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Biomedical subjects

J Bohner

Publications and source records attributed to J Bohner.

At least 19 recordsLinked to original sources
PubMed2001

Detection limit, cut-off and specificity of an improved rapid assay for cardiac troponin T.

The performance of an improved version of the troponin T rapid test TROPT Sensitive was investigated in a multicentre evaluation at twelve centres. The detection limit and the cut-off were determined in a method comparison with Elecsys Troponin T using a total of 365 samples from patients with suspected acute coronary syndromes and 91 samples from healthy blood donors or non-cardiological patients. The analytical specificity was determined by measuring 1271 blood samples from blood donors without any myocardial injury. The test cut-off (90% of results positive) is 0.08 microg/L, and the detection limit is about 0.05 microg/L. The analytical specificity of the test is between 99.7 and 99.9%. With its small area of undefined significance between positive and negative results and its high sensitivity and specificity, TROPT Sensitive is very well suited to the reliable detection of troponin T positive patients with acute coronary syndromes.

Biomarkers↗
PubMed2000

Platelet function analysis with PFA-100 in patients medicated with acetylsalicylic acid strongly depends on concentration of sodium citrate used for anticoagulation of blood sample.

Our data from 214 patients after cessation of long-term therapy with 100 mg/d ASA demonstrate that the determination of platelet-related primary hemostasis in citrated whole blood with PFA-100 is a reliable and sensitive method for the detection of ASA-induced platelet dysfunction. However, the sensitivity of the method is strongly dependent on concentration of sodium citrate used as anticoagulant. The results of PFA-100 testing show a clearly enhanced sensitivity for ASA when blood samples were collected with 0.129 M rather than 0.106 M sodium citrate. According to sample stability, PFA-100 results can only be confirmed up to 1 hour postcollection when blood was anticoagulated with 0.129 M but not with 0.106 M sodium citrate. Therefore, we recommend that testing with PFA-100 in patients with suspected ASA-induced platelet dysfunction should be performed exclusively in blood collected in buffered 0.129 M sodium citrate.

Artifacts↗
PubMed1998

Gestational age-dependent reference values for iron and selected proteins of iron metabolism in serum of premature human neonates.

The diagnosis and treatment of fetal and neonatal diseases requires knowledge of gestational age-dependent reference ranges for most laboratory values. It was the aim of the present study to establish reference values for serum iron, transferrin, ferritin and ceruloplasmin concentrations in premature neonates, thereby paying attention to the possible changes with gestational age. Blood samples were taken from 100 premature neonates within the first hour of life. Total serum iron, transferrin, ferritin and ceruloplasmin concentrations were determined, transferrin saturation was calculated. Newborns who developed a presumed oxygen radical disease of prematurity were excluded from the study (n = 37), because previous investigations could demonstrate significantly lower serum transferrin and ceruloplasmin concentrations in prematures suffering one of these disorders. Related to gestational age, only serum transferrin concentration showed a statistically significant increase and correlation (r = 0.47; p < 0.0001) with rising age. Although statistically not significant, even serum ferritin concentration increased with rising age of the neonates. None of the investigated laboratory values correlated with birth weight. Only ferritin showed a slight, but statistically not significant increase with higher body mass. We conclude that gestational age-dependent changes of serum transferrin levels must be considered in the judgement of fetal and neonatal diseases, whereas total serum iron and ceruloplasmin concentrations remain rather constant at least during the last weeks of gestation.

Birth Weight↗
PubMed1995

Transient bisalbuminemia: separation by isoelectric focusing of human albumin fractions linked to different numbers of benzylpenicilloyl groups.

The behavior of modified human serum albumin (HSA) from penicillin-treated patients and in vitro conjugated samples was studied by isoelectric focusing in the absence and presence of 8 M urea. It is shown that samples classified as bisalbuminemic after separation under native conditions display a spectrum of several major bands with decreasing pIs when focusing is done in the presence of 8 M urea. In this spectrum, the distances between two consecutive major bands are as expected from a 2-unit charge difference. Since this result is compatible with the blockage of a lysine residue with a benzylpenicilloyl (BPO) group, each major band can be interpreted as representing an HSA fraction covalently linked to different numbers of benzylpenicilloyl groups. The separation methods presented therefore seem to constitute simple and reliable tools for a detailed assessment of the extent of BPO covalent binding to HSA both in vivo and in vitro.

