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.

임상병리사 명칭 변경을 위한 타당성 연구

구본경 ( Bon-kyeong Koo ),김원식 ( Won Shik Kim ),박선구 ( Sun Gu Park ),박종오 ( Jong O Park ),윤성민 ( Seong Min Yoon ) 대한임상검사과학회 2021 대한임상검사과학회지(KJCLS) Vol.53 No.1

임상병리사 명칭 변경과 관련한 의견을 수렴하기 위해 사단법인 대한임상병리사협회에서는 정회원으로 등록된 총 22,638명에게 온라인을 통해 제시된 명칭에서 2개를 선택하는 설문 답변을 요구하였으며 이 중 3,999명(17.66%)이 설문조사에 회신 답변하였다. 명칭 선호도는 회원 1인당 2개를 선택하는 답변을 통해서 6,958건이 산출되었으며 그 중 5,555건(79.83%)가 ‘분석사’ 레벨을 선호하였다. 명칭에 대한 조사결과는 진단검사분석사가 2,417건(34.73%)으로 가장 많았고, 임상검사분석사는 1,710건(24.57%), 의생명병리사는 758건(10.89%), 의생명분석사는 730건(10.49%), 의생명검사분석사는 730건(10.03%), 임상검사과학사는 646건(9.26%) 순으로 조사되었다. 따라서 조사된 회원들의 요구도, 자문, 문헌고찰, 표준직업분류, 주요 대상국 현황을 기반으로 “진단검사분석사(Diagnostic Laboratory Analyst), 의생명검사분석사(Biomedical Laboratory Analyst), 의생명분석사(Biomedical Analyst)”를 명칭 정립으로 제언하고자 한다. To investigate and accommodate opinions on the revision of the official occupational title of the medical technologist, the Korean Association of Medical Technologists (KAMT) requested 22,638 people registered as its regular members to participate in an online survey and select their two preferred options from the alternative job titles presented. Survey responses were collected from 3,999 people (17.66%). To examine job title preferences among the KAMT members, each respondent was asked to choose two terms from the choice set. As a result, 6,958 responses were obtained, and out of the total responses, 5,555 (79.83%) indicated a choice for a job title that included the word ‘analyst’ as the preferred alternative. The survey results showed that “Diagnostic Laboratory Analyst” was the most preferred alternative selected by the largest proportion of respondents (2,417 responses, 34.73%), followed by “Clinical Laboratory Analyst” (1,710 responses, 24.57%), “Biomedical Pathology Technologist” (758 responses, 10.89%), “Biomedical Analyst” (730 responses, 10.49%), “Biomedical Laboratory Analyst” (730 responses, 10.03%), and “Clinical Laboratory Scientist” (646 responses, 9.26%). Therefore, based on the responses of the surveyed members, results of consultation and literature review, the Standard Classification of Occupations (SCO), and the current status of the job titles used in major countries, it is suggested that the occupational title of medical technologists should be changed by adopting “Diagnostic Laboratory Analyst”, “Biomedical Laboratory Analyst”, or “Biomedical Analyst” as their new official job title. Copyright Ⓒ 2021 The Korean Society for Clinical Laboratory Science. All rights reserved.

안저 출혈 시 형광안저혈관조영술 및 대체 검사의 유용성

연제진 ( Je-jin Yeon ),구본경 ( Bon-kyeong Koo ),박상구 ( Sang-ku Park ) 대한임상검사과학회 2021 대한임상검사과학회지(KJCLS) Vol.53 No.3

안저 출혈은 망막 조직과 혈관의 이상을 의미한다. 따라서 안과 의사는 안저의 출혈성 변화가 발생하면 이에 따른 치료 계획을 수립하기 위해 치료 전과 치료 중간, 치료 이후 등 병변의 진행 상황을 파악하기 위해 여러 가지 안과 검사의 출혈 성 정도의 평가를 위해 오더를 지시한다. 현재 가장 유용하고 보편적인 안저검사에는 빛간섭단층촬영(OCT), 안저촬영(FP), 형광안저혈관 조영술(FAG) 등이 있다. 중증 안저 출혈에 대한 치료 계획을 수립하기 위한 기존의 형광안저혈관조영술 검사에는 한계가 있다. 저자들은 광각형광혈관조영술을 이용하여 동공주위촬영과 5-quadrant 방법을 수행할 것을 제안한다. 이 방법을 사용하면 신속히 검사 부위를 결정하고 최대한 출혈의 반경을 피해 안과 의사에게 손상된 조직과 이상 혈관의 범위를 제공할 수 있다. 그런데도 불구하고 안과 의사가 안저 출혈이 매우 심각하여 광각 형광혈관조영술이 무의미하다고 판단하는 경우가 있다. 이런 경우 대체검사로 안과초음파 및 망막전위도의 오더가 발생한다. 따라서 우리는 안 초음파 및 망막전위도 검사 필요성에 대해 당위성을 인정해야 하고, 정확하게 수행해야 한다. Fundus hemorrhage refers to abnormalities in the retinal tissue and blood vessels. Therefore, when a hemorrhagic change in the fundus occurs, the ophthalmologist orders various ophthalmic tests to evaluate the degree of hemorrhage and determine the progress of the lesion before, during, and after treatment to accordingly establish a treatment plan. Currently, the most useful and universal fundus examination includes optical coherence tomography (OCT), fundus photography (FP), and fluorescein angiography (FAG). Existing fluorescein angiography test methods for establishing a treatment plan for severe fundus bleeding have limitations. The authors propose that peripheral pupil and the 5-quadrant method should be performed using ultra-wide-angle fluorescence fundus angiography (UWFFA). Using this method, it is possible to quickly determine the area to be described, avoid the radius of bleeding as much as possible, and provide the ophthalmologist with a range of damaged tissue and abnormal blood vessels. Nevertheless, there are cases in which ophthalmologists judge that fundus bleeding is so severe that ultra-wide-angle fluorescence fundus angiography is meaningless. In such cases, ophthalmic ultrasound and electroretinogram may be used in that order as alternative methods of examination. Therefore, some clinical situations require the use of ophthalmic ultrasound and electroretinogram and should be performed accurately. Copyright Ⓒ 2021 The Korean Society for Clinical Laboratory Science. All rights reserved.

