Web searches for laboratory animal medicine: using the "mouse" for access to online resources

Laboratory animal medicine professionals must be able to integrate information from a variety of sources to make sound decisions. To address concerns from preveterinary and veterinary students that information about the specialty is difficult to locate, the authors examined the utility of electronic search engines to provide links to appropriate websites of significant educational value to the field. They assembled this reference document to assist veterinary students, residents, and postdoctoral fellows in the acquisition of online texts, journals, newsletters, government regulations, and other sources of current information as they relate specifically to laboratory animal medicine.     

Campylobacteriosis--a "new" disease in laboratory animals

Campylobacter fetus ss jejuni is now recognized as a leading cause of diarrhea in humans. With the development of proper culture techniques, C jejuni has been isolated from humans with diarrhea as frequently as Salmonella or Shigella species. Laboratory animal models are being developed to study the pathogenesis of campylobacter-induced diarrhea; also, identification of C jejuni is occurring more frequently in a variety of laboratory animals, whether asymptomatic carriers or those with clinical diarrhea. Animals shedding C jejuni also have been incriminated as a source of campylobacter diarrhea in humans.     

A workflow management tool for laboratory medicine

To improve the efficiency and effectiveness of clinical laboratories, workflow analysis should be applied. To achieve this, specific laboratory functions and processes were identified. Methods for analyzing workflows and rules to control them are discussed. It is shown how workflow analysis can be applied in clinical laboratories using discrete event simulation. For this, a particular model (SCALES: Support and Consequences through Advanced Laboratory Expert Systems) is applied to analyze the workflow on several workstations. The results of a validation attempt are given. The information obtained from this study appeared to be very useful both from a methodological as well as a practical point of view.     

Miniaturized electrophoresis: an evolving role in laboratory medicine.

The promise of capillary electrophoresis (CE) for supplanting conventional methods in the clinical laboratory led to intense interest in this analytical tool a decade ago. Since then, a number of clinical applications have been defined along with those that have impacted the pharmaceutical, environmental, and forensic arenas. Concurrent with the development of CE applications was the emergence of electrophoresis in the microchip format. The main attraction of this platform, the ability to execute high-resolution separations in a few hundred seconds, was not its only attribute. The capability for parallel processing of separations was complemented by the potentialfor integrating sample preparation into the same device. This Review highlights recent progress towards CE and microchip electrophoresis as clinical diagnostic tools, with literature coverage from 1996 to 2000.     

Requirements for reference (calibration) laboratories in laboratory medicine

In addition to reference measurement procedures and reference materials, reference or calibration laboratories play an integral role in the implementation of measurement traceability in routine laboratories. They provide results of measurements using higher-order methods, e.g. isotope dilution mass spectrometry and may assign values to materials to be used for external quality assessment programs and to secondary reference materials. The requirements for listing of laboratories that provide reference measurement services include a statement of the metrological level or principle of measurement, accreditation as a calibration laboratory according to ISO 15195 and the participation in a proficiency testing system (regular inter-laboratory comparisons) for reference laboratories. Ring trials are currently conducted for thirty well-defined measurands and the results are made available to all laboratories. Through the use of reference laboratory services that are listed by the Joint Committee for Traceability in Laboratory Medicine there is the opportunity to further promote traceability and standardisation of laboratory measurements.     

Cystatin C--a paradigm of evidence based laboratory medicine

Cystatin C is a 13-kDa protein, of the cysteine proteinase inhibitor superfamily, produced by all nucleated cells. Its production rate is constant throughout the ages of 1 to 50 years. It is freely filtered at the glomerulus and then resorbed and fully catabolised by proximal renal tubules, making it an ideal marker of glomerular filtration rate (GFR). Serum creatinine, the most established marker of renal function, is affected by age, gender, muscle mass, nutritional status and analytical interference. The abbreviated Modifiation of Diet in Renal Diseases (MDRD) equation has recently been introduced in an attempt to overcome these shortcomings, but still has many limitations. Cystatin C is not affected by gender, muscle mass, malignancy, its production rate is usually constant and its plasma concentration therefore is dependent only on GFR. Cystatin C has been demonstrated to be more accurate than serum creatinine in the detection of early renal impairment and in specific populations may allow for early detection of renal disease. Cystatin C has also been found to be a strong predictor of long-term clinical outcomes in patients with cardiovascular diseases. Although cystatin C may have advantages in detection of early renal impairment there is a paucity of evidence that it significantly improves clinical decision making over creatinine. This coupled with assay cost may be the reason why cystatin C, although well recognised, has not been introduced into routine operational use, although that may eventuate with emerging evidence.     

