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At least 595 records · Page 33Linked to original sources
PubMedDate not supplied

Clinical applicability of transient evoked otoacoustic emissions: identification and classification of hearing loss.

The study aimed at the development of a clinically applicable methodology that could: (1) discriminate transient evoked otoacoustic emission (TEOAE) recordings from normal hearing or hearing impaired individuals; (2) classify the nature of the hearing loss as conductive or as cochlear, and (3) define clear-cut TEOAE clinical criteria. A classification algorithm based on a multivariate discriminant analysis of fast Fourier transform data from recordings evoked by click stimuli of 50 +/- 2, 62 +/- 2, 68 +/- 2 and 80 +/- 2 dB SPL was used to discriminate 302 normal subjects from 383 subjects suffering from mild to moderate hearing losses. The best discriminant model (QDF80) produced a sensitivity of 93.8% and a specificity of 79.4%. When extra correlation criteria were serially applied to the classification outcome, the specificity was increased to 85.3%, but the sensitivity was marginally decreased to 91.7%. The classification of the correctly identified hearing-impaired cases yielded 93.8% identification of conductive and 75.1% identification of cochlear cases. A sensitivity analysis of the misclassified hearing-impaired cases suggested that the TEOAE spectra are well correlated with the 2-kHz but poorly correlated with the 4-kHz octave frequency.

Acoustic Stimulation↗
PubMed2000

Clinical applications of capillary electrophoresis. Status at the new millennium.

Capillary electrophoresis (CE) is an extremely sensitive technique, which has been used in the clinical laboratory for almost 10 yr. The components of CE instrumentation are described, as are injection modes, buffers, and effects of electroosmotic flow. The modes of separation used in CE, namely, capillary zone electrophoresis, capillary isoelectric focusing, capillary isotachophoresis, and micellar electrokinetic capillary chromatography, are explained. References for 26 different clinical applications of CE are included, among them assays that are used routinely as well as niche assays for specialized applications of CE. Verification of CE assays, current instrumentation, and future development of CE in the clinical laboratory are addressed.

Blood Chemical Analysis↗
PubMed1965

CLINICAL APPLICATION OF IMMUNOFLUORESCENCE. I. GROUPING BETA-HEMOLYTIC STREPTOCOCCI.

Smith, Thomas B. (Armed Forces Institute of Pathology, Washington, D.C.). Clinical application of immunofluorescence. I. Grouping beta-hemolytic streptococci. J. Bacteriol. 89:198-204. 1965.-Procedures are described for the production of antistreptococcal serum in rabbits and for the preparation of group-specific conjugates for Lancefield groups A, C, and G. A modification of the conventional technique of absorption and inhibition to prevent cross-reactions with common antigens was used with excellent results. In addition, a promising new approach to eliminating cross-reactions of group A conjugate with antigens of groups C and G by dilution with group A-variant antiserum was tested. A complete method is introduced that enables the clinical laboratory to report whether group A streptococci are present in a given throat culture well within 24 hr after the physician collects the sample.

Animals↗
PubMed1980

Clinical applications of evoked responses: a survey.

Evoked responses were first described in the late forties. In the late fifties, technology had so far advanced that the method became practically useful in clinical applications. Descriptions of the normal response and the influence of age and the effect of attention were extensively studied. There are marked interindividual and interlaboratory differences, partly explained by differences in test set-up. This is why it is still necessary that every laboratory, using its own test set-up, should determine its own standard values in normal test subjects. The value of ER studies in clinical diagnosis may be summarized as follows: --ophthalmology, organic psychiatry, neuropaediatrics, multiple sclerosis, uraemia: ER studies often supply important diagnostic information; --local lesions of the cerebral hemispheres, peripheral nerves and spinal cord, coma: ER studies can be useful as source of supplemental diagnostic information; --non-organic psychiatry and psychology: ER studies are still of minor practical value in individual clinical diagnosis. Research into applications of spinal evoked potentials and brain stem potentials is still in its initial phase.

