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A freestanding proofreading domain is required for protein synthesis quality control in Archaea.

Threonyl-tRNA synthetase (ThrRS) participates in protein synthesis quality control by selectively editing the misacylated species Ser-tRNA(Thr). In bacteria and eukaryotes the editing function of ThrRS resides in a highly conserved N-terminal domain distant from the active site. Most archaeal ThrRS proteins are devoid of this editing domain, suggesting evolutionary divergence of quality-control mechanisms. Here we show that archaeal editing of Ser-tRNAThr is catalyzed by a domain unrelated to, and absent from, bacterial and eukaryotic ThrRSs. Despite the lack of sequence homology, the archaeal and bacterial editing domains are both reliant on a pair of essential histidine residues suggestive of a common catalytic mechanism. Whereas the archaeal editing module is most commonly part of full-length ThrRS, several crenarchaeal species contain individual genes encoding the catalytic (ThrRS-cat) and editing domains (ThrRS-ed). Sulfolobus solfataricus ThrRS-cat was shown to synthesize both Thr-tRNAThr and Ser-tRNAThr and to lack editing activity against Ser-tRNAThr. In contrast, ThrRS-ed lacks aminoacylation activity but can act as an autonomous protein in trans to hydrolyze specifically Ser-tRNAThr, or it can be fused to ThrRS-cat to provide the same function in cis. Deletion analyses indicate that ThrRS-ed is dispensable for growth of S. solfataricus under standard conditions but is required for normal growth in media with elevated serine levels. The growth phenotype of the ThrRS-ed deletion strain suggests that retention of the discontinuous ThrRS quaternary structure relates to specific physiological requirements still evident in certain Archaea.

Acylation↗

The Czech External Quality Control system in medical microbiology and parasitology.

The External Quality Control (EQC) system in activities of laboratories engaged in medical microbiology and parasitology was established in the Czech Republic in 1993 when to the first laboratories which applied coded serum samples were sent for diagnosis of viral hepatitis and bacterial strains for identification. In the course of years the number of control areas increased and in 2000 there were 31 and the number of those interested in participation in EQC increased from 79 in 1993 to 434 in 2000. This year a total of 13,239 samples will be sent to laboratories. Gradually thus almost all microbiological and parasitological laboratories concerned with examination of clinical material became involved. Seven-year experience with EQC in the Czech Republic revealed that gradually the results of various examinations became more accurate, that methods became standardized and the most suitable examination sets are used.

Czech Republic↗

Quality control in the endoplasmic reticulum.

The endoplasmic reticulum (ER) has a quality-control system for 'proof-reading' newly synthesized proteins, so that only native conformers reach their final destinations. Non-native conformers and incompletely assembled oligomers are retained, and, if misfolded persistently, they are degraded. As a large fraction of ER-synthesized proteins fail to fold and mature properly, ER quality control is important for the fidelity of cellular functions. Here, we discuss recent progress in understanding the conformation-specific sorting of proteins at the level of ER retention and export.

Animals↗

[Significance and availability of small scale quality control programs].

Characteristics of small scale or regional quality control (QC) programs are quick responses to resolving QC problems and cooperation. In this paper, we illustrated and discussed the positive results of the regional QC program in Shizuoka prefecture as a model for small scale QC assurance programs. Kitamura's allowable limitations for analytical error in internal QC were estimated from the physiological and technical variation of individual assays and compared with the coefficient of variation (CV) of each analyte in clinical laboratories. CV of analytes in 80% of the laboratories cleared Kitamura's allowable limitation with the exception of alkaline phosphatase and calcium. Many laboratories are now making extensive efforts toward clearing the allowable limitation in these two items. Many working groups (WG), such as enzymes, immunochemistry, and ion selective electrode WG, are very active in resolving problems found by QC programs. The results obtained in these working groups were effectively communicated to the clinical laboratories and bedside physicians. These responses in small QC program are surely complementary to large scale QC programs such as the QC program of the Japan Medical Association.

Humans↗

Low cost quality control human serum: method of preparation, validation of values and its comparison with the commercial control serum.

