CDe 표현형의 환자에서 항-E와 항-E/-c 항체 생성 특이성의 차이

안규대,김경희,임현호,정인화 대한수혈학회 2018 大韓輸血學會誌 Vol.29 No.3

Background: Anti-E or paired anti-E/-c antibodies can develop in patients with the Rh CDe phenotype. This study examined the differences in transfusion in patients with the CDe phenotype according to formation of anti-E or anti-E/-c antibodies. Methods: Retrospective reviews were carried out on the results of antibody identification tests performed in 2014. The Rh phenotype and antibody specificity were investigated. The transfusion and medical records of patients with the CDe phenotype were examined. Results: In total, 76 patients were included in the review. Of these 76 patients, 38 (50.0%) were of the CDe phenotype. Anti-E antibodies were the most frequent (60.5%), followed by anti-E/-c antibodies (23.7%). The total transfusion units and platelet transfusion units were significantly higher in patients with anti-E/-c antibodies (P=0.028 and P=0.01, respectively). The distribution of categorized diseases was similar in the patients with the anti-E and anti-E/-c antibodies. A frequency of transfusion episodes greater than or equal to four was higher in patients with hepatobiliary diseases (85.7%). Conclusion: In CDe phenotype patients, platelet transfusion was significantly higher in the anti-E/-c positive group than the anti-E positive group, indicating that platelets play a role in red blood cell alloimmunization. Because E is the most immunogenic antigen in Korea, it is important to define the disease group, in which patients with CDe phenotype require a transfusion of E and c-negative blood.

PCR로 확인한 PML-RARA와 BCR-ABL1 재배열이 동시에 동반된 급성전골수구백혈병 1예

안규대,임현호,우광숙,김경희,김정만,김성현,한진영 대한진단검사의학회 2017 Laboratory Medicine Online Vol.7 No.4

Acute promyelocytic leukemia (APL) is a distinct subtype of acute myeloid leukemia (AML) characterized by PML-RARA fusion and specific morphology. The BCR-ABL1 rearrangement is mainly observed in patients with chronic myeloid leukiemia (CML). However, it is also found in patients with acute lymphoblastic leukemia (ALL) and in a few patients with AML. However, it is very rarely observed in patients with APL. Here, we report a case of APL with t(15;17) and co-existence of PML-RARA and BCR-ABL1. Further study with more cases is warranted to find the right treatment and prognostic significance. 급성전골수구백혈병은 PML-RARA 유전자 이상과 특징적인 형태를 가진 급성 골수성백혈병의 한 종류이다. BCR-ABL1 유전자 이상은 주로 만성골수성백혈병 환자에게서 발견되는 유전자 이상이지만 성인 급성림프모구백혈병이나 드물게 급성골수성백혈병 환자에게서도 발견이 된다. 그러나 급성전골수구백혈병에서 발견되는 경우는 매우 드물다. 이에 저자들은 PML-RARA와 BCR-ABL1이 동반된 급성전골수구백혈병 1예를 경험하였기에 보고하는 바이다.

Evaluation of Automated Platelet Aggregation Test Using a Sysmex CS-5100 Analyzer

안규대,정인화,임현호,우광숙,김경희,김정만,한진영 대한진단검사의학회 2020 Laboratory Medicine Online Vol.10 No.2

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., U.S.A) 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. CS5100 can perform coagulation test and platelet aggregation test, simultaneously. Thus, CS-5100 can enable cost saving and reduce turn-aroundtime by reducing the inspection time.

수혈전 검사의 재검토: 항-E, 항-c, 항-Jkb 복합 비예기항체에 의한 급성 용혈수혈반응 1예

안규대,김경희,정인화,임현호,우광숙,한진영,김정만,정진헌,손영기 대한수혈학회 2017 大韓輸血學會誌 Vol.28 No.2

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-Jkb 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.

Characteristics of Red Blood Cell Alloimmunization in Patients with Hematologic Diseases

안규대,김경희 대한수혈학회 2022 大韓輸血學會誌 Vol.33 No.1

Background: Patients with hematologic diseases receive frequent transfusions of red blood cells (RBCs), platelets (PLTs), and fresh frozen plasma (FFP). These patients are more likely to develop alloimmunization due to repeated exposure to RBC antigens. The purpose of this study was to investigate the need for extended RBC matching in patients with hematologic diseases and a history of repeated transfusions. Methods: We assessed patients who had undergone bone marrow examination at the Dong-A University hospital, Busan, South Korea from January 2008 to December 2012. A total of 571 patients were examined. We retrospectively investigated the frequency and volume of the transfusions of RBCs, PLTs, and FFP, the diagnosis of each patient, and the generation of unexpected antibodies. Results: Alloimmunization occurred in 18 out of 571 patients (3.15%). Among the identified antibodies, Rhesus (Rh) group antibodies were the most frequently detected (58.6%). The number of RBC transfusion episodes was higher in the alloimmunized group than that in the non-alloimmunized group (P=0.0016). The RBC transfusion volume was also significantly higher in the alloimmunized group than that in the non-alloimmunized group (P=0.0020). Also, the number of PLT transfusion episodes and transfusion volume were higher in the alloimmunized group. There were no statistically significant differences in the sex, age, or FFP transfusions between the two groups. Conclusion: The number of RBC transfusion episodes and the RBC transfusion volume affected the possibility of generating unexpected antibodies. The number of PLT transfusion episodes and the PLT transfusion volume also affected alloimmunization. The Rh antigen should therefore be matched in elderly patients who are expected to receive repeated blood transfusions. (Korean J Blood Transfus 2022;33:14-23)

