• Korean Journal of Clinical Laboratory Science
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• v.49 no.4
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• pp.366-373
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• 2017

Urinalysis is considered to be easier and simpler than other tests. It has been known to cause no burden to patients, while offering important information on diagnosing, treating, and determining the prognoses of kidney and urinary tract diseases. Urinary sediments are usually performed by microscopic examination of centrifuged urine by technologist. The guidelines proposed by the Korean Association of External Quality Assessment Service are actually different from those actually practiced by medical institutions and taught to biomedical students in textbooks. Therefore, we verified whether different sediment preparation methods lead different test results. Specimens that tested positive from the occult blood and leukocyte esterase in the urine dipstick test were randomly selected for a microscopic examination. The differences in the urine sediment preparation affected the sediment concentrations, which influenced the cell grade and cell number per HPF. The first factor in determining the sediment concentration is the centrifugal force. Many medical institutions use 1,500 rpm as the centrifugal speed without considering the radius of the centrifuge; such a value may not be accurate for 400 G. Consequently, there were differences in urine concentrations, which influenced the results. The second factor is the amount of sediment in urine. Different amounts of the remaining supernatant led to different sediment concentration factors, again, causing different results. Furthermore, not only by using a pipette to obtain an accurate amount as stipulated, but also by roughly obtaining a drop, the microscopic examination using such a volume of sediment examined affected the results. Therefore, this study highlights the importance of standardization of urine sediment preparation procedures to promote consistency and accuracy across institutions.

• Korean Journal of Clinical Laboratory Science
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• v.55 no.2
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• pp.82-92
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• 2023

Urine sediments are performed by a microscopic examination of centrifuged urine by medical technologists. This study examined different urine sediment preparation procedures. The 107 fresh urine specimens that tested positive from white blood cells (WBCs) and red blood cells (RBCs) in the urine dipstick test and the cobas u 701 analyzer, respectively, were selected for manual microscopy. This study evaluated an automated urine sediment analyzer and three manual microscopy methods for WBCs and RBCs. The methods were performed according to the test guidelines. The coefficients of determination between the cobas u 701 analyzer and the Korean Association of Quality Assurance for Clinical Laboratory (KAQACL) for WBCs and RBCs were r2=0.977 and r2=0.970, respectively. The concordance rates between the cobas u 701 analyzer and KAQACL for WBCs and RBCs were 74.8% and 77.6%, respectively. A good correlation and concordance with the automatic analyzer were shown when the specimens were prepared and examined using the KAQACL method. Consequently, the differences in the urine sediment preparation procedures affected the sediment concentrations, influencing the cell number per high power field (HPF).

• Journal of Veterinary Clinics
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• v.13 no.1
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• pp.81-86
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• 1996

Systemic lupus erythematosus in a dog, suspected systemic lupus erythematosus in a dog, and autoimmune thrombocytopenic purpura hemmorrhagica in a dog are reported. A fice-year old, female Chihuahua (Case 1) showed initially hemorrhagic diathesis and purpura hemorrhagica. Afterward, it showed polymyositis and polyarthritis. LE-cell was demonstrated on LE-cell preparation trom blood. Systemic lupus erythematosus was diagnosed. This reponded well to the immunosuppressants, but developed iatrogenic Cushing syndrome and steroid hepatopathy. A two-and-half-year old, male toy poodle (Case 2) had chief complaint of red urine. Occult blood test for the urine sediment. This did not respond at all to antibiotics and carbazochrome, which is one of systemic coagulants. LE-cell was demonstrated on LE-cell preparation from blood. This responded relatively well to immunosupressants such as prenisolone, azathioprine and cyclophosphamide. systemic lupus erythematosus is suspected. A nine-year-and-three-month old, female Maltese (Case 3), which had history of congestive heart failure and ovariohysterectomy showed purpura hemorrhagica in the skin of chest. This had severe thrombocytopenia and leukocytosis. As prednisolone was administered before immunological examination or demonstration of LE-cell, it was impossible to diagnose whether purpura hemorrhagica developed as a member of systemic lupus erythematosus or independent of systemic lupus erythematosus. This responded well to prednisolone, and so autoimmune thrombocytopenic purpura hemorrhagica was diagnosed.

• Korean Journal of Clinical Laboratory Science
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• v.56 no.2
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• pp.135-146
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• 2024

Urinalysis is a fundamental diagnostic test routinely performed in clinical laboratories. We evaluated two manual microscopy methods, including a novel protocol, against the standardized chamber method. A total of 402 specimens, comprising 201 positive each for red blood cells (RBCs) and white blood cells (WBCs) by the strip test and automated urine sediment analyzer, were selected for the analysis. The correlation coefficients between the standardized chamber method and the novel protocol RBC and WBC test were both r=0.98, indicating a high degree of correlation. The pair-wise agreement rates for the same grade between these two methods were 86.1% for RBCs and 88.6% for WBCs, with rates within one grade difference of both at 99.5%. In contrast, the agreement rates between the standardized chamber method and smaller or medium-sized laboratory methods were notably lower, with the same-grade rates at 11.9% for RBCs and 13.4% for WBCs, and within one grade difference at 67.2% and 74.1%, respectively. Additional analyses using the intraclass correlation coefficient and Bland-Altman plots confirmed that the novel protocol exhibited superior agreement compared to the other three manual microscopy methods tested. Therefore, we recommend the novel protocol as a standardized procedure for urine sediment preparation, given its high correlation and agreement with the standardized chamber method.