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Biomedical subjects

E Henkel

Publications and source records attributed to E Henkel.

At least 37 records · Page 2Linked to original sources

First clinical evaluation of the CELL-DYN 3200 haematology analyser.

A prototype of the CELL-DYN 3200 haematology analyser was evaluated in a tertiary care hospital laboratory. Precision, effects of sample ageing, linearity, carry-over, and comparability of cellular blood counts and five-part leucocyte differentiation were determined in accordance with the ICSH guidelines for the evaluation of blood cell analysers; the results were satisfactory for all parameters tested: haemoglobin concentration, RBC, MCV, WBC, platelet count, and counts of neutrophils, lymphocytes, monocytes, and eosinophils. Two-hundred and forty-seven routine blood samples were used for the comparability studies. The cellular blood count results from the CELL-DYN 3200 and the Bayer Diagnostic H-1 systems corresponded closely (correlation coefficient r > 0.96 for all parameters). For 201 samples without an instrument-generated suspect flag the same was true with regard to the differential parameters, although somewhat lower correlation was observed for monocyte counts (r = 0.88). Comparisons to 400-cell microscopic differentials gave similar results (r > 0.93 for neutrophil, lymphocyte and eosinophil counts). Our results suggest that the CELL-DYN 3200 analyser will serve the needs for automated blood cell counting and differential leucocyte counting in a tertiary care hospital laboratory.

Adult↗

Identification of high- and low-risk patients before liver transplantation: a prospective cohort study of nutritional and metabolic parameters in 150 patients.

The clinical relevance of malnutrition and hypermetabolism in end-stage liver disease, as well as their effects on survival after liver transplantation (LTx), are largely unknown. This study investigates the prognostic value of nutritional and metabolic parameters obtained before LTx for survival after LTx. One hundred fifty patients with end-stage liver disease undergoing LTx were assessed prospectively and followed for a mean period of 46 +/- 16 months after LTx. All patients were randomized into a study group and a validation group, each comprising 75 patients. Body composition analysis (24-hour urinary creatinine excretion, anthropometry, bioelectrical impedance analysis), deviation of measured from predicted resting energy expenditure (deltaREE), year of transplantation, and several variables known to be of prognostic relevance in patients with liver disease undergoing conservative treatment were analyzed. Kaplan-Meier and log rank analysis showed that hypermetabolic patients (deltaREE > +20%) and patients with a body cell mass (BCM) < 35% of body weight tended to have reduced survival after LTx. A risk profile on the basis of deltaREE and BCM identified patients with high risk (5-year survival rate, 54%) and low risk (5-year survival rate, 88%; P < .01). The predictive power of this risk profile was independent of the presence of ascites and clinical edema, and its validity was confirmed in the validation group (P < .01). The Child-Pugh score was not of prognostic value. We conclude that a poor nutritional state, as well as hypermetabolism, adversely affects survival after LTx. These potentially treatable presurgical factors deserve close attention in interventional studies.

Adult↗

Macrolipasaemia in a patient with pancreas divisum and acute abdominal pain: a case report.

This study describes a rapid increase of serum lipase activity during an episode of severe abdominal pain in a female patient with macrolipasaemia and pancreas divisum. Serum lipase activity was persistently elevated in the patient with simultaneously low levels of amylase activity which only increased in association with endoscopic retrograde cholangiopancreatography. Polyethylene glycol precipitation experiments, as well as the results of exclusion chromatography, demonstrated that the high lipase activity was due to a macromolecule of approximately 200000 Da. Affinity chromatography and immunological investigations further indicated that the atypical time-course of lipase activity was not due to alterations of the patient's lipase, but due to lipase-binding autoantibodies resulting in the formation of immune complexes between lipase and immunoglobulin G lambda. Our results show that macrolipasaemia must be considered as a possible cause in patients with unexplained raised serum lipase activity.

Abdominal Pain↗

An evaluation of the CELL-DYN 1700 haematology analyser: automated cell counting and three-part leucocyte differentiation.

