BackgroundSepsis in elderly patients is a major cause of morbidity and mortality in the clinical setting. The aim of this study was to assess the diagnostic significance of volume conductivity scatter (VCS) parameters and to compare their reliability with that of inflammatory markers.MethodsPatients (N=85) were divided into 3 groups according to their clinical history and culture results: control (N=29), localized infection (N=38), and sepsis (N=18). VCS parameters were obtained using a UniCel DxH 800 Coulter system. Cut-off values were established based on receiver operator characteristic (ROC) curves.ResultsThe mean volumes of neutrophils (MNV) and monocytes (MMV) were higher in the sepsis group than in the localized infection and control groups (P=0.000 for both). The mean cell conductivity and low median angle light scatter of neutrophils were lower in the sepsis group than in the localized infection and control groups (P=0.029 and P=0.022, respectively). With a cut-off of 156.5, MNV had a sensitivity of 83.3% and a specificity of 78% in predicting sepsis.ConclusionMNV and MMV, which can be obtained easily using an automated blood analyzer, may be promising hematologic parameters for distinguishing elderly individuals with and without sepsis and may help clinicians in the diagnosis of sepsis.

BackgroundThe validation of sample stability through pneumatic tube system (PTS) is essential. The objective of this study was to evaluate the effects of PTS transportation on laboratory results.MethodsPaired EDTA and SST blood samples were collected from 56 randomly selected patients. Laboratory parameters were compared between PTS group and hand-delivered group.ResultsNo statistical differences were observed for complete blood counts, white blood cell differential parameters, erythrocyte sedimentation rate and most chemistry parameters between PTS and hand-delivered transport procedures. Mean platelet volume results obtained from samples transported through PTS were lower than that obtained from samples transported through hand-delivered method (P = 0.001). The results of aspartate aminotransferase (P = 0.000), lactate dehydrogenase (P = 0.000), and hemolysis index (P = 0.000) from PTS group were higher than that from hand-delivered group.ConclusionsAll laboratories should validate the stability of the results from samples according to transportation method.

Aim: To investigate the distribution of human leucocyte antigen (HLA) class I antigens and B27 subtypings in a group of B27(+) ankylosing spondylitis (AS) patients and a group of B27(+) control individuals, and to compare differences in their clinical features using subtyping. Methods:At otal of 143 B27(+) AS samples and 32 B27(+) control samples were collected consecutively from two rheumatology centres in South Korea. All patients were diagnosed according to the modified New York criteria for AS. Medical records of the patients were retrospectively reviewed for demographic information, Bath disease activity index (BASDAI) scores, laboratory parameters at diagnosis and extra-articular manifestations. Polymerase chain reaction-sequence-specific primer typing for the B27 subtypes was performed using the Dynal HLA-B27 high resolution kit.Results: Whereas subtypes in Korean AS patients include B*2704 (n = 11, 7.7%) B*2705 (n = 130, 90.9%), and B*2710 (n = 2, 1.4%), those of the control groups include B*2704 (n = 11, 34.4%), B*2705 (n = 19, 59.4%), B*2710 (n = 1, 3.1%), and B*2715 (n = 1, 3.1%). The proportion of B*2705 subtypes were significantly higher in the AS group than the control group (P < 0.01). There were no differences in clinical features (peripheral arthritis, uveitis, BASDAI scores) or laboratory parameters between the two groups. Conclusion:In Korean AS patients, not in the control group, the HLA-B*2705 subtype was higher than other subtypes, in contrast to AS patients from Japan and China. B27 subtypes in AS patients were not associated with clinical features or laboratory parameters.

Background JAK2 mutation status is a well-known risk factor for thrombosis in patients with myeloproliferative neoplasms. However, the clinical usefulness of JAK2 V617F allele burden is under investigation. Methods We retrospectively evaluated the impact of the JAK2 V617F allele burden on clinical characteristics and outcomes of JAK2 V617F-positive polycythemia vera (PV) and essential thrombocythemia (ET). The JAK2 V617F allele burden was measured using sequencing. Results Altogether, 127 patients with JAK2 V617F mutation (PV, N=61; ET, N=66) were included in this study. JAK2 V617F allele burdens were positively correlated with white blood cell counts, hemoglobin values, lactate dehydrogenase levels, and platelet counts. The median values of JAK2 V617F allele burden in patients with PV and ET were 58% and 30%, respectively. A JAK2 V617F allele burden of ≥30%, older age, and a higher hemoglobin level were risk factors for thrombotic events in ET. In patients with PV, older age was the only thrombotic risk factor. The 8-year probabilities of overall survival (OS) were 82.9% in all patients. A high JAK2 V617F allele burden (≥58%) was associated with poor OS in patients with PV. For the patients with ET, the difference in 8-year OS based on the JAK2 V617F allele burden was not significant. Conclusion The JAK2 V617F allele burden was correlated with hematologic parameters and clinical outcomes. Assessing the JAK2 V617F allele burden can be helpful in predicting the thrombotic risk and disease course in patients with JAK2 V617F-positive PV and ET.

Localized radiotherapy (RT) can cause immune dysfunction. Bojungikki-tang is known to restore immune function. We investigated the absolute counts and percentages of peripheral blood (PB) lymphocyte subtypes in end stage cancer patients before and after RT and after oral administration of Bojungikki-tang water extract (BJITE) and to evaluate the changes mediated by RT and BJITE. Absolute counts and percentages of lymphocyte and lymphocyte subsets were determined in whole blood using the TetraONE System (Beckman Coulter, USA). Flow cytometry results were compared before and after RT and after administration of BJITE. Absolute numbers of CD3+, CD4+, and CD8+ T cells and CD19+ B cells decreased significantly after RT (P < 0.05). Absolute numbers of CD3-CD56+ cells did not change in both groups. No significant differences were observed in the absolute counts of lymphocyte subtypes before and after administration of BJITE or vitamin group. When BJITE group was compared with vitamin group, absolute numbers of CD19+ B cells increased. RT-induced decrease in T cells and B cells in PB suggests that immune deterioration occurs after RT. Administration of BJITE might be effective in the restoration of number of B cells.