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Simplified quantification of urinary protein excretion in children.

The protein/creatinine ratio (Up/Uc) measured in 71 early morning urine samples (EMU) correlated closely with timed overnight urine (ONU) protein excretion rates (r = 0.96). The relationship was linear throughout the entire range of normal and abnormal protein excretion, an ONU rate of 1 mg/h/m2 body surface area being proportional to an EMU Up/Uc of 5 mg/mmol. Using the Coomassie Blue dye-binding method the upper limit of Up/Uc in 377 apparently healthy children and adolescents aged 3-19 years was shown to be 20 mg/mmol. Albumin/creatinine ratios (Ua/Uc) were also determined in the 377 healthy subjects, yielding a normal working upper limit of 3 mg/mmol. Although in normal individuals studied longitudinally the day-to-day variation of both Up/Uc and Ua/Uc was appreciable, all measurements remained within the cross-sectional normal range. While the determination of Ua/Uc has a role in the study of "microproteinuria", it is comparatively costly for routine use. The measurement of the EMU Up/Uc avoids errors and difficulties associated with timed urine collection, simplifies sample handling by the laboratory and is inexpensive. In clinical practice this is the method of choice for the quantification of proteinuria in patients with renal disease.

Adolescent↗

Stability experiments in human urine with EO9 (apaziquone): a novel anticancer agent for the intravesical treatment of bladder cancer.

EO9 (apaziquone) is a novel, promising anticancer agent, which is currently being investigated for the intravesical treatment of bladder cancer. EO9 contains a highly reactive aziridine ring in its structure that limits its chemical stability in acidic aqueous solutions. The stability of the pharmaceutically formulated EO9 in human urine, including the effects of several parameters such as temperature, buffer strength and pH have been investigated. Urine extracts were analyzed by high-performance liquid chromatography coupled to electrospray tandem mass spectrometry (HPLC-MS/MS) using a TurboIonspray interface and positive-ion multiple reaction monitoring. EO9 was unstable in urine at 43 degrees C during the instillation for longer than 1 h. However, the drug was stable in human urine for 3 h at 37 degrees C. EO9 is stable in urine stabilized with TRIS buffer (pH 9.0; 5 mM) for up to three freeze/thaw cycles at -20 and -70 degrees C and 3 months of storage at -70 degrees C. The results also illustrated that with the lower pH in urine, EO9 became more unstable. Furthermore, a new degradation product of EO9 was discovered and successfully identified as EO9-Cl. The outcomes of these stability experiments will be implemented to insure proper sample handling at the clinical sites, transport, storage, and sample handling during analysis in the forthcoming preclinical studies of EO9 in superficial bladder cancer, supported by bioanalysis and pharmacokinetic monitoring.

Antineoplastic Agents↗

Extracellular metabolisation of NADH by blood cells correlates with intracellular ATP levels.

A new assay allowing quantitation of extracellular NADH metabolisation by intact blood cells was compared with the intracellular ATP/ADP ratio of these cells. The sensitivity, reproducibility and NADH specificity of this assay were determined. The diagnostic potential of this test was examined in a study with highly conditioned athletes. NADH consumption was measured before and immediately after maximum aerobic performance as well as 1 day later and was compared with the ATP/ADP level in these blood cells. A significant decline of cellular energy after aerobic performance was detected with both approaches to a similar extent (P<0.01). However, the extracellular NADH metabolisation assay (ENMA) is more convenient to perform than the determination of intracellular ATP/ADP. Due to its easy and versatile handling, a huge array of possible applications like monitoring the training efficiency of athletes, the fitness of senior citizens or the recovery from disease may be envisioned.

Adenosine Diphosphate↗

Establishment of a CSF bank.

A bank of well-characterized CSF has been established by collecting and storing (-70 degrees C) CSF samples remaining after completion of routine clinical studies. Over 1,700 individual patient samples were collected during a 12-month period. A database derived largely from information down-loaded from existing hospital-based systems includes the results of individual CSF laboratory studies, in addition to the patient age, primary diagnoses, and details of any malignancy. CSF control material is used to verify storage conditions. The CSF bank supplies investigators with CSF handled in a standardized manner for more precise investigation of CNS disease.

Adolescent↗

Detection of bacterial contamination in bone marrow graft.

A rapid method of determining bacterial contamination was used in a series of fifty-five bone marrow harvests (20 allogeneic and 35 autologous transplantations). The microbiological culture assays executed on bone marrow samples soon after the harvest and before the manipulation, showed a positivity only in the autologous bone marrow group. Another positivity was revealed after the freezing process of bone marrows for autologous transplantation. Two samples in the bone marrow group submitted to purging were positive after treatment and freezing process. In this study, the increase of bacterial contamination frequency seemed to be related to extensive handlings, such as pharmacological in vitro purging and freezing procedures.

Bacteria↗

Bacteria in the oral mucosa and its effects on the measurement of cortisol, dehydroepiandrosterone, and testosterone in saliva.

