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[Significance of prostatic acid phosphatase, gamma-seminoprotein and prostatic specific antigen in the urine. First report: the measurement of PAP, gamma-Sm and PA in the urine of patients with prostatic diseases].

To study the significance of prostatic acid phosphatase (PAP), gamma-seminoprotein (gamma-Sm) and prostatic specific antigen (PA) in urine, we have determined the urinary levels of these proteins in women and infants, in patients without prostatic disease, in patients with benign prostatic hypertrophy, and in patients with prostatic adenocarcinoma. Women and infants were found to excrete little PAP (27.9 +/- 4.8 ng/mg) and undetectable levels of gamma-Sm except one case, and undetectable levels of PA in the urine. The excretion of PAP in patients with prostatic carcinoma who were either castrated, or treated with endocrine therapy was lower than the levels in women and infants, or the levels in patients without prostatic diseases, or the levels in patients with BPH. Urinary excretion levels of gamma-Sm and PA were undetectable in the patients with well-controlled prostatic carcinoma. The present study suggests that the determination of PAP, gamma-Sm and PA in the urine of patients with prostatic carcinoma may become a useful tool for monitoring of the primary locus of the carcinoma, but additional assays of urinary PAP, gamma-Sm and PA should be measured at regular intervals to be concluded.

Acid Phosphatase↗

Effects of vitamin C intake on whole blood plasma, leucocyte and urine ascorbic acid and urine oxalic acid levels.

Fifty volunteers among the students of the Faculty of Pharmacy at Ankara and Gazi Universities were taken 2 grams of Vitamin C per day at regular time intervals for two months. Blood and urine samples were collected in the beginning, one month and 2 months after vitamin administration. The whole blood, plasma and leucocyte ascorbic acid levels were increased after one and 2 months treatment. The urine ascorbic acid were also increased significantly. Urine oxalic acid were not elevated after vitamin C intake.

Ascorbic Acid↗

[Computer calculations on the effect of urine components on saturation relations of calcium oxalate in the urine].

With the help of a computer program the influence of magnesium, citrate, sodium, potassium, chloride and sulfate on the activity product of calcium oxalate is examined in a synthetic and in physiological urine by varying the several parameters. Natural urine shows a significant decrease of the supersaturation of calcium oxalate by enhancing concentration of citrate. A physiological average magnesium concentration shows no effect in the sense of an increase of supersaturation antagonizing the citrate. An additional increase of the concentration of magnesium is barely effective. Citrate shows a greater effect on the decrease of supersaturation of calcium oxalate than comparable quantities of magnesium concentrations. Within the normal range of sodium chloride concentration only a slight change of the supersaturation of calcium oxalate can be observed. Sulfate has also a very slight influence in natural urine within the normal physiological range, whereas potassium does not show any effect at all.

Ammonia↗

Solubility of calcium oxalate in human urine, simulated urine, and water.

The main factors that determine the amount of oxalate that can be held in solution in urine were found to be the ionic strength and the calcium and magnesium concentrations. Citrate seemed to be relatively unimportant at normal urine pH. Urea, pyrophosphate, chondroitin-4-sulphate, and chondroitin-6-sulphate were without effect at the concentrations normally found in urine.

Calcium↗

[Sports and measurement of components in urine--responses of renal blood flow, electrolytes and hormones and of excretion of proteins into urine to exercise].

Renal blood flow decreased depending on the increase in exercise intensity. The kidneys may have roles to conserve the electrolytes and body fluid, and maintenance of acid-base balance during and after severe exercise. Increases in plasma hormones involved in the regulation of electrolyte-water balance, and decreases in urine flow, Na, Cl and K excretions into urine were observed following moderate exercise under a warm environment. Inhibition of electrolytes and water excretion into urine following exercise in water was less than that following exercise on land. Exercise in water is good for patients with hypertension, obesity and a mild renal disease who have tendency to conserve sodium and/or water. Increase in urinary albumin excretion, glomerular-type proteinuria was observed after moderate exercise (50 approximately 75%HRmax) in the obese individuals who had higher levels of hematocrit, serum concentrations of triglyceride, total cholesterol, LDL-cho, apoprotein B, CIII, and fasting insulin. The findings suggest that moderate exercise causes a latent abnormality of renal glomerular basement membrane in the obese individuals who had an early disturbance of glucose-fatty metabolism.

Adult↗

Urine protein dipstick measurements. A screen for a standard, 24-hour urine collection.

