• Title/Summary/Keyword: Precision medicine (PM)

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Perspective of a New Precision Medicine and Health Care Research (새로운 맞춤형 정밀의학과 보건의료 연구에 대한 조망)

  • Park, Yoon Hyung
    • Health Policy and Management
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    • v.25 no.4
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    • pp.253-255
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    • 2015
  • The concept of precision medicine-prevention and treatment strategies that take individual variability into account-is hot issue of US in the year 2015. Precision medicine is a new concept that approach patients individually by there characteristics, such as genome, life style, environmental exposure, etc. For developing the precision medicine, National Institute of Health of US has been prepared the Precision Medicine Initiative Cohort Program, at least 1 million people cohort. The US President Obama announced the Precision Medicine Initiative on 30th January 2015. He announced that he will pioneer a new model of patient-powered research that promises to accelerate biomedical discoveries and provide clinicians with new tools, knowledge, and therapies to select which treatments will work best for which patients. Most medical treatments have been designed for the 'average patient.' As a result of this 'one-size-fits-all-approach,' treatments can be very successful for some patients but not for others. This is changing with the emergence of precision medicine, an innovative approach to disease prevention and treatment that takes into account individual differences in people's genes, environments, and lifestyles. Precision medicine gives clinicians tools to better understand the complex mechanisms underlying a patient's health, disease, or condition, and to better predict which treatments will be most effective. The healthcare researcher should prepare the new medicine era such as bio-information technology convergence, big data study.

The Evaluation of Proficiency Test between Radioimmunoassay and Chemiluminescence Immunoassay (방사면역측정법과 화학발광면역측정법간의 숙련도 비교평가)

  • Noh, Gyeong-Woon;Kim, Tae-Hoon;Kim, Ji-Young;Kim, Hyun-Joo;Lee, Ho-Young;Choi, Joon-Young;Lee, Byoeng-Il;Choe, Jae-Gol;Lee, Dong-Soo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.2
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    • pp.116-124
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    • 2011
  • Purpose: To establish accurate external quality assurance (EQA) test, cross institutional and modality tests were performed using WHO certificated reference material (CRM) and same pooled patients serum. Materials and Methods: Accuracy and precision were evaluated using CRM and pooled patients' serum for AFP, CEA, PSA, CA 125, CA 19-9, T3, T4, Tg, TSH. To evaluate the accuracy and precision, recover test and coefficient variation were measured. RIA test were performed in major 5 RIA laboratory and EIA (CLIA) test were done in 5 major EIA laboratory. same sample of CRM and pooled serum were delivered to each laboratory. Results: In 2009, mean precision of total tumor marker of RIA was $14.8{\pm}4.2%$ and that of EIA(CLIA) was $19.2{\pm}6.9%$. In 2010, mean precision of 5 tumor marker and T3, T4, Tg, TSH was $13.8{\pm}6.1%$ in RIA and $15.5{\pm}7.7%$ in EIA (CLIA). There was no significant difference between RIA and EIA. In RIA, the coefficient variations (CV) of AFP, CEA, PSA, CA 125, T3, T4, TSH were within 20%. The CV of CA 19-9 was over 20% but there was no significant difference with EIA (CLIA) (p=0.345). In recovery test using CRM, AFP, PSA, T4, TSH showed 92~103% of recovery in RIA. In recovery test using commercial material, CEA, CA 125, CA 19-9 showed relatively lower recovery than CRM but there was no significant difference between RIA and EIA (CLIA). Conclusion: By evaluating the precision and accuracy of each test, EQA test could more accurately measured the quality of each test and performance of laboratory.

