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Biomedical subjects

B E Statland

Publications and source records attributed to B E Statland.

At least 19 recordsLinked to original sources
PubMed1992

Nutrition and cancer.

Diet can play a key role in the pathogenesis of cancer. Diets high in fat and low in fiber predispose individuals to colon cancer. A high-fat diet is also implicated in breast cancer and prostate cancer. The dietary fat-cancer linkage is supported by epidemiological evidence, animal studies, and prospective trials. The antioxidants vitamin E, ascorbic acid, and beta-carotene have a protective effect and act as antipromoters of carcinogenesis. A diet of less than or equal to 10% of calories from fat and less than or equal to 40 g of fiber daily that includes fruits and vegetables will prevent up to 35% of cancers.

Animals↗
PubMed1992

Colorimetric determination of potassium in plasma and serum by reflectance photometry with a dry-chemistry reagent.

We evaluated a colorimetric assay of potassium in plasma and serum with the Boehringer Mannheim Reflotron reflectance photometric analyzer, which is designed for near-patient testing in hospitals and physicians' offices. This potassium method does not require calibration or instrument maintenance by the operator. Analysis of 30 microL of plasma or serum takes approximately 140 s. Within-day imprecision (CV) was 1.0-1.2%. Total CVs over a 1-month period were 1.0-1.4%. Patients' results from the Reflotron correlated well with those from the IL 643 flame photometer and the Beckman Synchron CX3 ion-selective electrode methods. The accuracy of Reflotron values was also verified with Standard Reference Material 956 from the National Institute of Standards and Technology.

Colorimetry↗
PubMed1992

A multicenter evaluation of lipid profiling with a compact analyzer (Miles Clinistat).

We evaluated the Clinistat Analyzer (Miles Inc., Diagnostics Division, Elkhart, IN) for measuring cholesterol, triglycerides, and high-density lipoprotein (HDL) cholesterol at three medical centers. The system, based on multilayer film technology, uses precalibrated, dry film reagent disks. Ten microliters of serum is applied to the dry film reagent disk in the test procedure. For HDL-cholesterol measurement, serum is pretreated by precipitation with phosphotungstic acid and magnesium chloride. Total precision (CVs) of each of the three assays was less than or equal to 5%. The assay ranges were linear and satisfactory for clinical use. Patients' results compared well with established methods. No significant interferences were found with hemolysis, icterus, and lipemia.

Chemistry, Clinical↗
PubMed1991

Direct measurement of high-density lipoprotein cholesterol by the reflotron assay with no manual precipitation step.

We evaluated the quantification of high-density lipoprotein (HDL) cholesterol in plasma with the Boehringer Mannheim Reflotron reflectance photometric analyzer. The Reflotron is designed for testing in small to medium-size laboratories and physicians' offices. This HDL method does not require a manual precipitation step because the reagent tab contains dextran sulfate (Mr 50,000) and magnesium acetate. It takes 90 s to complete an analysis of 30 microL of plasma. Within-day standard deviations (SDs) were 0.02-0.04 mmol/L (6-16 mg/L). Total SDs over a three-month period were 0.03-0.06 mmol/L (11-23 mg/L). The Reflotron values averaged 0.02 mmol/L (6 mg/L) or 1.3% lower than the Hitachi 737 values; the standard error of the estimate (Sy.x) was 0.07 mmol/L (29 mg/L).

Ascorbic Acid↗
PubMed1990

Present and projected consumption of hospital bed-days as a function of terminal days before death.

In 1983 the bed-day consumption per year per 1,000 inhabitants was 1,571 for all subjects in the Copenhagen County, and 774, 1,239, and 4,918 for subjects 0-19 years, 20-64 years, and above 65 years of age, respectively. Extrapolating from these data the hospital bed-day consumption per inhabitant is predicted to increase by 20.6% in Denmark by the year 2025 as compared to 1986. The mean hospital bed-day consumption per subject during the last 150 days prior to death in hospital was 25.0 days for males and 29.7 for females. Making the conservative assumption that only subjects who die in hospital consume hospital bed-days during the last 150 days before death, the bed-day consumption during 1983 of 0-64 years old subjects being in the terminal 150-day phase was 5.87% of the total annual bed-day consumption of this age group. For subjects 65 years of age or older, it was 18.1%.

Adolescent↗
PubMed1990

Multivariate techniques to assess laboratory tests in cancer patients.

