Rinsho Byori. The Japanese Journal Of Clinical Pathology[JOURNAL]
Sun
200 papers
[Biologics-Induced Kidney Injury -with Special Attention to Anti-Rheumatic Drugs -].
Kimura H
Rinsho Byori · 2016 Jun · PMID 30695331
A variety of anti-rheumatic drugs including biologics are currently used to treat rheumatoid arthritis (RA). These drugs, as well as RA itself, can cause kidney injury. RA may trigger mesangial proliferative glomeru- lon...
A variety of anti-rheumatic drugs including biologics are currently used to treat rheumatoid arthritis (RA). These drugs, as well as RA itself, can cause kidney injury. RA may trigger mesangial proliferative glomeru- lonephritis (MesPGN), membranous nephropathy (N), thin basement membrane disease, and renal amyloi- dosis. As for anti-rheumatic drugs, non-steroidal anti-inflammatory drugs (NSAID) increase serum Cr lev- els due to a reduction of glomerular circulation, particularly in the presence of dehydration. Among disease- modifying anti-rheumatic drugs (DMARD), methotrexate as an anchor drug for RA rarely causes tubular ob- struction as a result of its crystallization, and bucillamine occasionally elicits IN. Calcineurin inhibitors induce vasoconstriction of the afferent arteries. Recently developed anti-rheumatic drugs, biologics, include biological inhibitors of TNF-a, IL6, and CD80/26. These can generally induce the remission of RA, while they have been reported to albeit uncom- monly trigger autoimmune renal disorders (AIRD). A recent meta-analysis identified a total of 29 cases with biologics-induced AIRD, 62% of who manifested AIRD within 12 months after treatment with biologics. AIRD cases were classified into 3 different groups: isolated autoimmune renal disorders (IARD, n =13), glo- merulonephritis with systemic vasculitis (GNSV, n= 12), and glomerulonephritis with lupus-like syndrome (GNLS, n=4). The IARD cases had 4 MesPGN, 4 MN, and 2 crescentic GN, while the GNSV cases had 8 crescentic GN and 3 purpura GN, and the GNLS cases had all MesPGN. To detect these renal disorders early in RA patients, urinalysis and serum Cr measurement should be peri- odically performed. New urinary biomarkers (L-FABP and Ngal) may be more sensitive for kidney injury. Notably, in RA patients receiving biologics, ANA, anti-dsDNA, and ANCA should also be tested at the base- line and regular intervals. [Review].
[Molecular Targeted Therapy and Laboratory Tests].
Koshiba M
Rinsho Byori · 2016 Jun · PMID 30695330
Molecular targeted therapy is medical treatment targeting specific molecules, which are essential in the pathology of diseases. Most agents used are monoclonal antibodies ("biologics") and low-molecular-weight compounds....
Molecular targeted therapy is medical treatment targeting specific molecules, which are essential in the pathology of diseases. Most agents used are monoclonal antibodies ("biologics") and low-molecular-weight compounds. Molecular targeted therapy is widely utilized against malignancies, such as imatinib for chronic myelogenous leukemia blocking BCR-ABL tyrosine kinase, gefitinib for non-small cell lung cancer interrupt- ing signal transduction through EGFR, and trastuzumab for HER2-positive breast cancer. It is a companion diagnostic used as a companion to a molecular targeted drug to determine its applicability for a specific patient, showing the importance of laboratory tests for cancer treatment. While the pathogeneses of connective tissue diseases are still unknown, recent progress in understanding the pathophysiology enables us to use molecular targeted drugs for effective treatment. Rheumatoid arthri- tis (RA) is the most common connective tissue disease, and inflammatory cytokines such as TNFa and IL-6 play a pivotal role in the pathogenesis of RA. In Japan, successful treatment of RA with a chimeric antibody to TNFa(infliximab) is followed by a number of anti-cytokine drugs, such as humanized anti-TNFa, anti- TNF receptor, and anti-IL-6 receptor antibodies. A fusion protein (abatacept), an inhibitor of activated T- cells, composed of the extracellular domain of CTLA-4 and the Fc region of IgG1, and more recently Janus kinase inhibitor (tofacitinib), have also been demonstrated to be highly effective. Since molecular targeted therapy suppresses the immune function, patients receiving the therapy become susceptible to infection. Thus, clinical laboratory tests are of great importance, not only to classify potentially high-risk patients (especially in the case of the so-called post-infectious state of tuberculosis and hepatitis B to avoid reactivation) before treatment but also for the early detection of infections during treatment. [Review].
