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PubMed1988

Automated production of several positron-emitting radiopharmaceuticals using a single laboratory robot.

A Zymate Laboratory Automation System (Zymark Corp.), previously set up for the automated synthesis of 16 alpha-[18F]fluoroestradiol-17 beta [Brodack et al. (1986a) J. Nucl. Med. 27, 714] has been modified for the production of several short-lived radiopharmaceuticals in a single hot cell. All manipulations and apparatus normally used in the syntheses of carbon-11 and fluorine-18-labeled radiopharmaceuticals have been incorporated into the robot system. This achievement permits facile modifications of existing procedures used by the robot in addition to the incorporation of new routines in a minimal amount of time. Currently, the Zymate robot is programmed for the routine production of 16 alpha-[18F]fluoroestradiol-17 beta (7-11% EOS in 80 min), N-(3-[18F]fluoropropyl)spiperone (15-18% EOS in 70 min), and [1-11C]butanol (11-15% EOS in 25 min). A fourth compound, 2-deoxy-2-[18F]fluoro-D-glucose, is also synthesized by the robot. The yields and synthesis times of the robot-produced compounds are comparable to those obtained during manual syntheses. This method of automation represents a flexible and versatile alternative for the routine production of radiopharmaceuticals used in PET studies.

Fluorine Radioisotopes↗
PubMed2001

Efficient DNA database laboratory strategy for high through-put STR typing of reference samples.

DNA intelligence databases were installed successfully in various countries during the past few years. It is a general trend that laboratories performing STR analysis for DNA databases have to adjust to increased sample through-put, especially when dealing with a high number of reference samples. In contrast to routine forensic casework analysis, where samples of suspects and unknown samples are interpreted with regard to the specific circumstances of the case and are kept distinctly apart from other cases, DNA databases consist of single, primarily unlinked DNA profiles. Problems areas associated with the high number of anonymous DNA profiles are the risk of logistic errors, such as sample mix-up during the laboratory procedure, and the risk of typing errors during manual transcription of data and/or results. Thus, DNA databases clearly require new laboratory strategies to rise to the challenge. This paper presents an efficient automated laboratory strategy on the platform of a laboratory management information system (LIMS) with the Austrian DNA Intelligence Database as example. Two goals were tackled in particular: first, data safety by avoiding both manual interaction during critical laboratory steps (i.e. when DNA is transferred form one tube into another), and errors due to manual transcription of sample information and results. Secondly, efficient sample processing by automizing the laboratory procedure with the help of robotic instruments, thus, giving the DNA staff more time to analyze data.

Austria↗
PubMed2000

Modular robotic workcell for coagulation analysis.

BACKGROUND: Total laboratory automation (TLA) has been shown to increase laboratory efficiency and quality. However, modular automation is smaller, requires less initial capital, and requires less planning than TLA. We engineered and performed clinical trials on a modular robotic preanalytical workcell for coagulation analysis. METHODS: Timing studies were used to quantify the efficiency of the manual processes and to identify areas in the processing of coagulation specimens where bottlenecks and long waiting periods were encountered. We then designed our modular robotic system to eliminate these bottlenecks. Our robotic modular workcell was engineered to allow a choice of specimen introduction manually, by conveyor, or by mobile robot. Additional timing studies were performed during clinical trials of the robotic system. RESULTS: Prior to automation, the time required for preanalytical processing time was 18-107 min; after automation, it was 45-50 min. Additional improvements in workcell efficiency could be realized when high quality, prelabeled specimens were introduced into the system. CONCLUSION: Compared with manual methods, modular automation provides more predictable variation in specimen processing.

Blood Chemical Analysis↗
PubMed2002

Evaluation of an automated preanalytical robotic workstation at two academic health centers.

BACKGROUND: Purchase of automated systems in today's clinical laboratory needs justification based on demonstrable improvements in efficiency and a sound payback model. Few studies provide information on laboratory automation that focuses on the preanalytical portion of specimen processing. METHODS: We recently evaluated an automated preanalytical processing unit (GENESIS FE500) at two academic health centers. This preanalytical unit processes blood specimens through automated specimen sorting, centrifugation, decapping, labeling, aliquoting, and placement of the processed specimen in the analytical rack. We quantified the output of the FE500 by processing >3000 barcode-labeled specimens according to a protocol designed to test all of the features of this automated specimen-processing unit. RESULTS: Depending on the batch size, aliquot number requested, and percentage of tubes that required centrifugation, the mean system output performance varied between 93 and 502 total tubes/h. Throughput increased when the batch size expanded from 40 or 100 samples (mean = 211 total tubes processed/h) to batch sizes of 200 and 300 tubes (mean = 474 total tube processed/h). The GENESIS FE500 processed specimen tubes differing in size from 13 x 65 mm (width x height) to 16 x 100. At one site, the FE500 was operated by one person, compared with the three individuals required to perform the same tasks manually. Finally, the specimen-processing error rate determined at one of the institutions was significantly reduced. CONCLUSIONS: We conclude that the GENESIS FE500 effectively reduces the labor associated with specimen processing; decreases the number of laboratory errors that occur with specimen sorting, labeling, and aliquoting; and improves the integrity of specimen handling throughout the steps of specimen processing.

