Effect of citrate concentration in specimen collection tubes on the International Normalized Ratio

PROBLEM: Does citrate concentration in specimen collection tubes affect the International Normalized Ratio? METHODS: The International Normalized Ratio was determined on quadruplicate plasma specimens from 32 patients treated long term with oral anticoagulants-two from tubes with 3.2% citrate and two with 3.8% citrate. Two laboratories, using two different coagulometers, tested the specimens. RESULTS: International Normalized Ratios of plasma from tubes with 3.8% citrate were significantly higher than those from tubes with 3.2% citrate when tested with either coagulometer. Patients given adequate anticoagulation on the basis of the International Normalized Ratio at one concentration of citrate appeared either overanticoagulated and at risk of bleeding or underanticoagulated and at risk of thromboembolism at the other concentration of citrate. CONCLUSION: Results emphasize the need for using a single concentration of citrate for prothrombin time testing. We recommend 3.2% citrate.     

Review of small specimen test techniques for irradiation testing

Small specimen test technology has evolved out of the necessity to develop and monitor materials proposed for or used in nuclear power generation systems. Development of materials for improved cladding and in-core structures for fission reactors and assessment of core materials and pressure vessel steels already under irradiation necessitated the use of specimens which fit into existing irradiation space or which could be extracted from irradiated structures, such as cladding or ducts. Interest in simulating neutron irradiation by light and heavy ion irradiation led to the development of thin foil and wire geometry specimens. Further, interest in developing materials for fusion reactors has added additional constraints on specimen sizes associated with available irradiation volumes in existing and proposed high-energy neutron irradiation facilities. Consequently, a wide array of specimen geometries and test techniques has now been developed. It is the purpose of this paper to review these techniques and examine their status, problems, and potential for future applications. This paper is based on a presentation made in the symposium “Irradiation-Enhanced Materials Science and Engineering” presented as part of the ASM INTERNATIONAL 75th Anniversary celebration at the 1988 World Materials Congress in Chicago, IL, September 25–29, 1988, under the auspices of the Nuclear Materials Committee of TMS-AIME and ASM-MSD.     

Review of small specimen test techniques for irradiation testing

Small specimen test technology has evolved out of the necessity to develop and monitor materials proposed for or used in nuclear power generation systems. Development of materials for improved cladding and in-core structures for fission reactors and assessment of core materials and pressure vessel steels already under irradiation necessitated the use of specimens which fit into existing irradiation space or which could be extracted from irradiated structures, such as cladding or ducts. Interest in simulating neutron irradiation by light and heavy ion irradiation led to the development of thin foil and wire geometry specimens. Further, interest in developing materials for fusion reactors has added additional constraints on specimen sizes associated with available irradiation volumes in existing and proposed high-energy neutron irradiation facilities. Consequently, a wide array of specimen geometries and test techniques has now been developed. It is the purpose of this paper to review these techniques and examine their status, problems, and potential for future applications. This paper is based on a presentation made in the symposium “Irradiation-Enhanced Materials Science and Engineering” presented as part of the ASM INTERNATIONAL 75th Anniversary celebration at the 1988 World Materials Congress in Chicago, IL, September 25–29, 1988, under the auspices of the Nuclear Materials Committee of TMS-AIME and ASM-MSD.     

Serum digoxin concentration: dependence on body weight and age

In patients of a cardiological practice, 121 digoxin serum concentrations were determined by radioimmunoassay (RIA). Some drugs were suspected of interfering with the RIA or with the pharmacokinetics of digoxin. Patients having such additional drugs or patients with elevated serum creatinine were not included. The daily maintenance dose of digoxin was roughly adjusted to body weight. Patients with 0.5 mg digoxin daily showed unexpectedly low serum digoxin levels not fully explained by the relatively high body weight. This dose group was not included in the following correlations. At a maintenance dose of 0.25 and 0.375 mg digoxin and in the age groups 40-69 years (n = 66) there was an approximately inverse proportionality between serum digoxin concentration (per 0.25 mg digoxin daily) and body weight. When all age classes from 20 to 89 years were included (n = 96), a week positive correlation between serum digoxin concentration (per 0.25 mg digoxin daily and per 69.28 kg body weight) and age was found. A similar positive correlation resulted between serum digoxin concentration (per 0.25 mg digoxin daily) and the reciprocal of the nomographically determined creatinine clearance, always within the normal serum creatinine range. Based on these correlations, two simplified formulas are presented to predict the serum concentration and therapeutic maintenance dose of digoxin. The formulas are valid for the normal serum creatinine range and for digoxin tablets of optimal bioavailability.     

Utility of routine testing of bronchoalveolar lavage fluid for cryptococcal antigen

All cryptococcal antigen (CrAg) testing performed at our institution between 1989 and 1994 was reviewed for utility of routinely testing of bronchoalveolar lavage fluid (BAL) for this antigen. Forty-two of 1,506 BAL specimens were positive. Seventeen of these were felt to represent false positives (sensitivity, 71%; positive predictive value, 0.59). The data on CrAg in cerebrospinal fluid and serum and the fungal culture and histological results of BAL specimens did not support continued, routine testing of BALs for CrAg to diagnose cryptococcosis.     

