Neonatal septicemia is one of the major causes of morbidity and mortality worldwide during the neonatal period. It can be classified into two subtypes: early-onset sepsis (EOS) and late-onset sepsis (LOS) depending upon the time of onset. In the western developed countries, group B Streptococcal and Escherichia coli are leading pathogens for EOS, while the most frequent microorganism involved in LOS is coagulase negative Staphylococci, which are different from the domestic data. Clinical manifestations of neonatal septicemia are not specific, so that it is often misdiagnosed. This review describes the progress in diagnostic methods for neonatal septicemia, including blood culture, blood cell counts, cytokine profiles and umbilical cord blood examinations. It provides useful information for early diagnosis and treatment of neonatal septicemia.
Blood Cell Count ; C-Reactive Protein ; analysis ; Calcitonin ; blood ; Cytokines ; blood ; Humans ; Infant, Newborn ; Protein Precursors ; blood ; Sepsis ; blood ; diagnosis

OBJECTIVETo evaluate the comparability and bias of the test results of two detection systems for serum procalcitonin (PCT) under the same laboratory condition.

METHODSAccording to the profile NCCLS-EP9-A, the two systems were used to detect PCT to obtain the correlation coefficient and the liner equation for evaluation of the test result bias.

RESULTS AND CONCLUSIONThe test results of PCT showed no significant difference between the two detection systems (P>005) with a kappa value greater than 0.75. The correlation coefficients of both systems were above 0.975, suggesting a consistency between them for clinical detection of PCT.

Bias ; Blood Chemical Analysis ; methods ; Calcitonin ; blood ; Calcitonin Gene-Related Peptide ; Humans ; Protein Precursors ; blood

Acute Disease ; Bacterial Translocation ; C-Reactive Protein ; analysis ; Calcitonin ; blood ; Child ; Humans ; Pancreatitis ; diagnosis ; etiology ; therapy ; Protein Precursors ; blood

No abstract available.
Biological Markers/*blood ; Carcinoma, Hepatocellular/*diagnosis ; Humans ; Liver Neoplasms/*diagnosis ; Protein Precursors/*blood ; Prothrombin ; Tumor Markers, Biological/*blood

OBJECTIVETo investigate serum procalcitonin (PCT) concentrations in premature infants with different gestational ages at different times after birth.

METHODSA total of 217 neonates without infection, including 102 premature infants and 115 full-term infants, were enrolled in this study. The premature infants were further divided by gestational age into three subgroups: 30-32 weeks (n=30), 33-34 weeks (n=35) and 35-36 weeks (n=37). All the infants were studied to evaluate serum PCT concentrations at 0-12, 13-24, 25-36, 37-48, 49-72, 73-96, 97-120 and 121-144 hours after birth.

RESULTSIn the newborns, serum PCT concentrations increased gradually after birth, reached peak values at about 24 hours after birth, and then gradually declined and dropped to normal values for children at about 96 hours after birth. In the premature infants, serum PCT concentrations reached peak values at about 36 hours after birth, later than in the full-term infants, then declined slowly and dropped to levels similar to the full-term infants at 96 hours after birth. Serum PCT concentrations in the 30-32 week subgroup remained at low levels after birth, and increased gradually, later than in other premature infants, at 37-48 hours after birth.

CONCLUSIONSEarly after birth, neonates have a changing serum PCT concentration, increasing first and then decreasing. Peak serum PCT levels appear later in premature infants than in full-term infants. Serum PCT concentrations of premature infants with a gestational age of under 32 weeks remain at relatively low levels within 36 hours after birth.

Calcitonin ; blood ; Calcitonin Gene-Related Peptide ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; blood ; Protein Precursors ; blood ; Time Factors

OBJECTIVEMeasurement of biomarkers is a potential approach to early prediction of the risk of mortality in patients with sepsis. The aim of the present study was to evaluate the prognostic value of pro-atrial natriuretic peptide (pro-ANP) and pro-adrenomedullin (pro-ADM) levels in a cohort of medical intensive care patients and to compare it with that of other known biomarkers and physiological scores.

METHODSBlood samples of 51 consecutive critically ill patients admitted to the intensive care unit and 53 age-matched healthy control people were evaluated in this prospective study. The prognostic value of pro-ANP and pro-ADM levels was compared with that of acute physiology and chronic health evaluation (APACHE) II scores and various biomarkers such as C-reactive protein, interleukin-6 and procalcitonin. Pro-ANP and pro-ADM were detected by a new sandwich immunoassay.