Adolescent↗
PubMed2003

[Study on anatomy of anterior tibial tendon and its clinical application].

OBJECTIVE: To observe the normal and abnormal insertions of the anterior tibial tendon and store up knowledge for clinical application. METHODS: Forty-six antiseptic specimens of the foot of Chinese were selected for anatomical and histological studies on the insertions. The methods included taking the photos, adding up the numbers of the insertions that mainly attach to the first metatarsal os or the medial cuneiform os and measuring the length of the tendons from the line connecting the malleolus lateralis projection and malleolus medialis projection to the insertion. RESULTS: The insertions could be categorized as three types: 28 (60.87%) insertions belonged to the bundle type; 14 (30.43%) insertions were of the medial type; 4 (8.7%) insertions were of the bifurcate type. 40 insertions mainly attached to the medial cuneiform os; 6 insertions mainly attached to the first metatarsal os. The length of the anterior tibial tendon of adults was determined to be 72.33 +/- 5.29 mm and the length of the children's tendon 56.77 +/- 4.54 mm. CONCLUSION: The aboved finding suggest that in clinical treatment the insertions of the bifurcate type should be cut off completely as the anterior tibial tendons of the bifurcate type are transferred into the lateral part of the feet. The insertions of the bundle type and bifurcate type are not suitable for the split anterior tibial tendon transfer, but the medial type cases are suitable for this kind of operation.

Clubfoot↗
PubMed2004

[Clinical application of simplified gonadotropin releasing hormone stimulating test in management of female isosexual precocious puberty].

OBJECTIVE: To explore the clinical application of simplified gonadotropin releasing hormone (GnRH) test in the management of female isosexual precocious puberty (IPP). METHODS: Simplified GnRH stimulating test was performed in 42 girls with IPP. Thirty-eight of them were followed-up for a mean of 26 (3 - 78) months. RESULTS: Fourteen cases showed luteinizing hormone (LH)-predominant response after GnRH stimulation, 13 showed follicle stimulating hormone (FSH)-predominant response and 15 showed no response. In the LH-predominant group, one had hypothalamic harmatoma, the other 13 were idiopathic type. Ten of them had acceleration of growth and bone prematurity. There were 8 peripheral IPP in the no response group, i.e. ovarian granulose-theca tumor 1, autonomous ovarian follicular cysts 2, McCune-Albright syndrome 2, and exogenous IPP 3. Among them, 1/2 had growth acceleration and 3/4 had bone prematurity. The remaining 7 of the no-response group and 13 with FSH-predominant response had no known etiology and were considered as transient IPP or premature thelarche based on no progression of pubertal development during follow-up. One fourth of them also showed acceleration of growth and bone prematurity. CONCLUSION: Simplified GnRH test is helpful to objectively evaluate activation of the hypothalamic-pituitary-ovary axis, and is more reliable than those clinical features in differential etiological diagnosis of female IPP.

Child↗
PubMed2005

Clinical applications of sentinel lymph-node biopsy for the staging and treatment of solid neoplasms.

