Current laboratory diagnosis of coronavirus disease 2019

Jihyang Lim,Jehoon Lee 대한내과학회 2020 The Korean Journal of Internal Medicine Vol.35 No.4

Coronavirus disease 2019 (COVID-19) emerged in December 2019 in Wuhan, China; it has since caused a pandemic, with more than 10,000 confirmed cases (> 800,000 tests) in Korea as of May 2020. Real-time reverse transcription polymerase chain reaction (RT-PCR) is currently the most commonly used method for the diagnosis of COVID-19 worldwide. The Korean Society for Laboratory Medicine and Korea Centers for Disease Prevention and Control regularly update the guidelines for COVID-19 diagnosis. Emergency use authorization for some laboratory diagnostic kits has been granted, enabling the timely diagnosis and treatment of COVID-19, and the isolation of infected patients. Due to the collective efforts of the government, medical professionals, local authorities, and the public, Korea’s response to the COVID-19 outbreak has been accepted widely as a model. Here, we summarize the currently available laboratory tests for COVID-19 diagnosis. Although RT-PCR tests are used widely to confirm COVID-19, antibody tests could provide information about immune responses to the virus.

Enterobacter cloacae에서의 광범위 β-lactam제제에 대한 plasmid 매개 내성(4예 보고)

임지향,박연준,오은지,김병기,심상인 대한감염학회 1998 감염 Vol.30 No.3

배경 : Enterobacter 균종은 원내 감염의 원인균으로 빈도가 증가하고 있으며 β-lactam제제에 내성인 균주도 증가하는 추세이다. 하지만 국내에서 ESBL에 대한 연구는 주로 K. pneumoniae와 E. coli에서만 국한된 실정이다. 최근 저자들은 cephamycin을 포함한 광범위 항생제에 내성을 보인 4예의 Enterobacter cloacae가 생성하는 ESBL 유형의 특징을 알아보고자 하였다. 방법 : 항생제 감수성 검사에서 다제 내성을 보인 E. cloacae에 대하여 double disk synergy 검사와 접합 검사를 시행하였다. 또한 중합효소 연쇄반응을 이용하여 TEM, SHV, IMP 유전자의 존재유무를 알아보았다. 결과 : 접합 결과 double disk synergy 검사에서 양성을 보였던 4 균주중 ceftazidime에 대한 내성 전달은 2예에서, cefoxitin에 대한 내성 전달은 4예 모두에서 확인되었다. 중합효소 연쇄반응에서는 3예에서 TEM과 SHV 유전자가 동시에 검출되었고 1예에서는 TEM 유전자만 검출되었으며, ceftazidime 내성이 전달된 2예의 transconjugant에서도 TEM과 SHV 유전자가 모두 검출되었다. 결론 : 장내세균의 다약제내성이 plasmid에 의한 것일 경우 병원내 전파 우려가 있으므로, 이런 장내세균의 검출에 관심을 기울여야 할 것으로 사료된다. Background : Enterobacter species are frequent nosocomial pathogens and the proportion of β-lactam resistant strains are on the increase. Extended spectrum β-lactamases(ESBLs) were mainly investigated in Klebsiella pneumoniae and Escherichia coli in Korea. Recently, we experienced 4 strains of multidrug(including cephamycin)-resistant Enterobacter cloacae and characterized the ESBL types. Methods : Multidrug-resistant E. cloacae strains were tested for ESBL production by double-disk synergy test and conjugation. The presence of TEM, SHV or IMP gene was determined by polymerase chain reaction. Results : Of the four strains that revealed positive reaction in double-disk synergy test, ceftazidime-resistance was transferred in two and cefoxitin-resistance was transferred in four strains by conjugation. In the polymerase chain reaction, three out of four strains had both TEM and SHV genes and one strain had only TEM gene. Two ceftazidime transconjugants had both TEM and SHV genes. Conclusion : We should be aware of ESBL producing Enterobacteriaceae and the possible institutional spread of resistance genes.

