Urinary kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin as early biomarkers for predicting vancomycin-associated acute kidney injury: a prospective study.

OBJECTIVE: Previous studies have demonstrated that urinary kidney injury molecule-1 (uKIM-1) and neutrophil gelatinase-associated lipocalin (uNGAL) were superior to serum creatinine (Scr) in detecting acute kidney injury (AKI), but their ability to predict clinical vancomycin-associated AKI has not been investigated. This study aimed to investigate the abilities of uKIM-1 and uNGAL individually and in combination to predict vancomycin-associated AKI. PATIENTS AND METHODS: Scr, uKIM-1, and uNGAL were measured on the day before and days 1, 2, and 3 of vancomycin therapy in a generalized adult population. Levels of these biomarkers between AKI and non-AKI groups were comparatively analyzed. Predictive performances were evaluated by receiver operating characteristic curve (ROC) analysis. RESULTS: A total of 87 patients were enrolled, and among them, 11 (12.6%) patients developed AKI. Urinary KIM-1 and NGAL levels in the AKI group were higher than in the non-AKI group at all time points (p < 0.05), and the areas under the receiver operating characteristic curves (AUC) were 0.849 (95% confidence interval [CI] 0.750-0.948) for uKIM-1 and 0.824 (95% CI 0.726-0.922) for uNGAL, with cut-off values of 1.72 ng/mL and 9.07 ng/mL respectively. The AUC of uKIM-1 and uNGAL combined was 0.852 (95% CI 0.754-0.949), and the sensitivity and specificity were 90.9% and 75.0%, respectively. CONCLUSIONS: Urinary KIM-1 and NGAL could efficiently discriminate patients with or without vancomycin-associated AKI earlier than Scr, and the combined urinary biomarkers showed fair discrimination compared with the individual biomarkers.

On-line nanoliter cycle sequencing reaction with capillary zone electrophoresis purification for DNA sequencing.

An integrated system for DNA sequencing based on a nanoreactor for cycle-sequencing reaction coupled with on-line capillary zone electrophoresis (CZE) for purification and capillary gel electrophoresis (CGE) for separation is presented. Less than 100 nl of premixed reagent solution, which includes dye-labeled terminator pre-mix, bovine serum albumin and template, was hydrodynamically injected into a fused-silica capillary (75 microm I.D.) inside a laboratory-made microthermocycler for cycle sequencing reaction. In the same capillary, the reaction products were purified by CZE followed by on-line injection of the DNA fragments into another capillary for CGE. Over 540 base pairs (bp) of DNA can be separated and the bases called for single-standed DNA with 0.9% error rate. The total time was about 3.5 h, or a cycle time of 2 h with staggered operation. For double-stranded DNA, a longer reaction time was required and base calling up to 490 bp with 1.2% error rate was achieved. The whole system is readily adaptable to automated multiplex operation for DNA sequencing or polymerase chain reaction analysis.

Integrated electroosmotically-driven on-line sample purification system for nanoliter DNA sequencing by capillary electrophoresis.

An integrated on-line system is developed for DNA sequencing at the nanoliter scale. The technique involves the use of a nanoreactor for small-volume cycle-sequencing reaction, capillary zone electrophoresis (CZE) for purification of the sequencing fragments, and capillary gel electrophoresis (CGE) for separation of the purified DNA fragments. The nanoreactor and CZE are integrated into one capillary, where a 100-nl dye-labeled terminator cycle-sequencing reaction is carried out followed by CZE to separate excess dye-labeled terminators from the sequencing fragments. On-line electrokinetic injection of the purified DNA fragments into the CGE system is accomplished at a small-volume tee connector by which the CZE capillary is interfaced to the CGE system. The utility of the system is demonstrated in sequencing nanoliter volumes of single-stranded DNA (M13mp18) and double-stranded DNA (pGEM). The use of voltage to drive both CZE and CGE makes it feasible for automation and future adaptation of the whole system to a microchip.

Automated one-step DNA sequencing based on nanoliter reaction volumes and capillary electrophoresis.

