[Electronic communication for clinical laboratories. The Sundhedsstyrelsen took over the database on www.labinfo.dk].
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Biomedical subjects
Publications and source records attributed to I Bruunshuus.
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The term designating a substance being an active ingredient of a drug may be a generic name, a nonproprietary name, a registered trade name, a fantasy name or other. This causes difficulties in the transmission of request and report on such substances to and from the clinical laboratories, and in the collating of this information from different sources. The document comprises a list of properties of drugs of abuse in biological fluids as defined by the International Olympic Committee Medical Code for use in electronic transmission systems. Standard systematic names are presented with a code value for each. The coding schemes thus prepared are accessible on Internet from C-NPU Home page address: http://inet.uni-c.dk/ qukb7642.
This document is the first recommendation on the presentation of trace elements and their values in clinical laboratory sciences from IFCC and IUPAC. It forms part of the ongoing effort to standardize requests and reporting of laboratory data for transmission across cultural and linguistic domains, without attempting to standardize the language used by clinicians and laboratory practitioners. Subsequent documents deal with syntax, kinds-of-property, and properties and units used in other areas of clinical laboratory sciences.
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The hardware and software facilities for electronic storage, transfer and handling of data is such that multipurpose databases can be made accessible without geographic restriction at low cost. The versatile and flexible underlying structures allow for ease of access and retrieval of data and gives presentation formats fully comparable to printed counterparts. Because of the apparent ease of use and because of the wider distribution of the information, misinterpretation is more likely to occur than in oral or written presentation for more restricted and more culturally homogeneous audiences. This necessitates some degree of harmonisation/standardisation of data on transfer, while allowing local expression forms at sender and receiver ends (Fig. 1). This document is part of an ongoing international effort to agree on some sort of "standardisation" of the transmission and presentation of "laboratory results". It centers on the domain of drugs of abuse as defined by the International Olympic Committee.
We present a candidate Reference Method for determining the concentration of serum creatinine. The method is based on HPLC combined with enzymatic determination. Creatinine plus 14[C]creatinine is extracted by cation-exchange chromatography, subjected to reversed-phase HPLC, and finally quantified enzymatically. Enzymatic measurement ensures no interference from co-eluting compounds, which has been a problem for some reported HPLC assays relying on ultraviolet detection. The average corrected recovery was 100.1% (SEM = 1.1%; n = 15). The accuracy was verified by assaying five sera with target values determined by isotope dilution mass spectrometry. The total interassay CV was less than or equal to 2.5%. We applied the method to study the specificity of HPLC-ultraviolet detection, using 72 plasma samples from hospitalized patients; no interference was noted. Thus, HPLC-ultraviolet detection appears to be specific, provided that sample cleanup is based on cation-exchange chromatography. Our diode-array detector studies of peak homogeneity supported this conclusion. Still, combined HPLC-enzymatic determination ensures even greater accuracy, ranking close to that by isotope dilution mass spectrometry.
In the present study of 12 boys and 19 girls 2-16 years of age (median, 7 years) on oral 6-mercaptopurine (6MP) and methotrexate (MTX) maintenance therapy (MT) for non-B-cell acute lymphoblastic leukemia (ALL), we found that (a) during MT, 6-thioguanine nucleotides (6TGN) (the major cytotoxic metabolite of 6MP) accumulate in the erythrocytes (E-6TGN); (b) for patients receiving an unchanged dose of 6MP, no significant correlation could be demonstrated between the mean E-6TGN (mE-6TGN) and the dose of 6MP (r = -0.11, P = 0.28) (31 patients); (c) among 21 patients receiving 50-75 mg/m2 6MP, a variation of up to 3 orders of magnitude in mE-6TGN could be demonstrated, with the interindividual coefficient of variation (CV) in mE-6TGN for these patients being 0.31; (d) the median intraindividual CV in E-6TGN at an unchanged dose of 6MP was 0.11 (range, 0.04-0.18); and (e) the degree of myelodepression as measured by the mean white cell count was related to mE-6TGN (r = -0.55, P = 0.0006). These results indicate that E-6TGN could be a useful parameter for monitoring 6MP maintenance chemotherapy, although this needs to be explored in prospective studies.
We present a rapid, sensitive and specific high-performance liquid chromatographic method for the analysis of 6-mercaptopurine (6MP), 6-thioguanine nucleotides (6TGN) and 6-thiouric acid (6TU), with excellent chromatographic separation of the thiopurines. Thiopurines in plasma and erythrocytes were extracted by mercuricellulose and re-eluted with beta-mercaptoethanol. For quantitative detection a reverse phase column (Lichrosorb RP-18 4 mm X 30 cm) and a UV detector were used. Detection limits were 20 nmol/l for 6MP in plasma, 250 nmol/l for 6TGN in erythrocytes, and 10 nmol/l and 15 nmol/l, respectively, for 6MP and 6TU in urine diluted 1:100 with beta-mercaptoethanol. Within-run and between-run variations were less than 10%. Recovery of 6MP added to plasma, and 6TGN monophosphate added to haemolysed erythrocytes were 91% and 81%, respectively.
The effect of three cycles of high-dose cisplatin (40 mg/m2 day for 5 days) on renal tubular function was evaluated in 30 patients. A significant impairment of proximal tubular salt and water reabsorption rates was observed, but also distal tubular function seemed to be affected. These changes were also present 6 months after termination of treatment. Sodium and magnesium clearance increased significantly during treatment. Magnesium clearance normalized shortly after treatment but sodium clearance was significantly elevated 6 months after treatment. Proteinuria, albuminuria, and amino aciduria, together with an increase of beta 2-microglobulin and N-acetyl-beta-D-glucosaminidase (NAG) excretion rates, were observed during each treatment cycle. A good correlation was registered between the increase in urinary excretion rates of protein, NAG, and magnesium and the decrease in proximal tubular salt and water reabsorption during cisplatin administration.