Annual Report on External Quality Assessment Scheme for Urinalysis and Faecal Occult Blood Testing in Korea (2014)

In 2014, external quality assessment trials for urinalysis and faecal occult blood (FOB) were performed of 1,270 participants. Urine chemistry and FOB tests were evaluated three times, while urine sediment examination by photography was evaluated one time. Urine chemistry tests consisted of pH, protein, glucose, ketone, bilirubin, blood, urobilinogen, nitrite, leukocyte, and specific gravity (SG). The urine chemistry test results showed accuracy rates >95%, while those of the SG test by using a refractometer had accuracy rates <95%. In the FOB quality test, the Bio Focus reagent (BIO FOCUS Co., Korea) disclosed low positive rates (87%). The result of the FOB quantity test showed different values according to the instruments used, and the Kyowa instrument (Kyowa Chemical Industry Co., Japan) revealed the lowest values. In a urinary sediment examination, it is necessary to increase the frequency of the quality assessment trials due to low accuracy rates.

Annual Report on External Quality Assessment in Urinalysis in Korea (2009) / 임상검사와정도관리

Three external quality assesment trials which composed of 16 control materials(12 chemical materials and four sets of microscopic photograph of urinary sediment) for interlaboratory quality control assesment in urinalysis were performed with 796, 823, and 841 participants, in each, in the year of 2009. The response rate were 97.1% (796/820), 95.5% (823/862) and 97.1% (841/866), in the first, the second and the third trials, in each. The test items include pH, glucose, protein, ketone, bilirubin, blood, urobilinogen, nitrite, leukocyte estrase, specific gravity and four microscopic photographs of urinary sediment. The survey results are summarized as follows: 1. The chemical quality control test in urinalysis revealed generally good concordance. 2. The percentage of using urinalysis analyzer was slightly decreased as 82.3% and the distribution of using reagent strip was similar to the previous year. 3. The percentage of response rate of microscopic photographs of urinary sediment was 83.5% (702/841) and the percentage of good performance of these tests ware 83.6% to 99.1%.

Annual Report on External Quality Assessment in Clinical Chemistry in Korea (2009) / 임상검사와정도관리

Six trials with 3 samples for each trial for external quality assessment of general chemistry and blood gas were performed in 2009. All the control materials were sent in specifically-made boxes at the same time. The response rates were 87.5% in general chemistry and 89.3% in blood gas. The items included sodium, potassium, chloride, BUN, glucose, calcium, phosphorus, uric acid, creatinine, bilirubin, total protein, albumin, total cholesterol, triglyceride, AST, ALT, ALP, LD and GGT in general chemistry and pH, pCO2 and pO2 in blood gas. Compared with the previous year (2008), change of the methods of analysis was not remarkable. The peer group coefficient of variation and the VIS scores of general chemistry items were slightly improved.

Annual Report on External Quality Assessment in Clinical Chemistry in Korea (2008) / 임상검사와정도관리

Six trials with 3 samples for each trial for external quality assessment of general chemistry and blood gas were performed in 2008. All the control materials were sent in specifically-made boxes at the same time. The response rates were 93.5% in general chemistry and 88.1% in blood gas. The items included sodium, potassium, chloride, BUN, glucose, calcium, phosphorus, uric acid, creatinine, bilirubin, total protein, albumin, total cholesterol, triglyceride, AST, ALT, ALP, LD and GGT in general chemistry and pH, pCO2 and pO2 in blood gas. Compared with the previous year (2007), change of the methods of analysis and the peer group coefficient of variation was not remarkable and the VIS scores of general chemistry items were slightly improved.