RESULTSOn admission, 25 patients had systemic inflammatory response syndrome (SIRS), 12 sepsis, 9 severe sepsis and 5 septic shock. At that time, the median levels (ng/ml) of pro-ANP and pro-ADM were 87.22 and 0.34 respectively in patients with SIRS, 1533.30 and 2.23 in those with sepsis, 1098.73 and 4.57 in those with severe sepsis, and 1933.94 and 8.21 in those with septic shock. With the increasing severity of disease, the levels of pro-ANP and pro-ADM were gradually increased. On admission, the circulating levels of pro-ANP and pro-ADM in patients with sepsis, severe sepsis, or septic shock were significantly higher in non-survivors than in survivors (P less than 0.05). In a receiver operating characteristic curve analysis for the survival of patients with sepsis, the areas under the curve (AUCs) for pro-ANP and pro-ADM were 0.89 and 0.87 respectively, which was similar to the AUCs for procalcitonin and APACHE II scores.

CONCLUSIONPro-ANP and pro-ADM are valuable biomarkers for prediction of severity of septic patients.

APACHE ; Adolescent ; Adrenomedullin ; blood ; Adult ; Aged ; Atrial Natriuretic Factor ; blood ; C-Reactive Protein ; analysis ; Female ; Humans ; Male ; Middle Aged ; Protein Precursors ; blood ; Sepsis ; blood ; Shock, Septic ; blood

BACKGROUND: Hepcidin has recently been known as a negative regulatory hormone of iron. Hepcidin precursor, pro-hepcidin has been used as a surrogate and reported to be related to iron deficiency. We investigated serum pro-hepcidin levels in patients with iron deficiency anemia (IDA), anemia of chronic disorder (ACD) and ACD concomitant iron deficiency (ACD/ID) to assess its usefulness as a marker of iron deficiency and examined whether its level is associated with anemia, iron status or inflammation profiles involved in the synthesis of hepcidin. METHODS: We enrolled 50 patients with IDA, 46 with ACD, 12 with ACD/ID and 60 healthy controls. Complete blood cell count, iron parameters (iron, TIBC, trasferrin saturation, ferritin), C-reactive protein (CRP) and serum pro-hepcidin were measured. RESULTS: Patients with iron deficiency, the IDA group and ACD/ID group had lower serum pro-hepcidin levels than healthy controls and the ACD group. The cutoff value of pro-hepcidin for detecting iron deficiency was 230 ng/mL (sensitivity 88.1%, specificity 51.2%). Patients with increased CRP showed higher mean pro-hepcidin level than those with normal CRP and the difference was significant in the IDA group (P=0.02). And serum pro-hepcidin level was positively correlated with CRP level (r=0.30, P=0.04) in the IDA group but not with hemoglobin. CONCLUSIONS: In patients with anemia, pro-hepcidin measurement may be useful for differentiating anemia patients with iron deficiency, IDA and ACD/ID from those with ACD. Serum pro-hepcidin levels may be more affected by inflammation than by the degree of anemia.
Anemia ; Anemia, Iron-Deficiency ; Antimicrobial Cationic Peptides ; Blood Cell Count ; C-Reactive Protein ; Humans ; Inflammation ; Iron ; Protein Precursors ; Sensitivity and Specificity

The precursor of prostate specific antigen (proPSA) are distinct molecular forms of free PSA in serum. proPSA is comprised of native proPSA as well as several truncated forms, in which [-2] proPSA and [-4] proPSA are more prostate cancer (PCa)-associated than [-7] proPSA and [-5] proPSA. Clinical studies have recently provided evidence that [-2] proPSA can significantly improve the detection of PCa, particularly in patients with total serum PSA values less than 4 microg/L. In this paper, the mechanism and characteristics of proPSA formation and impact of proPSA on the early detection of PCa are reviewed.
Early Diagnosis ; Humans ; Male ; Prostate-Specific Antigen ; blood ; chemistry ; Prostatic Neoplasms ; diagnosis ; Protein Precursors ; blood ; chemistry ; Sensitivity and Specificity

