No abstract available.
Stroke ; Subclavian Artery

No abstract available.
Glycoproteins* ; Oligodendroglia* ; Rubella virus* ; Rubella*

BACKGROUND: AU5822 Automated Clinical Chemistry Analyzer (Beckman Coulter, USA) is a fully automated analytical platform designed for the analysis of general chemistry, specific serologic proteins, therapeutic drug monitoring, and drug abuse testing. AU5822 is a high-throughput system that can process up to 5,800 tests per hour and is easy to maintain. In this study, we evaluated the performance of AU5822 on 31 analytes. METHODS: The precision, linearity, correlation, and sample carryover of 31 analytes were evaluated in accordance with the guidelines of the Clinical Laboratory Standards Institute (CLSI). Lyphochek (Bio-Rad Laboratories Inc., USA), Liquichek (Bio-Rad Laboratories Inc.), Validate (Marine Standard Company, USA), and patient sera were used in the analysis. For the correlation study, we carried out a comparison of AU5822 and Cobas 8000 Modular Analyzer (Roche, Switzerland). RESULTS: The coefficients of variation of all samples showed values below 5%. The coefficient of determination (R2) was > or =0.99, with linearity in the clinically important range. The comparison with Cobas 8000 showed a good correlation, with a correlation coefficient of >0.975 for all of the analytes, excluding sodium that had a correlation coefficient of 0.9641. The test values of percentage sample carryover were less than 0.89%. CONCLUSIONS: AU5822 performed well in terms of precision, linearity, comparison, and sample carryover in the established assays for 31 analytes. Therefore, Beckman Coulter AU5822 Automated Clinical Chemistry Analyzer is expected to be useful for routine chemistry analysis in hospitals with large test volumes.
Chemistry ; Chemistry, Clinical* ; Drug Monitoring ; Humans ; Sodium ; Statistics as Topic ; Substance Abuse Detection

No abstract available.
Drug Monitoring ; Sirolimus ; Tacrolimus

BACKGROUND: National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) is the guideline for detection evaluation, and treatment of high blood cholesterol in adults. The risk of coronary heart disease (CHD) is assessed by the presence of CHD risk equivalents and the number of risk factors. LDL-cholesterol is the goal of treatment for hyperlipidemia. Contents: The most common approach for determining LDL-cholesterol level in clinical laboratory is to calculate it based on Friedewald formula. For accurate risk assessment by the calculated LDL-cholesterol, good analytical performances of total cholesterol, HDL-cholesterol and triglyceride are prerequisite. Even if the analytical performance of these three analytes are within the acceptable criteria, pooled imprecision and bias of the calculated LDL-cholesterol could not meet the criteria for LDL-cholesterol. Even under conditions satisfying the requirements of Friedewald formula, the calculated LDL-cholesterol level was lower than the directly measured level and the difference was dependent on the level of triglyceride, LDL-cholesterol and total cholesterol. When evaluatingpatients with hyperlipidemia, Friedewald calculation may underestimate the risk for coronary heart disease which may lead to inappropriate treatment option. CONCLUSIONS: When evaluating patients with hyperlipidemia, direct measurement of LDL-cholesterol appears to be better than Friedewald calculation.
Adenosine Triphosphate ; Adult ; Bias (Epidemiology) ; Cholesterol ; Coronary Disease ; Humans ; Hyperlipidemias ; Lipoproteins ; Risk Assessment ; Risk Factors

Point-of-care (POC) testing is desirable because of both the ease with which it can be administered and its short turnaround time. However, because standard POC devices cannot transmit test results automatically to a laboratory information system (LIS), each result must be recorded by hand. This inconvenience not only increases the possibility of clerical errors, but also limits the proper use of test results. If POC test results are not saved in the LIS, it is hard to either monitor patients' health trends or to quality control (QC) the test results. In this paper, we describe how we have solved these problems by connecting 250 POC blood glucose test devices to the LIS via a local area network (LAN). After connecting the POC devices (we used the Accu-Chek Inform II; Roche Diagnostics, Germany) to a manufacturer-provided POC data management system (Roche's Cobas IT 1000; Roche Diagnostics), we developed our own interface program for delivering data from the Cobas IT 1000 system to the LIS. By installing a program to scan the identification barcode worn by patients on their wrists, network-connected POC devices enable users to omit extra ordering, receiving, and recording processes, and they also reduce the possibility of patient misidentification. Such a system also provides an effective way for physicians to follow both the current and accumulated test results of patients. We note that performing QC on glucometers and the sending of data via LAN to the LIS are necessary steps to monitor both patients' results and the QC of those results.
Blood Glucose* ; Clinical Laboratory Information Systems ; Glucose ; Hand ; Humans ; Local Area Networks ; Point-of-Care Systems ; Quality Control ; Wrist