An integrated system with a nano-reactor for cycle-sequencing reaction coupled to on-line purification and capillary gel electrophoresis has been demonstrated. Fifty nanoliters of reagent solution, which includes dye-labeled terminators, polymerase, BSA and template, was aspirated and mixed with the template inside the nano-reactor followed by cycle-sequencing reaction. The reaction products were then purified by a size-exclusion chromatographic column operated at 50 degrees C followed by room temperature on-line injection of the DNA fragments into a capillary for gel electrophoresis. Over 450 bases of DNA can be separated and identified. As little as 25 nl reagent solution can be used for the cycle-sequencing reaction with a slightly shorter read length. Significant savings on reagent cost is achieved because the remaining stock solution can be reused without contamination. The steps of cycle sequencing, on-line purification, injection, DNA separation, capillary regeneration, gel-filling and fluidic manipulation were performed with complete automation. This system can be readily multiplexed for high-throughput DNA sequencing or PCR analysis directly from templates or even biological materials.

Multiplexed capillary zone electrophoresis and micellar electrokinetic chromatography with internal standardization.

Although liquid chromatography and gas chromatography are the main workhorses in the analytical laboratory, samples can only be analyzed consecutively in an instrument. In this study, capillary zone electrophoresis and micellar electrokinetic chromatography separations are performed in a 96-capillary array system with laser-induced fluorescence detection. Migration times of four kinds of fluoresceins and six polyaromatic hydrocarbons (PAHs) are normalized to one of the capillaries using two internal standards. The relative standard deviations after normalization are 0.6-1.4% for the fluoresceins and 0.1-1.5% for the PAHs. Quantitative calibration of the separations based on peak areas is also performed, again with substantial improvement over the raw data. This opens up the possibility of performing massively parallel separations for high-throughput chemical analysis for process monitoring, combinatorial synthesis, and clinical diagnosis.

Simultaneous genetic typing from multiple short tandem repeat loci using a 96-capillary array electrophoresis system.

Short tandem repeat (STR) markers are highly polymorphic and widely used in human identification and genetic mapping. We demonstrate fast and reliable genotyping based on the four STR loci vWF, THO1, TPOX, CSF1PO by multiple-capillary array electrophoresis. Extracted human genomic DNA was amplified by polymerase chain reaction (PCR). The PCR products were mixed with pooled allelic ladder as an absolute standard and coinjected from a 96-vial tray. Separations were performed in polyvinylpyrrolidone (PVP) sieving matrix with a one-hour turnaround time, with no degradation over 27 runs. Simultaneous one-color laser-induced fluorescence detection was achieved by using a charge-coupled device (CCD) camera. The allele peaks for the unknown sample were identified by comparing the normalized peak intensities of the mixtures to those of the pooled ladder by using a straightforward algorithm. An extremely high level of confidence in matching the bands was indicated with negligible crosstalk (< 0.89%) between adjacent capillaries. This scheme is applicable for STR genotyping with high resolution, high speed and high throughput.

Fast DNA separations using poly(ethylene oxide) in non-denaturing medium with temperature programming.

We demonstrated fast DNA separations in low viscosity entangled solutions with a temperature gradient in a non-denaturing separation medium. The separations were carried out in a solution of commercially available poly(ethylene oxide) (PEO) [1 x Tris(hydroxymethyl)aminomethane borate buffer, without urea] with a temperature gradient of 2 degrees C/min. The performance was compared with that of a solution of PEO with urea at ambient temperature. We found that the former condition gives sufficient resolution for accurate base calling and that in general, it gave better separation for fragments larger than 450 base pairs (bp). Most importantly, the separation speed approaches 30 bp/min. In addition, we describe a simple yet reliable gel preparation protocol for such separations.

Adjustment of precompression force to reduce mixing-time dependence of tablet tensile strength.

The dependence of tablet tensile strength on lubricant mixing time, pre- and main compression pressure was measured with microcrystalline cellulose, dicalcium phosphate dihydrate and starch 1500 on a rotary tablet machine. Loss of tablet tensile strength arising from lubricant overmixing can be substantially reduced in the case of microcrystalline cellulose by adjustment of pre- and main compression. This facility may be used in addition to or instead of reducing mixing time, or displacing lubricant by adding extra formulation components.