두 가지 자동화 Rapid Plasma Reagin (RPR) 검사와 수기법 RPR 검사의 정량적 검사 결과 비교

김영식,이제훈,이혜경,권희정,김현정,민기옥,서은주,김수영 대한진단검사의학회 2009 Annals of Laboratory Medicine Vol.29 No.4

Background : We compared two automated Rapid Plasma Reagin (RPR) assay kits with a manual RPR assay kit to evaluate the possibility of using the two automated RPR assays as an alternative to the manual RPR assay for a quantitative monitoring. Methods : One hundred eighty-five samples were analyzed, including 16 sera from patients with primary, secondary, and latent syphilis. Measured RPR unit (R.U.) values of two automated RPR assay kits, Mediace RPR (Sekisui Chemical Co., Ltd, Japan) and HBi Auto RPR (HBI Co., Ltd, Korea), were compared with the RPR titers of Macro-Vue RPR card test (Becton Dickinson BD Microbiology systems, USA). As a confirmatory test, Anti-Treponema pallidum EUROLINE WB (IgG) and Anti-Treponema pallidum EUROLINE WB (IgM) (Euroimmun, Germany) were used. Results : There was a prozone effect with Mediace RPR at RPR titer (card test) of 1:16, but not with HBi Auto RPR. The R.U. values of the two automated RPR assays did not show proportional increase to the RPR titer. Agreement between manual RPR and two automated RPR assay kits, Mediace RPR assay and HBi Auto RPR assay, were 83.8% and 83.2%, respectively. Conclusions : The two automated RPR assay kits could not be used as an alternative to manual RPR test for quantitative analysis of RPR titer. As Mediace RPR shows a prozone effect at relatively low RPR titer, caution is needed in the interpretation of the measured values. 배경 : 본 연구진들은 두 가지 자동화 Rapid Plasma Reagin (RPR) 검사와 수기법 RPR 역가를 비교하여 두 가지 자동화 RPR 검사 방법이 정량적 검사로서의 수기법 RPR 검사를 대체할 수 있는지 알아보고자 하였다. 방법 : 185검체를 분석하였으며 16검체는 일차매독과 이차매 독, 잠복기매독 환자로부터 얻은 것이었다. 두 가지 자동화 RPR 검사 방법, 즉 Mediace RPR (Sekisui Chemical Co., Ltd, Japan)와 HBi Auto RPR (HBI Co., Ltd, Korea)의 측정치를 수기법 Macro-Vue RPR card tests (Becton Dickinson BD Microbiology systems, USA)의 RPR 역가와 비교했다. 확진 검사로 Anti-Treponema pallidum EUROLINE WB (IgG)와 Anti-Treponema pallidum EUROLINE WB (IgM) (Euroimmun, Germany)을 이용하였다. 결과 : Mediace RPR는 RPR 역가 1:16에서 전역반응(prozone effect)을 나타냈지만 HBi Auto RPR은 나타내지 않았 다. 두 가지 자동화 RPR 검사로 측정된 측정치는 RPR 역가에 비례적으로 증가하지는 않았다. 두 가지 자동화 RPR 검사, 즉 Mediace RPR과 HBi Auto RPR의 RPR card 일치율은 각각 83.8%와 83.2%였다. 결론 : 두 가지 자동화 RPR 검사 방법은 수기법 RPR 검사를 대체하는 정량적인 검사로는 사용할 수 없을 것으로 판단된다. 특히 Mediace RPR은 낮은 역가에서도 전역반응을 나타내기 때 문에 결과 해석 시 주의가 필요할 것으로 판단된다.

