Evolution of glomerulopathies associated with rheumatoid arthritis / Evolución de las glomerulopatías asociadas a la artritis reumatoidea

Abstract Introduction: Rheumatoid arthritis is one of the most common clinical syndromes within rheumatological conditions and its association with glomerular diseases is rare. Objective: To describe the histopathological findings in renal biopsies in patients with rheumatoid arthritis and to correlate them with the clinical and laboratory manifestations at the beginning, at 6 months and at one year of follow-up. Patients and Methods: This is a retrospective observational study conducted in the Hospital de Clinicas "Jose De San Martin" in Buenos Aires, Argentina; Where we included 41 patients diagnosed with RA (ACR 1987) in a period of 20 years. Histopathological diagnoses of membranous nephropathy (MN), minimal change disease (MCD), secondary amyloidosis (AA), focal and segmental glomerulosclerosis (FSGS); mesangial glomerulopathy (MGP) and glomerulonephritis with extracapillary proliferation (GNEC) were included. Histopathological description, different treatments, years of evolution of rheumatoid arthritis Clinical and laboratory characteristics were analyzed during the first 6 months and one year of follow-up in order to determine the progression of renal failure calculated through the formula of MDRD of 4 variables (Modification of diet in renal disease) and the increase of proteinuria. Results: The most frequent histological finding was amyloidosis with 34,1 % (n=14), followed by mesangial glomerulopathy 21,9 % (n=9), membranous nephropathy 19,5 % (n=8), glomerulonephritis with extracapillary proliferation 12,1 % (n=5), focal and segmental glomerulosclerosis 7,3 % (n=3) and minimal change disease 8,2 % (n=2). Nephrotic syndrome was the most frequent presentation in patients with amyloidosis in 85,7 %, microhematuria occurred in 100 % of patients with MPG and in 80 % of patients with GNEC. In patients with AA, moderate to severe interstitial fibrosis occurred in 85,7 %, followed by GNEC and NM with 80 % and 40 % respectively. The 24-hour proteinuria, creatinine and glomerular filtration rate estimated by MDRD at 6 months and 12 months were evaluated. Concluding, that patients with AA, FSGS and GNEC had greater progression of renal failure at 12 months; the opposite occurred in patients with minimal change disease (MCD) and mesangial glomerulopathy (MGP) who had a lower progression of renal failure at one year of follow-up; There was a correlation in the glomerulopathies that had greater deterioration of the renal function had greater interstitial tubule involvement as was the case of amyloidosis. The glomerulopathies that presented greater proteinuria at the beginning were membranous nephropathy, amyloidosis and minimal change disease. Both membranous nephropathy and minimal change disease had partial remission at one year, in contrast to amyloidosis, which showed progression of proteinuria at 12 months of follow-up. Conclusion: The glomerulopathies that presented greater progression of renal failure at 1 year based on the estimation by MDRD 4, had a higher renal tubular interstitial involvement in renal biopsy and these were amyloidosis (AA), segmental focal glomerulosclerosis (FSGS), glomerulonephritis with proliferation extracapillary On the other hand, those with the best evolution in relation to the degree of proteinuria and the glomerular filtration rate determined by the MDRD4 equation were mesangial glomerulopathy, minimal change disease, and membranous nephropathy.

