[Laboratory diagnosis of gastrinoma. Nordic collaboration can improve the quality].

Measurement of gastrin in serum or plasma in patients with gastrinoma may be complicated by the presence of circulating biosynthetic intermediates which may not be detected by commonly available immunoassays. In contrast, the "processing-independent analysis" of gastrins developed by professor Jens Rehfeld et al in Copenhagen detects gastrin forms irrespective of their size. The authors review gastrinoma pathophysiology, the biochemistry of gastrin and other biomarkers of gastrinoma, the differential diagnosis of hypergastrinemia as well as other methods currently employed in the workup of gastrinoma patients, and illustrate with a clinical case.

[How reliable is the laboratory? Increased needs of patient-related quality assurance].

Recent developments in medical care and research involve the increased use of immunochemical assays for hormones, tumour markers, vitamins and drugs. External quality assurance programmes using pooled human sera usually fail to detect analytical interference due to substances (e.g.

The influence of early postoperative intraperitoneal chemotherapy on human wound healing.

Cell ingrowth, hydroxyproline accumulation, and mRNA expression of collagen I were measured in two polytetrafluoroethylene grafts implanted subcutaneously at the time of colorectal cancer surgery to evaluate the influence of early postoperative chemotherapy on human wound healing. Eleven patients treated with intraperitoneal 5-fluorouracil and intravenous folinic acid Days 1-6 after operation were compared with 15 patients who underwent surgery alone. At 1 week, chemotherapy-treated patients had accumulated less hydroxyproline (mean 0.

Selenium in malnourished Sudanese children: status and interaction with clinical features.

Plasma selenium (Se), haemoglobin (Hb) and packed cell volume (PCV) were measured in 53 malnourished Sudanese children, age 6-36 months, and 11 children who had tuberculosis. Twelve healthy well-nourished children served as controls. The mean (+/- SD) plasma Se (mg/kg) was 0.

Fragments of chromogranin A are present in the urine of patients with carcinoid tumours: development of a specific radioimmunoassay for chromogranin A and its fragments.

Chromogranin A is a well-known protein constituent in granules of neuroendocrine cells. It is also known that plasma levels of chromogranin A increase considerably in patients with neuroendocrine tumours and thus chromogranin A is used as a marker for these tumours. In the present study, we have shown that fragments of chromogranin A are excreted into the urine in some patients with carcinoid tumours.

A Nordic reference serum suitable for use as trueness control in the clinical routine laboratory.

The described reference serum is characterized by: liquid human serum at "normal" level stored in frozen state at -80 degrees C; minimum damage of proteins; aseptic preparation; cryoprecipitate and excess fibrin removed; serum cleared by ultracentrifugation; pH at 7.2-7.6; available in sealed glass ampoules with inert gas (one ml serum in each); specified components among most frequently analyzed analytes; homogeneity assured and stability monitored; produced under strict rules for good manufacturing practices (GMP).

A hyaluronan-loading test applied to patients with liver and joint diseases.

The serum hyaluronan disappearance data, after an intravenous bolus injection of hyaluronan, were evaluated in terms of model-based parameters. The loading test was performed in 10 healthy persons (basal serum hyaluronan concentration, C0, 24.9 +/- 8.

[Results of multicenter evaluation of reagents for determination of sodium, potassium and chloride ions using enzyme activation].

We present the results of a multicentre evaluation with Boehringer Mannheim/Hitachi instruments of new "enzymatic" methods for the determination of Na+, K+, and Cl- in serum or plasma. The between-day coefficient of variation was less than 1.4% (Na+), less than 2.

C-peptide but not insulin concentrations are related to the serum lipoprotein levels during insulin treatment of non-insulin-dependent diabetes mellitus (NIDDM) patients.

In 21 non-insulin-dependent diabetic patients with secondary drug failure, once-daily long-acting insulin lead to a moderately improved metabolic control. At the conclusion of the study (eight months) the fasting blood glucose and HbA1c concentrations were significantly decreased, but the postprandial blood glucose concentrations in the afternoon were unaltered. The peripheral insulin sensitivity, as measured by the intravenous insulin tolerance test, and the lipoprotein lipase activity in adipose and skeletal muscle tissue had increased.

Guidelines for evaluation of reagent strips. Exemplified by analysis of urine albumin and glucose concentration using visually read reagent strips. International Federation of Clinical Chemistry, Scientific Division.

Reagent strips are frequently used in the practice of laboratory medicine as well as outside the professional laboratories. In the present report, a scheme is presented which allows a reproducible description of the performance of reagent strips. This is exemplified using strips intended for estimation of urinary albumin and glucose.

Amino acid concentrations in cerebrospinal fluid in presenile and senile dementia of Alzheimer type and multi-infarct dementia.

