Expert consensus regarding standardization of sample preparation for clotting time assays.

Accurate clotting time assay results are vital, as the test is employed to indicate the amount of oral anticoagulant to be prescribed, while it is also used for screening the hemorrhagic and thrombotic diseases. The procedure chosen for preparation of a patient blood sample including centrifugation can contribute to significant differences in the results obtained. Thus, for the purpose of proposing a standardized method to appropriately prepare blood samples prior to assay, the Japanese Society of Laboratory Hematology organized the Working Group for Standardization of Sample Preparation for Clotting Time Assays (WG).

[Measures to prevent patient identification errors in blood collection/physiological function testing utilizing a laboratory information system].

We constructed an integrated personal identification workflow chart using both bar code reading and an all in-one laboratory information system. The information system not only handles test data but also the information needed for patient guidance in the laboratory department. The reception terminals at the entrance, displays for patient guidance and patient identification tools at blood-sampling booths are all controlled by the information system.

Transaortic approach to residual ventricular septal shunt after repairing corrected transposition of the great arteries.

Many surgical approaches have been taken when closing ventricular septal defects after correcting transposition of the great arteries in order to avoid postoperative complete heart block. We describe a residual ventricular septal shunt that developed after repair using de Leval's method in a patient with congestive heart failure. The defect was closed transaortically without a complete heart block.

[Comparison of portable apnea monitors in the detection of apnea episode during daytime rest].

Although polysomnography (PSG) is the golden standard for the diagnosis of sleep apnea syndrome (SAS), access to this procedure is limited because it requires special institution and trained technicians. Therefore, many portable recording devices have been developed for detection of SAS including home monitoring. The present study evaluated the usefulness of four portable devices in detecting apneic events.

Modified primary sutureless repair of total anomalous pulmonary venous connection in heterotaxy.

Early and late mortality remain high after palliative open heart surgery in low-weight neonates. In addition, the need for neonatal repair and the presence of pulmonary venous obstruction are risk factors for mortality in right isomerism. We describe a modified primary sutureless repair of infracardiac total anomalous pulmonary venous connection in a 1,600 g neonate with heterotaxy.

[Utilization of panic values in our institution: hematological testing].

A panic value is defined as an abnormal value indicating a life-threatening situation. Hematological examination results are sensitive to changes in treatment, and are likely to be influenced by blood collection techniques. Panic values may directly influence the diagnosis in many cases because they are treated as clinical evidence.

Atypical infantile form of scimitar syndrome with bronchomalacia.

A male infant presenting with severe heart failure and respiratory distress was diagnosed with a hypoplastic right lung, scimitar syndrome with pulmonary sequestration and multiple anomalous systemic arteries, left bronchomalacia, a large atrial septal defect and coarctation of the aorta. The infant underwent a successful combined treatment of surgical and transcatheter intervention, including coil embolization and endobronchial stenting.

A rapid and quantitative D-Dimer assay in whole blood and plasma on the point-of-care PATHFAST analyzer.

The objective of this study was to evaluate the accuracy indices of the new rapid and quantitative PATHFAST D-Dimer assay in patients with clinically suspected deep-vein thrombosis (DVT). Eighty two consecutive patients (34% DVT, 66% non-DVT) with suspected DVT of a lower limb were tested with the D-Dimer assay with a PATHFAST analyzer. The diagnostic value of the PATHFAST D-Dimer assay (which is based on the principle of a chemiluminescent enzyme immunoassay) for DVT was evaluated with pre-test clinical probability, compression ultrasonography (CUS).

Enhanced vertical alveolar bone augmentation by recombinant human bone morphogenetic protein-2 with a carrier in rats.

This study aimed to evaluate the effect of recombinant human bone morphogenetic protein-2 (rhBMP-2) on vertical bone regeneration of edentulous ridge. Bilateral upper first and second molars of 8-week-old Wistar rats were extracted and the ridges were allowed to heal for 3 weeks. Compressed poly(lactic-co-glycolic acid) copolymer/gelatin sponge (PGS) was used as a carrier of rhBMP-2.