Annual Report on External Quality Assessment in Urinalysis in Korea (2008) / 임상검사와정도관리

Three external quality assesment trials which composed of 16 control materials (12 chemical materials and four sets of microscopic photograph of urinary sediment) for interlaboratory quality control assesment in urinalysis were performed with 699, 718, and 732 participants, in each, in the year of 2008. The response rate were 95.4% (699/733), 96.6% (718/743) and 95.3% (732/767), in the first, the second and the third trials, in each. The test items include pH, glucose, protein, ketone, bilirubin, blood, urobilinogen, nitrite, leukocyte estrase, specific gravity and four microscopic photographs of urinary sediment. The survey results are summarized as follows: 1. The chemical quality control test in urinalysis revealed generally good concordance. 2. The percentage of using urinalysis analyzer was slightly decreased as 83.0% and the distribution of using reagent strip was similar to the previous year. 3. The percentage of response rate of microscopic photographs of urinary sediment was 81.3% (571/732) and the percentage of good performance of these tests ware 32.9% to 80.5%.

Annual Report on External Quality Assessment in Clinical Chemistry in Korea (2007) / 임상검사와정도관리

Six trials with 3 samples for each of external quality assessment for general chemistry and blood gas were performed in 2007. All the control materials were sent in specifically-made boxes at the same time. The response rates were 92.0% in general chemistry and 95.5% in blood gas. The items included sodium, potassium, chloride, BUN, glucose, calcium, phosphorus, uric acid, creatinine, bilirubin, total protein, albumin, total cholesterol, triglyceride, AST, ALT, ALP, LD and GGT in general chemistry and pH, pCO2 and pO2 in blood gas. Compared with the previous year (2006), the methods of analysis were slightly changed and the coefficient of variation and VIS scores of general chemistry items were not significantly changed.

Annual Report on External Quality Assessment in Urinalysis in Korea (2007) / 임상검사와정도관리

Three external quality assesment trials which composed of 16 control materials (12 chemical materials and four microscopic photographs of urinary sediment) for interlaboratory quality control assesment in urinalysis were performed with 638, 645, and 662 participants, in each, in the year of 2007. The response rate were 95.5% (638/668), 96.7% (645/667) and 97.1% (662/682), in the first, the second and the third trials, in each. The test items include pH, glucose, protein, ketone, bilirubin, blood, urobilinogen, nitrite, leukocyte esterase, specific gravity and four microscopic photographs of body fluid and urinary sediment. The survey results are summarized as follows: 1. The chemical quality control test in urinalysis revealed generally good concordance. 2. The percentage of using urinalysis analyzer was slightly increased as 87.5% and the distribution of using reagent strip was similar to the previous year. 3. The percentage of response rate of microscopic photographs of urinary sediment was 80.7% (536/662) and the percentage of good performance of these tests was 60.6% to 99.1%.

Annual Report on External Quality Assessment in Urinalysis in Korea (2007) / 임상검사와정도관리

Three external quality assesment trials which composed of 16 control materials (12 chemical materials and four microscopic photographs of urinary sediment) for interlaboratory quality control assesment in urinalysis were performed with 638, 645, and 662 participants, in each, in the year of 2007. The response rate were 95.5% (638/668), 96.7% (645/667) and 97.1% (662/682), in the first, the second and the third trials, in each. The test items include pH, glucose, protein, ketone, bilirubin, blood, urobilinogen, nitrite, leukocyte esterase, specific gravity and four microscopic photographs of body fluid and urinary sediment. The survey results are summarized as follows: 1. The chemical quality control test in urinalysis revealed generally good concordance. 2. The percentage of using urinalysis analyzer was slightly increased as 87.5% and the distribution of using reagent strip was similar to the previous year. 3. The percentage of response rate of microscopic photographs of urinary sediment was 80.7% (536/662) and the percentage of good performance of these tests was 60.6% to 99.1%.

