[Perioperative monitoring of hemoglobin fractions in homozygous sickle cell disease].

This case report presents the perioperative management of double-sided hip arthroplasty in a patient (female, 25 years old) homozygous for sickle cell anemia (SS). The fraction of sickle hemoglobin (Hb S) to total hemoglobin was monitored with an automated cation exchange microcolumn chromatography. The main purpose of ion exchange chromatography is to measure glycated hemoglobin A (HbA1c) in diabetic patients.

Perioperative ST-segment depression and troponin T release. Identification of patients with highest risk for myocardial damage.

Background: Patients undergoing major vascular surgery are at constant risk of developing perioperative myocardial complications, especially myocardial infarction. The following study was performed to answer the question whether ST segment changes, analysed by Holter monitoring and ST segment analysis, are accompanied by release of cardiac troponin T, a highly specific marker of myocardial damage.

Methods: Twenty patients undergoing elective aortic resection were studied by performing Holter ECG, including ST segment analysis, beginning on the evening before surgery until the third postoperative day.

Results of the multicenter evaluation of the CEDIA cortisol assay.

The present paper describes the multicenter evaluation of the CEDIA Cortisol test for total cortisol. The observed linearity of the test was between 1.2 and 50 micrograms/dL cortisol.

Results of the multicenter evaluation of the CEDIA Phenobarbital assay.

The CEDIA Phenobarbital assay has been evaluated in twelve clinical laboratories in Europe and U.S.A.

Liquid chromatographic analysis of phenobarbital, phenytoin, and theophylline.

Sera from the routine of therapeutic drug monitoring were assayed for phenobarbital, phenytoin, and theophylline with three different methods: fluorescence polarization immunoassay as the standard procedure, the new CEDIA assays within a multicenter evaluation and HPLC which is known to yield results with a high specificity. CVs for between-day imprecision ranged from 2.6-8.

Improved method for enzymic determination of cholesterol in lipoproteins separated by electrophoresis on thin layer agarose gels.

The cholesterol of lipoproteins, separated electrophoretically on thin layer agarose films, is visualised and quantitated by incubating the gels in an enzymic reagent containing cholesterol esterase and cholesterol dehydrogenase. The individual fractions are quantitated by scanning densitometry. No sample pretreatment is necessary.

A specific method for the direct determination of lipoprotein cholesterol in electrophoretic patterns.

Lipoproteins are separated electrophoretically and cholesterol is visualised with an enzymic reagent specific for cholesterol in which the gels are incubated. Quantitation of the individual fractions is accomplished by scanning densitometry. No sample pretreatment is necessary.

[Effect of different infusion regimens on the hormonal and metabolic reaction before, during and after cholecystectomy].

18 metabolically healthy female patients with cholelithiasis, who had to undergo cholecystectomy, were divided into 3 groups and studied for a 4-day period. Group I, n = 6, received beginning on the operationday 0,19 g/kg BW X h of a polyol-mixture-solution (Sorbitol/Xylitol 1:1) and 0,86 g 1-crystalline amino acids (AA)/kg BW X day. Group II, n = 6, received beginning 24 h preoperatively only 1,14 g 1-crystalline AA/kg BW X day.

Studies on the mechanism of the increase in serum alkaline phosphatase activity in cholestasis: significance of the hepatic bile acid concentration for the leakage of alkaline phosphatase from rat liver.

In experimental bile obstruction the serum activities of the membrane-bound liver enzymes, alkaline phosphatase, 5'-nucleotidase and gamma-glutamyltransferase are greatly increased, whereas in the liver only the alkaline phosphatase activity is elevated. After partial hepatectomy or tetrachloride poisoning the alkaline phosphatase activity in the regenerating live is increased to the same extent as in cholestasis without an accompanying elevation in serum activity. The following results support the hypothesis of a bile salt-mediated solubilization of membrane-bound enzymes in cholestatic liver: (1) 30 min after bile duct ligation the total bile acids in the liver were increased 5-fold, 2 h later as much as 10-fold.

[The need for a specific postoperative, total parenteral nutrition therapy after various intra-abdominal procedures].

119 metabolically healthy surgical patients, who had to undergo elective intraabdominal surgery, were separated into upper -- cholecystectomy, gastric resection -- and lower -- colonic and sigma surgery -- intraabdominal procedures and divided into 8 groups with different infusion regimes. During the early postoperative period patients with upper abdominal surgery had significantly higher postoperative enzyme changes compared with patients with lower abdominal surgery. Patients with cholecystectomy had the significantly highest postoperative enzyme changes.

[Comparison of xylose and glucose as energy sources in hypocaloric, postoperative parenteral nutrition].

After a 5 day preoperative preparing period 24 metabolically healthy patients, who had to undergo gastric resection, were fed postoperatively by hypocaloric total parenteral nutrition for a 5 day period. Group I (n = 13) received 0,11 g Xylitol/kg BW X h; Group II (n = 11) received 0,11 g Glucose/kg BW X h; Both groups received 1,71 g L-crystalline amino acids/kg BW X day. During the whole postoperative period group II had significantly higher serum Glucose and Insulin levels.