[Influence of pre-analytical storage conditions on four plasma coagulation molecular markers measured using a STACIA automatic coagulation analyzer].

We investigated the effects of specimen storage conditions on the analysis of the coagulation molecular markers, soluble fibrin (SF), thrombin-antithrombin complex (TAT), thrombomodulin (TM) and tissue plasminogen activator inhibitor-1 complex (total PAI-1: tPAI). Marker levels were measured using a STACIA automatic coagulation analyzer. Among these four markers in blood from healthy subjects, only tPAI increased gradually with time, and the differences were especially marked when blood samples were stored at room temperature. Patient blood samples were stored for 4 hours under three different conditions: whole blood storage on ice, storage on ice after centrifugation, and refrigerated storage after centrifugation. Analytical results were compared between the three sets of samples. There were no significant differences in TAT or TM after 4 hours' storage under the different conditions. However, SF was decreased in several samples. In 11 of 14 samples with >20 microg/ml SF, SF levels were reduced by >10 microg/ml when whole blood without centrifugation was stored on ice. tPAI levels increased slightly after storage for 4 hours under all three conditions. These results suggest that centrifugation followed by refrigeration is the optimal storage method for blood samples when all four markers are to be measured simultaneously in the same sample.

[The application of fluorescence in situ hybridization to the peripheral-blood preparations].

The hematologic malignancy with specific chromosomal/genetic abnormality is separately classified by the WHO classification of tumors hematopoietic and lymphoid tissues. The chromosomal abnormalities, t (9; 22), t (8; 21), t (15; 17) and inv (16) are especially important for the establishment of therapeutic strategy and prognostication. We examined in this study, five cases were analyzed, because abnormal cells were recognized by the differential white blood count of the peripheral-blood and specific chromosomal abnormalities were suspected. Whether peripheral-blood preparations after May-Grünwald Giemsa staining could be used for fluorescence in situ hybridization (FISH). The fusion signals were detected in the high rate by using a peripheral-blood specimen in four cases, except for one case that had no specific chromosomal abnormality.

[Clinical trial and evaluation of a direct report system of panic values at Fukuoka University Hospital].

In order to support a faster and more informative clinical practice, we established the criteria for panic (critical) values regarding the blood concentrations of glucose, Na, K, Ca, inorganic phosphate (IP), Hb and number of platelets, and also created a system to report these values directly to the doctors in charge. We initiated this system in September 2003. In order to evaluate the availability of this system, we analyzed the clinical data during a one year period, based on the findings of patients showing panic values, mainly concerning the disease states and the correspondences by the doctors who were directly informed. We also carried out questionnaire surveys about the panic values and the new system for all of the doctors in our hospital (recovery rate: 84.3%). The total number of panic values reported was 113 and the mean percentage of the number of ordered examinations was 0.019%. After the report, 79 cases (69.9%) were examined again or treated, while 34 cases (30.1%) had already been treated or watched carefully at the time of the report. Malignant diseases were the main causes of increased panic values (38 cases), especially in the Na, K and blood glucose of patients. The next disease state, which appeared to demonstrate high rates, was chronic renal failure (16 cases), in the low K, high Ca, and low IP patients. Most of the cases of low Hb were caused from bleeding of the gastro-intestinal tract, with malignancies next. A blood infusion was performed for all of the cases with low Hb except for one. As a result of the questionnaire survey among the staff doctors, we confirmed that this system did indeed work efficiently, and 88% of the doctors who answered the questionnaires, were satisfied with the system. In conclusion, we established a new system, which made it possible for panic values to be directly reported to the doctor in charge and this system was then evaluated for its clinical usefulness.