진단검사의학의 기원과 역사 = Origins and History of Laboratory Medicine

국문 초록 (Abstract)

진단검사의학은 의학적 의사결정에 중요한 역할을 한다. 가장 먼저 사용된 검사는 소변검사로 환자의 진단에 소변의 양상을 이용하여 진단하였고, 이후 채취방법 및 검사법의 발전으로 20세기부터 검사실에서 정규검사로 사용되었다. 현미경의 발명으로 혈액학이 발전하여 혈액 내 성분의 검사들이 시행되었다. 17세기부터 임상화학검사의 요구가 있어왔고, 18세기부터는 환자 혈액을 이용한 화학검사에 대한 연구가 시작되어 20세기에는 분광광도계의 발전으로 의학에서 사용하기 쉬운 검사법으로 화학검사가 시행되었다. 콜레라의 대유행 이후 많은 환자의 진단에 필요한 미생물 발견 및 검사법의 발전으로 검사실에서 미생물을 검출하는 데 기여하였다. 수혈의학은 혈액을 섭취하는 데서 시작하여 15세기 수혈이 시작되어 현재에는 의학의 치료요법 중 하나로 자리잡았다. 면역획득에 관한 가설이 18세기에 증명이 되면서 발전하여 다양한 면역측정법이 개발되었다. 19세기 멘델의 유전법칙의 발표 이후 20세기부터 발전된 현대 유전학의 기틀 위에 분자진단은 급속도로 발전하여 진단검사의학에서 현재 가장 발전하는 분야가 되었다. 이렇게 진단검사의학은 근간을 이루는 기초의학의 발전을 토대로 하나의 학문이 되었다. 인간 수명 100세를 앞둔 현 시대에 현대의학은 더욱 더 발전할 것이고, 그 발전의 길목에서 진단검사의학이 중요한 근거를 제시할 것이다.

다국어 초록 (Multilingual Abstract)

Medical diagnostics plays a significant role in clinical decisions. The first medical laboratory test to be developed was urine analysis, in which urine properties were analyzed for diagnosis. Urine analysis has been long used as a routine laboratory test that was improved with the development of sampling and test methods. As the field of hematology progressed with the invention of the microscope, blood tests were developed. Demands for tests based on clinical chemistry have existed since the 17th century, and research using patient blood began in the 18th century. In the 20th century, with the development of the spectrophotometer, chemical analyses were performed for diagnostic purposes. With the appearance of cholera outbreaks, the identification of microorganisms was necessary for patient diagnosis, and the development of specific test methods contributed to microorganism detection in the laboratory. Blood transfusion, which started with blood collection in the 15th century, is currently used as a therapeutic method in medicine. Moreover, once the hypothesis of acquired immunity was proven in the 18th century, various methods for measuring immunity were developed. Molecular diagnosis, which was established during the 20th century after the presentation of Mendel’s Genetic Laws in the 19th century, developed rapidly and became the predominant field in medical laboratory diagnostics. Thus, medical laboratory technology became an academic field, with foundations based on basic sciences. Modern medicine will further progress thanks to medical advancements, leading to an extension of average human lifespan up to 100 years. Laboratory medicine will provide significant support for this development.

참고문헌 (Reference)

• 1 Forsman RW, "Why is the laboratory an afterthought for managed care organizations?" 42 : 813-816, 1996
• 2 Hammarsten JF, "Who discovered smallpox vaccination? Edward Jenner or Benjamin Jesty?" 90 : 44-55, 1979
• 3 Hakim G, "What is on the molecular diagnostics horizon? Part 5b--a brief history of medical diagnosis and the birth of the clinical laboratory" 40 : 18-20, 2008
• 4 Helden AV, "The origins of the telescope" KNAW Press 32-43, 2010
• 5 Learoyd P, "The history of blood transfusion prior to the 20th century –Part 2" 22 : 372-376, 2012
• 6 Learoyd P, "The history of blood transfusion prior to the 20th century –Part 1" 22 : 308-314, 2012
• 7 Copeland DD, "Polishing the crystal ball : emerging trends in contemporary clinical laboratory medicine" 68 : 101-108, 2007
• 8 Robert EM, "Molecular diagnostics: for the clinical laboratorian" Humana Press 3-10, 2005
• 9 Cho MJ, "Medical microbiology" Elsevier Korea LLC 5-, 2007
• 10 Bolodeoku J, "Laboratory instrumentation in clinical biochemistry : an historical perspective" 90 : 570-577, 1997
• 11 Turgeon ML, "Immunology and serology in laboratory medicine" Mosby Inc. and Elsevier Inc 1-2, 2008
• 12 Bolodeoku J, "Historical perspectives on health. Origins of blood analysis in clinical diagnosis" 118 : 231-236, 1998
• 13 Wu AH, "A selected history and future of immunoassay development and applications in clinical chemistry" 369 : 119-124, 2006
• 14 Berger D, "A brief history of medical diagnosis and the birth of the clinical laboratory. Part 2--Laboratory science and professional certification in the 20th century" 31 : 32-34, 1999
• 15 Berger D, "A brief history of medical diagnosis and the birth of the clinical laboratory. Part 1--Ancient times through the 19th century" 31 : 28-30, 1999
• 16 Bersch C, "A brief history medical diagnosis and the birth of the clinical laboratory Part 5a- the foundation of molecular science and genetics" 38 : 16-18, 2006