Perspective for clinical laboratory management and its systematization--effects of the systematization of clinical laboratory management

There are a large number of ideas concerning the systematization of clinical laboratory management. Therefore many types of laboratory systems have been constructed. As our hospital is not large, we adopted a small scale laboratory system. In introducing it, we expected not only an increase in value-added labor productivity by automating laboratory tests, but also an improvement in technologist's cost awareness. Consequently, new system equipment has itself performed the former in many sections, but not the latter. Improvement in cost awareness was caused by the technologist's routine work in managing reagent and material stocks. We found that this soft-type systematization has been more important than the advanced hard-type system.     

Sequence-based diagnosis of hemoglobinopathies in the clinical laboratory

A high-angle neutron fibre diffraction study of the hydration of A-DNA has been performed using the single-crystal diffractometer D19 at the Institut Laue-Langevin (Grenoble, France). The sample was prepared using deuterated DNA extracted from E. Coli cells cultured on deuterated nutrients. In common with our previous neutron fibre diffraction studies of DNA, this work exploits the ability to isotopically replace H2O around the DNA by D2O. However this study benefitted additionally from the fact that the hydrogen atoms which are covalently bonded to carbon atoms in the DNA sugars and bases were replaced by deuterium so that incoherent scattering and absorption effects were minimised. Successive cycles of Fourier synthesis and Fourier difference synthesis allowed water peaks to be identified and their positional and occupancy parameters to be refined against the observed diffraction data. The results confirm the main hydration features noted in our earlier studies with a clear network of water running along the inside edge of the major groove linking successive OI phosphate oxygen atoms. The central core of water running along the axis of the double helix is very much clearer in this work. Additionally this study shows chains of ordered water lying in the centre of the major groove.     

Pellegrini-Stieda disease (shadow)]

Inadvertent use of tetracycline hydrochloride while producing calcium oxalate stones in the rat resulted in a reduction of papillary concretions by one-half. Parenchymal calcifications in the continuing long term, preformed stone group were reduced to levels comparable to that of other useful agents. In vitro studies corroborated these findings at physiologic urinary pH ranges. The rationale and comparisons to other anticalculus drugs are discussed.     

Acute phase proteins: clinical and laboratory diagnosis. A review

Acute phase proteins play an important role in clinical laboratory diagnosis, especially after recent development of quantitation methods. Turbidimetry and nephelometry, spectrophotometric procedures based on the quantitation of scattered and reflected light, permit laboratory analyses of higher precision, sensitivity and specificity compared to previously employed methods.     

Schizophrenia and its hospitalization (author''s transl)]

Radionuclide dacryography (RND) has the following indications: 1. Localisation of obstructions in the lacrimal drainage system. 2. Judgement of relative tear obstruction. 3. Pre- and post-operative control of the function of lacrimal drainage in surgical and radiotherapy of the inner canthus region. 4. Investigations of tear secretion are described and own preliminary results are discussed. 5. Resorption of suitable marker substances clinically. First results of conjunctival resorption of pertechnetate are reported. 6. The possibility of testing in vivo radioactive drug delivery systems is shown by means of own investigations. 7. The absorbed radiation dose using RND is very low as compared to radiological methods, thus justifying repeated controls and investigations even in children.     

Comparison of clinical diagnosis and standard laboratory and molecular methods for the diagnosis of genital ulcer disease in Lesotho: association with human immunodeficiency virus infection

A multiplex polymerase chain reaction (M-PCR) assay for Haemophilus ducreyi, Treponema pallidum, and herpes simplex virus (HSV) was compared with clinical and standard laboratory methods for the diagnosis of genital ulcer disease (GUD) in 105 patients; 36% were human immunodeficiency virus (HIV)-seropositive. Chancroid (80%), syphilis (8%), and genital herpes (8%) were the most frequent diagnoses. H. ducreyi and HSV were isolated from ulcers of 43% and 18% of patients, respectively; in 35%, all cultures were negative and the laboratory diagnosis indeterminate. M-PCR detected H. ducreyi, T. pallidum, and HSV in 56%, 23%, and 26% of patients, respectively; (no definitive diagnosis, 6%). The proportion of patients with more than one agent was 4% by culture and 17% by M-PCR (P = .002). Resolved sensitivities of M-PCR for H. ducreyi and HSV cultures were 95% and 93%, respectively. The sensitivities of H. ducreyi and HSV cultures were 75% and 60%, respectively. HSV, detected in 47% of specimens from HIV-infected versus 16% from HIV-uninfected patients (P < .001), may be emerging as a more frequent cause of GUD.     

Effectiveness of the use of immunological methods in clinical laboratory diagnosis

The efficacy of treatment of stomatological manifestations and visceral diseases in patients with Sjogren's disease (syndrome) by therapeutic complexes including plasmapheresis is assessed. Plasmapheresis was administered to 7 inpatients in an intermittent mode with exfusion of up to 1 liter of plasma per session. A course consisted of one to three sessions, the total duration of treatment was three to four weeks. The efficacy of plasmapheresis in a complex of therapeutic measures was assessed from the time course of the clinical picture, results of studies of the function of salivary glands, and parameters of metabolic processes and immunity. Plasmapheresis helped attain long remissions and improved the general status of the patients, this being paralleled by a positive time course of local symptoms of the disease and the principal homeostasis parameters.     

Roentgen diagnosis of renal tuberculosis (author's transl)]

Roentgenologic procedures are of limited value, compared with other possible examinations. Early radiologic diagnosis is made rarely. Roentgenologic procedures are important for demonstration of successful treatment and for legal documentation. Excretory urography is effective only in combination with zonography and ureteral compression provided the amount of injected contrast medium is sufficient. Angiography is important in progressive or silent renal tuberculosis, especially in cases of a partial or complete non-functioning kidney. Difficulities in differential diagnosis are possible in unspecific pyelonephritis and malignant tumors.     

Elecroencephalographic charactistics of Creutzfeldt-Jakob disease and its differential diagnosis

Although clinical electroencephalography is no longer as important as it used to be in differential diagnosis of a fair number of neurological and psychiatric diseases ever since imaging techniques have been making enormous strides, EEG is still an important diagnostic tool in dementias where specific morphological lesions are not immediately or not at all apparent which would otherwise be visible by imaging. Sporadic Creutzfeldt-Jakob disease is an important case in point. Although this is associated with some unspecific EEG findings, typical periodical sharp wave complexes (PSWC) become conspicuous in the course of the disease. If these are meticulously studied and particular attention is paid to their periodicity, a sensitivity of 67% and a specificity of 86% are attained. With the exception of one familial variant of Creutzfeldt-Jakob disease PSWC ar usually absent all other human prion diseases. Hence, it is not likely that they are linked to the aetiology of sporadic Creutzfeldt-Jakob disease. We present a patho-physiological hypothesis on the development of PSWC basing on the assumption that the specific periodicity of PSWC results from a still functionally active but greatly impaired subcortical-cortical circuit of neuronal excitability. This specific pattern of neuronal degeneration may obviously arise--albeit very rarely--also in other diseases independent of their aetiology, so that the EEG patterns appear identical. For this reason it is imperative to make complementary use of EEG and of recent clinical and laboratory data of Creutzfeldt-Jakob disease before PSWC and be considered a relevant diagnostic criterion. Conversely, clinical diagnosis of Creutzfeldt-Jakob disease should be reconsidered if repeated EEG recordings fail to reveal PSWC even under technically adequate conditions.