Etest for routine clinical antimicrobial susceptibility testing of rapid-growing mycobacteria isolates

Tumors depend on their blood supply for growth. The blood supply to metastatic neoplasia of lung is usually from the pulmonary circulation or both the pulmonary and systemic circulation. The antineoplastic effect of pulmonary artery occlusion was investigated in a rat model of methylcholanthrene-induced metastatic pulmonary sarcoma. Left pulmonary artery ligation was performed on day 7 after tumor inoculation, and animals were sacrificed on day 14. The tumor burden of the left lung decreased 44% when compared with the control group. The survival of non-tumor-bearing rats undergoing left pulmonary artery ligation for 24 hours followed by right pneumonectomy after 2 weeks was also studied. No significant lung damage after a period of left pulmonary artery ligation was seen, as evidenced by both survival after contralateral right pneumonectomy and histology. Balloon occlusion of pulmonary artery, together with regional chemotherapy for patients with lung metastases, may warrant investigation.     

Opt-out testing for stigmatized diseases: A social psychological approach to understanding the potential effect of recommendations for routine HIV testing.

Objective: Little research has studied experimentally whether an opt-out policy will increase testing rates or whether this strategy is especially effective in the case of stigmatized diseases such as HIV. Design and Main Outcome Measures: In Study 1, a 2 × 2 factorial design asked participants to make moral judgments about a person’s decision to test for stigmatized diseases under an opt-in versus an opt-out policy. In Study 2, a 2 × 2 factorial design measuring testing rates explored whether opt-out methods reduce stigma and increase testing for stigmatized diseases. Results: Study 1 results suggest that getting tested draws suspicion regarding moral conduct in an opt-in system, whereas not getting tested draws suspicion in an opt-out system. Study 2 results suggest that an opt-out policy may increase testing rates for stigmatized diseases and lessen the effects of stigma in people’s reluctance to test. Discussion: A social psychological approach to health services can be used to show how testing policies can influence both the stigmatization associated with testing and participation rates. An understanding of how testing policies may affect patient decision making and behavior is imperative for creating effective testing policies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

检测机构对标准文献需求的特征及应对措施

标准文献有其明显特征,是标准化工作的一个重要组成部分,它是检测机构工作依据和工具。提出了标准文献管理要适应检测机构的特点,注重收集的有效性,保证质量管理体系的受控状态,利用现代检索工具及时掌握标准信息动态就显得十分重要。     

Genetic toxicology testing requirements: official and unofficial views from Europe

This work presents genetic toxicity testing requirements in three industry sectors; pharmaceuticals, pesticides, and industrial chemicals.     

Antimicrobial susceptibility testing of Bilophila wadsworthia isolates submitted for routine laboratory examination

MICs of antibiotics against Bilophila wadsworthia isolates were measured by agar and broth microdilution with pyruvic acid and by Etest. The inoculum size influenced greatly agar dilution. Despite discrepancies in MICs depending on the measurement method used, clindamycin consistently showed potent activity. Broth microdilution and Etest appear to be candidates for laboratory susceptibility testing.     

Minimum structural requirements for peptide presentation by major histocompatibility complex class II molecules: implications in induction of autoimmunity

The precise mechanisms of failure of immunological tolerance to self proteins are not known. Major histocompatibility complex (MHC) susceptibility alleles, the target peptides, and T cells with anti-self reactivity must be present to cause autoimmune diseases. Experimental autoimmune encephalomyelitis (EAE) is a murine model of a human autoimmune disease, multiple sclerosis. In EAE, residues 1-11 of myelin basic protein (MBP) are the dominant disease-inducing determinants in PL/J and (PL/J x SJL/J)F1 mice. Here we report that a six-residue peptide (five of them native) of MBP can induce EAE. Using peptide analogues of the MBP-(1-11) peptide, we demonstrate that only four native MBP residues are required to stimulate MBP-specific T cells. Therefore, this study demonstrates lower minimum structural requirements for effective antigen presentation by MHC class II molecules. Many viral and bacterial proteins share short runs of amino acid similarity with host self proteins, a phenomenon known as molecular mimicry. Since a six-residue peptide can sensitize MBP-specific T cells to cause EAE, these results define a minimum sequence identity for molecular mimicry in autoimmunity.     

Neuroprotective effects of NMDA receptor glycine recognition site antagonism: dependence on glycine concentration

