HER1-4 protein concentrations in normal breast tissue from breast cancer patients are expressed by the same profile as in the malignant tissue.

Background: The epidermal growth factor receptor HER2 is overexpressed or amplified in 25%-30% of patients with breast cancer. The mechanism behind HER2 amplification is unknown, but may be a patho-physiological phenomenon caused by continuous stimulation and activation of the HER1-4 system. We have mapped the protein concentrations of HER1-4 in breast cancer tissue, autologous reference tissue, normal breast tissue and serum samples, to see whether non-cancer cells from these patients express a protein profile indicating general activation.

Azithromycin Concentrations and Microbiology of Tonsils during Weekly Medication in Patients with Recurrent Tonsillitis.

This study was performed in order to assess whether 500mg of azithromycin given orally once per week could produce tonsil tissue concentrations above minimum inhibitory concentrations for key target pathogens in patients with recurrent tonsillitis. For the measurement of tissue concentrations an automated solid phase extraction (SPE) method for cleaning the tissue extracts was developed. Concomitantly, the influence of this treatment on the microbiological flora of the tonsillar surface was monitored.

Work-related bilateral osteoarthritis of the first carpometacarpal joints.

Background: A 44-year-old industrial worker produced panels for folding doors for 9 years. During this period, he developed osteoarthritis (OA) of both first carpometacarpal joints. Surgery was performed without improvement.

Mesenchymal stem cells with high telomerase expression do not actively restore their chromosome arm specific telomere length pattern after exposure to ionizing radiation.

Background: Previous studies have demonstrated that telomeres in somatic cells are not randomly distributed at the end of the chromosomes. We hypothesize that these chromosome arm specific differences in telomere length (the telomere length pattern) may be actively maintained. In this study we investigate the existence and maintenance of the telomere length pattern in stem cells.

HER-2 protein concentrations in breast cancer cells increase before immunohistochemical and fluorescence in situ hybridization analysis turn positive.

Background: The level of HER-2/neu in breast cancer cells is normally measured by immunohistochemistry (IHC) and/or fluorescence in situ hybridization (FISH). It determines whether patients should be treated with trastuzumab (Herceptin). In this study, HER-2 protein in breast cancer tissue was measured using a quantitative method.

Analysis of methylmalonic acid in plasma by liquid chromatography-tandem mass spectrometry.

Background: Methylmalonic acid (MMA) is a biochemical marker for cobalamin deficiency, particularly in cases where the cobalamin concentration is moderately decreased or in the low-normal range. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) with electrospray ionization is a rapid, robust method that has been used in MMA analysis. We developed a simple method combining solid-phase extraction (SPE) and derivatization to prepare serum or plasma for LC-MS/MS analysis of MMA.

Clinical outcome estimates based on treatment target limits of laboratory tests: proposal for a plot visualizing effects and differences of medical target setting exemplified by glycemic control in diabetes.

Background: In modern medicine many laboratory measurements are used as a surrogate for clinical outcome. There is therefore a need for models to quantify this approach. The target plot presented here is based on the difference plot.

Improvement in glycemic control over 11 years in patients monitored for diabetes in one county.

Background: Hemoglobin A(1c) (HbA(1c)) has been used in controlled trials for the last 10 years but has never been evaluated in clinical practice as an effective parameter for clinical outcome. We investigated the trend for glycemic control over 11 years in one county of 350,000 citizens.

Methods: We studied 226,382 HbA(1c-DCCT-aligned) from 39,455 patients in whom routine monitoring for diabetes was initiated in 1993, 1996, or 2001.

Saliva Interleukin-6 in patients with inflammatory bowel disease.

Objective: The inflammatory bowel diseases (IBD), Crohn's disease (CD) and ulcerative colitis (UC) are chronic inflammatory conditions that affect the gastrointestinal tract. In regulation of this inflammatory process, Interleukin-6 (IL-6) has a major role. Overproduction of IL-6 by immunocompetent cells contributes to development of the inflammatory condition.

Glycemic control in diabetes in three Danish counties.

Background: Hemoglobin A1c (HbA1c) is a proxy measure for glycemic control in diabetes. We investigated the trend for glycemic control in patients from three Danish counties using HbA1c measurements.

Methods: We studied 2454 patients from a population of 807,000 inhabitants for whom routine monitoring of diabetes using HbA1c-DCCT aligned was initiated in 2001.

How accurate are clinical activity indices for scoring of disease activity in inflammatory bowel disease (IBD)?

Clinical activity indices are essential instruments in monitoring inflammatory bowel diseases such as Crohn's disease (CD) and ulcerative colitis (UC). To subclassify components of disease indices in CD and UC, investigate technical noise in estimation of the indices, establish a signal-to-noise ratio (SNR), evaluate correlation between indices and calculate the reference change value (RCV) for selected biochemical variables in individual cases, 50 patients with CD and 49 patients with UC were included in the study. Qualitative index variables were assessed for scoring errors.

Controlled storage conditions prolong stability of biochemical components in whole blood.

Blood specimens from primary care centres are normally transported to central laboratories by mail. This necessitates centrifugation and separation, especially since the potassium ion concentration in whole blood changes during storage at ambient temperature. Thus, because of the growing awareness of and concern for pre-analytical contributions to the uncertainty of measurements, we investigated 27 components and their stability under controlled temperature conditions from 17 to 23 degrees C.

The clinical impact of screening for gestational diabetes.

Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance during pregnancy. In Denmark the health service offers selective screening for GDM, i.e.

Creation of a low-risk reference group and reference interval of fasting venous plasma glucose.

