Analysis of the Relationship between the Expression Levels of Neutrophil Gelatinase-Associated Lipocalin and Cytokine Genes in Bone Marrow.

Background: Recently, various associations of NGAL with several hematological cancers have been reported. However, given that the regulation of NGAL gene expression by cytokines is tissue-specific, NGAL expression in relation to those of cytokine genes has not been analyzed in bone marrow (BM) tissue. The purpose of this study was to analyze the association between NGAL and 48 cytokine gene expression levels in mononuclear cells (MNCs) of BM at the time of diagnosis of hematological malignancy and to explore the expression pattern of NGAL and related cytokine genes in patients with hematological malignancies and controls. Methods: BM MNCs were isolated from 48 patients, who were classified as patients presenting myeloproliferative neoplasm, acute myeloid leukemia, myelodysplastic syndrome, and as controls. NGAL and cytokine genes were analyzed using NanoString. Data on hematological parameters were collected from medical records. Single and multiple regression analyses were performed to analyze relationships. Results: Normalized counts of 26 cytokine genes were related to NGAL normalized counts, while STAT3 and TLR4 normalized counts had the highest explanatory power. The following multiple regression model was developed: NGAL normalized counts=4316.825 + 9.056 × STAT3 normalized counts + 844.226 × IL5 normalized counts + 17.540 × TLR1 normalized counts - 28.206 × TLR2 normalized counts - 42.524 × IRAK4 normalized counts. In the multiple regression analysis, STAT3 and TLR4 normalized counts showed multicollinearity. NGAL, STAT3, IL5, and TLR4 normalized counts showed similar intergroup patterns. Conclusions: NGAL normalized counts was predicted by a multiple regression model, while they showed similar intergroup patterns to STAT3, IL5, and TLR4 normalized counts.

Analysis of bone marrow supernatant neutrophil gelatinase-associated lipocalin and hematological parameters in hematological malignancy.

BACKGROUND: Neutrophil gelatinase-associated lipocalin (NGAL) is a urine biomarker related to acute renal injury. Whereas several studies have evaluated NGAL levels in hematological malignancy, using peripheral blood (PB). Recently, bone marrow (BM) NGAL level was reported to be higher than PB NGAL level in individuals with hematological malignancy, suggesting that BM NGAL would reflect BM microenvironment better than PB NGAL. We measured BM NGAL levels in patients with hematological malignancy, comparing those with NGAL levels in normal BM. We evaluated the association of BM NGAL with hematological parameters including neutrophil counts. METHODS: BM samples were collected from 107 patients who underwent BM examination. Immunoassays were used to assess NGAL levels. Data on hematological parameters were collected from medical records. Intergroup comparisons were performed using the Kruskal-Wallis H test and Pearson chi-square test. Single and multiple regression analyses were performed to analyze the relationships. RESULTS: The independent factors that affected the BM NGAL level were neutrophil counts and BM band neutrophil%, while neutrophil count was the main influencing factor. The acute myeloid leukemia (n = 18) and myelodysplastic syndrome (n = 25) groups showed statistically lower BM NGAL levels than patients with normal BM. The myeloproliferative neoplasm group (n = 34) showed higher BM NGAL levels than patients with normal BM, but this difference was not statistically significant. Neutrophil counts and BM band neutrophil% showed intergroup patterns similar to those of BM NGAL levels. CONCLUSION: BM NGAL was related to neutrophil count and BM band neutrophil%, showing different levels according to hematological malignant disease entities.

Association of peripheral blood neutrophil gelatinase-associated lipocalin levels with bone marrow neutrophil gelatinase-associated lipocalin levels and neutrophil count in hematologic malignancy.

