• Korean Journal of Veterinary Research
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• v.26 no.1
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• pp.187-194
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• 1986

The purpose of this study is to develop a new method which enables the goat ESR to be used as an effective clinical test. Blood samples were taken from 61 Korean native goats aged above one year old and the effect of tube inclinations, tube bores, tube lengths, environmental temperatures during tests and packed erythrocyte volumes (PCV) on the ESR were observed. The results were summarized as follows. 1. The ESR/hr using capillary hematocrit tube (Micro-Ht-tube) was gradually increased as the tube angle inclined from 90 (vertical) to 15 degrees and the best angle in view of both security and fast sedimentation rate was found to be an angle of 45 degrees. 2. The 45-degree angled ESR ($45^{\circ}$-ESR) increased as the diameter of tube bore decreased. 3. The tube length did not affect the $45^{\circ}$-ESR in percent. 4. The $45^{\circ}$-ESR increased with the increased environmental temperature during the ESR test. 5. The heparinized Micro-Ht tubes did not affect the $45^{\circ}$-ESR of EDTA-blood in healthy group but in anemic group. In the anemic group, the ESRs by the heparinized Micro-Ht-tubes were slightly higher than those by non-heparinized Micro-Ht-tubes. 6. By using the autologous plasma, PCV of the blood was adjusted to be 10, 20, 30, 40 and 50ml/100ml and $45^{\circ}$-ESRs were determined in the Micro-Ht-tubes. The $45^{\circ}$-ESRs increased as the values of PCV decreased. The regression of the $45^{\circ}ESR$ to PCV was curvilinear with the second degree polynomial, $Y=42.1838-1.7355X+0.0180X^2$(r=0.9997). 7. The $45^{\circ}$-ESR/hr, using non-heparinized Micro-Ht-tubes at $20^{\circ}C$, was determined in 35 healthy Korean native goats. The average PCV was $30.6{\pm}1.4ml/100ml$. The observed ESR values averaged $6.8{\pm}1.7%$ and the corrected ESR values to the standard PCV of 31ml/100ml averaged $6.5{\pm}1.2%$. From these results, the angled capillary tube method was found to be desirable ESR test of goat blood in which EDTA-blood is filled in nonheparinized Micro-Ht-tubes held at an angle of 45 degrees for an hour at $20^{\circ}C$.

• Korean Journal of Clinical Laboratory Science
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• v.36 no.2
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• pp.239-244
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• 2004

Recently automatic equipment has been well popularized for the erythrocyte sedimentation rate, a widely used test, but no standard quality control has been established yet. Thus, we are going to report a case that established and applied a quality control method using the TEST 1 automatic analyzer. For internal quality control, we adopted the repeatability test through comparison with daily mean check, with a manual method using patients' specimens and with the results of a test on the previous day. In order to set the tolerance standard for each quality control method, we compared the results of 50 specimens that showed a wide range of ESR results and examined correlation and differences according to result. After setting the tolerance standard, we applied the standard at tertiary university hospitals for 120 days and investigated positive rates and re-examination rates. If the tolerance standard was exceeded, the cause was also identified. We selected a specimen of below 25 mm/hr (T1), one between 26-50 mm/hr (T2) and one of over 51 mm/hr (T3) at random. The correlation between the manual method and the automatic method was quite high (r=0.98), and it is found appropriate to set based on differences in result values below 25 mm/hr, the upper limit of the reference value, and based on differences in the percentage of result values above 25 mm/hr. Accordingly, we set the criteria for rejection above 10 mm/hr and above 20%. When the criteria were applied in the laboratory, 1.7% of specimens in the range of T1, 8.3% of those in the range of T2 and 7.5% of those in the range of T3 were rejected. Because all the rejected ones fell within the tolerance limit in re-examination calibration verification was not carried out. With the wide popularization of erythrocyte sedimentation rate analyzers that can carry out a lot of tests quickly using automatic methods, it is necessary to improve the reliability of test results by establishing internal quality control policies. We expect that an agreed standard quality control method may be established based on the method proposed in this study.

