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At least 703 records · Page 39Linked to original sources
PubMed1997

Reliability of the quantitative angiographic measurements in the New Approaches to Coronary Intervention (NACI) registry: a comparison of clinical site and repeated angiographic core laboratory readings.

To assess the agreement of clinical site and angiographic core laboratory readings obtained in the New Approaches to Coronary Intervention (NACI) registry, we reviewed the angiographic results obtained in 787 lesions assessed both by the sites and the core laboratory, including 135 lesions analyzed twice (> or =2 months apart) by the angiographic core laboratory. Although moderate agreement was demonstrated between the clinical site and angiographic core laboratory for qualitative lesion morphology such as lesion calcium (kappa [kappa] = 0.42), only fair agreement was found between site and core laboratory estimation of lesion ulceration (kappa = 0.33); thrombus (kappa = 0.30); and eccentricity (kappa = 0.27); with poor agreement for angulation (kappa = 0.16); and proximal vessel tortuosity (kappa = 0.03). Agreement for qualitative morphology was better for repeated core laboratory readings of lesion eccentricity (kappa = 0.75); angulation (kappa = 0.72); thrombus (kappa = 0.68); proximal vessel tortuosity (kappa = 0.66); and calcification (kappa = 0.64). Quantitative angiographic measurements correlated moderately between the clinical site using the digital caliper method and the core laboratory using the automated edge-detection method, including preprocedural percentage diameter stenosis (intraclass correlation [R] = 0.50) and postprocedural percentage diameter stenosis (R = 0.63). Repeated core laboratory readings had almost perfect agreement, with R ranging from 0.88 for postprocedural percentage diameter stenosis to 0.93 for reference vessel diameter and pre- and postprocedural minimal lumen diameters. Repeated angiographic core laboratory readings provided highly consistent quantitative and qualitative morphologic results in the NACI registry, but the core laboratory readings varied substantially from those obtained at the clinical site. More standardized angiographic analytic criteria and core laboratory feedback to investigators may improve agreement between the clinical sites and the angiographic core laboratory in subsequent studies.

Angioplasty, Balloon, Coronary↗
PubMed1978

Abridged differential leucocyte counts provided by a Coulter Channelyzer in a routine haematology laboratory.

We have used automated differential leucocyte counts by volume analysis for the past six months after initial evaluation had shown several advantages--namely, accuracy, simplicity, speed, and low cost. We describe the operation of the Coulter Channelyzer Model C-1000, which is linked to a Coulter Model S cell counter, analyse the cost, and comment on the clinical and laboratory consequences of adopting this method.

Costs and Cost Analysis↗
PubMed2004

Economical choices in setting up a diagnostic myeloma laboratory.

In setting up a diagnostic myeloma laboratory the popular, highly automated and otherwise excellent choices of equipment and laboratory practices, so exorbitantly raise costs that the sustainability, even in large government hospitals in third world countries may become difficult. Based on our experience in a regional cancer center in India, we offer here, guidelines for carrying out high resolution electrophoresis, densitometry, immunofixation and urine concentration. We show that by simply employing well established techniques and doing them properly, one can get results of excellent quality at minimum cost and minimum dependence on costly imports.

Blood Protein Electrophoresis↗
PubMed1995

[Some aspects of newly developed instruments for blood coagulation tests].

Five newly developed instruments for five routine blood coagulation tests including prothrombin time, APTT, thrombotest, normotest and fibrinogen assay and the other specialized tests were introduced by each manufacturer. In four instruments, the principal of clot detection is based on the change of optical density due to fibrin thread. One instrument detects viscosity change. All instruments were easy to use due to full-automation, and the precision and accuracy in one laboratory use were high in quality. There were difficult problems when a user switches from the reagent recommended by the manufacturer to another commercially available one. The user needs to re-evaluate the standard curve using international reference plasma. In Japan, international normalized ratio (INR) presentation of prothrombin time is not common even in a large scale laboratory. When a patient with warfarin moves to another hospital, the presentation of prothrombin time from the former laboratory can not be used because of the difference in reagent and equipment. Much confusion concerning prothrombin time occurred due to differences in reagent and equipment after the Hanshin-Awaji earthquake. Many patients taking warfarin had to evacuate under severe stress condition, and had prothrombin time out of the optimal therapeutic range not knowing whether it was due to quake-stress or intra-laboratory difference. Selection of automated coagulation instrument which can easily print out the INR in prothrombin time is recommended.

