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PubMed2006

The impact of resident duty hours reform on the internal medicine core clerkship: results from the clerkship directors in internal medicine survey.

PURPOSE: In July 2003, resident duty hours regulations were implemented. The impact of these regulations on medical student education has received minimal attention. The objective of this study was to evaluate the perceptions of internal medicine clerkship directors about the impact of resident physician duty hours reform on medical student teaching, assessment, and clerkship structure. METHOD: A survey was sent to 114 institutional members of Clerkship Directors in Internal Medicine in May 2004. The survey included 17 attitude items rated on a 5-point Likert scale, five items related to clerkship structure, and four open-ended questions. Descriptive statistics were performed on the responses. RESULTS: Ninety-six surveys were returned (84%). The majority of respondents did not believe duty hours reform had a positive impact on clerkship students' educational experiences, whereas 48.3% agreed or strongly agreed that residents had more difficulty evaluating students' clinical skills. There was not a significant change in inpatient clerkship structure after duty hours implementation. Time for teaching students, concerns about a shift-work mentality, and student continuity with their teams were major challenges. Impact on ambulatory internal medicine rotations was minimal. CONCLUSIONS: Internal medicine clerkship directors are concerned about the impact of resident duty hours reform on student education. Additional studies of this educational impact are needed.

Attitude↗
PubMed1987

Recommendations for reference method for haemoglobinometry in human blood (ICSH standard 1986) and specifications for international haemiglobincyanide reference preparation (3rd edition). International Committee for Standardization in Haematology; Expert Panel on Haemoglobinometry.

Scientific symposia on haemoglobinometry were held at the 9th Congress of the European Society of Haematology, Lisbon, 1963 (ESH 1964) and the 10th Congress of the International Society of Haematology (ISH), Stockholm, 1964 (ISH 1965). The International Committee for Standardization in Haematology (ICSH) made recommendations endorsed by the General Assembly of ICSH in Sydney on 23 August 1966 (ICSH 1967), for a reference method for haemoglobinometry and for the manufacture and distribution of an international reference preparation. Further symposia were held at the 12th Congress of the ISH, New York, 1968 (Astaldi, Sirtori & Vanzetti 1979) and at the 13th Congress of ISH, Munich, 1970 (Izak & Lewis 1972). The recommendations were reissued in 1978 (ISH 1978). On the basis of continuing experimental studies, the reference method and the specifications for the international reference preparation have been modified. The revised recommendations are described in this document.

Drug Stability↗
PubMed2006

International standards for minimum potency of anti-A and anti-B blood grouping reagents: evaluation of candidate preparations in an international collaborative study.

BACKGROUND AND OBJECTIVES: The aim of the study was to evaluate lyophilized monoclonal IgM anti-A and anti-B preparations for use as international standards (IS) to specify recommended minimum potencies of anti-A and anti-B blood grouping reagents in tube tests. MATERIALS AND METHODS: The candidate IS for minimum potency of anti-A and anti-B blood grouping reagents, codes 03/188 and 03/164, respectively, were evaluated against a wide range of commercial anti-A and anti-B blood grouping reagents in an international collaborative study involving 16 laboratories in nine countries. Laboratories titrated 03/188 and 03/164 in parallel with as many commercial anti-A and anti-B blood grouping reagents, respectively, as were available to them, in tube tests according to specified haemagglutination methodology. Three of these laboratories and a further laboratory also titrated 03/188 and 03/164 in parallel with currently available reference preparations for anti-A and anti-B. The ratios of the mean endpoint titres of the anti-A and anti-B reagents to those of 03/188 and 03/164, respectively, within each laboratory were calculated. RESULTS: The ratios of the mean titres of the anti-A reagents to the mean titre of 03/188 within a laboratory fell within 0.062 and 4, i.e. the potencies of the anti-A reagents were between a sixteenth to four times as strong as 03/188. The ratios of the mean titres of the anti-B reagents to the mean titre of 03/164 within a laboratory also fell within 0.062 and 4, with one outlier. CONCLUSIONS: By international consensus, a 1 in 8 dilution of the candidate IS for anti-A, 03/188, and a 1 in 4 dilution of the candidate IS for anti-B, 03/164, were considered appropriate to define the recommended minimum potencies of anti-A and anti-B blood grouping reagents, respectively, in tube tests. On the basis of these results, preparations 03/188 and 03/164 were established by the World Health Organization as International Standards for Minimum Potency of Anti-A and Anti-B Blood Grouping Reagents respectively, and by the US Food and Drug Administration Center for Biologics Evaluation and Research as Minimum Potency Reference Reagents.

