Backgrounds.Hepatitis C virus (HCV) exists as population of closely related genetic variants known as quasispecies. HCV quasispecies diversity is strongly influenced by host immune pressure on virus. Quasispecies diversity is expected to decline as host immune response to HCV decreases over natural course of progressing from chronic hepatitis C (CHC) to hepatocellular carcinoma (HCC).Methods.Ultradeep pyrosequencing (UDPS) was used to evaluate degree of quasispecies diversity in 49 patients infected with HCV including 26 with CHC and 23 with HCC. Whole structural protein of HCV genome was subjected to UDPS.Results.Shannon’s indices for quasispecies diversity in HCV E1 were significantly lower in patients with HCC than in those with CHC. 14 amino acid positions differed significantly between two groups. Area under curve of ROC analysis for differentiating HCC from CHC was >0.8 for all of 14 amino acid positions.Conclusion.HCV quasispecies diversity as indicator of declining host immune functions was easily assessed by UDPS technology. Shannon’s indices in 14 amino acid positions were found to differentiate between patients with CHC and those with HCC. Our data propose that degree of HCV quasispecies measured by UDPS might be useful to predict progression of HCC in chronic HCV patients.
The 2019 Kidney Disease Outcome Quality Initiative guidelines emphasize the importance of selecting dialysis based on the life expectancy of the patient. However, it is difficult to predict the life expectancy of a patient during arteriovenous fistula creation. We investigated whether neutrophil-to-lymphocyte, monocyte-to-lymphocyte, and platelet-to-lymphocyte ratios measured before dialysis could predict mortality. Between January 2016 and December 2020, we retrospectively analyzed electronic medical records of 448 patients aged ≥ 70 years undergoing first-time arteriovenous access surgery at three tertiary care hospitals, all of whom had not received prior dialysis treatment. Only patients undergoing blood tests on the day before surgery were included in the analysis. Patients who died within one year after surgery were included in the non-survival group, while those who died after one year were included in the survival group. Patients were categorized into non-survival (n = 52) and survival (n = 396) groups. Multivariate analysis for one-year mortality revealed that the preoperative neutrophil-to-lymphocyte ratio demonstrated a 1.15 hazard ratio ( p < 0.001 ). Also, cancer (HR 2.50, p = 0.02) and peripheral arterial disease (HR 4.62, p < 0.001) were risk factor for one-year mortality. The preoperative platelet-to-lymphocyte and monocyte-to-lymphocyte ratios were not identified as one-year mortality risk factors. In the total mortality multivariate analysis, monocyte-to-lymphocyte ratios were one of the risk factors (HR 2.74, p < 0.007). The neutrophil-to-lymphocyte ratio was a risk factor associated with one-year mortality in patients aged ≥ 70 years. However, further research is required to determine whether these can be used for predictive purposes.
Background: Cerebrospinal fluid (CSF) analysis is essential for diagnosing various disorders affecting the central nervous system (CNS). Traditionally, CSF cell count analysis is performed manually using a Neubauer chamber hemocytometer, which is labor-intensive and prone to subjective interpretation. Methods: In this study, we evaluated the analytical and clinical performance of the Microscanner C3, an automated cell counting system, for CSF analysis using artificially prepared samples and 150 clinical CSF samples. Results: The lowest detectable white blood cell (WBC) count was 3.33 cells/µL, and the lowest detectable red blood cell (RBC) count was 3.67 cells/µL. The coefficients of variation (CV%) for the Microscanner C3 were lower than those for the Neubauer chamber at all cell concentrations. The correlation coefficients (R) between the Microscanner C3 and conventional methods were high: 0.9377 for WBCs and 0.9952 for RBCs when compared with the Neubauer chamber, and 0.8782 for WBCs and 0.9759 for RBCs when compared with the flow cytometer. Additionally, the Microscanner C3 showed good agreement with both the Neubauer chamber and flow cytometer in the Passing–Bablok regression analysis and Bland–Altman analysis for WBC count at all concentrations and RBC count at concentrations of 0–1000 cells/µL. Conclusions: The Microscanner C3 proved to be more sensitive, precise, and consistent compared to the conventional hemocytometer. The new system is also compact, convenient, and cost-effective, making it a valuable option for clinical laboratories.