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대한임상병리사협회> 조직세포검사학회 초록집

조직세포검사학회 초록집 update

The Korean Experiment Society of Histology and Cytology

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수록정보
수록범위 : 1991권1호(1991)~2019권1호(2019) |수록논문 수 : 589
조직세포검사학회 초록집
2019권1호(2019년 08월) 수록논문
최근 권호 논문
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1Extraction and Diagnosis Platform for Liquid Biopsy Using Biocompatible Hydrogel Bead

저자 : Tae Hee Lee , Jiyoon Bu , Sung Hee Hyun

발행기관 : 대한임상병리사협회 간행물 : 조직세포검사학회 초록집 2019권 1호 발행 연도 : 2019 페이지 : pp. 129-129 (1 pages)

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Background
Circulating cell-free DNA (cfDNA) has attracted a great deal of scientific interest as predictive biomarker for diagnosis and prognosis in gastric tumors. However, the technical challenges in extracting cfDNA with high sensitivity and specificity limit its clinical use.
Methods
we coated alginate beads with polydopamine (PDA)-silica hybrids to enhance cfDNA detection. The strong adhesion properties and polyvalent metal-mediated coordination of PDA facilitate cfDNA to adsorb onto the PDA-silica-coated surface, demonstrating cfDNA capture enhanced by 1.3-fold, compared to the conventional silica-based approach (P=0.001).
Results
For the clinical study, patients with gastric malignant tumors showed significantly higher cfDNA concentration compared to patients with benign tumors (P<0.001) or healthy controls (P<0.001). The receiver operating characteristic (ROC) curve analysis demonstrated clinical capability of cfDNA in discriminating malignant tumor patients from benign patients or healthy controls, with an area under ROC curve (AUC) of 0.969 (P<0.001) and 0.999 (P=0.002), respectively. Among malignant patients, cfDNA concentration increased along with tumor progression, particularly with the size/extent of the tumor and development of metastasis. Furthermore, HER-2 expression on cfDNA was strongly associated with the tissue HER2 level, showing AUC of 0.976 (P<0.001) for HER2-positive tumors. We further explored the prognostic value of cfDNA and found that disease-free survival of patients with cfDNA concentration ≥2.1 ng/μL were remarkably shorter than those of patients with lower cfDNA concentration
Conclusion
Our novel technology demonstrates the potential to achieve efficient cfDNA detection from blood of gastric cancer patients, which correlates well with clinical indications of the disease.

2HCL-01 : Deduction of Optimal Medical Device Selection Framework for Introduction of Advanced Medical Devices

저자 : Ju Hyeok Park

발행기관 : 대한임상병리사협회 간행물 : 조직세포검사학회 초록집 2019권 1호 발행 연도 : 2019 페이지 : pp. 203-203 (1 pages)