High-affinity NMDA receptor glycine recognition site antagonists protect brain tissue from ischemic damage. The neuroprotective effect of 5-nitro-6,7-dichloro-2,3-quinoxalinedione (ACEA 1021), a selective NMDA receptor antagonist with nanomolar affinity for the glycine binding site, was examined in rat cortical mixed neuronal/glial cultures. ACEA 1021 alone did not alter spontaneous lactate dehydrogenase (LDH) release. Treatment with ACEA 1021 (0.1-10 microM) before 500 microM glutamate, 30 microM NMDA, or 300 microM kainate exposure was found to reduce LDH release in a concentration-dependent fashion. These effects were altered by adding glycine to the medium. Glycine (1 mM) partially reversed the effect of ACEA 1021 on kainate cytotoxicity. Glycine (100 microM-1 mM) completely blocked the effects of ACEA 1021 on glutamate and NMDA cytotoxicity. The glycine concentration that produced a half-maximal potentiation of excitotoxin-induced LDH release in the presence of 1.0 microM ACEA 1021 was similar for glutamate and NMDA (18 +/- 3 and 29 +/- 9 microM, respectively). ACEA 1021 also reduced kainate toxicity in cultures treated with MK-801. The effects of glycine and ACEA 1021 on glutamate-induced LDH release were consistent with a model of simple competitive interaction for the strychnine-insensitive NMDA receptor glycine recognition site, although nonspecific effects at the kainate receptor may be of lesser importance.     

Minimum alveolar concentration of desflurane for tracheal extubation in deeply anaesthetized, unpremedicated children

We have studied 25 children, aged 4-9 yr, to determine the minimum alveolar concentration (MAC) of desflurane at which safe tracheal extubation can be performed in deeply anaesthetized children. The end-tidal concentration of desflurane was noted at tracheal extubation. Successful extubation was defined as one in which there was no coughing or bucking on the tracheal tube during suctioning of the pharynx, no movement or coughing within 1 min of tracheal extubation and no breath-holding or laryngospasm after extubation. Successful extubation was followed by extubation at a concentration of 0.5% less, and so on in subsequent subjects, until unsuccessful extubation occurred. After a reaction, the percentage was increased in the next patient, continuing up and down in pairs, until the required number of subjects was achieved. In 50% of children aged 4-9 yr, tracheal extubation may be accomplished without coughing or moving at an end-tidal concentration of 7.7%. The end-tidal concentration of desflurane to achieve satisfactory extubation in 95% of children was 8.5%.     

Minimum chemical requirements for adhesin activity of the acid-stable part of Candida albicans cell wall phosphomannoprotein complex

This study was conducted to define adhesive characteristics of the acid-stable moiety of the Candida albicans phosphomannoprotein complex (PMPC) on adherence of this fungus to marginal zone macrophages of the mouse spleen. Complete digestion of the acid-stable moiety (Fr.IIS) of the C. albicans PMPC with an alpha-mannosidase or hydrolysis with 0.6 N sulfuric acid destroyed adhesin activity, as determined by the inability of the soluble digests to inhibit yeast cell adherence to the splenic marginal zone. Fr.IIS adhesin activity was decreased following digestion with an alpha-1,2-specific mannosidase. Oligomannosyls consisting of one to six mannose units, which were isolated from the acid-stable part of the PMPC, did not inhibit yeast cell binding and thus do not function alone as adhesin sites in the PMPC. To gain more insight into the minimum requirements for adhesin activity, PMPCs were isolated from a Saccharomyces cerevisiae wild-type strain and from mutant strains mnn1, mnn2, and mnn4; the PMPCs were designated scwt/Fr.II, scmn1/Fr.II, scmn2/Fr.II, and scmn4/Fr.II, respectively. S. cerevisiae scmn2/Fr.II lacks oligomannosyl side chain branches from the outer core mannan, and scmn2/Fr.II was the only PMPC without adhesin activity. S. cerevisiae scwt/Fr.II, scmn1/Fr.II, and scmn4/Fr.II showed adhesin activities less than that of C. albicans Fr.II. These three S. cerevisiae PMPCs are generally similar to Fr. IIS, except that the S. cerevisiae structure has fewer and shorter side chains. Immunofluorescence microscopy show that the acid-stable part of the PMPC is displayed homogeneously on the C. albicans yeast cell surface, which would be expected for a surface adhesin. Our results indicate that both the mannan core and the oligomannosyl side chains are responsible for the adhesin activity of the acid-stable part of the PMPC.     

Effects of tromethamine buffer on coagulation variables and ionized calcium concentration in dogs

OBJECTIVE: To evaluate coagulation variables in 2 groups of dogs after tromethamine administration. ANIMALS: 13 Beagles. PROCEDURES: Both groups of dogs received a 30-minute IV infusion of 10 ml of 0.3M tromethamine/kg of body weight. In unsedated dogs (group 1, n = 8), prothrombin time, activated partial thromboplastin time, normalized ionized calcium concentration, platelet numbers, and platelet function were measured prior to treatment, at the end of the infusion, and 1 hour after the infusion. In xylazine-sedated dogs (group 2, n = 5), buccal mucosal bleeding time and plasma percentage of von Willebrand factor antigen were measured before and 1 hour after infusion, and fibrin degradation products concentration was measured 1 hour after infusion. Platelet function was assessed by determining platelet aggregation and by measuring ATP release from the aggregating platelets over 6 minutes, using a whole blood aggregometer, with 20, 10, and 5 microM ADP and 5 and 10 micrograms of collagen/ml as platelet activation agonists. RESULTS: There was no significant change in any of the variables measured in either group of dogs, compared with baseline values. CONCLUSIONS AND CLINICAL RELEVANCE: When administered to healthy dogs, tromethamine does not change the coagulation indices measured.