BACKGROUND: Although neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker for acute kidney injury, recently, high NGAL levels have been reported in hematologic malignancies. Given the mechanism underlying NGAL synthesis and secretion in neutrophilic series, it is speculated that NGAL levels are higher in bone marrow (BM) than in peripheral blood (PB). Additionally, PB NGAL levels are thought to be associated with neutrophilic parameters. We aimed to test both hypotheses in hematologic malignancies. METHODS: Paired BM and PB samples were collected from 41 patients undergoing BM examination for hematologic malignancies. NGAL levels were measured using immunoassays. Data on hematologic parameters were collected from medical records. Single and multiple regression analyses were performed to analyze the relationship. RESULTS: PB and BM NGAL (n = 41) levels were significantly different (163.0 ± 258.3 and 413.1 ± 616.2 ng/mL [mean ± standard deviation], respectively; P < 0.05). Simple regression analysis and multicollinearity assessment showed that BM NGAL levels, BM neutrophil%, and neutrophil count were significant predictors of PB NGAL. Two multiple regression models were developed (model 1, PB NGAL = 21.467* neutrophil count - 0.785*BM neutrophil%; model 2, PB NGAL = 21.202*neutrophil count- 0.915*BM neutrophil% +0.10*BM NGAL). Akaike's information criterion and adjusted R2 values showed that model 1 had higher predictive accuracy for PB NGAL. In both models, neutrophil count was the only significant predictor. CONCLUSION: BM NGAL was significantly higher than PB NGAL in hematologic malignancy. In addition, PB NGAL could be expressed as a multiple regression model including neutrophil count and BM neutrophil%, being significantly influenced by neutrophil count.

Comparison between Saliva and Nasopharyngeal Swab Specimens for Detection of Respiratory Viruses by Multiplex Reverse Transcription-PCR.

Nasopharyngeal swabs (NPSs) are being widely used as specimens for multiplex real-time reverse transcription (RT)-PCR for respiratory virus detection. However, it remains unclear whether NPS specimens are optimal for all viruses targeted by multiplex RT-PCR. In addition, the procedure to obtain NPS specimens causes coughing in most patients, which possibly increases the risk of nosocomial spread of viruses. In this study, paired NPS and saliva specimens were collected from 236 adult male patients with suspected acute respiratory illnesses. Specimens were tested for 16 respiratory viruses by multiplex real-time RT-PCR. Among the specimens collected from the 236 patients, at least 1 respiratory virus was detected in 183 NPS specimens (77.5%) and 180 saliva specimens (76.3%). The rates of detection of respiratory viruses were comparable for NPS and saliva specimens (P = 0.766). Nine virus species and 349 viruses were isolated, 256 from NPS specimens and 273 from saliva specimens (P = 0.1574). Adenovirus was detected more frequently in saliva samples (P < 0.0001), whereas influenza virus type A and human rhinovirus were detected more frequently in NPS specimens (P = 0.0001 and P = 0.0289, respectively). The possibility of false-positive adenovirus detection from saliva samples was excluded by direct sequencing. In conclusion, neither of the sampling methods was consistently more sensitive than the other. We suggest that these cost-effective methods for detecting respiratory viruses in mixed NPS-saliva specimens might be valuable for future studies.

Report on the Project for Establishment of the Standardized Korean Laboratory Terminology Database, 2015.

The National Health Information Standards Committee was established in 2004 in Korea. The practical subcommittee for laboratory test terminology was placed in charge of standardizing laboratory medicine terminology in Korean. We aimed to establish a standardized Korean laboratory terminology database, Korea-Logical Observation Identifier Names and Codes (K-LOINC) based on former products sponsored by this committee. The primary product was revised based on the opinions of specialists. Next, we mapped the electronic data interchange (EDI) codes that were revised in 2014, to the corresponding K-LOINC. We established a database of synonyms, including the laboratory codes of three reference laboratories and four tertiary hospitals in Korea. Furthermore, we supplemented the clinical microbiology section of K-LOINC using an alternative mapping strategy. We investigated other systems that utilize laboratory codes in order to investigate the compatibility of K-LOINC with statistical standards for a number of tests. A total of 48,990 laboratory codes were adopted (21,539 new and 16,330 revised). All of the LOINC synonyms were translated into Korean, and 39,347 Korean synonyms were added. Moreover, 21,773 synonyms were added from reference laboratories and tertiary hospitals. Alternative strategies were established for mapping within the microbiology domain. When we applied these to a smaller hospital, the mapping rate was successfully increased. Finally, we confirmed K-LOINC compatibility with other statistical standards, including a newly proposed EDI code system. This project successfully established an up-to-date standardized Korean laboratory terminology database, as well as an updated EDI mapping to facilitate the introduction of standard terminology into institutions.

Clinical performance evaluation of the Sofia RSV FIA rapid antigen test for diagnosis of respiratory syncytial virus infection.