• Pediatric Infection and Vaccine
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• v.23 no.1
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• pp.25-30
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• 2016

Purpose: We undertook this study to investigate discrepancies in C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) values, and variations following intravenous immunoglobulin (IVIG) therapy in Kawasaki disease (KD). Methods: A total of 123 KD patients were retrospectively enrolled. Patients were treated with IVIG 2 g/kg at 2 to 9 days after disease onset. We obtained white blood cell (WBC) count, percentage of neutrophils (% neutrophils), CRP, ESR, and N-terminal pro-brain natriuretic peptide (NT-proBNP) values before and 48 to 72 hours after IVIG treatment. Discrepancy was defined as $CRP{\geq}10mg/dL$ and ESR <50 mm/hr (Group 1), or CRP <10 mg/dL and $ESR{\geq}50mm/hr$ (Group 2). Results: Thirty-six of 123 subjects (29.2%) had a discrepancy: 25 (20.3%) in Group 1 and 11 (8.9%) in Group 2. In Group 1, 15 patients (60%) had fever for <5 days (early presenter) and 10 (40%) had fever for ${\geq}5days$ (late presenter). There were six early presenters (55%) and five late presenters (45%) in Group 2. Late presenters had higher ESR than early presenters ($34.3{\pm}21.0mm/hr$ vs. $26.3{\pm}19.3mm/hr$, P=0.029). After IVIG treatment, elevated WBC count, % neutrophils, CRP, and NT-proBNP levels normalized. In contrast, ESR increased from $37.4{\pm}21.9mm/hr$ to $48.0{\pm}22.7mm/hr$ (n=36, P=0.051). Conclusions: A discrepancy may be related to the duration of fever. Due to discrepancies in CRP and ESR values in acute KD, both should be measured to assess the degree of inflammatory activity before IVIG treatment. After IVIG treatment, the ESR should not be used as a marker of response to therapy in KD.

• Journal of Pharmacopuncture
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• v.18 no.3
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• pp.19-31
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• 2015

Objectives: Correlations of the levels of the nonspecific inflammatory markers C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) and of the coagulation marker fibrinogen with the treatment period of wheel balanced cancer therapy were determined. Methods: Electronic charts of stage IV cancer patients hospitalized from February 1, 2008, to November 30, 2013, were reviewed retrospectively. Patients whose laboratory follow-up tests included at least two data points for at least one marker were included. Patients receiving chemotherapy or radiotherapy or having Eastern Cooperative Oncology Group (ECOG) levels exceeding 2 were excluded. Correlations of the markers with the length of treatment for treatment periods ${\geq}21$ and ${\leq}20$ days were determined by gender and whether or not surgery had been performed. Results: Analyses of the CRP and the ESR revealed a higher proportion of patients with stable marker levels than with increased or decreased levels. Also, only the ESR in female and the CRP in male groups had higher proportions of patients with stable marker levels than with increased or decreased levels. The ${\geq}21$ day group had a higher proportion of patients with stable CRP and ESR levels than the ${\leq}20$ days group. Only the ESR in female and the CRP in male groups had higher proportions of patients with stable marker levels in the ${\geq}21$ day than in the ${\leq}20$ day group. In addition, only the CRP in the surgery group and the ESR in the non-surgery group had higher proportions of patients with stable marker levels in the ${\geq}21$ day group than in the ${\leq}20$ day group. Conclusion: For stage IV cancer patients at hospitals that offer Korean medicine, more than 21 days of long-term wheel balanced cancer therapy (WBCT) should help maintain the CRP and the ESR levels and should have a favorable effect on the survival rate.

