• 한국의료질향상학회지
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• 제19권1호
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• pp.64-72
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• 2013

Objective: To improve customer satisfaction through accurate information using computerized automation of the test reservation system and by performing all fasting tests on the same day with one fasting. Methods: Quality improvement activities of the test reservation system of Seoul National University Bundang Hospital improves internal and external customer satisfaction at the time of test scheduling by having the reservation system reflect test order and test time automatically and making the system to increase the same day test reservation rate. Results: Test process was smooth due to accurate test reservation and information based on test priority due to the introduction of the computerized test reservation system. Internal and external customer satisfaction improved due to the marked reduction in time required for making a reservation thanks to the improvement of work process. Conclusion: Building a computerized test reservation system was an effective measure to improve external and internal customer satisfaction.

• Journal of Korean Dental Science
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• 제15권2호
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• pp.101-111
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• 2022

The purpose of laboratory tests in the field of oral medicine can be divided into two categories: (1) medical evaluation of patients with systemic diseases that are planning to receive dental care and (2) diagnosis of patients with certain oral diseases. First, laboratory tests are commonly used to evaluate patients with systemic diseases who need dental management. A combination of multiple tests is usually prescribed as a test panel to diagnose and assess a specific disease. Test panels closely related to oral medicine include those for rheumatoid arthritis, connective tissue disease/lupus, liver function, thyroid screening, anemia, and bleeding disorders. Second, laboratory tests are used as auxiliary diagnostic methods for certain oral diseases. They often provide crucial diagnostic information for infectious diseases caused by bacteria, fungi, and viruses that are associated with pathology in the oral and maxillofacial regions. Laboratory tests for infectious diseases are composed of growth-dependent methods, immunologic assays, and molecular biology. As the field develops, further application of laboratory tests, including synovial fluid analysis in temporomandibular joint disorders, salivary diagnostics, and hematologic biomarkers associated with temporomandibular disorders and orofacial pain conditions, is currently under scrutiny for their reliability as diagnostic tools.

• Asian Pacific Journal of Cancer Prevention
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• 제15권21호
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• pp.9077-9083
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• 2014

Background: This study aimed to summarize the potential diagnostic value of serum DKK1 levels in cancer detection. Materials and Methods: Serum DKK1 was measured using enzyme-linked immunosorbent assay in a case-control study. Then we performed a meta-analysis and the pooled sensitivity, specificity, diagnostic odds ratio, and summary receiver operating characteristic (sROC) curves were used to evaluate the overall test performance. Results: Serum DKK1 levels were found to be significantly upregulated in gastric cancer as compared to controls. ROC curve analysis revealed an AUC of 0.636, indicating the test has the potential to diagnose cancer with poor accuracy. The summary estimates of the pooled sensitivity, specificity and diagnostic odds ratio in meta-analysis were 0.55 with a 95% confidence interval (CI) (0.53-0.57), 0.86 (95%CI, 0.84-0.88) and 12.25 (95%CI, 5.31-28.28), respectively. The area under the sROC was 0.85. Subgroup analysis revealed that the diagnostic accuracy of serum DKK1 in lung cancer (sensitivity: 0.69 with 95%CI, 0.66-0.74; specificity: 0.95 with 95%CI, 0.92-0.97; diagnostic odds ratio: 44.93 with 95%CI, 26.19-77.08) was significantly higher than for any other cancer. Conclusions: Serum DKK1 might be useful as a noninvasive method for confirmation of cancer diagnosis, particularly in the case of lung cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제14권8호
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• pp.4699-4704
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• 2013

Background: MicroRNAs have been demonstrated to play important roles in the development and progression of colorectal cancer. Several studies utilizing microRNAs as diagnostic biomarkers for colorectal cancer (CRC) have been reported. The aim of this meta-analysis was to comprehensively and quantitatively summarize the diagnostic value of microRNAs for detecting colorectal cancer. Methods: We searched PubMed, Embase and Cochrane Library for published studies that used microRNAs as biomarkers for the diagnosis of colorectal cancer. Summary estimates for sensitivity, specificity and other measures of accuracy of microRNAs in the diagnosis of colorectal cancer were calculated using the bivariate random effects model. A summary receiver operating characteristic (SROC) curve was also generated to summarize the overall effectiveness of the test. Result: Thirteen studies from twelve published articles met the inclusion criteria and were included. The overall sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odd ratio of microRNAs for the diagnosis of colorectal cancer were 0.81 (95%CI: 0.79-0.84), 0.78 (95%CI: 0.75-0.82), 4.14 (95%CI: 2.90-5.92), 0.24 (95%CI: 0.19-0.30), and 19.2 (95%CI: 11.7-31.5), respectively. The area under the SROC curve was 0.89. Conclusions: The current evidence suggests that the microRNAs test might not be used alone as a screening tool for CRC. Combining microRNAs testing with other conventional tests such as FOBT may improve the diagnostic accuracy for detecting CRC.