A recently introduced Sofia respiratory syncytial virus (RSV) fluorescent immunoassay (FIA) was evaluated against the BinaxNOW RSV card and the SD Bioline RSV test using 348 respiratory samples. The Sofia, BinaxNOW, and SD Bioline kits showed sensitivities of 66%, 65%, and 64%, respectively, for detecting RSV-A, and 71%, 63%, and 65% for detecting RSV-B, respectively.

Detection of platelet-monocyte aggregates by the ADAM(®) image cytometer.

BACKGROUND: Inappropriate platelet activation is known to be associated with various thrombotic disorders. Platelet-monocyte aggregates (PMAs), whose formation is mediated by platelet surface P-selectin (CD62P), can be used as a reliable marker to detect platelet activation. Previous studies have generally detected PMAs through flow cytometry-based approaches. Recently, the ADAM(®) image cytometer (Nanoentek Inc., Seoul, Korea) was developed for image-based cellular analysis. In this study, we detected PMAs with the ADAM(®) cytometer, evaluated the reproducibility of the measurements made by the ADAM(®) cytometer, and compared the abilities of the ADAM(®) cytometer and a flow cytometric assay to detect PMAs. METHODS: Whole blood samples were collected from patients. Within 5 minutes of collection, anticoagulated whole blood samples were fixed in 10% paraformaldehyde and 5% glyoxal. Nineteen clinical specimens were collected; each was analyzed three times with the ADAM(®) cytometer in order to assess the reproducibility of its measurements. To compare the ability of the ADAM(®) cytometer with that of a flow cytometer to detect PMAs, each cytometer was used for 23 clinical samples and the correlation of the measurements was determined. RESULTS: The PMA measurements made by the ADAM(®) cytometer showed good reproducibility (CV < 10% for all specimens). Moreover, the PMA measurements made by the ADAM(®) cytometer exhibited a high correlation with those made by a flow cytometric assay (R = 0.944). CONCLUSIONS: The ADAM(®) cytometer is a suitable alternative method to the flow cytometry-based assays. Since the ADAM cytometer does not need specialized instrument knowledge or software proficiency (unlike flow cytometry), the ADAM(®) cytometer can be used as a rapid and reliable POCT device to measure platelet activation in peripheral blood. This, in turn, will provide valuable information regarding patient propensities to thrombotic diseases.

Flow cytometric enumeration of parasitemia in cultures of Plasmodium falciparum stained with SYBR Green I and CD235A.

A flow cytometric (FACS) detection method for Plasmodium falciparum cultures (P. falciparum) was developed using SYBR Green I and CD235A and compared against the Giemsa stained microscopic examination. The cultured P. falciparum were spiked into red blood cells (RBCs) to yield parasitemia, ranging from 0.01% to 22.0%. FACS analysis demonstrated a clear separation between P. falciparum infected and uninfected RBCs. The measured percentage of parasitemia by FACS revealed higher precision (CV of 2.2-37.2%) with the sensitivity of 0.01% parasitemia than Giemsa stained microscopic examination (CV of 7.2-66.0%). High correlation of measured parasitaemia (r=0.98, P<0.05) was observed between FACS and Giemsa stained microscopic analyses. The higher levels of parasitaemia detection were observed in all ranges by FACS in comparison to Giemsa stained microscopic analysis. The currently reported FACS method using SYBR Green I and CD235A is potentially useful for measuring parasitemia in treating patients.

Novel approach exploring the correlation between presepsin and routine laboratory parameters using explainable artificial intelligence.

Although presepsin, a crucial biomarker for the diagnosis and management of sepsis, has gained prominence in contemporary medical research, its relationship with routine laboratory parameters, including demographic data and hospital blood test data, remains underexplored. This study integrates machine learning with explainable artificial intelligence (XAI) to provide insights into the relationship between presepsin and these parameters. Advanced machine learning classifiers provide a multilateral view of data and play an important role in highlighting the interrelationships between presepsin and other parameters. XAI enhances analysis by ensuring transparency in the model's decisions, especially in selecting key parameters that significantly enhance classification accuracy. Utilizing XAI, this study successfully identified critical parameters that increased the predictive accuracy for sepsis patients, achieving a remarkable ROC AUC of 0.97 and an accuracy of 0.94. This breakthrough is possibly attributed to the comprehensive utilization of XAI in refining parameter selection, thus leading to these significant predictive metrics. The presence of missing data in datasets is another concern; this study addresses it by employing Extreme Gradient Boosting (XGBoost) to manage missing data, effectively mitigating potential biases while preserving both the accuracy and relevance of the results. The perspective of examining data from higher dimensions using machine learning transcends traditional observation and analysis. The findings of this study hold the potential to enhance patient diagnoses and treatment, underscoring the value of merging traditional research methods with advanced analytical tools.

pLDH level of clinically isolated Plasmodium vivax and detection limit of pLDH based malaria rapid diagnostic test.

