Candida albicans 추정 동정을 위한 발아관 형성 조건

박금보래,이미경 대한의진균학회 2008 대한의진균학회지 Vol.13 No.1

Background: Candida albicans is the most prevalent species found in human yeast infections. The germ tube test is still frequently used for its rapid presumptive identification. Recently Candida dubliniensis as well as C. albicans has been reported to form germ tubes. Objective: The purpose of this study was to evaluate the germ tube test at various conditions for rapid presumptive identification of C. albicans. Methods: C. albicans ATCC 14053, C. albicans ATCC 18804, C. dubliniensis ATCC MYA 646, and C. dubliniensis KCTC 17427 were tested. Human pooled serum (HPS), HBV, HCV infected patient serum, fetal bovine serum (FBS) and rabbit serum (RS) were used for germ tube test. The germ tube formation was evaluated at different keeping condition of various sera, after mixing with 5 different bacterial suspensions and at various incubation conditions. Results: The germ tube formation of C. albicans was more in the RS or FBS than in the HPS. For the various sera fresh sample was always the best expression of germ-tube forming ability. In the HCV infected patient serum and mixing with Pseudomonas aeruginosa germ tube formation was suppressed. C. dubliniensis did not form germ tube in the HPS, only formed in the FBS or RS. Conclusion: For rapid presumptive identification of C. albicans not C. dubliniensis the best selection of serum is the fresh HPS. We recommend the examination with isolated colony free from bacteria after incubation for 2 to 3 hours. Background: Candida albicans is the most prevalent species found in human yeast infections. The germ tube test is still frequently used for its rapid presumptive identification. Recently Candida dubliniensis as well as C. albicans has been reported to form germ tubes. Objective: The purpose of this study was to evaluate the germ tube test at various conditions for rapid presumptive identification of C. albicans. Methods: C. albicans ATCC 14053, C. albicans ATCC 18804, C. dubliniensis ATCC MYA 646, and C. dubliniensis KCTC 17427 were tested. Human pooled serum (HPS), HBV, HCV infected patient serum, fetal bovine serum (FBS) and rabbit serum (RS) were used for germ tube test. The germ tube formation was evaluated at different keeping condition of various sera, after mixing with 5 different bacterial suspensions and at various incubation conditions. Results: The germ tube formation of C. albicans was more in the RS or FBS than in the HPS. For the various sera fresh sample was always the best expression of germ-tube forming ability. In the HCV infected patient serum and mixing with Pseudomonas aeruginosa germ tube formation was suppressed. C. dubliniensis did not form germ tube in the HPS, only formed in the FBS or RS. Conclusion: For rapid presumptive identification of C. albicans not C. dubliniensis the best selection of serum is the fresh HPS. We recommend the examination with isolated colony free from bacteria after incubation for 2 to 3 hours.

Erythroleukemia Relapsing as Precursor B-cell Lymphoblastic Leukemia

박금보래,박찬정,장성수,서을주,지현숙,이정희 대한진단검사의학회 2011 Annals of Laboratory Medicine Vol.31 No.2

AML relapsing as ALL has rarely been reported. We describe the case of a 62-yr-old man who was diagnosed with erythroleukemia with a complex karyotype and achieved complete hematologic and cytogenetic remission after induction chemotherapy. However, 4 months after the initial diagnosis, he showed relapse with blasts showing a different morphology and immunophenotype and was diagnosed with precursor B-cell ALL. The relapsing precursor B-cell ALL presented with the same leukemic clones as the primary erythroleukemia. Cytogenetic analysis of his bone marrow (BM) at the time of the primary erythroleukemia showed complex karyotypic abnormalities, including monosomy 5 and monosomy 7. At relapse, his BM showed reemergence of these leukemic clones of complex karyotypic abnormalities with clonal switch. To our knowledge, this is the first case of a lineage switch from erythroleukemia to ALL.

병원환경의 변화가 병원-획득성 요로감염에 미치는 영향

박금보래,김혜련,이미경 대한임상미생물학회 2006 Annals of clinical microbiology Vol.9 No.2

Background: To estimate the influence of a change in the hospital environment on a hospital-acquired urinary tract infection (HAUTI), we analyzed and compared the rates of HAUTI and the associated risk factors between an old hospital (Phil-dong) and a new hospital (Heucksuck-dong) of Chung-Ang University. Methods: Retrospective studies of patients with urinary tract infection were conducted at the old and new hospital during the period from July 2003 to June 2004 and from January to December 2005, respectively. HAUTI was defined as the isolation of one or two microorganisms at greater than 105 CFUs/mL from urine at 48 hours or more after admission. The risk factors of HAUTI included sex, age, duration of hospitalization, as well as malignancy, chronic disease, diabetes mellitus, intensive care unit care, immune deficiency, renal function, Foley catheterization, and immobility. Results: The rates of HAUTI at the old and new hospital were 2.9% (206 cases per 7,088 patients) and 2.0% (289 per 14,704), respectively (P<0.05), but there were no statistical differences in the associated risk factors between the two hospitals (P>0.05). Conclusion: Although both the old and new hospitals were served by the same health-care staff and inspectors using the same methods, the rate of HAUTI was significantly lower at the new hospital. This suggests that a change of the hospital environment, including new instruments and equipment, has an influence on the rate of HAUTI.

