Fundamental evaluation of apolipoprotein B-48 by chemiluminescence enzyme immunoassay--identification of apolipoprotein B-48 with immunoblotting

BACKGROUND: Apolipoprotein B-48 (apo B-48) is a constituent of chylomicrons and chylomicron remnants, and its fasting concentration has been reported to be a marker of postprandial hyperlipidemia, which is thought to be a risk factor of atherosclerosis. AIM: We evaluated the serum apo B-48 concentrations by chemiluminescence enzyme immunoassay (CLEIA), which was recently introduced as Lumipulse f fully automated immunosaasy analyzer by Fujirebio Inc (Tokyo, Japan), and performed immunoblotting on agarose gel electrophoresis with anti-apo B-48 antibody. RESULTS: Apo B-48 assay was intra-assay reproducible (CVs: 1.9-3.1%) and inter-assay reproducible (CVs: 2.2-4.4%). The assay range for apo B-48 was from 0.2 to 40.0 microg/ml. The effects of interfering substances such as free/conjugated birirubin, hemoglobin, Intrafat, ascorbic acid and rheumatoid factor were negligible. For storage, it was preferable to freeze, and to avoid frozen-thaw process as much as possible. Anti-apo B-48 antibody was reactive over a wide range from origin to the position of very-low-density lipoproteins in immunoblotting after agarose gel electrophoresis. CONCLUSION: Apo B-48 measurement by CLEIA was feasible to clinical use for the assessment of lipoprotein metabolism.     

Surgical site infection in a university hospital: post-release surveillance and risk factors

The aim of this study was to determine the incidence of the Surgical Site Infection (SSI) in the hospital and after discharge in patients submitted to digestive system surgeries (SDS), and to verify the association between SSI and the type of surgery, the time of hospital internment, the patient's clinical condition, the classification of the surgical wound and the duration of the surgical procedure. It is a prospective study carried out at a university hospital between August of 2001 and March of 2002. Of 357 patients submitted to SDS, 64 SSI cases were notified--16 in the hospital and 48 after discharge, incidences of 4.5% and 13.9% respectively. It was verified an association of SSI with the preoperative stay in hospital and with the classification of the surgical wound. The global incidence of SSI was 18.0%, and there was a four-fold increase when the post-discharge surveillance was carried out. In consequence, it can be concluded that if the post-discharge surveillance is not conducted the global SSI incidence would be strongly undernotified.     

Genetic and non-genetic factors responsible for antiplatelet effects of clopidogrel in Japanese patients undergoing coronary stent implantation: An algorithm to predict on-clopidogrel platelet reactivity

Introduction

Antiplatelet effects of clopidogrel appear to be affected by various factors including genetic polymorphism. So far, there has been little information about the response of clopidogrel in Asians, whose prevalence of a CYP2C19 loss-of-function (LOF) allele is high.

Methods and Results

We investigated background and clinical factors affecting on-clopidogrel platelet reactivity in Japanese patients undergoing coronary stent implantation (n = 114). In univariate analysis, antiplatelet effects of clopidogrel in a steady state were associated with not only CYP2C19 genotypes but also several factors including dyslipidemia. In addition, we developed an algorithm that can estimate P2Y12 Reaction Units (PRU) in a steady state by multiple regression analysis and evaluated the adequacy of the algorithm by the Akaike Information Criterion.

Conclusions

We revealed several factors influencing on-clopidogrel platelet reactivity in Japanese patients. We also succeeded in developing an algorithm that estimates PRU in a steady state, although it is uncertain whether the algorithm can be applied to other populations.     

Transplantation of the neonatal suprachiasmatic nuclei into rats with complete bilateral suprachiasmatic lesions

The suprachiasmatic nuclei (SCN) obtained from neonatal day 1 rats were transplanted into the third ventricle of SCN lesioned rats which had shown circadian arrhythmicity in wheel-running activity for more than 2 months. In 8 out of 16 rats that received SCN transplantation, appearance of circadian rhythms in wheel-running activity was observed between 2 and 9 weeks after transplantation. Histological examination revealed ingrowth of the grafts into the periventricular zone, caudal from the lesioned SCN. These findings suggest that the recovery of circadian rhythmicity was the result of functional reinnervation of the periventricular zone by efferent fibers from the SCN.     

An epidemiological study of children with status epilepticus in Okayama, Japan: incidence, etiologies, and outcomes

To clarify the incidence of first-ever episodes of status epilepticus (SE), their etiologies and outcomes among Japanese children, we performed an epidemiological study in Okayama City. One hundred and twenty patients (69 males, 51 females) experienced first-ever SE episodes between 2003 and 2005. Overall, the annual incidence of SE was 42.0 per 100,000 population (95% CI: 34.5-49.5). The highest incidence was seen in patients aged <2years, especially in the second year of life. Febrile SE accounted for 59 (49.2%) cases, and acute-symptomatic etiologies accounted for 21. Ten were considered to have remote-symptomatic etiologies, and eight to have acute-on-remote-symptomatic etiologies. Ten were classified as cryptogenic/idiopathic epilepsy-related, and 12 were unclassified. Nineteen (15.8%) patients were diagnosed with exanthema subitum, including three with encephalitis/encephalopathy, and 17 (14.2%) patients with influenza, including four with encephalitis/encephalopathy. After SE, eight (6.7%) patients suffered from motor disturbance with or without mental disturbance. One of these died during the follow-up period. Ultimately 34 (28.3%) of the 120 patients had been diagnosed with epilepsy by the end of the follow-up. We conclude that the incidence of SE among Japanese children is higher than the reported incidence among Caucasian children. Febrile SE accounted for approximately half of the cases. Among the etiologies, exanthema subitum was the most important infectious disease, followed by influenza. Both types of infection caused encephalitis/encephalopathy associated with SE as well as febrile SE.     