[Automation of the Examination for Autoantibodies].
Hayashi N
Rinsho Byori · 2016 Jun · PMID 30695329
Antinuclear antibody (ANA) testing is indispensable for diagnosing and estimating clinical conditions of autoimmune diseases. This literature explains the usability and problem points regarding routine laboratory tests w...
Antinuclear antibody (ANA) testing is indispensable for diagnosing and estimating clinical conditions of autoimmune diseases. This literature explains the usability and problem points regarding routine laboratory tests with examples of our own experiments regarding ANA diagnostics with some new technologies. The indirect immunofluorescence assay (IFA) is the gold standard for ANA screening, and it can detect more than 100 different antibodies, including the anti-proliferating cell nuclear antigen as well as anti- cytoplasmic antibodies. However, complicated procedures of conventional IFA and visual interpretation require highly skilled laboratory staff. The EUROPattern Cosmic IFA System (EUROIMMUN, Cosmic Corporation) and HELIOS* (Aesku Diag- nostics, MBL), which are computer-aided microscope systems for ANA testing, showed concordance of the positivity rate as high as 93.3 and 91.9%, respectively, and concordance of the antibody titer as high as 94.0 and 98.8%, respectively (within +/-1 titer) compared with the conventional method, on the measurement of different populations for each system. Although the computer-aided microscope system is not considered a complete system and laboratory staff should verify each result, it is a useful system for routine ANA analysis because it contributes to ANA stand- ardization and an efficient workflow. In our previous study, we demonstrated that BioPlex2200 (Bio-Rad), a fully automated immunoassay ana- lyzer using suspension bead array technology, was useful for the clinical diagnosis of autoimmune diseases. As an ANA screening test, the positive rate was low (7.2%) in healthy subjects, and comparable with that of IFA ( X160). The prevalence of disease-specific ANA in connective tissue disease patients was comparable with the general occurrence rate except for anti-dsDNA antibody in SLE. In accordance with the results of double immunodiffusion and Western blotting with the conventional method, the concordance rate between BioPlex2200 and conventional methods was high (95.0-100%) except for anti-dsDNA antibody. To provide high-quality and prompt clinical tests while considering the efficiency of working and cost reduc- tion, each laboratory should actively innovate and operate these advanced inspection technologies. [Review].
[Molecular-Targeted Therapy and Autoimmune Disease].
Takemura M, Wada T
Rinsho Byori · 2016 Jun · PMID 30695328
Recently, biological treatment agents such as antibody preparations have been widely used in clinical fields, and these agents provide benefits for many patients. They actually show effectiveness against lymphoma, as wel...
Recently, biological treatment agents such as antibody preparations have been widely used in clinical fields, and these agents provide benefits for many patients. They actually show effectiveness against lymphoma, as well as rheumatoid arthritis, which is an autoimmune disease. Accordingly, such biological treatment has altered the concept of treatment, from symptomatic therapy to maintenance of remission. However, it is a fact that there are also some patients for whom this treatment has little benefit. Antibodies for the treat- ment of rheumatoid arthritis can be divided into two groups: tumor necrosis factor (TNF) as cytokine signal blockade, and interleukin-6 (IL-6) as signal blockade from CTLA-4 on the T-cell membrane. It is well- known that the action mechanism of these biological treatment agents can affect the immune system. Thus, cases with side effects, including abnormal laboratory data, must be reported for further study. Since these agents are extremely expensive, their benefit will be marked only when biomarkers for the early detection of complications and prediction of beneficial effects are developed. The aim of this symposi- um is to discuss the role of the clinical laboratory in this molecular-targeted therapy. [Review].
