[Clinical chemistry in a fog].

In medical practice, laboratory tests, especially chemical tests, has been used as an important supplementary tool for diagnosis. However, recent "clinical chemistry" as a science is stagnant and wandering. Since the clinical importance of "clinical chemistry" has been clarified in various fields and deeply permeated into daily practice, "clinical chemistry" as a science has come up against a brick wall. With such a background, some researchers attempted to find a way in the technical field or accuracy management field, i.e., "analytic chemistry". In this field, certain results have been obtained, and the analytic accuracy has been so improved as to reflect in vivo changes at extremely high accuracy. However, this "analytical chemistry" is, so to speak, a field of emergency refuge of "clinical chemistry" and not its original state. Many clinical chemical items can be analyzed using automatic analyzers, and academic interest is lost due to autoanalysis as a black box. In present status, we should develop a new "clinical chemistry". The borders between examination areas have become unclear, and immunological laboratory techniques have been introduced into clinical chemistry. We should estimate new approach using these new techniques and establish their clinical significance. In medical practice, not only diagnostic imaging test, such as ultrasound imaging CT, MRI for evaluation of organic in vivo changes but also clinical test including chemical test for sensitive evaluation of functional changes is indispensable. These two examination methods should be combined in medical care with "patients" placed in its central position.