The Guthrie bacterial inhibition assay (BIA) tests for elevated phenylalanine (PHE) by measuring B. subtilis growth zone density in an agar medium. Dried blood spots with elevated PHE on initial BIA screening undergo repeat BIA testing and thin-layer chromatography (TLC). Specimens with elevated PHE by TLC or BIA on second-tier testing require recall. To streamline PKU screening and reduce the recall rate, we tested a modified BIA protocol incorporating autoclaving of dried blood spots. Autoclaving improves growth zone appearance and has been previously reported to reduce the number of specimen requiring repeat testing. From June to October 2006, dried blood spot samples with initially elevated PHE were autoclaved at 110°C for 5 min, then retested by BIA. Samples with still-elevated PHE were analyzed by TLC. 1078 of 37,268 samples (2.89%) had initially elevated PHE. After autoclaving, 1036 no longer exhibited elevated PHE decreasing to 42 (0.11%) the number requiring TLC. By comparison, the unmodified algorithm resulted in 3.14% of samples received from July - December 2006 requiring both repeat BIA and TLC testing. We have since modified our PKU screening algorithm to require repeat BIA testing from autoclaved samples prior to TLC analysis. This translates to a significant reduction in time and resources for second-tier testing and follow-up, and prevents stress for the parents of a newborn who would have been recalled unnecessarily.

Agar ; Chromatography, Thin Layer ; Phenylalanine ; Mandatory Testing ; Parents ; Algorithms ; Phenylketonurias

PURPOSE: A questionnaire is a mandatory screening tool for the deduction of an androgen deficiency in aging males (ADAM). The aim of this study was to translate the ADAM questionnaire into Korean and validate it linguistically. MATERIALS AND METHODS: Two native Korean speakers, who were also fluent in English, independently translated the original English version of the ADAM questionnaire into written Korean. A panel, consisting of the aforementioned translators and four urologists, reviewed the translations to form a single acceptable forward translation. Another translator, having never seen the original version, back-translated the first draft into English. The discrepancies between the original form and the first draft of the Korean translation were reviewed by the panel. Cognitive debriefing interviews with five impotent males with low serum total testosterone levels (>250 ng/dl) were conducted to test the interpretation of the translation. RESULTS: After the forward translation of the ADAM questionnaire, the cultural, linguistic and emotional aspects were discussed, item-by-item, to arrive at a first version. Another bilingual translator then back- translated the first Korean version into English. The panel discussed every discrepancy and decided to modify questions 6 and 8 (second version). Five ADAM patients gave their opinions on the understandability of the translated questionnaire and clarified the questions on a standard form. Through this cognitive debriefing process, the second version was verified as the final Korean version of the ADAM questionnaire, without modifications. CONCLUSIONS: The linguistic validation of Korean version of the ADAM questionnaire has been completed, which might be a useful and reasonable screening tool for the detection of androgen deficiency in aging Korean males.
Aging* ; Humans ; Linguistics ; Male* ; Mandatory Testing ; Mass Screening ; Surveys and Questionnaires* ; Testosterone ; Translations

BACKGROUND: Tissues for transplantation can save lives or restore essential functions. According to national policies and regulations, access to suitable transplantation, as well as the level of safety, quality, efficacy of donation, and transplantation of tissues, differ significantly between countries. We reviewed a few guidelines on tissue banking from the aspect of screening tests. In addition, four-year experience with screening panels for donated bones and donors at a tertiary hospital is introduced. METHODS: Seven national and international guidelines for screening tests for donors and donated tissues were reviewed. At our institution, screening tests for donation involve two steps. At retrieval, the first screening panel, including ABO/Rh typing, unexpected antibody screening, VDRL, HBsAg, anti-HBs, anti-HBc IgM, anti-HCV, anti-HIV, and microbiological cultures was performed. The second screening panel, including the same tests, except culture studies, was performed after 90 days. From 2008 to 2011, a total of 245 retrievals of bone tissue were performed and the screening panel results were analyzed. RESULTS: Mandatory screening serologic tests for living donors can differ according to local law or regulation and/or screening for endemic diseases. At our institution, among 245 donated bones for a period of four years, 61 bone tissues were discarded due to noncompliance for the second screening (n=32), contamination or no culture study results (n=9), abnormal serologic test results (n=8), and so on. CONCLUSION: Donor screening policies for tissue banking are various according to national laws or endemic disease status. Second screening tests with consideration of the window period should be adopted.
Adoption ; Bone and Bones ; Donor Selection ; Endemic Diseases ; Hepatitis B Surface Antigens ; Humans ; Immunoglobulin M ; Jurisprudence ; Living Donors ; Mandatory Testing ; Mass Screening ; Serologic Tests ; Social Control, Formal ; Tertiary Care Centers ; Tissue Banks ; Tissue Donors ; Transplants