Kazunobu Une

KL-6, a Human MUC1 Mucin, as a prognostic marker for diffuse alveolar hemorrhage syndrome.

BackgroundDiffuse alveolar hemorrhage syndrome is a life threatening condition with diverse etiologies. Sensitive prognostic markers for diffuse alveolar hemorrhage have not been well investigated. Serum KL-6 is a biomarker for various interstitial lung disease associated with disease activity and prognosis. The purpose of the present study was to evaluate the clinical utility of serum KL-6 level as a prognostic marker for diffuse alveolar hemorrhage.MethodsWe retrospectively collected 41 consecutive patients clinically diagnosed as having diffuse alveolar hemorrhage who were admitted to the Intensive Care Unit of Hiroshima University Hospital between 2004 and 2011. Correlation between prognosis and age, sex, laboratory findings including serum KL-6, radiological findings, ventilatory modes or therapeutic regimens were evaluated.ResultsBaseline and peak serum KL-6 levels were significantly higher in non-survivors compared with survivors. An increase in KL-6 levels during the initial week was associated with a subsequent deterioration of the oxygenation index. Higher baseline KL-6 levels and higher peak KL-6 levels were strongly correlated with death. With a cut-off level of 700 U/mL for peak KL-6, the sensitivity, specificity and accuracy for non-survival were 75%, 85% and 78%, respectively. In the multivariate analysis, only the peak KL-6 level ≥700 U/ml was an independent poor prognostic factor for diffuse alveolar hemorrhage.ConclusionsPeak serum KL-6 level ≥700 U/ml may become a clinically useful marker of poor prognosis for diffuse alveolar hemorrhage.

A Case of Severe Puffer Fish Poisoning: Serum Tetrodotoxin Concentration Measurements for 4 Days after Ingestion

Yasumasa Iwasaki1, Akira Namera2, Hiroshi Giga1, Yoshiko Kida1, Kohei Ota1, Kazunobu Une1, Tadatsugu Otani1, Shinichiro Ohshimo1, Nobuyuki Hirohashi1, Koichi Tanigawa1 1Department of Emergency and Critical Care Medicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan 2Department of Forensic Medicine, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan *Corresponding author: Yasumasa Iwasaki, Department of Emergency and Critical Care Medicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan, Tel: 81-90-8242-4859; E-mail: yiwasaki@hiroshima-u.ac.jp