with dizziness, respectively. The incidence of orthostatic hypotension and postural orthostatic tachycardia syndrome were 12.3% each, both of which are higher than other previous reports. Other causes were Meniere's disease, benign paroxysmal positional vertigo, vestibular neuritis and so on. CONCLUSION: VM and BPVC were the most common causes of pediatric dizziness. Also, the incidence of orthostatic dizziness was rather high in pediatric population. The evaluation of dizziness in children should include a thorough check of history (questionnaire), neurotological examination, vestibular function tests and a tilt table test.
Benign Paroxysmal Positional Vertigo ; Brain ; Child ; Dizziness* ; Electrocardiography ; Hematologic Tests ; Humans ; Hypotension, Orthostatic ; Incidence ; Magnetic Resonance Imaging ; Medical Records ; Meniere Disease ; Methods ; Migraine Disorders ; Pathology ; Physical Examination ; Postural Orthostatic Tachycardia Syndrome ; Retrospective Studies ; Tilt-Table Test ; Vertigo ; Vestibular Function Tests ; Vestibular Neuronitis

Medical diagnostics plays a significant role in clinical decisions. The first medical laboratory test to be developed was urine analysis, in which urine properties were analyzed for diagnosis. Urine analysis has been long used as a routine laboratory test that was improved with the development of sampling and test methods. As the field of hematology progressed with the invention of the microscope, blood tests were developed. Demands for tests based on clinical chemistry have existed since the 17th century, and research using patient blood began in the 18th century. In the 20th century, with the development of the spectrophotometer, chemical analyses were performed for diagnostic purposes. With the appearance of cholera outbreaks, the identification of microorganisms was necessary for patient diagnosis, and the development of specific test methods contributed to microorganism detection in the laboratory. Blood transfusion, which started with blood collection in the 15th century, is currently used as a therapeutic method in medicine. Moreover, once the hypothesis of acquired immunity was proven in the 18th century, various methods for measuring immunity were developed. Molecular diagnosis, which was established during the 20th century after the presentation of Mendel's Genetic Laws in the 19th century, developed rapidly and became the predominant field in medical laboratory diagnostics. Thus, medical laboratory technology became an academic field, with foundations based on basic sciences. Modern medicine will further progress thanks to medical advancements, leading to an extension of average human lifespan up to 100 years. Laboratory medicine will provide significant support for this development.
Adaptive Immunity ; Blood Transfusion ; Chemistry, Clinical ; Cholera ; Diagnosis ; Disease Outbreaks ; Foundations ; Hematologic Tests ; Hematology ; History, Modern 1601- ; Humans ; Inventions ; Jurisprudence ; Medical Laboratory Science ; Methods ; Pathology, Molecular

OBJECTIVES: The ratio of second to fourth digit length (2D : 4D) could be a potential epigenetic marker of sexual dimorphism reflecting prenatal testosterone exposure. Testosterone is known to affect the development of the brain through an epigenetic mechanism. The purpose of this study was to investigate the effects of exposure to fetal testosterone on the metabolic syndrome based on 2D : 4D of schizophrenia patients and the relationship with the age of onset of schizophrenia. METHODS: A total of 214 schizophrenia patients participated in this study. The participant's physical and blood tests were performed according to the American National Cholesterol Education Program's Third Amendment of the Metabolic Syndrome Diagnostic Criteria, and the 2D : 4D was measured by the method designed by McFadden. Data were statistically analyzed by t-test, Pearson's correlation analysis and multiple regression model analysis. RESULTS: 2D : 4D was significantly higher in female than male in both hands, and there was a statistically significant negative correlation between 2D : 4D and the age of onset of schizophrenia in male. However, 2D : 4D did not show statistically significant correlation with metabolic factors. CONCLUSIONS: Fetal testosterone suggests the possibility of affecting the age of onset of schizophrenia through the epigenetic mechanism, but there is no clear relationship with metabolic factors.
Age of Onset* ; Brain ; Cholesterol ; Education ; Epigenomics ; Female ; Hand ; Hematologic Tests ; Humans ; Male ; Methods ; Schizophrenia* ; Testosterone

