Annals of Laboratory Medicine最新文献

{"title":"Utility of ABO Genotyping by Integrating the ABO Gene into Diagnostic Gene Panels for Patients with Hematologic Malignancies.","authors":"Yun Mi Park,Gye Cheol Kwon,Seon Young Kim","doi":"10.3343/alm.2024.0573","DOIUrl":"https://doi.org/10.3343/alm.2024.0573","url":null,"abstract":"Serologic ABO typing might be hampered in some patients with hematologic malignancies. We performed ABO genotyping using next-generation sequencing as part of a routine hematologic malignancy gene panel to determine the ABO blood type of patients with hematologic malignancies. Targeted sequencing of seven ABO gene exons was performed within a hematologic malignancy gene panel for 520 patients diagnosed with various hematologic malignancies. The distribution of predicted ABO blood phenotypes determined through genotyping was as follows: 33.3% A, 27.3% B, 26.7% O, and 12.7% AB. No significant associations were identified between ABO allele distributions and specific hematologic malignancy diagnoses. We compared the phenotypes predicted using ABO genotyping with serological ABO testing results in 502 samples where serological data were available. All genotyping-based phenotypes were accurate, with 99.8% (501/502) of initial serological results aligning with the true phenotypes. Unusual serological results were observed in 21 samples (4.2%). The percentages of recipient cells containing ABO allele variants indicated chimerism in relapsed patients who had undergone ABO-mismatched transplantation. Thus, incorporating ABO genotyping into the hematology gene panel provides valuable information offering a cost-effective approach to address challenges in blood typing and post-transplant care.","PeriodicalId":8421,"journal":{"name":"Annals of Laboratory Medicine","volume":"69 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143885492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Six Large Language Models for Clinical Decision Support: Application in Transfusion Decision-making for RhD Blood-type Patients.","authors":"Jong Kwon Lee,Sooin Choi,Sholhui Park,Sang-Hyun Hwang,Duck Cho","doi":"10.3343/alm.2024.0588","DOIUrl":"https://doi.org/10.3343/alm.2024.0588","url":null,"abstract":"BackgroundLarge language models (LLMs) have the potential for clinical decision support; however, their use in specific tasks, such as determining the RhD blood type for transfusion, remains underexplored. Therefore, we evaluated the accuracy of six LLMs in addressing RhD blood type-related issues in Korean healthcare.MethodsFifteen multiple-choice and true/false questions, based on real-world transfusion scenarios and reviewed by specialists, were developed. The questions were administered twice to six LLMs (Clova X, Gemini 1.0, Gemini 1.5, ChatGPT-3.5, GPT-4.0, and GPT-4o) in both Korean and English. Results were compared against the performance of 22 transfusion medicine experts. For particularly challenging questions, prompt engineering was applied, and the questions were reevaluated.ResultsGPT-4o demonstrated the highest accuracy rate in Korean (0.6), with significant differences compared with those of Clova X and Gemini (P <0.05). In English, the results were similar across all models. The transfusion experts achieved a higher accuracy rate (0.8). Among the five questions subjected to prompt engineering, only GPT-4o correctly responded to one, whereas the other models failed. All LLM models changed their responses or did not respond when the same question was repeated.ConclusionsGPT-4o showed the best overall performance among the models tested and may be beneficial in RhD blood product transfusion decision-making. However, its performance suggests that it may serve best in a supportive role rather than as a primary decision-making tool.","PeriodicalId":8421,"journal":{"name":"Annals of Laboratory Medicine","volume":"10 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143885494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Two Quinupristin-dalfopristin Susceptibility Testing Methods and Two Interpretive Criteria for Enterococcus faecium Bloodstream Isolates from Korean Hospitals.","authors":"Yong Jun Kwon,Ha Jin Lim,Soo Hyun Kim,Seung A Byun,Ga Yeong Lee,Ga-Gyeong Kim,Seok Hoon Jeong,Jeong Hwan Shin,Young Ah Kim,Young Uh,Jong Hee Shin","doi":"10.3343/alm.2024.0585","DOIUrl":"https://doi.org/10.3343/alm.2024.0585","url":null,"abstract":"Enterococcus faecium, particularly in its multidrug-resistant forms, causes invasive nosocomial infections. Given the limited data comparing the effectiveness of the European Committee on Antimicrobial Susceptibility Testing (EUCAST) and the CLSI clinical breakpoints (CBPs) for quinupristin-dalfopristin (QD) resistance and the need to evaluate their practical application, we retrospectively investigated the susceptibility patterns of 287 E. faecium