Bacteria load in saliva was experimentally manipulated, and the consequences for the measurement of salivary testosterone (T), dehydroepiandrosterone (DHEA), and cortisol (C) were examined. Healthy adults (n = 19) donated the first saliva sample upon rising after which they rinsed their mouths with water, waited 10 min, and donated a second sample. Samples were either left untreated or passed through a 0.22-microm filter and then frozen at -80 degrees C or incubated at room temperature (RT) for 10 days. Aliquots of each sample were cultured on agar to determine baseline and post-incubation (or freezing) bacteria load. Bacteria counts were not significantly influenced by rinsing (with water), were substantially reduced by filtration, and increased by incubation at RT. Average levels of salivary T and C, but not DHEA, were significantly lower in samples stored at RT than samples frozen the day of collection. The change in bacteria count induced by storing samples at RT was associated with a change in testosterone but not cortisol or DHEA. When samples were passed through a 0.22-microm filter bacteria counts were reduced, and the association between bacteria and testosterone was reduced to non-significant. These findings contribute to a growing body of literature revealing that the process of sample collection, storage, and handling can dramatically influence the accuracy of information generated when salivary biomarkers are integrated into research and clinical diagnostics.

Analysis of Variance↗

Mutation and inactivation of cultured mammalian cells exposed to beams of accelerated heavy ions. I. Irradiation facilities and methods.

This paper, which is the first of four covering the inactivation of clonogenic capacity and induction of mutation in cultured mammalian cells, deals briefly with the general aims of the work and describes the irradiation techniques used. Human diploid fibroblasts and V79 Chinese hamster cells were irradiated as monolayers with ions of helium, boron or nitrogen at LET's in the range 20 to 479 keV micrometer-1 in H2O. The physical aspects of the irradiation including measurement of ion energies, dosimetry and uniformity of dose and also the methods of handling large numbers of samples are described in detail. Subsequent papers will present the biological methods and results and a biophysical analysis of the data.

Animals↗

Analytic validation of an infrared milk urea assay and effects of sample acquisition factors on milk urea results.

The objective of this study was to determine if milk samples, as they are routinely collected by Ontario Dairy Herd Improvement, would yield accurate milk urea results with an infrared assay. This investigation involved analytic validation of the infrared assay and assessment of the effect of DHI routine sample acquisition factors on milk urea results. Analytic validation of an automated milk urea assay was performed by assessing the relative accuracy and precision of milk urea results produced by the Fossomatic 4000 Milk Analyzer, an infrared method of analysis, compared with the Eurochem test, an accepted reference method. Results indicated that, when interpreted at the group level, milk urea results between the infrared method and the reference test were in good agreement. The two tests shared a similar and high level of precision. Milk urea concentrations obtained from composite (metered) milk samples, and not quarter stripping samples, were most representative of concurrent serum urea concentrations. The addition of bronopol preservative did not result in a numerically important change in milk urea concentrations. Storage of preserved metered milk samples for up to 4 d at either room temperature or by refrigeration, or for up to 3 d by freezing, did not result in changes in milk urea concentrations. We concluded that milk samples, as they are routinely collected and handled by DHI, are suitable for measurement of milk urea concentrations with the infrared method of analysis if data are interpreted at the group level.

Animals↗

[Care for body materials obtained from autopsy].

During every autopsy, small tissue samples are taken from each organ for microscopic examination. Organs or part of organs are retained for a longer period if (a) the organ concerned is so small that the entire organ is needed for the microscopic examination; (b) the organ exhibits complicated abnormalities which can only be diagnosed following fixation or a special treatment; (c) the organ must be fixed before the examination can take place, for example, the brain. This means that the corpse is not buried or cremated in its entirety. Next of kin are not always aware of this procedure even if they have given their consent for an autopsy. Changes within society, especially the handling of aborted foetal material and foetal material from intra-uterine deaths, require new agreements and rules for the retention of organs. Next of kin must be able to have confidence in the provision of information and the careful management of body material retained during autopsies.

Autopsy↗

[Immunochemical screening: manipulation, handling and interpretation errors, exemplified by benzodiazepines].

The article describes problems related to immunochemical screening-tests with special regard to benzodiazepines, which are commonly used for therapeutic purposes. Focal points are adulteration, manipulation and handling of samples, the selection of cut-off-values, specificity and cross-reactivity, influence of biotransformation and frequently observed pitfalls in the interpretation of the analytical results.

Benzodiazepines↗

[Systematic and random errors in the determination of parameters of the acid-base equilibrium].

A review is given of the most common errors made in the estimation of the parameters of acid-base balance. Especially important are the systematic errors, for instance in handling the blood before estimation, by use of incorrect standard solutions or poor temperature control during the measurement of the pH. By paying attention to these details, it is possible to obtain excellent precision in final measurement in the standard apparatus.

