Clinical Laboratory

　Introduction

　　The clinical laboratory division has 17 technicians and 6 physicians. The division consists of clinical pathology laboratories, a physiological laboratory and anatomical pathology laboratories. There are five clinical pathology laboratories: biochemistry, serology, hematology, urinalysis, and bacteriology and blood banking. The physiological laboratory consists of four sections: ultrasonography (US), electrocardiography, electroencephalography and respiratory function tests. Two physicians and 2 technicians manage these sections. These laboratories assist clinicians by rapid and reliable data provision.
　　The anatomical pathology laboratories consisting of 4 technicians and 3 consultant pathologists, deal with surgical, cytological and autopsy specimens. All the data of this section are computer-filed, and are accessible to physicians at any time.

　Routine Activities

　　The most important role of the clinical pathology laboratories is rapid and highly reliable data provision to support prompt therapeutic decision making by doctors. We employ a bar-code system for specimen identification and an automatic analyzing system. In monthly meetings consisting of the chief technicians and physicians, the data quality control and laboratory management are discussed. Each section holds weekly conferences for data quality control.
　　The bacteriology laboratory plays an important role in the hospital infection control, reporting not only routine data but also monthly, quarterly and yearly statistical data of hospital infections.
　　The roles of the blood banking section are blood typing, irregular antibody screening and blood supply upon physician's request.
　　In the physiological laboratory, US is an important screening examination for malignancies in the neck and abdomen. Cardiac US provides valuable information on preoperative patients with cardiac disorders, and on patients who underwent chemotherapy with cardiac toxicity.
　　The anatomical pathology laboratories are engaged in the routine work of evaluating surgical, cytological and autopsy materials, and is responsible for histological and cytological diagnosis. To examine specimens in detail, immunohistochemical approaches and/or genetic analyses are frequently employed.

　New Developments

　　The Clinical Laboratory Division started to provide urgent examination services for emergency cases on Saturday and the New Year holiday mornings.
　　In the anatomical pathology laboratories, an image data base (Oracle) has been developed for a cytopathology application system. Microscopic and macroscopic images captured by a digital still camera (1280 x 1000) are stored in the server coupled with other diagnostic information. The images are easily available in our existing medical imaging conference system.

　Statistics

Number of Laboratory Tests Examined in 1993-1998
Section199319941995199619971998
Urinalysis105,531 110,037 98,640 117,440 132,396 139,568
Hematology215,486 245,640 259,388 283,725 337,205 354,182
Biochemistry562,796 657,960 709,597 747,924 892,794 958,767
Serology48,428 53,141 63,918 79,583 90,582 97,124
Bacteriology13,562 15,481 16,939 17,620 21,411 20,429
Surgical Pathology5,182 6,196 6,629 7,293 8,180 8,452
Cytology5,120 6,506 6,299 6,625 7,057 6,881
Blood Banking12,071 12,057 14,949 20,479 24,727 22,361
Physiology15,944 17,207 20,919 22,412 23,131 23,754
Total984,120 1,124,225 1,197,278 1,303,101 1,537,483 1,631,518


　
Number of Examinations in the Anatomical Pathology in 1993-1998
Examinations199319941995199619971998
Biopsy4,048　4,815　5,262　5,890　6,713　6,908　
Operation1,134　1,381　1,367　1,403　1,467　1,544　
Cytology5,120　6,506　6,299　6,625　7,057　6,881　
Autopsy55　44　49　35　33　23　

(Y. Nishiwaki)　

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