PubMed Health⌕ Search

Biomedical subjects

M D Shephard

Publications and source records attributed to M D Shephard.

At least 19 recordsLinked to original sources
PubMed1997

Measurement of plasma LDL cholesterol in patients with diabetes.

OBJECTIVE: To assess the accuracy of plasma LDL cholesterol concentrations estimated by the Friedewald formula and a direct immunoseparation method by comparison with a reference ultracentrifugation procedure in patients with diabetes. RESEARCH DESIGN AND METHODS: Fasting plasma samples with triglyceride concentrations < 4.5 mmol/l were collected from 100 patients with diabetes (28 type I and 72 type II) and LDL cholesterol concentrations were compared by the three methods. RESULTS: LDL cholesterol values determined by the reference beta-quantitation procedure were highly correlated with both the Friedewald formula (r = 0.96) and a direct immunoseparation method (r = 0.92). Calculated (Friedewald) LDL cholesterol coincided with the reference method with < 10% error in 74% of the total diabetic group (82% of type I and 68% of type II diabetic patients). However, agreement between the direct LDL cholesterol and reference methods was significantly less (P = 0.02), with only 44% of patients having an error of < 10% (52% of type I and 41% of type II diabetic patients). The direct immunoseparation method for LDL cholesterol showed a positive bias with increasing triglyceride concentrations, particularly for patients with type II diabetes. CONCLUSIONS: In the group of diabetic patients studied with plasma triglyceride concentrations < 4.5 mmol/l, the Friedewald formula provided an accurate estimation of LDL cholesterol. The direct immunoseparation method significantly overestimated LDL cholesterol at triglyceride levels between 2 and 4.5 mmol/l.

Adult↗
PubMed1994

Lipoprotein profiling by high performance gel chromatography.

High performance gel chromatography (HPGC) was used to separate lipoproteins on the basis of their size and to generate lipoprotein profiles for plasma collected from patients with different lipoprotein phenotypes. These profiles provided a direct measurement of low density lipoprotein (LDL)-cholesterol which was more precise than LDL-cholesterol values calculated by the Friedewald equation. In addition, LDL-cholesterol concentrations were obtained in patients with combined hyperlipidemia in whom LDL-cholesterol could not be accurately calculated by the Friedewald equation. The response of LDL-cholesterol to the drug gemfibrozil was reliably monitored and in addition changes in LDL particle size could be assessed from the LDL apolipoprotein B/cholesterol ratio. HPGC also assisted in the diagnosis of type III hyperlipidemia by revealing a characteristic lipoprotein profile. HPGC-derived lipoprotein profiles provided additional useful clinical information for combined hyperlipidemia (Fredrickson lipoprotein phenotypes IIb, III).

Apolipoprotein A-I↗
PubMed1992

Nephelometric determination of total protein in cerebrospinal fluid and urine using benzalkonium chloride as precipitation reagent.

Four different protein precipitants, namely trichloroacetic acid, sulphosalicylic acid, benzethonium chloride and benzalkonium chloride, were used to estimate the total protein concentration in cerebrospinal fluid and urine by nephelometry. Protein determinations for 50 cerebrospinal fluid samples and 100 urine samples were compared with values obtained by a trichloroacetic acid-Ponceau S spectrophotometric method. All methods were correlated well, but total protein results using acid precipitants were usually lower, while results obtained using benzethonium chloride were generally higher, than results obtained by the trichloroacetic acid-Ponceau S method. Anomalous results were obtained for some urine samples with benzethonium chloride, but not with benzalkonium chloride. Assays using benzalkonium chloride as precipitating reagent showed good precision and closest agreement with the trichloroacetic acid-Ponceau S dye-binding method. The use of benzalkonium chloride as precipitant is recommended for automated cerebrospinal fluid and urine protein estimations by nephelometry.

Benzalkonium Compounds↗
PubMed1990

Variation in plasma apolipoprotein A-1 and B concentrations following myocardial infarction.

