A computerised quality control testing system for B-mode ultrasound

Current methods of ultrasound (US) imaging quality control involve an observer taking a series of measurements on test object images. This process is very labour-intensive, rapidly becoming more so as the complexity of US scanners increases. Also, many of the measurements are based on the subjective judgement of the operator and are, therefore, prone to an undesirable level of intraobserver and interobserver variation. We have developed a suite of programs to analyse captured US images to estimate a number of performance parameters, including resolution, high- and low-contrast penetration depths and high- and low-contrast sensitivity. In this system, images of the ATS Laboratories Multipurpose Phantom Model 539 are acquired on a PC with a video capture card, and analysed using the software developed. Automated tests have been developed for resolution, low- and high-contrast penetration and low- and high-contrast sensitivity. A preliminary validation of the system was carried out using images from two curvilinear probes and a linear-array probe operating at 5 MHz, 7.5 MHz and 10 MHz, respectively. The 95% confidence intervals ranged from ± 17% to ± 21% for resolution measurements and from 0% to ± 1.5% for low-contrast penetration. The system provides an index of visibility for high- and low-contrast targets, as compared to the coarse visual assessment of a human observer, with 95% confidence intervals ranging from ± 6% to ± 13% for low-contrast sensitivity and from ± 3% to ± 25% for high-contrast sensitivity. Advantages of the system over the human observer include improved reproducibility and increased information regarding visibility of targets. A more detailed multicentre validation is currently being undertaken. (E-mail: ngibson@ncht.org.uk)     

Evaluation of a novel kit (TF-Test) for the diagnosis of intestinal parasitic infections

Intestinal parasitic infections are currently a source of concern for Public Health agencies in developing and developed countries. Since three ovum‐and‐parasite stool examinations have been demonstrated to provide sensitive results, we designed a practical and economical kit (TF‐Test) that is now commercially available (Immunoassay Com. Ind. Ltda., São Paulo, Brazil). This kit allows the separate collection of three fecal specimens into a preservative solution. The specimens are then pooled, double‐filtered, and concentrated by a single rapid centrifugation process. The TF‐Test was evaluated in four different laboratories in a study using 1,102 outpatients and individuals living in an endemic area for enteroparasitosis. The overall sensitivity found using the TF‐Test (86.2–97.8%) was significantly higher (P<0.01) than the sensitivity of conventional techniques such as the Coprotest (NL Comércio Exterior Ltda, São Paulo, Brazil) and the combination of Lutz/Hoffman, Faust, and Rugai techniques (De Carli, Diagnóstico Laboratorial das Parasitoses Humanas. Métodos e Técnicas, 1994), which ranged from 48.3% to 75.9%. When the above combined three specimen technique was repeated with three specimens collected on different days, its sensitivity became similar (P>0.01) to that of the TF‐Test. The kappa index values of agreement for the TF‐Test were consistent (P<0.01), being higher and ranking in a better position than conventional techniques. The high sensitivity, cost/benefit ratio, and practical aspects demonstrate that the TF‐Test is suitable for individual diagnosis, epidemiological inquiries, or evaluation of chemotherapy in treated communities. J. Clin. Lab. Anal. 18:132–138, 2004. © 2004 Wiley‐Liss, Inc.     

Impaired oxygen on-kinetics in persons with human immunodeficiency virus are not due to highly active antiretroviral therapy

OBJECTIVE: To determine the effects of human immunodeficiency virus (HIV) and highly active antiretroviral therapy (HAART) on oxygen on-kinetics in HIV-positive persons. DESIGN: Quasi-experimental cross-sectional. SETTING: Infectious disease clinic and exercise laboratory. PARTICIPANTS: Referred participants (N=39) included 13 HIV-positive participants taking HAART, 13 HIV-positive participants not taking HAART, and 13 noninfected controls. INTERVENTIONS: Participants performed 1 submaximal exercise treadmill test below the ventilatory threshold, 1 above the ventilatory threshold, and 1 maximal treadmill exercise test to exhaustion. MAIN OUTCOME MEASURES: Change in oxygen consumption (Delta.VO2) and oxidative response index (Delta.VO2/mean response time). RESULTS: Delta.VO2 was significantly lower in both HIV-positive participants taking (946.5+/-68.1mL) and not taking (871.6+/-119.6mL) HAART than in controls (1265.3+/-99.8mL) during submaximal exercise above the ventilatory threshold. The oxidative response index was also significantly lower (P<.05) in HIV-positive participants both taking (15.0+/-1.3mL/s) and not taking (15.1+/-1.7mL/s) HAART than in controls (20.8+/-2.1mL/s) during exercise above the ventilatory threshold. CONCLUSION: Oxygen on-kinetics during submaximal exercise above the ventilatory threshold was impaired in HIV-positive participants compared with a control group, and it appeared that the attenuated oxygen on-kinetic response was primarily caused by HIV infection rather than HAART.     

