土井 洋輝

BACKGROUND AND OBJECTIVES: Thawed plasma (TP) can be stored for several days to facilitate rapid emergency transfusion. However, in Japan, the 24-h post-thaw shelf life limit raises concerns about plasma wastage. We evaluated fibrinogen recovery in cryoprecipitate prepared from TP that was stored for 5 days after thawing. MATERIALS AND METHODS: Cryoprecipitate was prepared using the one-step method (OSM, n = 12), two-step method (TSM, n = 15) and the TP stored for 5 days post-thaw (n = 15). Cryoprecipitate was prepared using three protocols: OSM, in which fresh frozen plasma (FFP) was thawed once at 2-6°C for 24-30 h; TSM, in which FFP was thawed at 2-6°C, refrozen at -30°C and then thawed again at 2-6°C for 24-30 h; and TP, in which FFP was stored at 2-6°C for 5 days after initial thawing, then refrozen and thawed as in the TSM. All samples were centrifuged after the final thawing to collect the cryoprecipitate. Fibrinogen recovery was calculated from fibrinogen concentrations, and bacteriological testing was performed on the cryoprecipitate prepared from TP. RESULTS: Fibrinogen recovery differed significantly among the groups (p < 0.001), with the highest recovery in the TSM group, followed by the TP and OSM groups. Recovery in the TP group was significantly higher than that in the OSM group. No bacterial growth was detected in any of the samples. CONCLUSION: Using stored TP to prepare cryoprecipitate could offer a more efficient way to manage resources while supporting emergency transfusion readiness.

BACKGROUND/AIM: Andrographolide (Andro), a diterpene lactone from Andrographis paniculata, induces apoptosis via reactive oxygen species (ROS)-dependent mitochondrial dysfunction but achieves low plasma concentrations because of its lipophilicity. We investigated whether low-dose Andro potentiates the cytotoxicity of the mechanistically distinct agents cytarabine (Ara-C) and vincristine (VCR) in plasma cell neoplasm cell lines. MATERIALS AND METHODS: Human plasma cell neoplasm cell lines H929 and ARH77 were treated with Andro alone or in combination with Ara-C or VCR. Cell viability was assessed in dose- and time-response experiments, and pharmacologic interactions were quantified using the combination index (CI) method. Apoptosis was evaluated by Annexin V staining, and cell-cycle distribution was analyzed to examine mechanistic complementarity. RESULTS: Andro decreased viability in a dose- and time-dependent manner (IC50 at 48 h: 3.4 μM in H929; 7.5 μM in ARH77). Combining Andro with Ara-C or VCR further reduced viability; in H929 cells, all combination conditions yielded CI values <1.0, indicating synergy. Combination treatments markedly increased Annexin V-positive fractions, implicating apoptosis as a major contributor to enhanced cytotoxicity. While Andro alone did not appreciably alter cell-cycle profiles, it modestly influenced Ara-C- and VCR-associated changes in cell-cycle distribution, consistent with complementary mechanisms. CONCLUSION: Low-dose Andro strengthens Ara-C- and VCR-driven cytotoxic programs and provides a quantitative rationale for Andro-based combination strategies in plasma cell neoplasms and related hematologic malignancies.

BACKGROUND: Capillary blood collection offers a less burdensome alternative to venous sampling and may improve access to laboratory testing in resource-limited settings. However, manual procedures can yield pre-analytical variation, resulting in the need for skilled personnel. To address these limitations, we developed a prototype device that automates fingertip blood collection. METHODS: The device automatically punctures a fingertip using a disposable lancet, applies intermittent compression to the fingertip using a cuff, sequentially collects blood into two microtubes, and completes hemostasis with gauze. We evaluated the device in 58 healthy volunteers aged 20-60 years by comparing capillary blood collected with the device to venous blood via standard phlebotomy. Paired samples were processed and analyzed under hospital laboratory quality control. Measurements included 8 CBC parameters, glucose and HbA1c in whole blood, 3 electrolytes, and 15 biochemical analytes in serum. Agreement was assessed using Deming regression, and bias with 95% confidence intervals at medical decision levels (MDLs) was calculated. RESULTS: Most analytes exhibited biases within the allowable limits defined by the Clinical Laboratory Improvement Amendments (CLIA), except for white blood cell count (WBC), potassium (K), lactate dehydrogenase (LD), and glucose. Compared with the BD MiniDraw™, which involves manual finger compression, our device showed greater biases in WBC and K, likely due to the margination effect and hemolysis, respectively-both enhanced by stronger compression. CONCLUSION: The device demonstrated acceptable analytical performance for most parameters. Optimizing compression strength and duration may reduce bias. Automated capillary collection could support decentralized testing and reduce phlebotomy workload.