Measurements of plasma apolipoprotein A-1 and B concentrations are increasingly used for the laboratory assessment of risk of coronary artery disease (CAD). This study of 22 patients investigated the response of plasma apolipoprotein A-1 and B levels for up to 20 days following a myocardial infarction. Seven of these patients participated in a clinical trial using the drug Tissue Plasminogen Activator (TPA). We established that, unlike many other plasma proteins, apolipoproteins do not display a classic acute phase response following myocardial infarction, although large variations in plasma apolipoprotein levels were observed in the patients investigated. Our studies also show that the measurement of plasma apolipoproteins A-1 and B to assess future CAD risk in myocardial infarction patients should be deferred for a minimum of at least 14 days post-infarction. No significant difference was observed in the pattern of apolipoprotein response between patients receiving TPA and those not given this drug.

Adult↗
PubMed1990

Falsely low estimation of triglycerides in lipemic plasma by the enzymatic triglyceride method with modified Trinder's chromogen.

The enzymatic assay of triglyceride, based on the use of L-glycerol-3-phosphate oxidase (EC 1.1.3.21) and a modified Trinder's chromogen involving 4-chlorophenol, is subject to strong negative interference at concentrations of triglyceride greater than 20 mmol/L, such as occur in grossly lipemic plasma. This interference is caused by the rapid utilization of oxygen, resulting in the reaction becoming transiently anaerobic. The dye product already formed may then be reduced ("bleached") by acting as an alternative electron acceptor for glycerol-3-phosphate oxidase. Reduction of the dye leads to a marked decrease in final absorbance at 505 nm. Grossly underestimated values for triglyceride concentrations, apparently within the linear range of the assay, may therefore be inadvertently obtained with equilibrium methods. We suggest that samples giving unexpectedly low results for lipemic plasma should be re-assayed after dilution or with use of a smaller volume of sample.

Autoanalysis↗
PubMed1988

Evaluation of an enzymatic method for determining creatinine in plasma.

An enzymatic kit method for the determination of plasma creatinine was optimised for use with a centrifugal analyser and its performance characteristics and practicability compared with an end point and a kinetic Jaffé-based method. The enzymatic method exhibited several advantages over Jaffé-based methods--namely, smaller sample size, rapid sample throughput (200 per hour), and improved specificity. Glucose, acetoacetate, and cefoxitin did not interfere with the enzymatic method, although bilirubin did cause a negative interference which depended on both creatinine and bilirubin concentrations. The enzymatic method has particular clinical application in neonates, diabetic ketotic patients, and those receiving cephalosporins.

Acetoacetates↗
PubMed1987

Adaptation of methods for glutamate dehydrogenase and alcohol dehydrogenase activities to a centrifugal analyser: assessment of their clinical use in anoxic states of the liver.

Sensitive, precise, and rapid methods for the measurement of alcohol dehydrogenase (ADH) and glutamate dehydrogenase (GDH) were developed on the Cobas Bio centrifugal analyser. The optimal pH for ADH in caucasians was 9.8. Non-linearity of ADH enzyme activity was observed when samples were diluted in saline; linearity was restored when inactivated serum was used as diluent. ADH was shown to be a sensitive index of liver anoxia due to cardiorespiratory disturbance (clinical sensitivity 90%) and generalised anoxia. GDH exhibited sensitivity equal to that of alanine aminotransferase (ALT) but was inferior to gamma-glutamyltransferase (GGT) in the detection of specific liver disease. Both ADH and GDH were sensitive indicators of alcoholic liver disease.

Alanine Transaminase↗
PubMed1986

Quantitative method for determining serum alkaline phosphatase isoenzyme activity I. Guanidine hydrochloride: new reagent for selectively inhibiting major serum isoenzymes of alkaline phosphatase.