Autoanalysis↗
PubMed1992

Automated column equilibration, washing, sample loading and elution of bench-packed mini-columns.

In this paper we describe an easy and efficient way to pack mini-columns and use them in the Biomek 1000 Automated Laboratory Workstation. These procedures allow for automated column equilibration, column washing, sample loading and elution, and utilization of commercially available components. Various resins can be packed, allowing for automation of a variety of procedures in which minicolumns are used.

Automation↗
PubMed1995

Plasma input function determination for PET using a commercial laboratory robot.

A commercial laboratory robot system (Zymate PyTechnology II Laboratory Automation System) was interfaced to standard and custom laboratory equipment and programmed to perform rapid radiochemical assays necessary for plasma input function determination in quantitative PET studies in humans and baboons. A Zymark XP robot arm was used to carry out two assays: (1) the determination of total plasma radioactivity concentrations in a series of small-volume whole blood samples and (2) the determination of unchanged (parent) radiotracer in plasma using only solid phase extraction methods. Steady state robotic throughput for determination of total plasma radioactivity in whole blood samples (0.350 mL) is 14.3 samples/h, which includes automated centrifugation, pipetting, weighing and radioactivity counting. Robotic throughput for the assay of parent radiotracer in plasma is 4-6 samples/h depending on the radiotracer. Percents of total radioactivities present as parent radiotracers at 60 min, postinjection of 25 +/- 5.0 (N = 25), 26 +/- 6.8 (N = 68), 13 +/- 4.4 (N = 30), 32 +/- 7.2 (N = 18), 16 +/- 4.9 (N = 20), were obtained for carbon-11 labeled benztropine, raclopride, methylphenidate, SR 46349B (trans, 4-[(3Z)3-(2-dimethylamino-ethyl) oxyimino-3 (2-fluorophenyl)propen-1-yl]phenol), and cocaine respectively in baboon plasma and 84 +/- 6.4 (N = 9), 18 +/- 11 (N = 10), 74 +/- 5.7 (N = 118) and 16 +/- 3.7 (N = 18) for carbon-11 labeled benztropine, deprenyl, raclopride, and methylphenidate respectively in human plasma. The automated system has been used for more than 4 years for all plasma analyses for 7 different C-11 labeled compounds used routinely in our laboratory. The robotic radiotracer assay runs unattended and includes automated cleanup procedures that eliminates all human contact with plasma-contaminated containers.

Animals↗
PubMed1986

Interpretive reporting to improve the effectiveness of clinical laboratory test results. An ECRI technology assessment.

Interpretive reporting encompasses a range of efforts by the clinical laboratory community to develop improved methods of transferring information from laboratories to physicians in a form that they can understand and use. The purpose of laboratory tests is to provide clinically useful information that can be used to answer a specific question for the clinician. However, growing physician reliance on laboratory and other diagnostic tests and the increased testing volumes made possible by laboratory automation have yielded some unintended negative effects. Laboratories can now provide more information than can be effectively assimilated. The resulting "information overload" can cause clinicians to misinterpret tests, ignore significant results, or fail to act appropriately when results indicate a treatable condition. Research indicates, however, that interpretive reporting improves information transfer and thus increases clinicians' understanding of the significance of laboratory test results.

Artificial Intelligence↗
PubMed2005

[My Kumamoto life of 19 years].