Benzeneacetamides↗
PubMed1994

Thrombin-based antithrombin assays show overestimation of antithrombin III activity in patients on heparin therapy due to heparin cofactor II influence.

An extensive comparison has been performed on the clinical chemistry automate Hitachi 717 between thrombin- and Factor Xa-based methods for determination of antithrombin III activity. In 460 patients who did not receive any heparin therapy the agreement between assays was in general close although the thrombin-based methods resulted in slightly higher assignments of 0.3-2.6% antithrombin III activity. The discrepancy was, however, substantial in plasmas from patients receiving heparin of > or = 20000 IU/day, resulting in plasma levels of heparin of 0.8-1.2 IU/ml. Thus, analysis of 102 patients showed that the thrombin-based methods resulted in, on average, 7-16% higher assignment of antithrombin III activity as compared to the Factor Xa-based method used. Addition of antibodies to antithrombin III and heparin cofactor II revealed that the discrepancy was primarily due to contribution of heparin cofactor II activity in the thrombin-based methods. The results thus suggest that the Factor Xa-based antithrombin III activity method provides more valid results in patients on heparin therapy.

Antithrombin III↗
PubMed1989

Effects of human thyroxine-binding globulin and prealbumin on the reverse flow of thyroid hormones from extravascular space into the bloodstream in rabbits.

A plasma fraction rich in thyroid hormone-binding globulin (hTBG, human thyropexin) was injected iv into rabbits in order to see whether thyroid hormone concentrations in plasma would increase by return of T3 and T4 from the extravascular space. For this purpose, both [125I]T3 and [131I]T4 were simultaneously injected. After 1 h, or after 16 h in another series of experiments, 50 mg hTBG were injected iv. Thereafter, the mean radioactivity of both [125I]T3 and [131I]T4 in the plasma rose, and reached its peak 20-30 min after hTBG injection; [125I]T3 and [131I]T4 returned to the preinjection value slowly, after more than 3 h. When hTBG was injected 15-16 h after the radioactive hormones, the mean radioactivity of [125I]T3 reached its peak about 1 h after hTBG injection and returned to the base value after approximately 5.5 h, [131I]T4 reached its peak about 1 h after hTBG injection and returned to the base value within 12 h. After injection of hTBG, total T4 and T3 concentrations in plasma increased about 3- to 5-fold over the base values. At the same time, the percentage of both, free T4 and free T3 dropped instantly whereas absolute free T4 and free T3 values remained almost constant. After injection of 500 mg transthyretin (hTBPA), a similar flux of [125I]T3 and [131I]T4 was observed, whereas 500 mg human serum albumin were ineffective. These marked effects of injected hTBG and hTBPA on the serum levels of [125I]T3, [131I]T4, and total T3 indicate that reentry of T3 and T4 into the intravascular compartment is an important component of thyroid hormone distribution and transport. As can be anticipated from the animal experiments, the efficiency of plasmapheresis or hemofiltration methods may be improved by previous application of large doses of hTBPA or hTBG in cases of thyrotoxicosis.

Animals↗
PubMed1989

Evaluation of a new alpha-amylase assay using 4.6-ethylidene-(G7)-1-4-nitrophenyl-(G1)-alpha-D-maltoheptaoside as substrate.