ABO Blood-Group System↗
PubMed1989

International Standards for human prolactin: calibration by international collaborative study.

Three ampouled preparations of purified human prolactin were assessed by 20 laboratories in eight countries for their suitability to serve as International Standards for the estimation of human prolactin in serum. Bioassays (pigeon crop sac assays and NB2 cell assays) were carried out in two laboratories, radioreceptor assays by one laboratory and radioimmunoassays by 17 laboratories. By physicochemical analysis the preparations appeared similar. Each preparation contained small amounts of contaminants and/or prolactin variants. No major differences among the three preparations were detected by immunoassay although, in one radioreceptor assay system, one of the preparations was found to differ from the other two. On the basis of all the available information, the Expert Committee on Biological Standardization of the World Health Organization (ECBS) in 1986 established the preparation in ampoules coded 83/562 as the Second International Standard for Prolactin and in October 1988 established the preparation in ampoules coded 84/500 as the Third International Standard for Prolactin. A value of 0.053 IU (53 mIU) prolactin activity/ampoule was assigned to both the Second and Third IS on the basis that this unitage would, insofar as possible, maintain continuity of the IU defined by the First International Reference Preparation of Prolactin, human, for Immunoassay (coded 75/504).

Amniotic Fluid↗
PubMed1992

Internal medicine and the training of international medical graduates: a time for open discussion and new approaches.

The number of foreign national medical graduates entering internal medicine residency training programs in the United States has doubled since 1986. A rigorous, standardized preresidency evaluation of the basic clinical skills and language abilities of international medical graduates should be implemented. Those found to have significant deficits should undertake a preparatory curriculum designed to meet special educational needs before entry into the formal training program. A relevant curriculum might include formal lectures, reading assignments, physical diagnosis sessions, language classes, patient encounter sessions, and a tutorial on U.S medical culture that includes medical ethics and the basics of the our health care system. All or only some of these may be required for any given individual. The Educational Commission for Foreign Medical Graduates (ECFMG) could provide many of the methods needed for an evaluation program and work collaboratively with program directors. This new approach to training of international medical graduates will require an evaluation system to to measure its effectiveness. Important questions about the funding of graduate medical education for international medical graduates must also be addressed.

Clinical Competence↗
PubMed1975

[A giant aneurysm of the internal carotid artery treated by intracranial direct surgery--with a special reference to the anatomical relationship between the cavernous sinus and the internal carotid artery (author's transl)].

There have been a few reports about intracranial giant aneurysms treated by intracranial direct approaches. Especially, for giant aneurysms of the internal carotid artery, direct operation has been thought to be difficult to perform because of the anatomical particularity and the danger of rupture during surgery. So the cervical carotid ligation has frequently been indicated. However, the carotid ligation does not relieve the symptoms caused by the giant aneurysm as an "intracranial mass lesion". The authors have reported here, a cured case of a giant aneurysm of the intracavernous portion of the internal carotid artery, to which, as the first step, ligation of the internal carotid artery in the cervical region was performed, and as the second step, endaneurysmorrhaphy was carried out for the remaining symptoms caused by the "intracranial mass lesion". Furthermore, the surgical techniques for treatment of giant aneurysms of the internal carotid artery were discussed citing literatures, and the authors concluded that the combined operation of carotid ligation and endane-urysmorrhaphy could be effective to giant aneurysms in this region. Meanwhile, a new concept concerning the anatomy of the carotid-cavernous region already proposed by Bedford, was confirmed by our observation at operation. It may be considered that the intracranial direct approach to aneurysms in this region and also to carotid cavernous fistulae should more frequently be indicated than ever performed, according to the new concept of the anatomy in this region.

Adult↗
PubMed2004

Which primary care specialty? Factors that relate to a choice of family medicine, internal medicine, combined internal medicine-pediatrics, or pediatrics.