BACKGROUND: The malaria rapid diagnostic tests (RDTs) are now widely used in the world. Compared to Plasmodium falciparum, a poor sensitivity of RDTs was reported against Plasmodium vivax based on the adopted antibody against pan-Plasmodium antigen lactate dehydrogenase (pLDH) or aldolase. Levels of pLDH were measured from patient with P. vivax, and the correlations between the levels of pLDH and the sensitivities of RDTs were analysed among Republic of Korea (ROK) isolates. METHODS: Three RDTs, OptiMAL test, SD BIOLINE Malaria Ag P.f/Pan test, Humasis Malaria Pf/Pan antigen test, and the Genedia pLDH antigen ELISA were performed with blood samples from 152 febrile patients and 100 healthy controls. RESULTS: Three malaria RDTs revealed sensitivities between 85.5 (131/152) and 86.8% (132/152) with highest sensitivity for the detection of P.vivax by pLDH antigen ELISA test (145/152, 95.4%) in comparison to traditional microscopy using Giemsa-stained slides. None of the healthy control tested positive by three RDTs or ELISA, indicating 100% specificity in their respective test. Levels of pLDH among Korean P. vivax isolates ranged between 0 ng/mL and 22,387.2 ng/mL (mean ± standard deviation 3,917.5 ± 6,120.9 ng/mL). The lower detection limits of three RDTs were between 25 and 50 ng/mL with artificially diluted samples. The moderate degree of correlation was observed between parasitaemia and concentrations of pLDH (r = 0.4, p < 0.05). CONCLUSION: The pLDH levels of P. vivax are the main explanation for the variations in the performance of pLDH-based RDTs. Therefore, comparing sensitivities of RDT may need to include targeted biomarker value of patients.

Analysis of Correlation between Bone Marrow Vascular Endothelial Growth Factor per Platelet Count and Blast Percentage in Hematologic Malignancies.

OBJECTIVE: Bone marrow (BM) samples reflective of the BM condition are more suitable than peripheral blood samples for the measurement of vascular endothelial growth factor (VEGF) levels in relation to hematologic malignancy. However, BM VEGF levels require calibration, with respect to the platelet count, to eliminate any influence of VEGF released from platelets during sample processing. This parameter is termed the BM VEGF per platelet count. Our aim was to measure BM VEGF per platelet count of patients diagnosed with hematologic malignancy and to analyze its association with several hematological parameters, including BM blast percentages. We also compared the BM VEGF per platelet count and BM blast percentage between the disease and control groups. METHODS: BM plasma samples were collected from 73 patients classified into myeloproliferative neoplasm, acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), plasma cell neoplasm (PCN), and control groups. Luminex assays were used to quantify BM VEGF levels. BM cellularity and cell percentage were assessed using BM biopsy and aspiration slides, respectively. Data on hematological parameters were collected from medical records. Single and multiple regression analyses were performed to analyze the relationships between different parameters. Intergroup comparisons were performed using the Kruskal-Wallis H-test. RESULTS: Independent factors associated with BM VEGF per platelet count included BM blast percentage (%), BM band neutrophil %, BM neutrophil %, and BM cellularity. Multiple regression analyses using the four factors generated the following model (adjusted R2=0.290): BM VEGF per platelet count (×10-6 pg)=1.488+0.059×BM blast (%). BM VEGF per platelet count was the highest in the AML group (n=13) and lowest in the control group (n=14). Similarly, BM blast % was the highest in the AML group. Compared to that in the PCN group (n=11), the BM blast % in the MDS group (n=12) was higher. CONCLUSION: BM VEGF per platelet count was related to BM blast %, and both parameters showed similar intergroup patterns, indicating an association.

