Biomedical subjects
Publications and source records attributed to E F Freier.
A method involving the molybdenum blue reaction for measurement of serum phosphorus using a centrifugal analyzer is described. The need to measure a separate serum blank is eliminated by measuring the rate of color development compared to that of a known standard. The procedure which uses o-phenylenediamine as a reductant is precise and compares well with a continuous flow automated procedure.
Sodium, potassium, and chloride levels are artifactually depressed in hyperlipemic sera. Accurate electrolyte levels are needed for management of patients with hyperlipemia, but present methods for correcting the values (serum water and/or osmolality determinations) either are technically cumbersome or fail to provide accurate data to correct the falsely low levels. Alternatively, to determine true sodium, potassium, and chloride concentrations in hyperlipemic sera, only the required electrolyte values and the triglycerides are measured. The percentage by which the measured electrolyte levels in the hyperlipemic sample must be increased to approximate the true values is given by the following equation: per cent increase = 2.1 X triglycerides (Gm./dl.) - 0.6.
We compared two methods for serum thyroxine measurement by competitive protein binding - the Murphy and Pattee and the Seligson and Seligson methods. We found the Seligson and Seligson method, which requires less sample volume and analysis time, to be the method of choice on the basis of sensitivity, extraction efficiency, precision, and accuracy. Standard plots of time/10,000 counts versus thyroxine concentration are linear to 20 ug/dl, extraction efficiency is 99.6 per cent, within-day S.D. plus or minus 0.28 ug/dl, and 98.3 per cent of added thyroxine is recovered in the Seligson and Seligson method. The Seligson and Seligson method is superior to the Murphy and Pattee method with respect to all these parameters. The methods were also compared with correlation and normal value studies.
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We compared the blood glucose control of four intact and eight kidney recipient, metabolically unstable, ketosis-prone, insulin-dependent diabetic patients under two different regimens: (a) intensive conventional treatment with two to four insulin injections daily (48 patient-months) and (B) subcutaneous, portable insulin delivery system (IDS) (54 patient-months). Both regimens included frequent home blood glucose and 24-h urine glucose determinations and daily telephone follow-up to maximize compliance with treatment. Analyzed as a group the fasting blood glucose for intact patients (A: 172 +/- 13 mg/dl; B: 141 +/- 12, P less than 0.02) and the nonfasting blood glucose for kidney recipient patients (A: 165 +/- 10; B: 138 +/- 5, P less than 0.01) were significantly lower during treatment with the IDS than with multiple injections. Six out of 12 patients (2/4 intact and 4/8 kidney recipient patients) showed significant and consistent improvement of blood glucose concentrations. Four showed marginal and inconsistent improvement. Two patients (one intact and one kidney recipient) improved on the IDS but maintained the improvement when changed back to conventional treatment. The 24-h urine glucose, maximal glucose excursions, number of blood glucoses less than or equal to 40 mg/dl, and glycosylated hemoglobin decreased significantly in some patients on the pump. We conclude that subcutaneous, portable insulin delivery devices can significantly improve the metabolic control of some ambulatory, unstable diabetic patients during long-term treatment beyond that obtained with intensive, multiple-injection, conventional treatment. Normalization of the metabolic control, however, is not obtained. These infusion systems still pose several problems during ambulatory use, which could have serious consequences in patients less compliant and/or followed less closely than ours.
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