The performance of the CELL-DYN 1700 (Abbott Diagnostics, Abbott Park, IL, USA) was evaluated in a tertiary care hospital laboratory using the guidelines proposed by the German Society of Clinical Chemistry. Precision, accuracy, linearity, background counts, and carry-over were satisfactory for all measured standard parameters including haemoglobin concentration, haematocrit, red blood cell count, mean corpuscular volume (MCV), red cell distribution width (RDW), white blood cell count and platelet count. With 259 selected normal and abnormal blood samples the results of the CELL-DYN 1700 (CD1700) compared very well (r > 0.96 for all parameters with exception of RDW) with those obtained with the Bayer Diagnostic H-1 and the Hoffmann-La Roche Cobas Argos systems. This study considered in particular the performance of the CD1700 three-part leucocyte differential. For those samples without instrument-generated suspect flags, the neutrophil and lymphocyte percentages were highly correlated with the results of the H-1 blood cell counter (r = 0.97 and 0.98, respectively) and with manual 400-cell differentials (r = 0.91 and 0.88, respectively). In contrast, the CD1700 mid-fraction which comprised the composite total of monocytes, eosinophils, basophils and precursor white cells (when present) could not be directly compared to the differentials from the H-1 system or from manual microscopy. For those samples with CD1700 instrument suspect flags, the neutrophil and lymphocyte differential results also compared well with both the H-1 (r = 0.93 and 0.93, respectively) and manual estimates (r = 0.89 and 0.87, respectively). In conclusion, the CD1700 is an accurate haematology analyser for cellular blood counts and three-part leucocyte differentiation.

Adult↗

Lipid interference in the determination of the concentration of haemoglobin in plasma using the ACA SX analyzer.

In comparison to a triple wavelength procedure, the dual wavelength method for the determination of plasma haemoglobin concentration using the ACA analyzer showed considerable interference with hypertriglyceridaemic (triacylglycerols > 2.3 mmol/l) plasma. By addition of isolated human lipoprotein fractions to normotriglyceridaemic plasma, chylomicrons were identified as a major source of interference with the ACA plasma haemoglobin method, whereas VLDL was without effect up to a triacylglycerol concentration of 5.7 mmol/l. Airfuge ultracentrifugation proved to be a reliable means for removal of interfering lipid. We conclude that the extent of lipid interference with the ACA plasma haemoglobin method is highly dependent on the type of lipoprotein present. An accurate measurement of plasma haemoglobin concentrations in non-fasting plasma can only be ensured after lipid removal through airfuge ultracentrifugation.

Chylomicrons↗

Significance of antibodies to cardiolipin in unselected patients with systemic lupus erythematosus: clinical and laboratory associations. The SLE Study Group.

In a multicentre study anticardiolipin antibodies of the IgG and IgM isotypes were measured by a solid phase enzyme immunoassay in 368 patients with systemic lupus erythematosus (SLE) who were not selected on the basis of features of antiphospholipid syndrome. Clinical and laboratory associations of increased levels of anticardiolipin antibodies were evaluated. IgG and IgM antibodies to cardiolipin were documented in 224 (60.9%) and 128 (34.8%) patients, respectively. Regarding the symptoms of antiphospholipid syndrome, elevated amounts of anticardiolipin IgG were significantly associated with spontaneous abortion (P < 0.001), thrombocytopenia (P < 0.01), livedo reticularis (P < 0.01) and a positive direct Coombs test (P < 0.05), but not with thrombosis or central nervous system diseases such as epilepsy and psychosis. IgM antibodies to cardiolipin were associated with a positive direct Coombs test (P < 0.01), but with no other symptom of antiphospholipid syndrome. The predictive values of anticardiolipin antibody determinations in unselected SLE patients were poor for all features of antiphospholipid syndrome because of high proportions of false-positive and false-negative results. As for other manifestations of SLE, positive correlations between raised antibodies to double-stranded DNA and the occurrence of anticardiolipin antibodies of the IgG isotype were observed, and anticardiolipin IgM was negatively associated with nephritis.

