TAG: "Diagnostics"

UCLA launches joint venture with Chinese firm to open lab in Shanghai


Clinical laboratory will provide more accurate diagnoses of cancer and other diseases.

Scott Binder, UCLA

The University of California and UCLA Department of Pathology have signed an agreement with Centre Testing International Corp., a Chinese firm, to create a company that will operate a clinical laboratory in Shanghai. The new lab will support clinical trials and enhance medical care for Chinese patients with cancer and other diseases.

The new company, CTI-Pathology/UCLA Health, is jointly owned by CTI and the University of California. The 25,000-square-foot facility — the first of its kind in China — will offer genetic and molecular diagnostics and other sophisticated tests that exceed the scope of the average lab in China, and UCLA pathologists will train Chinese lab specialists to accurately interpret the tests. The lab is expected to open in September.

The partnership is the first between a Chinese company and a U.S. academic medical center to create a specialized laboratory in China. The agreement was signed today at Ronald Reagan UCLA Medical Center in a ceremony that was videocast to China.

“This joint venture is founded on UCLA’s desire to build strong global relationships that, through education, research and service, improve the health of people and communities throughout the world,” said Dr. Tom Rosenthal, chief medical officer for UCLA Health System and co-director of UCLA’s Center for World Health. “UCLA has a genuine interest in elevating the level of medicine around the world. This is one way we can really make a difference in the quality of the Chinese people’s health care and lives.”

UCLA will oversee management of the laboratory to ensure that its operations meet international standards for quality, and CTI will provide capital funding and marketing expertise. The University of California Regents approved the joint venture on Jan. 22.

“We are extremely pleased that the UCLA Health System, UCLA Department of Pathology and the UC Regents agreed to partner with CTI to establish and manage our joint venture laboratory in Shanghai,” said Sangem Hsu, president of CTI. “Our collaboration will offer the people of China oncology, pathology and laboratory medicine services they can trust. Many of these services are not largely available in China and are needed by physicians and health care providers to accurately diagnose and treat their patients.”

The Shanghai laboratory will be electronically and digitally linked with UCLA — enabling physicians and patients to consult with UCLA pathologists — and with hospitals, clinics and other laboratories throughout China.

“CTI will be an outstanding partner in our effort to significantly improve patient care in China,” said Dr. Scott Binder, senior vice chair of pathology and laboratory medicine at the Geffen School of Medicine, and director of pathology laboratory services for UCLA Health System, which performs more than 7 million tests and diagnose more than 90,000 tissue specimens a year.

Jianyu Rao, UCLA

Binder conceived the idea for a UCLA lab in China and made the first of several visits there in 2005. Dr. Jianyu Rao, a UCLA colleague who speaks Mandarin, helped move the plan forward.

“In the past, Chinese medicine focused more on treatment than diagnosis,” said Rao, a professor of pathology and laboratory medicine at the Geffen School of Medicine and director of cytopathology at UCLA Health System. “Due to the rise of a more-informed middle class, the Chinese people are recognizing the importance of accurate diagnoses for their conditions.”

The partnership also has led to teaching exchanges between UCLA and China. UCLA has already hosted Chinese pathologists and technologists for training on specialized diagnostics for skin, blood and brain tissue and other areas. In turn, UCLA pathologists will travel to China to learn about diseases that are common there but rare in the U.S.

“Because pathology has a history of being undervalued in China, the country has a shortage of pathologists trained to diagnose and interpret complex test results in specialized fields of medicine,” Binder said. “Our partnership gives CTI and UCLA the opportunity to save lives by changing that.”

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UCSF, Quest Diagnostics launch collaboration to advance precision medicine


Areas of focus will include autism, oncology, neurology and women’s health.

June Lee, UC San Francisco

June Lee, UC San Francisco

UC San Francisco and Quest Diagnostics, the world’s leading provider of diagnostic information services, have formed a collaboration to accelerate the translation of biomedical research into advanced diagnostics in the field of precision medicine, for improved patient care, treatment and outcomes.

Initial clinical areas of focus include autism, oncology, neurology and women’s health.

