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At least 217 records · Page 12Linked to original sources
PubMed1992

Effect of concomitant administration of piperacillin on the dispositions of isepamicin and gentamicin in patients with end-stage renal disease.

Piperacillin inactivation of the aminoglycosides isepamicin and gentamicin in 12 chronic hemodialysis patients was assessed. Six subjects each received isepamicin (7.5 mg/kg of body weight) or gentamicin (2 mg/kg) alone and in combination with piperacillin (4 g every 12 h for four doses). Isepamicin and gentamicin concentrations in plasma and urine were monitored over 48 h after each dose and analyzed by high-performance liquid chromatography and fluorescence polarization immunoassay, respectively. The pharmacokinetics of isepamicin were not significantly altered during combination treatment with piperacillin. The total body clearance (3.79 +/- 0.71 versus 3.94 +/- 1.05 ml/min), the steady-state volume of distribution (0.19 +/- 0.04 versus 0.18 +/- 0.03 liter/kg), and the terminal elimination half-life (47.91 +/- 7.20 versus 45.08 +/- 10.34 h) were not significantly altered in the presence of piperacillin. In contrast, the terminal elimination half-life (47.68 +/- 20.58 versus 35.67 +/- 11.18 h) of gentamicin was significantly reduced when gentamicin was given with piperacillin. The total body clearance (4.26 +/- 3.07 versus 4.89 +/- 1.94 ml/min) and the steady-state volume of distribution (0.19 +/- 0.04 versus 0.20 +/- 0.04 liter/kg) of gentamicin were not significantly altered during combination therapy; however, the nonrenal clearance of gentamicin administered in combination with piperacillin (3.56 +/- 0.38 ml/min) increased significantly compared with that of gentamicin (2.03 +/- 0.50 ml/min) given alone. The results of this study suggest that no additional dosage adjustment of isepamicin during concomitant therapy with piperacillin in hemodialysis patients is necessary. However, this does not preclude the need for appropriately ex vivo-handled specimens for monitoring isepamicin concentrations in plasma to ensure therapeutic efficacy and prevent toxicity. Furthermore, additional dosage adjustments may be necessary when gentamicin is used concomitantly with piperacillin, on the basis of the significant in vivo inactivation that takes place in end-stage renal disease patients.

Adult↗
PubMed1996

Detection of hepatitis C virus by PCR in second-generation enzyme immunoassay-seropositive blood donors by using matched pairs of fresh frozen plasma and pilot tube sera.

Between April 1993 and March 1995, 429 of 334,454 (0.13%) blood donations at the Toronto Centre of the Canadian Red Cross were reactive for hepatitis C virus (HCV) by second-generation enzyme immunoassay (EIA-2). Of the 429 EIA-2-positive donations, 189 (44%), 138 (32%), and 102 (24%) were positive, indeterminate, and negative by Second-Generation Recombinant Immunoblot Assay (RIBA-2). To assess HCV viremia and minimize the risk that specimen handling affected PCR-based detection, the qualitative AMPLICOR HCV test was performed on both pilot tube sera (PTS) and the corresponding fresh frozen plasma (FFP) from 294 EIA-2-reactive donations. AMPLICOR PCR results for PTS and FFP were 100% concordant and were confirmed by nested HCV PCR for 27 of 294 donations. The AMPLICOR HCV test was positive for 127 of 140 (91%) of RIBA-2-positive donations (81, 91, and 96% of donations with two, three, and four reactive bands, respectively), 5 of 88 (5.7%) indeterminate donations, and 0 of 66 (0%) RIBA-2-negative donations. The Third-Generation Recombinant Immunoblot Assay (RIBA-3) was performed on RIBA-2-negative, -indeterminate, and -positive, PCR-negative donations. RIBA-3 demonstrated enhanced specificity and resolved 18 of 88 (20%) of RIBA-2-indeterminate samples as HCV antibody positive. The study demonstrates that PTS are as suitable as FFP for PCR-based detection of HCV and can be used to determine if EIA-2-reactive blood donors are viremic at the time of donation.

Blood Donors↗
PubMed1997

Comparison of two automated DNA amplification systems with a manual one-tube nested PCR assay for diagnosis of pulmonary tuberculosis.

