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Biomedical subjects

S Landaas

Publications and source records attributed to S Landaas.

At least 19 recordsLinked to original sources

Rapid immunometric measurement of C-reactive protein in whole blood.

We examined an instrument-free test for C-reactive protein (CRP) in whole blood. The NycoCard CRP Whole Blood test uses a cell-solubilizing dilution liquid, a membrane-bound antibody that binds CRP, and a gold-conjugated antibody for making visible the bound CRP. We obtained essentially identical dose-response curves in citrate-, heparin-, and EDTA-treated blood. CVs were 6.7-12.5% within series and 10.1-14.7% between series. The detection limit was 12 mg/L. Intralipid added to blood increased measured CRP by 10-20%, whereas no change was seen with added bilirubin, added serum amyloid P component, or the presence of rheumatoid factor. In 234 patients' blood samples the results of the NycoCard Whole Blood test correlated well (r = 0.96) with those of a turbidimetric serum method. The test allows reliable measurement of CRP from a small volume of whole blood (25 microL) without using expensive equipment; it should be useful for decentralized testing in hospital departments, emergency units, and primary health care centers.

Antibodies, Monoclonal

[Which laboratory tests should be performed by general practitioners--and how to assure good analytical quality?].

Near patient testing is increasing both in Norway and abroad. Having test results ready when the patient is present is beneficial in a number of clinical situations, as well as being efficient for both doctor and patient. However, the analytical quality in general practice has proved unstable and in many instances poor. Public expenditures to reimburse near patient tests are soaring. Therefore, high priority must be given to ensuring that the practitioner's laboratory is sound, both professionally and economically. The following items are considered important: All analytical work should be subjected to regular quality assessment. We list a number of constituents that are suitable for near patient analysis. The constituents are divided in two groups: those that all practices should be capable of analyzing, and constituents which should be analyzed in practices with doctors with a special interest in this field. We also suggest changes in the Norwegian public system of reimbursement for near patient testing.

Chemistry Techniques, Analytical

[Abbot Vision. An interesting laboratory instrument for small hospitals].

Abbott Vision is a technologically advanced chemistry analyzer developed for decentralized testing. About 30 different tests can be performed using disposable test packs containing wet reagents. The instrument was evaluated in a smaller hospital and (except for potassium) good results were obtained with respect to precision and conformity with results from a referral laboratory. The analyzer is considered to be of special advantage in cases of emergency and when there is no laboratory technician on duty. The cost per analysis is much higher, however, than with conventional techniques.

Chemistry Techniques, Analytical

C-reactive protein: a new rapid assay for managing infectious disease in primary health care.

Quantitative C-reactive protein (CRP) measurement has become increasingly valuable as a test for rapid diagnosis of infections in hospital medicine. CRP has not obtained the same importance in primary health care. This has, at least partly, been due to methodological difficulties, with no simple or rapid tests with quantitative results available. A new immunometric semi-quantitative assay, NycoCard CRP, has recently been developed. CRP was analysed at the local health centres by the new assay in 288 consultations where patients came because of infections. Parallel CRP values were obtained by an established reference method. The two procedures had an acceptable correlation (r = 0.85). The primary care doctors also registered the clinical information they obtained from each CRP result. CRP was helpful in indicating the presence, or absence of bacterial infection in more than half the consultations due to new infections. CRP was thought to yield more clinical information than the erythrocyte sedimentation rate in almost every case.

Blood Sedimentation

A new case with hereditary xanthinuria: response to exercise.

The concentration of purines in plasma and urine from a 37-yr-old healthy man with a very low plasma urate concentration was measured by HPLC. A persistent increase in xanthine and a slight elevation of hypoxanthine was found. The metabolic response to intensive treadmill running and long distance running was investigated. The hypoxanthine concentration increased to about the same level as in healthy controls, but the elimination from plasma was considerably slower. The high xanthine level was practically unchanged by exercise.

Adult

Biochemical changes and endocrine responses in cystic fibrosis in relation to incremental maximal exhaustive exercise.