매독검사를 위한 Auto RPR Plus와 Auto TPIM Plus 시약의 평가

김현정,나은희,조선,정소영 대한진단검사의학회 2018 Laboratory Medicine Online Vol.8 No.3

Background: Serologic testing is considered a standard method for syphilis diagnosis. We compared Auto RPR Plus and Auto TPIM Plus with previously developed assays. Methods: The precision around the cut-off, linearity, and recovery rate of Auto RPR Plus and Auto TPIM Plus was evaluated using their positive/negative control materials. The results of these two tests were compared with those of Mediace RPR and Abbott Syphilis TP using 431 remnant serum samples collected from people who underwent medical examinations. Results: The within-run precisions (coefficient of variation, CV values) of negative/positive control materials of Auto RPR Plus, Mediace RPR, Auto TPIM Plus and Abbott Syphilis TP were 15.7/2.3%, 20.4/2.3%, -/2.7%, and 8.5/2.3%, respectively; between-run precisions were 67.7/3.3%, 39.1/3.4%, -/4.0%, and 7.0/1.5%, respectively. Auto RPR Plus showed better precision around the cutoff level (1.0 U) compared to Mediace RPR (7.2–7.3% vs. 12.2–14.3%). The CVs of Auto TPIM Plus around the cutoff (10.0 U) were 13.5% at 10.5 U and 6.6% at 12.5 U. Agreement rates between Auto RPR Plus and Mediace RPR and between Auto TPIM Plus and Abbott Syphilis TP were 97.2% and 98.4%, respectively. However, twelve samples showed discrepant results for Auto RPR Plus (-)/Mediace RPR (+) and false-positive Mediace RPR results could not be excluded around the cutoff of 1.0 U. Conclusions: Auto RPR Plus showing good precision near the cutoff can be used for syphilis screening in health checkups. However, Auto TPIM Plus needs improvement in precision and adjusting the cutoff to be used for syphilis screening. 배경: 매독의 원인균은 일반적인 배양법으로 분리되지 않기 때문에, 혈청학적 진단이 기준방법으로 고려되고 있다. 본 연구에서 저자들은 매독의 새로운 혈청검사시약을 평가하고자 하였다. 방법: Auto RPR Plus와 Auto TPIM Plus의 판정기준치 근처 농도의 정밀도, 직선성, 회수율을 양성/음성 정도관리물질을 이용하여 평가하였다. 건강검진을 시행한 431명의 남은 혈청을 이용하여 Auto RPR Plus와 Auto TPIM Plus의 결과를 Mediace RPR과 Abbott Syphilis TP의 결과와 비교하였다. 결과: Auto RPR Plus, Mediace RPR, Auto TPIM Plus, 그리고 Abbott Syphilis TP의 검사 내 정밀도는 음성/양성 정도관리물질에서 각각 15.7/2.3%, 20.4/2.3%, -/2.7%, 7.0/1.5%였다. 검사 간 정밀도는 음성/양성 정도관리물질에서 각각 67.7/3.3%, 39.1/3.4%, -/4.0%, 8.5/2.3%였다. Auto RPR Plus는 Mediace RPR과 비교하였을 때, 판정기준치(1.00 U) 부근에서 더 나은 정밀도를 보이는 것으로 추정되었다(Auto RPR Plus 변이계수, 7.2–7.3%; Mediace RPR 변이계수, 12.2–14.3%). Auto TPIM Plus의 판정기준치(10.0 U) 근처의 변이계수는 10.45 U에서 13.5%, 12.54 U에서 6.6%였다. 직선성은 Auto RPR Plus의 경우 0.10–8.70 U, 그리고 Auto TPIM Plus의 경우 2.0–270.0 U에서 관찰되었다. Auto RPR Plus와 Mediace RPR 간 및 Auto TPIM Plus와 Abbott Syphilis TP 간 일치율은 각각 97.2%와 98.4%였다. 결론: Auto RPR Plus와 Mediace RPR 간, Auto TPIM Plus와 Abbott Syphilis TP 간 일치율은 우수했다. Auto RPR Plus와 Auto TPIM Plus는 허용 가능한 민감도와 직선성을 보였다. 판정기준치 근처에서 좋은 정밀도를 보이는 Auto RPR Plus는 건강검진에서 매독의 선별검사로 쓰일 수 있을 것으로 보인다. 그러나 Auto TPIM Plus는 건강검진에서 매독의 선별검사로 쓰이기 위해서는 정밀도와 판정기준치의 조정이 필요할 것이다.