Resumen Introducción: La artritis reumatoidea (AR) es uno de los síndromes clínicos con mayor frecuencia dentro de las afecciones reumatológicas y su asociación con las enfermedades glomerulares es poco frecuente. Objetivo: Describir los hallazgos histopatológicos en las biopsias renales en pacientes con artritis reumatoidea y correlacionarlos con las manifestaciones clínicas y de laboratorio al inicio, a los 6 meses y al año de seguimiento. Pacientes y métodos: Es un estudio observacional retrospectivo realizado en un hospital Universitario en Buenos Aires, Argentina. Se incluyeron 41 pacientes con diagnóstico de artritis reumatoidea de acuerdo a los criterios establecidos por el Colegio Americano de Reumatología publicados en 1987; en un período de 20 años. Se incluyeron diagnósticos histopatológicos de nefropatía membranosa (NM), enfermedad de cambios mínimos (ECM), amiloidosis secundaria (AA), gloméruloesclerosis focal y segmentaria (GEFS); glomerulopatía mesangial (GPM) y glomerulonefritis con proliferación extracapilar (GNEC). Las características clínicas, de laboratorios, la descripción histopatológica, los años de evolución de la artritis reumatoidea y los diferentes tratamientos fueron analizados durante los primeros 6 meses y al año del seguimiento. Con esto, se buscó determinar la progresión de la insuficiencia renal, calculada a través de la fórmula de MDRD (Modification of Diet in Renal Disease) de 4 variables y el aumento de la proteinuria. Resultados: El hallazgo histológico más frecuente fue la amiloidosis, con un 34.1 % (n=14), seguido de la glomerulopatía mesangial (21,9 %, n=9), la nefropatía membranosa (19,5 %, n=8), la glomerulonefritis con proliferación extracapilar (12,1 %, n=5), la glomeruloesclerosis focal y segmentaria (7,3 %, n=3) y enfermedad de cambios mínimos (8,2 %, n=2). El síndrome nefrótico fue la forma de presentación más frecuente en los pacientes con amiloidosis (en un 85,7 % de los casos), la microhematuria se presentó en el 100 % de los pacientes con GPM y en el 80 % de los pacientes con GNEC. En el 85,7 % de los pacientes con AA, se presentó fibrosis intersticial moderada a severa, mientras que en la GNEC y la NM la fibrosis se observó en un 80 % y 40 % respectivamente. Se evaluó la proteinuria de 24 horas, la creatinina y la filtración glomerular estimada por MDRD a los 6 y a los 12 meses. Se concluyó que los pacientes con AA, GEFS y GNEC presentaron mayor progresión de la insuficiencia renal a los 12 meses. Lo contrario sucedió en los pacientes con enfermedad de cambios mínimos (ECM) y glomerulopatía mesangial (GPM), los cuales tenían una menor progresión de la insuficiencia renal al año de seguimiento. Hubo una correlación entre las glomerulopatías que tenían mayor deterioro de la función renal en las cuales se observó a su vez, mayor compromiso tubulointersti-cial, (este fue el caso de la amiloidosis). Las glomerulopatías que presentaban mayor proteinuria al inicio eran la nefropatía membranosa, la amiloidosis y la enfermedad de cambios mínimos. Tanto la nefropatía membranosa como la enfermedad de cambios mínimos, tenía remisión parcial tras un año, a diferencia de la amiloidosis, la cual presentaba progresión de la proteinuria a los 12 meses de seguimiento. Conclusión: Las glomerulopatías que presentaron mayor progresión de la insuficiencia renal al año, con base en la estimación por MDRD4, tenían en la biopsia renal mayor compromiso tubulointersticial. Estas fueron la amiloidosis secundaria, la glomeruloesclerosis focal y segmentaria, y glomerulonefritis con proliferación extracapilar. Por el contrario, las de mejor evolución respecto al grado de proteinuria y tasa de filtrado glomerular determinado por MDRD4, fueron la glomerulopatía mesangial, la enfermedad de cambios mínimos y la nefropatía membranosa.

Analysis on interference of blood urine on UF-1000i automatic urinary sediment analyzer / 医疗卫生装备

Objective To investigate the interference of blood urine on red cell detection of subsequent adjacent specimen on Sysmex UF-1000i flow cytometer urine sediment analyzer and to propose some countermeasures.Methods Totally 60 copies of fresh urine specimens having the results in normal range were chosen,and then each copy was divided into three pieces.All the pieces of specimens were put on the tube rack between the low-,medium-and high-concentration blood urine,and the urine was in front of the specimens.UF-1000i automatic urinary sediment analyzer was used for detection under auto sampling mode,and paired t-test was carried out for the results before and after interferences by concentrations of blood urine.The carryover was measured for the specimens and blood urine,and the specimens underwent microscopy.Results The RBC results had no significant difference before and after the interference by low-concentration blood urine (P＞0.05),while had statistical differences before and after the interferences by medium-and high-concentration blood urine (P＜0.01).There was also obvious difference between the RBC results interfered by medium-concentration blood urine and by highconcentration one.There were no significant differences between the results of WBC,epithelial cell and cast before and after the interferences (P ＞0.05).The urinary sediment microscopy results were within the normal range,and the highconcentration blood urine had the carryover gain the maximum value.Conclusion UF-1000i automatic urinary sediment analyzer has the RBC result higher than the actual one after the interference,and the interference deteriorates with the increased concentration of blood urine.The blood urine specimen has to be tested separately,and deep cleaning has to be performed for the analyzer.The test by the analyzer had better be combined with microscopy to avoid carryover.