OBJECTIVE: To determine if the sum of urine protein dipstick values recorded during every void can be used to screen for patients who need a standard, 24-hour urine collection for determination of protein excretion. STUDY DESIGN: Thirty inpatient and 17 outpatient pregnant women undergoing 24-hour urine collection for protein concentration were enrolled. The volume, dipstick protein values and time of void were recorded. The 24-hour quantitative analysis of protein excretion performed by the laboratory was compared to the 24-hour sum of the products of each voided volume and dipstick value (dipstick factor). RESULTS: The dipstick factor significantly correlated with the total 24-hour protein excretion (correlation coefficient 0.84, P < 1 x 10(-7)). A dipstick factor of > or = 300 mg, indicated proteinuria with a sensitivity of 96%, specificity of 90%, positive predictive value of 92% and negative predictive value of 95%. Separately, we found differences in the amount of protein excretion when the 24-hour period was divided into six 4-hour periods, using analysis of variance. Paired t test analysis of the mean protein excretion from 16:00 to 04:00 showed significantly higher results than did the protein excretion from 04:01 to 16:00 (1,197 +/- 356 mg vs. 674 +/- 158 mg, P < .0001). CONCLUSION: The sum of dipstick factors in a 24-hour period is a reliable screening test for identifying patients who need the standard laboratory test for proteinuria.

Adult↗

Definition of the mutation responsible for maple syrup urine disease in Poll Shorthorns and genotyping Poll Shorthorns and Poll Herefords for maple syrup urine disease alleles.

The organisation of the E1alpha subunit of bovine branched-chain alpha-keto acid dehydrogenase gene was established. c DNA was cloned from Poll Shorthorn x Poll Hereford calves affected with Maple Syrup Urine Disease to identify the mutation responsible for the disease in Poll Shorthorns. Clones containing the c DNA sequences inherited from the Poll Shorthorn sire of the affected calves were identified. Paternal clones were sequenced and a cytidine to thymidine transition was found at nucleotide 1380. The mutation is predicted to substitute leucine in place of a highly conserved proline at codon 372. A polymerase chain reaction procedure was developed for detection of the 1380C-->T mutation in genomic DNA. Three Poll Shorthorn parents of affected calves and three affected Poll Shorthorn x Poll Hereford calves were heterozygous and an affected Poll Shorthorn calf was homozygous for this mutation. An improved polymerase chain reaction procedure was also devised to genotype Poll Herefords for the 248C-->T mutation. The procedures will facilitate disease prevention programs and assist in differential diagnosis of conditions in new-born calves that present with a rapid onset of progressive neurological disease and are characterised histologically by 'status spongiosus'. Maple Syrup Urine Disease (MSUD) is an autosomal recessive defect reported in humans (Danner and Elsas 1989), and in Poll Hereford (PH) and Poll Shorthorn (PS) calves (Harper et al 1986, Healy et al 1992). The clinical, biochemical and pathological manifestations of the disease are identical in the two breeds of cattle, and are characterised by the rapid onset of progressive neurological disease, leading to death within a few days of birth. The disease is caused by a deficiency of activity of the mitochondrial enzyme branched-chain alpha-keto acid dehydrogenase (BCKADH). This deficiency leads to elevated concentrations, in blood and tissues, of branched chain alpha-keto acids and their precursors, the branched chain amino acids, valine, leucine and isoleucine. BCKADH consists of four subunits E1alpha, E1beta, E2 and E3 that are encoded by separate genes, and MSUD may result from deficiency of any of the subunits. In PH s, the disease in caused by premature termination of translation, of the E1alpha subunit, that is induced by a cytidine to thymidine transition exon 2 (248C-->T), that converts the glutamine codon -6 to a stop codon (Q-6ST; Zhang et al 1990). We have shown that MSUD -affected PSxPH calves are heterozygous at the PH locus, illustrating molecular heterogeneity exists for bovine MSUD (Healy and Dennis 1994a). The fact that these crossbred calves are affected, indicates the PS, like the PH mutation, resides in the E1alpha subunit.

Alleles↗

Urine bactericidal activity against resistant Escherichia coli in an in vitro pharmacodynamic model simulating urine concentrations obtained after 2000/125 mg sustained-release co-amoxiclav and 400 mg norfloxacin administration.