Differentiation of lymphatic endothelial cells from embryonic stem cells on OP9 stromal cells.

Objective: The discovery of vascular endothelial growth factor C (VEGF-C) and VEGF receptor-3 (VEGFR-3) has started to provide an understanding of the molecular mechanisms of lymphangiogenesis. The homeobox gene prox1 has been proven to specify lymphatic endothelial cells (ECs) from blood ECs. We investigated the process of lymphatic EC (LEC) differentiation using embryonic stem (ES) cells.

Prospective identification of cardiac progenitors by a novel single cell-based cardiomyocyte induction.

Dissection of cardiomyocyte differentiation process at the cellular level is indispensable in the research for cardiac development and regeneration. Previously, we have established an embryonic stem cell differentiation system that reproduces early vascular development from progenitor cells that express Flk1, a vascular endothelial growth factor receptor, by the combinatory application of 2-dimensional culture and flowcytometry. Here we show that cardiomyocytes can be successfully induced from a single Flk1+ cell on 2-dimensional culture, enabling the direct observation of differentiating cardiomyocytes and the prospective identification of cardiac progenitor potentials.

Left pulmonary arterioplasty--extended end-to-end anastomosis.

Surgical arterioplasty for left pulmonary branch stenosis often produces unsatisfactory results. We report a new operative approach involving a modification of end-to end anastomosis, providing a widely patent and nonredundant anastomosis.

Cusp extension technique for bicuspid aortic valve in Turner-like stigmata.

A 19-year-old girl with bicuspid aortic valve and Turner-like stigmata underwent a successful repair with a cusp extension technique using fresh autologous pericardium for aortic insufficiency. She also had a simultaneous artificial graft replacement for ascending aortic dilatation. Aortic valve function showed no significant stenosis and slight insufficiency 2 years postoperatively.

Evaluation of regional aortic distensibility using color kinesis.

Regional aortic stiffness cannot be evaluated by conventional methods. Regional aortic wall velocity during systole in the descending aorta was evaluated by using transesophageal echocardiography with color kinesis. The authors defined regional aortic distensibility (RAD) by considering pulse pressure, with RAD (microm/s/mm Hg) = (regional aortic wall velocity)/(pulse pressure).

Transannular patching for tetralogy of Fallot with an anomalous right coronary artery.

A 7-year-old girl underwent transannular patching under the mobilized anomalous right coronary artery across the right ventricular outflow to treat progressing infundibular stenosis 6 years after total repair of the tetralogy of Fallot. The procedure completely relieved recurrent stenosis. Simultaneous angiography of the coronary artery and right ventricle were useful in precisely evaluating coronary anatomy.

[Proceedings of the workshop "The future aspect of clinical hematology laboratory and the role of medical technologists"].

In the workshop of the 34th in-service training course for University Hospital Medical Technologists in 2000 sponsored by the Ministry of Education, all participants discussed future aspects of the clinical hematology laboratory and the role of medical technologists. We report here a summary of the discussion.

Suppression of the secretion of atrial and brain natriuretic peptide after total cavopulmonary connection.

Objectives: Among the modifications of the Fontan operation currently being used, total cavopulmonary connection offers the greatest potential for optimizing early and long-term postoperative outcomes. Although studies have established that abrupt increases in right atrial pressure elevate the plasma atrial natriuretic peptide level after the Fontan procedure, changes in plasma natriuretic peptide levels after total cavopulmonary connection have not been clarified. Our hypothesis is that secretion of atrial natriuretic peptide may be suppressed in patients undergoing total cavopulmonary connection because the atrium continues to function at low pressure in those patients.

[Midterm results of bilateral enlargement of the aortic valve ring for valve replacement].

From 1989, 4 patients underwent bilateral enlargement of the aortic valve ring for valve replacement. Age at the operation ranged from 2 to 8 (mean 6) years; body weight ranged from 14.9 to 25.