Intracardiac Shunt-Use of the Hydrogen-Sensitive Catheter to Clarify False Positive Diagnosis of Left-to-Right Shunt

The charts of 142 patients who had diagnostic right heart catheterization with conventional oximetry, oxygen content determinations and hydrogen electrode curve recording for left-to-right shunt were reviewed. A false positive diagnosis of surgical significance would have been made in nine patients if the hydrogen electrode had not been used. In addition, a diagnosis of left-to-right shunt could have been made at the wrong chamber level in three additional cases.     

Intracardiac Shunt—Use of the Hydrogen-Sensitive Catheter to Clarify False Positive Diagnosis of Left-to-Right Shunt

The charts of 142 patients who had diagnostic right heart catheterization with conventional oximetry, oxygen content determinations and hydrogen electrode curve recording for left-to-right shunt were reviewed. A false positive diagnosis of surgical significance would have been made in nine patients if the hydrogen electrode had not been used. In addition, a diagnosis of left-to-right shunt could have been made at the wrong chamber level in three additional cases.     

Merkel-cell carcinoma of the skin.

Three cases of Merkel-cell carcinoma of the skin have been presented. The need for a correct clinical and histologic diagnosis has been highlighted. Rapid widespread growth of the tumor occurs when surgical treatment is delayed. Immunohistochemistry is essential for accurate differential diagnosis.     

Accuracy of clinical diagnosis in a Canadian teaching hospital.

Two hundred autopsies were investigated to determine the correlation between the clinical and pathological diagnoses in three categories--major underlying disease, cause of death and significant incidental pulmonary findings. There was concurrence in diagnosis of the major underlying disease in 76% of cases, with 12% of disagreements being considered minor and 12% major. In only three cases might different management have affected the outcome had the correct diagnosis of the major underlying disease been made during life. There was concurrence of the diagnosis of the cause of death (which was often different from the underlying disease) in 64% of cases, and in 10% of cases the outcome might have been different had the clinical diagnosis been accurate. The clinical opinion that lung disease was the cause of death was confirmed at autopsy in 54% of cases, and 45% of the pulmonary causes of death as determined at autopsy had been recognized clinically. Major incidental pulmonary findings diagnosed clinically were confirmed in 76% of cases, and major pulmonary findings diagnosed at autopsy had been recognized clinically in 83%. The major sources of these discrepancies were pulmonary embolism and pneumonia. If autopsies are to play a role in patient management, clinicians will have to be made aware of discrepancies between clinical and autopsy diagnosis. The real test of efficacy would be modification of patient management for the good.     

Toward practical, DNA-based diagnostic methods for parasitic nematodes of livestock--bionomic and biotechnological implications

Parasitic nematodes of livestock have a major economic impact worldwide. In spite of the health problems caused by nematodes and advances toward the development of vaccines and new therapeutic agents against some of them, relatively limited attention has been paid to the need for improved, practical methods of diagnosis. Accurate diagnosis and genetic characterization of parasitic nematodes of livestock are central to their effective control, particularly given the current, serious problems with anthelmintic resistance in nematode populations. Traditional diagnostic techniques have considerable limitations, and there have been some advances toward the development of molecular-diagnostic tools. This article provides a brief account of the significance of parasitic nematodes (order Strongylida), reviews the techniques that have been evaluated or used for diagnosis and describes developments in polymerase chain reaction (PCR)-based methods for the specific diagnosis of nematode infection/s and the genetic characterisation of the causative agents. The advances made in recent years provide a solid foundation for the development of practical, highly sensitive and specific diagnostic tools for epidemiological investigations and for use in control programmes.     

A possible population monitoring system on environmental mutagens: statistical studies on retinoblastoma in Japan.

Because an increasing number of environmental mutagens have been detected by laboratory screening, the need to monitor human populations directly for mutational risk has been emphasized by many geneticists. They have proposed various monitoring systems but none of them has been practically applied because a large number of samples would need to be studied systematically in such systems. Recent studies by KNUDSON on some malignant tumors give hope that these diseases might be used to assess somatic mutation rates, as suggested by SUTTON (1972). According to KNUDSON, the age of first diagnosis of the diseases may be related to the annual somatic mutation rate. The ages of first diagnosis of unilateral and bilateral retinoblastomas have been compared among four university hospitals in Japan for cases since 1965. Three different types of analysis have been tried: (1) normal distribution; (2) KNUDSON's method; and (3) a modification of VERSCHUER's method for calculating penetration. The age at diagnosis of unilateral cases has fallen in the past ten years. A significant difference in the age of first diagnosis in bilateral retinoblastoma has been found in a hospital in Japan. The changes observed may result from the increased rate of somatic mutations induced by some environmental mutagens.     