A handicap in treatment and follow-up of ankylosing spondylitis: sports hematuria

A 19-year-old male patient with a 7-year history of ankylosing spondylitis (AS) was admitted to our clinic. After completion of the laboratory and radiologic investigations, we prescribed an exercise program besides his medical therapy. After these exercises, he complained of painless dark urine sometimes with passage of clot that disappeared the following day. To investigate this hematuria related with exercise, further laboratory and radiologic studies were carried out. After exclusion of the other causes of hematuria, we concluded that the diagnosis was sports hematuria.     

稳定期慢性阻塞性肺疾病患者深吸气量测定的临床意义

目的探讨深吸气量测定对稳定期慢性阻塞性肺疾病（COPD）患者气流阻塞变化和呼吸困难严重程度的临床意义。方法对61例中度稳定期COPD患者进行常规肺功能检测，以Borg指数判断受试者呼吸困难的严重程度。所有患者在吸入400μg沙丁胺醇后重复检测肺功能和呼吸困难分级，36例在进行6min步行试验（6MWT）后重复肺功能检测和呼吸困难分级。结果吸入沙丁胺醇后，COPD患者的深吸气量和第一秒用力呼气容积（FEV1）分别为（1．6±0．5）和（1．3±0．4）L，均显著高于吸入前的（1．4±0．5）和（1．1±0．4）L，深吸气量平均改善率为（20±16）％，FEV。平均改善率为（11±4）％，差异有统计学意义（t=-3．970，P〈0．01）；其中深吸气量改善率≥10％的占75．4％（46／61），FEV1改善率≥10％的占39．3％（24／61），差异有统计学意义（x^2=16．190，P〈0．01）。治疗后Borg指数（3．0±0．7）显著低于治疗前（3．9±0．8）。6MWT后，COPD患者深吸气量为（1．1±0．4）L，FEV1为（1．0±0．4）L，均显著低于6MWT前的（1．4±0．5）和（1．1±0．4）L，深吸气量平均恶化率为（26±8）％，FEV1平均恶化率为（14±6）％，差异有统计学意义（t=-7．279，P〈0．01），其中深吸气量恶化率≥10％的占100％（36／36），FEV1恶化率≥10％的占72．2％（26／36），差异有统计学意义（x^2=11．613，P〈0．01）。运动后Borg指数（5．6±1．0）显著高于运动前（3．9±0．9）。治疗前后深吸气量差值与治疗前后Borg指数差值、运动前后深吸气量差值与运动前后Borg指数差值均呈显著正相关。静息状态未吸入沙丁胺醇时深吸气量与功能残气量、治疗前后深吸气量差值与治疗前后功能残气量差值、运动前后深吸气量差值与运动前后功能残气量差值均呈显著负相关。结论与FEV1比较，深吸气量检出稳定期COPD患者气流阻塞变化的敏感性比较高，能较准确地反映患者呼吸困难的严重程度。     

阴道分泌物真菌感染5种检测方法比较

目的比较分析用于检出阴道分泌物中真菌的5种检测方法,从中选择出诊断真菌感染性阴道炎的灵敏度、特异度较好,同时快速、经济、简单的实验方案。方法选取2016年5-8月在该院妇科进行阴道分泌物检测的患者共442例,对442例标本同时进行真菌培养法、盐水KOH悬浮法、革兰染色、瑞氏染色、全自动六联5种方法检测,其中真菌培养为金标准,来评价其他4种方法的特异度、灵敏度、阴性预测值、阳性预测值、准确性。结果真菌培养法检测442例阴道分泌物标本,真菌感染的阳性率为34.8%(154/442)。与真菌培养法比较,4种检测方法的特异度、灵敏度、阴性预测值、阳性预测值、准确性分别为盐水KOH悬浮法97.9%、64.9%、83.9%、94.3%、86.4%;革兰染色96.5%、83.1%、91.4%、92.7%、91.8%;全自动六联检测84.7%、46.8%、74.8%、62.0%、71.5%;瑞氏染色96.9%、78.6%、89.4%、93.1%、90.5%。结论革兰染色灵敏度、特异度、准确度在4种检测方法中最高,是对临床送检阴道分泌物标本进行真菌检测的特异、灵敏、快速、经济、简单的检测方案,临床工作中如采用其他方法检测阴道分泌物中真菌,可同时结合革兰染色法以提高其准确度。     

运动训练对心衰患者的影响

目的探讨运动训练对慢性心力衰竭患者运动耐苗的影响。方法将60例NYHA心功能Ⅱ-Ⅲ级心哀患者随机分为训练组和对照组,两组均予以常规抗心哀治疗,训练组予以有氧操训练1次,d,疗程10周。两组均分别在入院后24h内（治疗前）及治疗10周后分别进行6分钟步行试验及行超声心动图检查,测定左室射血分数（LVEF）,并比较两组前后的结果。结果治疗10周后,两组6分钟步行的行止距离及LVEF均有所增加,且训练组增加更明显。结论适量运动训练与其他常规药物联用可显著增强心哀患者的运动耐量,可作为该病治疗的辅助方法。