Efficient Load Balancing Algorithms for a Resilient Packet Ring

Kwang Soo Cho,주운기,이형섭,김봉태,Won Don Lee 한국전자통신연구원 2005 ETRI Journal Vol.27 No.1

The resilient packet ring (RPR) is a data optimized ring network, where one of the key issues is on load balancing for competing streams of elastic traffic. This paper suggests three efficient traffic loading algorithms on the RPR. For the algorithms, we evaluate their efficiency via analysis or simulation.

국방 M&S 가상시험 연동 환경을 위한 SimCoreDB 설계 및 적합성 평가

최미선(Mi-Seon Choi),최성우(Sung-Woo Choi),이예나(Yena Lee),김영국(Young-Kuk Kim) 한국정보과학회 2014 정보과학회논문지 : 데이타베이스 Vol.41 No.2

현존하는 국방 M&S(Modeling & Simulation) 가상시험들에서 DBMS의 활용은 참조 데이터나 사후분석 로그 저장과 같은 용도로 국한되고 있다. 국방 M&S 가상시험에 DBMS를 적극 활용하면, 체계적이고 효율적인 데이터관리가 가능하고 가상시험 개발이 용이해지며, 데이터 분석 성능 향상, 데이터 마이닝 기술 활용 등으로 고급 사후분석이 가능하게 될 것이다. 본 논문에서는 DBMS를 이용한 전문 데이터관리 및 분산 DBMS 동기화를 통해 분산 시뮬레이션들의 상호 운영성을 제공해줄 수 있는 새로운 DBMS기반 국방 M&S 가상시험 연동환경을 제안한다. 이를 위해 RPR-FOM을 바탕으로 국방 M&S 가 상시험들을 위한 표준 코어DB인 SimCoreDB를 관계형 및 객체지향형 DB모델로 설계하고 상용 DBMS들을 이용하여 SimCoreDB를 구축한 후, 국방 M&S 가상시험 테스트베드를 구현하고, 관계형/객체지향형 SimCoreDB의 성능평가를 실시하여, 국방 M&S 가상시험에 대한 적합성을 평가하였다. The roles of DBMSs in most of existing defense M&S(Modeling & Simulation) simulations are limited to fields like storing some read-only data referred during simulation and log data kept for after-action-review processes. Utilizing DBMSs in defense M&S simulations allows systematic/efficient data management and easy development of M&S simulations. In addition, advanced data analysis on simulation results would be possible via improved performance in data analysis, application of data mining techniques, etc. We proposed a new DBMS-based defense M&S simulation interoperating environment which provides defense M&S simulations with professional data management capabilities and guarantees interoperability between each simulation through distributed DBMS synchronization. For that purpose, we designed SimCoreDB, a standard simulation core DB for defense M&S simulations operating in this environment, in a relational/object-oriented model, and built SimCoreDB on commercial DBMSs for each data model. We also implemented a defense M&S simulation testbed using SimCoreDB and performed experiments to assess the conformity and performance of SimCoreDB built on relational/object-oriented DBMSs.

On-off controllable RNA hybrid expression vector for yeast three-hybrid system

( Geunu Bak ),( Se Won Hwang ),( Ye Rim Ko ),( Jung Min Lee ),( Young Mi Kim ),( Kyung Hwan Kim ),( Soon Kang Hong ),( Young Hoon Lee ) 생화학분자생물학회 2010 BMB Reports Vol.43 No.2

생화학 자동분석기용 Mediace RPR 검사의 성능 및 위양성 평가

노재광,고학현,윤여민,최영숙,이상곤,신수,한규섭,송은영 대한진단검사의학회 2008 Annals of Laboratory Medicine Vol.28 No.4