Validity of Luminex and Enzyme-Linked Immunosorbent Assay Measuring Vascular Endothelial Growth Factor and Six Cytokines Quantitatively in Bone Marrow Aspiration Supernatant: Pilot Study.

OBJECTIVE: Vascular endothelial growth factor (VEGF) and other cytokines have been reported to be implicated in the molecular pathogenesis of hematologic malignancy. However, a quantitative measurement of VEGF and related cytokines is necessary to reflect the real situation in the bone marrow (BM). Currently, no such quantitative assays exist for use in the BM supernatant as their concentrations have not been previously validated in the BM. Here we performed linearity and recovery tests to quantitatively measure the concentrations of VEGF and six related cytokines in the BM. METHOD: A total of 24 BM supernatant samples were collected from patients who underwent a BM examination for hematological malignancies. The levels of VEGF and six cytokines - granulocyte colony-stimulating factor (G-CSF), interferon-ß (INF-ß), interleukin (IL)-1ß, IL-6, IL-17A, and tumor necrosis factor-α (TNF-α) - were measured using Luminex assay and enzyme-linked immunosorbent assay. Percentage recovery and linearity were calculated, with the acceptable range being 80-120%. The undiluted and diluted (1:2, 1:4, and 1:8) concentrations of VEGF and the six cytokines in 24 spiked and unspiked BM supernatant samples and controls were also measured. RESULTS: For VEGF, both assays passed the percentage recovery and linearity tests; wherein the undiluted and all diluted concentrations of VEGF in all six unspiked BM samples showed linearity parallel to those of VEGF in spiked BM samples and controls. For the other six cytokines, both assays did not pass the percentage recovery and linearity tests, with the undiluted and diluted concentrations in all seventeen unspiked BM samples (except G-CSF in one sample) showing a lack of parallelism to those in spiked BM samples and controls. CONCLUSIONS: Quantitative VEGF measurement in real BM specimens was validated using both Luminex assay and ELISA. All six cytokines, except for VEGF, whether undiluted or diluted, could not be accurately measured in the BM supernatants, indicating the presence of inhibitors to the analytes. Quantitative measurement of VEGF-related cytokines in the BM will have to be validated in further studies with more samples.

Genetic variability in Plasmodium vivax aldolase gene in Korean isolates and the sensitivity of the Binax Now malaria test.

Introduction of rapid malaria diagnostic tests (RDT) initiated numerous field evaluations in various epidemiologic settings. But the efficiency of some RTD kits based on aldolase raised reservations for direct implementation of RDT into clinical settings. We performed Binax Now malaria test in 84 Korean Plasmodium vivax isolates and compared it with the traditional Giemsa stain microscopy test as the reference standard. The sensitivity of Binax Now was 62.0% for P. vivax cases (52/84, 95% CI 51.2-71.6%) with 100.0% specificity (50/50, 95% confidence interval 92.9-100%). After the aldolase gene sequence analysis of 84 isolates, two synonymous mutations in aldolase gene were identified in both Binax Now positive and negative samples. No significant association between the mutations and Binax Now malaria tests was found. Thus, the genetic variability would not explain the poor performance of P. vivax RDTs by detecting aldolase in ROK isolates.

Evaluation of Plasmodium vivax ELISA for the blood screen.

Plasmodium vivax malaria is the indigenous strain in the Republic of Korea (ROK). Plasmodium vivax can be transmitted through the transfusions of various blood components, which became a severe problem with the safety of blood transfusions and blood-related products in ROK. We evaluated a P. vivax-specific enzyme-linked immunosorbent assay (Genedia Malaria Ab ELISA 2.0, Green Cross, ROK) with blood samples from four groups: 251 samples from P. vivax-infected patients, 39 samples from post-treatment patients upon follow-up, 200 samples from healthy volunteers and 421 samples from domestic travellers to and from high endemic areas of ROK. The positive cases from the ELISA test were confirmed by both Giemsa microscopic and polymerase chain reaction methods. The clinical sensitivity and specificity of detecting P. vivax with ELISA test were 94.4% and 99.0%, respectively. Thirteen of 421 domestic travellers (3.0%) to endemic areas tested positive. The results indicate the effectiveness of detecting antibodies against P. vivax in blood with Genedia Malaria Ab ELISA 2.0 test in a large blood screen setting.

