[Evaluation of the activity of a clinico-diagnostic laboratory].
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Biomedical subjects
Publications and source records attributed to D Dochev.
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Wistar male rats underwent a midline ventral abdominal incision under pentobarbital anaesthesia and were divided into two groups: the experimental rats were injected with 0.04 ml.kg-1 bodyweight Ethibloc (Ethicon-FRG) into a tributary of the superior mesenteric vein, close to the hepatic portal vein and the control, saline. The animals were sacrificed by decapitation on the 1st and on the 30th day after the treatment. The serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activities are significantly increased at the 24 hr following the i.v. injection in the experimental rats. The 30th LDH5 level is decreased 19% in the experimental group from the ones in the control group. The serum activities of lactate dehydrogenase (LDH), hydroxybutyrate dehydrogenase (HBDH), gamma-glutamyl transpeptidase (GGTP) and serum cholinesterase do not differ substantially in the experimental group from these in the control group in the different periods of assessment.
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Hypertrophy and hyperplasia of islet tissue, established by morphometry, were proved in the pancreas of rats, treated chronically for a period of 2 months (with urbason-50 mg/kg of body mass). B-cells were granulated. Structures with myelin-like form of membranes were observed in some of them by electron microscope. Mixed islet B-acinar cells were established as well. These data were possibly a morphological expression of stimulating action of urbason on B-cells of Langerhans islets.
The first morning urine in 206 women with pregnancy or no pregnancy was examine for and increase of chorionic gonadotropic hormone by means of three tests: Sevatest HCG latex, Gravimmun 2 (imported by first direction) and Gravindex HCG (imported by second direction). Diagnostic reliability of the tests was studied in women to establish early pregnancy. It was fond that the tests, imported by the first direction, could successfully substitute those, imported by the second direction, in the routine diagnostic practice.
The analytical reliability of the immunoenzyme methods for determination of the thyroid hormones thyroxin, triiodothyronine, thyroid-binding globulin, thyrotropic hormone and the thyroid-binding capacity was examined by the peroxidase activity of the marker enzyme of "Specol-11" 28 healthy controls, 28 patients with subcompensated insulin-dependent diabetes with mean duration of 8.4 years and 11 patients with hypogonadism were examined. In the diabetic patients were found changes in their thyroid state characteristic for hypothyroidism--increased thyroxin and a decrease of the thyroid-stimulating hormone with a lowered level of the binding proteins. The patients with hypogonadism showed changes mainly in the binding proteins level, a decrease of the thyroid-binding capacity with 70%. The results reveal interrelations between the thyroid gland hormonal state and other hormonal disorders.
The analytical reliability of the determination of pH, pCO2 and pO2 by the automatic analyzer "ABL 300" (Radiometer) was studied. Control materials were used: Confirm, Acidbasol and Qualicheck in the normal, acid and alkaline sphere, and arterial blood, too. The precision within run and between runs for pH and pCO2 meets the contemporary standards (variation coefficient: pH--below 0.2%, pCO2--below 5%. The precision between runs for pO2 is unsatisfactory by low partial oxygen pressure. The accuracy of the three directly determined indices meets the contemporary standards. The comparative analysis of the results obtained by "ABL 300" and "Corning 178" shows a high degree of correlation between the two apparatuses.
The results of examinations carried out in 37 clinical laboratories in Bulgaria which participated in the interlaboratory quality assurance check are discussed. The check included 202 laboratories from 5 countries members of the Council of Mutual Economic Aid and covers the examinations of chlorine, sodium, potassium, calcium, urea, creatinine, total protein, cholesterol, glucose, inorganic phosphorus. The results are assessed by the "normative standard deviation" which differs from the "absolute quality index" used in the national external laboratory quality assurance check. The results of the Bulgarian laboratories are better in the examinations of glucose, urea, cholesterol and inorganic phosphorus. The analytical variations in protein, sodium and chlorine equal those of the other participants while the results of calcium, potassium and creatinine show greater variations. The interlaboratory variations of the results obtained by the different analytical methods are discussed. The results of the examinations of calcium and potassium are least acceptable.
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Triglyceride determination in serum is of a great importance because of the existing correlation between the risk of origination of atherosclerosis and triglyceride values. Two methods were compared: enzymatic method with colorimetric completion used in Boehringer test-packages and the colorimetric method, based on Hantzsch reaction, developed in test packages of Bio-La-Test--Lachema (CSSR). A correlation analysis was made on the base of the results, obtained by the two methods (r = 0,875). The reliability of the method was studied--reproducibility in series and time, and accuracy. As a result from the data obtained, the colorimetric method, developed by CSSR for the determination of triglycerides in serum could well be recommended.
Sixty one patients were studied, 23 with diabetes, type I and 38 with type II. The level of glycosilized hemoglobin was determined in all, corresponding to the routine battery of symptoms and laboratory data, used in the practice in the evaluation of the state of the diabetic patients. A low correlation coefficient was established (type I r = 0,1 and type II r = 0,1) between the calculated glucose and mean blood sugar from blood sugar profiles. Glycohemoglobin level under and over 10% was established both in patients with increased and normal blood sugar. The use of the routine control methods gave no possibility of objective evaluation for the state of metabolic diabetic disorders in all patients. The determination of glycosilized hemoglobin presented a possibility of obtaining unique information on metabolic compensation of diabetes and the effectiveness of the treatment applied.
The analytical reliability was studied of the results from the determination of pH, pCO2, and pO2 obtained by automatic analyzers "Corning 178" and "ABL 2". Control materials Confirm, Certain and Acidbasol were used for that purpose, within the normal, acid and alkaline region, as well as arterial blood. The reproducibility in series and in time for all three parameters correspond to the present day requirements for both preparations (VC: pH--under 0,2%; pCO2 and pO2--under 5%), pH--better for "Corning 178". The accuracy of the results for pH and higher values of pO2 is better (d%: pH--under 0,2%; pO2--under 5%). With the diminution of the values of the latter index--the accuracy deteriorated. The accuracy established for pCO2 is unsatisfactory with both the apparatuses and with all three control materials. The results from the comparative analysis reveal a high-degree positive correlation between the apparatuses (rover 0,9). The analytical reliability established for both automatic pH and blood gases analyzers is sufficient to provide the diagnostic reliability of the results necessary for the clinical practice.
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