면역 결핍 환자에서 발생한 Fusarium oxysporum에 의한 범발성 피부 감염 1예

임숙희,이동원,이준영,임지향,한경자,조백기 대한의진균학회 2000 대한의진균학회지 Vol.5 No.1

With the wide and extensive use of immunosuppressive agents and broad-spectrum antibiotics, opportunistic fungal infections have been increased. Fusarium spp. are known to be significant emerging pathogens of opportunistic local infection. But very rarely it may cause fatal systemic infection. A 4-year-old boy with acute Iymphocytic leukemia developed asymptomatic disseminated purpura with high fever unresponsive to the antibiotics during chemotherapy. The skin lesions gradually increased in size and number, and progressed to forming central necrosis. Many septated hyphae and variable sized spore-like fungal elements are found in the epidermis, dermis and subcutis on histologic sections. The pathogenic fungus was identified as Fusarium oxysporum by culture and scanning electronic microscopic findings. [Kor J Med Mycol 5(1): 24-30]

The Family Functioning and Stress Coping Methods in Families with a Mentally Retarded Child

Seoungtag Park,Jihyang Lim 한국신학교육연구원 2002 Korea Journal of Theology Vol.3 No.-

Methotrexate 과량 복용 후 발생한 골수이형성증후군 1예

김수영,임지향,한경자 대한임상병리학회 2000 대한임상병리학회지 Vol.20 No.6

Current Status of Flow Cytometric Immunophenotyping of Hematolymphoid Neoplasms in Korea

Park Mikyoung,Lim Jihyang,Ahn Ari,Oh Eun-Jee,Song Jaewoo,Kim Kyeong-Hee,Han Jin-Yeong,Choi Hyun-Woo,Park Joo-Heon,Shin Kyung-Hwa,Kim Hyerim,Kim Miyoung,Hwang Sang-Hyun,Kim Hyun-Young,Cho Duck,Kang Eun 대한진단검사의학회 2024 Annals of Laboratory Medicine Vol.44 No.3

Background: Flow cytometric immunophenotyping of hematolymphoid neoplasms (FCI-HLN) 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, positive/negative 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. Positive/negative 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.

Phenotypic and genetic characterization of adult T-cell acute lymphoblastic leukemia with del(9)(q34);SET-NUP214 rearrangement.

Chae, Hyojin,Lim, Jihyang,Kim, Myungshin,Park, Joonhong,Kim, Yonggoo,Han, Kyungja,Lee, Seok,Min, Woo Sung Springer International 2012 Annals of hematology Vol.91 No.2

<P>SET-NUP214 rearrangement is a recently recognized recurrent chromosomal translocation mostly observed in T-ALL. In order to characterize this rare entity, we performed phenotypic and genetic characterization of SET-NUP214 rearrangement through an investigation of a series of 40 consecutive samples of adult T-ALL that was selected among 229 adult ALL cases during 4?years in a single institution. Four cases (10%) of SET-NUP214 translocation were identified in our study. In all cases, diagnosis of T-ALL was established according to the World Health Organization (WHO) classification, and clonal TCR rearrangements were found. The immunophenotypic markers were indicative of the precursor nature of T lymphoblasts, and they expressed one or both of the myeloid-associated antigens (CD13, CD33). Conventional cytogenetic analysis revealed complex chromosomal aberrations in all four SET-NUP214 rearranged cases and del(12)(p13)/ETV6 was frequently involved. Array-CGH demonstrated additional genomic imbalances in addition to deletion 9q34. The genomic breakpoint sequencing identified breakpoints at SET intron 7 and NUP214 intron 17, and random nucleotide addition was found in two cases at the site of rearrangement. Our independently derived data set from a single institution confirms previous findings of SET-NUP214 rearrangement, indicates the relatively high incidence of SET-NUP214 rearrangement in adult T-ALLs, and also demonstrates comprehensive clinical, phenotypic, and genetic characteristics of this entity. Also, our report on genomic breakpoints demonstrates the homogeneity in the localization of the genomic breakpoints at 9q34. Concurrent chromosomal aberrations identified in this study should provide further areas of interest in investigation of SET-NUP214-mediated leukemogenesis.</P>