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Background
In patient care, the efficiency of providing medical services is further emphasized by rapid changes in the medical environment, such as the development of diagnostic and therapeutic technologies and the advancement of medical device, and the importance of supply and demand of related medical device is raised The pathology department invests in high-cost medical equipment or systems for the use of advanced technologies such as Digital-pathology, Next-generation sequencing (NGS), and Tracking systems, but lacks objective data to assess their effectiveness or demonstrate their efficiency. The selection of medical devices is an important variable in medical competitiveness. In order to select a more optimal medical device from the laboratory, it is necessary to understand the process of the entire medical device cycle and to understand the medical device industry and each stakeholder. The effectiveness of the introduction of medical devices should be maximized through objective medical device evaluation methods.
Methods
This study presents a general framework for evaluating medical devices for users to select the best medical devices. This general framework was intended to start from a wide range of perspectives for general use by various stakeholders, and further to allow quantitative measurement of the evaluation results of medical devices. Then, using the framework presented, the results of the assessment were obtained on the indicators of each item of medical device assessment through literature and surveys. Next, the Analytical Hierarchy Process (AHP) conducted to medical device experts, and weight were applied to each item of the indicator. In addition, the general evaluation frame for evaluating the medical technology was reinterpreted to divide the evaluation from the technical aspect, the economic aspect, and the user aspect, and to comprehensively evaluate the medical device.
Results
The AHP analysis results for the representative evaluation methods presented in the evaluation frameworks had different importance to each stakeholder. It was shown that the high weights for different assessments by stakeholders consisted of assessments that considered the different stakeholder perspectives, and that the deviations of the weight values of the commonly presented evaluation indexes were balanced in the composition of the assessment indexes. In addition, AHP analysis was performed on each of the stakeholders perspectives, as well as on the general presentation of the evaluation frame, to construct characterization indicators that fit each characteristic. The weight value obtained through AHP analysis is a numerical indication of the priority of the representative evaluation and the evaluation results of the medical device. It can be said that the evaluation frameworks presented in this study alone have the advantages of not only the comparison of different medical devices but also the superiority of a single medical device.
Conclusion
In this study, usability evaluations that were not included in the general evaluation frameworks of medical devices could be included to widen the evaluation base of medical devices and balance the assessment among stakeholders. Considering that usability evaluation was a high priority in the survey results, I think it will be an important factor in future general medical device evaluation frames. Considering the potential for advancement of pathological medical device technology, it is indispensable to evaluate medical devices that are objective and transparent to recognize the value of medical devices and to provide a good means for mutual growth with stakeholders as well as for efficient laboratory operation, and to hope that they will become a good basis for development in the medical device industry ecosystem by applying them to other medical devices as well as to medical examination devices.

3HCL-02 : Development of Pathology Medical Equipment Website

저자 : Ji Hye Kim

발행기관 : 대한임상병리사협회 간행물 : 조직세포검사학회 초록집 2019권 1호 발행 연도 : 2019 페이지 : pp. 203-203 (1 pages)

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Background
Modern pathological medical devices have streamlined the workflow of manual-based traditional pathological tasks and increased the accuracy of quantitative diagnosis, but more careful purchases are required for reasonable purchases of medical devices of various products that have not been experienced in the past. Purchase of medical devices at medical institutions is done through decision-making processes of various stakeholders, such as the user department, the purchasing department, and the CEO. The use department will then play a leading role in the adoption of medical devices to explore potential suppliers and make decisions on eligibility requirements. Realistically, however, the search for information for purchasing plans is unprofessional and simple. In the case of professional medical devices, the distribution infrastructure for online shopping is not well established, so obtaining primary information is to share the opinions of salespeople and other agencies user departments. Consumers who need medical devices are not experts in purchasing administration, and they have difficulty choosing because of the asymmetry of information.
Methods
In this study, a website was created for analyzing prior research data and comparing and retrieving medical device information at a glance based on public data provided by the Ministry of Food and Drug Safety and Health Insurance Review and Assessment. The distribution and purchase process of medical devices was analyzed through the existing literature review, and the information supply status of medical devices and the factors of consumers decision to purchase medical devices were identified. The medical institution provided legal and useful medical device information by establishing a range of information available to consumers through expert advice, upload medical device information using public data and medical device company information, and share information freely through user bulletin board.
Results
Based on the designed layout, a website was established by creating a website centered on pathology and medical devices using free templates provided by large portals. ('오픈마켓 형 의료기기 정보검색 마스터 https://medicalequipment.modoo.at'). On the main screen, the product inquiry, product introduction, FAQ and Q&A are categorized. They are both operated on mobile and PC and can be searched and edited.
Conclusion
This study tried to mitigate the problem of information asymmetry between consumers and suppliers through its website to make the most of the information consumers need. Desired use of medical devices requires an environment in which medical device users or end consumers can make reasonable choices. Through the website, consumers can easily and conveniently search for a variety of scattered information through a single source, and suppliers can post their products fairly and objectively through medical device search sites. This new paradigm shift in online sales marketing through non-human resources will provide an opportunity to increase the domestic market share by enhancing the brand image of the low-rated local medical equipment maker. Furthermore, if the government supports and manages the role of intermediaries of websites that can connect medical device users to medical device suppliers, it is expected to contribute to the development of the health care industry as well as the improvement of the distribution of complex medical devices and transparent management of the medical device industry.