Analysis on interference of blood urine on UF-1000i automatic urinary sediment analyzer / 医疗卫生装备

Objective To investigate the interference of blood urine on red cell detection of subsequent adjacent specimen on Sysmex UF-1000i flow cytometer urine sediment analyzer and to propose some countermeasures.Methods Totally 60 copies of fresh urine specimens having the results in normal range were chosen,and then each copy was divided into three pieces.All the pieces of specimens were put on the tube rack between the low-,medium-and high-concentration blood urine,and the urine was in front of the specimens.UF-1000i automatic urinary sediment analyzer was used for detection under auto sampling mode,and paired t-test was carried out for the results before and after interferences by concentrations of blood urine.The carryover was measured for the specimens and blood urine,and the specimens underwent microscopy.Results The RBC results had no significant difference before and after the interference by low-concentration blood urine (P＞0.05),while had statistical differences before and after the interferences by medium-and high-concentration blood urine (P＜0.01).There was also obvious difference between the RBC results interfered by medium-concentration blood urine and by highconcentration one.There were no significant differences between the results of WBC,epithelial cell and cast before and after the interferences (P ＞0.05).The urinary sediment microscopy results were within the normal range,and the highconcentration blood urine had the carryover gain the maximum value.Conclusion UF-1000i automatic urinary sediment analyzer has the RBC result higher than the actual one after the interference,and the interference deteriorates with the increased concentration of blood urine.The blood urine specimen has to be tested separately,and deep cleaning has to be performed for the analyzer.The test by the analyzer had better be combined with microscopy to avoid carryover.

Study of applications of urine routine and urinary sediment in urine test / 中国生化药物杂志

Objective To study the relationship between urine routine and urinary sediment in urine test.Methods 80 cases of patients accepted urine test in our hospital from May 2014 to May 2016 were selected, these patients were divided into urine routine group (n=40) and urinary sediment group (n=40) two groups according to the detection methods, the sampling collected time, obtained time, Resultstime, urine protein, white blood cells, red blood cells, crystallization, tube type test results of the two groups were statistically analyzed.ResultsThe differences of sampling collected time, obtained time, results time between the two groups were not significant;the detection positive rates of urinary protein, white blood cells, red blood cells, crystallization, tube type of the urine routine group were 15%, 20%, 22.5%, 27.5%, 25%, respectively, the urine sediment group were 15%, 20%, 25%, 30%, 27.5%, respectively.The differences of detection positive rates of urinary protein, white blood cells, red blood cells, crystallization, tube type between the two groups were not significant;the detection positive coincidence rates of urinary protein, white blood cells, red blood cells, crystallization, tube type of the two groups were 15%, 17.5%, 22.5%, 25% 22.5%, respectively, the negative coincidence rates were 82.5%, 77.5%, 72.5%, 72.5%, 70%, respectively, the total detection rates were 97.5%, 95%, 95%, 97.5%, 92.5%, respectively.Conclusion Combined detection of urine routine and urinary sediment in urine test can significantly improve detection accuracy.

Value of Sysmex UF-1000i Urinary Sediment Analyzer in Diagnosis of Urinary Tract Infection due to Different Urinary Specimen Collection Methods / 医学研究杂志

