Background: Flow cytometric immunophenotyping of hematolymphoid neoplasms (FCIHLN) is essential for diagnosis, classification, and minimal residual disease (MRD) monitoring. FCI-HLN is typically performed using in-house protocols, raising the need for standardization. Therefore, we surveyed the current status of FCI-HLN in Korea to obtain fundamental data for quality improvement and standardization. Methods: Eight university hospitals actively conducting FCI-HLN participated in our survey.We analyzed responses to a questionnaire that included inquiries regarding test items, reagent antibodies (RAs), fluorophores, sample amounts (SAs), reagent antibody amounts (RAAs), acquisition cell number (ACN), isotype control (IC) usage, positiveegative criteria, and reporting. Results: Most hospitals used acute HLN, chronic HLN, plasma cell neoplasm (PCN), and MRD panels. The numbers of RAs were heterogeneous, with a maximum of 32, 26, 12, 14, and 10 antibodies used for acute HLN, chronic HLN, PCN, ALL-MRD, and multiple myeloma-MRD, respectively. The number of fluorophores ranged from 4 to 10. RAs, SAs, RAAs, and ACN were diverse. Most hospitals used a positive criterion of 20%, whereas one used 10% for acute and chronic HLN panels. Five hospitals used ICs for the negative criterion. Positiveegative assignments, percentages, and general opinions were commonly reported. In MRD reporting, the limit of detection and lower limit of quantification were included. Conclusions This is the first comprehensive study on the current status of FCI-HLN in Korea, confirming the high heterogeneity and complexity of FCI-HLN practices. Standardization of FCI-HLN is urgently needed. The findings provide a reference for establishing standard FCI-HLN guidelines.

Purpose: The purpose of this study was to analyze nurse staffing according to patients' acuity and dependency by measuring nursing hours. Methods: The study sample included patients who visited the adult emergency departments (EDs) of three tertiary referral hospitals and nurses who worked on shifts for 48 hours from October 24 to 26, 2019. Hourly patient census and nurse staffing were analyzed. Patient acuity was measured using the Korean Triage and Acuity Scale (KTAS), ranging from Level 1 (highest) to Level 5 (lowest). Patient dependency was measured using six items (e.g., clinical attention and communication) and classified into four groups. Nursing activities were observed every 10 minutes and nursing hours per patient and nurse staffing were analyzed according to acuity and dependency. Results: Nurse-to-patient ratio ranged from 1:1.8 to 1:4.2 during the 48 hours of observation. The average work hours of nurses, excluding breaks and meals, was 8.57 hours; 42.5% of which was spent providing direct care. Higher acuity and dependency were associated with higher nursing hours and staffing level. Patients with KTAS Level 1 were provided 74.3 minutes per hour, 5.02 times higher than Level 5 (14.8 minutes). Patients in the highest dependency group were provided 87.4 minutes per hour, 5.75 times higher than the lowest group (15.2 minutes). Newly arrived patients received more nursing hours than continuously stayed patients within the same KTAS Levels. Conclusion Large variations were found in hourly patient census, acuity, and dependency. Nurse staffing in EDs should be determined based on patient acuity and dependency.

Background: The platelet aggregation test is widely used to measure antiplatelet therapy response and to detect platelet function disorders. CS-5100 (Sysmex Co., Japan) is a recently introduced coagulation analyzer that can also measure platelet aggregation. We evaluated the performance of CS-5100 in the platelet aggregation test for use in clinical laboratories. Methods: We investigated the precision, stability, dilution test, and correlation of CS-5100 with a traditional aggregometer. Precision was tested using normal and patient samples. Stability was assessed over 5 different time points for 8 hours. The dilution test was performed with normal samples using ADP agonists. We tested correlations between the results of Chrono-log aggregometer (Chrono-Log Co., USA) and CS-5100 using 10 samples with 5 agonists each. We also calculated the reference range of 5 agonists using 22-30 normal samples. Results: The coefficients of variation using normal samples were 7.45% and 3.27% for ADP and arachidonic acid, respectively. Stability was maintained for up to 2 hours in most samples. Dilution tests showed similar results until reaching a dilution factor of 2. Strong correlations of the results between Chrono-log and CS-5100 were found, except for ristocetin. The reference ranges of 5 reagents in CS-5100 were similar to those obtained with the Chrono-log aggregometer. Conclusions The performance of CS-5100 in platelet aggregation tests showed reliable results compared to a traditional aggregometer. CS-5100 can perform coagulation test and platelet aggregation test, simultaneously. Thus, CS-5100 can enable cost saving and reduce turn-around-time by reducing the inspection time.