Eighty-four specimens of respiratory secretions culture positive for mycobacteria (70 positive for Mycobacterium tuberculosis and 14 positive for nontuberculous mycobacteria) and 120 culture-negative specimens were evaluated by three DNA amplification techniques: a manual in-house single-tube nested PCR (nPCR) and two commercial automated assays (the Cobas Amplicor System [aPCR-h] from Roche Diagnostic Systems and the Abbott LCx Probe System [aLCx-p] from Abbott Laboratories). The overall diagnostic sensitivities of the nPCR, aPCR-h, and aLCx-p were 77.1, 84.3, and 77.1%, respectively, and the sensitivities were 57.9, 57.9, and 36.8%, respectively, for smear-negative specimens. Specimens culture positive for nontuberculous mycobacteria were negative by all three assays. Eight culture-negative specimens which were positive by one or more assays had previously been documented by culture to be positive for M. tuberculosis and were taken from patients who were treated with antituberculosis agents. Retesting of specimens negative by one assay by the other two assays revealed that each test had its unique group of negative specimens. When considering the DNA extraction and amplification steps of these assays separately, it was found that extracts from aPCR-h and aLCx-p were compatible with nPCR amplication, while the two automated assays could only amplify extracts processed with their own reagents. Limiting dilution analysis revealed that the order of analytical sensitivity was nPCR, followed by aLCx-p and then aPCR-h. Comparison of the work flow of each assay revealed that although the aPCR-h demands the least specimen handling, the turnaround time of aLCx-p is the most favorable.

Antigens, Bacterial↗
PubMed1997

Descriptive profile of tuberculin skin testing programs and laboratory-acquired tuberculosis infections in public health laboratories.

The increase in numbers of cases of tuberculosis in the United States has placed greater demands on mycobacteriology laboratory workers to produce rapid and accurate results. The greater number of specimens generated by the increased emphasis on detecting the disease has placed these workers at greater risk of laboratory-acquired infection. We surveyed 56 state and territorial public health laboratories to determine the status of existing tuberculin skin testing (TST) programs and to evaluate the frequency of probable laboratory-acquired tuberculosis for each responding mycobacteriology laboratory. Probable laboratory-acquired infections were determined by each laboratory's evaluation of occupational positions, duties, and employee histories and review of medical records. Two-step TST for new employees was routinely practiced in only 33% of responding laboratories, and mycobacteriology laboratorians were found to be most frequently screened when they were compared to employees of other departments. Of 49 (88%) responding laboratories, 13 reported that 21 employees were TST converters from 1990 to 1994. Seven of these 21 employees were documented to have laboratory-acquired infections based on evaluations by their respective laboratories. Based on Centers for Disease Control and Prevention guidelines, converters are categorized on the basis of both a change in the size of the zone of induration and the age of the person being tested. By the definitions in the guidelines, 14 mycobacteriologists were identified as recent converters, 7 of whom were > or = 35 years of age and 4 of whom were exposed in the laboratory within a 2-year period. Inadequate isolation procedures, the high volume of specimen handling, and faulty ventilation accounted for these laboratory-associated infections. These results suggest that more frequent periodic evaluations based on documented TST conversions for workers in mycobacterial laboratories should be performed, since this population is at increased risk of becoming infected with Mycobacterium tuberculosis. Although general assessments are necessary to accurately and effectively evaluate the risk of tuberculosis transmission, they are especially important for those working in high-risk areas within a public health laboratory.

Humans↗
PubMed2000

A 5' nuclease PCR (TaqMan) high-throughput assay for detection of the mecA gene in staphylococci.

