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Biomedical subjects

R N Carey

Publications and source records attributed to R N Carey.

At least 19 recordsLinked to original sources
PubMed1993

A systems approach to assure optimal proficiency testing in the hematology laboratory.

Although CLIA 88 has probably caused the laboratorian to place inordinate emphasis on proficiency testing, we believe that it will ultimately improve clinical laboratory practice. Due to the increased numbers of challenges within a mailing, the laboratorian has a greater ability to gauge magnitudes and types of any existing error. These magnitudes can be compared with previously established limits to determine the need for corrective action. Laboratories are encouraged to devise a system to guarantee accurate preanalytic, analytic, and postanalytic PT processing and reporting. Due to the relatively low imprecisions of today's hematology analyzers compared with the HCFA limits, most hematology laboratories should focus their attention on measures of and factors affecting long-term control and calibration. More attention should be paid to moving averages of indices and the analytic performance in regional or manufacturer control pools.

Calibration↗
PubMed1991

Multirule quality control procedures.

Multirule quality control procedures employ combinations of individual quality control rules to increase the probability of error detection without increasing the probability of false rejections to unacceptable levels. Performance characteristics of several example multirule procedures are described, and general recommendations are made for their selection and use. Multistage quality control procedures tailor the control rules employed to the frequency of errors expected during a given phase of analyzer operation. During analyzer startup, sensitive rules are employed; after acceptable analyzer performance is demonstrated, less sensitive rules are used for routine monitoring. As they tend to deteriorate quality control rule performance, between-run variations should be minimized.

Chemistry, Clinical↗
PubMed1985

Multicentric reticulohistiocytosis and Sjögren's syndrome.

A 66-year-old man with an 18-year history of cutaneous multicentric reticulohistiocytosis (MRH) developed a chronic destructive symmetrical arthritis and xerostomia. Biopsies of synovium and minor salivary glands established a diagnosis of MRH polyarthritis and lymphocytic infiltrative Sjögren's syndrome, respectively. Anti-Ro(SSA) antibody was present. Hypothyroidism was also identified. This report of Sjögren's syndrome in MRH may enlarge the spectrum of autoimmune diseases associated with MRH.

Aged↗
PubMed1981

Clinical studies of a fast homoarginine-sensitive alkaline phosphatase in patients with cancer.

The activity of an isoenzyme of alkaline phosphatase (FHAP) was measured in serum samples obtained from 1692 individual subjects. The median FHAP concentration in patients with untreated or recurrent cancer (2.73 IU/liter) was two-fold higher than in hospitalized control patients with illnesses other than cancer (1.17 IU/liter) and three-fold higher than in healthy control subjects (0.93 IU/liter). Among patients with either breast or colorectal cancer who were clinically disease free following their initial therapy, the median FHAP concentration (1.54 IU/liter) was intermediate between the median FHAP concentration in patients with untreated or recurrent cancer and that of healthy control subjects. In order to illustrate the potential clinical application of FHAP as a diagnostic cancer marker, we have selected a serum FHAP concentration of 2.22 IU/liter as a reference value above which only 3% of healthy control subjects would have a "positive" test. Utilizing this reference value, 58% of the patients in the present study with untreated or recurrent cancer would have a positive FHAP test, whereas only 11%, of hospitalized patients with illnesses other than cancer would have a positive test. These data suggest that FHAP may be equivalent to the carcinoembryonic antigen as a diagnostic cancer marker.

Adult↗
PubMed1979

A comparison of hard and soft glass blood-drawing tubes.

The authors examined both hard and soft glass evacuated blood-drawing tubes for possible effects on clinical chemistry measurements. Using routine laboratory procedures, no clinically or statistically significant difference could be detected in 34 analytes using 66 different methods. A special high-precision study utilizing an adaption of the NBS round-robin procedures for calcium, magnesium, sodium, and potassium detected no difference between paired sera when drawn or stored for 72 hours, or both, in the two types of glass. The authors conclude that the type of glass used in production of the evacuated blood-drawing tubes does not affect the clinical chemistry results obtained.

Blood Specimen Collection↗
PubMed1978

Albumin activation of urinary amylase as determined with the Du Pont aca.

