Deployment of Smart Specimen Transport System Using RFID and NB-IoT Technologies for Hospital Laboratory.

In this study, we propose a specimen tube prototype and smart specimen transport box using radio frequency identification (RFID) and narrow band-Internet of Things (NB-IoT) technology to use in the Department of Laboratory Medicine, King Chulalongkorn Memorial Hospital. Our proposed method replaces the existing system, based on barcode technology, with shortage usage and low reliability. In addition, tube-tagged barcode has not eliminated the lost or incorrect delivery issues in many laboratories. In this solution, the passive RFID tag is attached to the surface of the specimen tube and stores information such as patient records, required tests, and receiver laboratory location. This information can be written and read multiple times using an RFID device. While delivering the specimen tubes via our proposed smart specimen transport box from one clinical laboratory to another, the NB-IoT attached to the box monitors the temperature and humidity values inside the box and tracks the box's GPS location to check whether the box arrives at the destination. The environmental condition inside the specimen transport box is sent to the cloud and can be monitored by doctors. The experimental results have proven the innovation of our solution and opened a new dimension for integrating RFID and IoT technologies into the specimen logistic system in the hospital.

Hemoglobin Pakse: presence on red blood cell membrane and detection by polymerase chain reaction-single-strand conformational polymorphism.

Nondeletional gene mutations giving rise to alpha-thalassemia can be found at polymorphic frequency in Southeast Asia. Although the most common is hemoglobin Constant Spring (Hb CS), caused by a termination codon mutation (UAA --> CAA, Gln) in the alpha2-globin gene and resulting in reduced synthesis of the elongated alpha-globin variant, Hb Pakse (UAA --> UAU, Tyr) also has been observed at a significant prevalence. Western blot analysis of ghost membrane proteins separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis from an individual with alpha-thal 1/Hb Pakse revealed the existence of a higher molecular weight globin of 18 kd consistent with an alpha(Pakse)-globin chain. The presence of alpha(Pakse)-globin on membranes of Hb Pakse-containing red blood cells affords an explanation for the severity of anemia observed in such patients. However, because the 2 Hb variants cannot be distinguished by current biochemical techniques, we developed a convenient single-tube polymerase chain reaction-single-strand conformational polymorphism (PCR-SSCP) protocol for the simultaneous diagnosis of Hb CS and Hb Pakse by amplifying a short fragment covering the termination codon of the alpha2-globin gene. This PCR-SSCP method required no internal control coamplification or use of restriction enzymes and has the potential of identifying all the other possible termination codon mutations in a single reaction with only 1 pair of primers.

Leukocyte counts in cerebrospinal fluid with the automated hematology analyzer, Technicon H*3.

BACKGROUND: Presently, the counting of leukocytes in cerebrospinal fluid (CSF) is still performed manually. This requires sufficiently experienced medical technologists. At present, specific automated systems for CSF cell counting are not available. In this study, we evaluated the use of the automated hematology analyzer, Technicon H*3 in the analysis of cerebrospinal fluid (CSF). METHODS: We tested the hematology analyzer, Technicon H*3, which was not designed for CSF analysis. Sixty CSF samples were analyzed by the analyzer, Technicon H*3. Then the counts obtained were compared with the manual microscopic method. RESULTS: Linearity was tested by both plasma and normal saline solution (NSS). Concerning the NSS dilution, a good correlation can be observed at theoretical number of WBC > 30 cells/microL and so did the plasma dilution. The results of the comparison of both methods used for the determination of total leukocytes in the CSF gave a good correlation (r = 0.984). Concerning the determinations of neutrophils and lymphocytes, the correlation coefficients were 0.855 and 0.835, respectively. CONCLUSIONS: According to our study, the use of this automated analyzer for cell counting in CSF is probably feasible. The high degree of accuracy and linearity that is offered by the analyzer should prompt us and the manufacturers to remedy the interfering factors as described by improving the algorithms. Once this is done, these analyzers may be very useful for cell counts in CSF.

Effects of lifestyle modification on oxidized LDL, reactive oxygen species production and endothelial cell viability in patients with coronary artery disease.

OBJECTIVES: We evaluated the effects of lifestyle modification (LM) on lipid profile, oxidative stress and serum-stimulated human coronary artery endothelial cell (HCAEC) viability in coronary artery disease (CAD) patients after 6months. DESIGN AND METHODS: Thirty patients with CAD were randomly assigned to LM intervention (n=15) and usual care control (n=15) groups. LM-intervened patients were instructed to consume low-fat, high-antioxidants and fiber diets. Moderate exercise and stress management were also advised. Group support to maintain patients' compliance was applied. RESULTS: Serum cholesterol, triglyceride, oxidized LDL and protein carbonyl were decreased in LM group. Serum triglyceride was increased in control group. HCAEC viability was increased, while intracellular reactive oxygen species was decreased, by serum from the LM group. CONCLUSION: LM is capable of improving lipid profile, reducing oxidative stress and increasing HCAEC survival in the patients with CAD, hence lowering a risk for the future cardiovascular event.

Protection of cells from oxidative stress by microsomal glutathione transferase 1.

Rat liver microsomal glutathione transferase 1 (MGST1) is a membrane-bound enzyme that displays both glutathione transferase and glutathione peroxidase activities. We hypothesized that physiologically relevant levels of MGST1 is able to protect cells from oxidative damage by lowering intracellular hydroperoxide levels. Such a role of MGST1 was studied in human MCF7 cell line transfected with rat liver mgst1 (sense cell) and with antisense mgst1 (antisense cell). Cytotoxicities of two hydroperoxides (cumene hydroperoxide (CuOOH) and hydrogen peroxide) were determined in both cell types using short-term and long-term cytotoxicity assays. MGST1 significantly protected against CuOOH and against hydrogen peroxide (although less pronounced and only in short-term tests). These results demonstrate that MGST1 can protect cells from both lipophilic and hydrophilic hydroperoxides, of which only the former is a substrate. After CuOOH exposure MGST1 significantly lowered intracellular ROS as determined by FACS analysis.

Microsomal glutathione transferase 1 in anticancer drug resistance.

Glutathione transferases (GSTs) are often upregulated in tumors and have been suggested to play an important role in multiple drug resistance in cancer chemotherapy. As a consequence GST-dependent pro-drugs and inhibitors are being developed. Little is known, however, on the potential role of membrane-bound GSTs in drug resistance despite the fact that detoxication of cytostatic drugs and upregulation in tumors has been demonstrated. Therefore, we have studied the involvement of membrane-bound microsomal GST1 (MGST1) in cellular resistance to anticancer drugs. As a tool we have developed a cell system utilizing MCF7 cells stably overexpressing MGST1. Here, we show for the first time that MGST1 can protect cells from several cytostatic drugs, chlorambucil, melphalan and cisplatin in an acute toxicity test (MTT assay) as well as a long-term colony forming efficiency cytotoxicity test. It is of note that these cells do not overexpress multidrug transporters, a prerequisite for protection with certain other GSTs investigated in this system. The cytostatic drugs used comprise both those that are known/predicted to be substrates as well as non-substrates. Thus, the mechanism most probably entails both direct detoxication and downstream protection of the cells from oxidative stress.