bloodstream isolates from Korean hospitals to QD using the updated EUCAST and CLSI CBPs and two antimicrobial susceptibility testing methods: disk diffusion (DD) and Sensititre broth microdilution (Sensititre). QD resistance rates were 5.9% (CLSI) and 18.8% (EUCAST) for DD and 22.6% (CLSI) and 28.2% (EUCAST) for Sensititre. The most prevalent QD resistance gene types among QD-resistant isolates were ermB+msrC+ or ermB-msrC+. Categorical agreement between DD and Sensititre ranged from 77.7% to 90.7%, depending on the testing method and CBPs applied. The EUCAST zone diameter CBPs more effectively help identify QD-resistant E. faecium isolates using the DD method than the CLSI zone diameter CBPs. In comparison, the CLSI minimum inhibitory concentration (MIC) CBPs provide more reliable results for resistance classification in the Sensititre method than EUCAST MIC CBPs. These findings would help improve clinical decision-making for treating multidrug-resistant E. faecium infections.","PeriodicalId":8421,"journal":{"name":"Annals of Laboratory Medicine","volume":"39 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143885495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-vitro Activities of Zoliflodacin and Solithromycin Against Neisseria gonorrhoeae Isolates from Korea.","authors":"Kyoung Ho Roh,Nguyen Dinh Luong,Changseung Liu,Young Hee Seo,Hyukmin Lee,Magnus Unemo,Kyungwon Lee","doi":"10.3343/alm.2024.0522","DOIUrl":"https://doi.org/10.3343/alm.2024.0522","url":null,"abstract":"Novel antimicrobial agents are continually developed to address the global threat of multidrug-resistant Neisseria gonorrhoeae. Promising candidates include zoliflodacin and, possibly, solithromycin. We evaluated their in-vitro activities against gonococcal isolates collected in Korea. In total, 250 N. gonorrhoeae isolates obtained across Korea between 2016 and 2018 were used to determine the minimum inhibitory concentrations (MICs) of 10 therapeutic agents using the CLSI agar dilution method. Most isolates (94.8%, 237/250) demonstrated non-susceptibility to penicillin G, tetracycline, and ciprofloxacin, and susceptibility to ceftriaxone and spectinomycin was substantially high. The half-maximal IC (MIC50) and 90% IC (MIC90) values for zoliflodacin were 0.03 and 0.06 μg/mL, respectively; 0.06 and 0.12 μg/mL, respectively, for solithromycin; and 0.03 and 0.12 μg/mL, respectively, for ceftriaxone. Notably, no cross-resistance was observed between zoliflodacin and ciprofloxacin, despite both targeting DNA topoisomerase II enzymes. Zoliflodacin and solithromycin demonstrated significant in-vitro activity against multidrug-resistant N. gonorrhoeae isolates, and zoliflodacin has shown non-inferiority to ceftriaxone/azithromycin dual therapy in a clinical phase 3 trial. Collectively, our findings highlight the potential of zoliflodacin as a novel therapeutic agent for gonococcal infections, particularly in the context of rising multidrug resistance, and highlight the need for continued surveillance and development of alternative antimicrobial strategies.","PeriodicalId":8421,"journal":{"name":"Annals of Laboratory Medicine","volume":"36 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143885541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin K Deficiency: Diagnosis and Management.","authors":"Natalie Mathews,Catherine P M Hayward","doi":"10.3343/alm.2024.0590","DOIUrl":"https://doi.org/10.3343/alm.2024.0590","url":null,"abstract":"Vitamin K (VK) deficiency (VKD) commonly causes coagulopathy across the age spectrum. The reduced form of VK is an essential cofactor for the post-translational γ-carboxylation of coagulation factors (Fs) II, VII, IX, and X; proteins C and S; and additional proteins. This carboxylation creates high-affinity calcium-binding sites that are important for their functions. VK is a fat-soluble vitamin, with half of the daily needs met by vitamin K1 from the diet (particularly green leafy vegetables) and the other half met by vitamin K2 produced by gut flora. VKD can develop within days because of limited tissue stores of VK. VKD increases risks for bleeding, with neonates and infants at the highest risk unless they are administered routine VK prophylaxis at birth. Diagnosing VKD is challenging because of the different forms and half-lives of VK isoforms. Often, patients with suspected VKD-related coagulopathies are assessed for coagulopathy correction within 1-2 days after receiving VK, either orally or parenterally. VKD increases the plasma levels of proteins induced by the absence of VK, such as des-γ-carboxylated factor II, which is more commonly used as a biomarker for hepatocellular carcinoma than as a VKD biomarker. VKD causes notable discrepancies in FII levels measured by factor assays based on the prothrombin time (PT) rather than Ecarin reagents, as the Ecarin prothrombin