Rinsho byori. The Japanese journal of clinical pathology
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From the work at ISO/TC212 (Clinical laboratory testing and in vitro diagnostic test systems), the international standards on medical laboratories--particular requirements for quality and competence and reference materials were issued. The accreditation of clinical laboratory was started using ISO 15189. Furthermore, on setting and usage of reference materials were constituted with compatibility global harmonization by newly organizing JCTLM (Joint Committee on Traceability in Laboratory Medicine). As the results, the work of the standardization based on reliability such as validation of reagent's kits and the measured values and uncertainty evaluation would be internationally advanced.
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We introduce change in pulse transit time (change in PTT: noninvasive intrathoracic pressure monitoring) as a new monitoring test of sleep apnea syndrome, which is being developed for clinical application. In addition, we report the kinetics of cardiogenic oscillation (CGO: noninvasive upper airway obstruction monitoring), which was published in this journal in 2003, and the response of the upper airway in clinical practice (under an endoscope). We also review diaphragmatic movement by abdominal echography (respiration generator monitoring).
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This review article introduces the official guideline for the lung function testing firstly established by the Japanese Respiratory Society in November 2004. The members of the Japanese Society of Laboratory Medicine were also included in the working group to make the guideline. A central goal of the guideline is to standardize the skill of lung function testing and thus minimize its variability. ⋯ Furthermore, the algorithm for differential diagnosis using the lung function testing is demonstrated in the last chapter. The lung function testing can bring a strong impact on patients' lifestyle and future treatment plan. We sincerely hope that this guideline will contribute to routine laboratory practice.
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Despite of plethora of reports on stem cell transplantation leading to neovascularization in infarct models, whether sustaining clinical benefit in post-myocardial infarction patients is manifested by myocyte repair remains unclear. Cardiac muscle regeneration in adult heart is thought to occur through the mobilization and differentiation of mesenchymal stem cells in bone marrow origin, however, recent studies have suggested that substantial cardiac stem cells may exist in the heart itself, repopulating the damaged cardiac muscle during injury or aging processes. ⋯ Introduction of cardiac stem cells may improve myocardial function, but several hurdles exist and should be coaxed far beyond the clinical application of cardiac regenerative therapies. On-going investigations may lead to the discovery of mediators of cardiac stem cells migration, proliferation and differentiation that, in turn, might result in the mending of the broken heart after injury.
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Myocardial infarction without chest pain occurs in high incidence in elderly. However, the pathophysiological significance of the silent ischemia is still unknown. To elucidate the significance of the "painless" symptom during myocardial ischemia induced by exercise, we analyzed the incidence of silent ischemia on treadmill tests and attempted to examine the severity of the coronary stenosis in such painless subjects. ⋯ Painless ischemia during the treadmill test was found in high incidence in the elderly. Painless ischemia must be treated as same as ischemia with chest pain.