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[Education and research toward the development of clinical laboratory techniques].

We have entered an era to discuss the modalities of the education of the students who are qualified as medical technologists. Continual acquisition of new knowledge and information, and the development of new diagnostic laboratory methods and new laboratory techniques coping with acquired knowledge and information are the research themes that are very adequate for the postgraduate students to whom the places for education and research are provided to aim top-ranking leading medical technologists. If they could progress toward the application for patent and commercialization of the research results, they would be encouraged to advance their researches further.

Clinical Laboratory Techniques↗

Assessment of clinical laboratory techniques in the measurement of oxygen saturation in whole blood.

The accuracy and advantages of determining percentage of hemoglobin oxygen saturation of whole blood by advanced instruments of oximetry, gas chromatography, and the computation of oxygen saturation from pO2 and pH data are compared with the Van Slyke-Neill manometric method. It was found that oximetry is extremely fast, less expensive, and more accurate than in the past, the apparatus requires little training to operate and has diminutive service maintenance. The gas chromatograph proved to be highly accurate and could serve as a standard calibration check method in place of the more time-consuming Van Slyke-Neill apparatus for oximetry and pO2 and pH electrode instrumentation. Computation of O2 saturation from pO2 and pH data also proved to be accurate, confirming that this method is more useful during cardiac surgery because it can provide additional acid-base information. In the low oxygen saturation range (less than 60%), all three methods proved to be of similar sensitivity.

Chromatography, Gas↗

[Molecular biology techniques as clinical laboratory tests].

The quality of results obtained with molecular biology techniques depends on the control of preanalytical and analytical error associated with such techniques. Preanalytical error can be introduced during the isolation of DNA and RNA. The type of detergent used in cell lysis can affect the amplification of DNA by techniques such as the polymerase chain reaction(PCR). Ribonuclease(RNase) contamination is a serious problem in the isolation of undegraded RNA, and, thus, this enzyme should be inhibited. Anticoagulants used for blood collection can affect the quality of results with molecular biology techniques. The control of contamination from the working environment is essential to the minimization of preanalytical, analytical and postanalytical error. Molecular biology techniques for a wide range of clinical laboratory tests have been established in hospitals such as clinical laboratory tests for infections, molecular diagnoses of leukemia and aberrant genes in metabolism.

Blood Coagulation Factors↗

Diagnostic methods for Helicobacter pylori detection and eradication.

Helicobacter pylori is the principal cause of peptic ulcer disease and an important risk factor for the development of gastric cancer. The efficacy of 1 week triple therapies, which often have eradication rates of>90%, is undermined by poor patient compliance and bacterial antimicrobial resistance. The development of new anti-H. pylori therapies presents enormous challenges to clinical pharmacologists, not only in the identification of novel targets, but also in ensuring adequate drug delivery to the unique gastric mucus niche of H. pylori. Animal models of H. pylori infection have been developed but their clinical validity has yet to be established. Vaccination, to prevent or treat infection, has been demonstrated in animal models, but human studies have not been so encouraging.

Anti-Bacterial Agents↗

Conservative inlay fixed partial denture: a clinical and laboratory technique.

Fiber-reinforced composite (FRC) fixed partial dentures (FPDs) offer a clinical alternative for the restoration of single missing teeth and short-span posterior and anterior FPDs. This treatment modality is conservative and cost-efficient. The continuous improvement of adhesives and resin-based composite systems makes this type of restoration successful with good esthetic and functional results. This article reports the case of a patient who received an FRC FPD as a treatment modality and illustrates the clinical procedure as well as a new laboratory technique utilizing a clear matrix for the fabrication of the prosthesis.

Bisphenol A-Glycidyl Methacrylate↗

The relative usefulness of automated apolipoprotein A-I and high-density lipoprotein cholesterol assays as markers for coronary artery disease.