In this chapter the application of multivariate techniques for the assessment of laboratory tests in cancer patients has been reviewed. We emphasize that the transformation of laboratory test values into just two categories (normal or abnormal) may entail a considerable loss of information. For instance, correlation between two laboratory tests that may be important for differentiating among various clinical categories of patients may disappear when this procedure is used. When only a single set of laboratory results measured in the same specimen is available for a given patient, we must compare these values to those obtained from other patients or healthy subjects to make inferences about the patient on the basis of the laboratory results. Thus, the analysis of the data must be group based. Discriminant analysis, logistic regression analysis, and survival analysis based on Cox's regression model are the techniques most often used in this situation. By contrast, when previous results are available from the same patient we may compare his or her present values to those previously obtained when we want to make inferences about the patient. Our objective is to make a prediction about the time that will elapse until some specified event (death or recurrence of disease) occurs. Two models that have been applied in this situation--the Markov chain and the autoregressive time series model--were reviewed and examples of specific medical applications presented.

Analysis of Variance↗
PubMed1989

Indianapolis cholesterol screening 1987: does mass screening accomplish its goal?

To evaluate the impact of large scale population screening for elevated total cholesterol, a city-wide event was scheduled in Indianapolis during nine days in February 1987. Altogether, 29,954 individuals were screened, and more than 32% were found to be at moderate or high risk using the classification recommended by the National Institutes of Health at the time of the screening for heart disease on the basis of their total plasma cholesterol concentrations. Although larger numbers of females and whites volunteered to be screened, the screened population represented a broad range of age and education levels. Results of a followup questionnaire returned by 18% of those at moderate of high risk revealed that after receipt of an elevated cholesterol result, 67% of the respondents scheduled a physician visit. The majority of those not doing so (53%) contacted their physician for other reasons or by telephone. Results of the followup indicate that screened subjects responded appropriately to the results received. The results of this project indicate that mass screening is only one tool to successfully identify individuals at risk. Given the biases present in the screened population, other strategies should be used to identify at-risk members of population groups unlikely to participate in similar screening events.

Adult↗
PubMed1988

Monoclonal antibody to human cross-linked fibrin.

Cross-linked Fibrin II was prepared using Kabi grade (L) fibrinogen. Fibrin plasmic digest was separated on Sepharose CL-6B. Fragments Mr 135-300 kDa were used to immunize 6-9 weeks old female BALB-c mice. A stable hybridoma secreting monoclonal antibody (MAb) TD-1 (IgG 2a, Kappa) was prepared by fusion using myeloma cells (P3-NS1/1-Ag4-1) and immunized cells. Fibrinogen and plasmin digest of fibrinogen in serial dilutions did not compete with the immunizing antigen. To prove that TD-1 binds specifically to cross-linked fibrin, immunoprecipitation with S. aureus and affinity chromatography were performed. In both experiments, we demonstrated that TD-1 binds specifically to a protein Mr greater than 200 kDa which is found in XL-fibrin and not fibrinogen. Reduced samples showed the antibody bands (heavy and light chains) and three protein bands, Mr greater than 80 kDa (gamma-gamma dimer), Mr greater than 45 kDa (beta chain of fragment D) and Mr greater than 16 kDa (alpha chain from fragment D) were present. TD-1 reacted strongly with HPLC fraction of the immunizing antigen Mr 220 kDa (probably DD/E complex). Affinity binding constants (Scatchard Plot Analysis) were determined. The highest affinity was obtained with XL-fibrin fraction Mr 220 kDa, KD = 1.39 X 10(-8) and high molecular weight XL-fibrin fragments, KD = 1.6 X 10(-7). Fragment DD had KD of 2.8 X 10(-6). These results suggest that TD-1 is specific for the DD region of human cross-linked Fibrin II.

Antibodies, Monoclonal↗
PubMed1988

Automated urinalysis.

Many sources of variation affect urinalysis testing. These are due to physiologic changes in the patient, therapeutic interventions, and collection, transportation, and storage of urine specimens. There are problems inherent to the manual performance of this high-volume test. Procedures are poorly standardized across the United States, and even within the same laboratory there can be significant technologist-to-technologist variability. The methods used can perturb the specimen so that recovery of analytes is less than 100 per cent in the aliquot examined. The absence of significant automation of the entire test, with the one exception of the Yellow IRIS, is unusual in the clinical laboratory setting, where most other hematology and chemistry testing has been fully automated. Our evaluation of the Yellow IRIS found that this system is an excellent way to improve the quality of the results and thereby physician acceptance. There is a positive impact for those centers using this instrument, both for the laboratory and for the hospital.

Autoanalysis↗
PubMed1987

Utilization review and management of laboratory testing in the ambulatory setting.