• Pediatric Infection and Vaccine
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• v.26 no.1
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• pp.51-59
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• 2019

Purpose: The aim of this study was to evaluate the relationships between cytokine and chemokine levels and the clinical severity of Mycoplasma pneumoniae pneumonia. Methods: A retrospective analysis of clinical and laboratory parameters were performed. Serum levels of interleukin (IL)-6, IL-8, IL-10, IL-18, interferon-${\gamma}$-inducible protein-10 (IP-10), macrophage inflammatory $protein-1{\beta}$, and tumor necrosis $factor-{\alpha}$ were measured. The severity of patients' clinical course and radiologic findings were also assessed. Results: Seventy-two patients (35 males and 37 females) with a median age of 3.9 years (range, 1-16 years) were enrolled. Patients with lobar pneumonia (n=29) had significantly higher C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and IL-18 values than those with broncho-interstitial pneumonia (n=43). However, the cytokine and chemokine values did not differ between the group that was treated with corticosteroids (n=31) and the one that was not (n=41). The CRP, ESR, lactate dehydrogenase (LDH), IL-18, and IP-10 values showed positive correlations with fever duration prior to admission. The CRP and ESR values were positively correlated with IL-18, and LDH, with IP-10 levels. Conclusions: CRP, ESR, LDH, IL-18, and IP-10 values were associated with the severity of the disease, manifesting lobar pneumonia or prolonged fever duration prior to admission.

• Journal of Veterinary Clinics
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• v.11 no.2
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• pp.579-583
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• 1994

In the present studies, samples of blood were taken from 24 Holstein cattle over 2 years old. By using the angled tube method the normal ESR values were determined in cattle under various diseases. The results obtained were summarized as follows ; The standardized ESR/hr using 45$^{\circ}$ angled capillary tubes were 19.0% in case of necrotic mastitis, 23.0% in nephritis, 12.2% in anemia and 4.2% in diarrhea. And the ESR was increased from some necrotic disease, decreased from diarrhea conditions and general the normal ESRs were shown in the sub-clinical or recovery stage of infections or disorders.

• Journal of Korean Neurosurgical Society
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• v.44 no.6
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• pp.385-388
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• 2008

We herein describe the case of a focal spontaneous spinal epidural abscess who was initially diagnosed to have a free fragment of a lumbar disc. A 71-year-old woman presented with history of low back and right leg pain. Magnetic resonance imaging suggested a peripherally enhancing free fragment extending down from S1 nerve root axilla. Preoperative laboratory investigation showed elevation of c-reactive protein (CRP), erythrocyte sedimentation rate (ESR) levels. She was taken for surgery and a fluctuating mass at the axilla of S1 nerve was found. When the mass was probed with a dissector, a dark yellow, thick pus drained out. Pus cultures were negative. Patients who present with extreme low back plus leg pain and increased leucocyte count, ESR and CRP levels should raise the suspicion of an infection of a vertebral body or spinal epidural space.

• Tuberculosis and Respiratory Diseases
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• v.65 no.2
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• pp.99-104
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• 2008

Background: Acute respiratory distress syndrome (ARDS) is ultimately an inflammatory state. The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level are inflammatory markers. The aim of this study was to evaluate the value of the ESR, CRP and APACHE II score as prognostic factors for patient with ARDS. Methods: We retrospectively analyzed the medical records of 87 ARDS patients. The predictors (APACHE II score, ESR and CRP) and outcomes (mortality and length of the total hospital stay, the ICU stay and mechanical ventilator care) were obtained from the patients' records. The patients were grouped according to survival as the Survivor and Non survivor groups. We compared the APACHE II score, the ESR and the CRP level between the survivor group and the nonsurvivor group. We evaluated the correlation between the predictors and the outcomes. The initial ESR, CRP level and APACHE II score were checked at the time of ICU admission and the second ESR and CRP level were checked $3.3{\pm}1.2$ days after ICU admission. Results: Thirty-eight (43.7%) patients remained alive and 49 (56.3%) patients died. The APACHE II score was significantly lower for the survivor group than that for the non survivor group ($14.7{\pm}7.6$ vs $19.6{\pm}9.1$, respectively, p=0.006). The initial ESR and CRP level were not different between the survivor and non-survivor groups (ESR $64.0{\pm}37.8mm/hr$ vs $63.3{\pm}36.7mm/hr$, respectively, p=0.93, CRP $15.5{\pm}9.6mg/dl$ vs $16.3{\pm}8.5mg/dl$, respectively, p=0.68). The decrement of the CRP level for the survivor group was greater than that for the non survivor group ($-8.23{\pm}10.0mg/dl$ vs $-1.46{\pm}10.1mg/dl$, respectively, p=0.003). Correlation analysis revealed the initial ESR was positively correlated with the length of the total hospital stay and the ICU stay (correlation coefficient of the total hospital days: R=0.43, p=0.001, correlation coefficient of the ICU stay: R=0.39, p=0.014). Conclusion: The initial APACHE II score can predict the mortality of ARDS patients, and the degree of the early CRP change can be a predictor of mortality for ARDS patients. The initial ESR has positive correlation with the ARDS patients' duration of the total hospital stay and the ICU stay.