4HCL-04 : Multi-screening of Nucleic Acid and Bioinformatics for Quality Control in Hepatocellular Carcinoma

저자 : Tae Hee Lee , Hee Kyoung Yang , Ji Eon Kim , Jung Ha Choi

발행기관 : 대한임상병리사협회 간행물 : 조직세포검사학회 초록집 2019권 1호 발행 연도 : 2019 페이지 : pp. 204-204 (1 pages)

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Background
Typical hypervascular hepatocellular caricnoma (HCC) is nourished by arteries. Transarterial chemoembolization (TACE) is a way to treat liver cancer. TACE is used to control tumor growth and try to shrink the tumor. For quality control, we investigated to stability of biospecimens and information, which liver sample following to surgical biopsy or TACE extracted protein and nucleic acid. Quality control is considered important in order to distribute following to accept of biospecimens. High quality biospecimens for molecular and immunological applications are substantial for procedure liable and consistent results.
Methods
In our study, we confirmed that accepted biospecimens evaluate if our resources appropriate stability and concentration in order to distribute.
Results
The clinical information and experimental results were investigated follow to: Edmondson grade, tumor size, cirrhosis, platelet, total protein, albumin, total bilirubin, AST, ALT, ALP, PIVKA-2, RNA concentration, RNA integrity number, and cDNA concentration.
Conclusion
Our accepted biospecimens have an appropriate concentration and stability in case of hepatocellular carcinoma. Forward, we will conduct an evaluation between normal and tumor from tissue and will apply to other tumors. The biospecimens and data used for this study were provided by the Biobank of Chungnam National University Hospital, a member of the Korea Biobank Network.

5HCL-03 : Digital PCR for Bio-distribution of Stem Cell in Animal Model

저자 : June Seok Heo , Ja Yun Lim , Sang Shin Pyo , Dae Wui Yoon , Bo Yong Kim , Jin Hee Kim , Seung Gwan Lee , Jinkwan Kim

발행기관 : 대한임상병리사협회 간행물 : 조직세포검사학회 초록집 2019권 1호 발행 연도 : 2019 페이지 : pp. 204-204 (1 pages)

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Background
One of the most promising tools in cellular therapy is the use of mesenchymal stem (MSCs) because of their differentiation potential and immune regulatory properties. Accordingly, many animal studies have been devoted to develop stem cell therapy that can be applied to certain specific diseases. To develop new biological therapies, bio-distribution of MSCs has to be assessed for filing pharmacokinetic data before approval of IND. Quantitative RT-PCR has been considered as a gold-standard method for detection of human cells spiked in animal tissues by KFDA. However, to calculate copy numbers from the results of RT-PCR, a certified reference material is needed, and it takes time to make it. Contrarily, there is no need for standards, and copy number of each sample is available after the experiment is over in digital PCR (dPCR). Thus, dPCR can be an alternate for RT-PCR. However, it has not been certified whether the results of dPCR reflect those from RT-PCR enough to replace the method.
Methods
In this study, we administered human umbilical cord-derived MSCs into nude rats intra-tendinously. Animals were sacrificed one week after administration, and DNA was extracted in organs such as heart, lung, liver, etc. Both RT-PCR and dPCR were conducted using Alu element to detect human DNA (hDNA), from which copy numbers were calculated. A correlation of copy numbers between the two PCR methods were evaluated.
Results
As results, both methods showed similar specificity to detect hDNA in animal tissues. The obtained copy numbers were well correlated between the two methods with the correlation coefficient being 0.99.
Conclusion
Thus, we conclude that dPCR is a useful alternate for RTPCR in bio-distribution assay of hDNA in animal tissues, given that researchers get acquainted with this method(This work was supported by the Bio & Medical Technology Development Program of the National Research Foundation (NRF) funded by the Ministry of Science, ICT & Future Planning (NRF-2015M3A9E6028677) and funded by the Ministry of Education (2019R1I1A3A01050978).