Background : We evaluated the performance and false positive rate of Mediace RPR test (Sekisui, Japan), a newly introduced nontreponemal test using a chemistry autoanalyzer. Methods : The sensitivity of Mediace RPR test was analyzed using sera from 50 patients with syphilis in different stages (8 primary, 7 secondary, and 35 latent), 14 sera positive with fluorescent treponemal antibody absorption (FTA-ABS) IgM, and 74 sera positive with conventional rapid plasma regain (RPR) card test (Asan, Korea) and also positive with Treponema pallidum hemagglutination (TPHA) test or FTA-ABS IgG test. The specificity was analyzed on 108 healthy blood donors. We also performed RPR card test on 302 sera that had been tested positive with Mediace RPR test and also performed TPHA or FTA-ABS IgG test to analyze the false positive rate of Mediace RPR test. A cutoff value of 0.5 R.U. (RPR unit) was used for Mediace RPR test. Results : Mediace RPR test on syphilitic sera of different stages (primary, secondary, and latent stages) and FTA-ABS IgM positive sera showed a sensitivity of 100%, 100%, 82.9% and 100%, respectively. Among the 74 sera positive with conventional RPR card test and TPHA or FTA-ABS IgG test, 55 were positive with Mediace test. The specificity of Mediace RPR test on blood donors was 97.2%. Among the 302 sera positive with Mediace RPR test, 137 sera (45.4%) were negative by RPR card and TPHA/FTA-ABS IgG tests. Conclusions : Although the sensitivities of Mediace RPR were good for primary and secondary syphilis, due to its high negative rate of Mediace RPR over the conventional RPR positive samples, further studies are necessary whether it can replace conventional nontreponemal test for screening purpose. Moreover, in view of the high false positive rate, positive results by Mediace RPR test should be confirmed with treponemal tests. (Korean J Lab Med 2008;28:312-8)

P034 : Automated rapid plasma reagin (RPR) test compared to conventional RPR card test in syphilis testing

( Dong Yun Shin ),( Jong Han Lee ),( Hyon Suk Kim ),( Min Geol Lee ) 대한피부과학회 2013 대한피부과학회 학술발표대회집 Vol.65 No.2

Background: Appropriate diagnosis protocols for syphilis disease should be well established. Recently, automated non-treponemal reagin (rapid plasma reagin, RPR) tests are developed and more frequently used than conventional RPR card test. Objectives: To evaluate automated RPR test comparing to conventional RPR card test for its clinical application Methods: A total of 62 patients` serum samples with syphilis and 50 syphilis-negative controls were enrolled for this evaluation. The percent agreement, kappa value, and overall sensitivity and specificity were compared between two RPR tests. Also, seroconversion rate of each RPR test were evaluated. Results: The percent agreement of both RPR tests was 78.6%. Overall sensitivity and specificity of the auto RPR test to TPPA (treponema pallidum particle agglutination assay) was 50% and 64%, respectively, while the same values for conventional RPR card test were 84.13% and 97.96%, respectively. The conventional RPR card test showed overall high positivity than the automated RPR test. The automated RPR test showed a higher seronegative changes (57.1%, 12/21) than the RPR card test (19%, 4/21) after treatment for syphilis (P=0.025). Conclusion: The automated RPR test showed a lower positivity compared to TPPA which shows high positivity during all the stages of syphilis regardless of treatment. However, the automated RPR test may be helpful to monitor the seroconversion responses after treatment for syphilis over a relatively short period of time.

