The American journal of medical technology最新文献

In 1980, ASMT-CMU students and alumni established the John C. Lang Memorial Trustee Award for Administration and Management to "recognize outstanding performance in the communication of ideas and information in administration and laboratory management and to encourage individuals to disseminate their information to the profession." Winners of this award are commissioned to prepare a manuscript for publication in the American Journal of Medical Technology. This article is the second in the John C. Lang Memorial Series. Its author, John R. Kimberly, PhD, is Associated Professor of Management and Health Care Systems at the Wharton School of the University of Pennsylvania. In the following article Dr. Kimberly takes a long, cold look at the impact that a number of current trends, both in the medical world and outside it, are likely to have on the nature of work and working relationships in the clinical laboratory.

Increased awareness of the importance of Streptococcus agalactiae (Group B streptococcus) in neonatal morbidity and mortality has demonstrated the need for a selective and differential primary plating medium. In this report we describe a selective pigment medium containing colistin and nalidixic acid that allows presumptive identification of S. agalactiae from the primary plate, even when specimens are polymicrobic. A preliminary study compared the value of three media for pigment production by 137 known S. agalactiae strains. This was followed by a clinical laboratory trial using the best of these pigment media at an obstetric hospital in which 581 specimens from neonates, female reproductive tracts, and urinary tracts were screened. Subsequent to the clinical laboratory trial, an epidemiological investigation using the selective pigment medium was conducted on a mother/infant population. Of the 1,331 specimens screened for S. agalactiae, 75 (5.6%) were positive on 5% sheep blood agar and 79 (5.9%) were positive on the selective pigment medium.

There are several "non-standardized" test methodologies for performing antimicrobial susceptibility tests on clinical isolates of fastidious aerobic organisms. Critical to the interpretation of a susceptibility test (or any clinical laboratory test) is correlation of the results with the clinical status of the patient. If previous extensive studies have not been performed for a given antimicrobial-organism combination using a specific method, the results must be interpreted with discretion. Even when documented correlative data are available, strict quality control measures must be followed to ensure optimal performance of the test system. Ideally, these include testing of quality control organisms of known susceptibilities similar to the test isolate. Such quality control strains of fastidious organisms are not readily available; however, they may be obtained through local health departments. In our laboratory, in order to inform clinicians of the limitations of the results generated from antimicrobial susceptibility testing of fastidious aerobic bacteria using non-standardized (not NCCLS) procedures, we have adopted a mechanism for reporting results of disc tests as "presumptive" (Figure 1). When reporting dilution test results that are derived using methods other than those described by the NCCLS dilution protocol, we indicate the modifications employed in the particular test (Figure 2). Our goals are to attempt to identify unusual resistance that may occur and to generate results that are as accurate, precise, and meaningful as possible, yet we must be aware of the limitations of the procedures with which we are working (Table V). It is only with these understandings that we can be of service to our clinicians and patients.

Since the discovery that human somatic cells contain 46 chromosomes, a number of diseases have been found to be related to abnormalities in chromosome structure or number. Many of these chromosome abnormalities are found in hematologic disorders, which have been called clinicocytogenetic syndromes. Cytogenetic studies in these disorders have proved to be helpful in both diagnosis and predicting response to therapy.

This issue focuses on the rapidly developing field of human cytogenetics. The first article discusses the methodology used in the study of human chromosomes as well as its application in the diagnosis of chromosomal disorders. The second article discusses the application of chromosome analysis to the diagnosis and prognosis of hematologic malignancies, and the final article illustrates clues found on a peripheral blood smear that lead to the diagnosis of a chromosomal disorder.

Particle size distribution analysis (PSDA) was evaluated as a rapid screening method for detecting significant bacteriuria by linking a C1000 Channelyzer to a Coulter Counter. Colony counts and PSDA screening results were compared for 800 urine specimens. The PSDA method proved to be 92% specific, but only 64% sensitive, for detecting at least 10(5) colony forming units (CFU)/ml. By performing serial dilution colony counts on 109 culture-positive specimens (greater than or equal to 10(5) CFU/ml), it was determined that the low level of sensitivity (64%) was due to culture-positive specimens that had between 10(5) and less than 10(7) CFU/ml. The sensitivity of the PSDA method increased to 90% and 100% when culture-positive specimens had 10(7) or more and 10(8) or more CFU/ml, respectively. The low level of sensitivity demonstrated in this investigation makes the introduction of this method into clinical usage unacceptable at this time.

The preferred learning styles of 76 associate degree medical laboratory technology students in four classes at two community colleges were assessed using the Modified Hill Cognitive Style Model. It was found that these students did not have a preference for finding meaning through spoken words or non-word symbols. They had little need to read body language or to be physically involved in order to learn; they preferred not to act out a role for acceptance, and they would have difficulty in influencing another's behavior. These students were capable of making decisions on their own and should do well studying independently. They preferred "categorical reasoning" as a basis for accepting or rejecting ideas and preferred to use deductive or syllogistic reasoning for inferences. Implications for instruction are discussed.

The following describes a new method for staining liver tissue in hemochromatosis with cirrhosis of the liver. This new technique produces results that clearly and consistently provide excellent color contrast, depicting both fibrous tissue and hemosiderin on the same slide. The technique is equally valuable for routine surveys of any tissue that may contain hemosiderin pigments and fibrous collagenous tissue.

Lack of adequate clinical facilities associated with the institution resulted in MLT students rarely receiving didactic and clinical instruction at the same time. Students had problems transferring knowledge from clinical situations to later lectures and from lectures one semester to clinical practicum next semester. Additionally, their success rate on certification examinations was low. An individualized curriculum utilizing cognitive style mapping for course "prescriptions" resulted in a greatly improved success rate on certification examinations; clinical preceptors and employers reported improved student and graduate performance at clinical sites.