Place of Culdocentesis in the Diagnosis of Ectopic Pregnancy

In developing countries the high incidence of anaemia and pelvic infection often makes the diagnosis of ectopic pregnancy difficult. Culdocentesis has been used in 100 doubtful cases out of 144 consecutive cases of ectopic pregnancy. The preoperative diagnosis was correct in 93 out of the 100 cases. There were three false-negative and four false-positive results; only two unnecessary laparotomies were performed. It is suggested that culdocentesis has an essential place in the early diagnosis of doubtful or atypical ectopic pregnancy. It was simple, safe, and reliable. Owing to earlier diagnosis maternal mortality and morbidity and the duration of stay in hospital have all been reduced.     

The reverse proteomics for identification of tumor antigens

The identification of tumor antigens is essential for the development of anticancer therapeutic vaccines and clinical diagnosis of cancer. SEREX (serological analysis of recombinant cDNA expression libraries) has been used to identify such tumor antigens by screening sera of patients with cDNA expression libraries. SEREX-defined antigens provide markers for the diagnosis of cancers. Potential diagnostic values of these SEREX-defined antigens have been evaluated. SEREX is also a powerful method for the development of anticancer therapeutics. The development of anticancer vaccines requires that tumor antigens can elicit antigen-specific antibodies or T lymphocytes. More than 2000 antigens have been discovered by SEREX. Peptides derived from some of these antigens have been evaluated in clinical trials. This review provides information on the application of SEREX for identification of tumor-associated antigens (TAA) for the development of cancer diagnostics and anticancer therapeutics.     

Molecular genetic characteristics of Duchenne-Becker muscular dystrophy in the Republic of Moldova

Solution to some problems of clinical genealogical and molecular genetic study of Duchenne muscular dystrophy (DMD) in the Republic of Moldova and prenatal diagnosis aimed at preventing the birth of infants with this disease is proposed. An integrated clinical and molecular genetic study of families with a high risk of DMD has allowed its specific characteristics in the Moldovan population to be identified. The spectrum of mutations at the gene level in DMD patients and their role in prenatal and clinical diagnosis has been determined. RFLP analysis and PCR have been used to estimate the informativeness of families with a high DMD risk; prenatal diagnosis has been performed in some of them. Population analysis of the frequencies of polymorphic restriction sites have been carried out for loci pERT87-8/Tag1, pERT87-15/BamH1, and 16intron/Tag1. The results of analysis of deletion frequencies in the dystrophin gene and the frequencies of the pERT87-8, pERT87-15, and 16intron intragenic polymorphic loci have served as a basis for a strategy of molecular diagnosis. The new strategy allows the informativeness to be evaluated and, hence, clinical, preclinical, and prenatal diagnosis to be performed in approximately 94% of cases. A modified PCR method (MPCR) using the system of primers pERT87-8/Tag1 and 16intron/Tag1 has been developed for direct search for deletions. The method makes it possible to avoid diagnostic errors and decrease both the duration and the cost of the analysis.     

Fine Needle Aspiration For the Diagnosis and Management of Granulomatous Disease

Fine needle aspiration is a quick, minimally invasive and cost-effective technique for the diagnosis of granulomatous disease. Cytological diagnosis can often be specific, with the help of special stains and microbiological culture of aspirated material, particularly in the case of tuberculosis, the most common infective granulomatous disease in this country. At a fine needle aspiration clinic many cases of granulomatous disease, some from unusual sites, have been diagnosed and the use of more invasive investigations has been avoided. The problems involved in cytological diagnosis are discussed using seven cases as examples.     

