bluuebunny/crossref_metadata_2025_split huggingface dataset:
Total and direct-reacting bilirubin values by automated methods compared with liquid chromatography and with manual methods for determining delta bilirubin
Authors: Rosenthal P , Keefe M T , Henton D , Cheng M , Lee C R , Hall R L , Newton M K 
Published: January 2020

Abstract
This study compares total and direct-reacting bilirubin values in 40 serum samples from patients with various diagnoses, as measured by automated methods (Beckman Synchron CX-5, Beckman Astra 8, Kodak Ektachem 700) and HPLC and by a manual method for delta bilirubin. For total bilirubin, within-run CVs were less than 6%. The Ektachem 700 method underestimated bilirubin with serum samples from patients with Crigler-Najjar syndrome and from newborns in whom unconjugated bilirubin concentrations were increased but conjugated bilirubins were not present or were present only in small amounts. The Astra 8 and Synchron CX-5 methods were inaccurate with cholestatic serum samples, in which conjugated bilirubin concentrations were increased and other compounds such as bile acids could be expected to interfere. We conclude that each automated method examined provides reasonable estimates for total and direct-reacting bilirubin values for routine clinical use. The need for each laboratory to select the appropriate bilirubin method for its particular situation is obvious.
Variant acute intermittent porphyria in a child
Authors: Badcock N R , Zoanetti G D , O'Reilly D A , Robertson E F 
Published: January 2020

Abstract
A child who was grossly malnourished and who showed increased excretion of porphyrin and porphyrin precursor had normal activity of erythrocyte porphobilinogen deaminase (EC 4.3.1.8) and leukocyte protoporphyrinogen oxidase (EC 1.3.3.4). Clinical symptoms, coincident with the excretion of rose-colored urine, were consistent with the diagnosis of an acute porphyria. The disease resolved spontaneously after the withdrawal of carbamazepine and sodium valproate and the commencement of parenteral nutrition with subsequent carbohydrate loading. In addition to normal concentrations of enzyme activities, the patient is unusual in presenting before puberty and in having no family history of porphyria.
Desialylated transferrin and mitochondrial aspartate aminotransferase compared as laboratory markers of excessive alcohol consumption
Authors: Kwoh-Gain I , Fletcher L M , Price J , Powell L W , Halliday J W 
Published: January 2020

Abstract
Concentrations of both desialylated transferrin (dTf) and the mitochondrial isoenzyme of aspartate aminotransferase (EC 2.6.1.1, mAST) have been claimed to be increased in sera of alcoholic subjects. To investigate the diagnostic usefulness of these new biochemical markers of alcoholism and to compare them with more conventional markers, we measured dTf and mAST in the sera of controls, alcoholic subjects, and patients with nonalcoholic liver diseases (NALD). Alcoholic subjects had significantly (P less than 0.001) higher ratios of dTf to total transferrin than did either healthy controls or patients with NALD (sensitivity 81%, specificity 97%). The mAST was increased in 92% of alcoholic subjects but also in 48% of patients with NALD. The mAST/total AST ratio differentiated the alcoholic subjects from those with NALD (P less than 0.001) with a sensitivity of 92%, but the specificity was only 70%. In contrast, the conventional markers were less sensitive and less specific. We conclude that the best available single laboratory marker for current heavy alcohol consumption is the ratio dTf/total transferrin.
Urinary excretion of cyclohexanediol, a metabolite of the solvent cyclohexanone, by infants in a special care unit
Authors: Mills G A , Walker V 
Published: January 2020

Abstract
Using gas chromatography-mass spectrometry, we investigated the urinary excretion of organic acids of 278 newborn babies in a special care unit to obtain reference data and monitor metabolism. In 101 of 584 urine samples analyzed, we found isomers of cyclohexanediol. trans-1,2-Cyclohexanediol was always most abundant, with small amounts of 1,3- and 1,4-cyclohexanediol and, sometimes, traces of cis-1,2-cyclohexanediol. Glucuronide conjugates were not detected. The probable source was the solvent cyclohexanone, which was found as a contaminant of intravenous dextrose and the parenteral feeding solution, and was also leached into the infusion fluids from the administration set. We recovered 0.89 mg (range 0.74-0.98 mg, n = 5) of cyclohexanone from 150 mL of dextrose pumped through the infusion apparatus over 24 h, the normal rate for a 1-kg premature baby. Although this is well below toxic doses reported for mature animals, more data are needed for the newborn, particularly preterm infants who have a decreased capacity for glucuronide conjugation.
Improved radioassay of anti-acetylcholine receptor antibody: application for the detection of extremely low antibody titers in sera from patients with myasthenia gravis
Authors: Ohta M , Ohta K , Mori F , Itoh N , Nishitani H , Hayashi K 
Published: January 2020