Sysmex XE-2100 자동혈구분석기에서 가성호산구증가증을 보인 말라리아 3예

박금보래,차영주 대한진단검사의학회 2006 Annals of Laboratory Medicine Vol.26 No.2

우리나라에서는 현재 꾸준히 말라리아가 발병되고 있고, 특히민간인과 감염지역이 아닌 지역에서 말라리아가 증가하고 있는 실정이다. 말라리아의 진단을 위하여서는 임상증상과 함께 말초혈액도말에서 적혈구 내, 외에 존재하는 원충을 확인하는 것이 필수적이다. 그러나 말초혈액도말에서 원충을 확인하는 것은 경험과 시간을 요하므로 발열이 있는 환자에서는 항상 실시하는 전체혈구계산(CBC) 및 백혈구감별계산에서 이를 선별할 수 있다면 말라리아를 미처 의심하지 않은 환자에서도 진단이 늦어지는 일이 없고 매우 편리하리라고 사료된다. 최근 저자들은 Sysmex XE-2100 자동혈구분석기에서 혈소판감소증과 함께 가성호산구증가증을 보인 말라리아 환자 3예를 경험하였고, 자동혈구분석기에서 발견되는 hemozoin을 탐식한 백혈구로 인하여 나타나는 가성호산구증가증을 통하여 말라리아 원충을 확인하는 계기가 될 수 있 다 고사료되어 문헌 고찰과 함께 보고하는 바이다.

Loss of Mismatched HLA Detected in the Peripheral Blood of an AML Patient who Relapsed After Haploidentical Hematopoietic Stem Cell Transplantation

박금보래,손용학,홍선표,오흥범,서을주,장성수 대한진단검사의학회 2015 Annals of Laboratory Medicine Vol.35 No.5

Clinical significance of donor-specific anti-HLA-DR51/52/53 antibodies for antibody-mediated rejection in kidney transplant recipients

박금보래,박윤희,주동진,허규하,김명수,김순일,김유선,김현숙 대한이식학회 2019 Korean Journal of Transplantation Vol.33 No.3

Background: The presence of donor-specific antibodies (DSAs) to human leukocyte antigen (HLA) increases the risk of antibody- mediated rejection (ABMR) after kidney transplantation (KT). However, the clinical relevance of anti-HLA-DR51/52/53 antibodies remains unclear because of their weak antigen expression. This study evaluated the association between anti- HLA-DR51/52/53 DSAs and ABMR. Methods: We retrospectively reviewed the single-antigen-bead panel reactive antibody (single PRA) results of 130 patients tested between August 1, 2009 and March 6, 2015, based on clinical necessity after allograft KT. Single PRA analysis was performed using Luminex assay kits (Lifecodes LSA class I and II). We reviewed the clinical course and biopsy results of patients with anti- HLA-DR51/52/53 DSAs. Results: Post-KT DSAs were identified in 89 of the 130 patients (68.5%), with 26 of 32 class I DSAs and 63 of 66 class II DSAs being immunodominant DSAs. Thirteen patients had anti-HLA-DR51/52/53 DSAs. Three patients with anti-HLA-DR51/52/53 immunodominant DSAs alone were diagnosed with biopsy-proven ABMR. One patient who developed anti-HLA-DR DSA 13 days after KT showed a rapid increase in anti-HLA-DR51 DSA and had biopsy-proven ABMR. Conclusions: Although the expression of the HLA-DR51/52/53 antigen was weak, anti-HLA-DR51/52/53 DSAs might be correlated with biopsy-proven ABMR. Therefore, anti-HLA-DR51/52/53 DSAs must be evaluated as a cause of ABMR after transplantation.

