doi: 10.1093/labmed/22.5.303pmid: N/A
Article PDF first page preview Close This content is only available as a PDF. © American Society of Clinical Pathologists
doi: 10.1093/labmed/22.5.305pmid: N/A
Article PDF first page preview Close This content is only available as a PDF. © American Society of Clinical Pathologists
doi: 10.1093/labmed/22.5.309pmid: N/A
Article PDF first page preview Close This content is only available as a PDF. © American Society of Clinical Pathologists
Sodeman, Thomas, M.;Colmer,, Jane
doi: 10.1093/labmed/22.5.313pmid: N/A
Abstract The upper respiratory tract microbiology centers around pharyngitis. Issues of rapid detection of group A β-hemolytic streptococci along with concepts of scoring systems that limit the need for cultures have dominated the literature. Both approaches have serious limitations that indicate culture is still the first-line approach to pharyngitis. The role of Moraxella (Branhamella) catarrhalis in acute otitis media is discussed. Resurgence of Bordetella indicates a need for review of laboratory procedures. This content is only available as a PDF. © American Society of Clinical Pathologists
Markin, Rodney, S.;McPherson, Richard, A.
doi: 10.1093/labmed/22.5.319pmid: N/A
Abstract Part I of this article dealt with a background of laboratory procedures generally applied to the evaluation of organ transplant recipients with specific case histories of renal and cardiac transplantation. This part concentrates on liver transplantation and the laboratory measurements especially useful in monitoring the survival and function of hepatic allografts. This content is only available as a PDF. © American Society of Clinical Pathologists
doi: 10.1093/labmed/22.5.325pmid: N/A
Abstract Two of the three major isoenzymes of creatine kinase (CK), MM and MB, undergo postsynthetic modification resulting in the creation of five isoforms. On the basis of their relative electrophoretic migration, the isoforms are designated MM3, MM2, MM1 MB2, and MB1 (from most cathodal to most anodal). CK isoform formation is a naturally occurring phenomenon mediated by carboxypeptidase (CPase) N. CPase N cleaves the carboxy-terminal amino acid, lysine, from the M subunits of MM3 to form MM2 and MM1 and from the M subunit of MB2 to form MBV MM3 and MB2 are tissue isoforms, and MM2, MM1, and MB1 are formed after the tissue isoforms are released into the circulation. The CK isoforms can be used as markers for confirmation of an acute myocardial infarction (AMI) and for successful reperfusion of AMI patients treated with thrombolytic therapy. Both MM3 and MB2 are significantly increased in the blood shortly after an AMI. Total MM3 and MB2 and the MM3/MM1 and MB2/MBl ratios are all elevated subsequent to AMI and prior to total CK and CK-MB levels. The CK-MB isoforms are preferable to the MM isoforms for diagnosing AMI and reperfusion because they are more myocardial tissue specific. The CK isoforms can be assayed using electrophoresis, isoelectric focusing, chromatofocusing, highperformance liquid chromatography, and immunoinhibition. Rapid, precise, and sensitive electrophoresis procedures allow CK isoform analysis to be used for diagnosis and treatment of patients as early as 2 to 6 hours after AMI. This content is only available as a PDF. Author notes " The opinions expressed herein are the private views of the author and are not to be construed as official or as reflecting the views of the Department of the Air Force or the Department of Defense. © American Society of Clinical Pathologists
Bartley, Suzette, L.;Dowell, Vulus, R.