OBJECTIVES: To explore the urine bactericidal activity of co-amoxiclav and norfloxacin against Escherichia coli in an in vitro pharmacodynamic model simulating the human urinary concentrations observed after administration of a single oral dose of 2000/125 mg sustained-release co-amoxiclav and 400 mg norfloxacin. METHODS: Six E. coli isolates exhibiting amoxicillin/clavulanic acid MICs of 4/2 (two strains), 8/4, 16/8, 32/16 and 64/32 mg/L and norfloxacin MICs of < or =0.25 mg/L (three strains), 32, 64 and 256 mg/L were used. Colony counts were determined over 12 h and differences between the bacterial counts of initial inocula and the bacterial counts at each sampling time-point were calculated. RESULTS: With co-amoxiclav, bactericidal activity (>3 log(10) reduction) was obtained against the susceptible (MIC < or = 8/4 mg/L) and intermediate (MIC = 16/8 mg/L) strains from 3 to 12 h, and from 3 to 10 h against the resistant strains (MIC > or = 32/16 mg/L), which exhibited a 2 log(10) reduction at 12 h. With norfloxacin, bactericidal activity was obtained against the susceptible strains from 4 to 12 h and from 8 to 12 h against the resistant strain with an MIC of 32 mg/L. Regrowth, with respect to initial inocula, occurred from 8 h onwards with the strain with MIC = 64 mg/L and from 3 h onwards with the strain with MIC = 256 mg/L. CONCLUSIONS: While regrowth occurs after exposure of high norfloxacin-resistant E. coli to urine physiological concentrations of norfloxacin, this study suggests that clavulanic acid can be given twice daily (to protect amoxicillin activity) with respect to uncomplicated cystitis due to E. coli exhibiting amoxicillin/clavulanic acid MICs up to 64/32 mg/L.

Amoxicillin-Potassium Clavulanate Combination↗

Unsatisfactory performance of flow cytometer UF-100 and urine strips in predicting outcome of urine cultures.

UF-100 flow cytometer and urine strip results were cross-interpreted to predict culture outcomes. The best negative predictive value was obtained with bacteria at > or =1,000/microl, white blood cells at > or =20/microl, or leukocyte esterase positivity. Nine of 24 false negatives were clinically significant. Thus, UF-100 and urine strip results do not accurately predict the outcome of cultures.

Adolescent↗

Measurement of urine temperature as an alternative to observed urination in a narcotic treatment program.

Upper and lower limits have been determined for the temperature of freshly voided ur;ne. When specified procedures are followed, more than 99% of measurements lie between 32.5 and 36.7 degrees C. This provides a basis for monitoring urine collection in a drug abuse treatment program in a manner that does not invade privacy. The method is not foolproof, but it provides sufficient control if there are no penalties for illicit drug use so that there is no strong incentive to turn in a fraudulent urine sample.

Adult↗

Enzymatic method for branched chain alpha-ketoacid determination: application to rapid analysis of urine and plasma samples from maple syrup urine disease patients.

A new method for the determination of branched-chain alpha-ketoacid concentration using lactate dehydrogenase (E C 1.1.1.27) isozyme C4 (LDH C4) from mouse testes is proposed. The assay is performed on urine and plasma without previous treatment. Alpha-ketoglutarate and pyruvate are determined on the same sample using glutamate dehydrogenase (GDH, EC 1.4.1.2) and lactate dehydrogenase isozyme A4 (LDH5) respectively and subtracted from the total alpha-ketoacid concentration obtained with LDH C4. This value corresponds to the branched chain alpha-ketoacid. Results were linear within the concentration range 8 to 170 mumoles/L. Detection limit was 8 mumoles/L. Analytical recovery was higher than 91%. For microplate assays, recoveries were higher than 84% and the detection limit was 20 mumoles/L. Determinations performed with GDH, LDH A4 and LDH C4 allow differentiation of E3 deficiency from other clinical phenotypes of maple syrup urine disease. The method is simple and fast, and adaptation to microplates would allow screening of newborns.

3-Methyl-2-Oxobutanoate Dehydrogenase (Lipoamide)↗

Urine screening: an alternative to urine cultures.

Urine cultures represent one of the most commonly submitted specimens to a microbiology laboratory. In an attempt to manage effectively this type of specimen, Bac-T-Screen (BTS), nitrate and leukoestrase test were performed on all clean catch urine specimens sent for culture. Three hundred and four specimens were screened by these methods. The BTS, by itself, had the highest sensitivity, and specificity (92 percent and 81 percent, respectively) and the lowest false negative rate (9.8 percent) of the three tests. A combination BTS/leukoestrase test increased specificity (99 percent), but the sensitivity was only 73 percent.

Adult↗

A new simple approach to study the effect of changes in urine flow and/or urine pH on renal clearance and its applications.