No abstract available.
Leukemia, Myeloid, Acute

Bone marrow necrosis (BMN) is a pathologic state which is derived from various disease entities. Most commonly, it is accompanied by hematologic malignancies such as acute leukemia. The patients with marrow necrosis are generally known to have dismal prognoses but variations exist according to early diagnosis. Here we report a case of BMN in an acute lymphoblastic leukemia patient with Philadelphia chromosome at presentation.
Bone Marrow* ; Early Diagnosis ; Hematologic Neoplasms ; Humans ; Leukemia ; Necrosis* ; Philadelphia Chromosome* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Prognosis

We report a case of acute hemolytic transfusion reaction due to multiple alloantibodies. A 41-year-old male with multiple histories of transfusion was admitted for jaundice and oliguria after receiving two units of red blood cells in a local clinic. He showed acute renal failure and disseminated intravascular coagulation. Direct Coombs test was negative and antibody screening test showed strong positive results. Anti-E, anti-c, and anti-Jk(b) antibodies were identified in two panels of unexpected antibody assays. Acute hemolytic transfusion was diagnosed, and he was discharged after 1 month of supportive treatment. Unexpected antibody detection tests, including the antiglobulin phase, should be performed to prevent adverse transfusion reactions by unexpected antibodies. Better precision and quality control are necessary when performing pre-transfusion tests.
Acute Kidney Injury ; Adult ; Antibodies ; Coombs Test ; Disseminated Intravascular Coagulation ; Erythrocytes ; Humans ; Isoantibodies* ; Jaundice ; Male ; Mass Screening ; Oliguria ; Quality Control ; Transfusion Reaction*

BACKGROUND: Dyslipidemia is a major risk factor contributing to cardiovascular disease and its prevalence is steadily rising. Although screening tests are readily accessible, dyslipidemia remains undertreated. Evaluating health behavior patterns after diagnosis may help improve lifestyle interventions for the management of dyslipidemia. METHODS: Data from the fifth Korean National Health and Nutrition Examination Survey 2010–2012 were used. A total of 6,624 dyslipidemia patients over 20 years old were included according to National Cholesterol Education Program-Adult Treatment Panel III guidelines. Logistic regression analysis was completed using a weighted method to determine whether awareness of dyslipidemia was associated with health behavior. Health behavior was divided into two categories: behavioral factors (smoking, alcohol consumption, exercise) and nutritional factors (adequate intake of fiber, carbohydrate, fat, protein). RESULTS: There were no significant differences in health behavior among dyslipidemia patients according to awareness after adjustment for covariates, diabetes and hypertension. Awareness in women was associated with decreased smoking (odds ratio [OR], 0.55; 95% confidence interval [CI], 0.32 to 0.94), but when adjusted for diabetes and hypertension the result was not significant (OR, 0.61; 95% CI, 0.35 to 1.06). The same pattern applied to intake of carbohydrate in men (OR, 1.28; 95% CI, 0.99 to 1.67) and protein in women (OR, 1.22; 95% CI, 0.98 to 1.50). In subgroup analysis, awareness of dyslipidemia in men without hypertension or diabetes was associated with adequate intake of carbohydrate (OR, 1.70; 95% CI, 1.06 to 2.72). CONCLUSION: Increasing awareness alone may not be enough to improve healthy behavior in patients with dyslipidemia. Efforts including patient education and counseling through a multi-team approach may be required.
Adult* ; Alcohol Drinking ; Cardiovascular Diseases ; Cholesterol ; Counseling ; Diagnosis ; Dyslipidemias* ; Education ; Female ; Health Behavior* ; Humans ; Hypertension ; Life Style ; Logistic Models ; Male ; Mass Screening ; Methods ; Nutrition Surveys ; Patient Education as Topic ; Prevalence ; Risk Factors ; Smoke ; Smoking