The collaboration, which combines the research discoveries and capabilities of UCSF with the national testing database and technical and clinical development capability of Quest Diagnostics, has an overarching aim of enabling holistic and integrated diagnostic solutions that close gaps in care or enable new clinical value.

Under the terms of the agreement, scientists will jointly research, develop and validate diagnostic innovations to solve specific clinical problems and provide actionable information to improve patient care. The organizations will focus on diagnostics to advance precision medicine, an emerging field of medical science that aims to integrate the most informative data from molecular, clinical, population and other research to create predictive, preventive and precise medical solutions for patients. Quest Diagnostics would independently develop and validate any lab-developed tests for clinical use that emerge from the collaboration’s research.

Researchers will utilize laboratory-based diagnostics, imaging procedures and population analysis based on Quest’s national Health Trends database, the largest private clinical database in the U.S., based on more than 1.5 billion patient encounters, to advance precision medicine.

The alliance is the first master agreement that UCSF’s Office of Innovation, Technology and Alliances has signed with a clinical laboratory testing company and augments the university’s efforts to translate laboratory research into new therapies. The broad agreement lays the groundwork for multiple projects between the two organizations.

“Advances in technology and science have identified many promising opportunities to improve outcomes through insights revealed by novel diagnostic solutions, yet fulfilling the full potential of these opportunities often hinges on translational clinical studies which validate their value,” said Jay Wohlgemuth, M.D., senior vice president, science and innovation, Quest Diagnostics. “This unique collaboration between UCSF and Quest brings together the finest researchers and clinicians in the country to accelerate the development of a ‘product pipeline’ of scientific discoveries as clinically valuable diagnostic solutions that enable precision medicine for improved outcomes.”

The collaboration is launching with two specific projects already under way. One project involves Quest’s national database of molecular testing data to facilitate participation in research and development efforts related to genetic variations of autism, based on Quest’s CGH microarray ClariSure technology, which can help identify genetic mutations associated with autism and other developmental disorders. While there currently is no treatment for autism, a test that aids its diagnosis could help identify individuals who might be appropriate candidates for research studies that could lead to future therapies.

The second project aims to identify biomarkers to determine which children with glioma brain tumors may benefit from a drug that is currently available to treat the disease. That project will integrate molecular biomarker testing with advanced MRI imaging technologies. This project is the first phase of larger collaborative studies to develop and validate integrated care pathways, which would include laboratory diagnostics, imaging data and other clinical information to be used in the management of patients with brain cancer and neurological diseases.

UCSF has been at the forefront of the movement toward precision medicine, for which UCSF Chancellor Susan Desmond-Hellmann, M.D., M.P.H., co-authored the initial National Academy of Sciences paper that defined the new field. That paper set the vision of harnessing the vast amounts of genetic, environmental and health data worldwide to make health care more predictive, precise and targeted.

“There are many diagnostics projects underway at UCSF for which Quest could partner and contribute a great deal of value in turning an isolated research project into a diagnostic service or other technology that directly benefits patients,” said June Lee, M.D., F.A.C.C.P., director of early translational research at the UCSF Clinical and Translational Science Institute, which initiated the collaboration with Quest after several scientists from both organizations had formed isolated, but successful, research collaborations. “This agreement will give UCSF researchers access to Quest expertise in developing diagnostics, as well as in understanding the market conditions for projects on campus.”

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Chemists devise cheap, accurate way to detect prostate cancer


Method could facilitate at-home urine tests.

Reginald Penner, UC Irvine

Early screening for prostate cancer could become as easy for men as personal pregnancy testing is for women, thanks to UC Irvine research published today (May 22) in the Journal of the American Chemical Society.

After more than a decade of work, UC Irvine chemists have created a way to clearly identify clinically usable markers for prostate cancer in urine, meaning that the disease could be detected far sooner, with greater accuracy and at dramatically lower cost. The same technology could potentially be used for bladder and multiple myeloma cancers, which also shed identifiable markers in urine.