Reference intervals are recommended for naturally occurring quantities and required in the evaluation of new components in order to provide clinically useful information. The aim of the present study is to present a method for selecting reference individuals for the determination of fasting venous plasma glucose (f-vPG) reference intervals and ways to determine if disease groups can share reference intervals with an ideal reference population. Reference subjects were randomly selected, eligibility was judged according to predetermined inclusion and exclusion criteria.

Should we maintain the 95 percent reference intervals in the era of wellness testing? A concept paper.

The reference interval is probably the most widely used decision-making tool in clinical practice, with a modern use aiming at identifying wellness during health check and screening. Its use as a diagnostic tool is much less recognised and may be obsolete. The present study investigates the consequences of the new practice for the interpretation of prospective value, negative vs.

Low S-adenosylmethionine concentrations found in patients with severe inflammatory bowel disease.

Background: S-adenosylmethionine is a methyl donor in many cellular reactions including detoxification of constantly produced hydrogen sulphide in the colon. A reduced capacity to detoxify hydrogen sulphide may be implicated in the pathogenesis of inflammatory bowel disease. S-adenosylmethionine could be low if this assumption is correct.

The effect of the new ADA and WHO guidelines on the number of diagnosed cases of diabetes mellitus.

In the new lowered diagnostic discriminator for diabetes mellitus (DM) from the American Diabetes Association (ADA), fasting peripheral venous plasma glucose (f-vPG) of 7.0 mmol/l is identical to the 99.9 centile of f-vPG (7.

Measurement of glucose content in plasma from capillary blood in diagnosis of diabetes mellitus.

Overall, there is good correlation between glucose values obtained from ear capillary blood and those from peripheral venous plasma, but there are considerable individual differences. Results obtained with these two methods are generally not interchangeable and the converted values should not be used in the diagnosis of diabetes mellitus, because of the risk of misclassification. In Denmark this can affect 20-24000 persons.

Brånemark and ITI dental implants in the human bone-grafted maxilla: a comparative evaluation.

The development of new characteristics concerning implant surface makes it interesting to clinically compare different implant systems in the bone-grafted maxilla. The aim of this evaluation was to compare clinical data of a two-staged procedure on the augmented extremely atrophic maxilla using either Brånemark- or ITI-fixures. In 25 patients (18 females, seven males) the severely atrophied maxilla was reconstructed with autogenous iliac or mandibular bone and either Brånemark or ITI implants.

Fasting and post-glucose load--reference limits for peripheral venous plasma glucose concentration in pregnant women.

Recently both the American Diabetes Organization (ADA) and World Health Organization (WHO) have revised the diagnostic recommendations for gestational diabetes mellitus (GDM), however, they did not not reach agreement on the criteria for diagnosis, the referral criteria for the confirmatory oral glucose tolerance test (OGTT), its standardization, and diagnostic cut-off point. The aims of this study were to investigate if the fasting venous plasma glucose mmol/l (f-vPG) and the 2-hour venous plasma glucose mmol/l (2h-vPG) after a WHO standardized 75 g oral glucose tolerance test (OGTT) in a non-risk group of pregnant women during first and third trimester of pregnancy deviated from that of risk groups, to establish a reference interval for f-vPG and 2h-vPG, and to investigate the predictive role of f-vPG for the 2h-vPG glucose concentration. This is a population-based case-control study where a consecutive number of pregnant women were invited to screening irrespective of their risk factors for GDM.

Upper reference limit, analytical quality specifications and clinical use of haemoglobin A1C.

Haemoglobin A1c (HbA1c) is now the key component for monitoring glycaemic control in diabetes mellitus (DM), especially for its close relation to diabetes complications. However, treatment goals in terms of HbA1c concentrations have been difficult to define and compare because of lack of international standardization and lack of common reference values of HbA1c concentrations. The aims of our study were to document our HbA1c analysis and make it traceable to international reference laboratories with the aid of current reference preparations, to establish a reference interval based on a low-risk population, and to evaluate the analytical quality specifications, which could meet clinical needs.

Can capillary whole blood glucose and venous plasma glucose measurements be used interchangeably in diagnosis of diabetes mellitus?

According to new proposals from the American Diabetes Association (ADA) and WHO, venous peripheral plasma is the preferred system for measuring glucose for diagnosing diabetes mellitus. Owing to the instability of glucose in plasma after blood sampling, strict well-defined and standardized preanalytical conditions are essential to ensure that glucose concentration measured in plasma reflects real blood glucose in the patient. This is in contrast to the capillary whole blood measurements, which are easy to perform and well established.

Plasma glucose reference interval in a low-risk population. 2. Impact of the new WHO and ADA recommendations on the diagnosis of diabetes mellitus.

The aim of the study was to establish a reference interval of fasting venous plasma glucose (FPG) from healthy individuals. A prospective modified cross-sectional population-based study was made with random selection of 2100 persons in age-stratified groups > or = 18 years identified from the local Personal Identification Register. The invitation was accepted by 755 persons, of which 726 aged 18-92 years were eligible.

Optimization of preanalytical conditions and analysis of plasma glucose. 1. Impact of the new WHO and ADA recommendations on diagnosis of diabetes mellitus.

The new diagnostic criteria for type 2 diabetes from the American Diabetes Association (ADA) and World Health Organization (WHO) recommend measurements on plasma and a lowering of the glucose threshold for diabetes by 0.8 mmol/L. This narrows the distance between the upper end of the reference limit and the discriminatory level to a degree where analytical quality becomes critical.