두 단위 적혈구 성분채집술로 효과적으로 치료된 혈색소침착증 1예

박금보래,민유선,권석운 대한수혈학회 2009 大韓輸血學會誌 Vol.20 No.2

혈색소침착증은 철 대사이상으로 인해 다양한 장기에 철이 침착되어 피부 색소침착, 간경화, 심부전, 당뇨 등으로 진행할 수 있는 질환이다. 정맥절개술이 표준치료방법이며 철침착에 의해 유발되는 질환을 예방하는 것이 치료 목표가 된다. 저자들은 ALYX (Fenwal, DeerWeld, USA)를 이용한 두 단위 적혈구 성분채집술을 통해 혈색소침착증을 효과적으로 치료하였기에 보고하는 바이다. 60세 남성이 지속적인 AST, ALT 증가와 겨드랑이 부위 색소침착이 있었다. 내원 당시 혈청 페리틴(1,443 ng/mL), AST (199 IU/L), ALT (452 IU/L)는 모두 상승되어 있었고, 간조직 생검 결과 Kupffer 세포와 간문맥 주변에서 철 침착 소견을 보였다. 3개월 동안 4차례의 두 단위 적혈구 성분채집치료를 시행하였고, 치료 후 혈청 페리틴은 33 ng/mL, AST와 ALT는 105 IU/L, 188 IU/L로 감소되었다. 치료 중 부작용은 없었다. 본 증례는 국내에서는 처음으로 보고된 두 단위 적혈구 성분채집 치료를 이용하여 혈색소침착증을 성공적으로 치료한 예이다. Hemochromatosis is a disorder of the iron metabolism leading to organ damage, such as skin pigmentation, liver cirrhosis, heart failure and diabetes, due to progressive tissue iron overload. Phlebotomy is currently the standard therapy for hemochromatosis, which prevents the progression of tissue damage. We report a case of hemochromatosis treated successfully by ‘double red blood cell’ phlebotomy using ALYX (Fenwal, DeerWeld, USA). A 60-year-old man presented with skin pigmentation around the armpit and an increase in the AST and ALT levels. Upon admission, the ferritin (1,443 ng/mL), AST (199 IU/L) and ALT (452 IU/L) were elevated. A liver biopsy revealed iron deposition in Kupffer cells and portal tracts. Four sessions of double red blood cell phlebotomies were performed for 3 months. The ferritin, AST and ALT levels decreased to 33 ng/mL, 105 IU/L and 188 IU/L, respectively. The patient had no adverse effects during treatment. This is the first report of the successful treatment of hemochromatosis by ‘double red blood cell’ phlebotomy in Korea.

HLA 불일치 장기이식의 탈감작 치료

박금보래 대한수혈학회 2019 大韓輸血學會誌 Vol.30 No.1

In terminally ill patients, organ transplantation could be recommended as the treatment of choice. In Korea, living donor liver or kidney transplantation is much more frequent than deceased donor transplantation due to organ shortages from deceased donors. ABO or HLA incompatibility in transplantation can be a major barrier in living donor transplantation. Currently, the rate of ABO incompatible organ transplantation accompanied by desensitization is 20∼25% of living donor transplantation, and the blood bank laboratory plays an active role by plasmapheresis. The desensitization of HLA incompatible transplantation in highly sensitized patients is more difficult than that of ABO incompatible transplantation. The HLA antibody is not easy to remove and it is difficult to prevent sensitization. In addition, setting the target treatment goals and predicting the treatment outcomes based on the HLA antibody results are problematic. Therefore, a range of desensitization protocols have been attempted and various therapeutic goals have been introduced. This article reviews the various desensitization methods for antibody removal focusing on HLA incompatible kidney transplantation, and discusses the prognosis of desensitization methods for antibody removal based on the literature.

False Positive Class II HLA Antibody Reaction Due to Antibodies Against Denatured HLA Might Differ Between Assays: One Lambda vs. Immucor

박금보래,박윤희,Beom Seok Kim,Yu-Seun Kim,Hyon-Suk Kim 대한진단검사의학회 2020 Annals of Laboratory Medicine Vol.40 No.5

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Diagnostic Performance and Comparative Evaluation of the Architect, Liaison, and Platelia Epstein-Barr Virus Antibody Assays

박윤희,박금보래,하지혜,김현숙 대한진단검사의학회 2018 Annals of Laboratory Medicine Vol.38 No.5

Background: Epstein-Barr Virus (EBV) is one of the most prevalent causes of viral infection in humans. EBV infection stage (acute, past, or absent infection) is typically determined using a combination of assays that detect EBV-specific markers, such as IgG and IgM antibodies against the EBV viral capsid antigen (VCA) and IgG antibodies against the EBV nuclear antigen (EBNA). We compared the diagnostic performance and agreement of results between three commercial EBV antibody assays using an EBV performance panel (SeraCare Life Science, Milford, MA, USA) as a reference. Methods: EBV antibody tests of EBV VCA IgM, VCA IgG, and EBNA IgG antibodies were performed by the Architect (Abbott Diagnostics, Wiesbaden, Germany), Liaison (DiaSorin, Saluggia, Italy), and Platelia (Bio-Rad, Marnes-la-Coquette, France) assays. Agreement between the three assays was evaluated using 279 clinical samples, and EBV DNA and antibody test results were compared. Results: The three EBV antibody assays showed good diagnostic performance with good and excellent agreement with the performance panel (kappa coefficient, >0.6). The overall VCA IgM positivity rate was higher in EBV DNA-positive samples than in EBV DNA-negative samples for all three EBV antibody assays (P=0.02). The three EBV antibody assays exhibited good agreement in results for the clinical samples. Conclusions: The diagnostic performance of the three EBV antibody assays was acceptable, and they showed comparable agreement in results for the clinical samples.