A review of the clinical applications of sentinel lymph node (sN) biopsy has been performed with the aim of defining the rationale, the methods of detection, the accuracy, and the current indications to sN biopsy in different solid neoplasms. In melanoma patients, sN biopsy represents a standard procedure for staging purpose, although its therapeutic value is still under examination. The sN is an accurate method for the pathologic staging of the axilla in patients with early stage breast cancer, and it can be useful for the selection of patients with axillary metastasis who should undergo standard axillary dissection. In gynecologic malignancies, appreciable results are available in patients with vulvar and cervical cancer only. Patients with squamous cell vulvar cancer may benefit by sN biopsy because a complete bilateral inguino-femoral lymph-node dissection may be avoided whenever the sN is free of metastasis. As regards to cervical cancer, further studies are required with the combined technique (blue dye injection and gamma-probe guided surgery), which seems more promising, before abandoning pelvic lymphadenectomy in patients with histologically-negative sN. The experience in urologic cancer deals mainly with penile and prostate cancer; the modern procedures for the dynamic detection of sN are going to clarify its role in the surgical management of penile cancer; as regards to prostate cancer, very preliminary results suggest that the sN biopsy may enhance the pathologic staging of this neoplasm compared to modified pelvic lymphadenectomy, due to the individual variability of the lymphatic drainage of this cancer. In patients with clinically node-negative squamous head and neck cancer, the reliability of sN-guided neck lymph node dissection seems promising. The sN biopsy is also technically feasible in patients with differentiated thyroid cancer; however, the future role of this procedure in the clinical decision-making of these patients remains to be defined due to the questionable biological meaning of nodal metastases. Patients with non-small-cell lung cancer should be investigated by means of radiotracers injected at the time of thoracotomy or under CT-scan guidance in order to achieve a satisfactory identification rate (over 80%); the focused histopathologic staging of the sN improves current pathologic staging by conventional bi-valve assessment of all the lymph nodes of the surgical specimen; moreover, the prognostic role of isolated N2 metastasis can be better elucidated. In patients with gastrointestinal malignancies, the intraoperative lymphatic mapping with sN biopsy have suggested that the lymphatic drainage of the gastrointestinal tract is much more complicated than other sites, skip metastasis being rather frequent. In patients with gastric cancer, current data show that it can be detected by means of peritumoral injection of indocyanine green; the detection of tumor positive lymph nodes beyond the perigastric area could select patients amenable to D2 lymphadenectomy. As regards to colorectal cancer patients, the focused analysis of the sN may reveal disease that might otherwise go undetected by conventional surgical and pathological methods, and those patients which are upstaged can benefit by adjuvant chemotherapy. Finally, in patients with Merkel cell carcinoma, notwithstanding the limited experiences with sN biopsy, sN histology seems to predict regional lymph node status and may aid in selecting which patients are amenable to therapeutic lymph node dissection.

Breast Neoplasms↗
PubMed1992

Clinical application of two computerized diabetes management systems: comparison with the log-book method.

In two consecutive studies the clinical application and suitability of two computer-assisted data management systems (Camit and Cadmo) were evaluated in a prospective manner. In each study nineteen long-standing, stable insulin-dependent patients were randomly assigned to one of two groups. In study I assessment of metabolic control and insulin dose adjustments were based either on the Camit S1 data analysis or on the conventional log-book method, whereas in study II the Camit S2 and the Cadmo simulation programs were evaluated. HbA1c values decreased significantly in both studies (p < 0.05). A clear decline in hypoglycemic events as well as a significant reduction of the percentage of glucose values below 4.0 mmol/l (p < 0.005) and a marked increase (p < 0.05) in the percentage of glucose levels in the target range (4.0-10.0 mmol/l) were observed. We found both computerized assessment systems to be reliable and suitable for the assessment of blood glucose control and for insulin dose finding. The graphical and statistical presentation of the numerous glucose and insulin data allowed a better summary of blood glucose control and metabolic trends. More time could be spent for problem solving, which proved to be much less exhausting with the computer for the attending physician. Further studies should address the educational potential of computerized systems for the patient as well as for the physician.

Adult↗
PubMed1991

[Immunotherapy of tumors: from the first experimental studies to the recent clinical applications. I. Passive immunotherapy].

After a short introduction on the rationale of cancer Immunotherapy (IT), the Authors analyse the experimental and clinical treatments. Very interesting the results of the clinical trials with cells, used with success never reached before with the standards treatments. Particular emphasis has been dedicated to Lymphokine Activated Killers in association with Interleukin2 (IL2) and Tumor Infiltrating Lymphocytes, which have shown a very strong and specific anticancer activity. The encouraging therapeutical possibilities of the association with cytokines and immunosuppressors are also underlined. Monoclonal antibodies are considered a promising therapeutical approach which did'nt receive an effective clinical application, although their use as immunoconjugates with toxines chemotherapeutical and radioactive agents is giving incouraging results. Yet some technical and immunological problems remain to be solved for them to be used in the clinical setting against solid tumors.

