Clinical Laboratory Division
Introduction
The Clinical Laboratory Division
consists of clinical pathology laboratories, physiological laboratories including
a laboratory for ultra-sonography (US), and anatomical pathology
laboratories. At the beginning of 1999, the hospital
moved to a new building and medical care has started at the new hospital.
The division has a newly designed laboratory room, a new order entry system,
and a new laboratory system. The use of these new facilities and systems is
the topic of study this year.
The clinical pathology laboratories
consist of eight sections: biochemistry, endocrinology, urinalysis, hematology,
tumor markers, immunology, bacteriology, genetic testing, and blood banking.
The physiological laboratories consist of four sections: US, electrocardiography,
electroencephalography, and respiratory function testing. The sections of
the Clinical Laboratory Division assist clinicians in diagnosis and treatment
by providing laboratory data.
Routine Activities
There are 8 doctors, 38 medical
technologists, and 4 assistants working in the clinical pathology and physiological
laboratories. One monthly conference for laboratory management and several
weekly conferences in each section are held.
The Clinical Laboratory Division
plays an important role as one of the diagnostic divisions, examining daily
laboratory specimens, screening for various disorders, and conducting urgent
tests to assist in prompt therapeutic decisions made by internists and surgeons.
Most of the tests are processed and their values are determined employing
automated analyzers. The laboratories receive a large number of specimens
to be tested for tumor markers or to undergo other tumor-associated tests.
New markers are also evaluated. The new markers available in 1999 were HCV-RNA
quantification, serum hCG (germ cell tumor marker), and 1,5-AG (marker of
diabetes mellitus). We transferred the measurement of enzyme activities, such
as AST, ALT, CK, ALP, and gGTP to the Japanese Society of Clinical Chemistry (JSCC) method for
standardi-zation.
A new activity of our clinical
laboratory is assisting the sampling section, which is located near the outpatient
clinic and which is accompanied by a satellite laboratory. Two full-time technologists
and 2 part-time technologists take blood from patients and examine blood counts
and the like at the satellite laboratory. The sampling section and the satellite
laboratory are also assisted by new laboratory system.
We have introduced a compact
laboratory automation system in the biochemistry, endo-crinology, tumor markers,
and immunology sections. Under this system, blood specimens are automatically
checked in, samples for the main biochemical analyzer were picked up and automatically
examined, and then samples for other automated analyzers are distributed.
With these automated systems, technologists can play a more important role
in data processing.
The bacteriology section performs
DNA/RNA analysis as well as classic cultures for identifying infectious agents,
and it is also active in the control of hospital infection. A new order entry
system for bacteriology was introduced at the end of March. The role of the
blood banking section is to confirm blood types, to screen for irregular antibodies,
and to supply blood and its products as required, rapidly and safely. The
laboratory system for blood banking, especially tests for transplantation,
was systematically integrated. The genetic tests laboratory assists in the
high-quality advancing medicine protocol. The contents are DNA or RNA tests
for the differential diagnosis of hematological malignancies and other malignancies
in any field. This laboratory could become an independent section in the Clinical
Pathology Division.
In the physiological laboratories,
US plays an important role in imaging diagnostic procedures for diseases of
the abdominal organs, breast, thyroid gland, and other organs. Sonographic
examinations are frequently performed before and after chemo-therapy or surgery.
A new US filing system was introduced at the beginning of 1999. The system
gives us effective data utilization and easy and simple handling.
Research Activities
We have made efforts to provide
more useful laboratory information and services and to develop more effective
laboratory procedures. These activities include a search for better methodologies
and technologies.
Aberrant DNA methylation has
been identified as an important alternate mechanism in the inactivation of
tumor suppressor genes and mismatch repair genes during neoplasia. We developed
a procedure combining bisulfite treatment and PCR-SSCP and analyzed the methylation
status of several suppressor oncogenes and mismatch repair genes in clinical
samples
|
Numbers
of Laboratory Tests Performed in 1999 |
|||
|
Section |
Total |
Outpatients |
Inpatients |
|
Urinalysis |
474,196 |
275,077 |
199,119 |
|
Biochemistry |
2,063,087 |
1,121,301 |
941,786 |
|
Immunology |
183,241 |
118,325 |
64,916 |
|
Hematology |
754,828 |
372,284 |
382,544 |
|
Bacteriology |
41,709 |
5,896 |
35,813 |
|
Physiological tests |
33,378 |
23,181 |
10,197 |
|
Surgical pathology |
15,181 |
8,933 |
6,248 |
|
Cytology |
12,651 |
9,849 |
2,802 |
|
Blood transfusion tests |
54,920 |
13,431 |
41,489 |
|
Total |
3,633,191 |
1,948,277 |
1,684,914 |
(M.
MAEKAWA)