조명과 소리를 통한 주차장 공유 서비스 제안

임진섭(Jinseob Lim),김지향(Jihyang Kim),조원흥(Won-heung Jo),심유리(Yu-Ri Sim),연명흠(Myeong-Heum Yeoun) 한국디자인학회 2020 Design Works Vol.3 No.2

대한지구물리학회와 한국물리탐사학회의 설립 20 년, 한국지구물리·물리탐사학회로의 통합 10 년의 역사

임무택 ( Mutaek Lim ),진영근 ( Young Keun Jin ),이주한 ( Joohan Lee ),최지향 ( Jihyang Choi ) 한국지구물리·물리탐사학회 2017 지구물리와 물리탐사 Vol.20 No.4

1945년에 해방된 후부터, 우리나라에서는 지질과학 분야와 자원공학 분야의 전문가들이 서로 협조, 경쟁하면서 두 학문 분야를 발전시켜 왔다. 서로 공유하는 부분이 많은 지구물리 분야와 물리탐사 분야는 범위가 더 넓은 위 두 학문 분야 안에서 각각 자신의 분야를 더욱 깊이 발전시켜 왔다. 1990년대 후반부터 지구물리 분야와 물리탐사 분야의 전문가들은 자신의 분야를 다루는 독립적인 학회가 필요함을 느끼고 학회의 설립을 위한 논의를 거듭하였다. 1997년에 이르러서는 두 분야가 각각 학회를 설립할 것이 아니라, 두 분야를 아우르는 하나의 학회를 설립할 것을 논의한 바 있으나, 결국 1998년에 들어와서는 몇 가지 현실적인 문제로 인해 대한지구물리학회와 한국지구물리탐사학회(이후 한국물리탐사 학회로 바꾸었음)를 각각 따로 설립하였다. 양 학회의 설립 후부터 2000년대 중반까지 7 ~ 8 년이 지나는 동안, 양 학회가 다루는 분야들 중 서로 겹치는 분야가 많은 점, 많은 회원이 양 학회 모두의 회원인 점 등의 이유로, 양 학회의 많은 회원들이 양 학회가 통합하여 하나의 학회가 될 것을 바란다는 뜻을 나타내었다. 양 학회의 회장단도 이 의견을 받아들여, 2005년부터 본격적으로 통합을 논의하였고, 결국 2007년에 양 학회가 통합하여, 한국지구물리·물리탐사학회를 설립하였다. 2007년에 통합, 설립한 한국지구물리·물리탐사학회는 그 후부터 계속하여 우리나라의 지질과학 분야, 자원공학 분야의 다른 학회들과 활발히 서로 협조, 경쟁하면서 우리나라의 발전에 크게 기여할 뿐만 아니라, 아시아, 오세아니아, 아메리카 대륙 등 태평양을 둘러싸는 지역들의 외국 학회들과도 긴밀히 협조하면서 세계의 지구물리, 물리탐사 분야의 발전에도 크게 기여하고 있다. Since the liberation in 1945, Korean specialists in the field of geological science and mineral resources engineering have developed two disciplines through the cooperation and competition with each other. Specialists both in the geophysics and in the geophysical exploration, who share much, have developed their own fields deeper and broader. Since the late 1990s, specialists in both fields felt the need for an independent society to deal with their fields and discussed the establishment of such a society. In 1997, they discussed to establish a unified society which integrates both fields instead of separated societies. However, in 1998, the Korean Geophysical Society and the Korean Society of Exploration Geophysicists were separately established due to some practical problems. During 7 ~ 8 years since the establishment of the two societies, many members of the two societies intended that the two societies should integrate into a single comprehensive society based on the facts that many fields of each society are overlapped and naturally many members of one society are the members of the other society. The leaders of the two societies accepted these opinions also and began to discuss thoroughly the integration from 2005. Eventually, in 2007, the two societies successfully integrated and established the Korean Society of Earth and Exploration Geophysicists. The Korean Society of Earth and Exploration Geophysicists continues to cooperate and compete with other societies of geological science and mineral resources engineering in Korea and in circumpacific area including Asia, Oceania and Americas, contributing to the development of geophysics and geophysical exploration.