6HCL-05 : High throughput and Mass Producible Microstructure Platform for Rare Tumor Cell selection

저자 : Tae Hee Lee , Jiyoon Bu , Sung Hee Hyun

발행기관 : 대한임상병리사협회 간행물 : 조직세포검사학회 초록집 2019권 1호 발행 연도 : 2019 페이지 : pp. 205-205 (1 pages)

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Background
Circulating tumor cells (CTCs) play an important role in estimating the presence and the metastatic relapse of tumor. Despite of their importance, isolation of viable CTCs is still struggling, since chemical or mechanical damages are unavoidable when separating less than 1000 of CTCs out of billions of other blood components. Furthermore, the current CTC isolation devices show low productivity, since they are produced after a series of complicated fabrication processes.
Methods
Here, we present a low-cost and mass-producible microstructrue filters for the viable CTC isolation and the further molecular assay for profiling cancer-associated markers.
Results
By utilizing size-based sorting method, the microstructrue filter is capable to isolate both epithelial and mesenchymal CTCs, while slots with curved walls are beneficial for preventing the cell rupture by reducing 21.6% of mechanical stress compared to the conventional straight walled slots. We applied our filter to 11 human blood samples and found that the number of CTCs was closely related to the expression level of Ki-67, which is highly overexpressed in proliferative tumors.
Conclusion
The microstructrue filter might be an appropriate caner-screening tool in developing countries, where people suffer from insufficient healthcare services.

7HCL-06 : Analysis of Wnt Signaling by Confocal Microscopy

저자 : Tae Bok Lee

발행기관 : 대한임상병리사협회 간행물 : 조직세포검사학회 초록집 2019권 1호 발행 연도 : 2019 페이지 : pp. 205-205 (1 pages)

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Background
Transcription factor EB (TFEB) is a well-known master regulator of autophagy. Under nutrient deprivation condition, TFEB migrates into nucleus and stimulates expression of autophagy related genes. In previous studies, increased autophagy is deeply connected to bulk degradation of proteins including Wnt signaling components: Dvl and β-catenin. The studies, so far, depicted that TFEB regulates Wnt signaling via autophagy, and autophagy is also regulated by Wnt signaling based on nutrient condition. Here, we proposed a new hypothesis that Wnt signaling is inhibited by TFEB independent of autophagy in nutrient rich condition.
Methods
Overexpression of TFEB in HEK 293T cells considerably reduced Wnt reporter activity that was induced by the treatment of Wnt3a-CM or overexpression of Dvl1, β-catenin and β-catenin (S37A) even under autophagy elimination condition.
Results
translocation of TFEB into nucleus was observed after treatment of Wnt3a-CM even in the presence of nutrients whereas blocking of Wnt signaling by the treatment of IWR-endo, which stabilize Axin, prohibited Wnt mediated nuclear localization of TFEB. Inhibition of GSK3β caused by CHIR-99021 showed rapid TFEB nuclear translocation.
Conclusion
Taken together, Wnt/β-catenin signaling caused nuclear localization of TFEB under normal nutrient condition and the nuclear localized TFEB negatively regulates Wnt signaling in an autophagy independent manner.