The potential use of the protein denaturant guanidine hydrochloride to inhibit selectively the enzyme activity of serum alkaline phosphatase isoenzymes from liver, bone, intestine, and placenta was investigated. Inhibition of each isoenzyme was shown to be dependent on time and concentration of inhibitor. In the presence of 0.3 mol/l (28.7 g/l) guanidine hydrochloride for 170 seconds 14%, 47%, and 90% of the total alkaline phosphatase activity remained in samples of bone, liver, and intestinal origins, respectively. In contrast, the activity of the placental isoenzyme increased by 24%. The degree of inhibition was shown to be independent of total alkaline phosphatase activity. Investigations were performed at 37 degrees C using the Cobas Bio centrifugal analyser. We conclude that this reagent has several practical advantages over urea as a selective inhibitor of alkaline phosphatase isoenzymes, including a faster and more reproducible inhibition at a much lower reagent concentration.

Alkaline Phosphatase↗
PubMed1986

Quantitative method for determining serum alkaline phosphatase isoenzyme activity II. Development and clinical application of method for measuring four serum alkaline phosphatase isoenzymes.

A method for quantitating the liver, bone, intestinal and placental alkaline phosphatase activity of serum, using an algorithm for converting selective inactivation by guanidine hydrochloride, L-phenylalanine, and heat into equivalent isoenzyme activity is described. The method can individually quantify mixtures of isoenzymes to within a margin of 3%; it has acceptable reproducibility and has been used to develop both age and sex related reference ranges. Analysis time is about 30 minutes. The clinical reliability of this method has been shown in a study of 101 patients, in 79% of whom isoenzyme results were compatible with the final clinical diagnosis; in 10% a clinical diagnosis resulted from isoenzyme analysis, and in a further 11% the source of the increased alkaline phosphatase activity was identified and supported by electrophoresis, with a definite clinical diagnosis yet to be made.

Adult↗
PubMed1984

Evolution of a national urine quality assurance programme: the Australasian experience, 1981-1983.

A national interlaboratory quality assurance programme for quantitative urine analysis has been conducted over the past three years in Australasia under the auspices of the Royal College of Pathologists of Australasia and the Australian Association of Clinical Biochemists. Analysis of urine calcium has consistently improved over the three year period whereas urine protein analysis has consistently declined. Based on the findings in 1983, it is considered that urine sodium, potassium, creatinine, phosphate, glucose, and chloride are currently being measured satisfactorily by Australasian laboratories, while the analyses of urine proteins, urate, oxalate, 5-hydroxyindoleacetic acid and 4-hydroxy-3-methoxymandelic acid still require substantial improvement.

Australia↗
PubMed1982

A quality assurance programme for quantitative urine analyses.

Eighty-six Australasian laboratories participated in an interlaboratory quality assurance programme for 10 urine analytes. Twelve liquid samples were prepared from commercial lyophilized urine control material and distributed in 3 batches of 4. Use of pre-set acceptability limits for total laboratory error and target values facilitated timely feedback in graphic form. The samples had concentrations which were linearly related; this allowed simple calculation of overall imprecision and bias, graphic feedback of all submitted results, and comparison of performance between laboratories. A number of unsuitable and poor methods were identified. Particular attention must be paid, in future, to more widespread use of appropriate calibration and quality control materials, to avoidance of transcription and calculation errors, and to analysis of urine samples with elevated levels of analyte. Current laboratory performance can meet analytical goals for analyses of urine creatinine, phosphate, urate, and glucose but analysis of urine sodium, potassium, urea, calcium, osmolality, and proteins require a significant improvement.

Humans↗
PubMed1982

An inter-laboratory survey of qualitative urinalysis.

An inter-laboratory survey of qualitative urinalysis was carried out in Australasia during 1981. Eighty-one laboratories analysed 6 samples of urine distributed in 3 batches of 2 at regular bimonthly intervals, mostly with commercially available reagent strips. Fewer than 30% of laboratories performed any form of quality control for analytes other than pH. Results indicated that improvement in the analysis of urine bilirubin, protein, glucose, ketones and blood is required, and recommendations to improve standards are made.

Asia↗