Protein activation of urinary alpha-amylase (EC 3.2.1.1) activity was observed during an evaluation of the Du Pont aca procedure for the determination of urinary alpha-amylase. This activation effect became constant for urinary albumin concentrations exceeding 1.50 g/liter. It is recommended that urinary alpha-amylase be analyzed with sufficient albumin added to maximize this effect. The aca alpha-amylase procedure is compared to an amyloclastic method for both serum and urine analysis. Expected ranges are presented for the aca method for serum and urinary amylase, amylase clearance, and the amylase clearance/creatinine clearance ratio.

Albuminuria↗
PubMed1978

Evaluation of the co-immobilized hexokinase/glucose-6-phosphate dehydrogenase method for glucose, as adapted to the Technicon SMAC.

We assessed the analytical performance of the co-immobilized hexokinase (EC 2.7.1.1) and glucose-6-phosphate dehydrogenase (EC 1.1.1.49) method for D-glucose analysis on the Technicon SMAC. The enzyme-containing coils were usable for one month, or 12 000 tests. Bilirubin, hemoglobin, lipemia, creatinine, uric acid, citric acid, and ascorbic acid did not interfere. Results with this method were compared to those by the National Glucose Reference Method. The upper limits of the total error estimate (a combination of random and systematic errors) were 76, 74, and 125 mg/liter at concentrations of 500, 1200, and 3000 mg/liter, respectively. The error estimates were less than allowable errors based on medical usefulness; thus the method was judged to perform acceptably with respect to the Reference Method. We also present performance data for the routine SMAC glucose oxidase (EC 1.1.3.4)/Peroxidase (EC 1.11.1.7) 3-methyl-2-benzothianolinone hydrazone-N,N-dimethylaniline method, the direct hexokinase method with the Du Pont aca, and the glucose oxidase oxygen-rate method with the Beckman Glucose Analyzer.

Autoanalysis↗
PubMed1976

Assessment of the serum separator tube as an intermediate storage device within the laboratory.

An integral blood-drawing-serum separator tube, (SST) is evaluated for use as an in-laboratory serum storage device. Sera stored in the SST were compared with paired controls that were specimens from the same subjects stored in closed culture tubes. Eighty-six serum chemistry determinations showed no clinically significant change as a result of 48 hours of storage in the original blood-drawing tubes. Storage of serum in this manner provides the laboratory with specimens for reanalysis or additional analyses while eliminating manipulative steps, including serum removal, tube relabeling, and intertube transfers, and reducing errors due to misidentification and/or contamination.

Blood Chemical Analysis↗
PubMed1976

Assessment of a serum separator device for obtaining serum specimens suitable for clinical analyses.

We have evaluated a serum separator device that is designed to effect better separation and isolation of serum from clotted blood. This device consists of an evacuated blood-drawing tube (Vacutainer) containing 1.5 ml of a semi-solid silicon polymer that forms a barrier between serum and clot during centrifugation. We compared test specimens with conventionally processed (Vacutainer) specimens as controls. Eighty-one chemical, toxicological, and immunological reactions, tests, or methods were studied. For several tests we observed changes that are statistically but not clinically significant. The one clinically significant change in serum chemistry values occurred in the case of lactate dehydrogenase, for which values were increased by 5-8% of the upper limit of normal.

Blood Chemical Analysis↗
PubMed1976

Automated separation and measurement of lactate dehydrogenase isoenzymes.

We describe a totally automated, computer-controlled system for separating and measuring the activity of lactate dehydrogenase (EC 1.1.1.27) isoenzymes. These isoenzymes in tissue extracts were separated on disposable DEAE-cellulose mini-columns. Resolution was complete except that LD-1 was not resolved from LD-2.

Autoanalysis↗
PubMed1976

Performance studies on the Technicon "SMAC" analyzer: Precision and comparison of values with methods in routine laboratory service.

We present performance studies on the Technicon "SMAC" analyzer. Precision was estimated from control data during routine operation and from blind duplicates of sera from patients. Patients' specimens were analyzed with the SMAC and the SMA 12/60 during initial evaluation studies. Comparisons were also made with the Du Pont aca and other methods during routine service. Performance is judged relative to medical usefulness requirements, by using previously developed criteria and recommendations for decision levels and allowable errors.

Alkaline Phosphatase↗