医学检验专业医学寄生虫学与检验课程教学改革初探

目的改革医学寄生虫学与检验理论与实践教学方法,提高教学质量。方法框架式讲授理论与实验内容后,引入案例,通过启发式教学方法引发学生兴趣;以问题为导向,进行探究式学习,以专业需求为目标,设专题实验室,以实践性和综合性实验为主导,改革课程知识安排顺序和考核评价方法。结果学生学习主动性提高,专业重点清晰。结论教学改革取得满意的效果。     

S100 proteins: Diagnostic and prognostic biomarkers in laboratory medicine

S100 proteins are members of the superfamily of Ca²⁺-binding proteins characterized by the specific Ca²⁺-binding motif, the EF-hand. Proteins of this superfamily are of clinical use as important diagnostic and prognostic biomarkers in adult and pediatric Laboratory Medicine. For example, measurements of troponin are nowadays the ‘gold standard’ in the diagnosis of patients with acute coronary syndrome. Parvalbumins were identified as major fish allergens and blocking antibodies, induced by immunization with a hypoallergenic parvalbumin mutant, were shown to reduce allergic symptoms. Mutations in calmodulin are linked to inherited ventricular tachycardia, and cardiac arrhythmias. S100 proteins, the largest sub-group within the EF-hand protein family, are closely associated with cardiovascular diseases, various types of cancer, inflammation and autoimmune pathologies and brain diseases. The intention of this review is to focus on the clinical use of S100 proteins as biomarkers and potential drug targets helping to improve the diagnosis of these human diseases in children and adults leading to more selective therapeutic interventions.     

Rectangular tolerance regions and multivariate normal reference regions in laboratory medicine

Reference intervals are widely used in the interpretation of results of biochemical and physiological tests of patients. When there are multiple biochemical analytes measured from each subject, a multivariate reference region is needed. Because of their greater specificity against false positives, such reference regions are more desirable than separate univariate reference intervals that disregard the cross-correlations between variables. Traditionally, under multivariate normality, reference regions have been constructed as ellipsoidal regions. This approach suffers from a major drawback: it cannot detect component-wise extreme observations. In the present work, procedures are developed to construct rectangular reference regions in the multivariate normal setup. The construction is based on the criteria for tolerance intervals. The problems addressed include the computation of a rectangular tolerance region and simultaneous tolerance intervals. Also addressed is the computation of mixed reference intervals that include both two-sided and one-sided limits, simultaneously. A parametric bootstrap approach is used in the computations, and the accuracy of the proposed methodology is assessed using estimated coverage probabilities. The problem of sample size determination is also addressed, and the results are illustrated using examples that call for the computation of reference regions.     

Clinical laboratory testing in human medicine based on the detection of glycoconjugates

The purpose of this review is to provide a concise overview of developments over the last 15 years in the field of laboratory tests in human medicine that are based on the detection of alterations in the glycan part of glycoconjugates. We show how glycosylation-based diagnostic testing is widespread in the current clinical practice, in different formats. To provide the necessary focus in this extremely broad field, we have only included assays that are either in actual clinical use or that are under active development towards clinical use, with some bias towards assays that were recently developed. The fields included are: cancer, infectious disease, genetic defects of glycoconjugate biosynthesis and catabolism, auto-immunity, drug abuse and liver disease. To conclude this review, we provide a viewpoint on the future of the glyco-diagnostics field in terms of novel technologies, especially with regard to the discovery and clinical implementation of biomarkers that are based on pathologically altered endogenous glycotopes.     

The future of laboratory medicine: understanding the new pressures

Since the future role of Laboratory Medicine is strongly and equally challenged by economic and new technological pressures, it is essential to take a broad view of the discipline and present to the administrators and other decision-makers the full spectrum of activities and benefits Laboratory Medicine can provide. In particular, the importance and the true impact of Laboratory Medicine can only be achieved by adding value to laboratory tests, represented by their effectiveness in influencing the management of patients and related clinical outcomes.