[New Guidelines for Hematuria Diagnosis and Future Perspectives on Urinalysis -Chairmen's Introductory Remarks -].
Inagaki I, Tanaka Y
Rinsho Byori · 2016 Jun · PMID 30695327
Although microscopic hematuria examinations to obtain information on erythrocyte morphology tend to be influenced by subjective views, these views can be corrected to some extent according to the procedures stated in the...
Although microscopic hematuria examinations to obtain information on erythrocyte morphology tend to be influenced by subjective views, these views can be corrected to some extent according to the procedures stated in the JCCLS GP1-P4, standards guideline for urinary sediment examination 2010. Since the accura- cy of FCM (flow cytometry) technology is high, FCM-based assessment should be further promoted in rou- tine practice. Furthermore, technicians in charge of urine tests should exert efforts to achieve a better understanding of the diagnostic guidelines for hematuria and respond to clinicians' requests. The new diagnostic guidelines for hematuria are an achievement at an international level, although they are several challenges to be addressed, and routine practice in laboratories and the active involvement of clini- cians are expected to significantly contribute to hematuria diagnosis and treatment. [Review].
[Training of Medical Technologists Who Will Be Able to Contribute to Emergency Medical Care].
Otsuka Y
Rinsho Byori · 2016 Jun · PMID 30695326
Although health care is provided by many different medical professionals, medical technologists are usually not present in emergency care settings. Kameda Medical Center has established and been implementing a system of...
Although health care is provided by many different medical professionals, medical technologists are usually not present in emergency care settings. Kameda Medical Center has established and been implementing a system of in-house certification as emergency medical care examiners. Medical technologists who have undergone seven-month-or-longer in-house and emergency medical care training and passed the final screening are certified as emergency medical care examiners, and their presence in critical care centers for 24 hours a day has improved the quality and safety of medicine. [Review].
[What Medical Laboratory Testing/Technicians Can and Should Do in Emergency Medicine].
Hagawa N
Rinsho Byori · 2016 Jun · PMID 30695325
Technology used in clinical laboratory tests has made marked progress in the field of emergency medicine, which has developed simultaneously. Emergency tests have expanded to the bedside as a system called point-of-care...
Technology used in clinical laboratory tests has made marked progress in the field of emergency medicine, which has developed simultaneously. Emergency tests have expanded to the bedside as a system called point-of-care testing, and it is now essential for emergency room, critical care unit, and prehospital settings. The favorable relationship between them will continue if we are able to use new testing techniques effective- ly both now and in the future. However, taking the best advantage of them is challenging. This problem will be resolved by the efforts of SHELL Model and Crew resource management (CRM). The SHELL Mod- el offers an important suggestion that a major inhibitor of their effective use is liveware. It is difficult to use liveware resources as efficiently as possible in the numerous emergency medical centers. Referencing CRM, I propose concrete actions to make it possible to: 1) promote 2-way-comunication; 2) share a common language, information, and goals; 3) take the initiative in solving patient problems; 4) establish a trusting rela- tionship between medical staff; 5) eliminate discrepancies at any time and at any center. In these ways, in- tervening actively in care, technologists are closely associated with the patient-centered emergency service, understating not what they have done for patients, but what has become of patients. In addition, they can learn from doctors, other staff, and patients, and vice versa. We, doctors and technologists, can fully interact with each other with emergency testing, and promote healing power that computers cannot harness. [Review].
[New Role and Contribution of Medical Technologists in the Actual Settings of Emergency Medical Care].