Antibodies↗
PubMed1995

Clinical application of modified Anyang type 2 esophageal intubation instrument--a new esophageal intubation method.

The preliminary experience in the clinical use of Anyang Type 2 esophageal intubation instrument, designed by ourselves, in 11 patients with severe esophageal obstruction due to advanced carcinoma of the esophageal was reported. The diagnosis of all 11 cases was confirmed by barium-meal roentgenography. After intubation, all the patients could take liquid or soft diet by mouth. There was no operative mortality and the patients survived 2 to 14 months (mean 5.7 months). All of them could take food by mouth before death. The clinical application proved that the intubation has been a safe and suitable management.

Adult↗
PubMed1996

Clinical application of three-dimensional myocardial imaging: evaluation of efficacy of medical treatment on myocardial perfusion.

To investigate the clinical applicability of the three-dimensional (3D) myocardial imaging using a newly developed system (the Application Visualization System-Medical Viewer), thallium-201 myocardial single photon emission computed tomography was performed in 19 patients with previous myocardial infarction before and after treatment with nisoldipine. We have developed a new method for automatically reconstructing 3D imaging for the stereoscopic evaluation of myocardial perfusion. The left ventricular myocardial volume with a radioisotope count > or = 50% of maximum was calculated by using the conventional surface rendering method. With these images, the effect of nisoldipine on myocardial perfusion was assessed and the myocardial volume with a radioisotope count > or = 50% of maximum was compared. In fifteen (88%) of 19 patients, myocardial perfusion increased in the infarct areas after nisoldipine treatment. Nisoldipine significantly increased the myocardial volume with a radioisotope count > or = 50% of maximum from 141 +/- 17 to 153 +/- 18 ml on the stress 3D imagings. These findings indicate that nisoldipine improved myocardial perfusion during exercise. 3D imaging provided stereoscopic assessment of the changes in myocardial perfusion following treatment with nisoldipine and also detected transient enlargement of the left ventricular lumen induced by exercise.

Aged↗
PubMed2001

Clinical applications of tandem mass spectrometry: ten years of diagnosis and screening for inherited metabolic diseases.

This paper reviews the clinical applications of tandem mass spectrometry (MS-MS) in diagnosis and screening for inherited metabolic diseases in the last 10 years. The broad-spectrum of diseases covered, specificity, ease of sample preparation, and high throughput provided by the MS-MS technology has led to the development of multi-disorder newborn screening programs in many countries for amino acid disorders, organic acidemias, and fatty acid oxidation defects. Issues related to sample acquisition, sample preparation, quantification of metabolites, and validation are discussed. Our current experience with the technique in screening is presented. The application of MS-MS in selective screening has revolutionized the field and made a major impact on the detection of certain disease classes such as the fatty acid oxidation defects. New specific and rapid MS-MS and LC-MS-MS methods for highly polar small molecules are supplementing or replacing some of the classical GC-MS methods for a multitude of metabolites and disorders. New exciting applications are appearing in fields of prenatal, postnatal, and even postmortem diagnosis. Examples for pitfalls in the technique are also presented.

Humans↗
PubMed1998

A clinically applicable assay for tumoral thymidylate synthase combining reverse transcriptase-PCR and high-performance liquid chromatography.