BACKGROUND AND OBJECTIVES: This study was conducted to examine factors used by medical students to select a primary care specialty that may differentiate students who choose the primary care specialties of family medicine, internal medicine, pediatrics, and combined internal medicine-pediatrics. METHODS: A questionnaire was sent to all family physicians and an equal number of other primary care physicians graduating from one of 24 medical schools in 1997-1999. Twelve schools had increasing proportions of graduates choosing family medicine in this study period, and 12 had decreasing proportions. The questionnaire asked about factors related to choice of specialty, which could be grouped into the specialty domains of type of patients, process, content, and setting. RESULTS: For family physicians, the most important factor was patient relationships, and the second most important was wanting an approach to the practice of medicine similar to that of family physicians. Internists indicated as most important wanting to work with adults and as the next most important an "internal medicine approach" to the practice of medicine. Most important for pediatricians was working with children and next most important was having patient relationships like other pediatricians. Those in combined internal medicine-pediatrics most often indicated a desire to work with children and next most important was an approach to medicine like others in their specialty. CONCLUSIONS: The most important reasons for choice of specialty were similar for all primary care specialties and related to congruence between the graduate and the physicians in the specialty or the process of providing care within that specialty. The factors that differentiated the four specialties related to the content of the specialty.

Adult↗
PubMed1988

[Two cases of spontaneous occlusion of the internal carotid artery due to a giant intracranial internal carotid artery aneurysm].

Although spontaneous thrombosis of a giant intracranial aneurysm is comparatively common, its parent artery occlusion is rare. Recently we experienced two cases in which spontaneous thrombosis of giant intracranial internal carotid artery aneurysm and occlusion of its parent artery were occurred. Case 1. A 49-year-old man, complaining esotropia was referred to us by an ophthalmologist. He had no particular past history. Neurological examination revealed left oculomotor, abducens palsy and disturbance of left trigeminal first branch. CT scan revealed a round high density mass in the left middle fossa. The size was 3 cm in diameter. Left CAG revealed severe stenosis of left internal carotid artery and in delayed phase, faint shadow was seen near posterior clinoid process. MRI revealed a high intensity mass of the intraaneurysmal thrombus in the left middle fossa with small low intensity area indicating residual lumen. With conservative treatment, the symptom was gradually improved and one month after admission, complete occlusion of the left internal carotid artery was seen by angiography. The patient returned to his previous occupation. Case 2. A 21-year-old man was admitted to our hospital complaining dysarthria and left hemiparesis. He had been diagnosed as left internal carotid giant aneurysm 5 years before when he had suffered from right visual disturbance. Neurological examination revealed left hemiparesis and dysarthria. CT scan revealed high density mass which extended from the base of the right middle fossa to the third ventricle.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

The First International Standard for Somatropin: report of an international collaborative study.

Following an earlier decision to move away from the in vivo bioassay for determination of the potency of therapeutic somatropin (recombinant DNA human growth hormone), 18 laboratories in 12 countries participated in an international collaborative study designed to establish an international standard for somatropin, calibrated both by bioassay and by physicochemical assays of somatropin content. The mean in vivo biological potency of preparation studied, coded 88/624, was 6.75 IU/ampoule (fiducial limits 6.30-7.23). Determination of the protein content by quantitative amino-acid analysis yielded a mean estimate of 1.98 mg protein per ampoule. (Relative standard deviation = 2.88%). Data from the study also yielded mean values of 97.2% +/- 0.8% for the monomer content of the preparation, and 8.18 (RSD = 4.00%) for A1% at 276 nm. At its 45th meeting, in October 1994, the ECBS of WHO formally established the preparation 88/624 as the First International Standard for Somatropin, with a defined content of 2.0 mg protein per ampoule, and a defined specific activity of 3.0 International Units per milligram.

Animals↗
PubMed1993

Predicting the first-year performances of international medical graduates in an internal medicine residency.

BACKGROUND: Recent growth in the number of international medical graduates (IMGs)--i.e., graduates of non-U.S. and non-Canadian medical schools--who fill positions in internal medicine residencies requires examination of the predictive validity of selection criteria. METHOD: Data were analyzed for 46 foreign-born IMGs who entered the internal medicine residency at Wright State University School of Medicine between January 1985 and January 1991. The t-test and Pearson correlation were used to relate ten selection variables (age, gender, foreign clinical experience, U.S. clinical experience, clinical experience in the two years prior to residency, time between medical school graduation and residency, performance on the Foreign Medical Graduate Examination in the Medical Sciences--FMGEMS--Parts I and II, interview language skill, and interview rank category) to performance ratings the IMGs received in the first year of residency. RESULTS: Only performance on the FMGEMS Part I (p = .045) and clinical experience in the two years prior to residency (p = .005) were related significantly to subsequent performance in residency. CONCLUSION: The results suggest that recent clinical experience and performance on standardized examinations are the two selection criteria most predictive of foreign-born IMGs' first-year performances as internal medicine residents.