Fukuda A
Rinsho Byori · 2016 Jun · PMID 30695324
The Japan Organization for Emergency Laboratory Technologists founded in 2012 has proposed a new con- cept to shift emergency laboratory services from conventional to acute pathological condition-focused ap- proaches. It...
The Japan Organization for Emergency Laboratory Technologists founded in 2012 has proposed a new con- cept to shift emergency laboratory services from conventional to acute pathological condition-focused ap- proaches. It expects that the shortening of the TTAT (therapeutic turnaround time), including the pre- and post-laboratory phases, rather than the simple TAT (turnaround time), will provide a basis for medical tech- nologists to lead future emergency medical care from their standpoint. For the shortening of the TTAT, the further promotion of TQA (therapeutic quality assurance) is indispensable. Therefore, it may be necessary for medical technologists to develop basic knowledge and skills related to emergency medical care, in addition to accessing the actual settings of emergency medical care, and appropriately managing diverse conditions they may encounter with sufficient expertise. [Review].
[Chairmen's Introductory Remarks -Close Association between Emergency Medical Care and Clinical Examinations -].
Fukuda A, Tohyama K
Rinsho Byori · 2016 Jun · PMID 30695323
Clinical examinations are essential medical elements to determine clinical conditions and make diagnoses, and their utility has also been established in emergency medical care. Furthermore, with the introduction of the 2...
Clinical examinations are essential medical elements to determine clinical conditions and make diagnoses, and their utility has also been established in emergency medical care. Furthermore, with the introduction of the 24-hour care system by an increasing number of health care institutions in recent years, the importance of clinical examinations is expected to further increase. Although there has been an increase in laboratory technicians' awareness of emergency medical care and emergency testing in response to this trend, a standardized system has yet to be established to meet de- mands in clinical settings. The primary role of clinical examinations in emergency medical care is to help determine the clinical condi- tions of patients, and they support laboratory technicians in making judgments on the prioritization of exami- nations and their urgency, in addition to the prompt and timely provision of information on examinations re- quired by emergency physicians. In this context, we sincerely hope that this symposium will serve as a signpost to guide clinical examina- tions in the right direction for the future of emergency medical care. [Review].
[New Insights into Diagnosis and Pathogenesis of Amyloidosis by Mass Spectrometric Analysis].
Tasaki M, Obayashi K, Ando Y
Rinsho Byori · 2016 Jun · PMID 30695322
Amyloidosis is one of the most well-known protein-misfolding diseases caused by the deposition of insolu- ble amyloid fibrils in extracellular spaces. At least 31 amyloid fibril proteins have been identified. To elu- cid...
Amyloidosis is one of the most well-known protein-misfolding diseases caused by the deposition of insolu- ble amyloid fibrils in extracellular spaces. At least 31 amyloid fibril proteins have been identified. To elu- cidate the pathogenesis and diagnose the type of amyloidosis, mass spectrometric techniques, including liquid chromatography/tandem mass spectrometry and matrix-assisted laser desorption/ionization time of flight mass spectrometry, have been widely used for the analysis of biological samples, such as serum, urine, and tissues. We review new insights into the diagnosis and pathogenesis of amyloidosis using several mass spectrometric methods. [Review].
[Upcoming Challenges of Next-Generation Clinical Laboratory Tests with Mass Spectrometric Technique -Chairman's Introductory Remarks -].
Nakanishi T
Rinsho Byori · 2016 Jun · PMID 30695321
Many medical researchers and technologists have measured proteins, hormones, lipids, carbohydrates, and nucleotides in body fluids using conventional analytical techniques. After the 1990s, -omics devices includ- ing sof...