“Our goal is a device the size of a home pregnancy test priced around $10. You would buy it at the drugstore or the grocery store and test yourself,” said the study’s corresponding author, Reginald Penner, UC Irvine Chancellor’s Professor of chemistry. “We’re on the verge of a very important breakthrough in a new era of personal health management.”

About 240,000 men in the U.S. are diagnosed with prostate cancer each year, and 29,000 are expected to die of it in 2013. But current, widely utilized testing does not always catch the disease in its early stages, often yields false positives and can lead to unnecessary, risky treatments.

A recent report concluded that the prostate-specific antigen, or PSA, test can be more harmful than beneficial, although it remains important for detecting recurring prostate cancer. The UC Irvine researchers used a different biomarker, PSMA, and plan to test others to pinpoint if a cancer is growing aggressively or not.

“A big problem is that the approach used now does not catch cancer soon enough,” said co-author Gregory Weiss, a UC Irvine biochemist. “We want this to be a disruptive technology that will change how we save lives and that will bring down health care costs drastically.”

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Chemists mimic nature to design better medical tests


Research may improve performance of DNA detectors and aid diagnostics for HIV or cancer.

Kevin Plaxco (left) and Alexis Vallée-Bélisle, UC Santa Barbara

Over their 3.8 billion years of evolution, living organisms have developed countless strategies for monitoring their surroundings. Chemists at UC Santa Barbara and University of Rome Tor Vergata have adapted some of these strategies to improve the performance of DNA detectors. Their findings may aid efforts to build better medical diagnostics, such as improved HIV or cancer tests.

Their research is described in an article published this week in the Journal of the American Chemical Society.

Nature often serves as a source of inspiration for the development of new technologies. In the field of medical diagnostics, for example, scientists have long taken advantage of the high affinity and specificity of biomolecules such as antibodies and DNA to detect molecular markers in the blood. These molecular markers allow them to monitor health status and to guide treatments for diseases, including HIV, cancer and diabetes.

Kevin W. Plaxco, a professor of chemistry at UCSB, whose group carried out the research, notes that despite their great attributes, a main limitation of such biosensors is their precision, which is confined to a fixed, well-defined “dynamic range” of target concentrations. Specifically, the useful dynamic range of typical biomolecule binding events spans an 81-fold range of target concentrations.

“This fixed dynamic range complicates — or even precludes — the use of biosensors in many applications,” said Plaxco. “To monitor HIV progression and provide the appropriate medication, for example, physicians need to measure the levels of viruses over five orders of magnitude. Likewise, the two orders-of-magnitude range displayed by most biosensors is too broad to precisely monitor the concentrations of the highly toxic drugs used to treat many cancers. Our goal was, therefore, to create sensors with extended (for applications needing a broad dynamic range) or narrowed (for applications needing high measurement precision) dynamic ranges at will.”

The key breakthrough underlying their new approach came from the simple observation of nature. “All living organisms monitor their environments in an optimized way by using sensing molecules that respond to either wide or narrow change in target concentrations,” said Alexis Vallée-Bélisle, a postdoctoral fellow and the first author of the study. “Nature does so by combining in a very elegant way multiple receptors, each displaying a different affinity for their common target”.

Inspired by the optimized behaviors of these natural sensors, the UCSB research group teamed up with Francesco Ricci, professor at the University of Rome Tor Vergata to do their own mixing and matching of biomolecules to manipulate biosensors’ dynamic ranges. To validate their approach, they used a widely employed DNA-based biosensor used for detecting mutations in DNA called a “molecular beacon.”

By combining sets of molecular beacons all binding the same target molecule but with differing affinities, the international team was able to create sensors with rationally “tuned” dynamic ranges. In one case, they developed a sensor that monitors DNA concentrations over a six orders of magnitude range. In another example, they developed an ultrasensitive sensor that precisely detects small changes in target concentration over only a five-fold dynamic range. Finally, they also built sensors characterized by complex, “custom-made” dynamic ranges in which the sensor is insensitive within a window of desired concentrations (e.g., the clinically “normal” concentration range of a drug) and very sensitive above or below this “appropriate” concentration range. The researchers believe that these strategies can be in principle applied to a wide range of biosensors, which may significantly impact efforts to build better point-of-care biosensors for the detection of disease biomarkers.