Adult↗
PubMed1984

The Na+-dependent regulation of the internal pH in chick skeletal muscle cells. The role of the Na+/H+ exchange system and its dependence on internal pH.

The internal pH (pHi) of chick muscle cells is determined by the transmembrane Na+ gradient. Li+, but not K+, Rb+ or Cs+, can substitute for Na+ for regulating the internal pH of chick muscle cells. Pharmacological evidence using amiloride and amiloride analogs has shown that the Na+/H+ exchange system is the membrane mechanism that couples the pHi to the transmembrane Na+ gradient. The pHi dependence of the amiloride-sensitive Na+/H+ exchange mechanism was defined. Internal H+ interacts cooperatively with the Na+/H+ exchange system, in contrast with external H+, thus indicating an asymmetrical behaviour of this exchanger. The half-maximum effect for the activation by the internal H+ of the Na+ transporting activity of the amiloride-sensitive Na+/H+ exchange was observed at pH 7.4. The Hill coefficient of the H+ concentration dependence is higher than 3. Insulin was shown to have no effect on the pHi of chick muscle cells.

Amiloride↗
PubMed2001

Third International Standard for pertussis vaccine: international confirmation study of activity of British Standard for pertussis vaccine, coded 66/303.

The first British Standard (BS) (Code 66/303) for pertussis whole cell vaccine was prepared from the same suspension of Bordetella pertussis as the now exhausted Second International Standard for Pertussis Vaccine (2ndIS). The BS and the 2ndIS were compared and calibrated in a previous international study. This report describes a small international study, which included the BS, the 1stIS and the 2ndIS so that the present relationship of these preparations to one another could be assessed. The results of this study show that the relationship of the BS to the 1stIS is consistent with its established unitage of 46 IU per ampoule. The results further show that the potency of the BS is broadly consistent with that of the 2ndIS and that the BS has not lost activity relative to the 2ndIS (from which it was previously found to be indistinguishable). Based on its original calibration and supported by the results of this present study, the BS has been established as the Third International Standard for Pertussis Vaccine, with an assigned unitage of 46 IU per ampoule.

Humans↗
PubMed1990

A non-selective cation channel in rabbit corneal endothelium activated by internal calcium and inhibited by internal ATP.

The apical membrane of the rabbit corneal endothelium contains a cation selective channel of 21.7 +/- 0.4 pS conductance which is activated by internal Ca2+ and inhibited by internal ATP. Patch clamp studies show the channel to be quite selective for cations over anions but not to select between Na+ and K+. In excised patches in the inside-out configuration, the open probability increases when the internal Ca2+ is raised above 10(-4) M. ATP decreases the open probability when its internal concentration exceeds 10 microM. At 1 mM ATP, no channel openings are ever seen. AMP and ADP also inhibit at least as well as does ATP. One microM AMP-PNP, a non-hydrolyzable ATP, also inhibits gating and so phosphorylation by a PO4(-3) cleaved from ATP is not the mechanism of ATP inhibition. The channel is apparently impermeable to divalent ions since neither Ba2+ nor Ca2+ carry any detectable current. Quinidine produces a flickery, weakly voltage dependent blockade when applied to the channel's cytoplasmic surface. Both Ca2+ and ATP work at concentrations not expected to occur inside healthy cells. It is presently uncertain if this is a physiologically important channel in these cells.

Adenosine Diphosphate↗
PubMed1989

Transfontanelle pulsed Doppler measurement of blood flow velocity in the internal jugular vein, straight sinus, and internal cerebral vein in preterm and term neonates.

This paper presents the range of normal blood flow velocity in different cerebral veins in early infancy measured by transfontanelle pulsed Doppler ultrasonography. The blood flow velocity of the internal jugular vein (38 infants), internal cerebral vein (28 infants), and straight sinus (18 infants) in a group of clinically stable neonates and young infants (body weight 1060-3750 g, age 1-86 d, gestational age 28-41 wk) is specified. The time mean of maximum velocity (Vma) of internal jugular vein was 8.4 +/- 4.7 cm/s, of internal cerebral vein 5.5 +/- 1.6 cm/s, and of straight sinus 12.6 +/- 7.8 cm/s. While the variability between infants was high, the reproducibility of the method was in the range of 4.4-10.2% for Vma. This compares well with studies on cerebral arteries and offers a noninvasive approach to the study of the venous cerebral hemodynamics in neonates undergoing intensive care.

