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Color and conventional image-directed Doppler ultrasonography: accuracy and sources of error in quantitative blood flow measurements.

Accuracy of two systems--conventional (DRF 400, Diasonics) and color-coded (Angiodynograph, Quantum/Phillips) image-directed Doppler ultrasonography--was investigated using an in vitro model that generated both monophasic and triphasic pulsatile flow patterns. Estimated and actual blood volume flow rates showed good correlations, but the sampling with a hand-held transducer led to wide variations in measurement error for the conventional (-69.2% to 50%) and the color-coded (-79.3% to 265.7%) systems. By performing multiple measurements, one could improve accuracy considering only the maximal values of a series instead of the mean values. Accuracy was impaired by interposed muscular or fatty tissue due to false low time-average velocity measurements caused by a loss of Doppler signal. Comparison of both systems revealed significant differences between pulsatility index values (p less than 0.001), blood flow velocities (p less than 0.001), and blood volume flow rates (p less than 0.05 for program flow, p less than 0.001 for manual and automatic flow program of the color-coded system).

Blood Flow Velocity↗

Sources of error in the diagnosis of Guillain-Barre syndrome.

A careful monitoring of the accuracy of diagnosis in six cases of Guillain-Barre syndrome has shown that a substantial proportion of these patients initially diagnosed as having Guillain-Barre syndrome on the basis of characteristic clinical findings and an elevated level of protein in the spinal fluid had a neuropathy caused by another etiology. The pitfalls in the laboratory and clinical diagnosis of disorders that were confused with Guillain-Barre syndrome were several: the pattern of neurological dysfunction in the Guillain-Barre syndrome was not unique to that disorder; no specific laboratory test existed to confirm the diagnosis of Guillain-Barre syndrome; and the laboratory diagnosis of other causes of similar neurological disorders (especially heavy metal intoxication) depended upon tests that are very unreliable.

Adult↗

Endogenous thymidine and hypoxanthine are a source of error in evaluating methotrexate cytotoxicity by clonogenic assays using undialyzed fetal bovine serum.

None of 13 fresh human tumor samples of various histology cloned in a two-layer agar culture system with 20% undialyzed fetal bovine serum (FBS) showed sensitivity to three antifolates, methotrexate (MTX), trimetrexate and 5,8-dideazaisofolic acid (IAHQ), even after continuous exposure to the highest concentrations (100 microM) for 21 days. In order to investigate this lack of antifolate drug effect, we compared the toxicity of continuous MTX exposure in the human colon carcinoma cell line HCT-8, cloned in a thymidineless medium (RPMI 1640) supplemented with 10% horse serum (HS), 10% fetal bovine serum (FBS), 20% FBS or 20% dialyzed FBS. In the presence of native FBS, when the minimum clone size was set at 30 cells/colony, the survival of HCT-8 cells reached a plateau at approximately 60% of untreated control after exposure to MTX concentrations between 0.1 microM and 100 microM. Only when the minimum clone size was set at 2 X 10(3) cells/colony was the sensitivity of HCT-8 cells to the antimetabolite comparable to that obtained in HS or dialyzed FBS (ED50 values in the range of 0.01 microM). MTX protection experiments indicated that even very small concentrations of thymidine and hypoxanthine together were sufficient to reproduce the pattern of sensitivity to MTX observed under culture conditions with undialyzed FBS. We conclude that for a proper evaluation of MTX cytotoxicity in clonogenic assays, dialyzed FBS and thymidine-less media should be employed; if native FBS is an absolute requirement for growth, only very large colonies (at least 10 cell divisions) should be scored.

Adenocarcinoma↗

Nonspecific amine immobilization of ligand can Be a potential source of error in BIAcore binding experiments and may reduce binding affinities.

The interaction of monovalent forms of NC41, an anti-viral neuraminidase antibody, and the antiidiotype antibody 11-1G10 has been used as a model system for BIAcore analysis to demonstrate the potential problems resulting from the nonspecific amine coupling procedure. To avoid complications due to antibody bivalency, monovalent Fab fragments and monomeric recombinant scFvs were used. When immobilized by amine coupling, the 11-1G10 anti-idiotype fragments were found to have an artificially reduced affinity for NC41 compared to the results obtained using site-directed immobilization via C-terminal thiol residue and from solution equilibrium measurements. The NC41 antibody fragments, on the other hand, were able to retain their 11-1G10 binding affinity when immobilized nonspecifically through free amine groups. These data, in combination with the known sequences of the two antibodies, suggested that nonspecific immobilization through one or more lysine residues close to or within the CDR2 region of the 11-1G10 VH domain was responsible for the reduced strength of the interaction with NC41. These results emphasize the need to use site-specific immobilization strategies when accurate kinetic measurements are required.

Amines↗

Possible sources of error in the calculation of ferrokinetic parameters using Ricketts' triexponential model.

The triexponential model developed by Ricketts et al. in 1975 for the calculation of ferrokinetic parameters has been widely used to obtain quantitative information about effective and ineffective erythropoiesis. However, a calculation error in one of the formulae of this method may have a considerable effect on those results which depend on the value of the third exponential constant, gamma 3. Moreover, the analysis of plasma 59Fe activity needs to be based on good counting statistics, which lambda-counting seldom provides after the first 24 h; therefore, 59Fe beta-counting is considered to be the best method.

Anemia↗

Sources of error associated with sample collection and preparation of nucleated blood cells for flow cytometric analysis.

Analysis of cellular DNA content by flow cytometry has been used to detect genetic changes associated with exposure to environmental contaminants. In lower vertebrates, nucleated red blood cells can be collected for analysis without harm to the animal. Because erythrocytes sampled from an individual should have identical amounts of DNA, the coefficient of variation (CV) around the G0/G1 peak should be small. Increases in CV can indicate genetic aberrations, but may also be caused by sample handling and preparation or problems with instrumentation. To increase confidence in associating increases in CV with external causes, artifactual changes in CV due to sample treatment and instrument parameters should be identified and minimized. We assessed the effects of various sampling and handling protocols on the CV of nucleated blood cells collected from largemouth bass (Micropterus salmoides). We also compared the distribution of cells among the G0/G1, S, and G2/M phases of the cell cycle to see whether these were affected by sampling or treatment protocols. Groups of 7 fish were bled on 7 consecutive days, and blood from each fish was analyzed by flow cytometry when freshly collected, and after freezing for 1 hour or 10 days. The same fish were bled again over a consecutive 7-day period, and the experiment was repeated. CV and cell cycle distribution were not affected by our freezing protocol. Repeat sampling from the same individual did not affect CV, but altered the distribution of cells in the cell cycle, suggesting increased hemopoiesis in response to blood sampling.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Changing measurement instrument at follow-up: a potential source of error.

The purpose of this investigation was to determine whether headache activity information collected over the phone can be directly compared with headache activity information collected by systematic self-observation without jeopardizing internal validity because of calibration differences between the two measurement methods. A number of headache studies have relied on phone information for long-term follow-up data, while using systematic self-observation to collect all other data. Twenty-six headache sufferers participating in a tension headache study reported their headache activity over the phone and subsequently charted their headaches. Correlations were computed between the two measures. Results indicated that differences exist in the calibration of the two measurement methods. This seriously limits the conclusions of studies that used phone information to obtain follow-up data. Other recommendations concerning follow-up methodologies are discussed.

Adult↗