Adolescent↗

Effect of increased protein intake and nutritional status on whole-body protein metabolism of AIDS patients with weight loss.

The aim of this study was to investigate nutritional status and protein metabolism during total parenteral nutrition (TPN) in AIDS patients with weight loss. Six patients on treatment for AIDS-associated complications were investigated and reviewed TPN that supplied energy equivalent to 1.5 times the resting energy expenditure (REE). Amino acid (AA) supply increased from 0.6 g/kg body weight (BW)/d on days 1 to 3 and 1.2 on days 4 to 6 to 1.8 on days 7 to 9. Nonprotein energy was given as equicaloric amounts of glucose and fat emulsion. There were repeated measurements of nitrogen balance and whole-body protein turnover (WBPT) using a bolus 15N-glycine method on the morning of days 3, 6, and 9. Principal findings were as follows: (1) increasing the supply of AAs significantly improves nitrogen balance in AIDS patients; (2) there is no simple linear effect of increasing amounts of AAs on WBPT in AIDS patients; (3) WBPT is high and variable in these patients; and (4) mean WBPT of each patient is significantly correlated with body cell mass (BCM) as a proportion of BW (P < .001, r = .92). We conclude that poor nutritional status in AIDS patients with weight loss is associated with high WBPT. However, these patients can attain at least transiently positive nitrogen balance with sufficient protein intake, predominantly through an increase in whole-body protein synthesis (WBPS).

Acquired Immunodeficiency Syndrome↗

Plasma prostacyclin and thromboxane concentrations in 160 normotensive, hypotensive, and preeclamptic patients during pregnancy, delivery, and the post partum period.

Plasma concentrations of 6-keto-prostaglandin F1 alpha, a stable metabolite of prostacyclin, and TxB2 were measured in 160 women during pregnancy (n = 106), delivery (n = 40), and in the postpartum period (n = 14). Fifty nine patients had normal blood pressure, 10 had mild and 9 severe preeclampsia while 38 patients were hypotensive. Normotensive patients were grouped according to their gestational age: 22-26 weeks (n = 22), 27-31 weeks (n = 22), and 32-38 weeks (n = 15). 20 patients were in early first stage of delivery (cervical dilatation < or = 5 cm), 20 patients in late first stage (cervical dilatation > or = 6 cm). The concentration (mean value +/- SEM) of the PGI2 metabolite tended to increase during pregnancy without reaching significance (218 +/- 11; 225 +/- 10; 250 +/- 15 pg/ml). At the same time, TxB2 showed a decrease, which was most pronounced at 27-31 weeks (65 +/- 15; 40 +/- 2; 48 +/- 4 pg/ml; p < 0.001). The ratio of PGI2/TxA2 increased in parallel (4.9 +/- 0.4; 6 +/- 0.4; 4 +/- 0.5). There was no difference in plasma concentrations of PGI2 (figure 4) and TxA2 in patients with normal blood pressure, mild preeclampsia and hypotension, whereas in severe preeclampsia, the plasma concentration of PGI2 was significantly lower (p < 0.001) and of TxA2 significantly higher (p < 0.001). The ratio of PGI2/TxA2 shifted significantly to vasoconstriction in patients with severe preeclampsia (p < 0.0001) and to vasodilatation in those with hypotension (p < 0.03).(ABSTRACT TRUNCATED AT 250 WORDS)

Epoprostenol↗

[Evaluation of the Heidelberg cancer information service by the consumer].

