Biomedical subjects

P C Bartels

Publications and source records attributed to P C Bartels.

At least 19 recordsLinked to original sources

PubMed2001

Surplus value of eosinophil count and ECP to diagnose and monitor asthmatic patients.

BACKGROUND: Eosinophil cationic protein (ESP) is one of the granule proteins in eosinophilic granulocytes. Release of this protein may reflect the activity state of eosinophilic granulocytes in diseased subjects. The purpose of this study was to evaluate the additional value of serum ECP measurement over the eosinophil count, (specific) IgE concentration and CRP concentration in order to evaluate the effects of treatment in patients started on corticosteroids and to distinguish individual patients with asthma from healthy subjects on the basis of laboratory results. METHODS: In a longitudinal study, serial measurements of serum ECP, eosinophil count and other laboratory parameters have been evaluated and compared with spirometry and tests of bronchial hyperresponsiveness in ten asthmatic subjects. The subjects were investigated before therapy was started and 3, 6 and 9 months after the start of therapy with inhaled corticosteroids. Laboratory parameters in the patient group are compared with results obtained from a reference group of apparently healthy subjects (n=223). RESULTS: Statistically significant correlations are observed between blood eosinophil counts and serum ECP concentrations with the hyperresponsiveness tests PC20 (r=0.44 and r=0.46, respectively) and with a decrease in FEV(1) after exercise (r=0.66 and r=0.60, respectively). A significant difference was detected between serum ECP concentrations from the patients' group and from the reference group. However, a wide range of overlapping results was observed between the reference group and the asthmatic patients. CONCLUSIONS: Asthma is a disease which is now more frequently treated by general practitioners. In general practice there is not always the opportunity to evaluate asthma activity by the application of hyperreactivity tests. When hyperreactivity testing is not available, measuring serum ECP concentration or eosinophil blood count would be an alternative method to monitor the effects of corticosteroid treatment. In this study the additional value of serum ECP in addition to the eosinophil count is evaluated to determine the effects of treatment in patients who started with application of corticosteroids. However, because of the analogous correlation coefficients of laboratory parameters with tests regarding hyperresponsiveness, no additional benefit of serum ECP concentration over eosinophil blood count in monitoring the effect of corticosteroids can be detected. The additional value of serum ECP concentrations and eosinophil counts to detect an asthmatic constitution for individual cases is doubtful.

Adrenal Cortex Hormones↗

PubMed2001

Long-term reduction of plasma homocysteine levels by super-flux dialyzers in hemodialysis patients.

BACKGROUND: Hyperhomocysteinemia is an independent risk factor for cardiovascular disease in chronic hemodialysis (CHD) patients. Treatment with folic acid normalizes total homocysteine (tHcy) in only a minority of the patients. The present investigation has been conducted to study the influence of various dialyzers with different flux characteristics on the reduction of tHcy in the long term. METHODS: Total Hcy, folate, vitamin B6, vitamin B12, and albumin levels were assessed prospectively in 10 patients undergoing HD with high-flux polysulfon (PS; F 60) and 20 patients with super-flux dialyzers (N = 10 PS, F 500S; N = 10 CTA, Tricea 150G). Blood samples were collected before hemodialysis both at the beginning of the study and after 12 weeks. RESULTS: At baseline, all the groups showed similar tHcy levels. During high-flux dialysis, tHcy remained stable. In contrast, during dialysis with both super-flux modalities, tHcy decreased significantly (F 500S week 1, 29.6 +/- 9.9 micromol/L, and week 12, 21.5 +/- 8.5 micromol/L, P = 0.007; Tricea 150G week 1, 24.4 +/- 8.7 micromol/L, and week 12, 15.3 +/- 3.7 micromol/L, P = 0.008). The difference between high-flux and super-flux dialyzers was highly significant (mean: high-flux increase 15.6%, super-flux decrease 33. 3%, P = 0.001). Multivariate analysis showed a significant effect of super-flux dialysis on tHcy (P = 0.001), independently of the previously mentioned variables. CONCLUSIONS: Our findings clearly show that both types of super-flux dialyzers reduced tHcy significantly. As the molecular weight of free homocysteine is less than 268 D, the most likely explanation seems to be the removal of uremic toxins with inhibitory activities against enzymes involved in the extrarenal homocysteine metabolism.