Reference Interval of Serum Thyroid Hormones in Healthy Korean Adults / 예방의학회지

OBJECTIVES: This study was conducted to determine the reference interval of serum thyroid hormones (TSH, FT(3), FT(4)) in healthy Korean adults. METHODS: Health examination data from 1,591 healthy Korean adults who visited an university hospital were analyzed. Patients with specific health conditions capable of altering laboratory results were excluded from the study. Serum thyroid hormones were measured using IMMULITE 2000 (DPC, USA, 2002). Subjects were 18-65 years old; 911 were male, and 690 were female. RESULTS: The arithmetic means of TSH, FT(3), and FT(4) values for male subjects were 1.28+/-1.84 micronIU/ml, 3.23+/-0.57 pg/ml, and 1.42+/-0.22 ng/dl, respectively. In female subjects, the arithmetic means of TSH, FT3, and FT4 values were 1.49+/-2.08 micronIU/ml, 3.08+/-0.54 pg/ml, and 1.29 +/-0.24 ng/dl, respectively. The arithmetic mean FT(4) value for males decreased with age (p<0.01). The arithmetic mean FT(3) value for females increased with age (p<0.01). The arithmetic mean thyroid hormone values of all study subjects differed significantly based on season. The arithmetic mean of male FT(4) decreased with increasing BMI (p<0.01). The arithmetic mean of female FT(3) increased with increasing BMI (p<0.01). The reference intervals recommended by the IMMULITE 2000 manufacturer are 0.40-4.00 micronIU/ml for TSH, 1.80-4.20 pg/ml for FT(3), and 0.80-1.90 ng/dl for FT(4) (same values for both genders). CONCLUSIONS: There was a significant difference in the interval of thyroid hormones between males and females, but the reference interval of IMMULITE 2000 was not established by gender. There is a need to reestablish the reference interval for thyroid hormones in Korean healthy adults.

Acute Myeloid Leukemia with t(8;21)(q22;q22) (AML1/ETO) in a Patient with Marked Hypocellularity and Low Blasts Count / 영남의대학술지

According to the World Health Organization (WHO) classification system, cases with t(8;21)(q22;q22) should be diagnosed as acute myeloid leukemia (AML) even with a blast count of less than 20 percent in blood or bone marrow. It is an uncommon manifestation, moreover hypocellularity is rarely observed in this subtype of leukemia. Here, we report a case of t(8;21) in a patient with marked hypocellularity of less than 5 percent and a blast count of less than 20 percent. This patient responded relatively well to chemotherapy. An allogeneic bone marrow transplantation was performed with good engraftment . This case suggests that hypocellular AML with a t(8;21) has as good a prognosis as hypercellular AML with t(8;21).

Annual Report on External Quality Assessment in Clinical Chemistry in Korea (2005) / 임상검사와정도관리

Ten trials of external quality assessment for Clinical Chemistry in general chemistry and blood gas were performed in 2005. All the control materials were sent in specifically-made boxes at the same time. The response rates were 90.1% in general chemistry and 84.8% in blood gas. The items included sodium, potassium, chloride, BUN, glucose, calcium, phosphorus, uric acid, creatinine, bilirubin, total protein, albumin, total cholesterol, triglyceride, AST, ALT, ALP, LD and GGT in general chemistry and pH, pCO2 and pO2 in blood gas. Compared with the previous year (2004), the methods of analysis were changed and the coefficient of variation and VIS scores of general chemistry items were increased.

Annual Report on External Quality Assessment in Urinalysis in Korea (2005) / 임상검사와정도관리

Three external quality assesment trials which composed of 16 control materials (12 chemical materials and four microscopic photographs of urinary sediment) for interlaboratory quality control assesment in urinalysis were performed with 451, 452, and 476 participants, in each, in the year of 2005. The response rate were 95.6% (451/472), 91.9% (452/492) and 95.6% (476/498), in the first , the second and the third trials, in each. The test items include pH, glucose, protein, ketone, bilirubin, blood, urobilinogen, nitrite, leukocyte estrase, specific gravity and four microscopic photographs of urinary sediment. The survey results are summarized as follows: 1. The chemical quality control test in urinalysis revealed generally good concordance. 2. The percentage of using urinalysis analyzer was slightly increased as 91.2% and the distribution of using reagent strip was similar to the previous year. 3. The percentage of response rate of microscopic photographs of urinary sediment was 76.5%(387/498) and the percentage of good performance of these tests ware 63.6% to 86.5%.