In this paper titled "My Kumamoto Life of 19 Years; The Travel for Times", the memorial lecture on my retirement from Kumamoto National University Corporation Integrated Medical and Pharmaceutical Sciences, Department of Biomedical Informatics (Chairman) is summarized. As they say "Time flies", time extends from seconds to years. The lecture includes a summary of my short term research and long term studies, such as age-dependant and gene-related changes in ageing over 5 or more years in the healthy elderly. Short-term study mostly involved of newly evaluated assay methods for important substances such as the second level in the cell life span in the variation of lipid metabolite of cardiovascular diseases based on atherosclerosis, Alzheimer disease, and their evaluation by homogeneous assay of HDL-C, LDL-C, enzymatic assay for choline relating metabolites, and lipoperoxide as the results of free radical reactions. The intermediate-term studies were mainly on the development of total laboratory automation (TLA) for the management of the laboratory of the university hospital. The hospital has various degrees of sophistication in its laboratory services. Technicians were allowed to transport specimens immediately by using an air-shooter system after drawing blood, from the emergency room to the central laboratory. Routine specimens could be measured within 30 min and the results could be automatically sent to the physician's office. It greatly minimized reporting errors, decreased the exposure to biohazards, reduced labor expense, improved operation efficiency, and shortened turnaround time. Moreover, for the outpatients and emergency laboratories, we constructed a robotic measuring system which was assembled into a sequential method for the analysis of chemistry, hematology and urinalysis specimens by using a polyarticular robot. The robot arm extends to a bar-coded tube, picking up and placing test tubes on a turn table of autoanalyzers for analysis without manpower. This is the first known effective unmanned procedure for assay in the world of laboratory medicine. Also, our research on pathological informatics was begun. Our laboratory had 7 themes; the study of the reference intervals in the elderly as one of strategy of standardization on laboratory data (Drs. Uji Y, Sugiuchi H), the study of the activation mechanism of ribosomal proteins by the functions of blood cells (Drs. Shibuya Y, Senba U), the evaluation of diagnostic methods in latent ailments by gene analysis (Dr. Ando Y), the evaluation of a highly sensitive method for disseminated intravascular coagulopathy (Okajima K), the study of the neogenesis of blood vessels by physical invasion (Uchiba M), the study of the deposition mechanism of amyloid proteins and evaluation of the diagnostic methods in the autonomic system(Drs. Ando Y, Nakamura M), and the study of the function of blood stem cells in blood transfusion services (Drs. Yamaguchi K, Yonemura M, Tsunemi M). Finally, my long term work also included research into the early diagnosis and prediction of latent ailments and the variation of serum proteins levels in the healthy aged. The conclusion was that the reference value of healthy populations and individuals (intra-personal) who had no combined ailments, in follow-up for 5 years, categorized by age, sex, and social conditions, gave a narrower range of variation than did large mixed populations (inter-personal), in laboratory tests and activity of daily living (ADL). Concerning the early diagnosis and prediction studies for the latent ailments in the aged, variations of serum protein levels in the healthy aged were classified into 3 types: serum proteins levels increased with advancing age (alphaAT, mainly acute phase reactant proteins), those that decreased with advancing age (albumin mainly transporting proteins) and proteins with no significant variation. The higher increase of the alpha1AT/beta2 III ratio in the healthy aged over 60 years old is suspected to create symptoms in the near future. The papers presented concerning ageing studies were presented at the APCCC Symposium (India, 2002) and the IFCC Symposium (Kyoto, 2002), and the TLA study was also presented at the Symposium of XX World Congress of Pathology and Laboratory Medicine (San Paulo Brazil 1999).

Clinical Laboratory Information Systems↗
PubMed1998

The status and future of clinical pathology in Korea.

Since its introduction half a century ago, modern clinical pathology in Korea has become an essential part of medical practice. The foundations of such fast development are manpower development systems, the government-certified clinical pathologist board system, the medical technologist license system, a medical insurance system providing universal coverage and the decisive introduction of modern technologies. Current issues in clinical pathology are the below cost fee system, the high rate at which claims are rejected, the government's intention to introduce an alternative fee system and 'overheated' competition among commercial laboratories. The 'fee-for-service system' inducing deviated medical practices and low publicity for the discipline-leading to reduction in the number of applications for residency-are serious issues which demand a solution. For continuing success, total laboratory automation (TLA), together with information and core laboratory systems, and an accreditation and audit system must be introduced. Clinical pathologists should, in addition, be trained as laboratory physicians. To extend laboratory usage by developing new demands and needs and expanding the future market for laboratories, effective publicity campaigns through the mass media and internet should be emphasized.

Delivery of Health Care↗
PubMed2003

Windows to the ward: graphically oriented report forms. Presentation of complex, interrelated laboratory data for electrophoresis/immunofixation, cerebrospinal fluid, and urinary protein profiles.