Acid-Base Equilibrium↗

Protecting health care workers from the occupational risk of disease.

Recent medical literature has voiced growing concern over the potential spread of human immunodeficiency virus and hepatitis B among health care workers. In response to this concern, the Central Ohio Medical Group developed an infection control policy involving employee immunizations, needle stick protection protocols, and protocols for handling potentially infectious material. Although it is too soon to measure the infection control policy's health effects, the existence of a consistent set of policies and procedures has succeeded in alleviating apprehension among employees.

Accidents, Occupational↗

How to run a brain bank. A report from the Austro-German brain bank.

The sophisticated analysis of and growing information on the human brain requires that acquisition, dissection, storage and distribution of rare material are managed in a professional way. In this publication we present the concept and practice of our brain bank. Both brain tissue and information are handled by standardized procedures and flow in parallel from pathology to neuropathology and neurochemistry. Data concerning brain material are updated with clinical information gained by standardized procedures.

Austria↗

Intraocular lymphoma. Clinical and histopathologic diagnosis.

BACKGROUND: Intraocular lymphoma is associated with significant morbidity and mortality, but early diagnosis and treatment may improve prognosis. METHODS: The diagnostic features of 12 cases of intraocular lymphoma diagnosed at the National Eye Institute between 1984 and 1992 were retrospectively reviewed. RESULTS: A pathologic diagnosis of large B-cell lymphoma was made on vitrectomy specimens in ten patients, cerebral spinal fluid in one, and on an enucleation specimen in one. The mean time from onset of symptoms to diagnosis was 21.4 months (range, 1-66 months). All 12 patients were given a final diagnosis of non-Hodgkin's lymphoma of the central nervous system (NHL-CNS), based on the epidemiology, pathology, and clinical course of their tumors. Although an initial vitrectomy was negative for malignant cells in three of ten patients, a repeat vitrectomy specimen subsequently showed intraocular lymphoma. Results of examination of the cerebrospinal fluid (CSF) showed malignant cells in 5 of 11 patients, although malignant cells were only identified after repeat examination of additional samples of CSF in three of these patients. Malignant cells often are difficult to identify, and an experienced cytopathologist was critical in making the correct diagnosis. In addition, corticosteroids are lympholytic to the lymphoma cells, and they appeared to decrease the viability of tumor cells obtained in samples of vitreous and CSF. CONCLUSION: The prompt, appropriate handling of specimens and review by an experienced cytopathologist are critical to the diagnosis of intraocular lymphoma. Malignant cells often are present in the cerebral spinal fluid at the time that ocular lymphoma is diagnosed. Nevertheless, multiple vitrectomies and lumbar punctures may be necessary before the correct diagnosis is made.

Adult↗

[A passive sampler for nitrogen dioxide].

Passive samplers run without electric power supply, are easy to handle and thus are suitable for exposure measurements in epidemiological studies, to evaluate indoor air quality, to control ambient concentrations etc. Passive sampler values agree with continuous measuring apparatus within 85 to 105% and the lower detection limit is 4 micrograms/m3 for a one week exposure or longer.

Air Pollutants↗

Antigen levels of plasminogen activator inhibitor type 1 in citrated plasma: determination of the contribution of platelets.

To estimate the extent of the release of plasminogen activator inhibitor type 1 (PAI-1) from platelets following their accidental activation in vitro during blood collection, we studied the antigen levels of PAI-1 and beta-thromboglobulin (beta TG) in plasma and sera from 38 healthy volunteers. For each volunteer, we calculated the ratio of platelet-derived PAI-1/platelet-derived beta TG from the difference in their respective concentrations in serum and plasma. The mean +/- SD (0.012 +/- 0.003) and median (0.012) ratios were identical before and after 10 or 20 min of venous occlusion. The platelet contribution of PAI-1 in plasma was estimated by multiplying the plasma concentration of beta TG (as a marker of platelet activation) with the above-mentioned individual ratio. Under our conditions of blood collection (1/10 vol of 0.1 M citrate, pH 4.5, as anticoagulant, and handling of blood at 4 degrees C and within 30 min), the platelet contribution to the PAI-1 concentration in plasma was on average 12% and always negligible in plasma with high levels of PAI-1.

Adult↗

An approach to handling pediatric thyroid and adrenal tumors excluding neuroblastoma.

Thyroid and adrenal tumors, excluding neuroblastoma, are infrequent in children. Because of the problems involved in applying diagnostic and prognostic criteria developed for adult tumors to pediatric tumors, proper diagnosis of thyroid and adrenal tumors in pediatric patients and proper patient management require close collaboration on the part of clinicians, surgeons, and surgical pathologists. In view of that fact, an approach to handling thyroid and adrenal tumors is presented. Special attention is paid to the following aspects of managing both types of tumors: procedure, fine-needle aspiration, intraoperative consultation (frozen sections), gross examination, histologic examination, special studies, diagnosis, and prognostic features.

Adolescent↗