Blood Flow Velocity↗
PubMed2004

Evaluation of internal lung motion for respiratory-gated radiotherapy using MRI: Part II-margin reduction of internal target volume.

PURPOSE: To analyze the relationship between lung motion and skin surface motion during respiration, determine the uncertainties and variability of such a relationship, and assess the potential of reducing internal target margin for gated radiotherapy. METHODS AND MATERIALS: Three healthy volunteers and four lung cancer patients were recruited in a prospective imaging study using MRI to track the internal lung and external skin motion during breathing. The relationship between the lung and skin motion was modeled using linear regression analysis. The slope of the linear fit and its confidence interval were analyzed for different lung locations, skin surface locations, and breathing patterns from separate imaging sessions. The margins of the internal target volume were calculated based on the residual lung motion during gating and its uncertainties from multiple treatment fractions for the gated treatment. RESULTS: The slope and confidence interval of the linear regression from the motion analysis were uniquely defined by the locations of the lung, skin surface, and breathing patterns. Statistically significant differences were observed among individuals and between different times of measurement. The normal free-breathing motion averaged from all volunteer and patient data was 13.4 +/- 7.4 mm along the superior-inferior (SI) direction and 6.9 +/- 2.6 mm along the anterior-posterior (AP) direction. With simulated respiratory gating, the average margin reduction was 5.5 +/- 4.8 mm and 1.6 +/- 1.0 mm, respectively, along the SI and AP directions (or 36% +/- 15% and 25% +/- 14%, respectively, relative to free-breathing motion). CONCLUSION: Because respiratory movement is rather complex, the relationship between the lung and skin surface motion is affected by many anatomic and physiologic factors. The reduction of internal target margin and efficacy of the free-breathing gating technique should be assessed for individual cases.

Adult↗
PubMed2004

Evaluation of internal lung motion for respiratory-gated radiotherapy using MRI: Part I--correlating internal lung motion with skin fiducial motion.

PURPOSE: To measure the internal lung motion due to respiration using magnetic resonance images (MRIs); to evaluate the correlation between lung motion and skin surface motion and the reliability of tracking lung motion with external fiducials. METHODS AND MATERIALS: An MRI protocol using fast gradient-echo sequences was developed to acquire dynamic cine images of the thoracoabdominal region along the axial, sagittal, and coronal planes. The subjects (3 healthy volunteers and 4 lung cancer patients) were instructed to perform normal or altered breathing during MRI. Lung vessels identified on MRI were used as anatomic landmarks for internal lung structures. From sagittal cine MRI scans, the positions of the lung vessels and skin surface were tracked and their movements measured. Correlation between the movements of the external markers and internal structures was then calculated and analyzed. RESULTS: Lung vessel motion in the superior-inferior (SI) direction correlated best with mid-upper abdominal skin surface movement (correlation coefficient, 0.89 +/- 0.09 and 0.87 +/- 0.23 for volunteers and patients, respectively). The anterior-posterior (AP) vessel motion generally correlated poorly with the skin surface movement, with marker placement on the upper chest yielding the strongest results (correlation coefficient, 0.72 +/- 0.23 and 0.44 +/- 0.27 for volunteers and patients, respectively). The strength of the correlation depended on the locations of the tracked vessels, locations of the skin surface, and subjects' breathing patterns. The best correlation was seen between the motion of an abdominal fiducial and SI lung motion. Significant intersubject variability was also observed. CONCLUSION: Movement of an external fiducial may not correlate fully with, or predict, internal lung motion. Effective monitoring of respiration may have to rely on a combination of multiple fiducials and other physiologic parameters, such as lung volume and/or air flow.

Adult↗
PubMed1995

Reimplantation of the right internal thoracic artery as a free graft into the left in situ internal thoracic artery (Y procedure). One-year angiographic results.