Adult↗

PubMed2001

Total amount of ECP per eosinophil as indicator for the activity state of eosinophils.

Eosinophil cationic protein (ECP) serum concentrations yield additional information regarding the activity of allergic diseases because ECP serum concentrations correlate very well with blood eosinophil counts. We established spontaneous serum ECP release per eosinophil during in vitro coagulation amounting to 0.03-0.5 pg per eosinophil. When comparing the ECP per eosinophil ratio with the eosinophil concentration, a decreasing trend of released ECP in serum was observed towards higher eosinophil counts. The total amount of extractable ECP in eosinophilic granulocytes is determined by means of extraction with application of a 0.5% Cetyl-trimethyl-ammonium-bromide solution. The total amount of extractable ECP in eosinophils amounts to 0.4-17 pg/eosinophil. Results showed a slight tendency to decrease with higher eosinophil counts. Irrespective of their concentration in blood, eosinophils were demonstrated to release 2-4% of their total ECP amount. It is concluded from experiments in this study that release during in vitro clotting or measuring the total amount of extractable ECP does not yield any additional diagnostic value in detecting the degree of activation in eosinophils.

Adolescent↗

PubMed2001

Hemostatic imbalance in active and quiescent ulcerative colitis.

OBJECTIVE: In healthy conditions, factors inducing or inhibiting coagulation and factors inducing or inhibiting fibrinolysis are in balance. In ulcerative colitis, hypercoagulation is presumed, which may explain part of the clinical features of this disease. Therapy strategies affecting hemostasis may improve the course of ulcerative colitis. This study was conducted to evaluate the balance of coagulation and fibrinolysis in the course of treatment of active ulcerative colitis. METHODS: Patients with active ulcerative colitis were studied by serial determination of markers of the coagulation cascade (thrombin-antithrombin complexes and fibrin degradation products [FbDP]) and the fibrinolytic cascade (fibrinogen degradation products [FgDP]). Parameters of inflammation were also measured (C-reactive protein [CRP], erythrocyte sedimentation rate [ESR], albumin, platelet count, and fibrinogen). Disease activity was assessed by endoscopic and histopathological scores. Follow-up measurement was performed in the course of treatment at the third or fourth month after baseline. Measurements were compared with healthy controls. RESULTS: Thirty-three patients and 22 healthy controls were included. During active ulcerative colitis, inflammatory parameters (CRP, ESR, platelet count) and hemostatic parameters (thrombin-antithrombin complexes, fibrinogen, FgDP, and FbDP) were elevated in comparison with healthy controls. Albumin was decreased and antithrombin-III remained unchanged. During treatment, disease activity decreased significantly endoscopically and histopathologically (p < 0.001). CRP, ESR, platelet count, and fibrinogen also decreased significantly. The hemostatic balance, expressed as the ratio between the plasmin-dependent generation of FgDP and coagulation-dependent generation of FbDP, increased from 0.69 to 1.12 during treatment, mainly because of a decrease of FbDP. In healthy controls, this ratio was CONCLUSIONS: The coagulation and fibrinolytic cascades were activated in active ulcerative colitis, with a hemostatic imbalance in favor of coagulation. This hypercoagulability persisted in 20% (7/33) of patients with ulcerative colitis in remission. The decrease of FbDP and the increase in the FgDP/FbDP ratio during reconvalescence of ulcerative colitis showed that the coagulation cascade was more activated than the fibrinolytic cascade in active disease.

Adult↗

PubMed2001

Effect of immunotherapy on eosinophil activation in pollen sensitive children.

Immunotherapy is a well documented method for treatment of children with allergic airway diseases and allergic rhinitis. The aim of this investigation was to establish the effect of immunotherapy on the presence and activation state of eosinophils in pollen sensitive patients, measured by eosinophil counts and their degranulation product in serum, eosinophil cationic protein in comparison with the (specific) IgE concentration in pollen sensitive patients. In both groups intra-individual variations in (specific) IgE concentrations, due to increase of pollen exposure, were not observed. Blood eosinophil counts and serum ECP concentrations showed consistent results after starting immunotherapy. Overall release of ECP per eosinophil remained also unaffected after the start of immunotherapy. Results of ECP concentrations and eosinophil counts in the subjects' group did not show any deviation when compared with the control subjects' group. It is concluded that the laboratory parameters are not helpful in monitoring the efficacy of immunotherapy in patients with seasonal rhinitis.