This work was funded by the National Institute of Health, the Fond Québécois de la Recherche sur la Nature et les Technologies, the Italian Ministry of University and Research (MIUR) project “Futuro in Ricerca.”

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New test spots early signs of inherited metabolic disorders


Simple universal test spots biomarkers for group of disorders, may speed diagnosis.

Jeffrey Esko, UC San Diego

A team of scientists, led by researchers at the University of California, San Diego, School of Medicine and Zacharon Pharmaceuticals, have developed a simple, reliable test for identifying biomarkers for mucopolysaccharidoses (MPS), a group of inherited metabolic disorders that currently are diagnosed in patients only after symptoms have become serious and the damage possibly irreversible.

The findings will be published online Sunday in the journal Nature Chemical Biology.

MPS is caused by the absence or malfunctioning of a lysosomal enzyme required to break down and recycle complex sugar molecules called glycosaminoglycans, which are used to build bone, tendons, skin and other tissues. If not degraded and removed, glycosaminoglycans can accumulate in cells and tissues, resulting in progressive, permanent damage affecting appearance, physical abilities, organ function and often mental development in young children. The effects range from mild to severe.

There are 11 known forms of MPS, each involving a different lysosomal enzyme. A number of treatments exist, including enzyme replacement therapy and hematopoietic stem cell transplantation, but efficacy depends upon diagnosing the disease and its specific form as early as possible. That has been problematic, said Jeffrey D. Esko, Ph.D., professor in the Department of Cellular and Molecular Medicine and co-director of the Glycobiology Research and Training Center at UC San Diego.

“The typical time from seeing first symptoms to diagnosis of MPS is about three years. Since the early signs of disease are common childhood issues like ear infections and learning disorders, the disease is usually not immediately recognized,” Esko said.

“A child often has multiple visits with their pediatrician. Eventually they are referred to a metabolic disease specialist, where rare diseases are considered. It takes an expert to identify MPS and its most likely form in each patient. Every subclass of MPS has its own specific diagnostic test, so developing better diagnostics is an essential part of effective treatment. ”

In their paper, the scientists describe an innovative method to detect tell-tale carbohydrate structures specific to glycosaminoglycans in the cells, blood and urine of MPS patients. The biomarker assay identifies all known forms of the disease.

Esko is collaborating with Zacharon Pharmaceuticals, a San Diego-based biotechnology company, to develop a commercial diagnostic assay for differentiating forms of MPS from urine and blood samples, a screening test for newborns and a tool for measuring the biochemical response of MPS patients to existing and novel therapies.

“Since the severity of the disease is highly variable among patients, this could provide a tool that a doctor can use to optimize dosing or treatment,” said Brett Crawford, vice president for research at Zacharon. “Currently, all patients are treated with the same dose of drug.”

The biomarker test may also be used to discover new forms of MPS and better characterize existing ones.

Disclosure: Esko co-founded Zacharon Pharmaceuticals in 2004 with Brett E. Crawford and Charles Glass. He is a scientific advisor to the company.

Co-authors include Roger Lawrence and William C. Lamanna, UC San Diego Department of Cellular and Molecular Medicine, Glycobiology Research and Training Center; Jillian R. Brown, James R. Beitel and Brett E. Crawford, Zacharon Pharmaceuticals; Geert-Jan Boones and Kanar Al-Mafraji, University of Georgia, Athens.

Funding for this research came, in part, from the National Institutes of Health, a Kirschstein National Research Service Award and the National MPS Society.

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$2.8M grant to develop saliva test to diagnose Sjögren’s syndrome


Clinical trial will test a new diagnostic approach for the disorder, which affects Venus Williams and millions of others.

David Wong, UCLA

In August, tennis star Venus Williams withdrew from the U.S. Open, saying she was suffering from fatigue and other symptoms related to Sjögren’s syndrome, an autoimmune disorder that results in the loss of the ability to produce saliva and tears. Her announcement focused public attention on this malady, which affects nearly 4 million Americans.