Abstract
We examined sera from 113 patients with myasthenia gravis (MG). Most of the patients with ocular MG without thymoma and 15% of the patients with generalized MG had immunoprecipitation (IP) titers of anti-acetylcholine receptor (anti-AChR) antibodies within the normal range for healthy subjects. We developed a highly sensitive radioassay using Staphylococcus aureus cells, and re-examined the 86 serum samples that had negative titers by IP. Using the radioassay, we detected anti-AChR antibodies in 27 (31%) of these myasthenic sera, of which 19 were from ocular MG patients without thymoma. By combining the standard IP assay and our new radioassay, we increased to 50% the overall percent positivity of detecting nonblocking-type antibodies in ocular MG patients without thymoma. We detected no anti-AChR antibodies in nearly all patients with various immunological and neurological diseases other than MG, and in all the healthy controls. The data for these sera indicate that in some cases the standard IP assay gives false-negative reactions. Thus, use of the more sensitive radioassay is preferable for accuracy.
Time-related changes in the diagnostic utility of total lactate dehydrogenase, lactate dehydrogenase isoenzyme-1, and two lactate dehydrogenase isoenzyme-1 ratios in serum after myocardial infarction
Authors: Galbraith L V , Leung F Y , Jablonsky G , Henderson A R 
Published: January 2020

Abstract
Using receiver-operating characteristic (ROC) curve and likelihood ratio analysis, we examined the diagnostic utility of total lactate dehydrogenase (LD; EC 1.1.1.27) activity (I). LD isoenzyme-1 activity (II), and the LD-1 percentage of total LD activity (III), LD-1 LD-2 (IV), and LD-1/LD-4 (V) in 347 persons admitted to the Cardiac Care Unit (of whom 173 were subsequently proven to have had myocardial infarction). Blood was sampled from these subjects at about 6-h intervals for up to 96 h from the onset of chest pain. Defining an "effective" test as one having an area under the ROC curve of greater than or equal to 0.9, we determined the ranked utility (greatest to least) of these tests as V = IV greater than III greater than II greater than I. Tests III, IV, and V had by this criterion, diagnostic effectiveness equivalent to measurements of creatine kinase-2 in serum but in samples obtained at later time intervals. The decision thresholds for both high (constant) test sensitivity and specificity varied with time, to differing extents, over the entire 96-h period, a finding with important diagnostic implications. We document positive and negative likelihood ratio values for each of these tests throughout the entire period of study.
Coupled-enzyme determination of catalase activity in erythrocytes
Authors: Van Lente F , Pepoy M 
Published: January 2020

Abstract
This coupled-enzyme method for determining the activity of catalase (EC 1.11.1.6) in erythrocyte lysates is based on measuring the absorbance at 340 nm of NADH produced from the peroxidic reaction between ethanol, hydrogen peroxide, and catalase. Hydrogen peroxide is produced as a substrate in situ from the oxidation of glucose catalyzed by glucose oxidase (EC 1.1.3.4). Catalase oxidizes ethanol to acetaldehyde in the presence of hydrogen peroxide. Acetaldehyde is then oxidized by aldehyde dehydrogenase (EC 1.2.1.5) to produce acetate with concomitant conversion of NAD+ to NADH. The reaction did not follow strict zero-order kinetics; enzyme activity was quantified by using initial rates and standards prepared from purified catalase. The method demonstrated within-run and between-run CVs of 1.0% to 2.9% and 2.4% to 3.3%, respectively. This semiautomated method correlated well (r = 0.92) with the more tedious manual method involving measurement at 240 nm.
Interference in an automated radial partition fluorescent immunoassay of thyrotropin associated with liver-function abnormalities
Authors: Sacks D B , Lim M M , Parvin C A , Kessler G 
Published: January 2020

