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Lab Tech Charged

A former lab technician at Exeter Hospital in New Hampshire is being charged in connection with a hepatitis C outbreak at the hospital, Reuters reports. David Kwiatkowski, who worked in the cardiac catheterization unit there, is being charged with fraudulently obtaining controlled substances and tampering with a consumer product. Prosecutors say Kwiatkowski stole syringes of Fentanyl, injected himself with the drug, and then replaced it with saline, which was eventually given to patients. In the process, Kwiatkowski allegedly infected patients who received the saline with hepatitis C. Reuters add that the outbreak is thought to have affected 30 people.

July 25, 2012

This Week in the Journal of Clinical Pathology

Researchers led by Isao Okayasu at Kitasato University School of Medicine in Kanagawa, Japan, report in the Journal of Clinical Pathology that overexpression of L-type amino acid transporter 1, or LAT1, in pancreatic ductal adenocarcinomas is predictive of poor prognosis. The researchers examined LAT1 expression in various pancreatic cancers and found that "AT1 overexpression was related to poor prognosis in each group divided by tumour differentiation, size and surgical margin status," they write. Further, the researchers "propose that elevated LAT1 expression in PDAC is a novel biomarker for high-grade malignancy independent of Ki-67 LI."

Also in the Journal of Clinical Pathology, researchers from Korea University and Korea University College of Medicine write that multi-photon microscopy can be used to determine the relative levels of copper and zinc ions in colon neoplasms. Cu(I) and Zn(II) ions are cofactors of superoxide dismutases. As such, changes in their concentrations may be linked to neoplasm and malignancies. "The Cu(I)/Zn(II) ratio increased 3.5-fold from normal to adenoma/adenocarcinoma tissue," the researchers write. "This result suggests that a high Cu(I)/Zn(II) ratio is indicative of colon adenocarcinoma."

July 25, 2012

Accuracy Versus Access

Having access to a diagnostic test may be better for public health than having a test that is more accurate but unavailable to much of the public, says MedPage Today. A computer simulation, presented as a poster at the Alzheimer's Association International Conference, "indicated that more patients would receive proper treatment with a test of medium accuracy and low access problems, compared with a highly accurate test that fewer patients actually receive," MedPage Today reports.

July 24, 2012

This Week in Modern Pathology

Researchers from Johns Hopkins University School of Medicine and University Medical Center Utrecht in The Netherlands report in Modern Pathology that mutations in ATRX or DAXX and alternative telomere lengthening occur late in pancreatic neuroendocrine tumor development. Focusing on samples from patients with multiple endocrine neoplasia-1 syndrome — who are predisposed to developing pancreatic neuroendocrine tumor due to a MEN-1 mutation — the researchers examined ATRX and DAXX protein expression as well as telomere status in 109 lesions. They found that ATRX and/or DAXX expression loss correlated with the alternative telomere lengthening phenotype and that those events occurred only in patients with tumors larger than three centimeters.

Also in Modern Pathology, researchers led by Northwestern University Feinberg Medical School's Jian-Jun Wei report their analysis of MIR182 expression — a negative regulator of BRCA1 — in ovarian carcinoma. The researchers looked at MIR182 expression as well as the expression of its downstream target genes in patients with advanced ovarian cancer and found that MIR182 and HMGA2 were expressed at higher levels in high-grade serous ovarian carcinoma while BRCA1 expression was decreased. Further, the researchers say that of MIR182's targets, HMGA2 was associated with serous carcinomas, ascites, and a higher death rate. "Although we found a significant dysregulation of other selected genes in ovarian cancer, correlation between MIR182 and its target genes has not been established, indicating a complex regulation of these genes in ovarian cancer and lower sensitivity for semiquantitative immunohistochemical scores," Wei and his colleagues write.

July 24, 2012

In the Lab

Philip Wurth, a medical technologist in Pennsylvania, tells the local The Patriot-News that he chose to become a clinical lab technician after seeing that it involved interesting coursework and was a stable career path. "The clinical lab is a high volume, low error workplace, where continuing education and rapid error resolution are taken seriously. Working in this environment gives me a great sense of accomplishment and constant improvement," Wurth says. He adds that it's a good career for people who can "multitask and function in an at-times high-stress workplace."