Annual Report on External Quality Assessment in Clinical Chemistry in Korea (2004) / 임상검사와정도관리

Ten trials of external quality assessment for Clinical Chemistry in general chemistry and blood gas were performed in 2004. All the control materials were sent in specifically-made boxes at the same time. The response rates were 92.0% in general chemistry and 86.0% in blood gas. The items included sodium, potassium, chloride, BUN, glucose, calcium, phosphorus, uric acid, creatinine, bilirubin, total protein, albumin, total cholesterol, triglyceride, AST, ALT, ALP, LD and GGT in general chemistry and pH, pCO2 and pO2 in blood gas. Compared with the previous year (2003), the methods of analysis are not changed much and the coefficient of variation and VIS scores of general chemistry items are decreased.

Annual Report on External Quality Assessment in Urinalysis in Korea (2004) / 임상검사와정도관리

Three external quality assesment trials which composed of 16 control materials(12 chemical materials and four microscopic photographs of urinary sediment) for interlaboratory quality control assesment in urinalysis were performed with 446, participants, in each, in the year of 2004. The response rate were 93.4% (422/452), 91.7% (411/448) and 91.7% (410/447), in the first , the second and the third trials, in each. The test items include pH, glucose, protein, ketone, bilirubin, blood, urobilinogen, nitrite, leukocyte estrase, specific gravity and four microscopic photographs of urinary sediment. The survey results are summarized as follows: 1.The chemical quality control test in urinalysis revealed generally good concordance. 2.The percentage of using urinalysis analyzer was slightly increased as 87.9% and the distribution of using reagent strip was similar to the previous year. 3.The percentage of response rate of microscopic photographs of urinary sediment was 80.7% and the percentage of good performance of these tests ware 85.8% to 95.8%.

Comparison between Soluble Transferrin Receptor, Serum Ferritin and Trans-ferrin Saturation in Chronic Renal Failure Patients / 대한진단검사의학회지

BACKGROUND: In chronic renal failure (CRF) patients, iron deficiency is a common problem and a primary cause of resistance to recombinant human erythropoietin (rHuEPO) therapy. Serum ferritin and transferrin saturation (TS) are most commonly used parameters of iron status in CRF patients but may be influenced by the presence of inflammation and malnutrition. Recently soluble transfer-rin receptor (sTfR) has been advocated as a useful parameter of iron deficiency. We evaluated sTfR as an iron deficient marker in CRF patients. METHODS: Included in this study were 73 CRF patients, 30 uncomplicated iron deficiency anemia (IDA) patients, and 55 normal control. Serum sTfR, serum ferritin, TS, and complete blood count were measured. The CRF patients were classified as absolute iron deficient, functional iron deficient, non-iron deficient, and iron overload groups according to National Kidney Foundation Kidney Disease and Dialysis Outcome Quality Initiative (NKF-K/DOQI) guideline. RESULTS: The sTfR concentrations were significantly higher in uncomplicated IDA patients (3.9 +/-1.5 mg/L) and significantly lower in CRF patients (1.1 +/-0.4 mg/L) than in normal controls (1.4 +/-0.4mg/L). In uncomplicated IDA patients, sTfR was inversely correlated with MCV, MCH, and MCHC. In CRF patients, sTfR had a weak inverse correlation with TS and MCHC, but not significantly different between the four groups. The sTfR was not significantly different between the CRF patients with the normal CRP and those with an increased CRP. CONCLUSIONS: The sTfR is useful for diagnosis of uncomplicated IDA, but not for the detection of iron deficiency in CRF patients. Further studies are needed for the evaluation of sTfR as an erythro-poietic marker with rHuEPO therapy.