In an effort to find a rapid, efficient, and reliable method of screening large numbers of bacterial isolates for specific antimicrobial resistance genes, we compared conventional PCR results to the results generated using the TaqMan 5' nuclease PCR kit in conjunction with an ABI Prism 7700 Sequence Detector for detecting the mecA gene in various species of staphylococci. DNA was extracted using two techniques. The first used a high-salt extraction method suitable for conventional PCR but resulted in a 7.2% rate of PCR inhibition with the TaqMan technique. PCR inhibition could be overcome by diluting samples 1:5 prior to testing. The second method used the Qiagen QIAamp Tissue Kit; no instances of PCR inhibition were encountered with this method. A total of 197 (96%) of the 206 samples with no inhibition showed agreement between the two methods. Eight of the nine disagreements were likely the result of low-level DNA cross contamination caused by frequent specimen handling. Target DNA in all eight of these samples was first detected in the initial tests only after >30 PCR cycles, and all were negative upon repeat testing even after 40 PCR cycles using freshly extracted DNA. Among those positive samples in agreement, target DNA was invariably detected before 30 PCR cycles. The TaqMan assay eliminated the need to load, run, stain, and read agarose gels and provided the advantage of instant detection of PCR product by laser-activated fluorescence. Thus, final results were obtained 2 h after PCR was initiated, as opposed to a requirement of 2 days to examine 96 samples by agarose gel electrophoresis.

Bacterial Proteins↗
PubMed2006

My approach to pancreatic fine needle aspiration.

Pancreatic fine needle aspiration cytopathology has earned a reputation as a rapid, safe, accurate and cost-beneficial modality of investigation of pancreatic mass lesion. Optimal results can be expected only if these procedures are undertaken regularly in gastroenterology departments processing large numbers of patients; occasional aspirators cannot exploit the technique to full potential. Professional teams following a dedicated approach to patient selection and management develop requisite expertise over time. Cytodiagnosis rests as much on morphological examination as on the milieu in which is it practised, and as much on sample quality as on cellular criteria. This article focuses attention on specimen handling, with particular reference to rapid on-site evaluation. The significance of particular cytodiagnoses in patient care is evaluated, and tumour types that may be encountered are enumerated and illustrated.

Adenocarcinoma, Mucinous↗
PubMed1981

Data handling and reporting for microbiology specimens with a small laboratory computer system.

A small laboratory computer system designed for general application in chemistry, haematology, and urinalysis has been adapted for the bacteriology section of the laboratory using the same available programming routines. Specimens are requisitioned according to predetermined common site codes, with both preliminary and final reporting allowed for where desired. Sensitivity data also appended and entered where required, even for different organisms in the same culture.

Bacteriology↗
PubMed1978

CT-assisted pelvic and abdominal aspiration biopsies in gynecological malignancy.

Twenty-four CT-directed biopsies were performed in 17 women with proved gynecological malignancy which had been treated previously by surgery, radiotherapy, chemotherapy or a combination of modalities. CT proved superior to ultrasound biopsy in that the presence of gas in the bowel does not hinder imaging and the use of contrast agents to outline bladder and ureters enables identification of pathological masses even in the presence of massive adhesions and anatomical distortion. Even in small lesions, CT can locate the tip of the needle. The technique, difficulties, specimen handling and clinical relevance are discussed.

Adult↗
PubMed2004

Advancement of biomarker discovery and validation through the HUPO plasma proteome project.

The Human Proteome Organization (HUPO) Plasma Proteome Project has mounted a Pilot Phase focussed on key problems essential for standardization of specimen collection, specimen handling, choice of fractionation and analysis technologies, and search engines and databases for protein identifications. This international collaboration will lay the groundwork for many large-scale clinical and epidemiological studies of health and disease.

Biomarkers↗
PubMed1975

Mechanical preparation of cells for chromosome studies.

A machine, performing hypotonic treatment and fixation of blood samples for chromosome analysis under standard conditions, is described. The machine has now handled specimens from 4,100 persons. 12 tubes are shaken at a rate of approximately 2,800/min, and simultaneously solutions for hypotonic treatment and fixation are added during 30-45 sec from a distribution chamber. The apparatus produces long, slender chromosomes suitable for staining by modern techniques which yield banded chromosomes.

Cells, Cultured↗
PubMed1987

Artifacts in ultrastructure of respiratory cilia caused by various fixation procedures and different types of handling.

The ciliary ultrastructure with different fixatives and buffer combinations and artifacts caused by handling the specimens was studied in samples from respiratory mucosa. After different standard fixatives the ciliary ultrastructure did not vary much. Glutaraldehyde in cacodylate gave the best result; the contrast was good and the cell membrane did not show undulation and so many blebs as with other fixatives. With old 4% formaldehyde + 1% glutaraldehyde inphosphate the cytoplasm was darker and the contrast was not as good as with a fresh fixative. Mechanical damage caused rupture of the cell membrane and sometimes changes in axonemal architecture. These findings are similar to those often seen in human samples. The axonemal architecture was always intact if the cell membrane was intact.