After entering the renal tubular lumen either through glomerular filtration or tubular secretion, drug molecules are considered to be removed from there by two competing processes: tubular fluid flow for urinary excretion and tubular reabsorption into blood circulation. The relative overall magnitude of the "force" or "efficiency" of these two processes will determine the fraction of drug molecules to be either excreted or reabsorbed, and hence their renal clearance (CLr). Urine flow rate (Q) is assumed to be proportional to the mean flow rate of tubular fluid at reabsorption sites (mainly in distal tubules), and used as an index to indirectly estimate the relative reabsorption "force" or "efficiency" (this may also be called apparent intrinsic reabsorption clearance). With the above assumptions, a plot of 1/CLr vs. 1/Q should yield a straight line under apparent first-order conditions. This has been confirmed for urea, theophylline, ethanol, chloramphenicol, amobarbital, riboflavin and fluoride based on human and dog (riboflavin only) data reported in the literature. Assuming that tubular reabsorption occurs only through the diffusion of unionized molecules, a plot of 1/CLr vs. fn/Q should also yield a straight line for weak acids and weak bases under linear conditions; the fn is the mean fraction of drug present in the unionized form at reabsorption sites whose mean pH is approximated or reflected by the urinary pH. The above straight line plot has been confirmed with human data for phenobarbital as well as human and rat data for salicylic acid. The effect of urine pH on biological half-life of pseudoephedrine in humans has also been successfully characterized.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

A scanning electron microscopic study of urine droppers and urine collecting systems.

In this study we have shown extensive microbial colonization of the surface of urine droppers and urine collecting systems from bacteriuric patients. In all instances there was an extensive background matrix and fibrous strands interconnected the bacteria. A "slime" layer completely encased bacteria on occasion. These observations suggest that incorporation of blockers of bacterial adhesion into the surfaces of these devices should be explored as one method of delaying, or in some cases preventing, catheter-acquired bacteriuria.

Bacteria↗

The results of analyte enhancement and use of supplied urine protein standard on the CAP Urine Chemistry Survey Program.

Thirteen analytes were presented for participant analysis during the year 1979. Included were amylase, calcium, phosphorus, sodium, potassium, creatinine, osmolality, total protein, glucose, urea nitrogen, 17-ketosteroids, 17-ketogenic steroids, and vanillylmandelic acid. A urine protein standard was provided, and approximately half of participating labs used it. The severe biases demonstrated in past years between urine protein analytic methods was eliminated, and interlaboratory precision was greatly improved. Among labs not choosing to use the standard, poor interlaboratory precision and severe bias between methods persisted. Elevation of sodium and calcium concentration to levels simulating human disease resulted in significantly poorer analytic performance.

Chemistry, Clinical↗

Objectionable urine spraying and urine marking in cats: evaluation of progestin treatment in gonadectomized males and females.

The increasing use of long-acting progestins to treat objectionable urine spraying and urine marking in gonadectomized cats prompted a survey of the comparative effectiveness of the injectable medroxyprogesterone acetate (MPA) and the orally administered megestrol acetate (MA). Both drugs were successful, overall, in about 1/3 of the patients. However, the proportion with favorable response was higher for males (48%) than for females (13%) and was higher for cats from single-cat homes (50%) than for cats from multi-cat homes (18%). Because of the reportedly higher frequency of depression and increased appetite following MA treatment, when compared with MPA treatment, it is recommended that MPA be used initially for routine treatment of these behavioral problems. The survey revealed that if MPA proves ineffective, subsequent treatment with MA can be expected to yield favorable results in some of these patients.

Administration, Oral↗

Evaluation of urine composition and calcium salt crystallization properties in standardized volume-adjusted 12-h night urine from normal subjects and calcium oxalate stone formers.

The volume of 12-h night urine from ten normal men (NM), ten normal women (NW) and 31 male calcium stone formers (SFM) was adjusted to 750 ml and analysed with respect to supersaturation with calcium oxalate (CaOx) and calcium phosphate (CaP), inhibition of CaOx crystal growth and aggregation, as well as the CaOx and CaP crystallization propensity. Concentrations of oxalate and glycosaminoglycans and AP(CaOx) index, an estimate of the CaOx ion-activity product, were higher and the concentration of citrate lower in NM than in NW. In SFM the directly assessed risk of CaOx crystallization was higher and the inhibition of CaOx crystal growth lower than in NM. There were no differences between the groups regarding inhibition of CaOx crystal growth by 74% dialysed urine or inhibition of CaOx crystal aggregation. SFM with mixed CaOxCaP stones had a higher concentration of phosphate and a higher AP(CaP) index at pH 7.0 than SFM with CaOx stones.

Adult↗