Experience of Use of the Automated Chemistry Analyzer Cobas(R) 6000 to Improve Work Flow of Emergency Chemistry Laboratory / 임상검사와정도관리

BACKGROUND: Soon Chun Hyang University Hospital emergency laboratory introduced Cobas(R) 6000 (Roche Diagnostics, Switzerland) to improve the turnaround time of emergency chemistry tests at peak time period. METHODS: For the designated period, before and after introduction of Cobas(R) 6000 the numbers of tests and test time were compared and we analyzed the process of the tests using Workflow simulator (Roche Diagnostics). RESULTS: The numbers of tests of 8 days (every Monday and Thursday) in June, 2007 and 2008 were 22,902 and 27,384. The mean test time of the 8 days in June, 2007 and 2008 were 13 min 41 sec and 12 min 22 sec. In 2007, increased mean test time was due to prolongation of waiting times in rotor within equipment for tests at peak time period. CONCLUSIONS: Using Cobas(R) 6000, the numbers of tests were increased at peak time period but mean test time was reduced, which made physicians and laboratory all satisfied.

The Influence of Anticoagulants and Time of Measurements on D-Dimer Determinations / 대한진단검사의학회지

BACKGROUND: We evaluated the effects of anticoagulants used in blood sampling and time of mesurements after blood collection on D-dimer determinations. METHODS: A total of 32 samples of sodium citrated plasma, and 23 samples each of serum and ethylene diamine tetraacetic acid (EDTA) plasma, were studied. D-dimer was measured by enzyme linked fluorescent assay using a VIDAS analyzer. RESULTS: The mean+/-SD (median) of D-dimer titers in citrated plasma, serum, and EDTA plasma samples immediately after blood collection were 282.7+/-201.1 (224.6) microgram/L, 255.1+/-206.8 (197.3) microgram/L, and 313.3+/-230.8 (246.4) microgram/L respectively. The results obtained for the three different sample groups were well correlated. While the upper limit of the reference range for D-dimer for citrated plasma has been set at 500 microgram/L, the cut-off values for serum and EDTA plasma were 400 microgram/L (100%sensitivity and specificity), and 585 microgram/L (100% sensitivity and 94.7% specificity), respectively CONCLUSIONS: In addition to citrated plasma, both serum and EDTA plasma can be used for D-dimer assay. A delay in the time of measurements after blood collection does not influence the results significantly.

Humphrey SITA and Octopus TOP Perimetry on Normal Korean Subjects

PURPOSE: To evaluate and compare the inter-individual variability and normal limits of Humphrey SITA and Octopus TOP which were recently developed for shortening test time and decreasing the patient's fatigue. METHODS: Humphrey SITA and Octopus TOP tests were performed on 100 normal Korean subjects and their test results were analyzed. RESULTS: The average test duration was 294.02+/-29.61 seconds in SITA and 147.93+/-9.78 seconds in TOP. There was no significant difference between the two perimetric tests in MD (mean deviation), but PSD (pattern standard deviation) of TOP program was significantly higher than that of SITA (P< 0.01). Mean sensitivity of SITA was 30.15+/-1.00 dB and that of TOP was 26.79+/-1.11 dB, so mean sensitivity of SITA was about 3 dB higher than that of TOP. In topographical map, averaged threshold sensitivity decreased with the eccentricity in both perimetries. Topographically, SITA showed the more regularly increasing standard deviation of threshold sensitivity toward periphery of visual field, but TOP showed the irregular pattern of distribution of the standard deviation. Most of the subjects (88.8%) replied that they were more comfortable with the TOP than the SITA program because of the shorter test time. CONCLUSION: Inter-individual variability in the normal Korean subjects was smaller in Humphrey SITA than Octopus TOP program, but Octopus TOP had the advantage of shorter duration of the test and lower fatigue.

Comparison between New Threshold Visual Field Strategy, SITA-standard and Full Threshold Strategy and Their Clinical Us efulness

We compared the full threshold method, central 30-2 Humphrey perimetry with a newer strategy of SITA-standard.To valuate the clinical usefulness, 30 glaucoma patients and 20 normal persons underwent both tests. MD, PSD and test time were comparatively analyzed.In glaucoma patients, the mean test time was 7 min 37 sec[+/-1 min 54sec]for the SITA-standard, while it was 14 min 55 sec[+/-1 min 58 sec]for the full threshold method.The mean value of MD were -7.62 +/-7.93 and 8.85 +/-8.19, while PSD were 5.89 +/-4.24 and 6.50 +/-4.07, repectively. In normal persons group, the mean test time was 6 min 56 sec[+/-1 min 3sec]for the SITA-standard, while it was 14 min 1 sec[+/-1 min 24 sec]for full threshold method.The mean values of the MD were -2.41 +/-0.87 and 3.00 +/-1.31, while the mean values of the PSD were 2.04 +/-0.47, 2.12 +/-0.50, respectively. In conclusion, the SITA-standard did not show any significant differences in both MD and PSD.However, the test time was reduced 49%in glaucoma patients and 53%in normal persons.Therefore, the SITA-standard exhibited similar clinical significance on both glaucoma patient and glaucoma suspect.So it was an useful and effective test to reduce test time.