Animals↗
PubMedDate not supplied

Increase in the incidence of peritoneal collagen balls over a 10-year period.

OBJECTIVE: To describe the detection of collagen balls in peritoneal washings over a 10-year period, revealing an unexpected and unexplained higher incidence than in the past. STUDY DESIGN: Reports of routinely processed, Papanicolaou-stained smears and cytospins and hematoxylineosin-stained cell blocks from peritoneal washes and ascitic fluids seen over an 8-year period (1995-2002) were reviewed, and the percentage of specimens in which collagen balls were noted was determined. To rule out a learning curve phenomenon, the first 100 consecutive peritoneal washings and ascitic specimens from years 1993-2001 plus 2002 were rescreened, and the percentage of specimens containing collagen balls was determined. RESULTS: The percentages of cases with collagen balls increased steadily beginning with 8 of 467 cases (3.2%) in 1995 to 185 of 650 (28.5%) in 2002, as reported in the case records. Rescreened cases also showed a similar increase, 4.0% in 1993 to 29% in 2002. No procedural modifications were made in specimen processing during this interval, nor are we aware of any procedural change in obtaining cytologic samples. CONCLUSION: An unexplained 7-fold increase in the percentage of peritoneal samples with collagen balls occurred over a 10-year period. This increase cannot be attributed to changes in specimen handling or to a learning curve phenomenon. This finding is of unknown significance and may warrant further investigation.

Ascitic Fluid↗
PubMed1992

Demineralization and remineralization evaluation techniques--added considerations.

Methods used for the analysis of tooth de- and remineralization include techniques with various degrees of sophistication and quantitative capabilities, ranging from direct measures of mineral gain/loss (e.g., microradiography) to indirect measures (e.g., iodide permeability) of changes in tooth mineral properties. In all instances, the capabilities of methods for accurate determination of changes in tooth mineral properties are affected by procedures used in the preparation of specimens for analysis, the magnitude of change taking place in the test (vs. the detection limits of the techniques), and protocols for specimen analysis. In specific instances, such as in the case of dentin, unique specimen-handling and analysis procedures must be used to prevent artifacts. The choice of techniques for the assessment of de- and remineralization depends strongly upon study protocols and laboratory capabilities; however, 'quantitative' measures of mineral gain and loss are possible only if direct chemical or radiographic techniques are used. Either radiographic, cross-sectioned microhardness or polarized light can be used for the determination of lesion depth. Porosity, light-scattering, and surface microhardness are indirect techniques which complement direct measures of mineral gain and loss. Whatever methods are used in the analysis of de- and remineralization, researchers must take care to differentiate accurately among the quantitative capabilities of techniques used in analysis.

Dental Enamel↗
PubMed2002

Health and safety of laboratory science students in Ibadan, Nigeria.

Laboratory science students are engaged in laboratory practice under supervision during the course of their training programme. They are exposed to the risk of laboratory-acquired infection and need to be adequately informed and equipped with facilities to protect their health. A questionnaire was administered to laboratory science students to determine their perception of hazards in laboratory practice and the observance of safety codes in their work practices. Of 128 students, 118 completed the questionnaire, a response rate of 92%. Sixty of them (51%) were males and 53 (45%) were females; five students did not indicate their sex. The results revealed that only 34 (29%) of the students use gloves for handling biological samples and 26 (22%) use gloves for handling clinical waste. Ninety-four students (80%) reported that they washed their hands after handling specimens. Eighteen of the students (15%) had been immunised against tuberculosis, 80 (68%) against tetanus, six (5%) against hepatitis B, and 18 (15%) against yellow fever. Ninety-six students (81%) thought the greatest hazard in laboratory practice was harmful biological organisms, while 13 (11%) indicated that chemical agents were the greatest hazard. Virology was thought to be the most hazardous specialty by 41 students (35%) while morbid anatomy was ranked as least hazardous by 48 (41%) of the students. These findings indicate that whilst laboratory science students are aware of the hazards in laboratory practice, this knowledge is not translated to safe practices and students may endanger their health as a result of exposure to laboratory practice. They therefore need to be provided with adequate facilities to protect themselves and adequate supervision to ensure that they imbibe safe work practices during their training years.