Free amino acid levels were measured in cerebrospinal fluid (CSF) from demented patients (D, n = 30) suffering from presenile and senile dementia of Alzheimer type (PDAT, n = 7; SDAT, n = 9), multi-infarct dementia (MID, n = 14) and a reference sample group consisting of young neurotic patients (R, n = 16). Comparing the amino acid levels in the dementia subgroups, significantly higher alanine, methionine, phenylalanine and tyrosine levels were found both in MID and SDAT vs. PDAT.

Early changes of some serum proteins and metals in diabetic children.

Serum concentrations of prealbumin, albumin, orosomucoid, magnesium, zinc and calcium were studied in 30 children with newly diagnosed IDDM aged 3-15 years, during the first two years of the disease, and in 44 healthy control children. On admission serum prealbumin was significantly lower in IDDM children (149 +/- 48 mg/l) (M +/- SD) than in healthy controls (194 +/- 39 mg/l) (p less than 0.001).

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.

Lipoprotein composition of human suction-blister interstitial fluid.

Interstitial fluid (IF) was obtained in 27 apparently healthy subjects (12 males, 15 females) by applying mild suction (200-250 mm Hg) on the skin either on the midvolar forearm or on the paraumbilical region of the abdomen. The IF concentrations of lipids and apolipoproteins (apo) were studied and compared with those of serum (S). The mean ratio between interstitial fluid and serum (IF/S ratio) varied from 0.

Saliva and sweat secretion in man during a one-hour calcium clamp.

The effect of a 1-h calcium infusion, directly regulated to obtain and maintain a predetermined blood calcium level ('calcium clamp'), on the composition of parotid saliva, mixed saliva, and sweat was determined in healthy volunteers. An increase in amylase content of the parotid saliva under hypercalcaemic conditions was observed, but the 'calcium clamp' had no effect on flow rate, total and ionized calcium, sodium, potassium, and phosphate levels as well as pH in parotid and mixed saliva. The sweat calcium concentration was negatively correlated with sweat rate, in contrast to sodium and chloride concentrations.

Post-operative substrate utilisation and gas exchange using two different TPN-systems: glucose versus fat.

Twenty patients were studied over the first 4 post-operative days following abdominal aortic surgery. Ten patients had 93% of their non-protein energy as glucose and insulin was given to keep blood glucose below 10 mmol/l. The other 10 patients had 80% of non-protein energy as fat (Intralipid).

Copper malabsorption in coeliac disease.

Copper uptake during three hours from an oral test dose of copper sulphate solution giving three mg Cu++, close to the recommended daily dietary intake, was significantly reduced in patients with proximal intestinal disease, compared with normal subjects. Three out of ten patients had abnormal and otherwise unexplained blood counts compatible with the known haematological effects of copper deficiency and were restored to normal levels on a gluten-free diet. Copper deficiency and proximal intestinal disease should be suspected in patients with otherwise unexplained anaemia, especially neutropenia.

Effects of human albumin infusion on transepidermal water loss in newborn infants.

A study was made to determine whether the high transepidermal water loss in preterm newborn infants is affected by infusion of human albumin. In 7 preterm infants, born after 25-30 weeks of gestation, 0.5 g of human albumin per kilogram body weight (b.

Haemotherapy with red-cell concentrates and a new red-cell storage medium.

The effects on plasma proteins and haemostasis of haemotherapy with buffy-coat-poor red-cell concentrate and red cells suspended and stored in a new medium containing sodium chloride, adenine, glucose, and mannitol (SAGM) were studied in elective surgery. In patients with normal preoperative serum albumin levels no transfusion of plasma was necessary before 50% of blood volume had been lost. When three different types of haemotherapy were investigated in patients undergoing orthopaedic surgery, it was found that when whole blood was replaced by red-cell concentrate and, later, by red-cell suspension in SAGM medium, the peroperative bleeding pattern did not change.

Changes in metabolism during a fasting period and a subsequent vegetarian diet with particular reference to glucose metabolism.

During an investigation on the effect of fasting and a vegetarian diet on the symptoms and signs in chronic cutaneous and arthritic diseases studies were made of glucose metabolism, liver function and the plasma concentration and urine excretion of some minerals. The study was performed on 27 patients who stayed as in-patients on a metabolic ward for five weeks. After the fasting period the blood glucose and serum insulin concentrations were lower (p less than 0.

Decrease of lipoprotein lipase activity in skeletal muscle in man during a short-term carbohydrate-rich dietary regime. With special reference to HDL-cholesterol, apolipoprotein and insulin concentrations.

Seven men took part in a study in which the diet was changed from an ordinary mixed one to a fat-rich diet [greater than 70% energy (E)] for 3 days followed by a carbohydrate-rich diet (greater than 70% E) for 3 days. Blood was drawn and muscle biopsies [for analysis of lipoprotein-lipase (LPL) activity] were taken before the study and at the end of each diet period. Insulin, apolipoprotein (apo) B, A-I and A-II, cholesterol and triglyceride concentrations were determined in serum and the lipids also in the high density lipoproteins (HDL).