Objective To explore the value of Sysmex UF-1000i urinary sediment analyzer in diagnosis of urinary tract infection (UTI) and clarify the influence caused by different specimen on UF-1000i diagnosing UTI.Methods Totally 466 specimens examined bacterial culture and routine urinalysis were collected from patients suspected of UTI during July and August,2015 (samples of group A).148 specimens during late March and early April were gathered to implement a urine culture and then the rest of urine were detected byUF -1000i urinary sediment analyzer instantly(samples of group B).Bacteria and leukocyte counts were gathered and then receiver operating characteristic (ROC) carve was drawn regarding thegold standard as bacterial culture by SPSS18.0.Next,the threshold values of bacteria and leukocyte counts for diagnosis of UTI were found out.Meanwhile,itssensitivity,specificity,positive/negative predictive value,false positive/false negative value,and diagnostic accuracy were calculated.Results The cut off values to samples of group A were101.7 bacteria/μl and 18.8WBC/μl respectively and to samples of group B were 98.7 bacteria/μl and 11.1WBC/μl respectively.The area of Bacteria and leukocyte counts under ROC carve was 0.604 and 0.661 to samples of group A and 0.941 and 0.848 to samples Of group B.To samples of group B,combined Bacteria and leukocyte counts for UTI,the optimum sensitivity was 82.4％,specificity was 92.1％,positive predictive value was 77.8％,negative predictive value was 93.8％,false positive rate was 7.9％,false negative rate was 17.6％,and accuracy was 89.9％.Bacterial culture was reduced by 70.9％.Conclusion UF-1000i urine sediment analyzers have the value of early screening value and help to diagnose UTI.Urine that was sterilely collected and examined within two hours can make the value of UF-1000i maximized.

Recurrent IgA nephropathy after renal transplantation:not always a benign prognosis / 器官移植

Objective To discuss the clinicopathological characteristics and prognosis of the recurrence of IgA nephropathy (IgAN)after renal transplantation.Methods A total of 1 48 patients,pathologically diagnosed with IgAN which progressed into end-stage renal failure,undergoing renal transplantation in National Clinical Medical Research Center of Kidney Diseases,Nanjing General Hospital of Nanjing Military Command from January 1 996 to April 2009,were included in this study.According to whether IgAN recurred,all patients were assigned into recurrence (n =46)and non-recurrence groups (n =1 02).Urinary red blood cell (U-RBC)count,24 h urinary protein level,renal function including serum creatinine (Scr)and glomerular filtration rate (GFR)at 0,1 ,2,3 and 5 years after renal transplantation were statistically compared between two groups.The incidence of histopathological renal injury and survival rate of transplant kidneys was compared between two groups.Results In recurrence group,U-RBC count and 24 h urinary protein level were gradually elevated and renal function steadily declined.Compared with non-recurrence group,U-RBC count at 2-,3-and 5-year after renal transplantation significantly increased,and renal function was significantly aggravated at postoperative 5 years (all in P<0.01 -0.001 )in recurrence group.Renal pathological findings revealed that compared with non-recurrence group,the incidence of cellular crescent formation,glomerulus adhesion,mesangial cell proliferation,increased mesentery matrix, glomerulosclerosis,segmental glomerulosclerosis,glomerular dysfunction and tubulointerstitial fibrosis was significantly higher in recurrence group (all in P <0.001 ).After renal transplantation,chronic kidney injury index in recurrence group was 7.7 ±2.3,which was significantly higher than 4.6 ±1 .4 in non-recurrence group (P <0.01 ).Compared with non-recurrence group,the incidence of chronic rejection,glomerulopathy of transplant kidney (without IgAN)and positive C4d deposition was significantly higher in recurrence group (P <0.01 -0.001 ).At 1 -and 3-year after renal transplantation, survival rates of transplant kidney did not significantly differ between recurrence and non-recurrence groups (93.8% vs.86.7%,95.6% vs.88.3%,both in P >0.05).However,the survival rate at 5 years after transplantation was 51 .4% in recurrence group,significantly lower compared with 83.8% in non-recurrence group (P <0.001 ).In recurrence group,1 0 patients (22%)presented with renal failure after renal transplantation,and 9 patients (9%)in non-recurrence group.Conclusions After renal transplantation,the recurrence of IgAN characterized by asymptomatic microscopic hematuria, albuminuria and progressive aggravation of renal function reduce long-term survival rate of renal graft and indicate poor prognosis.

Marcadores de necrose tubular aguda e lesão inflamatória glomerular no sedimento urinária de pacientes com síndrome / Acute tubular necrosis markers and inflammatory glomerular injury urinary sediment syndrome patients