BACKGROUND: We evaluated the performance of the GEM Premier 4000 (Instrumentation Laboratory, USA), a new blood gas/electrolytes/co-oximetry analyzer, according to the Clinical and Laboratory Standard Institute (CLSI) guidelines. METHODS: Within-run precision, total-run precision, linearity and sample-related carryover were analyzed using quality control materials at three different concentration levels for each analytes. Correlation was compared with the routinely used NOVA CCX2 (Nova Biomedical, USA) with patients' whole blood samples. RESULTS: The within-run and the total-run precisions of the GEM Premier 4000 showed very low CV of 0.04~4.40% and 0.06~4.11%, respectively, in all parameters except the lactate, which had CV of 5.58% in Level 1 QC material. The system showed a good linearity (r2=0.997~1.000, systemic error=0.00~0.20%) for all items. Sample-related carryover was -4.35%~0.15%. In comparison with the NOVA CCX2 instrument, correlation was high in all parameters with the r value ranging from 0.983-0.999 except for carboxyhemoglobin (r=0.804) and methemoglobin (r=0.010) whose concentrations were in the lower level. CONCLUSIONS: GEM Premier 4000 showed good analytical performance required for blood gas analyzer in its precision, linearity, sample-related carryover, and close correlation with NOVA CCX2. It fulfills most of the requirements for both point-of-care and laboratory use.
Carboxyhemoglobin ; Lactic Acid ; Methemoglobin ; Quality Control

No abstract available.
*Algorithms ; Automation ; Clinical Laboratory Information Systems/*standards ; Humans ; Immunoassay/*methods ; Indicator Dilution Techniques ; alpha-Fetoproteins/*analysis

BACKGROUND: We aimed to assess the performance of the five creatinine-based equations commonly used for estimates of the glomerular filtration rate (eGFR), namely, the creatinine-based Chronic Kidney Disease Epidemiology Collaboration (CKD-EPIcr), Asian CKD-EPI, revised Lund–Malmö (revised LM), full age spectrum (FAS), and Korean FAS equations, in the Korean population. METHODS: A total of 1,312 patients, aged 20 yr and above who underwent ⁵¹Cr-EDTA GFR measurements (mGFR), were enrolled. The bias (eGFR–mGFR) and precision (root mean square error [RMSE]) were calculated. The accuracy (P30) of four eGFR equations was compared to that of the CKD-EPIcr equation. P30 was defined as the percentage of patients whose eGFR was within±30% of the mGFR. RESULTS: The mean bias (mL·min⁻¹·1.73 m⁻²) of the five eGFR equation was as follows: CKD-EPIcr, -0.6; Asian CKD-EPI, 2.7; revised LM, -6.5; FAS, -2.5; and Korean FAS, -0.2. The bias of the Asian CKD-EPI, revised LM, and FAS equations showed a significant difference from zero (P<0.001). The RMSE values were as follows: CKD-EPIcr, 15.6; Asian CKD-EPI, 15.6; revised LM, 17.9; FAS, 16.3; and Korean FAS, 15.8. There were no significant differences in the P30 except for the Asian CKD-EPI equation: CKD-EPIcr, 76.6%; Asian CKD-EPI, 74.7%; revised LM, 75.8%; FAS, 76.0%; and Korean FAS, 75.8%. CONCLUSIONS: The CKD-EPIcr and Korean FAS equations showed equivalent analytical and clinical performances in the Korean adult population.
Adult* ; Asian Continental Ancestry Group ; Bias (Epidemiology) ; Cooperative Behavior ; Creatinine ; Epidemiology ; Glomerular Filtration Rate* ; Humans ; Renal Insufficiency, Chronic