[Testicular Tumor in a Patient with Delta Thalassemia Complicated with Hereditary Persistence of Fetal Hemoglobin].

A 30s male was diagnosed as having the left testicular tumor in 2010. He received the anti-neoplastic chemotherapy, and could achieve the complete remission. But, he relapsed with solitary retroperitoneal lymph node swelling in 2012, and he was referred to our hospital. Laboratory examination on his admission showed the significant increase of fetal hemoglobin (HbF) up to 16.4%. But, neither anemia nor hemolysis was found at that time. Coexistence of therapy-related myeloid neoplasm or HbF production by metastatic lesion was not definite. Isoelectrofocusing of his hemolysate showed the faint HbA2 in addition to dense HbF band. Molecular analysis of his Hb gene revealed the homozygous (G)gamma-158 (C-T) together with homozygous delta-77(T-C). From these findings, he was diagnosed as having hereditary persistence of HbF (HPFH) and homozygous delta thalassemia. The precise incidence of such combined genetic variation has been unknown because the majority of such cases seem to show no significant clinical symptoms as our case. Whereas, it seems necessary to remind the possibility of such genetic variation when adult patients with various acquired diseases such as testicular tumor or hematologic malignancies show the elevated HbF level.

High-performance solution-processable N-shaped organic semiconducting materials with stabilized crystal phase.

N-shaped organic semiconductors are synthesized via four steps from a readily available starting material. Such semiconductors exhibit preferable ionization potential for p-type operation, thermally stable crystalline phase over 200 °C, and high carrier mobility up to 16 cm(2) V(-1) s(-1) (12.1 cm(2) V(-1) s(-1) on average) with small threshold voltages in solution-crystallized field-effect transistors.

Furan fused V-shaped organic semiconducting materials with high emission and high mobility.

We report a facile synthetic protocol for preparation of dinaphtho[2,3-b:2',3'-d]furan (DNF-V) derivatives. DNF-V derivatives showed high emissive behaviour in solid. A solution-crystallized transistor based on alkylated DNF-V derivatives showed an excellent carrier mobility of up to 1.3 cm(2) V(-1) s(-1), thereby proving to be a new solution-processable active organic semiconductor with high emission and high mobility.

V-shaped organic semiconductors with solution processability, high mobility, and high thermal durability.

V-shaped organic semiconductors have been designed and synthesized via a large-scale applicable synthetic route. Solution-crystallized films based on such molecules have demonstrated high-performance transistor properties with maximum mobilities of up to 9.5 cm(2) V(-1) s(-1) as well as pronounced thermal durability of up to 150 °C inherent in the V-shaped cores.

[Evaluation of MRSA rapid detection by real-time PCR directly from positive blood cultures].

Methicillin-resistant Staphylococcus aureus (MRSA), a well-known causative multidrug-resistant pathogen responsible for nosocomial and community-acquired infections, particularly in blood stream infection, often proves difficult and expensive to treat. Despite the need for rapid, accurate MRSA detection for treatment and infection control, conventional testing including culture, have sensitivity and turn-around time (TAT) problems. We evaluated BD GeneOhm MRSA Detection Kit rapid detection performance directly from positive blood culture using real-time PCR. The kit recognizes, a specific part of the staphylococcal cassette chromosome mec (SCCmec) gene, not a mecA gene. Compared to conventional culture in 138 samples with gram stains showing gram-positive cocci (GPC) clusters, the kit's sensitivity was 100%, specificity 97.3%, positive predictive value 90% and negative predictive value 100%. Three of the 27 MSSA isolates found was false-positive, indicating that the kit detected SCCmec/orfX region sequences lacking mecA. Coupled with direct tube coagulase testing to rapidly differentiate MRSA from methicillin-susceptible S. aureus (MSSA) could provide optimum treatment through appropriate antibiotic use. The kit thus appears to be useful in rapidly diagnosing MRSA from blood culture, improving the prognosis and reducing medical cost.

[Evaluation of the MRSA rapid detection assay (BD GeneOhm MRSA detection kit) by a real-time PCR].

