Capillary-based chemiluminescence immunoassay for C-reactive protein with portable imaging device.

A capillary-based chemiluminescence immunoassay system using a charge-coupled device (CCD) camera as detector was established in this paper. The fused quartz capillary was easily activated in one step for immobilizing capture antibody, and the chemiluminescence immunoassay was carried out in the capillary in double-antibody sandwich format. Chemiluminescence signals were recorded by the portable imaging device which was installed with the CCD camera and the results were analyzed through gray intensity. The total cost time, which included not only the time for test but also the time for the preparation of experimental materials, was only 2 h. The immunoassay was performed without any complicated or expensive instruments. The consumption of the sample was only 0.8 µL in one test, which was significantly less than other methods. In this work, C-reactive protein (CRP), as a target, was quantitatively detected from 0.3 to 160.0 µg mL-1 with high specificity and low sample volume. The reproducibility and accuracy were tested in clinic human serum samples and shown good results. Thus, this rapid, easy preparation and using, portable immunoassay system indicated its usefulness as a novel technology platform. Graphical abstract ᅟ.

Refractory Case of Takayasu Arteritis in a Young Woman: A Clinical Challenge.

Takayasu arteritis (TA) is an idiopathic chronic inflammatory vasculitis of the aorta and its main branches, which if not treated can lead to severe vascular damage and fatal vascular events. Glucocorticoids (GCs) are the mainstay of the therapy of TA but a significant proportion of patients tend to experience flare-ups when their GCs are tapered. We report a case of a 42-year-old female with TA, diagnosed according to the 1990 American College of Rheumatology Criteria for TA. Cardiovascular assessment showed normal carotid upstrokes with bilateral carotid bruits and soft right and left subclavian bruits with weak peripheral pulses. A computed tomography (CT) aortogram of the chest showed severe stenosis of bilateral subclavian arteries and mild stenosis of right and left common carotid arteries at the origin. A CT aortogram of the abdomen showed an occluded left renal artery, a very small left kidney, and mild narrowing of the abdominal aorta below the level of renal arteries.  She was initially managed with GCs along with immunosuppressive therapy including methotrexate, azathioprine, and cyclophosphamide, but her disease remained active. She was then sequentially treated with inhibitor etanercept (ETN), inhibitor tocilizumab (TCZ) and monoclonal anti-CD20 antibody rituximab (RTX), and in spite of aggressive biologic therapy she continued to have active disease. To the best of our knowledge, this is the first case of refractory TA treated sequentially with three different biologic drugs.

Comparing histopathological and magnetic resonance imaging based mesorectal fascia status in patients with rectal carcinoma.

OBJECTIVE: To compare mesorectal fascia status on histopathological findings with MRI based radiological mesorectal fascia status in patients with rectal carcinoma taking histopathology finding as gold standard. STUDY DESIGN: Analytical study. PLACE AND DURATION OF STUDY: Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, from January 2011 to April 2012. METHODOLOGY: Biopsy proven cases of rectal adenocarcinoma undergoing abdominoperineal resection were included in this study. Microscopic examination of slides was done to determine mesorectal fascia status as involved or otherwise without knowing the results of mesorectal fascia status on MRI. Mesorectal fascia status of MRI was determined by a radiologist who was not aware of the histopathological assessment of mesorectal fascia. Mean and standard deviation was calculated for age. Frequency and percentage were calculated for gender and mesorectal fascia status. 2 x 2 table was generated to calculate sensitivity, specificity, positive predictive value and negative predictive values and diagnostic accuracy of MRI for mesorectal fascia involvement taking histopathology as gold standard. RESULTS: The sensitivity of MRI to detect mesorectal fascia involvement was 23.07% and specificity was 70.5%. Positive predictive value of MRI was 10% and negative predictive value was 54.54%. Diagnostic accuracy of MRI for mesorectal fascia involvement was calculated as 50%. CONCLUSION: MRI findings regarding mesorectal fascia status as involved or otherwise are not helpful when compared with histopathological findings which is the gold standard.