Department of Pathology [1] Clinical Pathology Services [2] Histopathology Services [3] Molecular Pathology [4] Other Special Function Services [5]

Phlebotomy
Venipuncture and other blood sampling procedures are provided by a well-trained and highly experienced team of phlebotomists who are all certified, with some of them having over 20 years of phlebotomy experience.

The BD Vacutainer^TM Blood Collection System
The team utilises the latest technology for sample collection. The BD Vacutainer^TM blood collection system provides different types of tubes suitable for various specialised tests. These include:

• Serum separation tube (SST) with clot activator and gel
• Plain tubes for general use
• Trace element tubes for determining trace elements in blood
• Rare elements tube with sodium heparin, sodium EDTA for rare elements and toxicology use
• Heparin tubes for plasma separation
• Potassium oxalate or sodium fluoride tubes for blood glucose testing
• EDTA tube for complete blood picture testing
• Citrate tubes for coagulation testing

Enhanced Safety
As safety is of paramount importance to patients and staff alike, the Department is insistent that guidelines are followed strictly to minimise any possible risk when collecting blood samples from patients. The Vacutainer^TM evacuation tube removes the risk of samples being exposed to the environment. Bright yellow sharps boxes are used for collecting used needles, syringes and glassware.


Electrocardiography
Electrocardiogram (ECG) is a representation of the heart's electrical activity recorded from electrodes placed on the body surface. In an ECG test, the electrical impulses made while the heart is beating are recorded. It records any problems with the heart's rhythm, and the conduction of heart beat which may be affected by underlying heart diseases. Information obtained can be used by physicians to better understand the type of heart disease the patient is having, and to monitor the patient's response to treatment.

A fully qualified technical staff will carry out the procedure, while Consultant Cardiologists will provide detailed interpretations of the report if required. Aside from conventional 12-lead ECGs, the equipment provides optional programmes for real-time continuous recording of 3, 6 or 12 channels.


C13 Urea Breath Test
Helicobacter pylori carriers have a high tendency of developing chronic gastritis, which may progress to duodenal or gastric ulcers and eventually carcinoma. Hence an early detection is advised to allow prompt treatment.

The mechanism is to diagnose H. pylori infection by measuring the urease activity of the bacterium. Urease breaks down the C13-labeled non-radioactive urea to produce labeled carbon dioxide and ammonia. Exhaled carbon dioxide is then collected in a test bag which is analysed by non-dispersive infrared spectrometry (NDIRS). Since the test is non-invasive and painless, it is suitable for all patients including children, the elderly and pregnant women.


Sleep Apnea Assessment
Obstructive Sleep Apnea [6] (OSA) is a temporary cessation of breathing during sleep when structures in the throat block the flow of air in and out of the lungs. It can be due to obstruction from the tongue, tonsils, uvula or fatty tissue deposits, or muscle relaxation in the throat which blocks air intake. OSA is often associated with low oxygen levels during recurrent partial awakenings, hence leading to pulmonary hypertension and right ventricular failure if untreated.

A private room is equipped and converted into a Sleep Laboratory, where polysomnography, the testing process used to investigate sleep conditions, will take place. It is a painless and non-invasive procedure, carried out by recording the brain waves, eye and body movements, heart rate, breathing pattern, muscle activities and oxygen levels during sleep. A consultant physician provides detailed analysis of the data collected to note for abnormalities, and also to monitor treatment of the condition with Continuous Positive Airway Pressure (C-PAP) titration.


Ambulatory Oesophageal pH Monitoring
The incidence of gastro-oesophageal reflux disease (GORD) is increasing alarmingly worldwide, and Hong Kong is no exception. With a strike rate of almost 1 in 10 of the adult population, GORD is a disease that causes the reflux of acidic digestive materials from the stomach back up to the oesophageal canal. Most patients only experience mild discomfort, but a proportion has atypical symptoms of angina-like chest pain, globus, hoarseness or atypical asthma.

The best way to diagnose GORD is by 24-hour ambulatory oesophageal pH monitoring. This test is performed by connecting the patient to a portable device via a pH catheter. The catheter is inserted into the patient's lower oesophageal region through the nostril and fixed into position. The patient is then hospitalised for 24 hours while data is collected. At the end of testing, the device is connected to a computer and the data is uploaded.

A Consultant Gastroenterologist provides detailed analysis of the data to make a diagnosis and to suggest a suitable treatment regimen.