Methicillin-resistant Staphylococcus aureus (MRSA) is well known to be a causative pathogen of skin and soft tissue or blood stream infections, and also to be a nosocomial drug-resistant bacteria in healthcare settings. Although a rapid and accurate detection of MRSA is indispensable for infection control, the conventional tests including culture method have some problems of sensitivity, procedure time, and so on. We evaluated the performance of the rapid detection assay of MRSA (BD GeneOhm MRSA Detection Kit) directly from specimens by a real-time PCR. The principle of this kit is characterized by recognizing not a mecA gene, but a specific part of SCCmec gene. Limits of detection of this method was 810 CFU/mL. Compared to the results of mecA PCR assay in 105 clinically isolated samples, the sensitivity, specificity, positive predictive value and negative predictive value were 100%, 97.4%, 98.5% and 100%, respectively. One of the 38 mecA negative isolates was found to be a positive result, this finding suggested that this method detect sequences of SCCmec/orfX region lacking of mecA. Because of the rapid turn-around time and the excellent negative predictive value, this method appears to be a useful tool for rapid diagnosis of MRSA.

[Establishment of a microbiology laboratory open 365 days a year and its impact].

The microbiology laboratory of our university hospital aims to provide accurate and rapid microbiological results and useful information for healthcare workers involved in both the treatment of infectious diseases and infection control. For this purpose, we have been running a microbiology laboratory open 365 days a year since 2005. Before starting this laboratory, we formulated both a precise procedural manual and educational program to increase the number of microbiological technologists from 4 to 8 persons and improve their skills. Moreover, we reviewed the reporting system. As a result, we could report positive blood cultures up to 1.4 days earlier than previously possible, and significantly improved the prognosis of MRSA bacteremia patients by the early treatment of anti-MRSA antimicrobials within 48 hours after positive blood culture. In addition, the rate of MRSA/Staphylococcus aureus decreased to 35.8%. It is essential for the treatment of infectious diseases and infection control to accept only appropriate specimens and report the results rapidly and accurately.

[Microbiology laboratory as a base of information sending].

The goal of our microbiology laboratory is to provide an accurate microbiological result and a useful information for every healthcare workers (HCWs). For this purpose, we were trying to do several activities, such as improving the work-flow of microbiology testings, starting 365-day-open microbiology tests, providing some training courses of microbiology and sending many useful informations about infectious diseases and infection control. Before these activities, we needed another 5 microbiology technicians beside 3 technicians and had started the program to educate them. We have successfully finished it and enabled all plans begin in April, 2005. Since then we are open for 365 days and also sending HCWs many newsletters for performing effective microbiological testings via the intra-network system and having lectures for both doctors and nurses, especially for new resident doctors at the orientation. We had also the training course for certified infection control nurses and accepted two technicians from Africa, who came to study a basic microbiology via JICA. These activities have enabled every technician not only to report and analyze microbiological test result effectively but also to improve writing and presentation skills. Through these activities all technicians have realized that accurate and rapid information from a microbiology laboratory is a key to treat patients with infectious diseases and improve their prognosis. It is suggested that skill-up of technicians lead to report an accurate result in microbiology and at the same time improve the attitude for their job.

[Status of the clinical laboratory in the mandatory postgraduate medical training system: from the medical technologists' view (2)].

When the new system of mandatory postgraduate medical training was introduced, we developed a new training program in our clinical laboratory. We will describe this training program in the microbiology laboratory and our experience. We have had 45 min practice of basic microbiology tests, including Gram staining and microscopic examination, for first-grade postgraduate doctors since 2004, and during this practice we emphasize the importance of quality in the clinical specimens collected for cultures and at the same time, explain how to read microbiological test results. Although we had prepared a kit for the Gram-staining procedure to be used any time they want, it was very disappointing that no doctors used this kit to diagnose an infectious disease. In 2005, four 2nd grade doctors selected the training course in our clinical laboratory for 2 months and 3 of them have finished. In the microbiological laboratory we were in charge of the program for 1 or 2 weeks, which includes the isolation and identification of bacterial pathogens from clinical samples and their susceptibility tests, and the isolation, identification and nucleic acid amplification test for Mycobacterium tuberculosis. All of these trainees acquired the basic knowledge and skills required for microbiological diagnosis. This activity gave us a great opportunity to understand what they do not know and what they want to know. We now have some useful suggestions to develop a good education system for medical microbiology for postgraduate doctors.