The main clinically relevant cellular target of 5-fluorouracil (5-FU) is the enzyme thymidylate synthase (TS). Both preclinical data and clinical data in digestive tract cancer indicate that an increased amount of TS in tumours can predict for 5-FU resistance. We developed an automated method combining the principle of RT-PCR coupled with HPLC separation and quantification. The RT-PCR HPLC method was applied to TS determination in tumoral biopsies from patients with colorectal cancer. The PCR samples were separated and quantified using a polystyrene divinylbenzene C 18 column. Within 22 min, it was possible to elute 18 peaks representing DNA sizes ranging from 34 to 622 bp. Both separation and quantification of beta 2 microglobulin (beta 2m, internal standard) and TS PCR products were achieved in approximately 10 min per sample. Validation of the RT-PCR HPLC method was established by comparing RT-PCR quantification of TS after electrophoresis and HPLC and by comparing the RT-PCR quantification of TS after HPLC with the classical biochemical method. The proposed HPLC method offers a 10-50 fold sensitivity advantage over electrophoresis. In addition, this RT-PCR HPLC procedure allows not only the quantification of TS expression but also the direct collection of unaltered amplified DNA sequence which could be useful for sequencing analysis, since TS mutations have been described. The present RT-PCR HPLC method for determining TS expression in tumoral biopsies is a valuable analytical approach as it is specific, sensitive and clinically applicable.

Adult↗
PubMed1996

Microwave ablation of the adrenal gland: experimental study and clinical application.

OBJECTIVE: To evaluate the heating effect of microwave irradiation on the dog adrenal gland and to assess the clinical feasibility of microwave ablation of adrenal tumours. MATERIALS AND METHODS: The thermal distribution and histology were evaluated after dog adrenal glands were irradiated at different intensities with microwaves. Irradiation at 70 W for 30 s was also performed after laparotomy, on the adrenal tumour of a patient with primary aldosteronism. RESULTS: Microwave irradiation at 70 W for 30 s provided a sufficiently high temperature to produce coagulation within a 5 mm radius of the microwave electrode. The adrenal tumor in the patient with primary aldosteronism was coagulated successfully by this dose of microwave irradiation. CONCLUSION: Microwave ablation of the adrenal gland may be clinically applicable in the treatment of adrenal tumours.

Adrenal Glands↗
PubMed2002

Clinical applications of pulmonary function and graphics.

Pulmonary function and mechanics testing are emerging as a valuable tool to aid clinical decision making in the management of ventilated infants. Although there are as yet no published randomized controlled trials to suggest that pulmonary mechanics testing reduces mortality or morbidity, it has--in conjunction with clinical, radiological, and blood gas monitoring--changed neonatal ventilation from "good judgement" to "informed judgement". It is not surprising that pulmonary graphics are increasingly being used as a tool for assessment of patient status, therapeutic evaluation, and management guidance of infants who become dependent on ventilator. A working knowledge of pulmonary graphics also improves understanding of pulmonary physiology and pathophysiology, and their responses to mechanical ventilatory support. Recent advances in microprocessor technology for on-line analysis of pulmonary mechanics have made such evaluations easily available for bedside clinical application.

Computer Graphics↗
PubMedDate not supplied

[Fundamental aspects of osteoinductive activity of bone tissue and potential clinical application].

Osteoinductive polypeptide factors such as the various isoforms of Bone Morphogenetic Protein described are of increasing scientific and clinical interest because of the great progress in this field of skeletal biology recently achieved. In a review some fundamental chemical and biological aspects of bone and its endogenous osteoinductive activity including isolation and assay of osteoinductive factors are described. Through combination of osteoinductive factors with appropriate carrier materials it seems possible to create osteoinductive implant materials and the results of such investigations and some basic aspects of carrier materials are summarized. The perspectives of the possible clinical applications of such composite are presented.

Biocompatible Materials↗
PubMed1989

Hematopoietic growth factors. Biology and clinical applications.