8HCL-07 : 신 병리 수가 개정에 따른 전산 자동화 및 병리 BPOC에 대한 고찰

저자 : 지우현 , 조승일 , 배문환 , 이신일 , 김대근 , 최상훈 , 김광일 , 설우빈 , 정지연 , 정환도 , 강윤근 , 이솔아 , 김현경 , 김순재

발행기관 : 대한임상병리사협회 간행물 : 조직세포검사학회 초록집 2019권 1호 발행 연도 : 2019 페이지 : pp. 206-206 (1 pages)

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배경
2018년 1월 1일부로 상대 가치 개정에 따른 병리 수가가 변경되어 현재까지 이르고 있다. 기존의 병리수가체계와는 달리 조직검사 접수과정에서 상당한 변화가 있었고 현재는 전국 모든 병원이 어느 정도안정화 되어 운영 중이다. 본원에서는 병리 수가 개정에 따른 처방 접수와 관련해서 수기가 아닌 자동화 전산 반영을 위해 전산개발절차를 거쳐 일부 처방 자동 전산 반영이 이루어지고 있으며 향후에도 다각도로 병리 전산 자동화에 노력할 것이다. 병리 검사는 검체 확인과 블록, Slide matching이 가장 중요한 과정 중 하나이며 문제 발생 소지가 있는 과정 중에 하나이다. 이에 본원에서는 병리 검사의 첫 단계인 육안 검사(gross finding) 과정에서 환자의 검체에 부여된 병리 블록 카세트와 환자 검체와의 일치 여부를 BPOC (barcode point of care)도입으로 자동화 matching 과정을 전산화 하여 검사 업무에 반영하는 계획으로 현재 초기 적용하는 단계에 이르고 있다 문제 발생 소지가 분명한 일련의 과정을 전산화 자동 시스템 도입으로 큰 성과를 낼 것으로 예상되지만 인력적인 부분, 장비, 검사 시 간에 대한 부분에서는 논의의 여지가 있다.
방법
본원 전산 시스템의 개발절차를 거쳐 육안검사 화면에서 자동으로 블록수를 counting하여 추가 처방관련 자동 전산반영을 위해 전산 알고리즘과 프로세스를 수정하여 반영하도록 하였다. 육안검사 화면에서 gross 확정 후 최종 반영된 블록수를 자동 등록하여 추가처방이 발생되도록 하는 방법으로 반영하였다. 병리검사 BPOC 도입은 병원 QPS팀의 협조하에 장비 및 전산 TEST 후 진행되었다.
결과
병리과 처방코드 중 블록 수에 따른 추가코드의 처방변경 자동화 1.수익개선 :퇴원환자의 접수 불가 문제 및 수기로 인한 에러, 누락 해결로 수익증대 총 년 간 추정 -42,455,556 원 정도의 미수금액 발생을 줄여주는 효과 2.업무 정확성: 수기로 입력하는 문제 해결(자동처방변환) 3.업무 효율화 : 자동처방변환으로 인한 업무 감소 육안검사 BPOC 도입으로 인한 검체 바뀜 Error 발생 건수 ZERO화 기여
결론
본원 병리과 처방 코드 중 블록 수에 따른 추가 코드의 처방 변경은 육안 검사 완료 후 의무전사실에서 하고 있으나 수술환자의 퇴원, 수기로 인한 누락 및 에러 등의 사유로 추가 코드 변환 접수가 제대로 원활하게 이루어지지 않아 수익적인 문제가 발생되고 있기에 육안 검사 단계에서 블록 수 확정 후 자동으로 추가 코드를 반영하여 수술환자 퇴원 전 올바른 검사 수가를 청구 할 수 있어 향후 타 기관에서 적극 활용하여 병리 전산화에 기인하였으면 한다. 육안 검사 BPOC 도입은 현재는 시작단계에 불과하지만 향후 문제 발생 소지를 미연에 방지하는 효과가 크게 나타날 것으로 보인다. 하지만 인력적인 부분, 장비, 검사 시간 지연 등의 문제는 각 기관의 현실적인 부분에 맞게 적용시켜 나간다면 병리 검사 error를 줄이는데 크게 기여할 것이다.

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국립산림과학원(구 임업연구원) 동원과학기술대학교 동의대학교 성균관대학교 강원대학교
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  • 1 국립산림과학원(구 임업연구원) (13건)
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  • 8 강북삼성병원 (2건)
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