Necrose tubular aguda (NTA) é a causa mais frequente de lesão renal aguda (LRA) em pacientes hospitalizados. Em pacientes com síndrome nefrótica (SNO), a NTA mimetiza, por vezes, quadro de glomerulonefrite rapidamente progressiva e requer instituição precoce de imunossupressores. A análise do sedimento urinário é uma ferramenta não invasiva, de baixo custo e ampla disponibilidade. O achado de células epiteliais no sedimento urinário de pacientes com LRA foi associado ao diagnóstico de NTA. Entretanto, estudos em pacientes com SNO associada são escassos. Técnicas de diagnóstico utilizando sedimento urinário corado normalmente não são utilizadas nesses casos. Além do mais, o sedimento urinário é uma importante fonte de proteínas; estudos proteômicos do sedimento urinário revelaram importantes frações de proteínas não encontradas em sobrenadante, que pode ser usado como potencial biomarcador de LRA. Nosso objetivo é identificar alterações citológicas e protéicas no sedimento urinário que permitam o diagnóstico diferencial entre NTA ou lesão inflamatória-proliferativa glomerular (INF) em pacientes com SNO. Trata-se de um estudo de corte transversal, onde foram incluídos 32 pacientes: 5 pacientes normais (grupo controle), 10 com NTA, 9 sem NTA e 8 com glomerulonefrites exsudativas. As células do sedimento urinário foram contadas, citocentrifugadas, coradas em hematoxilina/eosina ou Papanicolaou e contadas diferencialmente como pequenas (<30μm de diâmetro), médias (30-48μm)...

Acute tubular necrosis (ATN) is the most frequent cause of acute kidney injury (AKI) in hospitalized patients. In patients with nephrotic syndrome (NS), acute tubular necrosis mimic, sometimes, rapidly progressive glomerulonephritis and requires premature institution of immunosuppressive treatment. The analysis of urinary sediment is a noninvasive tool, low cost and wide availability. The found of epithelial cells in the urinary sediment of patients with AKI was associated to ATN diagnosis. However, studies in patients with AKI in the set of NS are scarce. Diagnostics techniques using stained urinary sediment are not ordinarily used in these cases. Furthermore, urinary sediment is an important source of proteins; proteomic studies revealed important fractions of proteins not found in urinary supernatant that could be used as potential biomarkers for AKI. Our goal is identify cytological alterations and protein in urinary sediment which allow the differential diagnosis between ATN and inflammatory-proliferative glomerular lesion (INF) in patients with NS. This is a cross sectional study, in which 32 patients were included: 5 normal patients (control group), 10 with ATN, 9 without ATN and 8 with exudative glomerulonephritis. The cells of urinary sediment were counted, cytocentrifuged, stained of hematoxylin/eosin or Papanicolaou and differentially counted as small (<30μm of diameter), medium (30-48μm)...

Correlation of quantitative examination of urinary sediment bacteria and urine culture / 国际检验医学杂志

Objective To evaluate quantitative examination of urinary sediment bacteria as a basic feasibility of screening indicators for urinary tract infection .Methods 191 outpatients and inpatient specimens were gathered firstly to implement a urine culture ,and then the rest of the urine were used for sediment bacteria quantitative testing .Meanwhile ,bacterial culture was conducted as the standard .According to the results of bacterial culture ,receiver operating characteristic(ROC) was drawn ,the threshold values of leukocyte and bacteria counts for diagnosis of urinary tract infection were found out and its sensitivity ,specificity ,positive / negative predictive value ,false positive/false negative rate and accuracy were calculated .Results The positive rate of urine culture was 39 .7% ,and the most common pathogen was Escherichia coli .The threshold value of bacteria and leukocyte counts for diagnosis of urinary tract infection was 1 024 .5/μL and 135 .8/μL respectively .When combined leukocyte and bacteria counts for urinary tract infection ,the optimum sensitivity was 62 .5% ,specificity was 98 .1% ,positive predictive value was 95 .7% ,negative predictive value was 79 .6% ,false positive rate was 1 .9% ,false negative rate was 37 .5% ,and accuracy was 83 .8% .Conclusion With UF‐1000i urinary sediment analyzer ,the combined determination of leukocyte and bacteria counts can remove the great mass of negative results ,Especially the results of bacterial culture positive predictability is higher ,but still can not replace of quantitative bacterial culture .

