Double Minutes Containing C-MYC oncogene with a Normal Karyotype in Acute Myelogenous Leukemia: A Case Report / 대한진단검사의학회지

We report a case of a female karyotype that was normal except for double minutes (dmin) in acute myeloid leukemia. Using fluorescence in situ hybridization, the amplification of C-MYC was detected in both interphase and metaphase cells. The patient of the present case had received only limited therapy with cytosine arabinoside, but lived for more than one year. It supports the recent notion that dmin may not necessarily be associated with a poor outcome.

Clinical Evaluation of i-STAT in the Neonatal Intensive Care Unit / 대한진단검사의학회지

BACKGROUND: i-STAT (i-STAT Corporation, Princeton NJ, USA), a hand-held point-of-care testing (POCT) analyzer with rapidity and minimal sample requirement, has the potential to bring about a significant impact on the management of neonates. However, there should be an overall deliberation of the routine use of i-STAT in the neonatal intensive care unit (NICU) as to whether it is technically reliable and cost-effective. The aim of this study was to assess the clinical aspects of the implementation of i-STAT in the NICU. METHODS: We surveyed physicians and nurses to measure the present status of POCT. We ana-lyzed 84 tests performed in the central laboratory, 88 tests by blood gas analyzer in NICU, and 95 tests by i-STAT for NICU patients. We investigated the indications, turnaround time (TAT), cycle time, and impact on patient care in each case during both pre- and post-i-STAT periods. Costs and user acceptability were also examined. RESULTS: Survey responders wanted rapid results but did not accept the responsibility for the quality of POCT. Turnaround time of i-STAT was shorter than that of the central laboratory, but did not make an impact on cycle time. The cost of i-STAT is 2.2 times higher than central laboratory cost, but the users were satisfied with i-STAT mainly because of its small sample volume and speed. Central laboratory testing volume decreased by 14.3% after the introduction of i-STAT. CONCLUSIONS: i-STAT may be acceptable in the NICU setting. However, the behavioral patterns of physicians need to be changed and a selective use of i-STAT is warranted to maximize its cost-effectiveness. Future studies on the clinical outcome are required to substantiate the potential role of i-STAT.

Evaluation of the i-STAT Point-of-Care Testing Analyzer / 대한진단검사의학회지

BACKGROUND: The usages for the i-STAT point-of-care testing (POCT) analyzer are increasing in emergency departments, intensive care units and dialysis units. We evaluated the performance of the i-STAT as a POCT analyzer. METHODS: We evaluated the analytical performance of the i-STAT through the measurement of sodi-um (Na), potassium (K), hematocrit, ionized calcium (iCa), PO 2 , PCO 2 and pH. We used two disposable cartridges including EG6+ cartridge for Na, K, hematocrit, PO 2 , PCO 2 and pH and EG7+ for iCa. RESULTS: The i-STAT revealed good linearity in Na and K except in hematocrit (r2 =0.9973, 0.9988 and 0.9179, respectively). In the precision study, the within-run and total-run coefficients of variation (CV, %) were within 10%. A high correlation was found between the i-STAT POCT analyzer and the analyzers in the central laboratory except sodium. In the study of the operator's effect, the intrapersonal CV and interpersonal CV were within 10% except in the PO 2 analysis. CONCLUSIONS: With its rapid turnaround time, small sample requirement, ease of operation, the i-STAT seems appropriate for clinical use in the management of patients in the emergency department, intensive care units and dialysis units where immediate access to clinically relevant laboratory testing is required.