• Journal of Genetic Medicine
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• 제8권1호
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• pp.28-34
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• 2011

대부분의 의사들은 임상시험을 치료약제개발 후 의료현장에서 사용하기 위해 진행되는 과정으로 생각할 것이다. 실험실에서 개발된 기술이 진단검사로써 도입되기 위해서는 치료약제의 경우와 유사한 임상시험 과정을 거쳐 그 안정성과 유효성에 대한 검증을 필요로 한다. 치료약제의 효과검증에서 가장 우수한 근거를 얻을 수 있는 연구방법은 무작위대조연구 방법이지만, 이를 검체진단검사에 그대로 적용하기는 어렵다. 검체진단검사의 경우 비교연구가 진단정확도의 검증을 위해 현실적으로 사용할 수 있는 연구방법이지만 대상군의 모집 방법과 구분 방법, 질환대상자의 질환 심각도, 참고표준의 선택과 적용, 눈가림 여부 등 여러 요인들이 진단정확도 지표에 직접적인 영향을 주기 때문에, 좋은 근거수준의 연구결과를 얻기 위해서는 이러한 요소들을 고려한 잘 고안된 연구디자인이 중요하다. 또한 검체진단검사는 치료약제의 경우와 달리 결과를 얻기 위한 검사과정이 사용자인 일선 검사실에 의해 계속 생산되어야 하고, 검사의 개발과 발전의 속도가 빠르며, 일선검사실이 최종사용자이자 개발자인 경우가 흔하다는 특성이 있다. 저자들은 이러한 검사의 특성을 고려하여 검사법 자체의 수행능력에 대한 검증으로부터 검사법 성능평가를 위한 질환확진군과 정상군에 대한 비교연구, 일련의 질환의심자 대상의 진단정확도 평가와 임상 효과성 평가, 도입 후 일상감시로 이어지는 임상시험의 진행단계를 제안하고자 한다.

• 대한임상검사과학회지
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• 제52권3호
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• pp.271-277
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• 2020

"건강검진"이란 건강상태 확인과 질병의 예방 및 조기발견을 목적으로 건강검진기관을 통하여 진찰 및 상담, 신체계측, 진단검사, 병리검사, 영상의학 검사 등 의학적 검진을 시행하는 것을 말한다. 건강검진의 종류에는 일반건강검진, 종합건강검진, 특수건강검진, 기타건강검진이 있다. 건강검진센터에서 근무하고 있는 임상병리사들의 일반건강검진 업무의 비중은 전체 업무에서 50% 이상 기여를 하고 있는 것으로 추정할 수 있다. 질환의심 비용적인 측면은 25% 이상 기여하는 것으로 추정할 수 있다. 진단검사 비용은 약 5%로 추정되며 의학진단 사용 비율은 70%를 차지하고 있다. 본 연구 결과에서 임상병리사들이 건강검진 업무에서 사회적, 경제적, 정책적인 타당한 처우를 받고 있는가를 검토되어져야 할 것이다. 임상병리사의 미래는 향후 업무적으로 정밀의료와 원격의료에서 진단검사 및 질 관리에서 전문성이 더욱 확대될 것으로 예측된다. 따라서 임상병리사들은 국가건강검진 관련 정부정책결정에 적극적으로 참여하고 더불어 처우개선의 노력이 필요할 것이다.

• Parasites, Hosts and Diseases
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• 제60권3호
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• pp.173-179
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• 2022

Malaria remains a global health threat. Approximately 97% of the population is at risk in sub-Saharan countries, particularly Nigeria. This study compared the performance of 2 diagnostic methods in assessing malaria endemicity in the rural communities of Ebonyi State, Nigeria. A total of 1,140 study participants were screened for malaria parasite using Rapid Diagnostic Test kits (RDT) in the field, while thick and thin films for microscopy were examined in the laboratory. Our result showed that malaria prevalence was 56.8 by RDT and 38.6% by microscopic test. Age group under 10 years had the highest prevalence of 28.9% (RDT) and 23.6% (microscopy), respectively. The highest prevalence of 19.5% by RDT was recorded in Onicha Local Government Area, while the highest prevalence of 13.4% with microscopy was recorded in Ezza North Local Government Area. The sensitivity and specificity of microscopic examination were both 100%, while those of RDT were 95.5% and 75.9%, respectively.