Abstract
In a previous evaluation of a "sensitive" radial partition fluorescent immunoassay on the Stratus system, thyrotropin (TSH) values exhibited a positive bias in icteric samples when compared with results of a nonsensitive radioimmunoassay. In the present study, we evaluated 366 patients samples to assess whether any biochemical markers of liver function could identify samples for which TSH values would be falsely increased. gamma-Glutamyltransferase and total bilirubin concentrations were unrelated to discrepant TSH values. In contrast, alkaline phosphatase (ALP) was significantly positively correlated with differences in Stratus and RIA TSH concentrations (P less than 0.001). However, this correlation explained only 34% of the observed residual variability around the estimated regression line. On average, the higher ALP values were associated with larger discrepancies between Stratus and RIA TSH values, although several samples with increased ALP did not have falsely increased Stratus TSH values. TSH measurements performed with a Stratus should be interpreted with caution in patients with abnormal biochemical markers of liver function.
A simple method for estimating association constants between monoclonal antibodies and derivatized or native antigens
Authors: Schramm W , Yang T , Meyerhoff M E , Bachas L G 
Published: January 2020

Abstract
We describe a simple method for estimating the association constant between an antibody and an antigen, based on a theoretical treatment of experimental dose-response data. We used this method to calculate the association constants of an anti-progesterone monoclonal antibody for native progesterone and for progesterone 11 alpha-hemisuccinate. These association constants provide a quantitative measure of the bridging-group recognition by the antibody.
Identification of an ascorbic acid metabolite among "uremic middle molecules"
Authors: Gallice P M , Monti J P , Braguer D L , Monti H M , Elsen R E , Berland Y F , Crevat A D 
Published: January 2020

Abstract
Among uremic toxins in the middle molecular mass range, 1H, 13C-nuclear magnetic resonance, ultraviolet spectrometry, and chromatographic analyses allow identification of the main component of the so-called "2-5-3 fraction" as ascorbic acid 2-sulfate, a conjugated metabolite of ascorbic acid. We previously (Clin Nephrol 1986;25:212-8) showed an inhibitory effect of the 2-5-3 fraction on microtubule formation. Therefore, we tested the action of ascorbic acid 2-sulfate and its synthetized enantiomers on tubulin polymerization. Because these molecules did not exert any inhibitory effect, we hypothesize that the 2-5-3 fraction is a mixture of compounds in which only a very low quantity of the inhibitory factor is present.
Ethics and Laboratory Medicine
Authors: McQueen Matthew J 
Published: January 2020

Abstract
Ethical issues have been given limited attention by professionals in laboratory medicine. Professional ethics is the moral bond that links a profession, the people it serves, and society. Understanding the complexities of individual and common good is essential for full professional participation in major issues in health care. Specific issues that challenge laboratory professionals in clinical research are allocation of health-care resources, testing conducted nearer the patient, confidentiality, screening tests, and molecular biology. A voice in ethical issues is an essential element of professional independence. The ethical attitudes we display influence the kind of people who choose to work in our profession. More open discussion about ethics is necessary in our professional literature.
A Decade of Development in Immunoassay Methodology
Authors: Gosling James P 
Published: January 2020

Abstract
Immunoassays are now very widely used in the clinical laboratory, either because no other type of assay system is feasible or because they are often the most effective and suitable of the possible analytical methods. The last decade has seen the development and refinement of many new immunoassay reagents and systems. The major trend has been away from liquid-phase assays involving radioisotopic labels, towards fast homogeneous or solid-phase assays capable of operation anywhere; and towards precise and reliable nonisotopic, automated or semi-automated laboratory assays, often with detection limits measured in pico- or attomoles. The use of monoclonal antibodies is now widespread, and the methodologies of labels and of solid-phase components are much more sophisticated. New assay formulations, novel homogeneous systems, immunosensors, free-analyte assays, the importance of thorough validation and of interfering substances, and future trends are discussed.
Differential electroimmunoassay of human LpA-I lipoprotein particles on ready-to-use plates
Authors: Parra H J , Mezdour H , Ghalim N , Bard J M , Fruchart J C 
Published: January 2020