July 23, 2012

This Week in Clinical Chemistry

Researchers led by the University of California, Los Angeles' David Wong report their transcriptome profiling of RNA isolated from saliva in Clinical Chemistry. Using the SOLiD system, the researchers analyzed RNA from cell-free saliva and whole saliva from healthy volunteers, finding that about a quarter of the cell-free saliva reads aligned to the human genome, while nearly a third aligned to the Human Oral Microbiome Database. "A single measurement provided RNA sequence information of gene transcript abundance for both coding and noncoding RNAs and identified sequences from [more than] 400 different microbial species within a single sample," the researchers write, adding that "the high degree of sequence alignment to annotated exons and introns for each of the respective reference genomes, with sequence coverage spanning the full length of the genes, provides strong evidence that the salivary transcriptome is a complex RNA network."

Also in Clinical Chemistry, French researchers evaluate the use of serum S100B as a biomarker of mild traumatic brain injury in children. They examined the levels of serum S100B in 446 children and saw "a linear increase in serum S100B concentration according to the severity of" brain injury. The researchers add that "after validation in a multicenter study that includes a high number of cases with abnormal CCT and bad CE, this determination could avoid unnecessary irradiation, produce hospital cost savings, and reduce the duration of mTBI management in pediatric emergency departments."

July 23, 2012

Finding MRSA

In the Journal of Clinical Microbiology, researchers at University Hospital Heidelberg in Germany evaluate how well the new BD Max MRSA assay can detect low-prevalence methicillin-resistant Staphylococcus aureus as compared to BD's GeneOhm MRSA achromopeptidase assay. The Max MRSA assay had a 93.9 percent sensitivity and a 99.2 percent specificity while the GeneOhm MRSA ACP assay 93.8 percent sensitivity and 98.3 specificity, though the researchers note that the differences were not statistically significant. Upon retesting, the Max MRSA test could resolve all samples while the GeneOhm MRSA ACP tests could not. In addition, the researchers point out that GeneOhm MRSA ACP assay took less time to deliver results, though it needed more hands-on time than the Max MRSA test did.

"This study shows that within a routine clinical setting in a population with low MRSA prevalence the fully automated BD Max MRSA assay and the established BD GeneOhm MRSA ACP assay have similar sensitivity and specificity characteristics," the researchers conclude. "The BD Max MRSA assay produced less unresolved results, had fewer false positive results and showed reduced handling requirements thereby facilitating use of this molecular assay."

July 20, 2012

Slight Growth for LabCorp

Laboratory Corporation of America has reported second quarter 2012 revenue of $1.42 billion, a 1.4 percent increase as compared to second quarter 2011's $1.4 billion. LabCorp also updated its expected revenue growth for 2012 to about 2 percent to 3 percent. "We delivered a solid quarter given that we continue to face a low-volume-growth environment," says David King, the chairman and CEO of LabCorp, in a statement. "We continued to build for the future as we received clearance to proceed with our acquisition of MedTox Scientific, which will broaden our expertise in esoteric toxicology testing. At the same time we achieved earnings growth through disciplined expense management, particularly in selling, general and administrative expenses." Net earnings for the quarter were $153.3 million, the company says.

The Sample's sister publication GenomeWeb Daily News has more here.

July 20, 2012

This Week in the Journal of Molecular Diagnostics

Alicia Goldman from Baylor College of Medicine and her colleagues present their approach to using alternative tissue sources, or ATS, such as fingernail clippings or blood spots, to collect DNA in the Journal of Molecular Diagnostics. The researchers compared, in parallel, the DNA quality, quantity, and genomics diagnostic ability of such alternative samples to conventional samples. "It was interesting to find that ATS were comparable to blood and other tissue samples that, with the exception of FFPE, are historically considered ideal specimens," Goldman and her colleagues write. "The ease of collection, storage, and lower cost of sample shipment and extraction make ATS a valuable resource to stand alone or complement other specimens that may be limited in quality, scope, or yield."

In a review in the Journal of Molecular Diagnostics, Patrick Murray from Becton Dickinson Diagnostic Systems in Sparks, Md., writes MALDI-TOF mass spectrometry can be used to identify microorganisms. He acknowledges that such an approach is not practical for routine identification purposes, though it would be useful for determining what uncommon microorganisms are. "MALDI-TOF MS offers the possibility of accurate, rapid, and inexpensive identification of microorganisms," he writes adding that "efforts by both users and manufacturers of commercial systems to include less commonly isolated organisms in the identification databases will further expand the utility of MALDI-TOF MS."