Many medical researchers and technologists have measured proteins, hormones, lipids, carbohydrates, and nucleotides in body fluids using conventional analytical techniques. After the 1990s, -omics devices includ- ing soft ionization mass spectrometry produced by Prof. John B Fenn and Dr. Koichi Tanaka en'abled us to more easily detect and identify new bioactive molecules in body fluids for the rapid and differential diagnosis of diseases. Especially, the MS techniques are leading to new breakthroughs in the fields of microorganism identification and pathological diagnosis. In this symposium, upcoming challenges of the modern MS techniques, such as electrospray ionization- and matrix-assisted laser desorption ionization-MS, in clinical tests for discovering biomarkers are being presented for the rapid diagnoses of infectious diseases and amyloidosis, and rapid detections of hormones and lipids in clinical samples by 4 speakers. [Review].
[Familial Hypercholesterolemia and Its Related Molecules].
Ogura M
Rinsho Byori · 2016 Jun · PMID 30695320
Familial hypercholesterolemia (FH) is a common genetic cause of premature coronary heart disease due to lifelong elevated plasma low-density lipoprotein (LDL) cholesterol levels. However, single gene disorders like FH ha...
Familial hypercholesterolemia (FH) is a common genetic cause of premature coronary heart disease due to lifelong elevated plasma low-density lipoprotein (LDL) cholesterol levels. However, single gene disorders like FH have been giving some clues to develop new pharmacological interventions that reduce LDL choles- terol. Within just a few years, three classes of novel LDL-cholesterol-lowering agents are receiving regula- tory approval. Alirocumab and evolocumab are monoclonal antibodies that bind to proprotein convertase subtilisin/kexin type 9 (PCSK9), lowering LDL by 50-70%. In Japan, evolocumab was approved for use in patients with cardiovascular disease or familial hypercholesterolemia whose LDL cholesterol levels are insuf- ficiently controlled by standard therapy, and alirocumab will be approved soon. Although definitive clinical efficacy and long-term safety data are still needed, antibody-based PCSK9 inhibitors promise to meet much of the unmet medical need in the treatment of raised LDL cholesterol. In addition, several other approaches to inhibiting PCSK9, as well as other classes of LDL-lowering therapies, are in clinical development. Further- more, lomitapide, a microsomal triglyceride transfer protein (MTP) inhibitor, and mipomersen, an antisense oligonucleotide for apolipoprotein B, inhibit the production of LDL. Since they also increase hepatic fat, only lomitapide will be approved specifically for homozygous familial hypercholesterolemia in Japan. This review summarizes the science behind the development of the newly developed LDL-lowering drugs. Finally, we discuss problems concerning FH, especially underdiagnosis. [Review].
[Biomarkers for Atherosclerotic Diseases: Significance of Intimal Smooth Muscle Cell-Derived Circulating Marker].
Bujo H
Rinsho Byori · 2016 Jun · PMID 30695319
Vascular cells with the active molecules they release are involved in the progression of atherosclerosis. These cell-related circulating markers are expected to reflect the pathological conditions of atherosclerotic lesi...
Vascular cells with the active molecules they release are involved in the progression of atherosclerosis. These cell-related circulating markers are expected to reflect the pathological conditions of atherosclerotic lesions. In response to stimuli from other cells or active molecules, smooth muscle cells (SMCs) in the medial layer change their phenotype from contractile to synthetic, migrate from the media into the intima, and there they proliferate and release various kinds of cytokines, proteinases, and extra-cellular matrices. Thus, the functions of intimal SMCs are believed to play key roles in plaque formation. The incomplete or sustained activation of intimal SMCs may cause the fragility of plaques under pathological conditions, i.e., diabetes and dyslipidemia. LR11 is one of the genes specifically expressed in intimal SMCs, but not in me- dial SMCs, and it increases the sensitivity of intimal SMCs to migration in response to cytokines including angiotensin II. The soluble form of LR11 is in circulation, and the levels increase transiently after coronary intervention in the period corresponding to the migration of SMCs. The increase in initial sLR11 levels is negatively correlated with event-free survival for CVD endpoints. These results suggest that biomarkers reflecting the pathological conditions of intimal SMCs may be useful as surrogate and/or companion markers for the treatment of atherosclerotic diseases. [Review].
