The radiologic "lead band" revisited

After prolonged heavy metal exposure (e.g., lead) "lead bands" develop at the metaphyseal ends of growing bones. These "lead bands," while a constant finding, are used as additional laboratory evidence to diagnose plumbism. In this study, the role of the proximal fibula in distinguishing physiologic sclerosis from pathologic thickening of the zone of provisional calcification is assessed. In addition, laboratory values are compared to radiographic findings in a controlled fashion to establish levels at which "lead bands" appear. The former is a useful adjunct in the radiographic diagnosis of plumbism, while the minimum blood levels at which "lead bands" are seen is much lower than previously described.     

A rational approach to "in vitro" thyroid function testing.

A system of "in vitro" thyroid function testing is proposed whereby laboratory staff select the most appropriate screening test depending on the information supplied by the clinician. Total serum triiodothyronine (T3) or thyroxine (T4) are used for screening as appropriate. In borderline cases, secondary tests are performed automatically according to a flow chart. This system improves efficiency and is cost effective, saving approximately 1,800 pounds annually in a laboratory handling about 5,000 requests for thyroid function tests each year.     

"Idiopathic destructive arthritis" of the shoulder: a still fascinating enigma

Idiopathic destructive arthritis of the shoulder is uncommon, and all previous reports appeared in the nonradiologic literature. The clinical, radiological, and laboratory findings are described. This rare form of rapidly destructive arthritis of the shoulder bear resemblance to several neuropathic-like arthropathies, and its etiopathogenesis is still unclear.     

"Abdominal crunch"-induced rhabdomyolysis presenting as right upper quadrant pain

A young, active duty sailor presented with right upper quadrant abdominal pain. History, physical, and laboratory findings initially suggested cholecystitis or related disease. Further evaluation found myoglobinuria and a recently increased exercise program, leading to the diagnosis of exercise-induced right upper abdominal wall rhabdomyolysis. Although not a common cause of abdominal pain, this diagnosis should be considered in the patient with abdominal pain and a recently increased exercise program, particularly exercises of the abdominal wall such as "abdominal crunches."     

Pulmonary metastatic microangiopathy of colon cancer presenting as a "tree in bud" pattern

The authors report an unusual case of a "tree in bud" pattern of vascular origin caused by colon cancer metastases. A 60-year-old man presented for routine follow-up of a colon tumour resected surgically 15 years previously. Clinical examination, laboratory tests, including carcino-embryonic antigen and inflammatory parameters, and chest radiograph were normal. Multislice CT of the lungs revealed the presence of several "tree in bud" opacities. The connection to the pulmonary arteries was well depicted by reformatted maximal intensity projection images. Biopsy of some of the nodules was characterized by mucinous material and neoplastic cells within the small vessels, consistent with metastases from the known colon adenocarcinoma.     

Papular-purpuric "gloves and socks" syndrome caused by parvovirus B19

This paper presents a 15-year-old boy with an acute febrile illness accompanied by purpuric and papular lesions located mostly on the dorsal areas of his hands and feet with the additional changes on his knees and elbows. Serologic studies confirmed the acute infection by parvovirus B19. Apart from mild leukocytosis there were no other abnormalities in hematologic and laboratory findings. The diagnosis of papular-purpuric "gloves and socks" syndrome (PPGSS) was made. Cutaneous changes completely resolved two weeks later. Herein the patient's condition was described together with a brief overview of the PPGSS literature concerning this relatively rare viral exanthema.     

Prototype of space vitamin greenhouse "Phytoconveyor"

Installation of a greens production system on the International space station will mean a leap toward biological regeneration of food in long-duration space mission. Today, priority is given to green cultures as supplements of space rations and a psychological support to crews in exploration missions to Mars, and also as least resource-intensive. Cylindrical salad greenhouse "Phytoconveyor" designed at the Institute for Biomedical Problems is highly productive, energy-efficient, and requires minimum of crew time for. Dimensions of the greenhouse are 540 x 590 x 400 mm, power demand is 0.25 kW, and the Plant chamber volume is about 0.09 m3. 'Phytoconveyor" has a planting unit with six cylindrical root modules. The total illuminated crop area is about 0.4 m2. The lighting unit consists of red (660 nm) and blue (470 nm) light-emitting diodes on the inner surface of a spiral cylinder coaxial with the roots module unit that generate the photon flux density 350 micromol x M(-2) x s(-1) at a distance of 4 cm. Each root module has a porous tube wrapped up in a fiber substrate with ion-exchange resins and is covered with a lightproof plastic with seed slits. The "Phytoconveyor" design includes a programmable reverse watering system. Given the 24-hr light period, the laboratory model of "Phytoconveyor" can produce up to 300 gram of fresh greens every 4-5 days. The greenhouse was designed with due account of resource limitations on the ISS Russian orbital segment.     