activator directly converts normal and des-γ-carboxylated FII to meizothrombin (resulting in higher FII levels than estimated with PT reagents). In this review, we summarize current information on the causes, consequences, diagnosis, prevention, and treatment of VKD.","PeriodicalId":8421,"journal":{"name":"Annals of Laboratory Medicine","volume":"69 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revolutionizing Laboratory Practices: Pioneering Trends in Total Laboratory Automation.","authors":"Youngwon Nam, Hyung-Doo Park","doi":"10.3343/alm.2024.0581","DOIUrl":"https://doi.org/10.3343/alm.2024.0581","url":null,"abstract":"<p><p>Total laboratory automation (TLA) is a transformative solution in clinical laboratories that addresses growing demands for operational efficiency, accuracy, and rapid turnaround times in patient care. TLA integrates advanced technologies across pre-analytical, analytical, and post-analytical phases, thereby streamlining workflows, reducing manual intervention, and enhancing QC. TLA adoption is driven by factors such as increasing test volumes, the need for cost reduction and regulatory compliance, and labor shortages. Key benefits of TLA include improved accuracy through error minimization, optimized resource utilization, enhanced staff well-being, and consistent delivery of high-quality results. Leading companies, including Abbott, Roche, Siemens, and Beckman Coulter, dominate the global TLA market with innovative solutions. Recent developments incorporate artificial intelligence (AI), machine learning, robotics, and Internet-of-things technologies, which enable predictive analytics and automated data management. However, challenges remain, including high implementation costs, the need for workforce training, cybersecurity concerns, and system integration complexities. Future trends indicate that TLA will advance through enhanced AI integration, sustainable practices, and big data analytics, fostering continuous improvements in precision diagnostics and clinical outcomes. Moreover, TLA has the potential to revolutionize laboratory operations globally, driving efficiency, accuracy, and sustainability while ultimately improving patient care. Successful adoption of TLA will require strategic planning, interdisciplinary collaboration, and alignment with emerging healthcare needs. In this review, we emphasize that overcoming these challenges through innovation and robust management is essential for ensuring that TLA continues to play a vital role in modern healthcare systems.</p>","PeriodicalId":8421,"journal":{"name":"Annals of Laboratory Medicine","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of Nontyphoidal <i>Salmonella</i> Infections in Korean Children and Genetic Factors Associated with Extra-intestinal Invasion: A Whole-Genome Sequencing Analysis.","authors":"Hyun Mi Kang, Jiyon Chu, In Hyuk Yoo, In Young Yoo, Jeong-Ih Shin, Mi-Ran Seo, Yeun-Jun Chung, Seung-Hyun Jung, Yeon Joon Park","doi":"10.3343/alm.2024.0378","DOIUrl":"https://doi.org/10.3343/alm.2024.0378","url":null,"abstract":"<p><strong>Background: </strong>Understanding the virulence and pathogenicity of invasive nontyphoidal <i>Salmonella</i> (iNTS) in children may support timely treatment and enable closer monitoring of chronic infections. iNTS epidemiology in Asia remains inadequately described. We analyzed the genetic diversity and virulence genes associated with extra-intestinal invasion in Korean children.</p><p><strong>Methods: </strong><i>Salmonella</i> isolates from children <18 yrs of age diagnosed with moderate-to-severe salmonellosis between January 2019 and December 2021 were subjected to antibiotic susceptibility testing and whole-genome sequencing.</p><p><strong>Results: </strong>In total, 58 cases were included. We identified 20 serotypes, the most prevalent being <i>Salmonella</i> Enteritidis (N=21), followed by Infantis (N=6), I 4,[5],12:i:- (N=5), and Bareilly (N=5). Extra-intestinal invasion occurred in 12 (20.7%) cases involving <i>Salmonella</i> Oranienburg (2/2), Give (1/1), Javiana (1/1), Paratyphi B var. L(+) tartrate+ (1/1), Schwarzengrund (1/1), Singapore (1/1), Montevideo (1/2), Saintpaul (1/2), I 4:b:- (1/2), Infantis (1/6), and Enteritidis (1/21). While the numbers of total virulence genes and genes belonging to major virulence categories did not significantly differ between iNTS and non-iNTS, several genetic factors, including <i>Salmonella</i> pathogenicity island (SPI)-1 (<i>P</i>=0.039), SPI-2 (<i>P</i>=0.020), SPI-5 (<i>P</i>=0.014), SPI-13 (<i>P</i>=0.010), cytolethal distending toxin-related genes (<i>P</i>=1.4×10^-4), <i>fepC</i> (<i>P</i>=0.021), and <i>tcpC</i> (<i>P</i>=0.040) were more frequent in invasive isolates.