[Lipoprotein Analysis -Measurement of Lipoprotein Fractions and Anion-Exchange High-Performance Liquid Chromatography].
Yoshida H
Rinsho Byori · 2016 Jun · PMID 30695318
Many clinical studies, including Framingham Heart study, have demonstrated that increased LDL choles- terol and decreased HDL cholesterol are associated with the risk of coronary heart disease (CHD), and lipo- protein ev...
Many clinical studies, including Framingham Heart study, have demonstrated that increased LDL choles- terol and decreased HDL cholesterol are associated with the risk of coronary heart disease (CHD), and lipo- protein evaluation is of importance in the prevention and treatment of CHD risk. Lipoprotein analysis methods by high performance liquid chromatography (HPLC) are divided broadly into 2 categories (HPLC with gel-filtration column and with anion-exchange column), and both methods can determine lipid levels of fractionated serum lipoproteins in a small volume of around 10 pL within 30 min. In contrast, with the gel- filtration HPLC method by Gaussian approximation following the particle sizes, the anion-exchange HPLC method elutes lipoproteins following the ion intensity of the lipoprotein particle surface and the hydrophobic property, and determines cholesterol levels of separated lipoproteins without overlapping lipoprotein frac- tions. We have established a method with anion-exchange chromatography using a 1.0-mL injection volume that 5.2 min takes to assay one sample. The within-day and between-day assay coefficients of variation of lipoprotein cholesterol values were 0.33-4.31 and 2.37-9.19%, respectively. Previous studies generating fractionated lipoprotein cholesterol data using anion-exchange HPLC revealed the clinical significance in a variety of settings and, in Japan, this rapid anion-exchange HPLC assay was approved as a medical examina- tion covered by health insurance for medical service fees in 2013, and the anion-exchange HPLC method for lipoprotein fraction cholesterol measurement has the potential to offer further clinical benefit. [Review].
[Small-Dense LDL, HDL2, 3].
Hirano T
Rinsho Byori · 2016 Jun · PMID 30695317
Low-density lipoprotein (LDL), an established atherogenic lipoprotein, can be fractionated into large buoy- ant (b) and small-dense (sd) particles based on their size and density. An abundance of clinical evidence has sh...
Low-density lipoprotein (LDL), an established atherogenic lipoprotein, can be fractionated into large buoy- ant (b) and small-dense (sd) particles based on their size and density. An abundance of clinical evidence has shown that sdLDL particles are more atherogenic than lbLDL particles, and the predominance of sdLDL is associated with a three-fold increased risk of coronary artery diseases (CAD). The sdLDL particle is a good substrate for oxidized LDL in the arterial wall. The LDL size is inversely regulated by serum levels of triglycerides (TG) and insulin resistance. Therefore, the level of sdLDL particles is increased in subjects with hypertriglyceridemia, metabolic syndrome, and type 2 diabetes. We established a simple precipitation assay and a homogenous assay for direct measurement of the sdLDL-cholesterol (C) concentration in serum or plasma. Our direct sdLDL assays have been adopted in well-known large cohort studies, and revealed that sdLDL-C more sensitively predicted CAD events than LDL-C or IbLDL-C levels. HDL also has subspecies, namely HDL2 and HDL3. Large cholesterol-rich HDL2 is inversely associated with plasma TG and insulin resistance, whereas small cholesterol-poor HDL3 is not. We established a sim- ple precipitation assay and a homogenous assay for direct measurement of the HDL3-C concentration in se- rum or plasma, which yields HDL2-C by subtracting HDL3-C from HDL-C. The clinical significance of HDL subspecies remains poorly understood, and so should be a subject of further clinical studies. [Review].
[A Case of Lupus Anticoagulant-Hypoprothrombinemia Syndrome with Phosphatidylserine-Dependent Anti-Prothrombin Antibody].