Abstract
We describe a method for directly measuring LpA-I lipoprotein particles containing apolipoprotein A-I (apo A-I) not associated with apolipoprotein A-II (apo A-II), by differential electroimmunoassay of plasma on ready-to-use plates. Lipoprotein particles containing both apo A-I and apo A-II (LpA-I:A-II) are retained close to the wells when a very high excess of anti-apo A-II is used as compared with anti-apo A-I, whereas the LpA-I particles migrate and react with anti-apo A-I. The method is specific, rapid, and precise. Within- and between-run CVs at three concentrations (high, medium, and low) ranged between 1.51% and 2.72% and 3.01% and 4.56%, respectively. Analytical recovery of isolated LpA-I was from 93% to 115%. Results correlate well with those obtained by two-phase electroimmunoassay, enzyme-linked differential-antibody immunosorbent assay, and immunoaffinity chromatography coupled to enzyme-linked immunosorbent assay. The average normolipidemic concentration of LpA-I was 600 mg/L in 45 women and 490 mg/L in 40 men (P less than 0.0001).
Prostatic Acid Phosphatase in Serum of Patients with Prostatic Cancer Is a Specific Phosphotyrosine Acid Phosphatase
Authors: Nguyen Linh , Chapdelaine Alcide , Chevalier Simone 
Published: January 2020

Abstract
We developed an assay to measure at acid pH the phosphotyrosine phosphatase activity in sera from patients with prostatic cancer. The method used quantifies the inorganic phosphate liberated from phosphotyrosine after incubation with serum, followed by the deproteinization of the reaction mixture. A high acid phosphatase (EC 3.1.3.2) activity towards phosphotyrosine was observed in all sera from patients with increased activity of prostatic acid phosphatase. This activity represented 96% of prostatic acid phosphatase and 77% of total acid phosphatase activities. Moreover, it was correlated (r = 0.91) with the amount of serum prostatic acid phosphatase determined by radioimmunoassay. When serum acid phosphatase activity was measured on several phosphorylated substrates, preferential hydrolysis was demonstrated for those in which the phosphate group was esterified on an aromatic ring rather than those presenting an aliphatic chain. Among phosphoamino acids, only phosphotyrosine was a good substrate, with little or no activity observed with phosphoserine and phosphothreonine. Human seminal plasma and partially purified prostatic acid phosphatase, tested for their activity on some of these substrates, gave similar results. On the other hand, sera from patients with above-normal alkaline phosphatase activity and no prostatic disease showed little or no activity on phosphotyrosine at both acid and alkaline pH values. Evidence is presented that the prostatic acid phosphatase in serum is a specific phosphotyrosine acid phosphatase.
Use of zinc protoporphyrin in screening individuals for exposure to lead
Authors: Zwennis W C , Franssen A C , Wijnans M J 
Published: January 2020

Abstract
We studied the relation between the concentrations of lead in blood (PbB) and zinc protoporphyrin in blood (ZPP) in a group of 801 men occupationally exposed for more than one year to lead or inorganic lead compounds. Linear regression of PbB on log ZPP provided 95% tolerance intervals for PbB values for a given ZPP value. The intervals we found are too large to warrant the estimation of PbB on the basis of ZPP measurements in health surveillance of lead workers. Instead we propose a procedure in which ZPP can be used as an indicator to decide which individuals exposed to lead need further investigation of PbB in light of existing limit values for PbB. The procedure is applicable only for PbB values of 2.4 mumol/L or more but may reduce considerably the costs for screening individuals or groups of people exposed to lead.
Critical appraisal of two methods for determining aluminum in blood samples
Authors: Hewitt C D , Winborne K , Margrey D , Nicholson J R , Savory M G , Savory J , Wills M R 
Published: January 2020