Establishment of the reference values of urinary formed elements detected by Sysmex UF-1000i fully automatic urine analyzer / 国际检验医学杂志

Objective To investigate the reference values of urinary formed elements detected by Sysmex UF‐1000i fully auto‐matic urine analyzer (UF‐1000i) in healthy people with different genders and different ages in Lanzhou .Methods 476 cases of clean midway urine samples were collected from healthy people .UF‐1000i was used to detect the urinary formed elements ,including WBC ,RBC ,EC ,CAST and BACT .Results There were differences in the results of urinary formed elements among healthy people with different genders and different ages .And the reference values of WBC ,RBC ,EC ,CAST and BACT were established respective‐ly in the crowds of male and female children ,adults ,and elderly .Conclusion It is necessary to establish the reference values of uri‐nary formed elements for the crowds with different genders and different ages in some region .

Análise comparativa de duas metodologias para a identificação de cilindros hemáticos urinários / Comparative analysis of two methodologies for the identification of urinary red blood cell casts

INTRODUÇÃO: A presença de hemácias dismórficas na urina é um forte indicativo da origem glomerular do sangramento, sendo uma ferramenta importante no diagnóstico de glomerulonefrites. Os cilindros hemáticos geralmente acompanham as hemácias dismórficas, sendo também fortes indicadores de hematúria glomerular, embora não sejam encontrados com frequência no exame parcial de urina. OBJETIVO: Comparar duas técnicas de concentração de amostras em uma série de exames de urina com hematúria dismórfica. MATERIAL E MÉTODOS: Foram selecionadas 249 amostras com hematúria dismórfica a partir de 4.277 amostras de urina de rotina. As amostras foram processadas utilizando-se duas técnicas: a convencional e a de concentração. O percentual de identificação dos cilindros hemáticos foi comparado de acordo com a metodologia utilizada. RESULTADOS: A presença de cilindros hemáticos pela técnica de concentração foi estatisticamente maior (52,6 por cento) em comparação com a positividade pela metodologia convencional (8,4 por cento) (p < 0,001). DISCUSSÃO E CONCLUSÃO: Sugere-se que a técnica convencional não concentrou suficientemente a amostra de urina e os cilindros hemáticos ficaram no sobrenadante, sendo descartados. A utilização da técnica de concentração aumentou a sensibilidade técnica para a pesquisa dos cilindros hemáticos. Portanto, a técnica de concentração, associada à presença de hemácias dismórficas, mostrou-se útil para aumentar a concordância dos dois parâmetros laboratoriais para a detecção da hematúria de origem glomerular como auxílio diagnóstico das glomerulopatias, importante causa de doença renal crônica.

INTRODUCTION: Dysmorphic red blood cells (RBCs) in the urine are a strong indicator of a glomerular bleeding source. RBC casts, which while generally following RBC dysmorphism are not frequently seen on routine urinalysis, are also important indicators of glomerular hematuria. OBJECTIVE: This study tested the superiority of a urine concentration technique (CT) over the standard method (SM) for RBC cast identification in a group of patients suspected of glomerular hematuria. MATERIAL AND METHODS: Of a total of 4,227 routine urinary samples, 249 with dysmorphic hematuria were selected. The samples were processed according to two techniques: standard method (SM) and concentration technique (CT). The percentages of RBC cast identification according to each method were compared. RESULTS: The CT showed a higher rate of RBC casts (52.6 percent) compared to the SM (8.4 percent) (p < 0.001). DISCUSSION AND CONCLUSION: We suggest that the SM did not sufficiently concentrate the urine sample, the RBC casts remaining in the supernatant and being discarded. The CT increased the sensitivity of the RBC cast yield. The CT, associated with the presence of RBC dysmorphism, was useful to increase the agreement of the two parameters used for identification of glomerular-based bleeding and the diagnosis of glomerular diseases, important causes of chronic kidney disease.

Annual Report on External Quality Assessment in Urinalysis in Korea (2009) / 임상검사와정도관리

Three external quality assesment trials which composed of 16 control materials(12 chemical materials and four sets of microscopic photograph of urinary sediment) for interlaboratory quality control assesment in urinalysis were performed with 796, 823, and 841 participants, in each, in the year of 2009. The response rate were 97.1% (796/820), 95.5% (823/862) and 97.1% (841/866), in the first, the second and the third trials, in each. The test items include pH, glucose, protein, ketone, bilirubin, blood, urobilinogen, nitrite, leukocyte estrase, specific gravity and four microscopic photographs of urinary sediment. The survey results are summarized as follows: 1. The chemical quality control test in urinalysis revealed generally good concordance. 2. The percentage of using urinalysis analyzer was slightly decreased as 82.3% and the distribution of using reagent strip was similar to the previous year. 3. The percentage of response rate of microscopic photographs of urinary sediment was 83.5% (702/841) and the percentage of good performance of these tests ware 83.6% to 99.1%.

