Preparation of a purified fibrinogen calibration material for Clauss method and turbidimetric immunoassay possessing biological activity and antigenicity

Fibrinogen plays a major role in basic coagulation tests such as prothrombin time (PT), activated partial thromboplastin time (APTT) and thrombin time (TT). These show high interlaboratory variation because of inaccurate instrumental calibration. The same is true of the fibrinogen assay, despite its being a quantitative assay. Most medical laboratories use automated coagulometers and commercially available calibration materials (calibrators) to obtain an accurate fibrinogen value, but, when checked, calibrators have been found to deviate from the assigned value. The Japan Society of Laboratory Medicine (JSLM) has identified the need for a reliable plasma fibrinogen standard. To enhance the reliability of calibrator fibrinogen values and thereby remedy the poor precision and accuracy of plasma fibrinogen testing, we undertook the preparation of a standard calibration material applicable to both the Clauss method and turbidimetric immunoassay (TIA). The calibrator was prepared from fresh human plasma by glycine precipitation and virus inactivation followed by affinity chromatography to remove contaminated plasminogen. In the resulting product, clottable fibrinogen accounted for 95% of total protein and within-run precision showed a CV of less than 1.8%. We believe the preparation will become a candidate material for laboratory and manufacturer use in Japan.

Synthesis of silver dendritic nanostructures protected by tetrathiafulvalene

Silver dendritic nanostructures protected by tetrathiafulvalene (TTF) were synthesized via reduction of silver ions with TTF in acetonitrile.

Synthesis of poly(vinylene-arsine)s: alternating radical copolymerization of arsenic atomic biradical equivalent and phenylacetylene

Novel organoarsenic polymers, poly(vinylene-arsine)s, were synthesized by a free-radical alternating copolymerization of phenylacetylene with cyclooligoarsines as an atomic biradical equivalent. The polymerization between pentamethylpentacycloarsine (1a) or hexaphenylhexacycloarsine (1b) with phenylacetylene (2) in the presence of a catalytic amount of AIBN (in benzene; refluxing; for 12 h) gave the corresponding poly(vinylene-arsine)s. The obtained polymers were soluble in common organic solvents such as THF, chloroform, and benzene. From gel permeation chromatographic analysis (chloroform, PSt standards), the number-average molecular weights of the polymers from 1a and 1b were found to be 11500 and 3900, respectively. The structures of the polymers were supported by 1H and 13C NMR spectroscopies. The corresponding polymer was also obtained by irradiation of a benzene solution of 1a and 2 with xenon lamp at room temperature. After the polymer from 1a was stirred vigorously with 30% H2O2, the 1H NMR spectrum of the polymer showed the methyl proton that was assigned to As(III)-Me, suggesting the insensitivity of the trivalent state arsenic in the main chain to the oxidation. The structures and the molecular weights of the polymers were insensitive to the feed ratio of the monomers. This result indicates that the addition of the arsenic radical to phenylacetylene was a rate-determining step in the copolymerization.

Wavelet and receiver operating characteristic analysis of heart rate variability

Multiresolution wavelet analysis has been used to study the heart rate variability in two classes of patients with different pathological conditions. The scale dependent measure of Thurner et al. was found to be statistically significant in discriminating patients suffering from hypercardiomyopathy from a control set of normal subjects. We have performed Receiver Operating Characteristc (ROC) analysis and found the ROC area to be a useful measure by which to label the significance of the discrimination, as well as to describe the severity of heart dysfunction.

Preparation of a novel core-shell nanostructured gold colloid-silk fibroin bioconjugate by the protein in situ redox technique at room temperature

A novel core-shell gold colloid-silk fibroin (SF) bioconjugate was prepared by the protein in situ redox technique at room temperature, in which the tyrosine (Tyr) residue of the SF, having strong electron donating properties, in situ reduced Au(III) ions to Au colloids showing a stable and highly monodispersed nature.

Fetal and maternal lactate increase during active second stage of labour

OBJECTIVE

To determine longitudinally fetal and maternal blood lactate concentrations during the second stage of labour.

DESIGN

Prospective, observational study of randomly selected labours.

SETTING

Labour ward, Sultanah Aminah General Hospital, Johore Bahru, Malaysia.

MAIN OUTCOME MEASURES

Fetal scalp and maternal venous blood lactate, umbilical arterial and vein lactate and acid-base balance at delivery.

RESULTS

Sixty-nine women and their infants were monitored in the second stage of labour. Mean maternal venous lactate by the end of the first stage was 2.6 +/- 1.0 (+/- S.D.) mmol/L and increased to 3.6 +/- 1.4, 4.2 +/- 1.7. 4.8 +/- 1.6, 5.4 +/- 2.1 and 4.3 +/- 0.9 mmol/L, respectively, for every 15 minute of bearing down. Corresponding values for fetal scalp blood lactate were 2.4 +/- 1.1, 3.1 +/- 1.6, 3.2 +/- 1.8, 4.2 +/- 2.4, 4.9 +/- 2.8 and 5.8 +/- 1.9 mmol/L. The mean slope of maternal lactate increase was 0.070 mmol/L per minute (95% CI 0.050, 0.090) and for fetal lactate increase 0.032 mmol/L per minute (95% C.I.: 0.018, 0.045). The duration of active second stage was significantly associated with fetal lactate (P < 0.001) and maternal lactate (P = 0.03) at the time of crowning of the fetal head, and lactate in umbilical arterial and vein blood at delivery (P < 0.001). Expulsion time > or = 45 minutes, compared with shorter active second stage, and acidaemia at birth implied larger arterial-venous lactate differences (P < 0.001). Fetal lactate at crowning was also significantly associated with the umbilical arterial-veonus lactate difference (P = 0.03).

CONCLUSIONS

Maternal and fetal lactate concentrations increase significantly with duration of the active second stage of labour, more rapidly in the mother. It is likely that fetal anaerobic metabolism is the main source for the fetal lactate increase.