PURPOSE: This study was to evaluate the relationship of 25(OH)D3 levels with anticonvulsant use and other possible factors in epileptic children and adolescents. MATERIALS AND METHODS: We studied 143 patients with epilepsy (90 boys, 53 girls; 11.21+/-4.49 years), who had been treated with anticonvulsants for more than 1 year. Patients who had taken multiple vitamins before the blood test and those who have the limitation of physical activity (wheelchair-bound) were excluded from the study. We evaluated the difference in vitamin D status according to the type and number of anticonvulsants taken and other factors such as gender, age, intelligence and seizure variables. RESULTS: For patients with mental retardation or developmental delay, 25(OH)D3 levels were lower than the levels in patients with normal intelligence quotient levels (p=0.03). 25(OH)D3 levels were lower in patients who had taken anticonvulsants for more than 2 years as compared to those who had taken them for less than 2 years (p=0.03). Those taking oxcarbazepine had significantly lower vitamin D levels than patients taking valproic acid (p=0.01). However, no effects of number of anticonvulsants taken were detectable. More than two-thirds of the patients were diagnosed with osteopenia or osteoporosis in patients showing either vitamin D insufficiency or deficiency. CONCLUSION: The possibility of vitamin D deficiency can be considered in pediatric patients taking anticonvulsants if they have mental retardation or developmental delay or if they have been taking anticonvulsants for more than 2 years or taking hepatic enzyme inducing drugs.
Adolescent* ; Anticonvulsants ; Bone Diseases, Metabolic ; Child* ; Developmental Disabilities ; Epilepsy ; Female ; Hematologic Tests ; Humans ; Intellectual Disability ; Intelligence ; Methods ; Motor Activity ; Osteoporosis ; Seizures ; Valproic Acid ; Vitamin D Deficiency ; Vitamin D* ; Vitamins*

OBJECTIVETo explore the prognostic value of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with gastric cancer.

METHODS591 cases of gastric cancer pathologically diagnosed at the Fourth Hospital of Hebei Medical University in 2006 were included in this study. The clinical information including age and gender, cancer, treatment, and the first blood test information at admission were collected from the medical record room and analyzed. The patients were followed up to March 15, 2012. The survival was calculated by Kaplan-Meier analysis. The differences between groups were compared using Log-rank test. Cox regression was used to analyze the factors which may affect the survival of the patients. Software SPSS 13.0 was used for statistical analysis.

RESULTSIn 2006, a total of 591 patients were enrolled in this study in accordance with the inclusion criteria. By the end of the study, 538 cases were followed up. The follow-up rate was 91.0%. Among them 353 cases died of gastric cancer, 185 patients are still alive. In the whole group of 538 cases, the 1-, 3-, and 5-year survival rate was 69.9%, 47.0%, and 37.5%, respectively. In the low NLR group, the 1-, 3-, and 5-year survival rate was 76.1%, 50.1%, and 42.7%, respectively, while those of the high NLR group was 53.1%, 38.6%, and 23.4%, respectively, showing a significant difference between the two groups (P < 0.05). Univariate analysis showed that the survival rate was significantly correlated with age, pathological type, TNM stage, operation, NLR and PLR (P < 0.05 for all). Multivariate analysis showed that TNM stage, operation, NLR and age of patients were independent risk factors for the prognosis of gastric cancer (P < 0.05 for all). According to the sub-site stratified analysis, TNM stage, operation and NLR were independent risk factors for gastric cardia adenocarcinoma (P < 0.05 for all), and age, TNM stage, operation for distal gastric cancer (P < 0.05 for all). PLR was not an independent prognostic factor of survival in patients with gastric cancer.

CONCLUSIONNLR may be an independent prognostic factor of gastric cancer.