자동화 매독검사인 Mediace Rapid Plasma Reagin (RPR) 검사의 성능평가

손보라, 신경섭 충북대학교 의과대학 충북대학교 의학연구소 2014 忠北醫大學術誌 Vol.24 No.1

연구목적 : 저자들은 자동화되고 정량검사를 할 수 있는 비트레포네마 매독 검사시약인 Mediace™ R PR (Sekisui Chemical Co., Ltd, Tokyo, Japan)의 성능을 평가하고자 하였다. 대상 및 방법 : 수기 RPR 카드(ASAN Pharm. Co., Ltd., Seoul, Korea)에 양성결과를 보인 68 개의 환자 검체를 포함한 188개의 검체를 대상으로 하였다. Mediace RPR 검사의 성능을 평가하기 위해 정밀도, 직선성 및 수기 RPR 카드, TPLA 및 FTA-ABS 검사와의 상관성을 분석하였다. 결 과 : Mediace RPR 검사의 일내 정밀도 및 일간 정밀도는 변이계수가 각각 4.48%와 4.84% 이 었다. 그리고 0에서 7.3 R.U.에서 직선성이 유지되었다. RPR 카드, TPLA 및 FTA-ABS 검사와의 상관성 검사에서 Mediace RPR 검사의 예민도 및 특이도는 각각 100%와 96.9% 이었다. RPR 카 드와 일치도는 96.8% 이었다. 결 론 : 정밀도, 직선성, 예민도 및 특이도를 포함하는 Mediace RPR 검사의 성능은 우수하였다. 그러 므로 임상검사실에서 매독의 선별검사에 Mediace RPR 검사의 적용은 매우 유용할 것으로 사료된다

KFDA 가이드 라인에 의한 RPR 카드와 Mediace RPR 검사의 비교

이해순 대한임상검사과학회 2012 대한임상검사과학회지(KJCLS) Vol.44 No.3

Syphilis is an infectious and sexually transmitted chronic disease caused by Treponema pallidum. On the basis of clinical findings, the disease has been divided into a series of overlapping stages, which are used to help guide treatment and follow-up. Persons who have syphilis might seek treatment for signs or symptoms of primary infection, secondary infection and tertiary infection. Latent infections are detected by serologic testing. A presumptive diagnosis of syphilis is possible with the use of two types of serologic tests: nontreponemal tests and treponemal tests assay. The use of only one type of serologic test is insufficient for diagnosis, because each type of test has limitations, including the possibility of false-positive test results in persons without syphilis. KFDA published Koreans guideline of Sexually transmitted infections in 2011. Two hundred samples were tested by RPR card test and Mediace RPR test with simultaneously. The agreement between RPR card test and Mediace RPR test was 95%, the discrepant samples was 5%. The characteristics of 10 discrepant samples was RPR card Positive and Mediace RPR negative nine samples, RPR card negative and Mediace RPR positive one sample. The nine samples were confirmed as FTA-ABS by KFDA guideline of syphilis test algorism, all IgM test was Negative, all IgG test was reactive. So, these cases were past or latent syphilis. The one sample was false-positive reaction. .

Comparison of RPR Card and Mediace RPR test by KFDA Guideline

( Hae Soon Lee ) 대한임상검사과학회 2012 대한임상검사과학회지(KJCLS) Vol.44 No.3

Syphilis is an infectious and sexually transmitted chronic disease caused by Treponema pallidum. On the basis of clinical findings, the disease has been divided into a series of overlapping stages, which are used to help guide treatment and follow-up. Persons who have syphilis might seek treatment for signs or symptoms of primary infection, secondary infection and tertiary infection. Latent infections are detected by serologic testing. A presumptive diagnosis of syphilis is possible with the use of two types of serologic tests: nontreponemal tests and treponemal tests assay. The use of only one type of serologic test is insufficient for diagnosis, because each type of test has limitations, including the possibility of false-positive test results in persons without syphilis. KFDA published Koreans guideline of Sexually transmitted infections in 2011. Two hundred samples were tested by RPR card test and Mediace RPR test with simultaneously. The agreement between RPR card test and Mediace RPR test was 95%, the discrepant samples was 5%. The characteristics of 10 discrepant samples was RPR card Positive and Mediace RPR negative nine samples, RPR card negative and Mediace RPR positive one sample. The nine samples were confirmed as FTA-ABS by KFDA guideline of syphilis test algorism, all IgM test was Negative, all IgG test was reactive. So, these cases were past or latent syphilis. The one sample was false-positive reaction.