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Biomedical subjects

M Knedel

Publications and source records attributed to M Knedel.

At least 37 records · Page 2Linked to original sources

Analysis of free stool porphyrins by high-performance liquid chromatography.

The determination of stool porphyrins is necessary for the diagnosis of some porphyrias in clinical laboratories. Quantitative methods for the analysis of faeces for porphyrins are unpleasant and difficult to perform. An extraction and ion-pair reversed-phase high-performance liquid chromatographic procedure is described for the separation and determination of individual free stool porphyrins. The within-assay coefficients of variation range from 2 to 6%. A linear response curve is observed between 38 and 380 nmol/g for coproporphyrin I in dry stool The method can be applied to the routine analysis of free stool porphyrins in the clinical laboratory.

Chromatography, High Pressure Liquid↗

Cluster-oriented discriminant analysis; taxonomic classification of the thyroid function.

A computer assisted procedure for the diagnosis of thyroid diseases, based on seven clinical chemical parameters, is proposed. The population studied consisted of 592 consecutive outpatients with a tentative diagnosis of thyroid disease. Thyroxine, triiodothyronine, T3 uptake test, TSH before and after TRH application, its difference and thyroxine binding globulin have been determined. The patients were clinically examined and in each case a Tc-scintigram was obtained. As a first step, 20 biochemical patterns were defined by cluster analysis (pattern cognition). T check how good in grouping process was, linear discriminant analysis was applied after which the reclassification rates were very satisfactory. The clusters found corresponded well to the pathophysiological situations with some exceptions. As a second step, patients were assigned to these patterns by use of the derived discriminant functions (pattern recognition). The proposed method seems to have some advantages over other diagnostic models published hitherto.

Alpha-Globulins↗

Evaluation of a new valproic acid enzyme immunoassay and comparison with a capillary gas-chromatographic method.

A new homogeneous immunoassay (EMIT) for valproic acid was evaluated. Besides testing the manual version of this enzyme immunoassay, we also developed two mechanized procedures for centrifugal analyzers (the CentrifiChem and the COBAS system), which take less time and are more precise than the manual method. Within-assay precision (CV) was 4.5% with the manual technique and 2% with the analyzers. Between-assay precision (CV) ranged from 4 to 13% for all three techniques. Accuracy of th manual method was checked by dilution and analytical recovery experiments. Our comparison of the EMIT results with those obtained by a comparison method (capillary gas chromatography) showed no significant difference. No interference from hemolysis, hyperbilirubinemia, or aliphatic amino acids was observed. At high concentrations of bile acids and with lipemic sera the analytical recovery rates decreased slightly, to 87% and 92%, respectively.

Amino Acids↗

[Optimization of sample splitting in a centralized clinical chemical institute (author's transl)].

Mechanized sample splitting machines controlled by a laboratory data processing system have been realized in only a few centralized laboratories. Bottlenecks and mistakes in sample processing are avoided by means of direct machine readable identification and parallel splitting of the secondary tubes. Our previous experience has shown that a strategy for sample splitting has to go far beyond these basic functional requirements. The splitting process must be suited to the organization of the particular laboratory, and it must be adjusted to deal with problems of individual samples containing analytically interfering substances, or variable splitting may be required in cases of inadequate sample volumes. In addition to sample identification, the secondary tube has to be coded with the date and the type of material. This allows cumulative on-line processing and series of analyses of different materials. A suitable positional arrangement of containers for control material must be born in mind for quality control performances. We have realized these additional requirements by means of a consequent mutual adaptation in the layout of the request form (marking of priority and additional information), the file structure of the data processing system and the control program of the sample splitting machine.

Chemistry, Clinical↗

Diagnosis of porphyrias by ion-pair high-performance liquid chromatography.

Ion-pair reversed-phase high-performance liquid chromatography together with fluorescence detection is useful in the analysis of urinary porphyrin carboxylic acids. The sensitive and quantitative detection facilitates the clinical diagnosis of porphyrias. The method described permits the detection of porphyrins down to 0.1 ng directly from urine without laborious sample pre-treatment. A linear response curve was obtained from 0.2 up to 200 ng for coproporphyrin I. The within-assay correlation coefficients ranged from 2.5 to 10.1%. Recovery experiments gave an accuracy of 89-109%. The rapidity and simplicity of the method allows its application to the routine analysis of urinary porphyrins in the clinical laboratory.

Chromatography, High Pressure Liquid↗

[Determination of thyroxine in serum by a heterogeneous enzyme immunoassay: results of a joint trial].