Yoshika M, Komiyama Y, Yoshida M … +3 more , Naito S, Ieko M, Tsuta K
Rinsho Byori · 2016 Jun · PMID 30695316
Lupus anticoagulant-hypothrombinemia syndrome (LAHS) is a rare disease involving hemorrhagic diathe- sis due to hypothrombinemia with lupus anticoagulant. We report a 28-week-pregnant woman at twenty years of age, who ha...
Lupus anticoagulant-hypothrombinemia syndrome (LAHS) is a rare disease involving hemorrhagic diathe- sis due to hypothrombinemia with lupus anticoagulant. We report a 28-week-pregnant woman at twenty years of age, who had been hospitalized with jaundice. In laboratory data, AST, ALT, and bilirubin were elevated and the prothrombin time (PT) and activated partial thromboplastin time (APTT) were prolonged. Although the liver failure was improved after she delivered a baby by Caesarean section, postoperative intraperitoneal bleeding persisted. The diagnosis by liver biopsy was autoimmune hepatitis. Although the bleeding was stopped on the seventh postoperative day, the prolongation of PT and APTT remained. LA was positive in the diluted Russell's viper venom time. Anti-cardiolipin and anti-beta-2-glycoprotein anti- bodies were also positive. The prothrombin activity was reduced. A high titer of phosphatidylserine- dependent antiprothrombin antibody (aPS/PT), which causes bleeding, was observed. Based on these data, she was diagnosed with LAHS. The liver dysfunction and prolongation of PT and APTT were normalized following the administration of corticosteroids. In this case, aPS/PT may have contributed to the pathological physiology of LAHS. [Case Report].
[Analysis of Hepatitis B Virus Reactivation in Fukuoka University Hospital].
Yuki M, Ishida H, Ohkubo K … +2 more , Kawashima H, Matsunaga A
Rinsho Byori · 2016 Jun · PMID 30695315
Immunosuppressive therapy or chemotherapy-induced hepatitis B virus (HBV) reactivation can cause se- vere hepatitis in inactive HBV carriers or patients with resolved infection. We surveyed patients with measured HBV DNA...
Immunosuppressive therapy or chemotherapy-induced hepatitis B virus (HBV) reactivation can cause se- vere hepatitis in inactive HBV carriers or patients with resolved infection. We surveyed patients with measured HBV DNA levels from 2009 to 2014, and analyzed the clinical profile, treatment regimen and the period leading up to HBV reactivation from therapy start date. Between 2009 and 2014, the total number of HBV viral load measurements taken in our hospital increased 2.3-fold. HBV DNA measurements requested by the Department of Gastroenterology and Hepatology ac- counted for 82.8% of the total in 2009; however, this was reduced to 38.0% in 2014, as the number of re- quests from other departments increased. We referred all patients with reactivated HBV infection to a hepatology specialist. The total number of reactivation patients in 2014 was increased to about 8.2 times that observed in 2009. Nineteen males and 24 females were included in our cohort, and the average age was 69±10.1 years old. Thirty-two patients had previously received chemotherapy, and seven had undergone immunosuppressive treatment. A delay of more than 12 months from commencement of therapy to HBV reactivation was observed in 49% of patients. These results indicate that it is very important to monitor HBV DNA and properly enforce pre-treatment examinations according to the guidelines for prevention and treatment of HBV during immunosuppressive therapy. [Original].
[The Study of a New Formula for Correcting Serum Calcium Levels, Considering the Difference in Albumin Analysis Methods].
Tanaka M, Takahashi Y, Umemori Y … +2 more , Asanuma K, Takahashi S
Rinsho Byori · 2016 Jun · PMID 30695314
In Japan, Payne's formula [corrected Ca=total Ca+ (4-ALB)] has been used to correct serum calcium concentration levels. However, the current methods for measuring calcium and albumin differ from those that were used to e...
