| Description |
In recent years there have been logarithmic upsurges of test demands placed on medical laboratories. Currently, there is a pre-existent and progressive shortage of medical technologists. The widening gap has in part been closed by automation. Automation is being heavily utilized to an increasing degree in most areas of the laboratory with enhanced accuracy and precision, decreased professional effort and significantly decreased cost to the patient as coincidental returns. Through automation mass screening is being performed and maximum quality control can be exercised. The urinalysis may be the last major hiatus still remaining. Inasmuch as the clinical laboratory scientist is dedicated to providing maximum excellence in patient care and because present methodologists (spot testing) in the area of urinalysis provide suboptimal clinical information, a study was undertaken to devise methodologies and essential equipment to improve laboratory diagnosis in the area. The routine urinalysis consisting of test for pH, specific gravity, protein, sugar, hemoglobin and ketones was studied. Two additional tests, creatinine and bilirubin, were also incorporated. Color determination was investigated colorimetrically and pH was studied with an electrometer. Methods utilizing micro-quantities of specimen were devised and adapted to two systems. One system was a urine analyzer designed and built especially for the study. The second system was fabricated from existing laboratory apparatus. The feasibility of automating urinalysis was established for both systems. Using healthy volunteers, the normal ranges and other pertinent data were established for each method. Pathologic specimens were included in the study. Comparison with existing spot test proved the value of the automated quantitative approach. Several innovations resulted from this study. The use of a double beam colorimeter eliminated possible background errors introduced by reagents or intrinsic pigments in the specimens. A new test for glucose was designed using a previously unreported coenzyme analog which permitted linear colorimetric readings up to 10000mg/100 ml without pretreatment of the specimen. Creatinine was determined for the first time on undiluted urine with a linear range up to 375 mg/ 100 ml. A novel approach for analyzing bilirubin was developed. A relatively "noise free" turbidimetric protein test system was adapted to continuous flow automation. Hemoglobin was estimated using O-dianisidine, with a degree of sensitivity five times greater than preciously attainable. An electronic system was proposed and fabricated which enabled three orders of signal magnitude to be compressed into one scale sweep. In summary, the automation of the urinalysis was achieved. In summary, the automation of the urinalysis was achieved. The quantitative automated approach appears technically and clinically superior to the qualitative manual method. |