임상병리사 업무 범위와 법률적 고찰

심문정 ( Moon-jung Shim ),구본경 ( Bon-kyeong Koo ),박창은 ( Chang-eun Park ) 대한임상검사과학회 2017 대한임상검사과학회지(KJCLS) Vol.49 No.2

최근 과학과 의료기술의 발전으로 의료행위에 있어 많은 변화를 가져왔으며 환자의 치료에 있어 그 역할이 강조되고 있다. 특히 임상병리사의 경우, 역할과 중요성이 의료과학 분야가 발달함에 따라 증가되고 있으며, 이에 따른 책임감 역시 증가하고 있다. 임상병리사의 전문성과 독립성의 증가로 더 이상 의사의 보조로만 여기지 않고, 의사의 진료와 의료기사 등의 의료 보조행위에 기초하여 현대 의료서비스는 보다 조직화되고 복잡화, 전문화 되고 있다. 그러나 “의료기사 등에 관한 법률”에서는 의료기사는 의사 또는 치과의사의 지도하에서만 면허범위 내의 행위가 가능하도록 규정하고 있다. 그래서 본 연구에서는 각종의료행위에 있어서 임상병리사를 중심으로 하여 “의료기사 등에 관한 법률”에서 나타나는 문제점과 그 중에서도 의료업무, 의료지도에 관한 부분 등에 관해 살펴보았다. 결론으로 “의료기사 등에 관한 법률”에 명시된 의사의 지도에 대한 명확한 해석이 필요하며, 국가면허시험의 자격과 역할을 “의료기사 등에 관한 법률”에 명시하고, 임상병리사의 역할에 대해 보건의료인들과의 소통 또한 필요하며, 독립된 법제정으로 임상병리사들의 영역 확대와 전문성을 확대 강화하는 것이 필요할 것이라고 생각한다. In recent years, medical practice has seen a drastic change due to the rapid, exponential expansion of scientific and medical technologies. Specially, the role of medical technologists (also known as medical laboratory scientists and/or clinical laboratory scientists) are increasing in the development of science of medical technology. As such, their responsibility has also been increasing. Therefore, given their highly specialized knowledge and skills, they are not regarded solely as doctor`s assistants. Their independence and deeper specialization have been increasing, as they perform medial practices under the guidance of doctors or dentists pursuant to the “Act on Medical Service Technologists.” From a legal point of view, medical guidance and scope of work were examined. As a conclusion, the definition of doctor`s superintendency on the “Act on Medical Service Technologists” is required, and the qualification for the Korean license examination and their roles should be stated clearly. Moreover, communications among health professions regarding the roles of medical technologists are necessary to further facilitate clarification of their role. There is a need for independent legislation to expand the field of medical technologists and to strengthen their professionalism.

비뇨생식기계 검체로부터 분리된 Ureaplasma 종의 Fluoroquinolone 내성과 관련된 gyrA, gyrB, parC, parE 유전자의 돌연변이 양상

조은정 ( Eun Jung Cho ),황유연 ( Yu Yean Hwang ),구본경 ( Bon Kyeong Koo ),박제섭 ( Jesoep Park ),김영권 ( Young Kwon Kim ),김성현 ( Sunghyun Kim ) 대한임상검사과학회 2016 대한임상검사과학회지(KJCLS) Vol.48 No.2