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Quality Assessment and Comparison of Several Radioimmunoassay Kits and Chemiluminescence Immunoassay Methods for Evaluating Serum Estradiol (혈중 Estradiol 농도 측정을 위한 여러 방사면역측정 검사키트 및 화학면역발광 검사법의 성능평가 및 상호비교)

  • Choi, Sung Hee;Noh, Gyeong Woon;Kim, Jin Eui;Song, Yoo Sung;Paeng, Jin Chul;Kang, Keon Wook;Lee, Dong Soo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.19 no.1
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    • pp.72-80
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    • 2015
  • Purpose Serum estradiol ($E_2$) measurement is requested for diagnosing menstrual cycles, ovulation induction, infertility, and menopause. $E_2$ is measured using several methods and kits including radioimmunoassay (RIA) and chemiluminescece immunoassay (CLIA). The purpose of this study was to evaluate quality of these methods and to compare them with each other. Materials and Methods Seven radioimmunoassay kits and two CLIA methods were included in the analysis. Using standard samples and patient samples, intra-assay precision, inter-assay precision, correlation between other methods, sensitivity, and recovery rate were evaluated. Results For all tested kits and methods, coefficients of variance (CVs) of intra-assay precision test were 10.9~13.6% in low-level samples and less than 10% in medium and high-level samples. CVs of inter-assay precision test were 10.8~12.3% in low-level samples and less than 10% in medium and high-level samples with all tested kits and methods. Recovery rates were $92.7{\pm}12.4%$ for SIEMENS, $101.4{\pm}18.4%$ for DIAsource, $95.1{\pm}11.5%$ for AMP, $108.4{\pm}18.5%$ for BECKMAN COULTER, $104.2{\pm}13.5%$ for BECKMAN COULTER Ultra Sensitive, $101.3{\pm}11.6%$ for CIS Bio, and $93.1{\pm}13.2%$ for MP kits. Sensitivity was 7.5, 6.2, 5.7, 6.2, 5.3, 4.5, and 5.5 pg/mL for SIEMENS, DIAsource, AMP, BECKMAN COULTER, BECKMAN COULTER Ultra Sensitive, CIS Bio, and MP kits, respectively. The measurement by MP kit was slightly higher than those by other kits in low-level samples, and the measurement by E170 was slightly higher than those of other kits in medium and high-level samples. In the measurement of standard sample for external quality control, SIEMENS kit produced relatively lower values whereas E170, Architect, and MP kits produced relatively higher values compared with other kits. Conclusion All tested kits for $E_2$ measurement have satisfactory performance for clinical use. However, correlation between kits should be considered when test kits are to be changed, because some pairs of kits do not have correlations with each other.

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Monitoring Ovarian Function by Solid- Phase Chemiluminescence Immunoassay

  • Kim, J.B.;Ku, P.S.
    • Clinical and Experimental Reproductive Medicine
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    • v.9 no.1_2
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    • pp.43-53
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    • 1982
  • 여성의 난소기능은 뇨중 Oestrone-3-glucuronide를 간편한 solid-phase 의 화학발광성 면역학적 측정법 (Chemiluminescence Imrnunoassay(CIA) 에 의하여 그 기능이 탐지될 수 있다. Oestrone-3-g1ucuronyl-6-bovine serum albumine에 대한 antiserum의 IgG fraction은 polystyrene 실험관벽에 흡착시켰으며, 항원으로서는 est r one-3- gl ucuronyI-6-aminoethyl-ethyl-isoluminol 을 항원 (antigen) 에 labeI 시킨 것이다. 시험 대상물인 뇨는 매일아침뇨(early morning urine) 을 희석 (1:1000 V/V)한 후 100mcl 를 취하여 이를 각기 이중분석액으로 택하였다. 시험관 내에서 결합반응 (1 hour at $4^{\circ}C)이 일어난 후에는 시험관내의 액체를 전부 흡입 폐기시켰으며, 항체반응이 일어난 후 ( antibody-bound fraction )에는 완충액 (400mcl)으로 한번 세척시켰다. 그후 염화수산화물(2N , 200mcl)을 가지고 $22^{\circ}C$에 60 분간 방치 혼합케 한 후 효소(microperoxidase) 와 과산화수소를 가하면서 산화작용에서 발생되는 발광양을 10초동안 측정하여 그 결과를 분석하였다. 위에 기술한 분석방법을 평가하면 다음과 같은 결론을 얻었다. Calibration curve sensitivity$3.12{\pm}0.75$ PG/tube ($mean{\pm}SD$)였고, lntra-assay precision(CV%) 9.52 (20 replicates;$38.4{\pm}3.66$nmol/1) 와 8.81 (15 replicates; $102.4{\pm}8.82$nmol/1)였다. Inter-assay precision(CV%) 은 11.9 (mean of 4 pools-7.03, 23.16, 52.11 과 117.53 nmol/1)로 2개월 동안에 걸쳐 시행되었고, 평균 비이어스(mean bias)는 -0.78 로 28에서 448 nmol 범위로서 매일아침 "뇨"의 차이분(different aliquots)은 좋은 결과를 얻었다. 건강한 여성으로부터 채취된 뇨중 Oestrone-3-glucuronide 의 농도(nmol/1)를 보면 월경주기의 여포기와 배난기 및 황체기에 있어서 각기 $40.2{\pm}9.9$ , $102.3{\pm}39.4$$84.3{\pm}13.3$nmol/1였다. 이와같은 결과는 동일한 검사뇨를 방사면역학적 방법(RIA)으로 측정 (6 menstrual cycle)한 결과와 유사한 측정치를 얻으므로서 간편하고 진보된 좋은 방법중의 하나라고 사료되는바이다.