The determination of alpha-amylase activity using an ethylidene-blocked 4-nitrophenyl-maltoheptaoside (EPS) has been evaluated in five laboratories on eight different analysers at 25 degrees C, 30 degrees C and 37 degrees C. The protecting ethylidene group inhibits hydrolysis at the non-reducing end of the substrate molecule by the auxiliary enzyme, alpha-glucosidase. The combined reagent is therefore stable for at least 10 days at 2-8 degrees C. HEPES is used, because the molar absorbance of 4-nitrophenol is independent of temperature in the presence of this buffer. Compared with the method using unprotected substrate 4-nitrophenyl-alpha-D-maltoheptaoside (4NP-G7), the present method is equal or better with respect to the imprecision, linearity and interlaboratory transferability of results in human and control sera. Since the protected and unprotected substrates differ in their turnover rate, the new assay yields activities which differ from those of the 4-nitrophenyl-alpha-D-maltoheptaoside method. Based on the homogeneous results obtained in method comparisons between EPS and 4-nitrophenyl-alpha-D-maltoheptaoside, and in order to maintain the 4-nitrophenyl-alpha-D-maltoheptaoside reference values, a conversion factor was derived to eliminate the above differences: activityEPS x 2.50 = activity4NP-G7. The temperature and instrument independence of this relationship was demonstrated in a total of 720 human sera and plasmas.

Glucosides↗
PubMed1987

Macro lipase--a new member of the family of immunoglobulin-linked enzymes.

This first report describes a variant form of lipase in the serum of a woman suffering from a malignant non-Hodgkin lymphoma. Activity measurements of serum lipase and amylase showed persistently elevated activities of lipase with simultaneously normal activities of amylase. Results of exclusion chromatography and immunological investigations clearly demonstrate that the atypical time-course of lipase activity is not due to injury of the pancreas or alterations of the patient's lipase, but rather due to the presence of lipase-binding autoantibodies, resulting in the formation of immune complexes with high molecular mass (Mr greater than 200,000) between lipase and immunoglobulin G lambda. A clinical significance, if any, of this macro lipase has yet to be determined.

Antigen-Antibody Complex↗
PubMed1985

Indices for the age of the creatine kinase M-chain in the blood.

The apparent activation energy of the CK reaction as well as the Michaelis-Menten constants and the isoelectric point of CK MM can be used as indices for the mean age of the CK M-chain in the blood in vivo and in vitro. Modifications in the CK M-chain take place in vivo in the blood and in vitro in a serum matrix. Gradual increases in the apparent activation energy are also observed both in vivo and in vitro. It is confirmed that the modification in the CK M-chain causes a rise in the apparent activation energy, mu. A gradual increase in apparent activation energy, due to the ageing process of the CK M-chain, was observed after myocardial infarction. A significantly increased value for u was observed at the time that total CK activity already had returned to reference values. In spite of the normal CK value, the apparent activation energy still indicated that there had been myocardial damage. The Michaelis-Menten constants for creatine phosphate and ADP are also influenced significantly by the modification in the M-chain. While the apparent activation energy increases, the Michaelis constants decrease in the order MM3, MM2, MM1. The Michaelis-Menten constants for both ADP and CrP can be used as an index for the mean age of the enzyme in the blood. The Michaelis-Menten constants for CrP and ADP show significant variations with the measuring temperature for virtually all CK MM forms.

Creatine Kinase↗
PubMed1985

Influence of autoantibodies to creatine kinase-BB on assays for MB isoenzyme.

We describe the influence of autoantibodies that bind creatine kinase BB (CK-BB) on the methods for MB isoenzyme. If these autoantibodies are present in patients' sera, they cause the formation of macro CK type 1 (immunoglobulin-linked CK-BB). In some of these cases they can bind not only endogenous CK-BB but also CK-MB without significantly affecting enzyme activity. Although these antibodies show distinctly less affinity for CK-MB than for CK-BB, they nevertheless bind CK-MB in these particular sera, because their concentration exceeds that of CK-BB isoenzyme. If a person with such autoantibodies has an acute myocardial infarction, the immunoinhibition method for CK-MB, which does not discriminate between CK-MB and CK-BB, will recognize the increase and peak of CK-MB with time, although persistent macro CK activity will be superimposed on the typical isoenzyme pattern. However, isoenzyme electrophoresis and recently introduced immunoenzymometric assays for CK-MB in these cases may be less sensitive for detecting myocardial infarctions, because the typical increase in CK-MB activity may be identified later in the progression of symptoms, or even be missed.