Annual Report on External Quality Assessment in Urinalysis in Korea (2008) / 임상검사와정도관리

Three external quality assesment trials which composed of 16 control materials (12 chemical materials and four sets of microscopic photograph of urinary sediment) for interlaboratory quality control assesment in urinalysis were performed with 699, 718, and 732 participants, in each, in the year of 2008. The response rate were 95.4% (699/733), 96.6% (718/743) and 95.3% (732/767), in the first, the second and the third trials, in each. The test items include pH, glucose, protein, ketone, bilirubin, blood, urobilinogen, nitrite, leukocyte estrase, specific gravity and four microscopic photographs of urinary sediment. The survey results are summarized as follows: 1. The chemical quality control test in urinalysis revealed generally good concordance. 2. The percentage of using urinalysis analyzer was slightly decreased as 83.0% and the distribution of using reagent strip was similar to the previous year. 3. The percentage of response rate of microscopic photographs of urinary sediment was 81.3% (571/732) and the percentage of good performance of these tests ware 32.9% to 80.5%.

Annual Report on External Quality Assessment in Urinalysis in Korea (2007) / 임상검사와정도관리

Three external quality assesment trials which composed of 16 control materials (12 chemical materials and four microscopic photographs of urinary sediment) for interlaboratory quality control assesment in urinalysis were performed with 638, 645, and 662 participants, in each, in the year of 2007. The response rate were 95.5% (638/668), 96.7% (645/667) and 97.1% (662/682), in the first, the second and the third trials, in each. The test items include pH, glucose, protein, ketone, bilirubin, blood, urobilinogen, nitrite, leukocyte esterase, specific gravity and four microscopic photographs of body fluid and urinary sediment. The survey results are summarized as follows: 1. The chemical quality control test in urinalysis revealed generally good concordance. 2. The percentage of using urinalysis analyzer was slightly increased as 87.5% and the distribution of using reagent strip was similar to the previous year. 3. The percentage of response rate of microscopic photographs of urinary sediment was 80.7% (536/662) and the percentage of good performance of these tests was 60.6% to 99.1%.

Annual Report on External Quality Assessment in Urinalysis in Korea (2007) / 임상검사와정도관리

Three external quality assesment trials which composed of 16 control materials (12 chemical materials and four microscopic photographs of urinary sediment) for interlaboratory quality control assesment in urinalysis were performed with 638, 645, and 662 participants, in each, in the year of 2007. The response rate were 95.5% (638/668), 96.7% (645/667) and 97.1% (662/682), in the first, the second and the third trials, in each. The test items include pH, glucose, protein, ketone, bilirubin, blood, urobilinogen, nitrite, leukocyte esterase, specific gravity and four microscopic photographs of body fluid and urinary sediment. The survey results are summarized as follows: 1. The chemical quality control test in urinalysis revealed generally good concordance. 2. The percentage of using urinalysis analyzer was slightly increased as 87.5% and the distribution of using reagent strip was similar to the previous year. 3. The percentage of response rate of microscopic photographs of urinary sediment was 80.7% (536/662) and the percentage of good performance of these tests was 60.6% to 99.1%.

Annual Report on External Quality Assessment in Urinalysis in Korea (2005) / 임상검사와정도관리

Three external quality assesment trials which composed of 16 control materials (12 chemical materials and four microscopic photographs of urinary sediment) for interlaboratory quality control assesment in urinalysis were performed with 451, 452, and 476 participants, in each, in the year of 2005. The response rate were 95.6% (451/472), 91.9% (452/492) and 95.6% (476/498), in the first , the second and the third trials, in each. The test items include pH, glucose, protein, ketone, bilirubin, blood, urobilinogen, nitrite, leukocyte estrase, specific gravity and four microscopic photographs of urinary sediment. The survey results are summarized as follows: 1. The chemical quality control test in urinalysis revealed generally good concordance. 2. The percentage of using urinalysis analyzer was slightly increased as 91.2% and the distribution of using reagent strip was similar to the previous year. 3. The percentage of response rate of microscopic photographs of urinary sediment was 76.5%(387/498) and the percentage of good performance of these tests ware 63.6% to 86.5%.