Attitude of Health Personnel↗
PubMed2006

American Society of Clinical Oncology/College of American Pathologists guideline recommendations for human epidermal growth factor receptor 2 testing in breast cancer.

PURPOSE: To develop a guideline to improve the accuracy of human epidermal growth factor receptor 2 (HER2) testing in invasive breast cancer and its utility as a predictive marker. METHODS: The American Society of Clinical Oncology and the College of American Pathologists convened an expert panel, which conducted a systematic review of the literature and developed recommendations for optimal HER2 testing performance. The guideline was reviewed by selected experts and approved by the board of directors for both organizations. RESULTS: Approximately 20% of current HER2 testing may be inaccurate. When carefully validated testing is performed, available data do not clearly demonstrate the superiority of either immunohistochemistry (IHC) or in situ hybridization (ISH) as a predictor of benefit from anti-HER2 therapy. RECOMMENDATIONS: The panel recommends that HER2 status should be determined for all invasive breast cancer. A testing algorithm that relies on accurate, reproducible assay performance, including newly available types of brightfield ISH, is proposed. Elements to reliably reduce assay variation (for example, specimen handling, assay exclusion, and reporting criteria) are specified. An algorithm defining positive, equivocal, and negative values for both HER2 protein expression and gene amplification is recommended: a positive HER2 result is IHC staining of 3+ (uniform, intense membrane staining of > 30% of invasive tumor cells), a fluorescent in situ hybridization (FISH) result of more than six HER2 gene copies per nucleus or a FISH ratio (HER2 gene signals to chromosome 17 signals) of more than 2.2; a negative result is an IHC staining of 0 or 1+, a FISH result of less than 4.0 HER2 gene copies per nucleus, or FISH ratio of less than 1.8. Equivocal results require additional action for final determination. It is recommended that to perform HER2 testing, laboratories show 95% concordance with another validated test for positive and negative assay values. The panel strongly recommends validation of laboratory assay or modifications, use of standardized operating procedures, and compliance with new testing criteria to be monitored with the use of stringent laboratory accreditation standards, proficiency testing, and competency assessment. The panel recommends that HER2 testing be done in a CAP-accredited laboratory or in a laboratory that meets the accreditation and proficiency testing requirements set out by this document.

Female↗
PubMed1993

Blastomycosis in otolaryngology: review of a large series.

Blastomycosis is a fungal disease whose signs, symptoms, and roentgenographic findings may suggest pneumonia, cancer, tuberculosis, or other fungal infections. Blastomycosis has a variable clinical course; it primarily affects the lower respiratory tract, although extrapulmonary manifestations are common. To determine the frequency of head and neck manifestations, we reviewed the records of patients with blastomycosis seen at the Mayo Clinic from 1960 to 1990 and found that involvement of the skin and mucosal surfaces, including the larynx, was common. Gross and histopathologic features of the lesions often resemble those of well-differentiated squamous cell carcinoma; thus, overly aggressive therapy may be mistakenly instituted. The clinical features, morphologic findings, and diagnosis of blastomycosis are discussed, and the importance of obtaining and handling specimens correctly is emphasized.

Blastomycosis↗
PubMed2003

Screen-detected adenocarcinoma of the lung. Practical points for surgical pathologists.

Recent technological advances in thoracic radiology and surgery have altered the types of lung specimens handled by cytologists and surgical pathologists. Increasing numbers of individuals with small peripheral adenocarcinomas undergo minimally invasive diagnostic procedures and, in some instances, minimally invasive surgical procedures. The pathologist's role in early lung adenocarcinoma research is central, as clinical and investigational studies depend more than ever on subtle pathologic distinctions. Establishing a diagnosis of malignant neoplasm on samples from fine-needle aspiration, core biopsy, or frozen section is fraught with new considerations, and surgically resected adenocarcinomas must be typed according to the recently revised World Health Organization classification. Familiarity with small glandular proliferations, including the putative precursor lesion atypical adenomatous hyperplasia, will prevent misdiagnoses and untoward impact on tumor staging, therapy, and outcome studies.

Adenocarcinoma↗