The purpose of this study was to compare biochemical changes and endocrine responses during an incremental maximal bicycle test in three well-trained 18-year-old patients with cystic fibrosis (CF) and in three healthy controls. Although the blood concentration at rest of the white cell count, haptoglobin, phosphorus, urea, creatinine, and uric acid were somewhat different in the two groups, the CF patients had similar biochemical changes in response to the exercise compared with the healthy men. The endocrine responses to exercise seemed to be different between the two groups with regard to changes in cortisol, growth hormone, and testosterone concentrations. The differences, however, were probably caused by differences in age, training situation, and psychological stress reaction rather than by pathological mechanisms.

Adolescent

Biochemical changes and endocrine responses in cystic fibrosis in relation to a marathon race.

Biochemical changes and endocrine responses during the New York Marathon (42195 m) were investigated in three 18-year-old male adolescents with cystic fibrosis (CF) and three healthy men who accompanied the CFs during the race. The ambient temperature was 20 degrees-28 degrees C and the relative humidity 98%-75% during the run. The CF patients, who had Shwachman scores of 60, 85 and 95 completed the run without major problems in 6.10, 4.42, and 4.32 h, respectively. Serum concentrations of Na and Cl decreased slightly, but the values were still within normal range. Na and Cl excretions in the urine decreased to very low levels in the CF adolescents during the run. All the other biochemical changes were similar to the changes in the controls. Aldosterone concentration increased to a higher level and maintained this increase for a longer time after the race in the CFs. Testosterone concentration decreased more in the CFs during the race compared with the controls. Growth hormone concentration showed individually varying changes in response to the exercise. This study demonstrates that patients with CF may participate in strenuous prolonged exercise even in humid and hot conditions, without untoward effects. The observed differences in hormonal responses to exercise might be explained by differences in age, training status, and relative exercise intensity rather than by hormonal or other disturbances in CF.

Adolescent

Vigorous exercise in a female with cystic fibrosis: spirometric, biochemical, and endocrine responses during four types of intensive exercise.

Spirometric, biochemical, and endocrine responses during a maximal ergometer cycle test and during three runs (10 km, 21.1 km, and 42.2 km) were investigated in one female with cystic fibrosis (CF) 27 years of age and in two healthy control females 26 and 29 years of age. One of the controls ran as a companion to the CF woman, while the other ran at her own speed. The CF woman has a chronic respiratory Pseudomonas aeruginosa infection, and her spirometric values were 50%-70% of predicted values at the time of the study. For the last years she has been training almost daily with aerobics, running, cycling, or skiing. She completed the four types of exercise without major problems. Her spirometric values increased transiently following the cycle test and for several hours following the three races (maximal 20%-30% increase of spirometric values), while the controls had transient decreases of the same variables in response to the runs. The biochemical and the hormonal changes were similar in the CF woman and the control who ran at her own speed, while the control who was a less stressed companion showed smaller changes. This study demonstrates that well-trained females with CF may participate in strenuous prolonged exercise without untoward effects.

Adrenal Cortex Hormones

Familial combined deficiency of muscle carnitine and carnitine palmityl transferase (CPT).

Two patients, brother and sister, aged 19 and 16, with combined, partial deficiency of carnitine palmityltransferase (CPT) are reported. Both patients had recurrent exercise-related myoglobinuria. The brother had also experienced an episode of transient renal failure associated with myoglobinuria. Both had elevated CK and myoglobin in plasma between attacks. There was a normal production of lactate in ischaemic forearm exercise, but elevated levels of NH3, resulting in an increased NH3/lactate ratio; 48-h fasting caused no significant changes in cholesterol, triglycerides or glucose, no rise of CK, and a normal ketogenic response, indicating no hepatic enzyme deficiency. Muscle biopsy showed slight changes of myopathy in both patients, with scattered atrophic fibres, but no lipid accumulation or other specific changes. Biochemical analysis of muscle tissue revealed a reduction of carnitine to 48% and 40% and a reduction of CPT to 55% and 59% of normal values, which is similar to the findings in the only previous report of combined partial carnitine and CPT deficiency. The heterogeneity of the laboratory findings in CPT deficiencies and the value of the various diagnostic procedures in metabolic myopathies are discussed.