조혈모세포이식 후 초기에 발생하는 일시적인 백혈구 증가의 의의

김명신,임지향,김용구,한경자,김원일,민창기,박종원,김춘추 대한조혈모세포이식학회 2003 대한조혈모세포이식학회지 Vol.8 No.2

연구배경: 조혈모세포이식 후 초기의 백혈구 수를 비희석 적혈구용 혈법을 이용하여 정확하게 추적한 결과 이식 후 초기에 백혈구 수가 일시적인 증가를 보이는 것이 알려졌다. 본 연구에서는 이식 초기에 나타나는 백혈구의 근원을 밝히고 이러한 일시적인 백혈구 증가의 임상적 의의를 알아보고자 하였다. 방법: 본 연구에서는 48예의 조혈모세포이식 후 환자를 대상을 비희석적혈구용혈법을 이용하여 이식 후 초기에 백혈구 수의 변화를 조사하였다. 백혈구의 일시적인 증가를 보이는 환자는 이식 후 1일에서 7일 사이에 백혈구 수가 이식전 최저치에 비해 50/μL 이상 증가하는 경우로 정의 하였다. 형광동소보합법을 이용하여 이식 후 출현하는 백혈구의 근원을 알아보았다. 결과: 전체 48예의 환자 중에서 11예의 환자에서 일시적인 백혈구 증가가 관찰되었다. 형광소보합법을 시행한 결과 이 기간에 나타나는 세포는 환자 자신의 세포가 대부분을 차지하였다(중앙값 85%). HLA 일치 혈연간 이식을 바기 위해 이식 전처치로 전신방사선조사를 받지 않은 중증재생불량성빈혈 환자 5예 모두에서는 일시적인 백혈구 증가가 관찰되었고, 전신방사선조사를 받은 43예의 환자들 중 6예의 환자에서 일시적인 백혈구 증가를 보였다. 이식후 환자들의 임상 경과를 추적한 결과, 이들 6예 중 단 한 예만이 이식 후 생존하였다. 이식 전처치로 전신 방사선조사를 받은 환자를 대상을 살펴보면, 이식 후 초기에 일시적인 백혈구 증가를 보이는 환자의 이식 후 사망률은 그렇지 않은 환자들에 비해 유의하게 높게 나타났다(83.3% vs. 21.6%, p<0.001). 결론: 전신방사선조사를 받은 환자들에서 조혈모세포이식 후 초기에 일시적인 백혈구 증가가 나타나는 소견은 이식 후 사망의 예측인자로 사용할 수 있을 것으로 생각된다. Background: We found that the total leukocyte count increased transiently in early post-transplant period by a new accurate leukocyte counting method using undiluted erythrocyte lysing technique. In this study, we determined the origin of leukocytes and clarified the significance of transient increase of leukocytes. Methods: Forty-eight patients who underwent stem cell transplantation (SCT) were included. Total leukocyte counts were performed using undiluted erythrocyte lysing technique. The transient increase of leukocytes was defined as a elevation in the leukocyte count greater than 50/μL when compared to the previous baseline level from the post-transplant day 1 to 7. Fluorescence in situ hybridization was performed to determine the origin of the cells in patients with a sex-mismatched graft. Results: Among the 48 patients, 11 showed a transient increase of leukocytes. The majority of cells that appeared during this period were originated from recipient (median 85%). All of the severe aplastic anemia patients who underwent allogeneic SCT and did not receive total body irradiation (TBI) showed transient increase (n=5). However, this study found that the other six patients with transient increase of leukocytes received TBI. Among these six patients, only one survived after the transplant. The mortality rate of the patients with transient increase of leukocytes was higher than without transient increase (83.3% vs. 21.6%, P<0.001). Conclusion: These results suggest that transient increase of leukocytes in the early post-transplant period can be a risk factor for an increase in post-transplant mortality in patients who received TBI.