• Journal of Veterinary Clinics
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• v.4 no.1
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• pp.395-401
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• 1987

In this study, the effect of ambient temperature on the 45$^{\circ}$micro ESR/hr of cattle blood were observed, and a correction chart for correcting observed values at any ambient temperature to standard values at 20$^{\circ}C$ was plotted. Besides, the effect of storage temperature of blood on the 45$^{\circ}$micro ESR/hr was surveyed. The results were as follows: 1. The values of the 45$^{\circ}$micro ESR/hr were increased as the ambient temperature were elevated(P<0.01), and lower the value of PCV, higher the effect of temperature on the 45$^{\circ}$micro ESR/hr was observed(P<0.01). 2. Regression of values of 45$^{\circ}$micro ESR to ambient temperature in all the group of different level of blood PCV showed linear regression with the highly significant coefficient of correlation. With the results, correction chart was drawn as in Fig. 1. 3. In the purpose to verify the reliability of correction chart, observed values of 45$^{\circ}$micro ESR/hr in field(out door) were corrected to values at 20$^{\circ}C$ by the correction chart(Fig. 1), comparing with the observed values at 20$^{\circ}C$ of standard temperature. No significant differences were found between two groups mentioned above. 4. In the study on the effect of storage temperature of the blood on the 45$^{\circ}$micro ESR/hr, group of storage temperature at 5$^{\circ}C$ showed statistically no significant differences untill 24 hours in contrast with standard control group.

• Korean Journal of Acupuncture
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• v.26 no.2
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• pp.27-38
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• 2009

Objectives: Rheumatoid arthritis (RA) is a chronic autoimmune disease, principally characterized by synovial inflammation of the joints. We previously reported the effect of acupuncture for RA, but the mechanism is still unclear. Various factors such as oxidative stress and angiogenesis were involved in the pathogenesis of RA, and recently, it has also been reported that cytokines also play a major role in RA. Thus, we investigated whether acupuncture could induce any changes in the levels of cytokines including vascular endothelial growth factor (VEGF), angiogenin and epidermal growth factor (EGF) as well as erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), and rheumatoid factor (RF) in the sera of RA patients. Methods: The forty three patients who met the American College of Rheumatology (ACR) criteria for RA recruited. The acupuncture group (n=21) underwent 14 sessions of partially individualized acupuncture treatment for 6 weeks, and the control group had no treatment (n=13) over the same periods. We evaluated ESR, CRP and RF. In addition, to find out the mechanism of acupuncture, we assessed the changes of the cytokine activities using protein cytokine array in the sera of the patients. Results: Acupuncture significantly decreased the levels of ESR and CRP, but RF were not changed after 6-week acupuncture treatments. Moreover, acupuncture reduced the levels of VEGF, angiogenin and EGF in the sera of the patients. Interestingly, they were related with angiogenesis, which is an important process in the pathogenesis of RA. The levels of oncostatin, interleukin(IL)-$1{\alpha}$, IL-8, leptin, monocyte chemotactic protein-1, macrophage-derived chemokine, macrophage inflammatory proteins-1, platelet-derived growth factor BB and RANTES were not changed significantly. Conclusions: The effect of acupuncture for reliving RA symptoms can be partially explained by inhibition of angiogenesis factors in the sera of the RA patients.