O-6 : Assessment of Rapid Antigen Tests for the Detection of Pandemic Influenza A (H1N1) Virus

( Hyun Lee ),( Sei Ick Joo ),( Eui Chong Kim ) 대한임상병리사협회 2009 임상미생물검사학회 발표자료집 Vol.2009 No.-

Background: Rapid antigen tests could play an important role in the detection of novel influenza A virus in epidemic countries. We investigated the detection limits of rapid influenza virus antigen tests and compared them with the cycle threshold (Ct) value detected by real-time RT-PCR assay. Methods: Fifty-four nasopharyngeal specimens were tested. All of them were positive in CDC real-time RT-PCR assay for Influenza A (H1N1). The specimens were tested using 4 kinds of rapid influenza antigen test kits such as QuickVue (Quidel Corp., USA), Directigen (Becton, Dickinson Com., USA), BinaxNOW (Binax Inc., USA) and SD (Standard Diagnostics Inc., Korea). To determine the limits of detection, one specimen which showed the lowest Ct value (15.7162) in this study was serially diluted 2-fold down to 213 and each dilute was tested by four rapid influenza antigen kits and real-time RT-PCR assay. Results: Twenty-three specimens (42.6%, Directigen and QuickVue) and Twenty-two specimens (40.7%, Binax and SD) were shown as positive by the rapid influenza antigen tests, respectively, and the Ct values of these specimens ranged from 15 to 23. In the higher Ct value group of over 24, the rapid influenza antigen tests did not detect the pandemic influenza A virus. The limit of detection of rapid antigen tests for the novel influenza A virus was lower than the Ct value of 23. In 16 specimens collected at 2 days after onset, 15 specimens were positive (93.75%). Conclusion: Rapid influenza antigen tests are useful to detect the pandemic influenza virus within 2 or 3 days after onset. The sensitivity of four rapid antigen detection kits is too low so that their negative results can not rule out pandemic influenza.

The Incidence and Clinical Implication of Sputum with Positive Acid-fast Bacilli Smear but Negative in Mycobacterial Culture in a Tertiary Referral Hospital in South Korea

이재석,( Eui Chong Kim ),( Sei Ick Joo ),( Sang Min Lee ),( Chul Gyu Yoo ),( Young Whan Kim ),( Sung Koo Han ),( Young Soo Shim ),( Jea Joon Yim ) 대한결핵 및 호흡기학회 2007 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.105 No.-

S-4 : The Aspects of Clinical Microbiology Laboratory in Korea

( Jang Ho Lee ),( Sei Ick Joo ),( Ji Sang Kang ),( Min Jung Kim ) 대한임상병리사협회 2009 임상미생물검사학회 발표자료집 Vol.2009 No.-

Although various techniques such as molecular biological analysis has been introduced in the field of clinical microbiology laboratory, the major and most important tasks still remain the isolation and identification of pathogenic bacteria and the antimicrobial susceptibility test for the isolates. The Korean Society of Microbiological Laboratory Sciences conducted a survey on the basic process and techniques or methods of clinical specimen culture in Korea. This was the first survey for the clinical microbiology laboratory in Korea. We report the results below. The survey was conducted from June to July 2009, and the target group was a total of 300 clinical microbiology laboratories which performed bacterial culture and which had a membership in The Korean Association of Quality Assurance for Clinical Laboratory. In the survey, basic information of the surveyed hospital or laboratory, culture media usage according to specimen site, antimicrobial susceptibility test and its statistic aspects, and mycobacterial culture methods were investigated. 59 laboratories in the target group of 300 laboratories (19.6%) participated in this survey. They consisted of 21 university hospitals, 31 general hospitals, 6 primary hospitals, and 1 commercial laboratory. All participants performed Gram stain, acid-fast stain, and bacterial culture. Of all participating laboratories, mycobacterial culture was tested in 35 laboratories, fungus were cultured and identified in 33 labs, and virus culture was performed in 8 labs. In 16 laboratories, molecular tests were reported. All of the results were analyzed according to hospital groups. In spite of the low response rate in this survey, most participants were in reference laboratories of each hospital group, and the survey results present the valuable aspects of clinical microbiology laboratory in Korea. The results will be useful data to build-up strategies, and the standardization of clinical microbiology laboratory in Korea.