doi: 10.1093/labmed/22.5.335pmid: N/A
Abstract Dowell reported in 1980 that two selective media, cycloserine mannitol agar (CMA) and cycloserine mannitol blood agar (CMBA), developed at the Centers for Disease Control (CDC), gave better results than cycloserine fructose egg-yolk agar or cycloserine cefoxitin fructose egg-yolk agar in the isolation of Clostridium difficile from feces and in the quantitative recovery of the organism from pure cultures. In 1983, Bartley and Dowell modified the basal medium for CMA and CMBA by deleting L-leucine and Lserine; since then, the modified media has been used for isolating C difficile from feces. In this study, we compared the modified CMA and CMBA media with cycloserine cefoxitin fructose agar (CCFA) in the quantitative recovery of C difficile isolates and modified CCFA from two vendors in the isolation of C difficile from feces. In addition, all fecal specimens were cultured on CDC anaerobe blood agar (BA) after treatment for 1 hour with 95% ethyl alcohol (BA-ETOH). Of 350 fecal specimens examined using all media, 105 yielded C difficile. Of the 105 specimens, 80 were positive with CMBA (76%), 68 with CMA (65%), 44 with CCFA (vendor A) (42%), 38 with CCFA (vendor B) (36%), and 95 with BA-ETOH (90%). The selective media ranked as follows in quantitative recovery of 24 C difficile strains from pure cultures: CMBA>CMA>CCFA. We conclude that the modified CMBA and CMA media are superior to modified CCFA medium for recovery of C difficile and that culture on BA following alcohol treatment is a superior and costeffective method for detecting C difficile from clinical fecal specimens. This content is only available as a PDF. Author notes Use of trade names is for identification only and does not imply endorsement by the Public Health Service or by the US Department of Health and Human Services. † Deceased. © American Society of Clinical Pathologists
Shapiro, Stanley, H.;Norman,, Christine.V.
doi: 10.1093/labmed/22.5.339pmid: N/A
Abstract Normal human kidney tissue blocks were processed in multiple trials for glycol methacrylate embedding utilizing formalin, acetic acid, zinc chloride, formalin (AZF), perfix or Bouin's fluid as fixatives, acidified 2,2-dimethoxypropane (DMP) as dehydrant, and catalyzed monomer for infiltration on varied tissue schedules in duplicate with and without ultrasonic treatment. Adequate processing was consistently attained with formalin or AZF fixation for 30 minutes, 2 changes of DMP 8 minutes each, and infiltration for a total of 30 minutes with ultrasound. We recommend this procedure for rapid processing of biopsy blocks. This content is only available as a PDF. © American Society of Clinical Pathologists
Hoak, David, R.;Kaldor,, George
doi: 10.1093/labmed/22.5.342pmid: N/A
Abstract The fully automated lipid panel described in this article is composed of four clinical tests—total cholesterol, triglycerides, apolipoprotein A- 1, and apolipoprotein B. A computer program was written to execute the simultaneous performance and evaluation of these methodologically dissimilar but clinically related tests. Diagnostic evaluation of the results for these tests was considered individually and together as a panel because the presence or absence of clinically meaningful patterns of lipid metabolism enhanced the usefulness of the individual tests. The sample volume for each profile test is less than 10 μL, there are no preparatory procedures, and all tests are highly accurate and can be performed for less than $3.00 per patient. Other apolipoprotein or enzyme tests measured at 340 nm may be added to the panel, making this approach suitable for detailed diagnostic examinations as well as clinical research. This content is only available as a PDF. © American Society of Clinical Pathologists
Becker, Donald, J.;Darcey, Barbara, A.;Blankenheim, Thomas, J.;Eggert, Arthur, A.
doi: 10.1093/labmed/22.5.347pmid: N/A
Abstract The presentation of a suitable bandbook of laboratory tests for the laboratory users and the collection of related information for the laboratory staff are both technical and clerical tasks. We developed a program to allow clerical entry of handbook information, but place the proofing, editing, and minor corrections into the hands of medical technologists. The numerous fields describing each test include its name with alternatives, how to order it, when it is available, the types of specimens on which it can be performed, and where to deliver the specimens, as well as reference and toxic ranges and clinical significance. Multiple documents, containing any combination of the various fields, can be produced from the same database. This content is only available as a PDF. © American Society of Clinical Pathologists
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