While women are nine times more likely than men to develop Sjögren’s, the disorder affects virtually every racial and ethnic group. Most patients develop symptoms after age 40, including dry eyes, dry mouth and often joint pain and chronic fatigue. And because of their paucity of saliva and the antibacterial chemicals it contains, patients may also develop tooth decay and cavities.

While much is known about the symptoms of Sjögren’s, the disease is complex and poorly understood, and in some cases, it can take more than six years to be diagnosed.

The UCLA School of Dentistry has now received a $2.8 million grant from the National Institute of Dental and Craniofacial Research, part of the National Institutes of Health, to support a multi-center clinical trial of a diagnostic test that uses patients’ saliva to determine whether they have Sjögren’s syndrome. This simple, non-invasive test will permit a diagnosis within minutes, rather than the weeks currently required when using blood or other tissue samples.

The project will be led by Dr. David Wong, associate dean for research and the Felix and Mildred Yip Endowed Professor in Dentistry at the UCLA School of Dentistry. For Dr. Wong and his colleagues, who have been conducting research on using saliva as a diagnostic tool for biomarkers of oral cancer, early-stage pancreatic cancer and other maladies for several years, this is an important step in moving from the research realm to actual clinical trials and, eventually, to use by medical and dental practitioners.

“This clinical trial will make it possible to validate the effectiveness of salivary diagnosis and move us a step closer to eventual FDA approval and clinical product development,” Wong said. “The establishment of scientifically credible biomarkers for this chronic autoimmune disease that are not invasive, painful or embarrassing is our goal.”

Clinical trials will be conducted at three major rheumatology centers, at University Medical Center Groningen in the Netherlands, the University of Minnesota and the Oklahoma Medical Research Foundation. Centers will enroll patients exhibiting sicca symptoms of dry eye and dry mouth and will perform the saliva biomarker assay based on a panel of highly discriminatory salivary biomarkers developed at UCLA. Researchers will benchmark the outcome with the current clinical practice of six clinical tests, including serology and a lip biopsy, to diagnose Sjögren’s syndrome (AECC 2002 criteria).

“The UCLA School of Dentistry is very proud to be at the forefront of this international effort to advance the field of saliva diagnostics from the research laboratory to clinical trials,” said No-Hee Park, dean of the UCLA School of Dentistry. “The prospect of early detection of Sjögren’s syndrome, and possibly other serious illnesses, in the future through this methodology is truly exciting.”

The UCLA School of Dentistry is dedicated to improving the oral health of the people of California, the nation and the world through its teaching, research, patient care and public service initiatives. The school provides education and training programs that develop leaders in dental education, research, the profession and the community; conducts research programs that generate new knowledge, promote oral health and investigate the cause, prevention, diagnosis and treatment of oral disease in an individualized disease-prevention and management model; and delivers patient-centered oral health care to the community and the state.

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Into the (mis)fold: A diagnostic tool for proteins


Berkeley Lab-developed technique could help pinpoint Alzheimer’s in its early stages.


Alzheimer’s disease is the most common form of dementia, currently affecting more than 35 million people worldwide. Although many genetic and hereditary factors are thought to contribute to the telltale deterioration of memory and cognitive functions resulting from Alzheimer’s, a central aspect to this disease is an accumulation of misfolded proteins in the brain.

Now, scientists at Berkeley Lab have engineered a universal, highly sensitive technique for detecting misfolded proteins in biological fluids. This groundbreaking nanoscience capability could help pinpoint Alzheimer’s in its early stages and enable researchers to discover new therapies for this devastating disease.

When a protein doesn’t fold into its normal shape, it also doesn’t perform its normal functions. This disruption in behavior could lead to proteins that aggregate into plaques or deposits and become toxic to cells. In Alzheimer’s disease, aggregates of a protein called beta-amyloid form in the central nervous system, causing damage to cells in the brain and triggering dementia.

An analytical capability for measuring tiny clusters of these proteins — before irreversible damage occurs — would be a powerful tool in the early detection of Alzheimer’s and other misfolded protein diseases. However, despite significant research efforts, there are currently no diagnostic tools available to selectively detect small-scale aggregates of misfolded proteins in biological fluids, such as blood or spinal fluid.