북한 임상검사인력에 대한 고찰

Bon-Kyeong Koo,Sei Ick Joo,Dai-Joong Kim,In-Ho Jang 대한임상검사과학회 2020 대한임상검사과학회지(KJCLS) Vol.52 No.1

There is a noticeable gap in the personnel structures of clinical laboratories between North Korea and South Korea. In North Korea, ‘Laboratory Doctor’ is similar to the workforce of ‘Medical Technologist (commonly known as Clinical Laboratory Technologist or Medical Laboratory Scientist)’ in South Korea. Considering preceding research based on the verbal evidence of North Korean healthcare personnel defectors, it is estimated that the status of laboratory doctor in North Korea generally corresponds to physician and feldsher (such as physician assistant in Western countries). Physicians and feldshers are trained and fostered for five and a half years in medical universities and for three years in medical vocational schools (so-called junior college of medicine). Unlike South Korea, the North Korea’s healthcare personnel system does not subdivide the tasks, education, qualifications and law regarding the specialties of health experts. It is thought that the Korean Association of Medical Technologists needs to collaboratively search and present the milestones for establishment of a professional system on clinical laboratory personnel in North Korea through cooperative research on policies with the related organizations for better preparation of the unification of the Korean Peninsula. 북한과 남한은 임상검사실 인력구조에서 차이가 있다. 북한에서는 남한의 ‘임상병리사’에 해당하는 유사인력을 ‘실험의사(검사의사)’라고 호칭한다. 본 연구자들은 탈북 보건의료인의증언을 바탕으로 한 선행연구를 고찰해 보면, 검사의사(laboratory doctor)의 신분은 의사(physician)와 준의(feldsher, physician assistant)일 것이라고 사료된다. 의사와 준의는 5.5년제 의학대학 및 3년제 의학전문학교에서 양성되고있다. 북한의 보건의료인력체계는 남한의 경우처럼 보건전문가들의 전문영역별 업무나 교육, 자격 및 법률이 세분화되어 있지않다. 대한임상병리사협회는 한반도 통일을 대비하여 유관 단체와 함께 정책연구를 통해서 북한 임상검사인력에 대한 직제전문화 구축과 발전 방향을 상호 모색해야 할 것으로 사료된다.

The Incidence and Clinical Implication of Sputum with Positive Acid-Fast Bacilli Smear But Negative in Mycobacterial Culture in a Tertiary Referral Hospital in South Korea

Lee, Jae Seok,Kim, Eui-Chong,Joo, Sei Ick,Lee, Sang-Min,Yoo, Chul-Gyu,Kim, Young Whan,Han, Sung Koo,Shim, Young-Soo,Yim, Jae-Joon Korean Academy of Medical Sciences 2008 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.23 No.5

Although it is not rare to find sputum that is positive acid-fast bacilli (AFB) smear but subsequent culture fails to isolate mycobacteria in clinical practice, the incidence and clinical implication of those sputa from new patients has not been clearly elucidated. The aim of this study was to determine the incidence and clinical implication of sputum with positive AFB smear but negative in mycobacterial culture. All sputa that were positive AFB smear requested during diagnostic work up for new patients visiting Seoul National University Hospital from 1 January 2005 through 31 December 2006 were included. Sputa producing a positive AFB smear but negative mycobacterial culture were classified into one of four categories: laboratory failure to isolate mycobacteria, false positive AFB smear, pathogen may show a positive AFB smear other than mycobacteria, and indeterminate results. Out of 447 sputa with a positive AFB smear, 29 (6.5%) failed to culture any organism. Among these 29 sputa, 18 were caused by laboratory failure to isolate mycobacteria, six were false positive smears, and five indeterminate. Although most sputum with a positive AFB smear but negative culture could be classified as a laboratory failure, clinicians should consider the possibility of false positive AFB smear.

Molecular Epidemiology of Clinical Cryptococcus neoformans Isolates in Seoul, Korea

( So Hae Park ),( Mina Kim ),( Sei Ick Joo ),( Soo Myung Hwang ) 한국균학회 2014 Mycobiology Vol.42 No.1

Cryptococcal infection is primarily caused by two species, Cryptococcus neoformans and C. gattii. Between the twospecies, C. neoformans var. grubii is the major causative agent of cryptococcosis in Asia. We investigated the molecular characteristics of 46 isolates of C. neoformans from patients with cryptococcosis between 2008 and 2012 in Seoul, Korea. All the isolates were determined to be C. neoformans var. grubii(serotype A), mating type MATα, and molecular type VNI by PCRrestriction fragment length polymorphism of the URA5 gene. Multilocus sequencing type(MLST) analysis using the International Society of Human and Animal Mycoses(ISHAM) consensus MLST scheme identified two sequence types(ST). Out of the 46strains, 44(95.7%) were identified as ST5, and remaining 2 were identified as ST31. Our study revealed that the clinical strains ofC. neoformans in Korea are genetically homogeneous with the VNI/ST5 genotypes, and new appearance of VNI/ST31 genotype may serve as an important indicator of global genetic analysis.