OBJECTIVE: To prepare low-cost quality controls (QC) human serum and scientifically evaluate its advantages/disadvantages when compared with commercially available sera. METHODS: The home made QC serum was prepared as per WHO recommended protocol from four healthy volunteers. It was screened for HIV, HCV and HBV, pooled together and stabilized with ethylene glycol. The initial 40 values were used for calculation of means, SDs and CVs for seventeen routinely measured analytes and results were compared with those of commercially available lyophilized human sera. RESULTS: The average concentrations of seventeen commonly analyzed constituents were found to be near the middle of the physiological range of healthy subjects and the home made serum could be a good substitute for the commercial serum of normal range. The narrower CVs of the analytes imply a lesser vial to vial variation in the home made sera. Additional advantages include easy preparation, no need for reconstitution and lower cost. CONCLUSION: Home made serum is a good substitute for the commercial serum of the normal range especially in developing countries like Pakistan.

Blood Chemical Analysis↗

Quality control in the endoplasmic reticulum: PDI mediates the ER retention of unassembled procollagen C-propeptides.

Quality control within the endoplasmic reticulum (ER) is thought to be mediated by the interaction of a folding protein with one or several resident ER proteins [1]. Protein disulphide isomerase (PDI) is one such ER resident protein that has been previously shown to interact with proteins during their folding and assembly pathways [2, 3]. It has been assumed that, as a consequence of this interaction, unassembled proteins are retained within the ER. Here, we experimentally show that this is indeed the case. We have taken advantage of our previous finding that PDI interacts with procollagen chains early on in their assembly pathway [2] to address the role of this protein in directly retaining unassembled chains within the ER. Our experimental approach involved expressing individual C-propeptide domains from different procollagen chains in mammalian cells and determining the ability of these domains to interact with PDI and to be secreted. The C-propeptide from the proalpha2(I) chain was retained within the cell, where it formed a complex with PDI. Conversely, the C-propeptide from the proalpha1(III) chain did not form a complex with PDI and was secreted. Both domains were secreted, however, from a stable cell line expressing a secreted form of PDI lacking its ER retrieval signal. Hence, we have demonstrated directly that the intracellular retention of one substrate for ER quality control is due to an interaction with PDI.

Cell Line↗

INTERMAP: the dietary data--process and quality control.

The aim of this report is to describe INTERMAP standardized procedures for assessing dietary intake of 4680 individuals from 17 population samples in China, Japan, UK and USA: Based on a common Protocol and Manuals of Operations, standardized collection by centrally trained certified staff of four 24 h dietary recalls, two timed 24-h urines, two 7-day histories of daily alcohol intake per participant; tape recording of all dietary interviews, and use of multiple methods for ongoing quality control of dietary data collection and processing (local, national, and international); one central laboratory for urine analyses; review, update, expansion of available databases for four countries to produce comparable data on 76 nutrients for all reported foods; use of these databases at international coordinating centres to compute nutrient composition. Chinese participants reported 2257 foods; Japanese, 2931; and UK, 3963. In US, use was made of 17,000 food items in the online automated Nutrition Data System. Average time/recall ranged from 22 min for China to 31 min for UK. Among indicators of dietary data quality, coding error rates (from recoding 10% random samples of recalls) were 2.3% for China, 1.4% for Japan, and UK; an analogous US procedure (re-entry of recalls into computer from tape recordings) also yielded low discrepancy rates. Average scores on assessment of taped dietary interviews were high, 40.4 (Japan) to 45.3 (China) (highest possible score: 48); correlations between urinary and dietary nutrient values--similar for men and women--were, for all 4680 participants, 0.51 for total protein, range across countries 0.40-0.52; 0.55 for potassium, range 0.30-0.58; 0.42 for sodium, range 0.33-0.46. The updated dietary databases are valuable international resources. Dietary quality control procedures yielded data generally indicative of high quality performance in the four countries. These procedures were time consuming. Ongoing recoding of random samples of recalls is deemed essential. Use of tape recorded dietary interviews contributed to quality control, despite feasibility problems, deemed remediable by protocol modification. For quality assessment, use of correlation data on dietary and urinary nutrient values yielded meaningful findings, including evidence of special difficulties in assessing sodium intake by dietary methods.