• 대한임상검사과학회지
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• 제50권1호
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• pp.20-28
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• 2018

결핵(TB)은 Mycobacterium tuberculosis (MTB) 복합체의 구성원에 의한 세균 감염 질병이다. 결핵은 전 세계 인구의 1/3이 감염된 것으로 알려져 있으며, 한국에서는 매년 약 4만 명의 새로운 결핵환자가 발생한다. 또한, 비결핵 항상균 감염이 증가하고 있는 추세이다. 전통적인 결핵 및 비결핵 항상균 진단방법은 세균 배양으로 3~4주 이상이 소요된다. 따라서, 신속하고 정확한 결핵균(TB) 및 비결핵 항상균(NTM) 진단법의 필요성이 요구되고 있다. 결핵균 및 비결핵 항상균을 구분하기 위하여, 전 세계적으로 다양한 진단 방법이 개발되고 있다. 특히, 결핵균과 비결핵 항상균을 신속하고 정확한 동정의 요구가 증가함에 따라, 정확하고 신속하게 진단하기 위한 체외 진단 방법이 개발 되고 있다. 그러나 현재 결핵과 비결핵 항상균에 대한 체외 진단 시약의 성능 평가는 부족한 실정이다. 최근 식약청은 결핵균 및 비결핵 항상균 체외 진단 시약에 대한 가이드 라인을 발표했다. 본 연구에서는, 미국 FDA에 승인을 받은 결핵균 및 비결핵 항산균에 대한 체외 진단 시약의 성능을 검토하였다. 이 검토는 결핵균 및 비결핵 항상균 체외 진단 시약 평가에 유용한 참고 자료가 될것으로 사료된다.

• 대한임상검사과학회지
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• 제42권1호
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• pp.38-45
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• 2010

The aim of this study was to assess the Clinical Usefulness of Helicobacter pylori Stool Antigen (HpSA) immunochromatographic assay for the diagnosis of H. pylori infection. In this study, we had compared HpSA-immunochromatographic assay with CLO test and UBT test. From a total of 140 patients (M:F=88:52) with upper endoscopy, biopsy specimens were obtained for CLO test. Stool specimens was collected from all patients and tested using a HpSA-immunochromatic assay. H. pylori infection status was defined as infected if the results of both CLO test and UBT test were positive. CLO test and UBT test findings showed that 92 patients were H. pylori positive and 48 patients were H. pylori negative. According to this definition, the sensitivity, specificity, and positive or negative predictive value (PPV, NPV) of HpSA-immunochromatographic assay were 97.8%, 100%, 100%, and 96%, respectively. Cross reactivity test of HpSA-immunochromatographic assay were performed with 10 enteric bacteria strains in fecal habitat, and there were no false positive reaction. We evaluated the usefulness of HpSA assay for eradication therapy with 10 of 92 H. pylori positive patients, positive results of them at pre-eradication therapy were converted to negative at post-eradication. The HpSA-immunochromatographic assay is a highly sensitive and specific non-invasive diagnostic method for detection of H. pylori infection, a useful diagnostic method for H. pylori in post eradication stage.

• Clinical and Experimental Pediatrics
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• 제49권11호
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• pp.1140-1151
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• 2006

Inherited metabolic disorders are individually rare but as a whole, they are nor rare. Since Archibald Garrod introduced a concept of "inborn error of metabolism" or "chemical individuality", more than 500 diseases are currently known, affecting approximately one in 500 newborns cumulatively. They frequently manifest with acute, life-threatening crisis that require immediate specific intervention or they present with insidious diverse symptoms and signs involving multiple visceral organs or tissues as well as central nervous system, hampering a correct diagnosis. In addition, many pediatricians are not familiar with all diagnostic and therapeutic strategies for diverse inherited metabolic disorders. However, the prognosis of affected children are heavily dependent on rapid and effective treatment. In this lecture, practical guidelines for the specific diagnosis based on diverse clinical features of inherited metabolic disorders will be described. Many sophisticated laboratory tests are available for confirmatory diagnosis of each disease, which challenge to general pediatricians with respect to knowledge about biochemical metabolite assay test, enzymatic test and DNA diagnostic tests. Sample collections, indications, methods and interpretation of results in varying laboratory tests will be listed as well.