Annual Report on External Quality Assessment in Urinalysis in Korea (2004) / 임상검사와정도관리

Three external quality assesment trials which composed of 16 control materials(12 chemical materials and four microscopic photographs of urinary sediment) for interlaboratory quality control assesment in urinalysis were performed with 446, participants, in each, in the year of 2004. The response rate were 93.4% (422/452), 91.7% (411/448) and 91.7% (410/447), in the first , the second and the third trials, in each. The test items include pH, glucose, protein, ketone, bilirubin, blood, urobilinogen, nitrite, leukocyte estrase, specific gravity and four microscopic photographs of urinary sediment. The survey results are summarized as follows: 1.The chemical quality control test in urinalysis revealed generally good concordance. 2.The percentage of using urinalysis analyzer was slightly increased as 87.9% and the distribution of using reagent strip was similar to the previous year. 3.The percentage of response rate of microscopic photographs of urinary sediment was 80.7% and the percentage of good performance of these tests ware 85.8% to 95.8%.

Analysis and Countermeasures of False Determination of the Results in Urine Particles with IQ200 Automated Urinalysis Analyzer / 医疗卫生装备

Objective To discuss the factors that affect the examination of urine formed elements by IQ200 automated uri-nalysis analyzer causing false positive and look for the solution methods. Methods 2,319 urine samples were tested by IQ200 automated urinalysis analyzer and microscopy. The results were contrasted and the false positive reasons were ana-lyzed. Results When using IQ200 automated urinalysis analyzer,the false positive rate of red cell is 14.7%. Crystals,bac-teria,yeast like fungus sometimes are regarded as red cell by analyzer. The false positive rate of white cell is 15.75%. Small round cells,lots of bacterium can cause false positive; the false positive rate of cast is 38.58 % and viscose rayon is main agent. Conclusion Many factors can affect the examination in IQ200 automated urinalysis analyzer and cause false positive,so IQ200 can only be used for scanning,which is very important to observe sediments by microscopic examination when pathologic ingredients in urine are increased and at the same time all above interferences are positive and manifold.

Development of intelligent vision analysis system for urinary sediments / 医疗卫生装备

This paper introduces an intelligent vision analysis system for urinary sediments,which includes the function modules of mechanical,automatic adding sample and cleaning,images collecting,processing and intelligent vision recognition,system software and so on.It implements the course of adding sample,cleaning,images collecting,feature extraction,recognition and counting,self-learning automatically.

Development and application of urinary sediment diagnostic system and its data management system / 医疗卫生装备

This paper introduces such information of a urinary sediment diagnostic system and its data management system saving data directly from urine analyzer and microscope as its hardware organization and software design.With the performances of easy tooperate and low cost,the system can be applied toclinical urine diagnosis and togenerating standardized reports,whose data management system has high security and accuracy for saving data,strong anti-interference capability,reliable performance,noerror in proceeding and Chinese interface.

Cytodiagnostic Urinalysis in the Differentiation of Leukocyturias of Children with Bacterial Urinary Tract Infection (UTI) from Those of Children without UTI

PURPOSE: Although routine urinalysis can detect leukocyturia, difficulties remain in differentiating subpopulations of leukocytes and various epithelial cells in urinary sediments. This study was performed to appreciate the value of cytodiagnostic urinalysis in the discrimination of leukocyturias of bacterial urinary tract infection (UTI) from those without UTI. METHODS: Urine from 12 children with UTI (UTI group) and from 11 children without UTI (non-UTI group) were subjected to cytodiagnostics urinalysis. The number of cases presenting one or more cells of each type in 10 high power fields, and the mean cell numbers observed in a high power field were compared between the two groups. RESULTS: Polymorphonuclear leukocytes (PMNs) appeared in all cases of the UTI group and in 55% of the non-UTI group, whereas renal tubular epithelial cells were detected in none of the UTI group and 55% of the non-UTI group. In the UTI group, more number of total cells, total WBCs, PMNs and less renal tubular epithelial cells were observed compared to the non-UTI group. CONCLUSIONS: Identification and measurement of the number of PMNs and the renal tubular epithelial cells by cytodiagnostic urinalysis can aid in the discrimination of leukocyturias of children with UTI from those without it.