Research studies have shown that apolipoprotein A-I (apo A-I) is a better marker for coronary artery disease (CAD) than high-density lipoprotein cholesterol (HDLC). Yet, it is unclear whether assays for apolipoprotein A-I, which is part of macromolecular lipoprotein complex, can perform as well when measured by routine automated clinical laboratory techniques. The purpose of this study was to compare automated apolipoprotein A-I assays with HDLC as a marker for CAD. The authors studied two groups of angiographically documented men, aged 44-70 years, 42 with CAD and 123 without CAD in an unmatched, controlled study. Standard clinical laboratory techniques for assaying HDLC, and automated kit rate immunonephelometric, end point immunonephelometric, and immunoturbidimetric assays for apolipoprotein A-I were used. High-density lipoprotein cholesterol was a better marker than apolipoprotein A-I, according to the Mann Whitney test; HDLC also showed better diagnostic sensitivity, specificity, and predictive value. Using a precipitation method, HDL3 was a better marker than HDL2, but not as good as total HDLC. The authors concluded that HDLC remains the best routine single CAD marker commonly available for evaluation of HDL status in a high-risk population.

Adult↗

Large-volume tissue ablation with radio frequency by using a clustered, internally cooled electrode technique: laboratory and clinical experience in liver metastases.

PURPOSE: To evaluate whether coagulation necrosis achievable with radio-frequency (RF) ablation can be increased by using a cluster of closely spaced electrodes. MATERIALS AND METHODS: RF was applied to ex vivo liver (n = 68), in vivo liver (n = 12), and in vivo muscle (n = 15) by using a cluster array of three separate internally cooled electrodes spaced 0.5 cm apart. The diameter of coagulation necrosis achieved with optimal RF deposition (1,400-2,150 peak mA) for 5-60 minutes of RF application was determined for electrode tip lengths of 1.5-3.0 cm and compared with that obtained by using a single electrode and otherwise similar technique. Ten patients with solitary intrahepatic colorectal metastases were also treated by using cluster electrode RF ablation. RESULTS: In ex vivo liver, simultaneous RF application to electrode clusters for 15, 30, and 45 minutes produced 4.7 cm +/- 0.1, 6.2 cm +/- 0.1, and 7.0 cm +/- 0.2 of coagulation necrosis, respectively. In in vivo liver and muscle, RF applied to electrode clusters for 12 minutes yielded 3.1 cm +/- 0.2 and 7.6 cm +/- 0.4 of coagulation, respectively. RF application to a single electrode produced maximal coagulation of 2.9 cm in ex vivo liver, 1.8 cm in in vivo liver, and 4.3 cm in muscle (P < .01, all tissues). In colorectal metastases, a single 12-15-minute application of RF to an electrode cluster induced 4.5-7.0 cm of coagulation necrosis. CONCLUSION: Simultaneous RF application to a cluster of three closely spaced internally cooled electrodes enables a larger volume of coagulation in ex vivo liver, in vivo tissues, and hepatic colorectal metastases than previously reported.

Animals↗

Spark erosion implant-supported overdentures: clinical and laboratory techniques.

Overdentures can be utilized effectively in treatment plans involving implants. Usually soft tissue support is necessary, which requires a conventional denture base. Implant-supported overdentures do not require conventional denture base extension unless necessitated by functional or esthetic considerations. With fixed-detachable hybrid dentures, flanges can often interfere with home care procedures. Spark erosion overdentures meet the requirements for esthetics, phonetics, retention, and support and also allow accessibility for proper patient oral hygiene. This article reviews the advantages and disadvantages of the spark erosion overdenture and provides guidelines for the fabrication of this type of prosthesis.

Dental Implants↗

Clinical and laboratory techniques for repair of fractured porcelain in fixed prostheses: a case report.

A technique used to repair the abutment tooth of a fixed partial metal-ceramic prosthesis is described. This prosthesis extended from the maxillary central incisor to the left canine. The whole porcelain facial aspect of the central incisor had been fractured. Following a reduction of the metallic structure, a single porcelain crown was bonded to that area. The repair was quick, less expensive and less difficult than removal of the prosthesis and fabrication of a replacement, and provided excellent esthetic and functional results.

Adult↗

Controlled assessment of diagnostic techniques: methodological problems.

The increasing requests for diagnostic tests is one of the many causes of rising costs in health care systems. Many health care professionals think today that this increase could be reduced if diagnostic tests were accurately assessed, as are drugs. If there are similarities between a controlled treatment trial and a diagnostic method trial, there are also many differences relating to the sample size, the choice of criteria for final judgment, the study design and the clinician's behaviour when faced with the problem. These differences make it difficult to organise controlled trials of diagnostic techniques. A different approach using simulation methods and a decision tree appears more appropriate in the evaluation of diagnostic techniques.

Clinical Laboratory Techniques↗