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Quantitative Analysis of Quartz, Mica, and Feldspar in Respirable Coalmine Dust in Taebaek Area by Fourier Transform Infrared Spectrophotometry (간섭식 적외선 분광기에 의한 태백지역 석탄광의 호흡성 분진 중 석영, 운모 및 장석의 정량분석)

  • Choi, Ho-Chun;Cheon, Yong-Hee;Kim, Hae-Jeong;Lee, Jeong-Joo
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.2 s.24
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    • pp.271-283
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    • 1988
  • A Fourier transform infrared spectrophotometric method was described for the determination of quartz, mica(sericite) and feldspar(potassium feldspar) in respirable dust in Taebaek area. The results were as follows; 1) The concentration of minerals were determined from the intensity of absorption peak of quartz at $799cm^{-1}$, sericite at $539cm^{-1}$, and potassium feldspar at $648cm^{-1}$ respectively. 2) The precision(C. V. %) for the quartz determination was $7.70{\pm}2.68%$ from 10 to $200{\mu}g$ of quartz. 3) The precision for the sericite determination was $16.34{\pm}6.82%$ from 30 to $500{\mu}g$ of serictite. 4) The precision for the potassium feldspar determination was $5.28{\pm}1.74%$ from 30 to $500{\mu}g$ of potassium feldspar. 5) The concentration of respirable dust in Taebaek area was $4.90{\pm}3.29mg/m^3$ (0.4-93.7%), percent quartz was $1.80{\pm}4.14%$ (0.01-20.56%), percent sericite was $11.37{\pm}6.43%$ (0.00-29.69%), percent potassium feldspar was 8.15% (n=7, 3.41-19.70%). 6) The difference of respirable coal dust, quartz, and sericite concentrations in drilling, coal cutting, hauling and seperating was significant respectively (p<0.05).

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Study on the Development of Meridian Impedance Measurement System (경락 임피던스 측정 시스템 개발에 관한 연구)

  • Lee, Woo-Cheol;Yin, Chang-Shik;Min, Kyoung-Kee
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.58 no.2
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    • pp.422-429
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    • 2009
  • Meridian which used as the basic theory of acupuncture treatment, is an important functional connection system of acupuncture point in oriental medicine. Yangdorak and EAV have lack of precision because of using 2-electrode method, occurring high non-uniformed current density and electrode contact status on electrode placement spot. Therefore we implemented a meridian impedance measurement system for measuring meridian impedance using 4-electrode method. In order to confirm the precision of developed system, we made an constant current characteristic experiment using standard resistor. As a results of clinical study with 18 subjects, the meridian impedance showed that reproductivity and repeatability of HT7 acupuncture point are $0.515[k{\Omega}]{\pm}0.000$(mean${\pm}$standard deviation) and $0.515[k{\Omega}]{\pm}0.002$, respectively. And reproductivity and repeatability of PC7 are $0.521[k{\Omega}]{\pm}0.000$ and $0.521[{\Omega}]{\pm}0.001$ respectively. The proposed system was stable and reliable. Therefore this study proved AC impedance method to valid in measuring meridian impedance, and also verified precision and repeatability of the proposed meridian impedance measurement system. The proposed system will serve as more effective method of measuring meridian phenomena as a bioelectric signal in clinical practice.