In Japan, Payne's formula [corrected Ca=total Ca+ (4-ALB)] has been used to correct serum calcium concentration levels. However, the current methods for measuring calcium and albumin differ from those that were used to establish the Payne's formula. For albumin measurement, particularly, values differ be- tween BCG and improved BCP method. In 2014, Ohba et al. reported a modified formula [corrected Ca= total Ca+0.7X (4-ALB)], which is more suitable for correcting calcium with the improved BCP method than with the Payne's method. In the same year, the recommendation for converting albumin concentration with the improved BCP method to that with the BCG method was presented by the Japanese Society of La- boratory Medicine. Thus, we conceived a new modified formula [corrected Ca=total Ca+ {4- (BCP+ 0.3) }], which is included in the contents of this recommendation, and examined the effects of this formula in comparison with the Payne and Ohba methods. The patients recruited for the calcium adjustment were as follows: (i) all patients; (ii) patients with albumin concentrations <4.0 g/dL; and (iii) patients with albumin concentrations ≤3.5 g/dL. Payne's formula overcorrected calcium with the improved BCP method. Ohba's method was suitable for (i), while the new for- mula was specifically more suitable for (iii) than the Payne and Ohba formulas. The present study showed that our new formula is more suitable for calcium adjustment in patients with albumin concentrations ≤3.5 g/dL. [Original].
[Experience of Collaborative Research through Department of Medical Instrumental Research and Technology in Kyoto Prefectural University of Medicine].
Saitoh K
Rinsho Byori · 2016 Jan · PMID 27192805
Both of Kyoto Prefectural University of Medicine which offers high, technical and safe medical treatment and Horiba, Ltd. which has small CBC analyzers in a core product established a joint research institute for develop...
Both of Kyoto Prefectural University of Medicine which offers high, technical and safe medical treatment and Horiba, Ltd. which has small CBC analyzers in a core product established a joint research institute for development of advanced laboratory test analyzer from January 1, 2012 in Kyoto Prefectural University of Medicine as the "advanced treatment hospital" where the Ministry of Health, Labour and Welfare has got approved. Clinical needs about analyzer and reagent for a laboratory test are being investigated to the emergency medical care unit and the intensive care unit as well as the laboratory test part in the affiliated hospital and many medical departments of the pediatrics, the internal medicine and the surgery. Developing the new analyzer based on high technology, evaluating the performance of them and spreading them to a medical examination and treatment site is our main target.
[Industry-Academia Collaboration in the Clinical Laboratory Field: Chairmen's Introductory Remarks].
Inaba T, Ikemoto T
Rinsho Byori · 2016 Jan · PMID 27192804
Industry-academia collaboration has become essential in contemporary medicine. Therefore, many institutes including university corporations have promoted the establishment of an endowed chair and/or performed collaborati...
Industry-academia collaboration has become essential in contemporary medicine. Therefore, many institutes including university corporations have promoted the establishment of an endowed chair and/or performed collaborative research. This symposium was held to overview the present status of industry-academia collaboration in the clinical laboratory field. As a representative of the industry, Mr. Taniguchi (Sysmex) presented the development process of M2BP Glycosylation Isomer, a new marker for liver fibrosis. Mr. Saitoh (Horiba) introduced the achievements of joint collaborative research with Kyoto Prefectural University of Medicine, especially the practical realization of an automated hematology analyzer capable of simultaneously measuring C-reactive protein. Mr. Setoyama (LSI Medience) presented on the characteristic collaboration between academia and commercial laboratories such as Tsukuba Medical Laboratory of Education and Research (TMER). On the other hand, as a representative of academia, Associate Prof. Imai (Kyoto Prefectural University of Medicine) summarized the necessity of clinical laboratories spread regenerative medicine. Finally, Prof. Koshiba (Hyogo College of Medicine) presented on the industry-academia collaboration in routine laboratory work in his institute.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe