Jaehyeon Lee

Evaluation of in vitro storage characteristics of cold stored platelet concentrates with N acetylcysteine (NAC)

Platelets play a vital role in hemostasis and thrombosis, and their demand and usage has multiplied many folds over the years. However, due to the short life span and storage constraints on platelets, it is allowed to store them for up to 7 days at room temperature (RT); thus, there is a need for an alternative storage strategy for extension of shelf life. Current investigation involves the addition of 50 mM N acetylcysteine (NAC) in refrigerated concentrates. Investigation results revealed that addition of NAC to refrigerated concentrates prevented platelet activation and reduced the sialidase activity upon rewarming as well as on prolonged storage. Refrigerated concentrates with 50 mM NAC expressed a 23.91 ± 6.23% of CD62P (P-Selectin) and 22.33 ± 3.42% of phosphotidylserine (PS), whereas RT-stored platelets showed a 46.87 ± 5.23% of CD62P and 25.9 ± 6.48% of phosphotidylserine (PS) after 5 days of storage. Further, key metabolic parameters such as glucose and lactate accumulation indicated reduced metabolic activity. Taken together, investigation and observations indicate that addition of NAC potentially protects refrigerated concentrates by preventing platelet activation, stabilizing sialidase activity, and further reducing the metabolic activity. Hence, we believe that NAC can be a good candidate for an additive solution to retain platelet characteristics during cold storage and may pave the way for extension of storage shelf life.

Molecular Epidemiological Features and Antibiotic Susceptibility Patterns of Streptococcus dysgalactiae subsp. equisimilis Isolates from Korea and Japan

Background The molecular characterization of Streptococcus dysgalactiae subsp. equisimilis (SDSE) has not yet been performed in Korea. This study aimed to find the differences or similarities in the clinical features, molecular epidemiological findings, and antimicrobial resistance patterns of SDSE from two countries (Korea and Japan). Methods SDSE isolates were collected from Korea (N=69) from 2012–2016 and Japan (N=71) from 2014–2016. Clinical characteristics, emm genotypes, and sequence types (STs) were compared. Microdilution tests were performed using different antimicrobials, and their resistance determinants were screened. Results Median ages were 69 years in Korea and 76 years in Japan. The most common underlying diseases were diabetes and malignancy. Blood-derived isolates comprised 36.2% and 50.7% of Korean and Japanese isolates, respectively; mortality was not different between the two groups (5.8% vs 9.9%, P=0.53). Among Korean isolates with 20 different combined ST-emm types, ST127-stG245 (N=16), ST128-stG485 (N=10), and ST138-stG652 (N=8) were prevalent. Among Japanese isolates with 29 different combined types, ST17-stG6792 (N=11), ST29-stG485 (N=7), and ST205-stG6792 (N=6) were prevalent. Resistance rates to erythromycin, clindamycin, and minocycline were 34.8%, 17.4%, and 30.4% in Korea and 28.2%, 14.1%, and 21.4% in Japan, respectively. Conclusions SDSE infections commonly occurred in elderly persons with underlying diseases. There was a significant difference in the distribution of ST-emm types between the two countries. Antimicrobial resistance rates were comparable with different frequencies of resistance determinants in each country.

Concurrence of e1a2 and e19a2 BCR-ABL1 Fusion Transcripts in a Typical Case of Chronic Myeloid Leukemia

Dear Editor, There are three types of BCR-ABL1 fusion transcripts that differ on the basis of the breakpoint in the BCR gene [1]. The major type, encoding p210, has two isoforms, b2a2 (e13a2) and b3a2 (e14a2), and is associated with more than 95% of Ph-positive CML cases. The minor type, encoding p190, is e1a2. The micro type, encoding p230, is e19a2. This micro type is rare, and has been associated with a variety of hematologic malignancies including neutrophilic CML (CML-N), all phases of classical CML, essential thrombocythemia (ET), and acute myeloid or lymphoblastic leukemia [2, 3]. Here, we describe the first case of chronic phase CML concurrently expressing e1a2 and e19a2 BCR-ABL1. An 89-year-old woman was referred to our hospital for evaluation of her leukocytosis. She appeared ill, but had no splenomegaly. The complete blood count (CBC) revealed 137.46× 10/L WBC, 10.0 g/dL Hb, and 194×10/L platelets. The blood smear demonstrated 3% blasts, basophilia, and eosinophilia, and bone marrow (BM) aspirate showed a hypercellularity (Fig. 1). The karyotype in BM was 46,XX,t(9;22)(q34;q11.2) [20] and the FISH result using an LSI BCR/ABL probe (Abbott Molecular Inc., Des Plaines, IL, USA) was nuc ish (ABLx3),(BCRx3),(ABL con BCRx2)[200/200]. JAK2 mutation was not detected. The commercial multiplex reverse transcription (RT)-PCR (HemaVision, DNA Diagnostic, Risskov, Denmark) result was positive for BCR/ABL in Master M6 and Split-out M6B PCR, and presented as an atypically thick band overlapping with the control band at 911 bp (Fig. 2A). Additional sequencing from the M6B amplicon revealed the BCR-ABL1 fusion was the micro type (e19a2) (Fig. 2B). Another real-time quantitative PCR for the minor BCR-ABL1 rearrangement indicated positivity (0.04, normalized copy number [NCN]), which was confirmed by sequencing (Fig. 2C). Therefore, it was determined that the patient had a BCR-ABL1 fusion consisting predominantly of the micro isoform (e19a2) with a small amount of the minor isoform (e1a2). The concurrence of those two isoforms might occur as a result of alternative splicing of the primary BCR-ABL1 fusion transcript [4]. The patient could not start any targeted therapy owing to her poor performance status and the potential interaction with her ongoing risperidone treatment. Only hydroxyurea (500 mg/day) was initiated. One month later, her WBC count decreased to 14.23 ×10/L. After 6 months, she showed no complications and her WBC count was 16.60×10/L. The e19a2 BCR-ABL1 fusion transcript can be associated