Bone Mineral Density Measurement of Rats Using Dual-energy X-ray Absorptiometry: Precision of In Vivo Measurements for Various Skeletal Sites with or without Repositioning (쥐에서 이중에너지 방사선 흡수법을 이용한 골밀도의 측정: 다양한 골부위에서 재위치 여부에 따른 생체내 측정의 정밀도)

  • Oh, Dong-Hyun;Jung, Jae-Ho;Woo, Sang-Keun;Cheon, Gi-Jeong;Kim, Byung-Il;Choi, Chang-Woon;Lim, Sang-Moo
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.1
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    • pp.72-78
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    • 2009
  • Purpose: Bone mineral density (BMD) measurements need to be precise enough to be capable of detecting small changes in bone mass of rats. Using a regular dual-energy X-ray absorptiometry (DXA), we measured many BMD of various skeletal sites in rats to examine precision of DXA in relation to the repositioning on the bones of rats. Materials and Methods: Using DXA and small animal software, scans were performed 4 times in all 12 male rats without repositioning (Group 1a). Another four scans for 6 of 12 rats were done with repositioning between scans (Group 2). Customized regions of interest (ROIs), encapsulate the right hind limb, L1-4, skull and pelvic bones were drawn at each measurement. The precision of the measurements was evaluated by measuring the coefficient of variation (CV) of four measurements of BMD at each skeletal site of all rats with or without repositioning. Significance of differences between group 1b (six rats out of group 1a, which were come under group 2) and group2 were evaluated with Wilcoxon Signed Rank Sum Test. Results: CVs obtained at different skeletal sites of all measurements in Group 1b and 2. It was $3.51{\pm}1.20$, $ 2.62{\pm}1.20$ for the hindlimb (p=0.173), $3.83{\pm}2.02$, $4.59{\pm}2.02$ for L1-4 (p=0.600), $3.73{\pm}1.87$, $1.53{\pm}0.89$ for skull (p=0.046), and $2.92{\pm}0.60$, $1.45{\pm}0.60$ for pelvic bones (p=0.075). Conclusion: Our study demonstrates that the DXA technique has the precision necessary when used to assess BMD for various skeletal sites in rats regardless of repositioning.

Evaluation of the Kit's Efficiency of Alpha Fetoprotein (AFP) Test (Alpha feto protein(AFP)검사 키트의 유효성 평가실험)

  • Cho, Hyun-su;Noh, Gyeong-woon;You, Tae-min
    • The Korean Journal of Nuclear Medicine Technology
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    • v.22 no.2
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    • pp.101-104
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    • 2018
  • Purpose Alpha fetoprotein(AFP) is a fetal serum protein that increases in germ cell tumors derived from liver cancer or egg yolk. AFP test has been used for screening of liver cancer, determination of tumor stage, determination of therapeutic effect, and fetal congenital malformations. The purpose of this study was to compare the results of the four kits, identify the advantages and disadvantages of each kit, and select the appropriate kits for our laboratory. Materials and Methods Blood samples were obtained from 89 patients attending the Seoul national university hospital. Experiments were carried out in accordance with manufacturer's instructions of four companies(A, B, C, D). The precision, recovery, linearity, and sensitivity test were performed for each kit. Results In case of the precision within the measurement, the CV value of the C kit was less than 5% at the low, middle, and high concentrations. The A, B and D kit's the CV value was less than 5% at the concentrations except the low concentration. The recovery rates of the A, B, C, and D kits were $100{\pm}15%$, $100{\pm}30%$, $100{\pm}16%$ and $100{\pm}14%$, respectively. All kits showed good linearity. Sensitivity was measured as 0.5 IU/mL for A, 0.4 IU/mL for B, 0.98 IU/mL for C, and 0.3 IU/mL for D. Conclusion The CV values of the four kits were within 10%, and the correlation coefficients were close to 1 for $R^2=0.978$, $R^2=0.992$ and $R^2=0.8957$. As a result, they are clinically available. Therefore, each laboratory should select the appropriate kit for their experiment's environment.