The Cancer Information Service (KID) was established 1986 as a model project of the BMJFFG in the German Cancer Research Center. Its task is to provide the general public with quickly accessible information about cancer research, cancer prevention, cancer diagnosis, cancer treatment and cancer after-care by phone. Aim of this study was to collect data by a questionnaire given to a sample of 444 callers to describe the characteristics of the callers, their motivation to use the service, the contents of the inquiries and their judgement of effectivity of the work of the service. It was found that nearly 80% of the callers were patients and their relatives, predominantly in the period after the primary treatment. Their questions concerned the field of medical treatment. Their motivation to use the service was not lack of information, but to reinforce the knowledge they already had. The callers fundamentally appreciated the institution of an information service and 62% were satisfied with the actual work of the KID.

Adult↗

Measurement of CEA, TPA, neopterin, CA125, CA153 and CA199 in sera of pregnant women, umbilical cord blood and amniotic fluid.

The following tumor markers were determined in body fluids associated with pregnancy: carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA), neopterin, CA125, CA153 and CA199. CEA levels (cut-off 5.0 ng/ml) were not elevated during gestation, whereas TPA was above cut-off (85 U/l) in 98 out of 107 cases (range 40-408 U/l). TPA was significantly higher during the 3rd trimester of pregnancy than during the 1st and 2nd trimesters. 38.3% of CA125 measurements were slightly above the chosen cut-off of 35 U/ml, and the mean concentration was 33.5 +/- 16.2 U/ml. During delivery, 14 out of 21 values (67%) were elevated. Only 9.4% of CA153 values were elevated. CA199 and neopterin were also hardly ever above cut-off. In general, there was a wide scattering of individual values. With the exception of CA153 (neopterin not determined), high concentrations of CEA (maximum: 207 ng/ml), TPA (maximum: 1,565 U/ml), CA125 (maximum: 2,371 U/ml) and also CA199 (maximum: 1,533 U/ml) were found in amniotic fluid. The distribution in mixed cord blood was similar but with more moderate elevations and a lower incidence of levels above cut-off. Thus, none of these antigens is tumor specific. The term 'tumor-associated antigen' instead of 'tumor marker' is more appropriate. CEA, TPA, CA125 and CA199, but not CA153, are oncofetal antigens.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Multicentre study of a new test for TSH-screening in blood spots.

A multicentre study for the detection of congenital hypothyroidism by enzyme-immunoassay of thyrotropin in filter paper blood spots is described. The method is accurate, with good precision and adequate sensitivity. No interference due to common blood constituents has been observed. Moreover, the TSH determination can easily be performed by photometric measurement of enzyme activity. Large series of samples can be processed by automation using common laboratory analysers. Values show good agreement with those obtained by RIA methods. We present a method for screening for congenital hypothyroidism which can be performed in all clinical laboratories.

Congenital Hypothyroidism↗

Comparative study of hormonal counterregulation during GCIIS-guided hypoglycemia tests using human proinsulin and human insulin (recombinant DNA).

Counterregulatory effect following administration of biosynthetic human proinsulin (BHPI) and human insulin (BHI) were compared during hypoglycemia standardized by means of a glucose controlled insulin infusion system (GCIIS). A total of 0.148 +/- 0.010 U/kg of BHPI had to be given by the GCIIS in order to obtain a minimal blood glucose (BG) of 26 +/- 2 mg/dl (means +/- SEM) at 43 +/- 2 min. In contrast, 0.083 +/- 0.004 U/kg of BHI were sufficient to produce a minimal BG of 21 +/- 1 mg/dl (n.s.) at 35 +/- 1 min. (P less than 0.005). Moreover, BHPI infusion resulted in prolonged hypoglycemia and delayed blood glucose recovery. On a molar basis, the acute BG lowering effect of BHPI was about 13% that of BHI (BHPI 3.94 +/- 0.27 vs. BHI 0.51 +/- 0.03 nmol/kg). Serum proinsulin after BHPI reached its maximum of 19.4 +/- 2 pmol/ml at 20 min. and still exceeded basal values markedly at the end of the test period at 240 min. Serum insulin peaked at 10 min. (162 +/- 47 microU/ml) and had already returned to basal values (7.5 +/- 1 microU/ml) after 45 min. No severe side effects were observed and there was no need for glucose administration, but clinical symptoms of hypoglycemia were more pronounced after BHPI. Compared to BHI, BHPI produced a higher cortisol peak (252 +/- 16 vs. 168 +/- 10 ng/ml), a more pronounced secretion of ACTH and GH as well as a stronger decline of serum potassium (3.20 +/- 0.06 vs. 3.58 +/- 0.08 mmol/l). Counterregulatory prolactin secretion did not differ significantly. Urinary epinephrine secretion following hypoglycemia after BHPI exceeded that after BHI (10.3 +/- 4.8 vs. 3.0 +/- 0.5 ng/120 min.). Serum lactate increase after BHPI was more prolonged (1.68 +/- 0.24 vs. 0.37 +/- 0.14 mmol/l at 120 min.). BHPI-induced inhibition of lipolysis, as determined by free fatty acid patterns, was delayed and less pronounced. Our results indicate that the observed more distinct glucose counterregulation is due to prolonged hypoglycemia rather than to any specific BHPI action on the hypothalamic-pituitary axis. We regard this as a consequence of the prolonged circulating and biological half-life. A preferential proinsulin action on the liver may play an additional role. Whether this "depot effect" may be beneficial in the treatment of diabetes mellitus remains to be established.