Reimplantation of the right internal thoracic artery, as a free graft, into the left in situ internal thoracic artery (Y procedure) has enabled us to bypass more distant marginal vessels, which was not possible by the bilateral technique alone. This prospective study was aimed at evaluating the clinical state of the patients and the degree of patency of grafts within 16 months of follow-up. All 80 patients who underwent the Y procedure between January 1988 and January 1992 were included. This group represented 10% of the 840 patients having coronary bypass during the same period. A total of 202 coronary anastomoses were performed in this series. Early postoperative (30 days) complications included three deaths (3.75%), eight myocardial infarctions (10%), one case of phrenic nerve paralysis (1.25%), two cases of respiratory failure (2.5%), and six wound infections (7.5%). At 3 months' follow-up, 96% of patients were free of symptoms. During the follow-up period, four patients died of noncardiac causes (lung, pancreatic, and brain cancer and rupture of an abdominal aortic aneurysm). At 1 year, 71 patients were free of symptoms (97%). Sixty-one patients underwent coronary angiography between 12 and 24 months. Six patients with peripheral arterial disease were not suitable for coronary angiography, and six refused to be tested. These 12 patients had normal thallium test results in the bypassed area (stress or dipyridamole test). The patency rate of the left internal thoracic artery was 98.3% (n = 60), occlusion rate 1.6% (n = 1), and incidence of threadlike arteries 4.9% (n = 3). Thus the rate of perfect patency was 93.4%. The patency rate of the right internal thoracic artery as a free graft was 93.4% (n = 57), occlusion rate 6.5% (n = 4), and the incidence of threadlike arteries 8% (n = 5). Thus the rate of perfect patency was 85.2%. A total of 169 anastomoses were studied. The rate of patency of the anastomoses to the left anterior descending coronary artery was 96% (n = 58) and the occlusion rate, 4% (n = 2). The patency rate of sequential anastomoses (side to side) to diagonal arteries was 100% (n = 16). Patency rate of anastomoses to obtuse marginal arteries was 95% (n = 58) and the rate of occlusion, 4.9% (n = 3). The patency rate of anastomoses to the posterior descending artery or distal branches of the right coronary artery was 80% (n = 4/5).(ABSTRACT TRUNCATED AT 400 WORDS)

Anastomosis, Surgical↗
PubMed2001

Report on the Tenth International Platelet Genotyping and Serology Workshop on behalf of the International Society of Blood Transfusion.

BACKGROUND AND OBJECTIVES: The aims of the 10th International Platelet Serology and Genotyping Workshop were to evaluate the proficiency of platelet immunology determinations. MATERIALS AND METHODS: There were 40 participants from 25 countries of four continents. Thirty-eight institutions reported results for genotyping, and 38 institutions reported their serological results. For genotyping, EDTA-anticoagulated whole-blood samples were provided (to allow the inclusion of DNA-separation methodology in the analysis) as well as separated DNA of a and b alleles for human platelet antigen (HPA)-1 to -6. For serological evaluations, sera contained allo- and autoantibodies, and for sensitivity testing a standard freeze-dried sample of HPA-5 antibody. RESULTS: All participants reported HPA-1, -2, -3 and -5 genotyping results; HPA-4 was determined in 29 laboratories and HPA-6 in 21. Results from 16 laboratories were concordant with the majority vote for all allotypes, eight institutions reported one deviation, five laboratories two, and nine laboratories three or more deviations. Twelve institutions had no deviation from the majority vote for HPA antibodies, nine had one, three had two, and 14 had three or more deviations. Most laboratories reported a reactivity of the standard anti-HPA-5b sample with HPA-5b platelets at a dilution of 1:4-1:8. Four laboratories detected anti-Gova in one sample. Seventeen laboratories reported no deviation from the majority vote for pan-reactive platelet antibodies, 12 had one deviation, two had two, and seven had three or more deviations. In addition, seven participants reported antibodies against glycoprotein IV (GPIV), three against glycoprotein V (GPV) and three against CD 109. These results were discussed at a meeting organized jointly with the International Society of Blood Transfusion (ISBT) 2000 Congress. CONCLUSION: The results for pan-reactive antibodies were heterogeneous with most discrepancies from the majority vote. The provision of sufficient samples for many participants is difficult. Based on the results and discussion it is clear that frequent workshops are needed in the future. Therefore, workshops shall be organized regionally, and each region shall participate with one institution in international workshops. The latter are needed to assure international exchange of experience and quality.

Antibody Specificity↗