Fluoroquinolone 계 항생제의 광범위한 사용으로 인해 이 약제에 대한 내성 Ureaplasma 종의 분리 비율이 높아지고 있다. Fluoroquinolone 계 항생제 내성은 주로 DNA gyrase와 topoisomerase IV 유전자의 돌연변이로 인해 발생하는 것으로 알려져 있다. DNA gyrase는 A와 B 2개의 소단위로 이루어져 있으며, gyrA와gyrB 유전자에 의해 암호화되어 있고, Topoisomerase IV는 parC와 parE 유전자에 의해 암호화되어 있다. 본 연구가 진행된 서울의 1개 3차 병원에서 2012년부터 2013년까지 1년동안 Ureaplasma 종의 fluoroquinolone 계 항생제인 OFL과 CIP의 항생제검사 감수성 결과를 분석한 결과 내성과 중등도를 합산할 경우 66.08%, 92.69%로 매우 높은 내성 비율을 보였다. 이에 Ureaplasma 종을 OFL과 CIP에 대한 감수성을 기준으로 4개 그룹으로 분류하여 gyrA, gyrB, parC, parE 유전자의 돌연변이 여부를 검사하여 항생제 내성과의 관련성을 밝히고자 하였다. 그 중 parC 유전자의 돌연변이 빈도가 높아 topoisomerase IV의 돌연변이가 fluoroquinolone계 약제에 대한 내성과 밀접한 관련이 있음을 확인할 수 있었다. 본 연구를 통해 GyrB의 Asn481Ser, ParC의 Phe149Leu, Asp150Met, Asp151Ile, Ser152Val, ParE의 Pro446Ser, Arg448Lys을 추가로 발견할 수 있었다. 최근 fluoroquinolone 계 항생제의 사용이 증가하고 있기 때문에 추후 Ureaplasma 종의 fluoroquinolone계 항생제 내성에 대한 지속적인 모니터링이 필수적일 것으로 사료되며, 이와 관련한 유전자의 돌연변이 양상과의 상관관계를 분석하여 기존 배양검사의 단점을 보완할 수 있는 분자 진단학적 검사법의 추가적인 분석이 필요할 것으로 사료된다. Ureaplasma species can normally colonize in the bodies of healthy individuals. Their colonization is associated with various diseases including non-gonococcal urethritis, chorioamnionitis, neonatal meningitis, and prematurity. In 2012, the sum of the resistant and intermediate resistant rates of Ureaplasma spp. to ofloxacin and ciprofloxacin was 66.08% and 92.69%, respectively. DNA point mutations in the genes encoding DNA gyrase (topoisomerase II) and topoisomerase IV are commonly responsible for fluoroquinolone resistance. Each enzyme is composed of two subunits encoded by gyrA and gyrB genes for DNA gyrase and parC and parE genes for topoisomerase IV. In the current study, these genes were sequenced in order to determine the role of amino acid substitutions in Ureaplasma spp. clinical isolates. From December 2012 to May 2013, we examined mutation patterns of the quinolone resistance-determining region (QRDR) in Ureaplasma spp. DNA sequences in the QRDR region of Ureaplasma clinical isolates were compared with those of reference strains including U. urealyticum serovar 8 (ATCC 27618) and U. parvum serovar 3 (ATCC 27815). Mutations were detected in all ofloxacin- and ciprofloxacin- resistant isolates, however no mutations were detected in drug-susceptible isolates. Most of the mutations related to fluoroquinolone resistance occurred in the parC gene, causing amino acid substitutions. Newly found amino acid substitutions in this study were Asn481Ser in GyrB; Phe149Leu, Asp150Met, Asp151Ile, and Ser152Val in ParC; and Pro446Ser and Arg448Lys in ParE. Continuous monitoring and accumulation of mutation data in fluoroquinolone-resistant Ureaplasma clinical isolates are essential to determining the tendency and to understanding the mechanisms underlying antimicrobial resistance.

의료기사 관련 직업 명칭에 대한 비교 연구: 표준직업분류를 중심으로

김대진(Dae Jin Kim),김대은(Dae Eun Kim),구본경(Bon-Kyeong Koo),황삼노(Samnoh Hwang),권민석(Minseok Kwon),하성일(Sungil Ha),이민우(Minwoo Lee) 한국보건의료윤리학회 2023 한국보건의료윤리학회지 Vol.2 No.1

Background: This study aimed to compare job titles of Medical Technologists with international and domestic standard occupational classifications, in order to provide fundamental data for various fields such as job ethics, workplace etiquette, research papers, immigration, employment, translation, university websites, educational evaluation, and unified education systems. Methods: The study conducted a comparative analysis of data from various sources, including the International Standard Classification of Occupations 2008 revision, Korean Standard Classification of Occupations 2017 revision, Standard Occupational Classification 2018 revision, NOC, National Occupational Classification 2011 revision, occupational outlook book, O*NET, and other organizational websites. Results: The study show that Medical Technologists typically received their entry-level education from 2-3 year junior colleges or 4-year universities. The various types of Medical Technologists included clinical laboratory technologists, radiological technologists, physical therapists, occupational therapists, dental technologists, dental hygienists, health information technologists, and opticians. In Korea, there was no standardized English name for Medical Technologists, so caution must be exercised when using official English names. For example, "clinical laboratory technologist" should not be translated as "medical/clinical laboratory scientist" and "health information technologist" should not be translated as "health information manager". Additionally, "optician" should not be translated as "optometrist" as the job skills and level of education required for each job are different. Conclusion: This study is that job titles of Medical Technologists are important for their self-esteem and identity, and therefore it is appropriate to use terms translated based on domestic and international standard occupational classifications.