Contribution of Diagnostics to Total Medical Care/Healthcare

Author: Narihiro OKU – The basic parameters for complete blood cell counts (CBC) contains the number of White blood cells (WBC), number and size of Red blood cells (RBC), the concentration of hemoglobin (Hgb) contained in the RBC, and the number of platelets (PLT). The clinical importance of the CBC is to diagnose and detect inflammation, anemia, hemostasis and many other disorders. For a long time, blood cells were counted manually using hemocytometer, thick glass microscope slide engraved with grooves creating a grid of perpendicular lines, and an optical microscope. In 1956, the Coulter Corporation developed an impedance method that dramatically improved the accuracy of these measurements. The basic concept of impedance method is to measure the voltage across an aperture in a constant electrical current. When a blood cell floating in saline solution passes through the aperture, the cell resistivity affects the voltage across the aperture, which enables to detect the existence of the cell.

Author: Arnaud PRADEL – According to this principal, HORIBA Medical is engaged into a long term mission, to provide laboratories with innovative products and services that exceed their expectations. We have built within our organization the sense of adaptation which, combined with 30 years of experience, brings a value to our dedication. (Figure 1, 2) Being the preferred partner in medical diagnostic solutions is not only our Vision but it also guides our daily decisions and choices. Quality is not just an assurance but our commitment to users; this is the foundation of a long term relationship. HORIBA Medical has clearly integrated this value on a continuous investment in product development, innovation and sustaining programs.

Author: Hiroshi KONDO – In hematology testing using hematology analyzer, there are no internationally certified reference materials. Therefore,an internationally recognized reference method that enables clarification of traceability of measurements is necessary because fresh blood must be used for the assurance of accuracy in hematology testing. Guidelines for the reference method are being formulated in an international framework. External quality assurance provides objective information for evaluation of the reliability of a measurement system, and standardization of the implementation of external quality assurance is critical.

Author: Osamu YAMADA –　Our hospital introduced POCT-compatible devices for blood glucose testing in our wards and other locations for point of care testing. Additionally, we utilized a data management system to handle both device management and data management. As the use of electronic chart systems increases in medical institutions, improving the quality of blood glucose testing with points of care and applying measurement data have become important issues. By combining sophisticated measurement devices with a data management system, we succeeded in pointing the way toward one integrated solution.

Author: Laurent ARAUD; Olivier POU – HELO: the Horiba Evolutive Laboratory Organization Over the past 5 years, HORIBA Medical has been proposing the “HaemCell” as the high-range solution for Hematology Laboratory organization which was based on software connections only and avoiding any mechanical link. To improve patient care and adapt to a highly evolving market, HORIBA Medical decided to make the HaemCell evolve toward the HELO concept and exploit at their best the analyzer’s performances and scalability for healthcare needs. Still driven by the LEAN philosophy the new HELO concept extends the flexibility of configuration by adding the possibility to work with a track system and offers around both the work-cell and the dedicated track a multiplicity of peripheral solutions to accommodate modern requirements of the Hematology laboratory as well as related disciplines.

Author: Mandy CAMPBELL; Manuela PASTORE – The last Olympic and Paralympic Games took place in London in 2012. Spire Healthcare, Laboratory Network in charge of the healthcare during this event, built a state-of-the-art facility within the Olympic Village to give over 10,000 Olympic and 6,200 Paralympic athletes, as well as associated team officials, access to 24-hour healthcare services. Since the London 2012 Olympics were heralded as one of the most sustainable, Spire was required to reflect this ethos and approached HORIBA Medical to secure a loan and service support for a Pentra 80 analyzer. About 250 samples were tested during this event. Finally, the NHS Trust concluded that the use the pathology services of the Olympic Village Polyclinic were able to satisfy demands and that a similar structure of facilities and expertise in one clinic was recommended when planning future mass participation sporting events.[1]

Author: Jean-Michel GARCIA; Elina ALATERRE; Sébastien RAIMBAULT; Guillaume CARTRON – Guilhem REQUIRAND, Jerome MOREAUX, Caroline BRET, Jean-François SCHVED With the increase of cancer occurrences, its management requires novel diagnostic tools, improved performance and adaptation to personalized medicine. Such technological development can only be successful by the convergence of expertise between the medical field and the experience of industry in translating innovation into products. In that spirit, HORIBA Medical teamed up with University Hospital Center (CHRU) of Montpellier. That collaboration is realized by the presence of a HORIBA laboratory within the hospital working closely with local teams. After a successful initial project on Minimal Residual Disease (MRD), the strategy was recently extended to other hemopathies aiming at the discovery of new oncological biomarkers that could advance earlier diagnosis as well as the constitution of an original bio-bank focused on hemopathies and in particular lymphoma and myeloma.

Author: Kazunobu OUCHI – - Global Strategies to Prevent the Increase of Bacterial Resistance- Principle of antimicrobial therapy in children is to select and use the most appropriate antibiotics based on the inferred causative agent and with consideration given to the special characteristics of children. Resistant organisms have been increasing in recent years, so it is very important to use proper antibiotics based on a knowledge of antimicrobial susceptibility trends and Pharmacokinetics/Pharmacodynamics (PK/PD). We are careful to use antibiotics based on proper differential diagnosis using rapid diagnostic methods, Complete blood flow (CBC), C-reactive protein (CRP) and so on. The most practical means of judicious antibiotic use is to treat each patient based on the newly revised guidelines. As it is unlikely that many new antimicrobial agents will be developed in the future, we must maximize the efficacy and life span of current antimicrobial agents through judicious use.

Author: Masahiro HAYAKAWA – The clinical characteristics of infections in neonates are different from those in children and adults. In particular, some neonates suffer from opportunistic infections and critical infections because neonates are physiologically immunocompromised. It is important that neonatologists make an early diagnosis and begin early treatment. However, early diagnosis is sometimes difficult because early-stage clinical symptoms are non-specific. Neonatologists should suspect neonatal infections when neonates have subtle symptoms. The diagnosis should be confirmed by laboratory data. Serial evaluation of C-reactive protein is useful for diagnosis of neonatal infections.

Author: Masaki NAKANISHI; Tohru INABA; Naohisa FUJITA – Accurate identification of infected organs, an infecting organism, the necessity of an antimicrobial and the degree of severity is important for the treatment of infection, for which it is essential to understand accurately the severity of inflammation. However, even if doctors perform careful evaluations, we occasionally come across the cases in which it is difficult to understand exactly the inflammation. These situations require a simple and accurate inflammatory marker. Although many inflammatory markers have been developed, there is no biomarker useful by itself for all of diagnosis, prognostic prediction, response evaluation and healing evaluation. CRP is considered to be useful in the treatment of infection as a biomarker that reflects the clinical course rapidly, at a low cost and in a balanced manner. Moreover, if we understand the mechanism of CRP production and its weak point, it has a great deal of potential in the daily medical practice.

Author: Miku SHIBUYA – There is growing emphasis on POCT (Point of Care Testing) which brings insitu test results to the treatment because it enables the provision of immediate and effective medical care. HORIBA, Ltd. has started the sales of a new model Antsense Duo, a small electrode type glucose analyzer deriving from the conventional cartridge-type analyzer. Hereunder, we describe the features, improvements and the performance evaluation.