高频超声、钼靶X射线在乳腺BI—RADSⅣ～Ⅴ级诊断中的应用对比研究

目的探讨高频超声、钼靶X射线单独与联合应用在乳腺影像报告与数据系统（BI—RADS）Ⅳ～Ⅴ级诊断中的应用价值及对比研究。方法136个病灶经病理证实为乳腺恶性肿瘤,回顾性分析高频超声、铝靶X射线影像表现,并对诊断的准确性进行统计学分析。结果高频超声、钼靶X射线及两者联合应用对乳腺BI～RADSⅣ～Ⅴ级诊断的正确率、误诊率比较,差异有统计学意义,P〈0．01．结论高频超声在乳腺肿块（BI—RADSⅣ～Ⅴ级）诊断正确率方面优于钼靶X射线,特别是肿瘤直径〈1．0cm,且不伴有钙化时,两者联合应用较单一方法更能提高乳腺肿块（BI—RADSⅣ～Ⅴ级）的检出率及良、恶性鉴别诊断。     

Features of malignancy in a benign pheochromocytoma

Pheochromocytomas are rare conditions with a prevalence of 1-2/100,000 in the general population and 1/1,000 hypertensive subjects [1]. 10% of pheochromocytomas are malignant and various attempts have been made to find useful prognostic indicators of malignancy. In general, increased plasma or urine dopamine concentrations or increased homovanillic acid excretion and lack of 131-methyliodo-benzylguanidine uptake have been associated with malignancy [2]. However, to date no specific metabolic, radiologic or histopathologic features of either benign or malignant pheochromocytomas allowing the safe diagnosis of one or the other have been identified. The diagnosis of malignant pheochromocytoma can be made only in the presence of local tissue invasion or distant metastases. We present a benign pheochromocytoma exhibiting several features suggestive of malignant disease.     

基于CRISPR/Cas的分子诊断传感器在非核酸分子诊断中的应用

CRISPR/Cas不仅是一种重要的基因编辑工具,而且还是一种有效的分子诊断工具。目前基于CRISPR/Cas建立了一系列的分子诊断传感器系统,广泛应用于核酸、非核酸等检测过程中。与应用较广泛的核酸分子诊断传感器系统相比,基于CRISPR/Cas的非核酸检测系统目前尚未见系统性综述,因此本文围绕基于CRISPR/Cas12和CRISPR/Cas13建立的两大类非核酸分子传感器诊断系统的基本特征、工作流程及其检测原理等进行了全面综述,期望能为CRISPR/Cas分子诊断系统在体外诊断中的应用提供依据。     

普鲁士蓝纳米粒子在生物医学诊断和治疗中的应用及进展

随着生物医学诊断和治疗的持续深入研究,出现了多种医学诊断和治疗新方法,为人类的健康提供了更大的保证,其中纳米生物技术在生物医学诊断和治疗中的应用日益增多,基于纳米技术,开发传统材料的生物医学新应用成为了人们的研究热点。普鲁士蓝是一种历史悠久的蓝色染料,其制备过程简单、绿色、成本低,化学结构稳定,具有优良的物理、化学、光学以及磁性等性能,已经在许多领域得到了广泛的应用。近年来,普鲁士蓝开始在生物医学诊断和治疗领域中崭露头角,它已经成功的被开发为新型的核磁共振造影剂和光声成像造影剂,并且在药物输送系统和光热治疗等领域也开始占有一席之地,开发基于纳米技术的普鲁士蓝的生物医学应用已经成为极具吸引力的研究方向。本文对普鲁士蓝在生物医学诊断和治疗中的应用及进展进行综述。     

Etiologic Diagnosis of Lower Respiratory Tract Infections

Decision as to the role of infection in lower respiratory tract disease requires examination by culture of specimens known to be derived from the infra-laryngeal respiratory tract. Methods that involve the upper respiratory tract in collection of specimens entail the hazard of contamination by microbiota resident in the upper respiratory tract.The extrapulmonary approaches of cutting-needle biopsy and needle aspiration of intrathoracic disease have not been impressively productive of etiologic diagnosis of infections. While open-chest surgical biopsy has been a highly effective means to diagnosis, this approach does have special requirements in facilities and technical skills.Percutaneous transtracheal aspiration of tracheo-broncho-pulmonary secretions-exudates has been productive of useful information. Because of inherent simplicity and safety, transtracheal aspiration should precede resort to more demanding, difficult, dangerous procedures.     