Eggerthella lenta Bacteremia after Endoscopic Retrograde Cholangiopancreatography in an End-Stage Renal Disease Patient

Eggerthella lenta Bacteremia after Endoscopic Retrograde Cholangiopancreatography in an End-Stage Renal Disease Patient Jaehyeon Lee, Yong Gon Cho, Dal Sik Kim, Hye Soo Lee Department of Laboratory Medicine, Chonbuk National University Medical School, Chonbuk National University Hospital Regional Center for National Culture Collection for Pathogens, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea

First Case of Catheter-related Malassezia pachydermatis Fungemia in an Adult

Jaehyeon Lee, M.D., Ph.D., Yong Gon Cho, M.D., Ph.D., Dal Sik Kim, M.D., Ph.D., Sam Im Choi, M.D., Ph.D., and Hye Soo Lee , M.D., Ph.D. Department of Laboratory Medicine, Chonbuk National University Hospital, Jeonju, Korea; Department of Laboratory Medicine, Chonbuk National University Medical School, Jeonju, Korea; Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea

Evaluation of Allplex Respiratory Panel 1/2/3 Multiplex Real-Time PCR Assays for the Detection of Respiratory Viruses with Influenza A Virus subtyping

The Allplex Respiratory Panel 1/2/3 (All16) is a multiplex PCR assay for detecting 16 respiratory viruses with influenza A virus (FluA) subtyping, and the first clinical assay based on multiple detection temperatures. We compared the results between All16 and Anyplex II RV16 (Any16) in 426 clinical samples. Samples showing discrepancies between the two tests were further tested using monoplex PCR. FluA subtyping based on the hemagglutinin type results of All16, which yielded H1, H3, and non-H1/H3, was compared with the results of the BioFire FilmArray respiratory panel. The positive and negative percent agreements and kappa value for each virus between All16 and Any16 ranged from 54.5-100.0%, 84.7-100.0%, and 0.57-1.00, respectively. FluA subtype results from All16 for 26 samples were consistent with those from FilmArray. Good agreement was observed between the two methods, except when analyzing human enterovirus (kappa value 0.70), and the All16 showed reliable FluA subtyping results. For parainfluenza virus 3, the All16 was more sensitive than Any16. When testing 28 samples simultaneously, the mean test time and hands-on time were 4.3 and 0.5 hours, respectively in All16. In conclusion, All16 showed reliable performance, but further studies are needed regarding human enterovirus analysis.

[Corrigendum] A novel t(9;22;11) translocation involving 11q24 in a patient with chronic myeloid leukemia: A case report

[This corrects the article DOI: 10.3892/ol.2017.5668.].

A novel t(9;22;11) translocation involving 11q24 in a patient with chronic myeloid leukemia: A case report

Variant Philadelphia chromosome translocations involving chromosomes other than 9 and 22 have been reported in 5–10% of patients with chronic myeloid leukemia (CML). As part of the three-way variant t(9;22;11) in patients with CML, 11q24 is a novel region that has not previously been investigated. A 22-year-old male exhibiting chronic phase CML developed a recurrence of the same phase subsequent to the interruption of imatinib treatment and showed the same chromosomal abnormality, t(9;22;11)(q34;q11.2;q24), that was detected at the initial diagnosis. The recurrent CML responded well to imatinib therapy. These findings suggest that the three-way variant, t(9;22;11), involving 11q24 may be associated with a good prognosis and response to imatinib. This is the first report of three-way variant involving 11q24 in a patient with CML.