Wiener klinische Wochenschrift. Supplementum最新文献

beta-N-acetylglucosaminidase (beta-NAG) and beta 2-microglobulin were assessed in two cohorts of patients with glomerular or tubulointerstitial diseases respectively. While beta-NAG activities did not differ statistically significantly between both groups, beta 2-microglobulin excretion was statistically highly significantly increased in the setting of tubulointerstitial diseases. On the whole mean beta-NAG activity at 37 degrees C and beta 2-microglobulin urinary excretion were elevated in both groups, when compared to normal controls. Increased beta-NAG activities above 10 U/g creatinine were associated with a marked increase of creatinine serum levels within 6 months in both, patients with glomerular and tubulointerstitial basic renal diseases. beta-NAG and beta 2-microglobulin are useful tools in diagnosis and assessment of renal diseases elucidating different aspects.

Reference intervals for beta-N-acetylglucosaminidase (beta-NAG) using the method with chlorophenol red-N-acetylglucosaminide (CPR-NAG) as substrate were evaluated in second morning urine samples of 358 adults, combined from 4 laboratories of 3 countries. As upper reference limits for 37 degrees C measuring temperature are proposed: 5 U/l or 4 U/g creatinine respectively.

Reference intervals for urinary albumin were determined for adults (n = 358) using second morning urine (spontaneous). Percentiles were as follows: 90th percentile: 18 mg/l or 16 mg/g creatinine. 95th percentile: 28 mg/l or 24 mg/g creatinine. When related to volume, albumin values of children aged from 3 to 5 years (n = 60) were in the same range. When related to urinary creatinine, however, significantly higher values were obtained. The preliminary upper reference limit is 30 mg/g creatinine.

Important criteria for the development of a new turbidimetric immunoassay Tina-quant Albumin in urine to determine urinary albumin are presented. The handling and calibration procedures are described. The new test is useful for a reliable determination of urinary albumin allowing a large measuring range on various photometers.

The preliminary results of a multicenter trial in the Netherlands comparing plasma exchange (PE) with high-dose intravenous immunoglobulin (IgIV) (dose 0.4 g/kg during 5 consecutive days, total dose of 2.0 g/kg) are reported. The trial was performed on 150 patients. After 4 weeks, 34.2% of the PE patients and 52.7% of the IgIV patients showed improvement. While in 11 patients plasma exchange had to be discontinued for medical reasons, no serious side effects were seen in the high-dose immunoglobulin treatment group. In 30% of the patients antibodies to GM1 ganglioside were found. The presence of such antibodies was correlated with a more severe clinical course and delayed recovery. Since improvement in the IgIV group occurred almost twice as often in GM1 negative patients, the effect appears to be limited in GM1-positive patients, who obviously need additional treatment. A current multicenter trial uses IgIV combined with high-dose methylprednisolone.

A critical overview on different procedures and methods for an early diagnosis of diabetic nephropathy is given. Genetic markers, morphology and function of glomerula, blood pressure and the metabolic state of diabetics are especially discussed. From the risk markers available today microalbuminuria (20 to 200 micrograms/min resp. 20 to 200 mg/l) is shown to be most suitable for recognizing patients developing nephropathy.

Results of the multicenter study with a new test Tina-quant Albumin in urine for the determination of the albumin concentration in urine were reported. The following specific areas are investigated: precision and accuracy, measurement range, detection limit, calibration stability, comparison with other methods of albumin determination, and the effect of various interfering factors. Our results in brief: Tina-quant Albumin in urine is a reliable and useful test which is barely influenced by endogenous and exogenous interfering factors. Agreement with other routine methods can be classed as remarkably good for an immunological method.

Some inflammatory diseases of the peripheral nervous system, most prominently the Guillain-Barré syndrome, are currently regarded to be of autoimmune origin. Experimental models show clearly that the balance between cellular and humoral autoimmune reaction against peripheral myelin components significantly determines the appearance of the disease. Yet, important questions, such as target antigens of the antimyelin reaction are still unresolved.

We report on the results of a multicentric evaluation of a new kinetic method for the determination of beta-N-acetylglucosaminidase. Main topics of investigation were imprecision, recovery in controls with interlaboratory survey, measuring range, calibration stability, method comparisons using native urine and interferences. Distinct advantages in practicability and interlaboratory transferability compared to the introduced methods were observed. The new method fulfills the conditions to be adapted as routine method in the quantitative photometric analysis of urine.