Blood Coagulation Tests↗
PubMed1996

An on-line automated sleep-wake classification system for laboratory animals.

A computerized sleep-wake classification program is presented that is capable of classifying sleep-wake states on-line in four animals simultaneously. Every 10 s the classification algorithm assigns sleep-wake states on the basis of the power spectrum of an EEG signal and the standard deviation of an EMG signal. The system was developed specifically for long-term circadian rhythm experiments and can run uninterrupted for an unlimited period of time. To validate the system a total of 5760 sleep-wake epochs from 4 rats was classified both visually and by computer. The results show a good agreement between visual and computer automated (kappa = 0.770) sleep-wake scoring. Therefore, the presented sleep-wake classification system can be regarded as a reliable time saving alternative for visual scoring in sleep research.

Animals↗
PubMed2004

A modified automated method for isolation of viable pancreatic islets in laboratory animals.

To achieve successful islet transplantation, a high viability is required. For this reason an automated method including two chambers: one for islets isolation and one for recirculation and collection was developed. Recently, we produced a modified version of this work by building a similar system of glass where marbles were not used for disaggregation, and the pancreatic tissue had to be disrupted mechanically before the digestion phase. By using the reconfigured system, we obtained 260 +/- 20 islets from each Wistar albino rat (weighing 220 to 240 g) pancreas. Islets were observed at 35 minutes after the start of perfusion (closed circuit) and the optimum time to stop the isolation determined to be 40 minutes based upon islets viability. Although the present system is configured for islet isolation from small laboratory animals (rat, mouse), we have also obtained thousands of islets at 25 minutes after treatment of a 0.5-g piece of pig pancreas. Compared to the time-consuming manual method usually used for islet isolation from small laboratory animals, the new technique is economic, easy to use, and does not reduce islets viability.

Animals↗
PubMed1993

Evaluation of the Sysmex NE-8000. Automated hematology analyzer in a high-volume outpatient laboratory.

An evaluation of SYSMEX NE-8000 (Toa Medical Electronics Co., Ltd., Kobe, Japan) hematology analyzer, including its automated five-part white blood cell (WBC) differential count, was performed in a high-volume outpatient laboratory. Precision, mixing studies, stability, carry-over, and linearity were all within the limits stated by the manufacturer. Evaluation of the five-part WBC differential revealed excellent correlation with manual differential neutrophil and lymphocyte counts. Monocyte, eosinophil, and basophil data were acceptable given the known poor precision of 200 cell manual WBC differential counts when low percentages of individual cell types are present. Overall, flagging for morphologic abnormalities displayed a sensitivity of 87% and a specificity of 97%. The combination of the flagging system with the visual record provided by the NE-8000 WBC histogram represents an effective tool for separating normal from abnormal specimens, and allows considerable selectivity in the performance of follow-up manual WBC differential counts.

Hematology↗
PubMed1980

Clinical laboratory determination of antithrombin III. A new semi-automated method.

A new, semi-automated method for determination of antithrombin III activity in the clinical laboratory is presented. The assay is performed utilizing the chromogenic substrate S-2238 and the ABA-100. Results are expressed in arbitrary units of activity; thus, construction of standard curves with interpolation of values is not necessary. The assay has a low day-to-day coefficient of variation (6%), is insensitive to heparin, and gives reliable results in a variety of clinical situations known to affect antithrombin III activity.

Antithrombin III↗
PubMed2005

Automating identification of adverse events related to abnormal lab results using standard vocabularies.

Laboratory data need to be imported automatically into central Clinical Study Data Management Systems (CSDMSs), and abnormal laboratory data need to be linked to clinically related adverse events. This import of laboratory data can be automated through mapping to standard vocabularies with HL7/LOINC mapping to the metadata within a CSDMS. We have designed a system that uses the UMLS metathesaurus as a common source to map or link abnormal laboratory values to adverse event CTCAE coded terms and grades in the metadata of TrialDB, a generic CSDMS.