Adult↗

[Quality control and cost-benefit analysis in surgical fracture treatment].

In recent years quality assurance is gaining increasing importance in all parts of medicine. In this article, different quality control measures in the field of operative fracture treatment are reviewed and illustrated. As in most other therapeutic specialties, the most commonly used measures are sporadic quality control studies. The Documentation Center of the association for the study of internal fixation [AO] offers in addition to all its contributing clinics an extraordinary measure for a continuous control of their treatment results. So far only a few instances of cost-benefit analysis have been published. Besides direct comparison of costs of different treatment options, improved quality of life may be calculated as well, using the method of Quality-Adjusted Life Years [QALY].

Cost-Benefit Analysis↗

Production of low glucose serum for quality control and evaluation of yeast treatment, lyophilization and storage conditions on serum constituents.

In order to provide quality control serum in the hypoglycemic range, pooled human serum was treated with yeast. Yeast destroyed about 50% of the serum glucose in about 4 1/2 hrs. The yeast-treated serum remained suitable for quality control of the most commonly analyzed clinical chemistry constituents which showed only very little change in most cases. Serum triglycerides were increased by about 40% and bilirubin decreased by about 20% during the treatment. Lyophilization of serum samples (yeast-treated or not) resulted in significant decreases of some enzymes activities. Exposure at 22 degrees C of samples lyophilized (7 days) and non-lyophilized (4 days) resulted in practically no change except for certain enzymes. No significant differences were observed in the clinical chemistry measurements including glucose one month and three months after preparation of samples lyophilized (stored in a refrigerator) and non-lyophilized (store in a freezer).

Bilirubin↗

Evaluation of quality control procedures for 24-h dietary recalls: results from the Girls Health Enrichment Multisite Studies.

BACKGROUND: Quality control methods are key components of dietary assessment, but have rarely been evaluated. METHODS: One hundred forty-four 8-10-year-old African-American girls at three field centers completed two 24-h dietary recalls at baseline before a pilot weight gain prevention intervention (one recall collected in-person and one by telephone). The dietary recall data were initially reviewed by the dietary interviewer (Phase 1), then by a local lead nutritionist at the field center (Phase 2), and then by the Nutrition Coordinating Center (NCC) (Phase 3); any differences identified by NCC were reconciled (Phase 4). Bland-Altman and generalizability theory methods were used to assess agreement of consumption for selected food variables and nutrients between phases. RESULTS: Only small differences occurred. Quality control procedures primarily reduced the variances of nutrients rather than caused the means to shift. Most of the variability among phases was due to individual level variability in dietary intake. CONCLUSIONS: Decisions to review dietary recall data beyond local review should be based on the level of precision and accuracy required for the study outcomes and the availability of financial resources.

Black or African American↗

Quality control Lactobacillus strains for use with the API 50CH and API ZYM systems at 37 degrees C.