The hematopoietic growth factors are potent regulators of blood-cell proliferation and development. The first phase of clinical trials suggests that they may augment hematopoiesis in a number of different conditions of primary and secondary bone marrow dysfunction. Future clinical use is likely to include combinations of these growth factors, in order to stimulate early marrow progenitors and obtain multilineage effects. An improved understanding of the biologic and clinical effects of hematopoietic growth factors promises future clinical applications for conditions of impaired function and reduced numbers of blood cells.

Colony-Stimulating Factors↗
PubMed1994

Noninvasive method for determination of arterial compliance using Doppler echocardiography and subclavian pulse tracings. Validation and clinical application of a physiological model of the circulation.

BACKGROUND: The Poiseuillian model of the arterial system currently applied in clinical physiology does not explain how arterial pressure is maintained during diastole after cessation of pulsatile aortic inflow. Arterial pressure-flow relations can be more accurately described by models that incorporate arterial viscoelastic properties such as arterial compliance. Continuous pressure and flow measurements are needed to evaluate these properties. Since the techniques used to date to acquire such data have been invasive, physiological models of the circulation that incorporate these properties have not been widely applied in the clinical setting. The purpose of this study was (1) to validate noninvasive methods for continuous measurement of central arterial pressure and flow and (2) to determine normal reference values for arterial compliance using physiological models of the circulation applied to the noninvasively acquired pressure and flow data. METHODS AND RESULTS: Simultaneously acquired invasive and noninvasive aortic pressures (30 patients), flows (8 patients), and arterial mechanical properties (8 patients) were compared. Pressure was measured by high-fidelity catheter aortic micromanometer (invasive) and calibrated subclavian pulse tracing (noninvasive). Aortic inflow was determined from thermodilution-calibrated electromagnetic flow velocity data (invasive) and echo-Doppler data (noninvasive). Arterial compliance was determined for two- and three-element windkessel models of the circulation using the area method and an iterative procedure, respectively. Once validated, the noninvasive methodology was used to determine normal compliance values for a reference population of 70 subjects (age range, 20 to 81 years) with normal 24-hour ambulatory blood pressures and without Doppler-echocardiographic evidence for structural heart disease. The limits of agreement between invasive and noninvasive pressure data, compared at 10% intervals during ejection and nonejection, were narrow over a wide range of pressures, with no significant differences between methods. Invasive and noninvasive instantaneous aortic inflow values differed slightly but significantly at the start of ejection (P < .05), but during the latter 90% of ejection, values for the two methods were similar, with narrow limits of agreement. Total vascular resistance and arterial compliance values derived from invasive and noninvasive data were similar. Arterial compliance values for the normal population using the two-element model (C2E) ranged from 0.74 to 2.44 cm3/mm Hg (mean, 1.57 +/- 0.38 cm3/mm Hg), with a beat-to-beat variability of 5.2 +/- 3.9%. C2E decreased with increasing age (r = -.73, P < .001) and tended to be higher in men (1.67 +/- 0.41 cm3/mm Hg) than in women (1.51 +/- 0.35 cm3/mm Hg, P = .07). Compliance values for the three-element model (C3E) were predictably smaller than for the two-element model (mean, 1.23 +/- 0.30; range, 0.59 to 2.16 cm3/mm Hg, P < .001 versus C2E) but correlated with C2E values (r = .81, P < .001) and were also inversely related to age (r = -.56, P < .001). Ridge regression and principal component analyses both showed the compliance value to be a composite function whose variation could be best predicted by consideration of simultaneous values for five major hemodynamic determinants: heart rate, mean flow, mean aortic pressure, minimal diastolic pressure, and end-systolic pressure. Multivariate analysis revealed age and sex to be independent predictors of compliance (P < .01 for both). There were no differences in compliance between black and white subjects. CONCLUSIONS: Noninvasive methods can be used to acquire the hemodynamic data necessary for clinical application of physiological models of the circulation that incorporate arterial viscoelastic properties such as arterial compliance. The strong inverse linear relation between model-based compliance estimates and age mandates incorporation of this demographic parameter in

Adolescent↗