Annals of clinical and laboratory science
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Ann. Clin. Lab. Sci. · Jan 2008
Influence of Nrf2 genotype on pulmonary NF-kappaB activity and inflammatory response after traumatic brain injury.
Inflammatory response plays an important role in the pathogenesis of acute lung injury (ALI) after traumatic brain injury (TBI). Nuclear factor erythroid 2-related factor 2 (Nrf2) is a key transcription factor that plays a crucial role in cytoprotection against inflammation. The present study explored the influence of Nrf2 genotype on the production of cytokines and on activation of transcription factors in a murine TBI model. ⋯ Nrf2 (-/-) mice were shown to have a greater increase in the lung wet/dry weight ratio compared to their wild-type Nrf2 (+/+) counterparts after TBI. This exacerbation of lung injury in Nrf2 (-/-) mice was associated with increased levels of TNF-alpha, IL-1beta, IL-6, ICAM-1, and their mediator, NF-kappaB. The results suggest that Nrf2 plays an important protective role in attenuating the pulmonary inflammatory response and NF-kappaB activation after TBI.
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Ann. Clin. Lab. Sci. · Jan 2008
Case ReportsPromyelocytic blast crisis of chronic myeloid leukemia during imatinib treatment.
A 32-yr-old man with the chronic phase of chronic myeloid leukemia (CML-CP) was treated with imatinib mesylate for 6 mo. The real-time quantitative reverse transcription PCR ratio for BCR/ABL in blood mRNA (BCR/ABL RT-QPCR) decreased from an initial value of 0.0159 to a low value of 0.0012 after 3 mo, indicating complete hematologic response. ⋯ Complete remission was achieved by therapy with all-trans retinoic acid (ATRA) and high-dose imatinib mesylate. Using retrospective PML/RARalpha RT-QPCR with a bone marrow specimen obtained at the initial diagnosis of CML-CP, we quantified the mRNA ratio as 0.000321, suggesting that the clonal evolution of PML/RARalpha translocation occurred early in the CML-CP.
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Ann. Clin. Lab. Sci. · Jan 2008
Case ReportsKidney injury molecule-1 expression identifies proximal tubular injury in urate nephropathy.
Urate nephropathy in children is uncommon, occurring mostly in those who have undergone chemotherapy or radiotherapy. The characteristic obstruction of distal nephron tubules by uric acid precipitates is considered key to the subsequent parenchymal injury. ⋯ In their renal biopsies, we demonstrate upregulation of kidney injury molecule-1 (KIM-1), a specific injury marker, in proximal tubular cells. This finding implicates a role for proximal tubular injury in urate nephropathy.
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Ann. Clin. Lab. Sci. · Jan 2008
Delta neutrophil index in automated immature granulocyte counts for assessing disease severity of patients with sepsis.
This study investigated the relationship between calculated immature granulocyte (IG) counts and the severity of sepsis. Coagulation parameters, fibrinolytic indices, bacterial isolation rates in blood cultures, and mortality were observed in 237 patients with suspected sepsis. The difference in leukocyte subfractions (delta neutrophil index; DN) identified by a cytochemical myeloperoxidase reaction and by a nuclear lobularity assay was determined with a blood cell analyzer (ADVIA 120, Siemens, Inc.). ⋯ Positive blood culture rate averaged 3.5-fold higher in patients with DN >40% vs the subgroup with low DN of 5-10%. The mortality rate of patients with DN >40% markedly exceeded the mortality rate of patients with DN of 5-10% (79% vs 15%, p <0.05). Thus, DN has implications for the severity of sepsis and may be valuable to assess the prognosis of patients with suspected sepsis.
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Ann. Clin. Lab. Sci. · Jan 2008
Case ReportsUse of bivalirudin to prevent thrombosis following orthotopic liver transplantation in a patient with Budd-Chiari syndrome and a history of heparin-induced thrombocytopenia.
Type II heparin-induced thrombocytopenia (HIT) is an immune-mediated syndrome that may arise in a time-dependent manner following heparin therapy, placing patients at significant risk for thromboembolic events. Therapy includes anticoagulation with a direct thrombin inhibitor and avoidance of heparin. ⋯ During the post-transplant graft function improvement, we observed a significant dose-effect alteration manifested by an increased bivalirudin dose requirement as factor V activity increased. This observation is an important consideration in the attempt to maintain an optimal balance between effective anticoagulation and a reduced risk of postoperative bleeding.