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 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 sampling
section is located near the outpatient clinic and 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.
We have
utilized a compact laboratory automation system in the biochemistry, endocrinology,
tumor markers, and immunology sections since 1999. 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.
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. A technologist at the section helps the collection of
peripheral stem cells from patients. 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.
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 has been applied since 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. Methylation was observed in a part of colorectal
cancer tissues for the hMLH1, p16, and HIC1 genes. Methylation status of the
hMLH1 and p16 gene promoters was correlated with micro-satellite instability
status, tumor location, and differentiation but not with K-ras mutation or
allelic loss of p53. We investigated
the methylation status of hTERT gene and found that the promoter region of
hTERT gene was methylated but that hTERT expression was elevated in cancer
tissues.
Recent
studies revealed that the t(11;18)(q21;q21) is often found in low-grade mucosa-associated
lymphoid tissue (MALT) lymphomas, and that API2 and MLT genes are recurrently
rearranged. We established a sensitive RT-nested PCR system to detect the
rearranged products, by a collaboration with hematology division.
We tried
to directly amplify the chimeric transcripts from whole blood. The preparation
of DNA or RNA is time-consuming, and it is convenient unless we need the preparation.
We could reveal the possibility that the chimeric transcripts are amplified
from whole blood without preparation of nucleic acids.
We have been challenging the early diagnosis of pancreatic cancer by means of biological fluids, such as blood or urine. This is a very difficult trial, but it is a highly important issue.
|
Numbers of Laboratory Tests Performed in
2000 |
|
||
|
Section |
Total |
Outpatients |
Inpatients |
|
Urinalysis |
501,334 |
305,820 |
195,514 |
|
Biochemistry |
2,383,558 |
1,273,652 |
1,109,906 |
|
Immunology |
210,535 |
133,706 |
76,829 |
|
Hematology |
861,022 |
409,738 |
451,284 |
|
Bacteriology |
49,843 |
8,520 |
41,323 |
|
Physiological tests |
35,207 |
25,890 |
9,317 |
|
Surgical pathology |
16,756 |
9,946 |
6,810 |
|
Cytology |
12,910 |
9,875 |
3,035 |
|
Blood transfusion tests |
73,689 |
22,947 |
50,742 |
|
Total |
4,144,854 |
2,200,094 |
1,944,760 |
(R. TSUCHIYA)
(M. MAEKAWA)