Regulation of hematopoiesis in rats exposed to antiorthostatic hypokinetic/hypodynamia: II. Mechanisms of the "anemia"

Results are presented which demonstrate a close similarity between the ability of antiorthostatic hypokinetic/hypodynamia and orthostatic hypokinetic/hypodynamia to induce anemia in laboratory rats. The "restraint anemia" (whether mediated directly by reduced activity or indirectly by possible changes in blood circulation or in altered weight-bearing capacity of the skeleton) was largely due to reduced food and/or water consumption and displayed the classical symptoms of inadequate nutrition, i.e. decreased serum erythropoietin (Ep) titers and reduced Ep sensitivity of hematopoietic tissue. Only changes in red blood cell (RBC) clearance were unique to the head-down (antiorthostatic) posture. During suspension, RBC clearance was reduced and then accelerated when suspension was terminated or the cells transfused into a normal environment. Changes in RBC clearance were due to both cell-associated and cell-independent factors and may be related to the alterations in RBC survival seen in rats during or immediately after space flight. In both suspension and weightlessness, these changes were limited to alterations in the force and/or direction of the gravity vector.     

The "liver scan" appearance in cholescintigraphy. A sign of complete common bile duct obstruction

One hundred consecutive Tc-99m IDA hepatobiliary scans were reviewed revealing 14 scans (14%), that showed nonvisualization of the common bile duct (CBD), gallbladder (GB), and small bowel (SB), but good hepatic uptake of Tc-99m IDA derivative, a pattern designated by us as "the liver scan appearance." In 11 of 14 cases (79%), the diagnosis of complete CBD obstruction was confirmed by surgery, percutaneous transhepatic cholangiogram (PTC), endoscopic retrograde cholangiopancreatography (ERCP), and/or percutaneous needle biopsy (PBx). Common bile duct obstruction was suspected but not proven in the other three cases. The cholescintigraphic, ultrasound, PTC, ERCP, intraoperative cholangiogram, clinical, laboratory, and surgical findings are presented and correlated. The "liver scan-appearance" by cholescintigraphy should suggest a diagnosis of complete common bile duct obstruction; however, it does not specifically differentiate between stone or tumor as the cause of obstruction.     

Battery life of the "four-hour" lithium ion battery of the LTV-1000 under varying workloads

OBJECTIVE: The objective of this study was to determine the effects of inspired oxygen concentration (FIO2), positive end-expiratory pressure (PEEP), and breath type on the battery life of the LTV-1000 external lithium ion battery (LiB). METHODS: An LTV-1000 ventilator and external LiB were tested in the laboratory. The ventilator was operated using pressure and volume breaths set to deliver a tidal volume of 750 mL. FIO2 was varied from room air (0.21) to 1.0. PEEP was set a 0, 10, and 20 cm of H2O. Duration of operation was determined from measurements of delivered tidal volume. RESULTS: At a baseline of volume control at an FIO2 of 0.21 and a PEEP of 0 cm of H2O, the ventilator operated for 300 +/- 11.6 minutes. Increasing FIO2 to 1.0 reduced battery life to 247 +/- 2.1 minute (p < 0.001). The addition of PEEP to 20 cm of H2O reduced battery life to 211 +/- 3.5 minutes (p < 0.001). The combination of FIO2 of 1.0 and PEEP of 20 cm of H2O further reduced battery life to 188 +/- 6.3 minutes (p < 0.001). At the baseline FIO2 and PEEP (0.21 and 0 cm of H2O), the use of pressure control reduced battery life to 142 +/- 3.5 minutes. CONCLUSIONS: Battery life of the external LiB is significantly reduced by the use of pressure control, increasing PEEP, and increasing FIO2. This information is critical to resource planning for medical missions.     