Adenocarcinoma ; Aged ; Blood Platelets ; Female ; Hematologic Tests ; methods ; Humans ; Kaplan-Meier Estimate ; Lymphocyte Subsets ; Lymphocytes ; Male ; Middle Aged ; Neutrophils ; Prognosis ; Stomach Neoplasms ; diagnosis ; Survival Rate

This study was aimed to explore the role of full-automatic blood analyzer Sysmex XE-2100 in early screening and diagnosing the hematologic malignancies. A total of 288 samples of the patients with hematologic malignancies was examined. Then, the scatter plots, alarm information and blood smears were analyzed. The results indicated that 76% of these samples showed abnormal scatter plots. CMML and AML-M3 patients had their own characteristic scatter plots, while others hadnt's. The coincident rate of CMML and AML-M3 determined by scatter plots with practical diseases was 100%; the coincident rate of ALL determined by scatter plots with practical disease was 67%. The coincident rate of alarm information of blast cells was 92.5%, the coincident rate of immature granulocytes was 77.1%, the coincident rate of nucleated red blood cells was 33.3%, the coincident rate of atypical lymphocytes was 31.3%. It is concluded that the abnormal scatter plots and alarm information are very important for finding the patients with hematologic malignancies and determining the disease type. The alarm information has high reliability for blast cells and immature granulocytes, but has only mirror value for nucleated red blood cells and atypical lymphocytes.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Hematologic Neoplasms ; blood ; Hematologic Tests ; instrumentation ; methods ; Humans ; Leukocyte Count ; Male ; Middle Aged ; Reproducibility of Results ; Young Adult

BACKGROUND: There is epidemiologic evidence to support vascular disease as a possible cause of Alzheimer's dementia (AD). The primary aim of this study was to determine the prevalence of vascular risk factors (vRFs) with respect to various clinical measures, such as axial-rated medial temporal lobe atrophy (MTA), ischemic white-matter changes, and cognition. The secondary aim was to determine the most significant clinical measure associated with cognitive outcome. METHODS: The study subjects comprised 198 probable AD and 38 subjective memory impairment-no cognitive impairment controls (SMI-NCI), for whom medical data including history vRF-related blood tests, clinical dementia evaluation, cognitive assessment, and brain MRI, were available. The grading of white-matter hyperintensities (WMHs) was achieved using Fazekas' method. MTA was graded by two neurologists independently based on axial T1-weighted MRI images. The prevalence of risk factors for Koreans aged > or =65 years was reviewed for comparison. RESULTS: All vRFs except smoking were more severe in the AD group than in both the SMI-NCI group and Koreans aged > or =65 years, but the high prevalence of vRFs had no impact on WMH lesions, axial MTA, or cognitive outcome. Both white-matter changes and MTA were significantly worse in AD than in SMI-NCI (p<0.001). The degree of MTA was negatively correlated with WMH grade (p<0.001), but the severity of clinical dementia was correlated only with increased axial MTA in AD (Instrumental Activities of Daily Living and Clinical Dementia Rating scores, p<0.001; Clinical Dementia Rating-Sum of Boxes score, p<0.005). CONCLUSIONS: WMHs and axial MTA were significantly more severe in the AD group than in the SMI-NCI subjects. The findings of this study indicate that worsening of cognitive dysfunction in AD appears to be driven by MTA, which is evident even in axial MTA visual grading, irrespective of WMH severity and the presence of vRFs.
Activities of Daily Living ; Alzheimer Disease ; Atrophy* ; Brain ; Cognition ; Dementia ; Glutamates ; Guanine ; Hematologic Tests ; Magnetic Resonance Imaging ; Memory ; Methods ; Prevalence ; Risk Factors* ; Smoke ; Smoking ; Temporal Lobe ; Vascular Diseases ; Pemetrexed

A microscopic examination of an appropriately prepared and well-stained blood smear by a knowledgeable laboratory professional is necessary and clinically useful in a number of circumstances and for a variety of reasons. In this article, an attempt is made to delineate the purpose and criteria for blood smear examination in a variety of circumstances that are encountered in everyday laboratory hematology practice. A blood smear scan serves to at least (a) verify the flagged automated hematology results and (b) determine if a manual differential leukocyte count needs to be performed. Blood smear examination/manual differential leukocyte count with complete blood count (CBC) provides the complete hematologic picture of the case, at least from the morphologic standpoint. Blood smear review with or without interpretation serves to ensure that no clinically significant finding is missed, besides providing diagnosis or diagnostic clue(s), particularly if and when interpreted by a physician.
Blood Cell Count ; Hematologic Tests/*methods ; Humans ; Leukocyte Count ; Leukocytes/cytology ; Medical Laboratory Personnel/standards