Adrenocorticotropic Hormone↗

Neopterin. A tumor marker in colorectal carcinoma?

Neopterin is compared with other tumor markers in colorectal carcinoma. Its sensitivity is clearly lower than that of CEA, TPA and CA 19/9 and is even lower than the sensitivity of the erythrocyte sedimentation rate. The ability of neopterin to discriminate between different tumor stages is also lower than that of the other markers. The discriminant analysis shows that measurement of neopterin in the serum of patients with colorectal carcinoma gives no essential additional information.

Adult↗

2-Chloro-4-nitrophenyl-beta-D-maltoheptaoside: a new substrate for the determination of alpha-amylase in serum and urine.

Tests for the determination of alpha-amylase activity based on oligosaccharides or their 4-nitrophenyl derivatives as substrates suffer from some disadvantages. Using a more acid indicator molecule and connecting this group in the beta-form to maltoheptaose leads to a new substrate, 2-chloro-4-nitrophenyl-beta-D-maltoheptaoside, for the determination of alpha-amylase activity. Due to its pK value, only half of the 4-nitrophenol formed from 4-nitrophenyl-alpha-D-maltoheptaoside is spectrophotometrically detectable, whereas the total product from the new substrate is responsible for a measurable absorbance. In addition the molar lineic absorbance of the product is 1.8 times higher. Thus the new test is more sensitive than those employing 4-nitrophenyl derivatives. Both P-type and S-type alpha-amylase isoenzymes have the same affinity for the new substrate; this is not the case for all the other substrates, i.e. oligosaccharides and their 4-nitrophenyl derivatives, used in alpha-amylase tests. The sample volume may be reduced, thereby removing interference by substances like bilirubin, glucose and haemoglobin. The test is insensitive to changes in temperature and pH and can be adapted to all mechanized analytical instruments.

Chromatography, High Pressure Liquid↗

Marker-free immunological analytical methods.

The antigen-antibody reaction itself acts as the "marker system" in the marker-free immunological methods. This group of analytical techniques includes radial immunodiffusion, nephelometry, turbidimetry and nephelometric inhibition. The Particle Counting-Immunoassay (PACIA) technique also belongs to this group, although it employs latex particles as markers for the intensification of the indicator reaction. The principles of the above methods are described, and their applications in diagnosis, their detection limits and important interfering factors are discussed. For all methods, the precision in series and from day to day is in the range of 5-10%. The detection limits are 1 ng/l for the PACIA technique, 10 micrograms/l for nephelometric inhibition, 1 mg/l for nephelometry as an end point technique, and 10 mg/l for for nephelometry as a kinetic technique. Commercial sources of reagents and apparatus are given in an appendix.

Antigen-Antibody Reactions↗