The API 50CH and API ZYM systems fulfil an important role in the polyphasic taxonomic identification of lactobacilli. When the API 50CH fermentation profile of the quality control Lactobacillus casei var. alactosus (Lb. paracasei subsp. paracasei) strain NCFB 206 was determined at 37 degrees C, it was found to differ from that determined at 30 degrees C by BioMéreiux SA (Montalieu Vercieu, France) and the National Collection of Food Bacteria (Aberdeen, Scotland). In addition, the API 50CH fermentation and API ZYM profiles of Lb. casei strain ATCC 334T determined at 37 degrees C differed from those determined at 30 degrees C by Lee and Simard (1984). Strains NCFB 206 and ATCC 334T were thus assumed to exhibit temperature-dependent variation in fermentation profile, a phenomenon recently described by Nigatu et al. (2000). In contrast, Lb. rhamnosus strain ATCC 243T did not exhibit temperature-dependent variation in fermentation profile. Moreover, the fermentation profile obtained at 37 degrees C differed in only one respect (positive beta-gentiobiose utilisation) from that published by Collins et al. (1989). In addition, Lactobacillus strain GG produced a stable and reproducible API ZYM profile at 37 degrees C, although some variation in the level of enzyme activity was evident. Thus, strain NCFB 206 was replaced by strain ATCC 243T as the quality control strain of choice for use with the API 50CH fermentation system, and Lactobacillus strain GG adopted for use as a quality control strain with the API ZYM system for strain identification of lactobacilli at 37 degrees C. The API 50CH and API ZYM profiles of the commercially important Lactobacillus strains NCFB 1748, GG, KLD, F19, and ACA-DC 212.3 were determined at 37 degrees C after anaerobic growth in MRS broth. The fermentation and enzyme profiles of strain NCFB 1748 were almost identical to those of Lb. crispatus ATCC 33820T, those of strain GG were found to be more similar to those of Lb. rhamnosus strain 243T than Lb. zeae strain ATCC 15820T, those of strain KLD were most similar to those of Lb. fermentum DSM 20052T, while those of strains F19 and ACA-DC 212.3 were similar to those of Lb. casei strain ATCC 334T.

Bacterial Typing Techniques↗

Inter-laboratory comparison of acid-base variable in human blood and in quality control materials.

Routine results, pH, partial pressure of carbon dioxide (pCO2) and of oxygen (pO2), and standard hydrogen carbonate ion concentration (SBC) in identical specimens of arterial blood from patients deviate substantially. The results from seven laboratories (each laboratory examining the same 12 patients and the same five types of quality control materials) and evaluation in terms of accuracy and precision suggest the variations between days (delta 2) and single measurements (sigma 2) to be the main factors for these deviations. A reduction of these variations must have the highest priority in quality control programmes, since the variations mask possible true level deviations between laboratories. The five control materials (Qualicheck, Quantra whole blood level I-II-III and hemolyzed donor blood) are not fully optimal as substitutes for patient blood in such quality control programmes.

Aged↗

[A quality control program for radiotherapy in Hodgkin's disease].

The importance of the quality of radiotherapy for Hodgkin's disease has been stressed, particularly in specific American and German studies. A quality control program for verification of technical files for each patient was implemented during the EORTC H8 protocol for patients with a supra-diaphragmatic stage I & II Hodgkin's disease. Today, 161 technical files have been reviewed. While the definition of the target volumes were in accordance with the protocol for most of the patients, we observed 13.6% of major deviations in terms of treated volumes, and 39.7% of major deviations in terms of dose (for volumes, a number of deviations were in the cervical areas, where the upper limit of the field was lowered in view of protecting the parotids, but the others were due to inadequate margins around the mediastinum and the hilum). Some of the dose deviations were due, in some cases, to the addition of a sub-carinal block after 30 Gy, but also, in cervical areas, in misinterpretation of the protocol. In conclusion, such a quality control program is justified by the number of major deviations which have been observed; it seems justified to carry out this program in the future H9 protocol.

Clinical Trials as Topic↗

Sequential sampling in clinical cytogenetics: a quality control viewpoint.

We have observed that there is some resemblance between the problems of sampling in industrial quality control and the process of diagnosis of mixed cell populations in cytogenetics. This resemblance enabled us to draw from the methodology of the former science to solve some diagnostic problems in the latter. We considered which of the several sampling procedures available for quality control would be more efficient and more suitable in clinical cytogenetics, concluding that 'sequential sampling' combines both features. We also studied the effect that some abnormalities due to technical factors had on sample size required to reach a diagnosis with a given level of confidence. We give a set of tables for sequential sampling in diagnostic laboratories, illustrating their use in discriminating between mosaicism and pseudomosaicism in prenatal diagnosis and in the diagnosis of the fragile X syndrome. Finally, we discuss the merits of sequential sampling as shown here, comparing it with the current method used in cytogenetics to exclude chromosomal mosaicism.

Cytogenetics↗

[Quality control in medical education and continuing medical education in allergology in Germany].