Autoantibodies↗
PubMed1985

Analytical patterns and biochemical properties of macro creatine kinase type 2.

Here we describe our findings for 105 patients' sera containing macro creatine kinase (CK) type 2, as confirmed by exclusion chromatography. Depending on the technique used for determining isoenzyme CKs (electrophoresis, ion-exchange chromatography, immunoinhibition), this variant CK shows characteristic patterns and interferes in CK-MB assays by different mechanisms and to various degrees, thus complicating test interpretation. Macro CK type 2 evidently is not of cytoplasmic origin; rather it is a separate CK activity of human serum, characterized by its heat stability and, especially, by its increased molecular mass and high energy of activation. These latter characteristics have never been associated with the normal-size, dimeric cytoplasmic CK isoenzymes, but are typical for mitochondrial CK isolated from human tissues. We conclude that mitochondrial CK released after severe cell damage usually appears in blood in macromolecular forms (macro CK type 2), not in a dimeric form.

Chromatography, Gel↗
PubMed1985

Macro creatine kinase type 2: results of a prospective study in hospitalized patients.

We determined total CK activity with the N-acetylcysteine-activated method and residual activity after immunoinhibition of the CK-M subunits in the sera of 2018 patients consecutively admitted to our university hospital for internal diseases, and of 936 outpatients, regardless of the patients' diagnoses. We could detect not more than two types of macro CK: macro CK type 2, which we observed in the sera of 85 patients (prevalence, 3.7% for hospitalized patients), and macro CK type 1. Most patients showing macro CK type 2 were older than 50 years, but we additionally observed a second peak at 20-30 years of age. We saw no preponderance by sex. We detected macro CK type 2 predominantly in severely ill patients of all ages, mainly those with malignant tumors or cirrhosis of the liver. Our findings support the assumption that macro CK type 2 is the manifestation of mitochondrial CK in serum. Occasionally, macro CK type 2 disappeared from the circulation after amelioration of the associated disease. Its occurrence in serum nevertheless is a sign of a serious illness with high mortality but not inevitably a sign of impending death.

Adult↗
PubMed1984

Immunological procedures in clinical enzyme diagnostics.

The paper presented deals with the general potentialities of the immunological determination of enzymes, using selected examples to describe the most important variants of the immunoassay for clinical chemical enzyme diagnostics. The principle of each test and the respective possibilities of interference are described. The analytical efficiency and applicabilities of these immunoassays are assessed critically.

Antibodies↗
PubMed1984

Determination of creatine kinase MB activity with the Du Pont aca: interferences from the sample matrix.

During the last three years we and other have observed discrepancies between results for creatine kinase isoenzyme MB as measured with the mechanized ion-exchange chromatographic method in the Du Pont aca and those by other techniques. These observations prompted us to investigate the influence of the matrix on the Du Pont CK-MB assay. We conclude that, apart from possible interferences by CK-MM, CK-BB, and both types of macro CK, the aca will give apparent CK-MB activities that are directly related to protein concentration and inversely related to sodium chloride concentration. Practical consequences for the routine and emergency laboratories are: no diluted samples are allowed; application is restricted to samples from patients suspected of acute myocardial infarction which show upper-normal total CK activity; and multiple timed samples are run, in order to recognize the typical change in enzyme pattern with time.

Autoanalysis↗
PubMed1983

Evaluation of the optimized bioluminescent assay for the determination of total creatine kinase and creatine kinase MB activities.

A very sensitive, optimized bioluminescent assay for certain kinase and creatine kinase MB activities is tested. We evaluated reagent blanks, sensitivity, precision and compared the results with those of the spectrophotometric immunoinhibition test. The main advantage of the new method is a detection limit of less than 1 U/l which, together with a high precision (s = 0.1 at detection limit), allows determinations of the creatine kinase MB activity even in normal sera in about 20 minutes. A disadvantage of the manual procedure is that it may be necessary to include up to five pipetting steps.

Creatine Kinase↗