Comparison of F-18 FDG Radioacitivity to Determine Accurate Dose Calibrator Activity Measurements (방사능 측정기를 이용한 F-18 FDG 방사능의 비교)

  • Jin, Gye-Hwan;Kweon, Dae-Cheol;Oh, Ki-Baek;Park, Hoon-Hee;Kim, Jung-Yul;Park, Min-Soo;Park, Dae-Sung
    • Progress in Medical Physics
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    • v.20 no.3
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    • pp.159-166
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    • 2009
  • Obviously, the administration of the prescribed amount of activity to the patient requires proper operation of the dose calibrator, which shall be verified by implementing the required quality control on the instrument. This investigation examined the accuracy and precision of dose calibrator activity measurement of the radiopharmaceutical F-18 FDG. To investigate the status of the nuclear medicine centers in Korea for the performance of dose calibrators, 10 centers providing PET/CT system services in Korea were inspected in 2008. We measured accuracy and precision in 10 equipments in consideration of PET/CT model, installation area, and installation time. According to the results of comparative analysis of 10 dose calibrators used to measure radioactivity of F-18 FDG, accuracy was -5.00~4.50% and precision was 0.05~0.45%, satisfying the international standards, which are accuracy ${\pm}$10% and precision ${\pm}$5%. This study demonstrated that, for accurate measurements, no adjustment is necessary for a dose calibrator setting when measuring different dose calibrators of F-18 FDG activity prescriptions.

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Validation of enzyme immunoassay for the quantitative measurement of human IgG antibodies specific for Haemophilus influenzae Type b capsular polysaccharide (Haemophilus influenzae type b 피막 다당질 특이 인간 IgG 항체의 정량적 측정을 위한 enzyme immunoassay의 타당성 연구)

  • Kim, Kyung Hyo;Lim, Soo Young
    • Clinical and Experimental Pediatrics
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    • v.50 no.2
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    • pp.143-150
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    • 2007
  • Purpose : This study was conducted to validate enzyme immunoassay (EIA) for the quantitative measurement of human IgG antibodies specific for Haemophilus influenzae type b (Hib) capsular polysaccharide. Method : We evaluated specificity, repeatability, intermediate precision, accuracy, lower limit of quantification (LLOQ), and stability to validate standardized EIA for the quantitative measurement of human anti-polyribosylribitol phosphate (PRP) IgG antibodies. Results : The results indicated that this EIA showed specificity to HbO-HA antigen and repeatability and intermediate precision were within acceptance criteria (repeatability: $CV{\leq}15%$, intermediate precision: $CV{\leq}20%$). The EIA-derived results from this laboratory were equivalent to those obtained by the standard radioactive antigen binding assay (RABA) for quantitation of anti-PRP antibodies in the 28 sera. Spiking recovery result was within acceptance criteria ($100{\pm}20%$). The precision and accuracy of samples in LLOQ were from -14.7 to -4.7% in nominal values, which were within acceptance criteria (precision: $CV{\leq}25%$, accuracy: ${\pm}25%$). Freeze-thaw stability and short term temperature stability were within ${\pm}20%$ of acceptance criteria. Conclusions : The EIA which is performed at the Center for Vaccine Evaluation and Study Ewha Medical Research Institute, is an appropriate serologic assay which can be used for quantitation of anti-PRP IgG antibodies in human sera.