A case of "Takotsubo" cardiomyopathy observed with myocardial scintigraphy from the acute phase

A 57-year-old woman was emergently admitted to our hospital because of chest oppression. On examination, blood pressure was 174/96 mmHg, pulse rate was 90/min and coarse crackle and third heart sound were audible. On laboratory data, the levels of LDH and CPK-MB were mildly elevated. Electrocardiogram (ECG) demonstrated elevation of the ST segment in leads I, aVL and V2-V5. 99mTc-tetrofosmin myocardial SPECT (TF) showed severely reduced uptake in the apex and anterior wall. Emergent coronary angiography (CAG) did not show any stenotic lesion. Left ventriculography (LVG), however, demonstrated akinesis of the apex, anterior, and inferior walls, and basal hyperkinesis. On the second hospital day, ECG demonstrated inverted T wave in leads I, aVL and V2-V5. 123I-BMIPP myocardial SPECT (BMIPP) and 123I-MIBG myocardial SPECT (MIBG) were performed on the second and fourth hospital days, respectively. These cardiac images showed severely reduced uptake equally. TF, BMIPP, and MIBG were re-examined on the eighth, tenth, and twelfth hospital days, respectively. MIBG, BMIPP, and TF showed reduced uptake in order of severity. On the fourteenth hospital day, CAG and LVG were re-examined. Coronary vasospasm provocation test was negative using ergonovine and acetylcholine, and LVG did not demonstrated any sign of asynergy. We considered that this case was "Takotsubo" cardiomyopathy and might be caused by microvascular spasm.     

Three-dimensional motion analysis of the lumbar spine during "free squat" weight lift training

BACKGROUND: Heavy weight lifting using a squat bar is a commonly used athletic training exercise. Previous in vivo motion studies have concentrated on lifting of everyday objects and not on the vastly increased loads that athletes subject themselves to when performing this exercise. HYPOTHESIS: Athletes significantly alter their lumbar spinal motion when performing squat lifting at heavy weights. STUDY DESIGN: Controlled laboratory study. METHODS: Forty-eight athletes (28 men, 20 women) performed 6 lifts at 40% maximum, 4 lifts at 60% maximum, and 2 lifts at 80% maximum. The Zebris 3D motion analysis system was used to measure lumbar spine motion. Exercise was performed as a "free" squat and repeated with a weight lifting support belt. Data obtained were analyzed using SAS. RESULTS: A significant decrease (P < .05) was seen in flexion in all groups studied when lifting at 40% maximum compared with lifting at 60% and 80% of maximum lift. Flexion from calibrated 0 point ranged from 24.7 degrees (40% group) to 6.8 degrees (80% group). A significant increase (P < .05) was seen in extension when lifting at 40% maximum was compared with lifting at 60% and 80% maximum lift. Extension from calibrated 0 point ranged from -1.5 degrees (40% group) to -20.3 degrees (80% group). No statistically significant difference was found between motion seen when exercise was performed as a free squat or when lifting using a support belt in any of the groups studied. CONCLUSION: Weight lifting using a squat bar causes athletes to significantly hyperextend their lumbar spines at heavier weights. The use of a weight lifting support belt does not significantly alter spinal motion during lifting.     

Relationship of training and life-style to 16-km running time of 4000 joggers. The '84 Berne "Grand-Prix" Study

To investigate running activity, life-style, and endurance capacity of joggers, all competitors of a popular 16-km race were surveyed by questionnaire. The response rate was 83.6%, yielding a study population of 4358 male runners over age 16. In univariate analysis, there were significant associations between 16-km running time and weekly training distance (average of 1 year), weekly training frequency, body mass index (BMI), age, cigarette smoking, years of regular running, and frequency of alcohol cosumption. A multiple regression analysis provided six significant, independent predictors of 16-km time, explaining 47% of its variance: weekly training distance (standardized regression coefficient = -0.46), age (0.37), BMI (0.23), years of regular running (-0.19), weekly training frequency (-0.11), and cigarette smoking (0.10). Based on laboratory treadmill testing of a subsample of runners, 16-km running times were transformed into maximum aerobic capacities (VO2 max equivalents) for all competitors. In comparison with the general population, even the slowest 5% of the runners showed a higher endurance capacity than the age-specific population mean. Application of the multivariate regression model for an estimation of the overall impact of training and life-style on endurance capacity showed that the great difference in mean endurance levels between joggers and the general population could entirely be attributed to differences in running activity, BMI, and smoking. We conclude that the joggers investigated were, on average, not selected concerning biological predisposition and genetic endowment since their behavior alone explained their high average endurance capacity.     