Adolescent↗

PubMed2001

Reduction of preanalytical errors due to in vitro activation of coagulation.

Statistically significant errors due to activation of coagulation may result from the blood sampling procedure. In order to establish the magnitude of errors, blood sample aliquots were drawn in triplicate from one venipuncture. A procedure is described for discrimination of inappropriate analytical results in 162 subjects. Estimated percentages of insufficient duplicate results amounted to 36% for thrombin-antithrombin complexes, to 5% for prothrombin fragment 1+2, to 2% for fibrinogen degradation products and to 4% for fibrin degradation products. It is concluded that the overall reliability of results for coagulation analytes can be considerably improved by drawing blood samples in triplicate and subsequent rejection of samples with inappropriate reproducibility for thrombin-antithrombin. Routine parameters like prothrombin time or activated partial thromboplastin time in normal conditions are not susceptible for the phenomenon of coagulation activation.

Antithrombin III↗

PubMed2000

Activation of coagulation during treatment with haemodialysis.

Generation of factor XII, thrombin antithrombin complexes, prothrombin fragment 1+2 and thrombus precursor protein has been monitored in 16 subjects during haemodialysis. Immediately after starting treatment, contact of blood with the negatively charged surfaces of the polyacrylnitril membrane AN-69 resulted in a 9-45% decrease in factor XII activity. Peak concentrations for thrombin antithrombin complexes (50 to 120 microg/L) were observed 30 min after the start of haemodialysis. Establishment of thrombus precursor protein concentrations yielded steadily increasing results without any tendency to decrease during treatment. Determination of thrombin antithrombin complexes is considered to establish the most sensitive short-term reacting parameter indicating activation of coagulation. A steady generation of fibrin and fibrinogen-fibrin complexes during treatment with haemodialysis is indicated by increasing results for thrombus precursor protein. In order to prevent clotting during haemodialysis, an additional supplementation of anticoagulant is needed.

Adult↗

PubMed2000

Serum eosinophil cationic protein in active and quiescent ulcerative colitis.

Inflammatory bowel disorders are characterized by an accumulation of eosinophilic granulocytes, mast cells, lymphocytes and neutrophilic granulocytes in the intestinal mucosa. The aim of this study was to examine the concentration of eosinophilic granulocytes in the blood of patients during active ulcerative colitis in comparison with patients during remission and apparently healthy control subjects. Besides counting, the activity grade of eosinophilic granulocytes has been studied by estimation of their degranulation product eosinophil cationic protein. Subjects with active ulcerative colitis could be distinguished from patients with quiescent ulcerative colitis by establishment of the eosinophil cationic protein concentration, neutrophilic granulocyte count, erythrocyte sedimentation rate, C-reactive protein and albumin concentration. After two weeks of corticosteroid treatment, serum eosinophil cationic protein concentrations and eosinophil counts in blood were significantly decreased. A decrease in blood eosinophil count was accompanied by a decrease in eosinophil cationic protein concentrations in serum in most subjects with ulcerative colitis. After twelve weeks of corticosteroid administration, serum albumin concentrations were significantly increased, whereas serum concentrations of C-reactive protein were significantly decreased. During treatment with corticosteroids, serum eosinophil cationic protein concentrations and blood eosinophil counts are appropriate laboratory markers to detect the effect of medication in the course of ulcerative colitis.

Adrenal Cortex Hormones↗

PubMed1999

Eosinophil cationic protein in serum from nonatopic and asymptomatic atopic individuals after standardized blood clotting at 37 degrees C.

Eosinophil cationic protein (ECP) and ECP/eosinophil ratio were measured in 223 apparently healthy subjects. The serum sample for ECP measurement was obtained by standardized clotting of the blood sample for 2 hours at 37 degrees C. Eosinophil count, ECP concentration and ECP/eosinophil ratio were no different between men (n = 122) and women (n = 101). Reference ranges for serum ECP and ECP/eosinophil ratio were 12-99 micrograms/L and 61-367 micrograms ECP per 10(9) eosinophils, respectively. Serum ECP and blood eosinophil count were positively correlated (y = 141x + 18, R2 = 0.45, P < 0.001). The ECP/eosinophil ratio, however, was found to decrease with increasing eosinophil count. Twenty-three per cent of the apparently healthy subjects were found to have a positive score for immunoglobulin E antibodies specific to inhalant allergens, and thus were considered atopic. Serum ECP concentrations and eosinophil counts were significantly higher in this group compared with the non-atopic group. In this healthy population no decision level for either eosinophil count, serum ECP or ECP/eosinophil ratio could be found that discriminated atopic from non-atopic individuals.

