성공적인 급성전골수구백혈병 치료 후 발생한 치료관련 골수종양 1예

권애린,박지영,권정혜,송헌호,신규성,이영경,조현찬 대한진단검사의학회 2011 Laboratory Medicine Online Vol.1 No.4

Acute promyelocytic leukemia (APL) is considered as a curative disease after combined chemotherapy based on all-trans retinoic acid (ATRA) and anthracycline. However, as long-term survivors continue to increase, reports on sporadic cases of therapy-related myeloid neoplasm (t-MN) after successful APL treatment are also increasing. Recently, we have experienced one patient who developed t-MN 7 yr after APL diagnosis. Even though he had not been exposed to alkylating agents at all, he showed alkylating agents-associated features such as long latency period ( >5 yr),first presentation as myelodysplatic phase (multilineage dysplasia with increased blasts), and complex karyotype including monosomy 5 and 7. He received only supportive care and expired 3 months after the diagnosis of t-MN (6 months of survival after the onset of cytopenias). t-MN after complete remission of APL is a rare but fatal complication, and patients with complex karyotypes show ominous prognosis in particular. For the early diagnosis of t-MN, long-term and close monitoring of the patient is needed. One should suspect this late complication whenever any unknown cytopenia develops, and should perform bone marrow biopsy and cytogenetic analysis.

신종인플루엔자 검사에 사용되는 신속항원검사와 실시간 역전사 중합효소연쇄반응검사의 비교

권애린,김재석,김한성,송원근,박지영,조현찬,이규만 대한임상미생물학회 2010 Annals of clinical microbiology Vol.13 No.3

Background: Novel swine influenza (H1N1) was first identified in Mexico in April 2009. Because of its high infectivity and worldwide distribution, a rapid and efficient screening test is necessary. Here we evaluated the usefulness of a rapid antigen test currently in use, compared to real-time RT-PCR (rRT-PCR) as a screening test for detection of novel swine influenza (H1N1). Methods: A total of 1,228 patients who visited Hallym University Kangdong Sacred Heart Hospital with influenza-like illness between 14 August 2009 and 30September 2009, and were tested by both rapid antigen and rRT-PCR tests, were enrolled in this study. Results: Sensitivity, specificity, predictive value of a positive test, and predictive value of a negative test for the rapid antigen test were 30.5%, 99.2%, 86.4%and 90.1%, respectively. Fifty-one (4.2%) patients were positive for both rapid antigen test and rRTPCR,and 1,053 (85.7%) were negative for both rapid antigen test and rRT-PCR. A total of 124 (10.1%)patients showed a discrepancy between the two tests. Among them, 116 (9.4%) were only positive for rRT-PCR and 8 (0.7%) were only positive for the rapid antigen test. The latter 8 patients all showed negative H1/M2 results in rRT-PCR. There were significant differences in detection rates of the rapid antigen test between different H1 Ct (threshold cycle)interval groups and for different age groups (P <0.05). Conclusion: Although the rapid antigen test is easy to perform and provides fast results, its limits as a screening test for detection of novel swine influenza (H1N1) due to its low sensitivity compared to rRTPCR need to be considered in practical situations. (Korean J Clin Microbiol 2010;13:109-113)

검체 운송 시스템의 온도 유지 기능 평가

이상곤,권애린,박승만,서소연,김영진,심효은,함초롱,김재석 대한진단검사의학회 2020 Laboratory Medicine Online Vol.10 No.2