BACKGROUND: Osteoarthritis (OA) is a chronic disease that commonly afflicts the elderly. This disease reduces the health-related quality of life (HRQoL) and causes a significant social burden. Whether the effect of coexisting chronic conditions on HRQoL varies according to the presence of OA remains unclear. Therefore, this study aimed to investigate this notion. METHODS: A total of 13,395 participants were identified from the 2009–2013 Korean National Health and Nutrition Examination Survey for analysis. HRQoL was assessed using the European quality of life-5 dimensions (EQ-5D) index. Patients with OA were defined as those diagnosed by a physician or those who displayed both, symptoms and radiological findings consistent with OA at the time of the survey. Associations between OA and 8 chronic conditions were tested using regression analysis. RESULTS: The EQ-5D index was lower in patients with OA than in those without (mean difference, −0.145; 95% confidence interval [CI], −0.138 to −0.151; P<0.001). Most patients with OA and chronic conditions showed a lower score than those without. EQ-5D was particularly lower in OA patients with hypertension, dyslipidemia, stroke, and renal failure. The estimated β coefficient for the interaction term was significant in renal failure (−0.034; 95% CI, −0.055 to −0.012), after adjusting for demographic and socio-economic variables. CONCLUSION: OA significantly affects HRQoL of Korean elderly individuals alone or when combined with other conditions. OA combined with renal failure is particularly detrimental. These results indicate the importance of managing OA, which is an underestimated disease in public health surveys.
Adult* ; Aged ; Chronic Disease* ; Comorbidity ; Dyslipidemias ; Humans ; Hypertension ; Korea* ; Nutrition Surveys ; Osteoarthritis* ; Public Health ; Quality of Life* ; Renal Insufficiency ; Stroke

BACKGROUND: The efficacy of two artificial tears, carboxymethylcellulose (CMC) and hyaluronate (HA), was compared in the treatment of patients with dry eye disease. METHODS: We conducted a systematic review and meta-analysis on randomized controlled trials in the PubMed, Embase, Cochrane Library, and ClinicalTrials.gov databases. The efficacy was compared in terms of the mean change from baseline in tear break-up time. The meta-analysis was conducted using both random and fixed effect models. The quality of the selected studies was assessed for risk of bias. RESULTS: Five studies were included involving 251 participants. Random effect model meta-analysis showed no significant difference between CMC and HA in treating dry eye disease (pooled standardized mean difference [SMD]=-0.452; 95% confidence interval [CI], -0.911 to 0.007; P=0.053). In contrast, fixed effect model meta-analysis revealed significant improvements in the CMC group when compared to the HA group (pooled SMD=-0.334; 95% CI, -0.588 to -0.081; P=0.010). CONCLUSION: The efficacy of CMC appeared to be better than that of HA in treating dry eye disease, although meta-analysis results were not statistically significant. Further research is needed to better elucidate the difference in efficacy between CMC and HA in treating dry eye disease.
Bias (Epidemiology) ; Carboxymethylcellulose Sodium* ; Eye Diseases* ; Humans ; Lubricant Eye Drops ; Tears ; Xerophthalmia

Severe acute pancreatitis (SAP) is associated with systemic complications and high mortality rate in dogs. Mesenchymal stem cells (MSCs) have been investigated for their therapeutic potential in several inflammation models. In the present study, the effects of canine adipose tissue-derived (cAT)-MSCs in a rat model of SAP induced by retrograde injection of 3% sodium taurocholate solution into the pancreatic duct were investigated. cAT-MSCs labeled with dioctadecyl-3,3,3′-tetramethylindo-carbocyanine perchlorate (1 × 10⁷ cells/kg) were systemically administered to rats and pancreatic tissue was collected three days later for histopathological, quantitative real-time polymerase chain reaction, and immunocytochemical analyses. Greater numbers of infused cAT-MSCs were detected in the pancreas of SAP relative to sham-operated rats. cAT-MSC infusion reduced pancreatic edema, inflammatory cell infiltration, and acinar cell necrosis, and decreased pancreatic expression of the pro-inflammatory cytokines tumor necrosis factor-α, interleukin (IL)-1β, -6, -12, -17, and -23 and interferon-γ, while stimulating expression of the anti-inflammatory cytokines IL-4 and IL-10 in SAP rats. Moreover, cAT-MSCs decreased the number of clusters of differentiation 3-positive T cells and increased that of forkhead box P3-positive T cells in the injured pancreas. These results indicate that cAT-MSCs can be effective as a cell-based therapeutic strategy for treatment of SAP in dogs.
Acinar Cells ; Animals ; Anti-Inflammatory Agents ; Cytokines ; Dogs ; Edema ; Inflammation ; Interleukin-10 ; Interleukin-4 ; Interleukins ; Mesenchymal Stromal Cells* ; Models, Animal ; Mortality ; Necrosis ; Pancreas ; Pancreatic Ducts ; Pancreatitis* ; Rats* ; Real-Time Polymerase Chain Reaction ; T-Lymphocytes* ; T-Lymphocytes, Regulatory ; Taurocholic Acid