探索形成性评价在医学检验教学中的应用

通过研究形成性评价体系在检验教学过程中的应用方法,深入分析形成性评价体系的优缺点,探讨形成性评价体系在检验教学体系中运用的成效,促进检验教学体系适应新课标理念,推动检验教育教学、课程考试改革顺利实施。     

Infection control in the dental laboratory: a review of the literature

The dental laboratory has been shown to be an area of potential disease transmission between patients and to laboratory personnel. This paper reviews pertinent literature on the subject and describes the "Barrier System," a proven infection control protocol to manage dental prostheses in the laboratory.     

检验科局域网在室内质量控制中的应用研究

 目的使用患者标本检验结果的均值绘制室内质控图来观察结果准确性的变化.方法应用临床检验信息系统软件对2002年6～9月20项生化检验数据进行统计分析,计算患者标本检验结果的均值并绘制室内质控图.结果患者检验结果均值呈正态分布且稳定变化,质控图可以灵敏的反映结果准确性的变化.结论患者结果均值质控法可以用来检查临床标本检测的准确度水平,控制与质控血清无关的重要误差因素,是室内质控的重要补充手段之一.     

转化医学模式下探讨检验医学人才的培养

转化医学是现代医学发展和研究的主要模式。人类基因组计划将生命科学的研究推到组学时代,各种组学技术使现代临床医学朝转化医学方向发展。检验医学作为医学学科群中最容易实践转化医学的专业之一,其人才培养问题值得我们深思与探讨。通过分析转化医学的特点及其与检验医学的关系,提出在转化医学模式下,迫切需要建立转化检验医学的人才培养理念,并在长期规划、职业道德、质量控制、继续教育、科研能力、信息化和检验医师等方面加强检验医学人才的培养,更好地迎接检验医学发展的新机遇与挑战。     

<Emphasis Type="Italic">Calliphora vicina</Emphasis> larvae grow at different rates on different body tissues.

Compared with the rate on pigs liver, larval growth of the blowfly, Calliphora vicina is significantly faster by as much as 2 days on lung, kidney, heart or brain tissue. Potentially this has major implications when laboratory growth rates of larvae fed on one food substrate (often liver) are used to calculate the amount of development, and therefore the postmortem interval in a forensic case.     

Plan to implementation: an in-depth look into a well-orchestrated, functional, CORE laboratory

The overall objective was implementation of a fully integrated and functional CORE laboratory. The "CORE laboratory" is a model of a fully integrated and functional, multifaceted, clinical laboratory. Delineation of the process is to enable clinical laboratory managers, in the government or civilian sectors, to make sound decisions about formulating and implementing the CORE laboratory concept. The defining and comprehensive decisions should be based on concept requirements, advantages, disadvantages, and employee core competency assessments. Operationally, the organizational change resulted in well-rounded, multidisciplinary, multiskilled laboratorians and instructors/mentors for the Phase II military medical laboratory technician (91K student) training program. As of this time, our laboratory is the only Department of the Army medical center that operates a fully integrated and functional CORE laboratory.     

国际互联网在医学检验教育中的综合应用

目的:提高国际互联网在医学检验教育中的综合应用水平。方法:通过HTML、Java语言、VB语言及图形制作工具等,编制医学检验教学课件,创建自己的国际互联网站点,建立考试题库及日常管理和学习系统。结果:在医学检验教育中利用国际互联网实现了计算机多媒体教学;在医学检验科研中建立了方便的中、英文信息查询及国内外学术交流系统;建成了医学检验考试题库及日常管理和网上学习系统。结论:通过国际互联网在医学检验教育中的综合应用,可极大地提高医学检验的教学、科研及管理水平。