감염관리 분야에서 감시배양검사의 표준화 연구

박창은 ( Chang-eun Park ),정나연 ( Na-yeon Jeong ),양민지 ( Min-ji Yang ),김한울 ( Han-wool Kim ),주세익 ( Sei-ick Joo ),김건한 ( Keon-han Kim ),성희경 ( Hee-kyung Seong ),황유연 ( Yu-yean Hwang ),임현미 ( Hyun-mi Lim ),손재철 ( J 대한임상검사과학회 2018 대한임상검사과학회지(KJCLS) Vol.50 No.3

의료 관련 감염을 예방하기 위한 필수적 방법은 일관성이 있는 감염감시 시스템을 구축하고 효율적인 감시 통제를 수행하기 위해 신뢰할 수 있는 상황에 대해 진단을 향상시켜나가는 것이다. 또한 의료 종사자의 손과 의복 및 장비는 환자 관리 및 환경과 접촉하여 병원체가 오염되는 요인이다. 병원체를 가진 시설 표면(예: 침대 레일, 침대 옆 탁자), 음용수, 냉각탑용수, 내시경기구, 급식위생, 공기매개, 멸균검사, 내독소검사, 및 의료 장비를 포함한 의료 환경의 오염은 일반적으로 발생한다. 또한 이러한 감염원을 활동 감시를 통해 MLST, PFGE의 기법으로 역학 분석을 수행한다. 따라서 HAI 예방을 위한 환경 감시배양 검사는 환자의 안전과 감염원의 차단을 향상시킬 뿐만 아니라 국가의 감염관리 시스템을 통제하여 최적의 효율적인 감염관리 예방을 가능케 하고 국가의 감염관리 시스템의 안전을 향상시킨다. 결론적으로 감시배양 검사의 표준화를 통해 실효성 있는 감염관리체계에 이바지하고 감염관리 전문인력으로서의 전문성을 확보하고자 한다. 이를 통해 표준화 마련의 일차적인 목표는 의료관련 감염을 줄이고 국가적 의료관리 체계를 향상시키는데 있다. An essential measure to prevent healthcare-associated infections (HAI) is to develop a consistent system of surveillance, thereby promoting a reliable situation diagnosis to perform efficient control for the problem. Patient-to-patient transmission of pathogens within the hospital plays a substantial role in the epidemiology of HAIs. Contamination of healthcare environments commonly occurs, including facilities surfaces (e.g., bed rails, bedside tables), drinking water, cooling tower water, endoscopic instruments, food, airborne, endotoxin test, sterile test and medical equipment, with pathogenic organisms. In addition, epidemiological analysis is performed by multi locus sequence tying, pulsed-field gel electrophoresis for active surveillance. Therefore, an environmental surveillance culture test for prevention improves patient safety and blocks infection agents. Effective infection control and increased safety are possible by controlling the national infection control system. In conclusion, this study contributes to an effective infection control system through the standardization of active surveillance culture laboratory and secure expertise as infection control specialist. The primary objective of the standardization is to improve the safety of the nation’s healthcare system by reducing the rates of HAIs.

쿠싱 증후군 산모에서의 부신피질 적출술 후 정상분만 경험예

양성식,김용성,김미림,남문석,홍성빈,김여주,김영완,이병익,조용범,신석환,김세중 대한내분비학회 1999 Endocrinology and metabolism Vol.14 No.3

We experienced a case of Cushings syndrome due to adrenal adenoma associated with pregnancy 23th week in a 26 year old female patient. On physical findings, hypertension, moon face, hirsutism, abdominal striae and buffalo hump were noticed. Laboratory findings showed increased serum cortisol, increased 24 hours-urinary cortisol, and decreased plasma ACTH. Abdominal MRI demonstrated 4 cm sized in long diameter, well marginated, and ovoid-shape right adrenal mass. Unilateral total adrenalectomy was performed at the 23th week of pregnancy and the mass it was confirmed to benign adrenal adenoma. Steroid replacement therapy was continued with 7.5 mg prednisolone during remaining pregnancy. At the 38th week of pregnancy, labor was developed and she delivered healthy female weighing 2.5 kg through normal vaginal delivery without complication. Pregnancy rarely occurs in patients with Cushings syndrome. We think she was the first case in Korea who had normal 38th week transvaginal delivery after adrenalectomy in adrenal Cushings syndrome during pregnancy (1 Kor Soc Endocrinol 14:562-567, 1999).

