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F Schiele

Publications and source records attributed to F Schiele.

104 records · Page 6Linked to original sources

Gamma-glutamyltransferase activity in plasma: statistical distributions, individual variations, and reference intervals.

Measurement of gamma-glutamyltransferase activity in plasma provides a useful index to liver function. Using as our study population those persons coming to the Center for Preventive Medicine, we described and measured the significance and importance of physiological and environmental variations. We established a classification for the variation factors. The three most important factors affecting this activity were drug intake, alcohol consumption, and excessive weight, followed by sex and age. We suggest a preliminary group of reference intervals for healthy subjects to be used in interpreting a laboratory test.

Adolescent↗

[Human plasma lactic dehydrogenase activity: individual variations and reference intervals].

Out of a population of 8 7600 people of all origins, we drew up frequent values for the activity of total lactate dehydrogenase. From these values, we defined a reference interval on a selected population. Variations between individuals were determined in relation to the following factors: age (8 to 70 years), sex, height, weight, socio-prefessional categories, any excess weight, exercise and drugs. There exist definite variations in relation to age, especially in children. On the other hand, this enzyme shows little variation in relation to the morphology of the individual adult. Socio-professional groups have more influence on the activity of total lactate dehydrogenase.

Adolescent↗

Aspartate aminotransferase and alanine aminotransferase activities in plasma: statistical distributions, individual variations, and reference values.

The determination of frequency value (percentile limits) and the classification of the different variation factors allow us to define more and more homogeneous subpopulations as we use these factors for sorting. Using as our study population those persons coming to the Centre for Preventive Medicine, we were able to: (a) Describe and measure the significance and importance of physiological variations or of variations attributed to age--the latter largely related only to excessive weight, which it seems to us is often the case. (b) Establish a classification for variation factors; the recapitulatory table should be useful to clinical chemists in helping physicians interpret a laboratory test result that falls within the zone of incertitude. (c) Suggest a preliminary group of reference values for healthy subjects, to be used in interpreting a laboratory test in this way.

Adolescent↗

[Harmonization of practices: application to the measurement of enzymatic activities used in prevention, screening, diagnosis and therapeutic monitoring].

The large metrological variation (CV, about 25%) observed between laboratories, at the national French level, for the measurement of enzymatic activities results in a loss of efficiency in using laboratory results. Current data show that the standardisation of methods is insufficient to solve this problem and needs to be completed by an harmonisation of the practices including the use of a common reference (calibrator). The present work, carried out by the joint working group between laboratories of the Centres for Periodic Health Examination and the French Society of Clinical Biology (SFBC), deals mainly with the feasibility and evaluation of the improvement of the consistency of the results. Twenty laboratories participated in this study. Five independent surveys were conducted during an height month period. Two enzymes were selected because of their clinical importance and their interest in prevention, screening, diagnosis or epidemiology: ALT (alanine aminotransferase) and GGT (gamma-glutamyltransferase). In each survey three kinds of samples i.e. control sera, candidate calibrators and human serum pools, each of them at two levels of activity (one physiological and the other pathological) were measured in duplicate. The low intra-laboratory imprecision and the high degree of the standardisation of used methods, due to an important effort previously done in this field, permitted to consider a common calibration. The stability and mainly the commutability, i.e. the ability for the candidate calibrator to show a behaviour similar to that of human samples towards the used methods, allowed to reduce the inter-laboratory variation by a half to two third-fold, reaching a coefficient of variation < 5% similar to those observed for cholesterolemia or glycemia. This level of consistency should permit to use common reference limits and common decision limits, after validation of this approach in real practice. The consequences of the harmonisation of practices, extended to the all laboratories, exceed largely the scope of this study. The reduction of the uncertainty and a better approach of the accuracy for the measurement of enzymatic activities should led to a real benefit for the patients in terms of prevention, screening, diagnosis or therapeutic monitoring and consequently for the public health.

Alanine Transaminase↗

[Enzyme calibrators: principle and practical use].

Results of catalytic activities of enzymes are highly dependent on the measurement procedures and on local conditions. Thus, only poorly marked improvement of interlaboratory comparability of results have been observed in clinical enzymology. To solve this problem, SFBC and IFCC have proposed to use "validated enzyme calibrators". Standardised operating procedures adapted to 37 C have been developed by IFCC for the most commonly used enzymes in clinical chemistry, and will be soon published. Reference materials which have been certified with these SOPs can be used as calibrators for a set of measurement methods which exhibit the same analytical specificity. Calibrators must be commutable, a property that must be checked experimentally. It is possible to produce stable and commutable materials for the calibration of a set of methods. Interest of this approach has been demonstrated for several enzymes. Results of two studies presented here show that the comparison of results to the upper limit of reference ranges does not improve the interlaboratory comparability of results in contrast to the calibration of different methods by a common calibrator which allowed to reach an interlaboratory CV close to 4% for ALT and gammaGT.

Calibration↗

[Changes of plasma and tissue gamma-glutamyltransferase under the influence of drugs].

Measurement of gamma-glutamyltransferase (GGT) activity in plasma is widely used in clinical biology (in order to detect hepatic diseases or to monitor treatment for alcoholism), and also in pharmacology (since this test is the only plasmatic marker for hepatic induction in human). However, the correct interpretation of a high plasmatic activity should take into account the various analytical factors which can affect results, as well as the physiological parameters known to modify this activity. It also requires its comparison to defined reference values. Several mechanisms may be involved in the increase of plasmatic activity as an index of hepatic induction, such as an increase in the protein synthesis, a release of the enzyme from the membrane or a modification in the biliary flux.

Chemical Phenomena↗

[Anticoagulant therapy with recombinant hirudin in patients with thrombopenia induced by heparin].

OBJECTIVES: Heparin-induced thrombocytopenia is an uncommon and severe complication of heparin therapy. Both venous and arterial thromboembolic events can occur, requiring withdrawal of the heparin therapy. When anticoagulant therapy is mandatory, recombinant hirudin can be used. METHODS: We used recombinant hirudin (HBW 023) in 6 patients with heparin induced thrombocytopenia. In case of venous thromboembolism, an initial intravenous bolus (0.07 mg/kg) was followed by continuous infusion (0.05 mg/kg/h); for arterial thromboembolism the initial bolus was 0.7 mg/kg and infusion rate 0.15 mg/kg/h. When possible oral anticoagulants were started and hirudin withdrawn when the INR ratio reached 3. RESULTS: The clinical course was uneventful in all 6 patients. There was no recurrent thromboembolism. Cephalin-activated coagulation time (patient/control) varied between 1.8 and 3.5 (median 2.4) during hirudin administration. Platelet count rose to the nadir (median 70 x 10(9)/l, range 15-90) reaching over 100 x 10(9)/l in all patients between the third and sixth day (median 5 days) after stopping heparin. CONCLUSION: Intravenous administration of hirudin provides effective immediate anticoagulation in patients with heparin-induced thrombocytopenia, thus allowing conversion to oral anticoagulants without risking recurrent thromboembolism.

Aged↗