Adolescent↗

PubMed1998

Time dependent increase of differential monocyte count on the Sysmex NE-8000.

During storage of whole blood samples the results of white blood cell counts on a Sysmex NE-8000 Hematology Analyser showed an apparent shift from the granulocytes towards monocytes. The effects of various storage conditions were investigated by incubating blood samples at different temperatures and time intervals. Granulocyte activation and degranulation during storage resulted in a false elevation of the automated monocyte differential counts. The phenomenon occurs at temperatures beyond ambient room temperature.

Artifacts↗

PubMed1998

[Decreased erythropoiesis and biochemical deviations in psychogeriatric patients].

Laboratory investigations were performed in group of 60 psychogeriatric patients on their admission into hospital, in order to elucidate the interdependence of erythropoiesis and the concentrations of albumin and several vitamins in blood or serum. The results of albumin concentration and ETK activity show that 47 out of 60 the patients (= 78%) are in a poor nutritional condition. In 13 of these 47 subjects (= 28%) deficiency with respect to vitamin B12 or folic acid is presumed from decreased serum concentrations. In 6 of the 47 patients in poor nutritional condition (= 13%) decreased reticulocyte concentrations are shown. Further evaluation of differences between the respective subgroups revealed significantly reduced ETK activity and lower reticulocyte concentrations in the group of delirium patients compared to the other patients groups and to the reference group.

Aged↗

PubMed1997

Eosinophil protein X concentration is dependent on eosinophil concentration.

The relationship between the eosinophil concentration and the serum eosinophil protein X concentration was investigated in 80 subjects. Higher eosinophil counts resulted in obviously increased serum eosinophil protein X concentrations. However, the amount of eosinophil protein X released per eosinophil granulocyte is significantly higher in subjects with lower eosinophil counts. Atopic subjects (N = 19) show a significantly higher eosinophil concentration (p = 0.002) and eosinophil protein X concentration (p = 0.004) and a significantly lower eosinophil protein X/eosinophil ratio (p = 0.02), compared with non-atopic subjects (N = 61). However, there appears to be no difference between the concentration of eosinophil protein X in atopic and non-atopic subjects if the eosinophil concentration is taken into account. When using eosinophil protein X as an indicator of eosinophil activation, for instance in asthmatic subjects, the eosinophil count should also be considered for correct clinical interpretation of results.

Adolescent↗

PubMed1997

Screening for EDTA-dependent deviations in platelet counts and abnormalities in platelet distribution histograms in pseudothrombocytopenia.

Screening for pseudothrombocytopenia caused by in vitro platelet clumping has been performed in 45,000 subjects attending a general hospital. In our region, the observed prevalence of EDTA-induced pseudothrombocytopenia in blood samples with an initial platelet count below 150 x 10(9)/l was estimated to amount to 0.1%. EDTA-induced pseudothrombocytopenia was confirmed by detection of platelet aggregates by means of microscopic evaluation from the blood smear. In routine investigations, pseudothrombocytopenia could be highly suspected when the Sysmex NE 8000 showed characteristic peculiarities in the white blood cell (WBC) scattergram and histogram. Platelet aggregation is avoided in such cases by the use of citrate as an anticoagulant instead of EDTA. Pseudothrombocytopenia was detected in 46 subjects. As a screening test for pseudothrombocytopenia, increased cut-off values derived from the WBC histogram demonstrated 90% sensitivity and 100% specificity. Automated flagging for platelet clumps, deviations reflecting MPV, or PDW abnormalities revealed lower scores with respect to sensitivity.

Anticoagulants↗

PubMed1997

Mean corpuscular volume-dependent deviations in red blood cell distribution width between Sysmex NE-8000 and SF-3000.

Values for red blood cell distribution width yield information concerning size heterogeneity of red blood cell populations. Comparative studies between various haematology analysers are obligatory to quantify apparatus-dependent deviations with respect to accuracy and subsequent consequences with respect to clinical interpretation of results. In this study a comparative assessment is performed between a Sysmex SF-3000 and NE-8000 Haematology Analyser. Fifty-four specimens with abnormal red blood cell volumes and a hundred specimens from apparently healthy subjects were assayed. Systematic deviations in values concerning red blood cell distribution width are demonstrated to show a tendency to decrease towards higher mean corpuscular volume values.