“This collaboration illustrates how a biomedical problem can also be a nanoscience problem, in which a chemical reagent is needed to recognize partially aggregated proteins,” said Ron Zuckermann, director of the Biological Nanostructures Facility at the Molecular Foundry, a nanoscience user facility at Berkeley Lab. “We were faced with the challenge of synthesizing a material that’s capable of specifically detecting this aggregated protein and not any of the other proteins in the blood.”

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‘Fingerprints’ for tumors


uch_ucla_tsengNew technologies for the diagnosis of cancer are rapidly changing the clinical practice of oncology. As scientists learn more about the molecular basis of cancer, the development of new tools capable of multiple, inexpensive biomarker measurements on small samples of clinical tissue will become essential to the success of genetically informed and personalized cancer therapies.

Researchers at UCLA have now developed a microfluidic image cytometry (MIC) platform that can measure cell-signaling pathways in brain tumor samples at the single-cell level. The new technology combines the advantages of microfluidics and microscopy-based cell imaging.

The ability to make these in vitro molecular measurements, or “fingerprints,” marks a new advance in molecular diagnostics that could ultimately help physicians predict patient prognosis and guide personalized treatment.

“The MIC is essentially a cancer diagnostic chip that can generate single-cell ‘molecular fingerprints’ for a small quantity of pathology samples, including brain tumor tissues,” said Dr. Hsian-Rong Tseng, a UCLA associate professor of molecular and medical pharmacology and one of the leaders of the research. “We are exploring the use of the MIC for generating informative molecular fingerprints from rare populations of oncology samples — for example, tumor stem cells.”

The research, which appears in the Aug. 1 issue of the journal Cancer Research, represents the teamwork of 35 co-authors from UCLA’s Jonsson Comprehensive Cancer Center with expertise in surgery, pathology, cancer biology, bioinformatics and diagnostic devices.

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Bone measurement tool


uch_ucsb_hansmaPaul Hansma’s face lights up when he talks about what his latest research might mean for people who suffer after breaking their hips or other bones that become more and more brittle as they age. Statistics show that a woman is more likely to die in the next year after a hip fracture than if she’s had a heart attack.

Hansma, a professor of physics at UC Santa Barbara who has spent much of the past 20 years developing Atomic Force Microscopes, has focused on biophysical research and the study of human bones. His renowned bone tissue research has led him to what he believes will be a significant step in the study of biomaterials: development of a new medical diagnostic tool — the Reference Point Indentation (RPI) instrument.

Hansma is a co-author of a new study published in the Journal of Bone and Mineral Research. In the study, “Microindentation for in vivo Measurement of Bone Tissue Mechanical Properties in Humans,” Hansma and his co-authors say they have validated the RPI as a new tool for measuring the strength and quality of bones by using live human test subjects.

“This is a revolutionary breakthrough,” Hansma said of the RPI. “People get excited when they hear about this.”

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Sorting cells, saving lives


uch_uci_duarteA two-day wait for blood test results turned into a hospital stay for Rodrigo Martinez-Duarte’s wife, Anne-Carole. A routine infection spread to her kidneys, making her very sick, while confirmation of her diagnosis was pending.

“If the results hadn’t taken so long, doctors could have begun treatment sooner and my wife might have recovered quicker,” says Martinez-Duarte, a UC Irvine doctoral candidate in mechanical & aerospace engineering.

He hopes a device he’s building will make blood and other cell-sorting tests faster – and cheaper. The technology someday could help diagnose and treat diseases ranging from Alzheimer’s and diabetes to leukemia and HIV.

To support his research efforts, Martinez-Duarte – who was born in Mexico and studied electrical engineering at Tecnologico de Monterrey before coming to UCI in 2005 – has been awarded a $10,000 Public Impact Fellowship from UCI’s Graduate Division.

Many diagnostic tests and therapies are based on sorting and isolating cells. Current methods are costly and time-consuming because of their complexity. Sorter machines can sell for thousands of dollars and weigh hundreds of pounds. Antibodies needed to identify cells are also expensive and require special handling by skilled personnel.