Depiction of the thoracic duct by magnetic resonance imaging: comparison between magnetic resonance imaging and the anatomical literature

Purpose  

The aim of this study was to compare thoracic duct (TD) configuration depicted by magnetic resonance imaging (MRI) with TD configuration described in the anatomical literature.     

Current status of employment and labor of occupational nurses in external agencies for industrial health

The purposes of this study were to survey the actual conditions of the employment status and activities of occupational health nurses who are employed in Japanese Industrial Health Organizations (IHOs), and to investigate whether the OHNs provide quality health services to employees. We mailed 1,780 questionnaires to nurses who belong to 92 IHOs (members of the National Federation of Industrial Health Organizations). A total of 976 questionnaires were returned (54.8% valid response rate) and 968 questionnaires were considered eligible for analysis. The results showed the following issues: 1) most public health nurses belonged to the department of occupational health service, but they did not have enough experience with industrial hazards or workers safety or health; 2) public health nurses want to participate more directly in care for workers; 3) Public Health Nurses provided health counseling in the charge of their enterprises, but they did not take managerial roles, including place-of-work patrol, attendance to safety, and health committees in their workplaces; 4) they were not satisfied with the present roles demanded by the other staff and their managers; 5) they did not have enough opportunities to attend the job training. Together, the results of this study suggest that the OHNs in IHOs need to have more opportunities to perform their expertise in industrial health & safety and job training in order to provide autonomous health services to the workers.     

MR imaging of thymic epithelial tumors: correlation with World Health Organization classification

Purpose The aim of this study was to determine magnetic resonance imaging (MRI) features of various subtypes of thymic epithelial tumors based on the World Health Organization classification. Materials and methods The study included 64 patients with histologically proven thymic epithelial tumors. Two observers evaluated the MRI findings in terms of tumor size, contour, lobulation, shape, homogeneity, the presence of intratumor high- and low-signal foci, enhancement degree and pattern, the presence of capsule and septum, and associated mediastinal lymphadenopathy and pleural effusion. Results Type A tumors were more likely to have a smooth contour, round shape, distinct capsule, and smaller size compared to any other type of thymic epithelial tumor. Thymic carcinomas demonstrated a higher prevalence of low-signal foci within the mass on T2-weighted images and mediastinal lymphadenopathy than any other types. The frequency of heterogeneous intensity on T2-weighted images increased from type A tumors to thymic carcinomas. Conclusion The presence of a smooth contour, round shape, and capsule is highly suggestive of a type A tumor. Foci of low signal intensity in the mass on T2-weighted images and mediastinal lymphadenopathy are highly suggestive of thymic carcinomas.     

67Ga-Binding substances in stomach,small intestine,pancreas, and muscle

Normal male rats were injected with either gallium citrate Ga 67 or sodium sulfate S 35. After 24 h, the stomach, small intestine, pancreas, and muscle were excised and homogenized. After the removal of the nuclear fraction, each of these homogenates was digested with protease. After digestion, the supernatants of the reaction mixtures were applied to a Sephadex-G-100 column. The radioactivity was eluted with buffer solution. The resultant eluates were analyzed for radioactivity and the levels of proteins, uronic acids, and sialic acids. In all four organs, sizable amounts of ⁶⁷Ga were bound to sulfated acid mucopolysaccharides with molecular masses of about 10,000 daltons and to sulfated acid mucopolysaccharides, a species whose molecular masses exceed 40,000 daltons. In the stomach, large amounts of ⁶⁷Ga were bound to sulfated acid mucopolysaccharides with molecular masses of about 10,000 daltons. from these results, it is obvious that the main ⁶⁷Ga-binding substances in these four organs are sulfated acid mucopolysaccharides, and that these acid mucopolysaccharides play the most important role in the concentration of ⁶⁷Ga in these organs.     

Effects of red blood cell concentrate transfusion on blood tacrolimus concentration

Background Elevated blood concentration of tacrolimus is frequently observed following transfusion of red blood cell concentrate in patients after allogeneic hematopoietic stem cell transplantation. Objective The aim of this retrospective study was to clarify the effects of transfusion of red blood cell concentrate on the blood concentration of tacrolimus. Setting Chiba University Hospital in Japan. Method Fifty-two patients (aged 0–65 years) receiving both tacrolimus and transfusion after allogeneic hematopoietic stem cell transplantation were enrolled. The ratio of measurement after transfusion to measurement before transfusion was calculated for hematocrit and blood concentration/dose ratio of tacrolimus (termed the hematocrit ratio and the tacrolimus ratio, respectively). Main outcome measure Change in blood concentration/dose ratio of tacrolimus and variable factors associated with variation in tacrolimus ratio. Results The blood concentration/dose ratio of tacrolimus was increased after transfusion compared with before transfusion (p?<?0.001). A statistically significant correlation was seen between the hematocrit ratio and tacrolimus ratio (r?=?0.32, p?<?0.001). Hematocrit ratio, age or body surface area, and difference in aspartate aminotransferase level before and after transfusion were associated with the variation in tacrolimus ratio. There was no correlation between tacrolimus ratio and change in serum creatinine or potassium level in the short term. Conclusion Change in the blood concentration/dose ratio of tacrolimus was associated with change in the hematocrit ratio after transfusion, and more attention is required for children or patients with small body surface area. Dose adjustment of tacrolimus is required if the blood concentration of tacrolimus is much higher than the target concentration.