Calibration of direct ion-selective electrodes for plasma Na+ to allow for the influence of protein concentration.
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Biomedical subjects
Publications and source records attributed to B M Buckley.
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This paper reports biochemical studies in a pregnant xanthinuric female (McKusick 27830) and compares the results with findings in three other xanthinurics studied by us, including a previously unreported female who had a nephrectomy for xanthine stones. The findings of raised levels of uric acid in plasma and urine at presentation in the third trimester of pregnancy, and the subsequent fall to almost undetectable levels 6 weeks post-partum, is regarded as evidence of the extent of fetal uric acid production and clearance by the maternal circulation.
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Difficulties in the estimation and interpretation of dextropropoxyphene and norpropoxyphene analyses have added to the controversy concerning the toxicity of these compounds. Poor performance in external proficiency assessment trials reflects the unsatisfactory state of many dextropropoxyphene and norpropoxyphene analyses in general use. There is substantial overlap between blood concentrations of dextropropoxyphene and norpropoxyphene encountered in chronic therapeutic dose and those associated with acute toxicity. As dextropropoxyphene and norpropoxyphene are often taken in overdose with other drugs, their blood concentrations must be interpreted in the context of careful identification and quantitation of such agents. The present availability of accurate methods for measurement of parent drug and metabolite should now make anecdotal reports unsupported by analytical data entirely superfluous.
Paracetamol and dextropropoxyphene were implicated on clinical and analytical grounds in 237 poison deaths in England and Wales in 1979. In addition to paracetamol, dextropropoxyphene and ethanol, other agents were detected in 61 of these cases (26%). Analytical evidence suggests that very substantial overdoses of paracetamol and dextropropoxyphene were ingested in the majority of cases; their mean plasma concentrations in those ingesting no other agents were 252 and 8.64 mg/l respectively. Significant quantities of ethanol were ingested in 133 of 237 cases (56%). The mean ethanol concentration in those in whom quantitative estimations of paracetamol, dextropropoxyphene and ethanol were undertaken and who had not ingested other drugs, was 1588 mg/l. There was no analytical support for the diagnosis of paracetamol and dextropropoxyphene poisoning in 74 of 305 cases (24%) of H.M. Coroners' returns to the Office of Population, Censuses and Surveys for the period 1 January-31 December 1979. In addition, dextropropoxyphene was detected analytically in six cases classified as being due to paracetamol alone.
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A production model of the Radiometer ICA1 ionized calcium analyzer has recently been evaluated in this Department. Performance characteristics such as stability, precision and selectivity are described and the problem of assessing accuracy is discussed. The influence of pH changes and of packed red cell volume on results is described. The potential of the instrument in routine and in research applications in clinical chemistry is considered. We conclude that the instrument represents a significant advance in providing convenient and precise ionized calcium measurement.
It is generally believed that measurement of ionized calcium in blood should more clearly reflect changes in calcium metabolism than measurements of total calcium concentration. We have investigated ionized calcium levels using the Radiometer ICA1 Analyzer in number of clinical situations where total calcium, hydrogen ion or protein concentrations are abnormal. While there are a number of clearcut situations in which ionized calcium measurements are superior to total calcium, it is apparent that chemical activity of calcium ions in blood may sometimes not reflect their physiological activity. In addition, the problem of clinical interpretation of ionized calcium levels found in patients with extreme disorders of acid-base balance or of plasma protein concentration remains to be resolved. The role of ionized calcium measurement in routine clinical chemistry will be discussed.
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A novel enzymimc cycling assay for the determination of acetate in biological material is described. Measurements of the acetate concentration in blood and liver samples from rats of various ages and nutritional states with this assay are reported. The contribution of the intestine, the liver and the rest of the body to maintaining the concentration of acetate in the circulation is examined. Evidence is presented that the gut flora constitute the main source of acetate in blood of fed adult rats, though endogenous production of acetate is of significance in other situations. The streptozotocin-diabetic rat has an elevated blood acetate concentration.