Analysis of neutrophil gelatinase-associated lipocalin, vascular endothelial growth factor, and soluble receptor for advanced glycation end-products in bone marrow supernatant in hematologic malignancies.

BACKGROUND: Inflammation is a known risk factor of cancer development, including inflammation-driven leukemogenesis. Evaluation of inflammation-related cytokines in early diagnosis stages is crucial to understand the development of hematologic malignancy. Our aim was to measure three cytokines- neutrophil gelatinase-associated lipocalin (NGAL), vascular endothelial growth factor (VEGF), and soluble receptor for advanced glycation end-products (sRAGE) in bone marrow (BM) samples from patients diagnosed with hematologic malignancy and compare these measurements with the control. Additionally, we evaluated whether NGAL was significantly associated with sRAGE, VEGF, and several hematological parameters. METHODS: BM samples were collected from 73 patients, who were classified into myeloproliferative neoplasm (MPN), acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), plasma cell neoplasm (PCN) and control groups according to the BM smear and pathology review. An immunoassay, a Luminex assay, and an enzyme-linked immunosorbent assay were used to quantitate NGAL, VEGF, and sRAGE, respectively, while all measurements of NGAL, VEGF and sRAGE were performed on BM supernatants. Data on hematological parameters were collected from medical records. Intergroup comparisons were performed using the Kruskal-Wallis H-test and Pearson Chi-Square test. Single and multiple regression analyses were performed to analyze the relationships among the parameters. RESULTS: The independent factors associated with NGAL were neutrophil counts and VEGF. As for both NGAL and VEGF, the MPN (n = 23) group showed the highest level, while the MDS (n = 12) group showed low levels. NGAL levels in the AML (n = 13) and MDS groups were lower than in the control group (n = 14). The MPN group demonstrated higher VEGF levels than the AML and MDS groups. The MDS group showed lower VEGF levels than the PCN (n = 11) group. No statistical difference between the hematologic malignancy and control groups or among the hematologic malignancy groups was observed for sRAGE levels. CONCLUSION: NGAL was related to neutrophil count and VEGF. NGAL and VEGF showed similar intergroup patterns, reflecting that NGAL was associated with VEGF.

Comparative evaluation of Plateletworks, Multiplate analyzer and Platelet function analyzer-200 in cardiology patients.

The objective of this study was to comparatively evaluate three commercial whole-blood platelet function analyzer systems: Platelet Function Analyzer-200 (PFA; Siemens Canada, Mississauga, Ontario, Canada), Multiplate analyzer (MP; Roche Diagnostics International Ltd., Rotkreuz, Switzerland), and Plateletworks Combo-25 kit (PLW; Helena Laboratories, Beaumont, TX, USA). Venipuncture was performed on 160 patients who visited a department of cardiology. Pairwise agreement among the three platelet function assays was assessed using Cohen's kappa coefficient and percent agreement within the reference limit. Kappa values with the same agonists were poor between PFA-collagen (COL; agonist)/adenosine diphosphate (ADP) and MP-ADP (-0.147), PFA-COL/ADP and PLW-ADP (0.089), MP-ADP and PLW-ADP (0.039), PFA-COL/ADP and MP-COL (-0.039), and between PFA-COL/ADP and PLW-COL (-0.067). Nonetheless, kappa values for the same assay principle with a different agonist were slightly higher between PFA-COL/ADP and PFA-COL/EPI (0.352), MP-ADP and MP-COL (0.235), and between PLW-ADP and PLW-COL (0.247). The range of percent agreement values was 38.7% to 73.8%. Therefore, various measurements of platelet function by more than one method were needed to obtain a reliable interpretation of platelet function considering low kappa coefficient and modest percent agreement rates among 3 different platelet function tests.

Effect of Irradiation on Microparticles in Red Blood Cell Concentrates.

