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Carlo Franzini

Publications and source records attributed to Carlo Franzini.

28 records · Page 2Linked to original sources

Precision and long-term stability of capillary electrophoresis measurement of serum protein zones.

BACKGROUND: Analytical evaluations of an available system for capillary zone electrophoresis (CZE) of serum protein have been reported. However, data concerning long-term precision and stability of the system, operated under routine conditions, are lacking. We report data from an internal quality control (QC) scheme, obtained over a 1-year period. METHODS: Measurements were done with a pair of instruments (Beckman Paragon CZE 2000 system), each equipped with seven capillaries. After preliminary (1 month) assessment of possible inter-capillary and inter-instrument variations, the QC material (a home prepared serum pool stored in the frozen state) was assayed daily over a 1-year period. RESULTS: Maximum inter-capillary and inter-instrument differences were 3.1% and 2.4%. No significant trend was observed for daily values (205 measurements over 1 year); in the same period overall imprecision values (CV) were in the interval 1.2% (albumin) to 3.2-6.1% (globulin zones). Mean monthly imprecision (CV) values were in the interval 1.1% (albumin) to 5.2% (globulin zones). There was no significant trend of monthly means with time. The observed imprecision values were within the biological variation-derived goals for imprecision. CONCLUSIONS: It is concluded that the assessed analytical instruments, operated in routine conditions, show long-term stability and imprecision consistent with the clinical use of the results produced.

Blood Proteins↗

Effects of acoustic stimulation on cardiovascular regulation during sleep.

The interaction of wake-sleep states and acoustic stimulation on cardiovascular regulation was studied on rats implanted with electroencephalogram and electromyogram electrodes and an arterial catheter. Mild acoustic stimuli (1000 Hz, 90 dB, 50-ms beeps) were administered during Wakefulness (W), non-rapid eye movement (NREM) sleep and REM sleep and the changes induced in heart period (HP, ms) and mean arterial pressure (MAP, mmHg) were analyzed. Two 30-s sequences of beat-to-beat HP and MAP values were considered before (I) and after (II) acoustic stimulation, respectively. By the effect of stimulation, state-dependent stimulus-locked HP and MAP oscillations were observed, HP oscillations being grossly parallel to the MAP ones but delayed with respect to MAP in the ascending part only; HP and MAP spontaneous fluctuations (HP and MAP variability) increased in NREM and REM sleep (but not in W); HP vs MAP correlation coefficient increased in an algebraic sense. These results show that 1) acoustic stimulation primarily affects the peripheral resistance, and secondarily, through the baroreceptor reflex, HP, thereby increasing the impact of peripheral versus centrally driven autonomic influences on the heart; 2) in NREM sleep, heart excitability is higher than requested by the baroreflex function; 3) cardiac variability is increased by acoustic stimulation during sleep (but not in W); this, in addition to the effects of point 2, may favor cardiac arrhythmias in NREM sleep. Thus, mild acoustic stimuli not perturbing cardiovascular regulation during W may create a specific risk factor during sleep in pathophysiologic conditions.

Acoustic Stimulation↗

Assay using succinyldithiocholine as substrate: the method of choice for the measurement of cholinesterase catalytic activity in serum to diagnose succinyldicholine sensitivity.

No comparative information is available concerning the ability of various cholinesterase (ChE) methods to identify succinyldicholine-sensitive patients, purely on the basis of the enzyme activity recorded in serum. Here, we evaluated six different methods for the measurement of ChE activity; 131 subjects were subdivided according to ChE phenotype and, therefore, to succinyldicholine sensitivity. ChE phenotype was determined by measuring dibucaine and fluoride numbers. DNA analysis was also performed to confirm correlation between the phenotype classification used in the study and the ChE genotype. The tested methods were significantly different in their ability to discriminate between the subjects with and without succinyldicholine-sensitive phenotypes. The succinyldithiocholine/5,5'-dithio-bis(2-nitrobenzoate) (DTNB) method showed the highest accuracy (area under the receiver operating characteristic (ROC) curve 0.97) followed by the propionylthiocholine/DTNB method (area under the ROC curve 0.94). On the other hand, the two methods using butyrylthiocholine as substrate and that employing benzoylcholine showed limited clinical utility in discriminating subjects at risk of prolonged apnea (area under the ROC curve < or = 0.9). Using the succinyldithiocholine method, a value < or = 23 U/l was approximately five times as likely to occur in a sensitive individual as in a normal one.

Anesthetics, Local↗

Capillary zone electrophoresis of serum proteins: effects of changed analytical conditions.