Annual Report on External Quality Assessment in Clinical Chemistry in Korea (2003) / 임상검사와정도관리

Ten trials of external quality assessment for Clinical Chemistry in general chemistry and blood gas were performed in 2003. All the control materials were sent in specifically-made boxes at the same time. The response rates were 90.3% in general chemistry and 91.8% in blood gas. The items included sodium, potassium, chloride, BUN, glucose, calcium, phosphorus, uric acid, creatinine, bilirubin, total protein, albumin, total cholesterol, triglyceride, AST, ALT, ALP, LD and GGT in general chemistry and pH, pCO2 and pO2 in blood gas. Compared with the previous year (2002), the methods of analysis are not changed much and the coefficient of variation and VIS scores of general chemistry items are decreased.

Annual Report on External Quality Assessment in Urinalysis in Korea (2003) / 임상검사와정도관리

Three external quality assesment trials which composed of 12 control materials(12 chemical materials) for interlaboratory quality control assesment in urinalysis were performed with 446, participants, in each, in the year of 2003. The response rate were 92.4% (414/448), 91.9% (419/456) and 91.3% (408/447), in the first, the second and the third trials, in each. The test items include pH, glucose, protein, ketone, bilirubin, blood, urobilinogen, nitrite, leukocyte estrase and specific gravity. The survey results are summarized as follows: 1. The chemical quality control test in urinalysis revealed generally good concordance. 2. The percentage of using urinalysis analyzer was slightly increased as 86.8% and the distribution of using reagent strip was similar to the previous year.

Prevalence of the TT virus viremia in Patients on Hemodialysis and General Populations / 대한진단검사의학회지

BACKGROUND: The TT virus (TTV) is a recently discovered, single-stranded circular DNA virus in the serum of the patients with post-transfusion hepatitis and it is thought to be one of the causative agents of cryptogenic hepatitis. In this study, we evaluated the prevalence and clinical significance of TTV viremia in general populations and patients on hemodialysis. METHODS: Sera of 115 general populations and 69 patients on hemodialysis were examined for TTV viremia by semi-nested polymerase chain reaction using primers deduced from the N22 region. RESULTS: The TTV was detected in 26.1% (18 of 69) of the patients on hemodialysis and was not different from the 20.9% (24 of 115) prevalence in general populations. Two patients on hemodialysis that revealed biochemical evidence of acute hepatitis were the sole TTV infection without other hepatitis virus infection but the mean alanine aminotransferase level was not significantly different according to the TTV viremia. The TTV was persistently detected in the sera of eight of thirteen patients (61.5%) 12 month later without any evidence of hepatitis. CONCLUSIONS: TTV is widespread in general populations and shows similar prevalence in patients on hemodialysis. Viral persistence and nonparenteral transmission may be possible. The relationship between the TTV viremia and hepatitis was not proved.

A Case of Chronic Myelogenous Leukemia with ider(22)(q10)t(9;22)(q34;q11.2) as Clonal Evolution / 대한진단검사의학회지

The ider(22)(q10)t(9;22)(q34;q11.2) is a rare secondary karyotypic aberration of Philadelphia chromosome positive chronic myelogenous leukemia (Ph+ CML) and was associated with disease progression and poor clinical outcomes in most of the previously reported cases. We experienced a case of Ph+ CML with the occurrence of ider(22)(q10)t(9;22)(q34;q11.2) as clonal evolution preceding an hematologic feature of accelerated phase for 3 years. So this chromosomal abnormality was not always correlated with poor prognosis. Relevant literature was reviewed.

Two Cases of Vitamin B12 Deficiency Anemia Combined with Iron Deficiency Anemia / 영남의대학술지

Simultaneous deficiency of Vitamin B12 and iron induces that the bone marrow erythroid megaloblastosis and peripheral blood macroovalocytosis are masked because of countervailing the tendency of iron deficiency to produce hypochromic microcytic erythrocytes. We report two cases of Vitamin B12 deficiency anemia with low mean corpuscular volume (MCV) due to combined iron deficiency anemia with review of literature.