The device Martinez-Duarte is developing sorts cells using electric fields instead of antibodies. Cells have properties that respond to different frequencies. Turn a particular electric field on, and targeted cells can be manipulated at will. The technique, called dielectrophoresis, dates to the 1970s but hasn’t gained popularity in clinical settings because the equipment involved is often bulky and complicated.

Martinez-Duarte’s innovation was to adapt DEP to a medium the size and shape of a compact disc. Cell-containing fluid on the disc can be controlled by changing the disc’s rotation speed and other parameters. The goal is an automated process in which a technician could load a sample, choose a sorting program and obtain results in just a few minutes.

Martinez-Duarte and his colleagues in Chancellor’s Professor Marc Madou’s lab hope the device will be in clinical use within the next few years.

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Pancreatic cyst treatment


uch_ucla_spiegelAs a result of improved imaging technology, pancreatic cysts are increasingly diagnosed in asymptomatic individuals who undergo scans for other reasons. And while most of these cysts follow a benign course, a small but significant number are either malignant at the time of diagnosis or have the potential to develop into pancreatic cancer during a patient’s lifetime.

The dilemma for both patient and clinician is determining which cysts to leave alone and which to surgically remove. Existing treatment guidelines don’t clearly address many treatment options beyond the removal of part of the pancreas — a major undertaking for an asymptomatic lesion.

Now, a UCLA-Veterans Affairs research team has developed an evaluation tool to help guide asymptomatic pancreatic cyst treatment. Published in the February issue of the journal Gastroenterology, the tool takes into account overall health, age, cyst size, surgical risk and patients’ views about quality of life.

“Surgery may not be the best initial approach for all patients diagnosed with a specific pancreatic cyst. The new tool may help with decision-making and mapping out a treatment plan,” said study author Dr. Brennan Spiegel, director of the UCLA-VA Center for Outcomes Research and Education at the David Geffen School of Medicine at UCLA and the VA Greater Los Angeles Healthcare System.

The diagnosis of asymptomatic cysts has increased fivefold over the past decade, due partly to an aging population and to improved diagnostics. Current imaging techniques — including computed tomography (CT), magnetic resonance imaging (MRI) and endoscopic ultrasound, in which a small camera is inserted down the throat and into the stomach and small bowel to image the pancreas — combined with pancreatic cyst fluid analysis, offer an 80 percent accuracy in cyst diagnosis.

“Pancreatic cysts are most often diagnosed in an older population, and although many are benign, these must be carefully tracked, since a small percentage can develop into pancreatic cancer,” said study author Dr. James J. Farrell, associate professor of digestive diseases at the Geffen School of Medicine and director of UCLA’s Pancreatic Diseases Program.

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Rapid test for viruses


uch_ucd_greenUC Davis Health System’s clinical laboratory now offers a test for respiratory viruses that its laboratory directors believe is more rapid, sensitive and comprehensive than any other test methods currently available in the Sacramento region.Known as the Respiratory Viral Panel (RVP) by RT-PCR, the test simultaneously detects 10 common respiratory viruses from patients with cold and flu-like symptoms, providing definitive results within 24 to 36 hours. In contrast, the tests used by most clinical laboratories detect fewer viruses and often take longer to generate results, potentially leading to delayed or inappropriate medical care.

The Respiratory Viral Panel by RT-PCR is particularly beneficial for severely ill patients when a fast and accurate diagnosis is needed to determine the optimal course of treatment. This was particularly true during the recent 2009 H1N1 influenza pandemic, when the RT-PCR test allowed rapid determination of whether a virus was the novel 2009 H1N1 strain or seasonal flu.

Physicians in the Sacramento area may request the RVP by RT-PCR test by ordering it through the UC Davis Health System Medical Diagnostic service.

“Rather than limiting this test to UC Davis patients, we would like to make the RVP by RT-PCR available to the entire Sacramento community, with the hope of improving diagnosis and care for as many patients as possible,” said Ralph Green, medical director of the health system’s Medical Diagnostics.

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