Analytical conditions in a system for capillary zone electrophoresis (Beckman Paragon CZE 2000) were originally selected to allow serum protein separation into five discrete protein zones, corresponding to those of conventional clinical electrophoresis. To improve the system's performance, new analytical conditions have been made available. We compared the two sets of conditions ("new" = y; "old" = x) for possible variations of results caused by the change. One hundred thirteen serum samples, covering wide intervals of values, were assayed on two twin instruments working under the old and the new conditions; results were assessed statistically and graphically. Possible clinical significance of differences was checked by comparison with the biological variation-based quality specifications for bias. Statistically significant (y-x) differences were observed for the alpha1-, alpha2- and beta-globulin zones; clinically significant differences were observed for all the zones, with the exception of the gamma-globulin zone. Therefore, old/new regression equations were calculated, whose reliability was assured by the wide interval of values, by the large sample size, and by the low dispersion of single values around the mean concordance estimates. Such equations may be used to convert "old" into "new" reference values, and for the intercomparison of patient results obtained under different analytical conditions.

Albumins↗

The cerebral circulation during sleep: regulation mechanisms and functional implications.

Cerebral blood flow measurements during sleep are reviewed and discussed in relation to the different techniques utilized (Positron Emission Tomography, functional Magnetic Resonance Imaging, Flowmeters, Radioactive MicroIspheres, Brain Temperature Recordings, Spectrophotometry) since these methodological approaches aim at diverse features of circulation changes in the spatial or temporal domain. The regulation of cerebral circulation during sleep reveals no specific state-dependent features, flow-activity coupling being the prevailing mechanism, with O(2) as the primary candidate for the metabolic side of the link. On a general level, the latest data on brain circulation are compatible with the classical hypothesis of a "restorative" function of sleep processes.

Brain↗

Recommendations for the routine use of pancreatic amylase measurement instead of total amylase for the diagnosis and monitoring of pancreatic pathology.

This document reviews the scientific evidence expected to persuade clinical laboratories to substitute pancreatic amylase measurement for total amylase in cases of suspected pancreatic pathology. A substantial evidence is now available to support such change. The measurement of pancreatic amylase in serum is: 1. more sensitive and specific for the detection of pancreatic tissue damage than that of the total enzyme activity, 2. easy and quick to perform in emergency conditions, 3. analytically precise in relation to its clinical application, 4. suitable for easy transfer and comparison of results from different care delivery units, and 5. characterized by well-defined decision limits for the diagnosis of acute pancreatitis.

Acute Disease↗

Intermethod variation in serum carcinoembryonic antigen (CEA) measurement. fresh serum pools and control materials compared.

This study was undertaken to evaluate the feasibility of using commercial control materials in a regional external quality assessment scheme (EQAS) for serum carcinoembryonic antigen (CEA) measurement. We have assessed the commutability of 12 commercial control materials using five automated immunochemical systems. We compared the intermethod behavior of the materials with that of 12-14 patient serum pools. In a total of 48 comparisons (12 materials x 4 pairs of analytical systems), seven instances of non-commutability were apparent, as shown by normalized residuals falling outside the +/-3 interval. The use of non-commutable materials generates two negative effects. In EQAS, the interlaboratory variation recorded is not representative of the variation expected in the assay of patient sera; in interlaboratory harmonization programs, recalibration with non-commutable materials increases, instead of decreasing, the interlaboratory variation. Both these effects were shown to occur in CEA measurement with the tested materials and systems. The materials planned to be used in our EQAS turned out to be commutable: this gave us the guarantee of measuring realistic interlaboratory variation values, although the check for commutability should be extended to all the analytical systems used by the participants in the scheme.

Calibration↗

Fecal elastase-1 as a test for pancreatic function: a review.

Pancreatic elastase-1 is a specific human protease synthetized by the acinar cells. Immunoreactive elastase-1 cannot be detected in either porcine or bovine pancreatic enzyme preparations. It is very stable and, in contrast to fecal chymotrypsin, elastase is unaffected by exogenous pancreatic enzyme treatment, and correlates well with exocrine pancreatic function tests. The measurement of this proteolytic enzyme in stool by means of an enzyme-linked immunosorbent assay (ELISA) is a sensitive, specific, and relatively inexpensive non-invasive test. It is an accurate function test for patients with chronic pancreatitis confirmed by endoscopic retrograde cholangiopancreatography and computerized axial tomography. It shows higher sensitivity and specificity for exocrine pancreatic insufficiency than fecal chymotrypsin determination and is comparable to oral pancreatic function tests such as the pancreolauryl test.

Animals↗