BACKGROUND/AIMS: Protein induced by vitamin K absence or antagonist II (PIVKA-II) appears to be a useful tumor marker for the evaluation of patients with hepatocellular carcinoma (HCC). But the usefulness of PIVKA-II was not yet clear in Korea where hepatitis B-virus is endemic. We investigated the usefulness of PIVKA-II in the diagnosis and follow-up after treatment of HCC. METHODS: We studied patients with HCC which was pathologically confirmed. PIVKA-II was measured by enzyme immunoassay. PIVKA-II levels before and after treatment, in correlation with imaging studies, were analyzed for the comparison of treatment responses. Kappa index was obtained. RESULTS: A total of 129 patients were included. 93 patients (72%) were HBsAg positive. 86 patients (67%) were PIVKA-II >40 mAU/mL. 52 patients (40%) were AFP >20 ng/mL and 77 patients (60%) were AFP 40 mAU/mL. 68 of 129 patients were evaluated treatment response. On the basis of radiologic response, CR was 33, PR 17, SD 12, and PD 6. Of the 33 radiologic CR patients, 30 patients were CR and 3 patients were PR by means of PIVKA-II response. Of the 17 radiologic PR patients, 6 patients were CR and 7 patients were PR. Therefore, tumor responses by radiologic and PIVKA-II were well correlated (Kappa index was 0.59). CONCLUSIONS: PIVKA-II can be used as a useful tumor marker for patients with HCC, especially those with low levels of AFP, before and after treatment in Korea.
Carcinoma, Hepatocellular/*diagnosis/therapy ; English Abstract ; Human ; Liver Neoplasms/*diagnosis/therapy ; Protein Precursors/*blood ; Prothrombin ; Tumor Markers, Biological/*blood

OBJECTIVENeonatal septicemia is a critical disease in neonatal period. Its incidence among live births is between 1 per thousand and 8 per thousand. Mortality of neonatal septicemia may be as high as 50% for infants who are not treated. The early signs of septicemia in the newborn are generally nonspecific. Blood culture and the other clinical diagnostic measures are not sufficiently sensitive. The present study aimed at evaluating potential use of soluble intercellular adhesion molecule-1 (sICAM-1), procalcitonin (PCT) and C-reactive protein (CRP) in diagnosis of septicemia.

METHODSThe experimental group consisted of 50 newborns with septicemia who were treated in Hebei Provincial Children's Hospital from April 1, 2002 to December 30, 2002. Thirty of the 50 cases had positive blood culture. The control group included 35 healthy newborns. Fasting blood samples were taken for bacterial cultures and sICAM-1, CRP, PCT determination. PCT and CRP contents were determined immediately after the specimens were collected. Analyses of sICAM-1 were done after inclusion of the last patient. Serum was separated from each specimen and stored at -20 degrees C within 2 hours. The analyses of sICAM-1 were performed by ELISA technique. CRP was analyzed by immunoturbidimetry assay (ITA). Immunochromatographic test was performed for detection of PCT from 200 ul serum. SPSS 10.0 was used to process the data. P values < 0.05 was considered to be statistically significant. One way analysis of variance (ANOVA), multiple comparison, chi-square test, paired-samples T test, linear correlation, Spearman correlation analysis, ROC curve were used for statistical analysis. The sensitivity, specificity, positive and negative predictive values, accuracy, Youden's index for sICAM-1, PCT, CRP and WBC count were calculated. These values were compared with each other.

RESULTS(1) The content of sICAM-1 in control group varied widely from 79 to 1252 ng/ml. Comparison of the data indicated that there was significant difference among the three groups in the content of sICAM-1, CRP and PCT (P < 0.05), but not in WBC count. These markers are considered positive if sICAM-1 >or= 300 ng/ml, CRP >or= 8 mg/l, PCT >or= 2 ng/ml. Their sensitivity was higher than WBC (P < 0.05). Among these indices, PCT has the highest specificity (94.3%), positive predictive (95.6%), negative predictive (82.5%), accuracy (89.4%), and Youden's index (80.3%). (2) No significant difference was found in sICAM-1 between pre- and post-treatment (P > 0.05); however, there was significant difference in CRP and PCT. (3) sICAM-1 was in direct proportion to CRP (r = 0.339,P < 0.01). PCT is correlated with sICAM-1, CRP (the spearman correlation coefficient 0.569, 0.482, P < 0.01).

CONCLUSIONDifferent individual is in different immune status; The level of sICAM-1 is related with neonatal septicemia. sICAM-1 concentration may be used as a diagnostic tool with high sensitivity (85%) and moderate specificity (54.3%) in neonates suspected of infection. The sensitivity and specificity of CRP (>or= 8 mg/l) were accordingly 87.5% and 54.3%. WBC count had low sensitivity for diagnosis (30.0%); Among these indices, PCT had the highest specificity (94.3%), positive predictive (95.6%), negative predictive (82.5%) Values, accuracy (89.4%), Youden's index (80.3%); No correlation was found between sICAM-1 concentration and their ages in day accordingly. CRP, PCT may be used to estimate the effect of therapy. The correlation of the infectious indices indicates that the body may mobilize many organs at the same time to resist the invasion of organism.

C-Reactive Protein ; analysis ; Calcitonin ; blood ; Calcitonin Gene-Related Peptide ; Humans ; Infant, Newborn ; Intercellular Adhesion Molecule-1 ; blood ; Protein Precursors ; blood ; Sepsis ; blood ; diagnosis