July 20, 2012

Flat Revenue at Quest Diagnostics

Quest Diagnostics had second quarter 2012 revenue of $1.91 billion, barely higher than last year's $1.9 billion for the second quarter, reports the Associated Press. The company also changed its prediction of 2012 revenue growth from 2 percent to 2.5 percent growth to 1 percent to 2 percent growth, indicating predicted revenue of $7.59 billion to $7.66 billion.

"Quest Diagnostics delivered earnings growth and margin expansion in the quarter, despite revenues that were essentially unchanged from a year ago," says Steve Rusckowski, president and CEO of Quest, in a statement. "We are accelerating our efforts to drive productivity improvements, reduce costs and restore revenue growth. And we remain focused on increasing shareholder returns through a combination of improved operating performance and disciplined capital deployment."

The company's net income increased 9 percent for the second quarter of 2012.

The Sample's sister publication GenomeWeb Daily News has more here.

July 19, 2012

This Week in Pathology

In Pathology, New Zealand researchers say that increased expression of the mitochondrial Tu translation elongation factor, or TUFM, may be a prognostic marker in colorectal cancer. They analyzed TUFM protein expression in 123 colorectal cancer cases and found that "increased expression of TUFM in CRC was associated with a significantly poorer cancer specific survival," though it was not associated with the stage of the disease.

Researchers led by Kyoung-Mee Kim at Sungkyunkwan University School of Medicine in Seoul, Korea, present their mutational screening of gastrointestinal stromal tumors using a mass spectrometry-based panel of multiplex assays in the journal Pathology. The researchers screened 22 GIST tumor samples for 390 mutations in 30 genes and compared those findings to those from Sanger sequencing. The panel could detect 48 percent of the KIT and 72 percent of the PDGFRA mutations in the Catalogue of Somatic Mutations in Cancer database, the researchers write. However, while the panel could detect 100 percent of the missense mutations found in KIT, it could only detect 17 percent of the deletion mutations. "In conclusion, mutations of oncogenes other than KIT or PDGFRA are rare among Korean GISTs. The MassARRAY approach alone is not sufficient to screen deletion mutations in GISTs," the researchers add.

July 19, 2012

More Molecular Diagnostics

With its purchase of the genetic testing company Navigenics, Life Technologies is building "its molecular diagnostics business through internal development, partnerships, and select acquisitions," the company says in a press release. Life Tech adds that Navigenics will bring infrastructure — including a CLIA lab — and expertise to Life Tech's molecular diagnostics business.

Ronnie Andrews, president of medical sciences at Life Tech, said at a press conference held at the American Association for Clinical Chemistry's annual meeting that this acquisition is the first of several that will "allow us to immediately address unmet medical needs," as the Sample's sister publication GenomeWeb Daily News reports. GWDN has more on Life Tech's announcement and plans here.

July 18, 2012

This Week in the Journal of Clinical Pathology

In the Journal of Clinical Pathology, Daniel Ezra at Moorfields Eye Hospital NHS Trust and his colleagues report that there are changes in the expression levels of genes in the Wnt and IGF-1 signaling pathway that are associated with thyroid-associated orbitopathy, or TAO. In their case-controlled study, the researchers examined gene expression levels in orbital fat samples from patients with untreated, active, inflamed TAO and from controls without TAO. Ezra et al. report that a number of genes, including IGF-1 and its receptor binding genes and downstream regulator genes, are differentially expressed in TAO, and that genes in the Wnt signaling pathway are dysregulated. The authors note that their report is the first to implicate IGF-1 signaling in TAO.

Also in the Journal of Clinical Pathology, the Charité-Universitätsmedizin Berlin's Carsten Denkert and his colleagues evaluated the performance of the RNA-based EndoPredict multigene test on evaluating core biopsies and surgical specimens of breast cancer. The researchers report that while the core biopsies yielded less RNA, the EndoPredict scores were comparable. "The data suggest that the EndoPredict score can be reliably determined in core biopsy specimens," they add.

July 18, 2012