Changes in microparticles (MP) from red blood cell (RBC) concentrates in the context of irradiation have not been investigated. The aim of this study was to evaluate how irradiation affects the number of MPs within transfusion components. Twenty RBC concentrates, within 14 days after donation, were exposed to gamma rays (dose rate: 25 cGy) from a cesium-137 irradiator. Flow cytometry was used to determine the numbers of MPs derived from RBC concentrates before and 24 hr after irradiation. The mean number of MPs (±standard deviation) in RBC concentrates was 21.9×109/L (±22.7×109/L), and the total number of MPs ranged from 2.6×109/L to 96.9×109/L. The mean number of MPs increased to 22.6×109/L (±31.6×109/L) after irradiation. Before irradiation, the CD41-positive and CD235a-positive MPs constituted 9.5% (1.0×109/L) and 2.2% (263×106/L) of total MPs, respectively. After irradiation, CD41-positive MPs increased to 12.1% (1.5×109/L) (P=0.014), but the CD235a-positive MPs decreased to 2.0% (214×106/L) of the total MPs (P=0.369). Irradiation increases the number of CD41-positive MPs within RBC concentrates, suggesting the irradiation of RBC concentrates could be associated with thrombotic risk of circulating blood through the numerical change.

Evaluation of the Performance of a Fecal Tumor M2-PK Rapid Kit Using Stool Specimens for Detection of Colorectal Tumors.

BACKGROUND: In gastrointestinal tumors, only subunits of pyruvate kinase isoenzyme type M2 are detectable, and mainly in the dimeric form termed tumor M2-PK. A rapid test for the detection of M2-PK in stool has been developed. We evaluated the performance of the M2-PK rapid kit for the detection of colorectal tumors compared with colonoscopy DESIGN: Stool specimens (n=268) were obtained from patients who had a fecal occult blood test and colonoscopy performed for clinical evaluation or routine health checkup. Collected stool specimens were kept frozen at -20°C until testing. The fecal tumor M2-PK test was performed using a ScheBo M2-PK Quick test (ScheBo(®)•Biotech AG, Giessen, Germany) RESULTS: A total of 236 patients were analyzed, including 87 with tubular adenoma and 126 controls. In tumor M2-PK testing, 37 of 87 tubular adenoma specimens (42.5%) and 2 of 4 sessile serrated adenoma specimens (50%) tested positive. The specificity of the M2-PK rapid test was 87.3% CONCLUSIONS: The tumor M2-PK test demonstrated moderate sensitivity for detection of colorectal adenoma. M2-PK test could be considered as a useful point-of-care testing device for detection of colorectal tumors.

A Case Report of an Infant with Robertsonian Translocation (15;22)(q10;q10) and Literature Review.

Rob(15; 22) is rare and account for only 0.6% of all Robertsonian translocations. We describe a case with rob(15;22) in which the phenotype includes generalized hypotonia, respiratory distress, tent shaped upper lips, hyporeflexia and single umbilical artery. Chromosome analysis with peripheral blood was performed, while the karyotype was interpreted as 45,XX,der(15;22)(q10;q10). In Prader-Willi/Angelman Syndrome FISH studies, deletion of the SNRPN gene was not observed, but deletion of 15p11.2 was noted. Prader-Willi/Angelman Syndrome methylation-specific polymerase chain reaction and chromosomal microarrays showed negative findings. Molecular studies associated with spinal muscular atrophy and progressive muscular dystrophy also showed negative findings. We suggest that rob(15;22) and deletion of 15p11.2 could be related to clinical presentation like this case.

Measurement of platelet aggregation functions using whole blood migration ratio in a microfluidic chip.

Platelets play a major role in maintaining endothelial integrity and hemostasis. Of the various soluble agonists, ADP is an important in vivo stimulus for inducing platelet aggregation. In this study, a simple, rapid, and affordable method was designed for testing bleeding time (BT) and platelet aggregation with a two-channel microfluidic chip. Whole blood migration ratio (MR) from a microchip system was evaluated in comparison to the closure time (CT) from PFA-100 assays (Siemens, Germany) and CD62P expression on platelets. To induce platelet aggregation, a combination of collagen (1.84 mg/ml) and ADP (37.5 mg/ml) were used as agonists. After adding the agonists to samples, whole blood MR from the microchip system was measured. The outcome of the assessment depended on reaction time and agonist concentration. MR of whole blood from the microchip system was significantly correlated with CT from PFA-100 (r = 0.61, p <  0.05, n = 60). In addition, MR was negatively correlated with CD62P expression (r =-0.95, p <  0.05, n = 60). These results suggest that the measurement of MR using agonists is an easy, simple and efficient method for monitoring platelet aggregation in normal and ADP-receptors defective samples, along with the BT test. Thus, usage of the current microfluidic method could expand to diverse applications, including efficacy assessments in platelet therapy.