Background: Clinical specimens are valuable materials that require a traceable management system. Maintenance of temperature and loss prevention during transport are important for the reliability of the clinical test results. Current transportation systems can suffer from temperature changes and agitation. Quality improvement in this pre-analytic phase is required. This study acquired preliminary data from a newly developed specimen transportation system adopting a real-time temperature monitoring during transportation using temperature sensor and global positioning system to establish appropriate guidelines. Methods: Temperature preservation performance was compared between two transportation boxes (newly developed one [A] and conventional one [B]) at exterior temperatures of 35°C and -18°C, reflecting the extreme temperature range in Korea. Influences of the temperatures on analytical results of whole blood, serum, plasma, and urine specimens were investigated, as were the effects of vibration. Results: The interior temperature of box A measured at multiple sites was maintained within 1.0-9.0°C at both exterior temperatures. The interior temperature of box B was outside of this range. The analyzed parameters varied comparably with the variations occurring at the recommended and published storage temperature. Vibration affected nonspecific enolase and lactate dehydrogenase. Conclusions: Temperature preservation and real-time monitoring during specimen transportation are important. The present data highlight the importance of transportation conditions and indicate that laboratories should know the characteristics of temperature changes in their transportation system. 배경: 임상 검체는 정확한 검사를 위해 전체 운반 과정의 엄격한 이력관리가 필요하다. 진단검사의 신뢰성을 위해서는 검체 운송과정 중 운송 온도 유지와 분실 방지가 중요하다. 검체 운송 시스템 현황은 이를 지키기 어려운 경우가 많으므로, 앞으로 지속적인검체 품질관리 수준 향상이 요구되고 있다. 본 연구는 온도센서와위성항법장치가 적용된 검체 운송 시스템에 대해 검체 운송 상자의 온도 유지 능력 및 검사결과에 미치는 영향을 조사하여 평가 모델을 제시하고자 하였다. 방법: 검체 운반시 온도 유지 성능을 신형 검체 운송 상자(A)와 구형 검체 운송 상자(B)로 평가하였다. 외기 온도 상온 35˚C와 영하18˚C에서 새로운 축냉제로 검체 운송 상자의 온도 변화를 관찰하였다. 온도 변화에 따른 검사결과 변화를 확인하고자 하고자 전혈,혈청, 혈장 및 뇨를 대상으로 검체를 실온 및 냉장 보관하여 검사결과를 비교하였다. 또한, 진동에 의한 영향도 평가하였다. 결과: 외기 온도 상온 35˚C와 영하 18˚C에서의 검체 운송 상자(A)의 내부 온도를 측정한 결과, 1.0-9.0˚C였다. 18시간 후 검체 운송상자(B)의 내부 온도는 이 범위를 벗어났다. 전혈, 혈청, 혈장을 이용한 검체 보관조건이 검사결과에 미치는 영향에서는 즉시 분석한 결과와 차이를 보였지만 대부분 분석 정밀도 이내의 결과값을보여주었다. 진동에 의한 결과값 변화에서는 신경 특이 에놀라제,젖산 탈수소 효소 등에서 편차를 보여주었다. 결론: 검체 운송 시스템의 핵심은 검체 운송 상자의 온도 유지와실시간 온도감시이다. 검체 운송 조건의 중요성에 초점을 맞춘 본연구는 검체 운송 과정에서 온도 변화에 미치는 요소들을 파악하여 적절한 온도 유지를 위한 관리 지표를 마련하는 데 활용될 수있을 것이다.

신생아의 출생 체중에 따른 혈액 여과지 17alpha-hydroxyprogesterone의 농도 분석 및 판정 기준 조정

박승만,권애린,양송현,박은아,최재황,황미정,남현경,이은희,Park, Seungman,Kwon, Aerin,Yang, Songhyeon,Park, Euna,Choi, Jaehwang,Hwang, Mijung,Nam, Hyeongyeong,Lee, Eunhee 대한유전성대사질환학회 2014 대한유전성대사질환학회지 Vol.14 No.2

The measurement of $17{\alpha}$-hydroxyprogesterone ($17{\alpha}$-OHP) in a dried blood spot on filter paper is an important for screening of congenital adrenal hyperplasia (CAH). Since high levels of $17{\alpha}$-OHP are frequently observed in premature infants without congenital adrenal hyperplasia, we evaluated cuts-off based on birth weight and performed validation. Birth weight and $17{\alpha}$-OHP concentration data of 292,204 newborn screening subjects in Greencross labopratories were analyzed. The cut-off values based on birth weight were newly evaluated and validated with the original data. The mean $17{\alpha}$-OHP concentration were 7.25 ng/mL in very low birth weight (VLBW) group, 4.02 ng/mL in low birth weight (LBW) group, 2.53 g/mL in normal birth weight (NBW) group, and 2.24 ng/mL in heavy birth weight (HBW) group. The cut-offs for CAH were decided as follows: 21.12 ng/mL for VLBW and LBW groups and 11.14 ng/mL for NBW and HBW groups. When applied new cut-offs for original data, positive rates in VLBW and LBW groups were decreased and positive rates in NBW and HBW groups were increased. The cut-offs based on birth weight should be used in the screening for CAH. We believe that our new cut-off reduce the false positive rate and false negative rate and our experience for cut-off set up and validation will be helpful for other laboratories doing newborn screening test.