</p><p><strong>Conclusions: </strong><i>Salmonella</i> Enteritidis-ST11 predominated in infections among Korean children, but invasive isolates were rare. Early detection of genetic factors associated with extra- intestinal invasion will be helpful for prompt and appropriate treatment.</p>","PeriodicalId":8421,"journal":{"name":"Annals of Laboratory Medicine","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of <i>IGH::DUX4</i> Rearrangements Using RNA-sequencing in a Patient with ALL: A Case Report.","authors":"Seoyoung Lim, Yu Jeong Choi, Eunju Yeom, Won Kee Ahn, Seung-Tae Lee, Jong Rak Choi, Seungmin Hahn, Saeam Shin","doi":"10.3343/alm.2024.0622","DOIUrl":"https://doi.org/10.3343/alm.2024.0622","url":null,"abstract":"","PeriodicalId":8421,"journal":{"name":"Annals of Laboratory Medicine","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ABO Antibody Titer Testing Harmonization in Korea: A 5-yr Analysis of External Quality Control Data.","authors":"Han Joo Kim, Yousun Chung, Sang-Hyun Hwang, Heung-Bum Oh, Hyungsuk Kim, Dae-Hyun Ko","doi":"10.3343/alm.2024.0521","DOIUrl":"https://doi.org/10.3343/alm.2024.0521","url":null,"abstract":"<p><p>Current ABO titration methods lack standardization and harmonization. We analyzed the consistency of ABO antibody titer testing among Korean laboratories and discussed future directions for standardization by analyzing external quality control data collected by the Korean Association of External Quality Assessment Service over 5 yrs (2019-2023). The analysis included the number of participating institutions and methods, as well as the proportion of acceptable results. To compare column agglutination technology (CAT) and tube methods, we created a normalized variable: ([log2 titer of laboratory test result]-[mean of log2 titer for the peer group]). The number of participating institutions and methods increased over time. The use of CAT methods expanded, whereas that of tube methods declined. The proportion of acceptable results ranged from 84.0% to 100%, with no significant differences between CAT and tube methods. An F-test revealed no significant variance differences among institutions using these methods. Tube methods demonstrated lower variance in anti-human globulin testing, and room temperature tube methods exhibited lower variance than that of CAT methods. Domestic laboratories demonstrated high-quality performance in ABO antibody titer testing, with no significant differences in acceptable result rates or variance across methods. Continuous efforts toward standardization remain essential.</p>","PeriodicalId":8421,"journal":{"name":"Annals of Laboratory Medicine","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjustment Formula for Harmonizing Triglyceride Values in the Korea National Health and Nutrition Examination Survey, 2005-2022.","authors":"Rihwa Choi, Jong Do Seo, Eun-Jung Cho, Woochang Lee, Yeo-Min Yun","doi":"10.3343/alm.2024.0317","DOIUrl":"https://doi.org/10.3343/alm.2024.0317","url":null,"abstract":"<p><strong>Background: </strong>Korea National Health and Nutrition Examination Survey (KNHANES) triglyceride testing changed from the glycerol blanking method (2005-2021) to the glycerol non-blanking method (2022). We converted triglyceride data from 2005-2021 to that obtained since 2022 with different analytical methods.</p><p><strong>Methods: </strong>To develop a conversion equation, 98 fresh serum specimen pairs were compared using Passing-Bablok regression analysis. Implications of the conversion equation on epidemiological data were evaluated using KNHANES data from 2019-2021. Bias estimations determined using the Lipid Standardization Program (LSP) of the United States Centers for Disease Control and Prevention (CDC) enhanced the accuracy and comparability of the triglyceride results.</p><p><strong>Results: </strong>Triglyceride concentrations measured via the glycerol non-blanking method were 10.7 mg/dL (0.12 mmol/L, 10.0%) higher than those from the glycerol blanking method, with a 9.9 mg/dL (0.11 mmol/L, 5.0%) difference at a concentration of 200 mg/dL (2.26 mmol/L, N=98). The conversion equation y (glycerol non-blanking, 2022)=11.94+0.99x(glycerol blanking, 2005-2021) changed the mean triglyceride concentrations of the KNHANES 2019-2021 data (N=16,015) from 123.7 mg/dL (1.40 mmol/L, 95% confidence interval [CI]: 122.2-125.1 mg/dL [1.38-1.41 mmol/L]) to 134.3 mg/dL (1.52 mmol/L, 95% CI: 132.9-135.8 mg/dL [1.50-1.53 mmol/L]). Since 2022, bias monitoring using the CDC's LSP has remained within a 5.0% limit.</p><p><strong>Conclusions: </strong>KNHANES triglyceride values in 2022 (non-blanking) were substantially higher than those from 2005-2021 (blanking). Conversion equations helped effectively adjust 2005-2021 data. Researchers should consider adjusting the KNHANES triglyceride data based on their study characteristics.</p>","PeriodicalId":8421,"journal":{"name":"Annals of Laboratory Medicine","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}