Clinical Laboratory Information Systems↗
PubMed1998

[Why medical consultation is needed in the clinical laboratory].

During the 20th century, at least until the 1980s, clinical laboratory practice had been rapidly expanded, mainly because of a significant advancement in medicine as a whole and also in laboratory technology. However, recent economic changes in health care environment worldwide have been influencing greatly future trends in clinical laboratory practice. Four major macroeconomic forces drive change in clinical laboratory practice as follows; (1) Increasing cost of health care, (2) Implications of an aging population, (3) Social change in the patient population, and (4) Explosion of new technologies. Obviously, the increasing cost of health care is the primary driver. Considering a rapid change in the health care environment, clearly there are two separate pathways to be considered with regard to future modes of delivering patient care services through the clinical laboratory: commercial independent laboratories and hospital laboratories. In most hospital laboratories, in addition to high-quality, accurate and precise laboratory data being delivered through automated informatics in a timely fashion, laboratory physicians and other laboratorians should be available 24 hours a day and 7 days a week. The primary purpose of this approach is to develop a system in which the physician can order the most efficient number of tests, which will provide the maximum amount of clinically relevant informations most rapidly and most accurately at the least cost to the patient. Laboratory physicians must play a key role particularly in hospital laboratories. Their most important roles include those of a professional supplier of laboratory results being useful for health care and clinically relevant, and that of a consultative role for primary care physicians and other co-medical staffs to make important medical decision, based on laboratory results obtained. Therefore, the Japan Society of Clinical Pathology started in 1990 in publishing a series of proposed guidelines for adequate utilization of laboratory tests in primary health care. Since April, 1997, the Japanese Ministry of Health and Welfare has set a specific fee for the hospitals, where a full-time laboratory physician is responsible for the quality management of its clinical laboratory and the Committee on Adequate Utilization of Laboratory Tests is established in the hospital. For the future 21st Century, laboratory scientists including physicians and technologists must change their concept and attitude in order to provide quality laboratory service with the minimal laboratory cost to the patient.

Clinical Laboratory Techniques↗
PubMed1993

Will the electrocardiograph replace the electrocardiographer?

Professional groups, endorsed by individual cardiologists involved in the practice of electrocardiology, have recently issued official policy statements declaring that there is no computer program for electrocardiographic interpretation that can replace interpretation by a skilled physician, and consequently, all computer electrocardiographic interpretations require careful overreading by a physician qualified to interpret electrocardiograms (ECGs). A somewhat different point of view is presented in this study, which asserts that the arguments brought forward against automated electrocardiographic interpretation may have been biased to some degree. The key issue in these deliberations is whether or not electrocardiographic analysis can be considered a laboratory test. This review elucidates factors that have hindered more widespread acceptance of automated electrocardiographic interpretation and presents possible solutions to some of the logistic problems observed. It is concluded that with relatively minor design improvements in electrocardiographic acquisition and interpretation software, a considerable fraction of ECGs can be identified that are amenable for electrocardiographic processing as an automated laboratory test. In turn, the remaining ECGs will require more advanced electrocardiographic software for differential diagnostic classification in combination with professional review using more comprehensive supplementary information than is presently provided in most routine electrocardiographic processing applications.

Arrhythmias, Cardiac↗
PubMed2006

Hints to blood groupers, 1950.

Sixty years ago, the premier blood grouping laboratory was that of Robert Race in London. Agglutination tests and blood grouping had provided breakthroughs in immunology, genetics, and the solution of clinical problems. The significance of immunohematology was recognized by the clinical hematology community as a potent force in the expanding field of disorders of the blood and blood-forming organs. The instructions by Race to his London workers entitled Hints to Blood Groupers provide a picture of the immunohematology laboratory even before automation and differed slightly from the American techniques that derived from Landsteiner. Before agglutination is replaced in the near future by the emergence of molecular methods, the detailed method of a superb laboratory is recorded.

Blood Grouping and Crossmatching↗