This paper describes the evaluation of a heterologous enzyme immunoassay for the determination of total thyroxine in serum by a group of seven clinical chemical laboratories. The test follows the principles of the enzyme linked immunosorbent assay (ELISA) and uses peroxidase as a marker. The evaluation of analytical reliability yielded the following results within the analytical range from 39 unto 322 nmol/l: 1. Within-batch precision ranged from 3.1 unto 10.4% (coefficient of variation) with single analyses. 2. Between-batch precision ranged from 3.7 unto 20.4% with single analyses. 3. Between-laboratories precision ranged from 5.4 unto 6.8%. 4. Pure thyroxine, added to serum or thyroxine-free serum, gave recoveries between 93 and 120%. 5. Analysis of control sera gave results essentially comparable to the assigned values based upon radioimmunoassays. 6. Analysis of 288 clinical sera gave slightly higher results by the enzyme immunoassay than by the analogous radioimmunoassay from the same manufacturer. 7. Comparison with other methods of analysis (radioimmunoassays, competitive protein ligand assays, hormonal iodine assay) yielded partly comparable, partly higher results. 8. Comparison with the homogenous enzyme immunoassay (EMIT) led to comparable results. 9. Interference due to hyperlipemia or hemolysis was not observed. 10. There might be an interference in hyperbilirubinaemic sera, due to an as yet unknown factor. With respect to practicability the ELISA-test compares favourably with the analogous solid phase radioimmunoassay. The main differences are the absence of radioactive material and a longer shelf-live of reagents. Following the manual procedure the time taken to perform the enzyme immunoassay is slightly longer than for the analogous radioimmunoassay.

Enzyme-Linked Immunosorbent Assay↗

Quantitation of adrenaline and noradrenaline from human plasma by combined gas chromatography--high-resolution mass fragmentography.

A gas chromatographic--high-resolution mass fragmentographic method for the simultaneous determination of adrenaline and noradrenaline from human plasma is presented. The catecholamines are separted by adsorption on alumina and converted by a selective, two-step procedure to the corresponding N-trifluoroacetyl-N-trimethylsilyl derivatives. The benzylic fragment C16H31O3Si3 (m/e 355.1568) of these derivatives is detected at a mass spectrometric resolving power of 5000. This high resolution detection was necessary to differentiate this fragment from others with the same nominal mass of 355 originating from the biological matrix and/or the bleeding from column and septum.

Epinephrine↗

[Creatine kinase isoenzymes: idiopathic occurrence of creatine kinase BB activities in patient serum (author's transl)].

By differentiation of creatine kinase isoenzyme activities in sera using immunological methods the published data about occurrence of creatine kinase BB activities in patients with different diseases or after surgical treatment, respectively, cannot be verified in general. With a frequency in the order of magnitude of 1 : 1000 in the serum of old patients (age 57 to 85 years with one exception), however, creatine kinase BB activities can be measured. The range of activities is 15 to 234 U/1, or 19 to 94% of total creatine kinase activities, respectively. At the present time there is no possibility to correlate this phenomenon to any specific disease. These cases are detected by abnormally high results of CK-MB activity measurements with the immunoinhibition test (range 60 to 202% of total creatine kinase activities) which lead to a repeated analysis using immunoprecipitation. The results of all CK-BB patients investigated till now are presented and discussed.

Adult↗

Performance of various mathematical methods for computer-aided processing of radioimmunoassay results.

Interpolation and regression methods are available for computer aided determination of radioimmunological end results. We compared the performance of 6 algorithms (weighted and unweighted linear logit log regression; quadratic logit log regression, smoothing spline interpolation with a large and small smoothing factor, respectively, and polygonal interpolation and the manual curve fitting on the basis of three radioimmunoassays with different reference curve characteristics (digoxin, estriol, human chorionic somatomammotrophin (HCS)). Great store was set by the accuracy of the approximation at the intermediate points on the curve, i.e. those points that lie midway between two standard concentrations. These concentrations were obtained by weighing and inserted as unknown samples. In the case of digoxin and estriol the polygonal interpolation provided the best results, while the weighted logit log regression proved superior in the case of HCS.

Computers↗

[Isoenzymes of creatine kinase: distribution in the skeletal muscle and in sera of patients with muscular diseases or damages (author's transl)].

