Virtual microscopy: applications to hematology education and training.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to Szu-Hee Lee.
Explore the source record for details and available documents.
BACKGROUND: Animal studies suggest that cell transplantation, including bone marrow-derived cells, can ameliorate left ventricular remodeling following myocardial ischemia. Clinical evaluation of the potential benefits of this approach is limited by the lack of safety and feasibility studies. We have assessed the safety and feasibility of intramyocardial transplantation of autologous bone marrow-derived cells in patients undergoing coronary artery bypass graft (CABG) surgery. METHODS AND RESULTS: Between December 2001 and May 2002 7 patients, scheduled for CABG, consented to the trial. All had CABG using hypothermic cardiopulmonary bypass (CPB) and cold cardioplegic arrest. An average of 21 10(6) (8.6 10(6) to 35.1 10(6)) nucleated cells, and 4.2 10(4) (2.5 10(4) to 8.1 10(4)) CD34+ cells were injected into the anterior-lateral wall of the left ventricle, after discontinuation of cardiopulmonary bypass. The end points to assess safety included death, massive bleeding, electrocardiographic or biochemical evidence of myocardial infarction, ventricular dysrhythmia, myocardial perfusion, ventricular function, and the patients' functional status. All patients recovered well without ventricular arrhythmia, bleeding, or other major peri-operative complications. The average intensive care unit (ICU) and hospital stay was 1 and 7 days, respectively. Repeat Technetium-99m myocardial perfusion stress imaging and echocardiography 6 weeks after surgery showed improvement in tissue perfusion, and an average improvement of left ventricular function of 13.5% +/- 11.54% (the mean pre- and post-operative left ventricular EF were 32.5% +/- 15.46% and 46% +/- 18.55%, respectively). Twenty-four hours Holter monitoring showed no significant arrhythmia, 3 months post-operatively. All patients with narrow QRS complex showed no evidence of late potential, on signal-averaged electrocardiogram. At 4 to 9 months after surgery patients were in NYHA functional class "I". CONCLUSIONS: This early clinical experience shows that autologous bone marrow-derived cell transplantation into myocardium is feasible and relatively safe. Further clinical trials to assess the role of cell transplantation for myocardial repair are required.
Virtual microscopy is the simulation of microscopy over a computer network. A virtual slide is a giant digital image file of a glass slide that can be displayed, panned, zoomed, and focused in a virtual slide viewer on a computer screen. Virtual slides represent a revolutionary advance over glass slides. They are easy to file, store, retrieve, annotate, and mark and can be preserved indefinitely. Furthermore, they are easy to duplicate and distribute and can be integrated into electronic patient records. Large virtual slides can be readily transmitted to users over a standard broadband connection. With the recent introduction of viewers that can focus virtual slides, virtual microscopy can simulate all the functions of real microscopy. Virtual microscopy has significant advantages over real microscopy in education and in proficiency testing. In education, virtual microscopy enables "anytime, anywhere" learning and has been favorably received by students and teachers. In proficiency surveys, all users view the same image, virtual slides are easy to distribute, and the slides do not deteriorate. Potential applications for hematology proficiency surveys include blood and bone marrow morphology, differential cell counts, cytochemistry and immunocytochemistry, detection of malarial parasites, and other tests. Virtual microscopy enables proficiency surveys of critical clinical parameters, such as the bone marrow blast count, and implementation of "locate and identify" exercises. It is conceivable that with the next generation of technological developments, virtual microscopy can be extended to diagnostic applications. Important goals are to minimize slide file size without loss of relevant detail, to establish diagnostic equivalence, and to automate virtual slide capture with high throughput for integration into laboratory information systems. Key factors that will drive implementation include user-friendliness, cost, data storage requirements, and throughput speed. Implementation may have constructive effects on teaching and learning, the peer-to-peer consultative process, and diagnostic accuracy and performance.
Cold agglutinin disease (CAD) is a hemolytic anemia due to anti-red cell autoantibodies that are reactive at cold temperatures. In the elderly, it may be associated with underlying B-cell lymphoma, usually a lympho-plasmacytic lymphoma variant. We report a case of CAD in an elderly Indonesian female, which was associated with a B-cell lymphoma that showed a histologic appearance consistent with large-cell lymphoma. Cytogenetic analysis revealed the presence of trisomies 3 and 12, which have been reported previously in B-cell lymphoma associated with CAD. In addition, a t(8;22) was found in 24 out of 28 metaphases. Translocation (8;22) is associated with Burkitt lymphoma or acute lymphoblastic lymphoma, French-American-British subtype L3. It has not been previously reported in B-cell lymphoma asssociated with CAD, and could represent a blastic transformation of the underlying B-cell lymphoma.
Explore the source record for details and available documents.
Medical laboratories in Singapore subscribe to External Quality Assurance Schemes run by the Licensing and Accreditation Unit of the Ministry of Health, Singapore, as well as a number of foreign medical laboratory quality assurance institutions. Through these organisations, a comprehensive range of laboratory tests are externally monitored for quality assurance at regular intervals in all medical laboratories. In recent years, an increasing number of local quality assurance schemes have been implemented, and an increasing number of laboratories have gained accreditation by foreign quality assurance institutions. The respective roles of these quality assurance activities are discussed.