건강인에서 NK세포 자극 후와 T세포 자극 후 분비된 Interferon-gamma 농도의 비교

안규대,김경희,임현호,김민찬,이상엽 대한진단검사의학회 2018 Laboratory Medicine Online Vol.8 No.1

Interferon-γ (IFN-γ) is an important cytokine produced by natural killer (NK) cells and T cells in response to various stimuli. The levels of IFN-γ secreted after stimulation of NK cells using a recombinant cytokine is represented as one of functions of NK cells. Recently, a method for evaluating NK cell activity in whole blood samples was developed. The levels of IFN-γ secreted after NK cell stimulation with PROMOCATM (ATGen, Korea) and T cell stimulation with phytohemagglutinin (PHA) were compared using two different commercial kits: NK Vue Gold (ATGen, Korea) and QuantiFERON- TB Gold In-Tube (Cellestis, Australia). Participants included 43 healthy individuals. Whole blood samples were incubated with either PROMOCA, a recombinant cytokine that specifically activates NK cells, or with PHA. IFN-γ levels in the supernatants were measured by ELISA. The level of IFN-γ by PROMOCA stimulation (PROMOCA IFN-γ) was more varied than that by stimulation with PHA (PHA IFN-γ) (median 1,544.4 pg/mL [ range 193.7–2,530.9] vs. median 2,470.1 pg/mL [ 2,250.1–2,874.4] P =0.0001). The median of PHA IFN-γ/PROMOCA IFN-γ ratio was 1.9 (1.1–12.4). There was a significant difference in levels of IFN-γ secreted after stimulation with PROMOCA or PHA in the healthy population.

새로운 ARCHITECT AFP Assay의 분석능 평가

우광숙,안규대,임현호,한진영 대한진단검사의학회 2018 Laboratory Medicine Online Vol.8 No.2

Alpha-fetoprotein (AFP) is frequently used for hepatocellular carcinoma (HCC) diagnosis and surveillance. Although the current ARCHITECT AFP (List number 7K67) assay range is 0–350 ng/mL, all samples with test results between 200 and 350 ng/mL must be diluted and retested until their levels are <200 ng/mL. A new ARCHITECT AFP (8100/3P36) assay with a dynamic range of up to 2000 ng/mL has been introduced. The aim of this study was to perform a method comparison between the current ARCHITECT AFP assay and the new assay. The precision study showed excellent results for both high and low controls. There was a positive correlation between the two assay systems and clinical samples. The new ARCHITECT AFP assay with a wide assay range demonstrated good analytical performance. Therefore, the current ARCHITECT AFP assay could be replaced by the new assay, which is more convenient and minimizes manual labor. 알파태아단백(AFP)은 간세포암의 진단과 감시에 흔히 사용된다. 이전에 사용하던 ARCHITECT AFP (List number 7K67) 시약은 그측정 범위가 0–350 ng/mL여서 200–350 ng/mL 사이의 검체는 희석이 필요하다. 새로운 ARCHITECT AFP (8100/3P36) 시약은 그측정 범위가 2,000 ng/mL로 확대되었다. 이 연구의 목적은 이전의시약과 새로운 시약의 비교평가이며 새로운 시약의 분석능 또한평가하였다. 비교평가 결과 우수한 상관성을 보였으며 정밀도 검사에서도 우수한 결과를 보였다. 새로운 ARCHITECT AFP 시약은그 측정 범위가 넓어 희석에 필요한 수고를 줄일 수 있으며 우수한분석능을 가지고 있으므로 이전의 시약을 대체하기에 충분한 것으로 사료된다.

Isolation of Carnobacterium divergens from Blood Culture in Korea : A Case Report and Literature Review

정인화,안규대,김남희,김경희,신상동,한진영,우광숙 대한임상미생물학회 2020 Annals of clinical microbiology Vol.23 No.3

Carnobacterium is a genus of gram-positive bacilli belonging to the family Lactobacillaceae. Generally, Carnobacterium species are considered nonpathogenic to humans and are mostly found in the natural environment, food, and food packaging. Furthermore, some Carnobacterium species play a bioprotective role in the food industry. Isolation of Carnobacterium from human blood or other sites, such as skin or abscess, has rarely been reported—there are only four published case reports worldwide, and none of them is from Korea. In all the reported cases, the patients reported contact with an aqueous environment or were administered nutrition via a parenteral route. Herein, we report the detection of Carnobacterium divergens bacteremia in an immunocompromised patient by using mass spectrometry in Korea.

A Case of Bone Marrow Necrosis in B-Acute Lymphoblastic Leukemia with Philadelphia Chromosome at Presentation

정인화,안규대,임현호,우광숙,김경희,김정만,이지현,한진영 대한진단검사의학회 2018 Laboratory Medicine Online Vol.8 No.4

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.

NUP98 Rearrangement in Acute Myelomonocytic Leukemia With t(11;19)(p15;p12): The First Case Report Worldwide

임현호,안규대,우광숙,김경희,김정만,김성현,한진영 대한진단검사의학회 2017 Annals of Laboratory Medicine Vol.37 No.3

Dear Editor, AML is a group of heterogeneous diseases derived from various cytogenetic and molecular abnormalities that are significant for diagnosis, treatment, and prognosis in many cases. We report a rare case of AML harboring t(11;19)(p15;p12) that was detected with whole-genome sequencing (WGS).