대한임상검사과학회지 50년사: 명칭과 KCI 등재에 대하여

구본경,성호중,이기종,양병선,주세익,최승구,장인호,양만길,Koo, Bon-Kyeong,Sung, Ho Joong,Rhee, Ki-Jong,Yang, Byoung-Seon,Joo, Sei Ick,Choi, Seung-Gu,Jang, In-Ho,Yang, Man-Gil 대한임상검사과학회 2017 대한임상검사과학회지(KJCLS) Vol.49 No.3

The Korean Society for Clinical Laboratory Science publishes the Korean Journal of Clinical Laboratory Science (KJCLS) as the official journal for the Korean Association of Medical Technologists. This year, 2017, marks the 50th anniversary of KJCLS. The original name was "the Korean Journal of Medical Technologists" (Volume 1, 1967~Volume 26, 1994), which was replaced with the "Korean Journal of the Clinical Laboratory Science" (Volume 27, 1995~Volume 35, 2003) and "the Korean Journal of Clinical Laboratory Science" (Volume 26, 2004~Present). The purpose of this study was to provide a framework for further development of KJCLS. In 1998, the National Research Foundation of Korea began the journal assessment service. The major domestic databases are KCI, KOFST, and KAMJE; the major international databases are SCI Index; SCI Core, SCI-Extended), SCOPUS, MEDLINE, and PUBMED. KJCLS has been registered with KCI of the National Research Foundation of Korea since 2014. More than 1,300 articles have been published, which all have made tremendous contributions to the field. To index KJCLS in the journal databases, we measured the value to understand the vocational level and social position. KJCLS is faced with a great challenge; immense effort will be needed to accomplish the original goal of KJCLS to become an internationally recognized journal. Ultimately, the goal of the Korean Society for Clinical Laboratory Science and the Korean Association of Medical Technologists should be to register KJCLS in databases such as KCI and SCOPUS.

우수한 임상병리사 양성을 위한 교육제도 및 국가면허시험제도에 대한 설문조사 분석

김홍성 ( Hong Sung Kim ),권필승 ( Pil Seung Kwon ),강지혁 ( Ji-hyuk Kang ),양만길 ( Man-gil Yang ),박종오 ( Jong O Park ),김대중 ( Dae-joong Kim ),김원식 ( Won Shik Kim ),주세익 ( Sei Ick Joo ),김은중 ( Eun-joong Kim ),이선경 ( Su 대한임상검사과학회 2017 대한임상검사과학회지(KJCLS) Vol.49 No.2

본 연구는 대학 교육제도와 국가면허시험 제도에 대한 교수와 병원실무자들의 의견을 조사하여 분석함으로써 우수한 임상병리사 양성을 위한 정책방향을 결정하는데 목표로 하고 있다. 2016년 8월에 온라인 설문지가 255명의 대학교수들과 4,000명의 병원실무자들에게 배포되었다. 회수율은 교수들은 59명(23%), 병원실무자들은 1,099명(27.7%)이 응답하였다. 결과는 기술통계분석과 비교분석을 통해 처리하였다. 대학 교육제도에서는 교수들과 병원실무자들 모두 대학 및 임상실습 교육의 질적 향상과 교육의 표준화가 필요하다고 조사되었다. 국가면허시험제도에서는 교수들과 병원실무자들 모두 특히 실기시험의 개편이 필요하다고 조사되었고, 면허시험제도도 개선이 필요하다고 조사되었다. 위의 결과들은 교수들과 병원실무자들은 우수한 임상병리사 양성을 위해서는 대학 및 임상교육의 질적 향상과 국가면허시험제도의 개선이 필요하다고 생각하고 있음을 보여준다. This study aimed at characterizing policy directions to foster competent medical technologists by analyzing the opinions of professors and medical technologists regarding university education and national licensing systems. An online survey questionnaire was distributed to 255 professors and 4,000 medical technologists in August of 2016. Fifty-nine professors (23%) and 1,099 medical technologists (27.7%) responded to the survey. The results were evaluated using descriptive statistics and comparative analysis. Professors and medical technologists agreed that there needs to be an improvement and standardization in both education at universities and practical training at hospitals. Moreover, both groups also thought that it was necessary to reform practical examinations and make improvements in the current licensing system. According to the survey results, professors and medical technologists thought that, the improvement of the quality of university education and hospital practical training should be essential, and the reform of existing national licensing examination should be necessary.