BACKGROUND: Automated laboratory analyzers that mass produce data have been linked to information systems for more than two decades, but little progress has been made in developing more comprehensible report forms. Results are still reported in computer-generated printouts containing hundreds of numbers crowded into columns on each printed page. METHODS: We developed three software applications focusing on the graphic presentation of laboratory results. RESULTS: The first application summarizes data for a patient with a monoclonal gammopathy. The report provides a cumulative graphic presentation of immunofixation/electrophoresis data without any additional interpretation, focuses on a color-coded electrophoresis scan, and records up to 5 years on a single page. The second application deals with cerebrospinal fluid analysis. The report calculates relevant data and graphs the complex relationship between albumin and immunoglobulin results from paired serum and cerebrospinal fluid samples. Manually added interpretive text assures an output comprehensible to clinicians in all specialties. The third application produces a report summarizing quantitatively measured urinary marker protein profiles. The report form is generated by a flexible, completely user-definable knowledge-based system. It calculates numerous ratios and formulae, supports reflex testing, supplies an automated interpretation, and generates a specific graphic signature pattern of the results (MDI LabLink proteinuria differentiation). CONCLUSIONS: Increased clinical demand for graphically oriented report forms 5 years after their introduction has provided evidence that these reports transfer complex laboratory data and results to the clinician more effectively. The highest (more than threefold) increase in demand has been for reports for urinary marker protein profiles that feature a largely self-explanatory graphic signature pattern.

Autoanalysis↗
PubMed1992

Implementing a regulation-complaint quality improvement program on a commercial laboratory information system.

Implementing a quality improvement (QI) program on an automated laboratory information system (LIS) in the current regulatory climate requires first that the QI program be defined and second that the selected LIS be able to capture important events and use flexible vendor-provided or user-defined routines to prepare reports. Reports key on specific monitors and thresholds defined in the QI program. The product of a pathology laboratory is communicated information. The QI program focuses on the accuracy, clarity and timeliness with which the whole information-generating process functions. To support peer review the LIS must be able to select reports for evaluation based on user-defined parameters, such as diagnosis keyed through Systematized Nomenclature of Medicine codes, or by random or pattern selection by accession number. Counting and review of revised reports will focus attention on accuracy and skill in communication since these indicators often reflect client satisfaction with the report. To link services--e.g., cytology with surgical pathology--the LIS must be able to gather cases from the accession lists of both services and to flag diagnostic inconsistencies. LIS transaction logging at every step in the information process allows tracking of work load, productivity and resource utilization by functional areas and by individual, thus meeting regulatory requirements. Transaction logging also provides management information, such as segmented turnaround time audits, pinpointing sources of delay by kind and location of work or individual involved. Critical data must be held on-line for at least five years.

Clinical Laboratory Information Systems↗
PubMed1994

A chromatographic procedure for fully automated isolation of DNA from human whole blood.

Isolation of DNA from peripheral blood constitutes a fundamental step in the molecular diagnosis of genetic disorders, analysis of mutations of oncogenes and detection of nucleic-acid sequences of pathogenic organisms in clinical samples. We investigated whether dextran sedimentation of blood followed by the chromatographic isolation of DNA could be applied to the Biomek-1000 automated laboratory workstation in order to develop a fully automated method of DNA isolation from whole blood. Under our experimental conditions, the Biomek-1000 could perform fully automated DNA isolation from seven human whole blood samples in less than 1.5 h. Our data indicate that the DNA isolated from human blood in this way is suitable for polymerase chain reaction.

Autoanalysis↗
PubMed1995

Chromatography in DNA radiolabeling: hands-off automation using a robotic workstation.

The experiments described in the present paper were performed in order to determine whether the Biomek-1000 (Beckman Instruments, Fullerton, CA, USA) automated laboratory workstation can be used in a fully automated DNA labeling method followed by automated gravity-driven size exclusion purification of molecular probes. To this aim, we performed random oligodeoxyribonucleotide priming of a HIV-1 LTR probe that was used for molecular hybridization to Southern blotted polymerase chain reaction products. The results obtained demonstrate that the automatically labeled probe can be efficiently purified by automated and gravity-driven Sephadex G-50 chromatography, without any major changes in hybridization property. This robotic methodology can be used in several procedures employing radioisotope labeling.

Base Sequence↗
PubMed1992

The basics of blood cell counter.

The time has come when a traditional hematologist of a developing country needs to change his frame of mind from time consuming, error prone, not so precise manual methodologies to economical, safe and precise automated procedures. More important is his role as a guide and teacher for his juniors who are exposed to automated laboratories from the beginning of their residency. At this juncture, one needs to be thorough with the principles of instrumentation, different models available, their merits and demerits and how and where these fit with the requirements of the laboratory. The haematologists also must be aware that automation has its own problems, limitations, disadvantages and interfering elements. The article discusses the present state of art.

Erythrocyte Count↗