In skeletal muscle isoenzymes of CK were determined by immunprecipitation and chromatography. The activity of CK-MB was between 17 and 47 U/g muscle, corresponding to a quota between 2,1 and 4,2% of the total activity. In sera of patients with muscular dystrophy, polymyositis, hypothyroidism, after arterial embolism, epilepsy, hyperventilation, operations and polytrauma with and without injury to the thorax isoenzymes were measure by immune precipitation- and immune inhibition-test. The percentage of CK-MB in all sera was less than 6% of the total CK-activity (range: 0 to 6%). Only patients in the first day after neurosurgical operations showed a quota till to 6.5% CK-MB. In serum of patients after polytrauma without injury to the thorax the percentage of CK-MB ranged from 0-5.7% while after polytrauma with injury to the thorax and a reasonable suspicion of a damage to the myocardium this quota was between 5.1 and 23.6% of the total activity. CK-BB activity was not detectable in any cases. Therefore a disease or damage of the skeletal muscle is more probable, if the percentage of CK-MB in less than 6%, because in sera of patients with myocardial infarction in the first 48 h after beginning of the symptoms this quota of CK-MB in the most cases in more than 6%.

Creatine Kinase↗

[Studies of activity kinetic of isoenzyme CK-MB in serum after myocardial infarction (author's transl)].

We investigated the activity kinetics of CK-total and CK-MB in 83 patients with proven myocardial infarctions. Serial serum samples were taken at intervals of 2--6 h. The activity of isoenzym CK-MB was determined by means of the immunological inhibition method. CK-MB activity was determined in all patients. The mean peak activity of CK-MB was 65 U/l (range: 9-241 U/l). At the time of peak CK-MB activity the mean percentage CK-MB activity was 13.2% (range: 3.4--21.7%). The CK-MB activity reached its peak at 17.4 h (range: 3.0--32.5 h) after the onset of retrosternal pain. This is 1.4 h after peak CK-total activity. The mean disappearance rate constant for CK-MB (n = 31) was found to be 9.3 X 10(-4) U/min with a large individual variation. This value corresponds to a half life of 12.5 h (CK-total: 15.5 h). The determination of CK-MB activity is therefore only of diagnostic significance within 48 h of possible myocardial occurrence. Moreover, isoenzyme CK-MB is not found exclusively in myocardium. For this reason it is better to use the percentage CK-MB activity in the differential diagnosis of myocardial infarction. With 80% of the patients this value is greater than 6% within 36 h of proven myocardial infarction.

Circadian Rhythm↗

Mass spectrometry of dimethylthiophosphinates of aromatic hydroxy compounds.

The mass spectra of 20 differently substituted dimethylthiophosphinic esters of aromatic hydroxy compounds are presented. Fragmentation routes were investigated using high resolution mass measurements, decoupled metastable determinations and deuterium labelling. All compounds exhibited abundant molecular ions and typical phosphorus-containing ions. Characteristic elimination processes strongly dependent upon the respective type of substitution were observed. Due to their high stability, their great ease of formation and their good gas chromatographic properties these new types of derivatives are of special interest for establishing gas chromatography mass spectrometry profiles of acidic catecholamine metabolites.

Gas Chromatography-Mass Spectrometry↗

Quantitative determination of creatine kinase isoenzyme catalytic concentrations in serum using immunological methods.

For the determination of creatine kinase isoenzyme catalytic concentrations in serum two methods based on immunological reactions are presented: One method uses inhibiting antibodies, which selectively block the activity of creatine kinase M subunits ("Inhibition Test"). This test is used for routine measurements of creatine kinase MB catalytic concentration; Another method uses precipitating antibodies, which allows a quantitative differentiation of creatine kinase isoenzymes MM, MB and BB ("Precipitation Test"). This test is used as a control for the Inhibition Test for the possible presence of creatine kinase BB activities in doubtful cases. Procedures, specificity, correlation and application of these methods are discussed.

Creatine Kinase↗

[The mechanization of the enzyme immunological determination of phenytoine with the Centrifichem (author's transl)].

The separation of free from bound antigen is not required in homogeneous enzyme immunoassays (EMIT). Therefore this technique can easily be mechanized. For the mechanization of the enzyme immunological determination of serum levels of Phenytoine the fast analyzer (CENTRIFICHEM) was found most satisfactory in our laboratory. The marked advantages over manual methods are: 1. The amount of sample and reagents needed can be reduced by half. 2. The intra- and interassay variance are significantly better compared to values found with manual techniques. 3. 60 samples can be determined in duplicate in under two hours.

Autoanalysis↗