Acyltransferases

The quality of laboratory analyses in the primary health care. A proficiency survey on hemoglobin, glucose, leucocyte count and sedimentation rate (ESR) measurements.

Freshly prepared quality control materials of different kinds were distributed by cars to all the public health centers, sanatoria and mother and child stations in Oslo. The recipients, who were unaware of the correct values, analysed each sample once without delay and reported the results back to our laboratory. A large variation was found for the measurements of sedimentation rate (ESR) and the counting of leucocytes. For the hemoglobin analyses the precision was relatively good, and also for reflectometrically measured glucose there were few extreme outlayers, though the scatter was rather wide. The accuracy was good for all the analyses. The study clearly demonstrates the need for regular quality control programs for the laboratory work in the primary health care units.

Analysis of Variance

Chemical analyses for early differential diagnosis between bacterial and viral meningitis.

The present study was undertaken to evaluate the benefit of measuring different chemical parameters in the cerebrospinal fluid (CSF), at the time of admittance to hospital, for rapid differentiation between bacterial and viral meningitis. In addition to the leucocyte count, the CSF concentration of total protein, glucose (together with blood glucose), lactate, lactate dehydrogenase and creatine kinase was determined. The results revealed that the CSF lactate and the CSF:blood glucose ratio were the two best parameters for this purpose. When the information from these analyses was combined a complete separation between the two kinds of meningitis could be obtained.

Adolescent

Macroamylase immunoglobulins show high affinity for animal and human amylases.

We have examined the affinity shown by the immunoglobulin fraction from each of five sera containing macroamylase for amylases from different sources: human saliva or human, porcine, or ovine pancreas. High affinity constants, 0.4 X 10(10) to 7.2 X 10(10) L/mol, were found in competitive binding experiments with human or porcine pancreatic amylase. All but one serum yielded linear Scatchard plots, indicating that in most sera the amylase-binding immunoglobulins are homogeneous, possibly monoclonal. The immunoglobulin fractions from different sera differed in their specificity: two of them bound all four types of amylases, whereas two bound only one type. Three of the five immunoglobulin fractions showed considerably higher affinity towards one or both of the animal amylases than towards the human ones, and may be primarily directed against some animal amylase.

Amylases

Macro creatine kinase BB in serum, and some data on its prevalence.

We report the case of a patient with persistently above-normal activity of creatine kinase (CK) in serum, a major fraction of which on electrophoresis moved as a band between the MM and MB isoenzymes and on anion-exchange column chromatography eluted in the MB fraction. Measurements in the presence of specific M or B subunit-inhibitory antibodies indicated that 93% of the activity consisted of B-isomers. From these experiments we conclude that the abnormal CK is of BB nature. Gel filtration and immunoglobulin precipitation showed that the CK-BB was complexed with IgG. Normal CK-BB, when mixed with the patient's serum, was converted to macro CK-BB. In vitro stability of 37 degrees C of the abnormal enzyme was much greater than that of normal BB and MM isoenzymes. Following this finding, we then assessed 310 sera, received for enzyme assay by the clinical laboratory, for electrophoretically abnormally migrating CK isoenzymes. Of these, five (1.6%) contained such enzymes, all being of BB nature. They were of increased molecular mass, and at least three of them were complexed with IgG.

Aged

Proficiency survey of serum protein analyses in Scandinavia.

A lyophilized human pool serum was distributed to Scandinavian clinical chemical laboratories for routine quantitation of different serum proteins. The analytical repertoir of the laboratories, and the methods and reference materials used, were registered. For almost all proteins the results varied considerably between the laboratories (CV 8--29%). The reasons for this variation are discussed together with possible recommendations to improve the accuracy of protein measurements.

Analysis of Variance