Abstract
We report two methods for determining aluminum concentrations in blood. Method 1, proposed for routine monitoring of patients with chronic renal failure, includes a collection procedure that can be adopted by any renal dialysis unit, with a minimum of sample contamination. Plasma samples are diluted fourfold with HNO3/Triton X-100 matrix modifier. Method 2 is proposed for determining aluminum concentrations in patients with normal renal function, e.g., in drug studies and environmental monitoring. Samples are diluted with an equal volume of Mg(NO3)2 matrix modifier and atomized from a L'vov platform. By either method, analytical recovery of aluminum added to serum ranged between 92% and 105% throughout the linear calibration range. The reference interval (mean +/- SD) for aluminum in 22 healthy subjects by method 2 was 0.044 +/- 0.030 mumol/L.
Cross-correlation of cyclosporine concentrations and biochemical measures of kidney and liver function in heart and heart-lung transplant recipients
Authors: Trull A , Hue K , Tan K , Gore S , Whitewood S , Smyth R , Scott J , Price C , Wallwork J 
Published: January 2020

Abstract
Cross-correlation of cyclosporine concentrations with results of biochemical tests of renal and liver function, measured during the first three months post-operatively, was carried out retrospectively in 24 heart and eight heart-lung transplant recipients to assess the temporal relationship between cyclosporine treatment and the development of possible toxic side-effects. We found a statistically significant negative correlation (95% confidence interval of the mean correlation coefficient did not overlap zero) between the five-day mean concentration of cyclosporine in whole blood (but not plasma) as measured with nonselective (NSRIA) and selective radioimmunoassays (SRIA) and the mean reciprocal creatinine concentration measured in the subsequent five days. In 15 of 32 (47%) patients the negative correlation coefficient exceeded 0.7 (high susceptibility), whereas in 11 of 32 (34%) it was between 0.5 and 0.7 (medium susceptibility), and in only six of 32 (19%) was it less than 0.3 (low susceptibility). We found no consistent correlations between cyclosporine measurements and results of other renal-function tests or liver-function tests. This suggests that therapeutic doses of the drug are not hepatotoxic in most patients. There was, however, a significantly correlated decrease in the NSRIA/SRIA ratio and in serum bilirubin concentration with time post-operatively, reflecting improvement in hepatic function and clearance of the cyclosporine metabolites that are detected by NSRIA. Assays of cyclosporine in whole blood, but not in plasma, are of value in anticipating changes in renal function after heart and heart-lung transplantation.
Consensus Document: Hawk's Cay Meeting on Therapeutic Drug Monitoring of Cyclosporine
Authors: Kahan Barry D , Shaw Leslie M , Holt David , Grevel Joachim , Johnston Atholl 
Published: January 2020

Abstract
The optimal measurement method and clinical application of the therapeutic drug monitoring of cyclosporine remain uncertain (1,2). At a workshop held at Hawks Cay, FL, from January 14 to January 17, 1990, 57 scientists presented their latest research findings, either in formal papers or as discussants. Lively debate and discussion followed presentation of extant and new methodologies for drug measurements as well as multicenter validation studies; applications of trough-concentration monitoring in renal, hepatic, and bone-marrow transplants as well as in autoimmune disease; and alternative pharmacokinetic approaches to guide cyclosporine therapy. The process of inducing and maintaining optimal immunosuppression to facilitate graft success is a complex and often challenging task, requiring the combined expertise of multiple disciplines. Thus, the assembly of four of the groups essential to the transplant process—clinicians, laboratory scientists, the pharmaceutical company, and the manufacturers of cyclosporine measurement kits—provided a unique opportunity to evaluate therapeutic drug monitoring issues facing the transplant field. Here we present the major conclusions reached at the meeting, brief discussions of the study data on which they are based, and a summary of unresolved problems that will require further rigorous investigations. The Consensus Document was reviewed by all the workshop participants before we submitted this final manuscript.
Physiology of blood flow and oxygen utilization by peripheral tissue in circulatory shock
Authors: Rackow E C , Weil M H 
Published: January 2020

Abstract
The primary defect that characterizes circulatory shock is acute perfusion failure, in which oxygen metabolism is critically impaired by decreased delivery of oxygen to tissues. Four categories of hemodynamic deficits are described as the basic mechanisms of circulatory shock: hypovolemia, cardiac failure, distributive deficits, and vascular obstruction. Perfusion failure can be identified by the development of lactic acidosis, because anaerobic metabolism is the consequence of the oxygen deficit during circulatory failure. Lactic acidosis at present represents the best single objective measure of the severity of shock.