Physicians are probably guilty of misusing the clinical laboratory by either ordering too many tests (overutilization) or ordering too few tests (underutilization). This article is concerned mainly with overutilization in terms of searching for asymptomatic disease, too frequent monitoring of tests, ordering of test clusters, and a failure to use available information. The strategies considered to decrease overutilization include educational strategies, audit with feedback, cost-awareness strategies, rationing strategies, financial incentives and risk-sharing strategies, changes in the test request procedures, and administrative mandates of set protocols for laboratory test ordering.

Ambulatory Care↗
PubMed1987

Calibration, quality control, and stability of a quantitative enzyme immunochromatographic method for therapeutic drug monitoring.

We describe a noninstrumented quantitative method for therapeutic drug monitoring (AccuLevel test) that uses a factory-calibrated unit test format and a novel single-level approach to quality control. The AccuLevel method is based on the principles of immunochromatography, which provides a number of convenient protocol advantages without sacrificing assay performance or quality assurance. Most of the benefits of the immunochromatographic method derive by virtue of the fact that quantification is dependent on enzyme migration rather than enzyme activity. Since migration height is almost solely a function of a highly stable, immobilized, dry antibody reagent, the AccuLevel test is extremely insensitive to environmental factors. The predictable and uniform dependence of quantification on antibody site concentration allows complete reliability with a single-level control. These features of stability, factory calibration, and unitized test components make the AccuLevel immunochromatography method amenable to new quality control schemes.

Antibodies, Monoclonal↗
PubMed1987

Measurement of six enzymes with the Kodak DTSC Module, a physician's office analyzer.

We evaluated the performance of the Kodak DTSC Module for determination of alanine aminotransferase (ALT; EC 2.6.1.2), aspartate aminotransferase (2.5.1.2), alkaline phosphatase (3.1.3.1), creatine kinase (2.7.3.2), gamma-glutamyltransferase (2.3.2.2), and lactate dehydrogenase (1.1.1.27). The DTSC is a "special chemistry" accessory for the DT60 analyzer; the same multilayer film technology as that of the Ektachem 700 is used. The overall precision, assessed over a three-month period with two serum-based quality control materials, ranged from 2.2 to 8.0%. DTSC results for patients' specimens correlated well with those by the Technicon RA-1000 analyzer. The performance of the analyzer in linearity and interference studies was satisfactory for clinical use. The DTSC is simple to operate and has no technique-dependent step; it should be useful for the physician's office laboratory.

Alanine Transaminase↗
PubMed1987

Increased activities of creatine kinase and lactate dehydrogenase isoenzymes in a patient with metastatic ovarian tumor.

A 50-year-old woman with metastatic rhabdomyosarcoma of the ovary had increased activities of creatine kinase (CK; EC 2.7.3.2), CK-MB isoenzyme, lactate dehydrogenase (LD; EC 1.1.1.27), and LD-2 isoenzyme in her serum. The isoenzyme activities did not show a pattern of increasing, then decreasing. Clinical findings, including electrocardiograms, did not support the diagnosis of myocardial infarction. We suggest that high activities of CK-MB and LD-2 in serum may serve as a marker of rhabdomyosarcoma.

Creatine Kinase↗
PubMed1986

The laboratory-user interface.

The purpose of this monograph is to define the laboratory-user interface, to contrast two types of users (the clinician and the hospital administrator), to assess the value/cost relationship of the laboratory-user interface, and to decide whether or not this value/cost ratio is sufficiently high in all cases.

Clinical Laboratory Techniques↗
PubMed1986

Evaluation of the Sysmex CC-800. An automated eight-parameter hematology instrument.

An evaluation of the Sysmex CC-800 hematology analyzer (TOA Medical Electronics, Kobe, Japan, and distributed by American Scientific Products, Chicago, IL) was performed at University Hospital at Boston University Medical Center to assess the analytic performance and ease of use of the instrument. The Sysmex CC-800 is the first self-contained, fully automated, eight-parameter hematology analyzer. It can handle as many as 100 whole blood specimens without constant operator intervention. Stat and predilute modes are also available. The optional PDA-410 (particle distribution analyzer) was not evaluated in this study. Precision, linearity, carryover, and reproducibility of values over time in the automode were well within the manufacturer's specifications. The correlation study was performed with the existing Coulter S-Plus (Coulter Electronics, Hialeah, FL). The Sysmex CC-800 allowed us to expand the linear range without dilution for white blood cells to 160 X 10(3)/microL, hemoglobin to 26 g/dL, and platelets to 2,000 X 10(3)/microL. The samples on the automode exposed to normal laboratory atmosphere for up to 120 minutes showed no significant difference from baseline. The two instruments correlated well (r greater than 0.99). The authors concluded that the Sysmex CC-800 would be a reliable and time saving instrument in their laboratory.

Automation↗