Physical mapping identifies DXS265 as a useful genetic marker for carrier detection and prenatal diagnosis of X-linked agammaglobulinemia

The gene responsible for X-linked agammaglobulinemia (XLA) has not been identified; however, in the course of genetic linkage studies designed to map the locus more precisely, a number of closely linked polymorphic loci have been identified. These have proved to be useful in identifying carriers and in pre-natal diagnosis of this disease. The DXS178 locus was found to be closest to the XLA locus and has been the most usefully employed probe to date. Using physical mapping techniques, we have identified a previously cloned genetic marker, DXS265, as being situated within 5kb of DXS178. So far, we have found one family that is not informative for DXS178 but that is informative for DXS265; females in this family can now be offered the possibility of carrier determination and pre-natal diagnosis for this life-threatening disease.     

The diagnosis of antileptospiral antibodies in human subjects by solid-phase immunoenzyme analysis

The possibility of using the enzyme-linked immunosorbent assay (ELISA) for the diagnosis of leptospirosis has been shown. This method has proved to be more simple and sensitive than the leptospiral microagglutination and lysis test. The data on obtaining genus-specific leptospiral antigens are presented. As revealed in this study, the antigens obtained by the complex treatment of microbial cells with ultrasound and detergents show the maximum activity in ELISA. The optimum parameters of the ELISA system for the diagnosis of leptospirosis have been established.     

Choriocarcinoma metastatic to the breast diagnosed by fine needle aspiration.

Fine needle aspiration (FNA) was used to study nodules in the left breast of a patient with a previous history of uterine choriocarcinoma. The FNA smears contained numerous malignant mononucleated cells and multinucleated giant cells. The cytologic diagnosis was metastatic choriocarcinoma, which was confirmed by histologic study of excised tissue. That diagnosis would have been difficult to make cytologically if the previous history had not been known; the differential diagnosis of multinucleated giant cells in an aspirate from a breast mass is discussed.     

结核分枝杆菌抗原蛋白的研究及其应用新进展

结核病(tuberculosis, TB)是由结核分枝杆菌(Mycobacterium tuberculosis, MTB)感染引起的慢性传染病,是仅次于正在暴发的新型冠状病毒肺炎(COVID-19)的第二大单一感染致死病因。COVID-19的大流行对TB的诊断及治疗造成了破坏性的影响,全球实现终结TB目标的进展偏离了轨道。因此,早诊断、早治疗依然是防控TB蔓延的关键。TB精准诊断一直受MTB抗原特异性、检测技术特异性和灵敏度的影响,因此亟需挖掘高特异性新抗原、开发新检测技术。随着蛋白质基因组学(proteogenomics)和质谱技术的快速发展,从临床体液、组织样本中高效、精准靶向检测MTB特异性已知、甚至新抗原的表达,以及监测治疗过程中的抗原表达量的动态变化,是TB诊断及治疗的发展趋势。在MTB标准菌株H37Rv的4 008个注释基因中(NC＿000 962.3, NCBI),国内外报道的已注释抗原虽有140多个,但仅有极少的抗原应用于TB的筛查及辅助诊断,离世界卫生组织(World Health Organization, WHO)的诊断标准尚远。本文通过对MTB已报道抗原以及基...     

Biotechnological advances in the diagnosis of avian coccidiosis and the analysis of genetic variation in Eimeria

Coccidiosis is an intestinal disease of chickens caused by various species of protozoan parasites within the genus Eimeria. This disease has a major economic impact to growers and to the poultry industry world-wide. The diagnosis and genetic characterization of the different species of Eimeria are central to the prevention, surveillance and control of coccidiosis, particularly now given the major problems with wide-spread resistance of Eimeria species against anticoccidial drugs (coccidiostats) and the residue problems associated with these compounds. While traditional methods have had major limitations in the specific diagnosis of coccidiosis, there have been significant advances in the development of molecular-diagnostic tools. The present article provides a background on coccidiosis, reviews the main molecular methods which have been used and describes recent advances in the establishment of polymerase chain reaction (PCR)-coupled electrophoretic approaches for the specific diagnosis of coccidiosis as well as the genetic characterization of species of Eimeria. These biotechnological advances are considered to represent a significant step toward the improved prevention and control of this important disease of poultry.