Anemia↗

PubMed1997

Evaluation of Sysmex SF-3000 performance concerning interpretive morphology flagging of the leucocyte differential count.

Results from the Sysmex SF-3000 automated haematology analyser are reported with special attention to leucocyte morphology flagging in pathological conditions. Results for leucocyte differential counts provided by the Sysmex SF-3000 were compared with those obtained from the Sysmex NE-8000 and a visual evaluation based on a differential count of 400 leucocytes. One hundred samples from apparently healthy subjects and 100 samples from patients with haematological abnormalities were examined. The SF-3000 yielded a rather high frequency of flagging inappropriately referring to blasts, immature granulocytes, left shift and nucleated red blood cells/platelet clumps. The presence of atypical lymphocytes was not indicated by appropriate flagging.

Data Interpretation, Statistical↗

PubMed1995

Fibrinolytic split products, fibrinolysis, and factor XIII activity in inflammatory bowel disease.

BACKGROUND: Factor XIII (F XIII), the last coagulation factor in the clotting cascade, plays a role in mucosal repair. Beneficial effects of F XIII supplementation in severe ulcerative colitis (UC) have been observed. The aim of this study was to relate plasma F XIII activity to the severity of inflammatory bowel disease (IBD). METHODS: A transversional and, in part, longitudinal study of F XIII activity and related clotting products was performed in 39 patients with UC, 31 patients with Crohn's disease (CD), and 20 controls. Disease activity was assessed with a combined activity score in UC and with the Dutch Activity Index in CD. RESULTS: F XIII activity was decreased in active UC (p < 0.05) and active CD (p < 0.05) and was inversely correlated with severity in both UC (r = -0.30) and CD (r = -0.46). In six patients with UC (15%) and six patients with CD (19%) F XIII activity was below the lower range of normal. In these patients apparent rectal bleeding was only found in severe UC. Hyperfibrinolysis was indicated by elevated levels of D-dimer (p < 0.001) notwithstanding increased concentrations of alpha-2 antiplasmin (p < 0.05). CONCLUSIONS: In active IBD we found decreased plasma F XIII activity and hyperfibrinolysis. Decreased F XIII activity was not associated with apparent rectal bleeding in IBD.

Adolescent↗

PubMed1994

Methodology-dependent variations in reticulocyte counts using a manual and two different flow cytometric procedures.

This paper describes a comparison between the microscopic brilliant cresyl blue and the flow cytometric thiazol orange (FACScan) and auramine O (Sysmex) methods for enumeration of reticulocytes. The mean intra-assay coefficients of variation for the microscopic, FACScan and Sysmex methods were established to be 33.9 and 5% respectively. A rather poor correlation was observed between the microscopic count and both flow cytometric methods (FACScan r = 0.61; Sysmex r = 0.57). However, the correlation between the flow cytometric methods was satisfactory (r = 0.79). Reference ranges for the reticulocyte count, corresponding with the 2.5th and 97.5th percentile, were determined for the microscopic (8-30/1000), FACScan (11-27/1000) and Sysmex (8-18/1000) methods. Sysmex R-3000 methodology definitely revealed the lowest and narrowest reference range. In conclusion, because of higher reproducibility, flow cytometric analysis of reticulocytes is an attractive alternative procedure for the microscopic enumeration method.

Flow Cytometry↗

PubMed1994

Effect of clotting temperature and eosinophil concentration on the eosinophil cationic protein concentration in serum.

Earlier investigations have indicated the need for detailed instructions about the incubation conditions of blood samples before establishment of eosinophil cationic protein concentration in serum. Therefore, the effect of different clotting temperatures and eosinophil concentrations on the serum eosinophil cationic protein concentration was quantified in 40 subjects. Our results show that serum eosinophil cationic protein concentrations strongly depend on the clotting temperature. Blood samples clotted for 1 h at 37 degrees C had 5-10 times higher serum eosinophil cationic protein concentrations than blood samples of the same subject clotted for 1 h at 0 degrees C. Higher eosinophil counts resulted also in increased serum eosinophil cationic protein concentrations.

Blood Coagulation↗