Quality control in education and training in allergology comprises activities at the different levels of the curriculum of medical schools, residency programs and postgraduate education. Unfortunately, until now allergology in Germany has not yet been regularly embedded in the medical curriculum of all medical schools. Therefore, the German Society for Allergology and Clinical Immunology (DGAI) has demanded for years that chairs and departments of allergology be introduced at every Medical Faculty in Germany. The new Medical Licensure Rules (Approbationsordnung) offer the possibility to select allergology, amongst others, as an obligatory subject in the medical state examination. Furthermore, allergological topics can now be introduced into the newly established interdisciplinary fields (Querschnittsbereiche). At the level of residency training, doctors who want to become allergists have to undergo a special curriculum in the field of allergology, formerly called additional specialisation in allergology (Zusatzbezeichnung) after having finished their board examination in an organ-related specialty subject. Following a decision of the German "Arztetag" in May 2003, this 24-months curriculum has unfortunately been reduced to 18 months. 12 months of this 18 months requirement may be fulfilled during a residency programme in either dermatovenerology, otolaryngology, internal medicine, pulmology and/or paediatrics. Compared to previous years, this results in a drastic deterioration of allergy training in Germany. The DGAI has decided to take up the fight for its improvement in both a quantitative and qualitative respect. The crucial issue is to develop quality criteria for persons as well as institutions eligible as training centres in allergology. As regards post-graduate education, the German Academy of Allergology and Environmental Medicine (Deutsche Akademie für Allergie und Umweltmedizin, DAAU) has introduced a system of certified continuing medical education (CME), which has been widely accepted in Germany. CME credit points are awarded in co-operation with the regional physicians' chambers ("Landesärztekammer"). Quality control in allergology has to be re-enforced and improved at all levels of medical curricula, training programmes and post-graduate education in order to achieve sustainable improvements in patient care for the large number of people in Germany suffering from allergies.

Allergy and Immunology↗

Internal quality control in serological tests for syphilis.

The importance of syphilis serological tests demands that laboratory reports are reliable. Internal quality control applied to the organisation of a syphilis serology service improves laboratory bench performance and reporting. Described here are internal quality control procedures of a department that serves a genitourinary medicine clinic and conducts 70 000 tests a year to investigate for syphilis.

Fluorescent Antibody Technique↗

Diagnostic quality control: the missing link in dental radiology quality assurance.

Film-quality review, critique, and remediation as an ongoing established process of assessment and evaluation as part of quality assurance programs in dental radiology have been neglected. This article reports successful efforts to establish such a procedure in a large group practice. The procedure, suitably scaled, would be suitable for other institutions, smaller group practices, or solo practitioners.

Group Practice, Dental↗

[Standardization of statistical procedures and evaluation scheme in external quality-control survey].

Numerous external quality assessment surveys are being conducted by variety of organizations throughout Japan, but the statistical processing and evaluation scheme are not compatible. Standardization of the procedures is essential to make comparison of results among surveys possible. A coding system is available only for names of analytes and analytical equipments. Systematic coding for analytical principles, manufacturers and standard materials is necessary. Regarding computation of peer-group statistics, the mean and SD are often biased when there are many, or wildly, outlying values. Therefore it is recommended to use an iterative method. The methodology removes a relatively large proportion of the population in the tails of the distribution and re-inflates the SD to compensate for the trimming, thus reaching an unbiased mean and SD by iteration. It is also useful to compute between-method CV and within method-CV by one-way analysis of variance. They represent overall levels of standardization and reproducibility of the analyte, respectively. The evaluation of results is usually based on the peer-group mean and SD. The scheme is unfair for those belonging to a peer-group with a narrow SD. It is recommended to use so-called "common CV evaluation scheme", which is based on a within-method CV computed from overall test results after excluding those peer-groups with large CVs. The common CV is applied to the unbiased peer-group mean to get the evaluation SD. For standardized data processing and statistical analysis, it is crucial to develop a unified, generalized soft ware. We developed its prototype named SurveyMaster I & II and herein introduce their potentials.

Clinical Laboratory Techniques↗