Clinical chemistry
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We report two pediatric cases of rhabdomyolysis. This disease involves the destruction of skeletal muscle, which can present with myalgia and a brown-pigmented urine. ⋯ Evidence of rhabdomyolysis in both patients included dark, o-tolidine-positive urine, granular casts in the urinary sediment, and grossly increased activities of creatine kinase (greater than 60 000 U/L) in serum. An uncommonly recognized entity in the pediatric age group, rhabdomyolysis often presents as an acute disease with severe onset but can be diagnosed with relatively simple laboratory tests.
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We describe a method for the simultaneous determination of the five clinically relevant hemoglobin derivatives (Hb, HbO2, HbCO, Hi, SHb) in a blood sample by means of a reversed-optics spectrophotometer (Hewlett-Packard HP8450 A UV/Vis). A built-in computer program is used for multicomponent analysis in an overdetermined system, i.e., a system in which the number of independent equations used exceeds the number of unknowns to be determined. ⋯ Thereafter, the multicomponent method for the simultaneous determination of the five hemoglobin derivatives is tested by comparison with conventional methods for the separate determination of oxygen saturation, HbCO, Hi, and SHb fractions. The multicomponent (multiwavelength) method is sufficiently reliable, accurate, and easy to justify its use in physiological chemical research as well as its routine application in the clinical chemical laboratory.
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Radioactive and nonradioactive L-carnitine and acyl-L-carnitine were used to evaluate the washing procedures used during the determination of free, total, short-chain, and long-chain acylcarnitine in human and sheep plasma. The volume of fluid trapped by the protein precipitated by perchloric acid is approximately 24% of the total fluid volume and thus contains 24% of free carnitine and short-chain acylcarnitine. ⋯ Washing the pellet twice with a 60 g/L solution of perchloric acid completely removes the trapped free carnitine and short-chain acylcarnitine but does not remove the bound long-chain acylcarnitines. Thus washing with perchloric acid is essential for accurate measurement of long-chain acylcarnitines in plasma samples.
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Transcutaneous carbon dioxide and oxygen tensions (tc-pCO2 and tc-pO2) were measured in seven healthy adult volunteers during hyperventilation in atmospheric air and during CO2 inhalation. Three skin sensors were applied to each subject: an O2 electrode, a CO2 electrode, and a combined O2-CO2 electrode, each heated to 44 degrees C. We observed close correlation between tc-pCO2 and capillary-pCO2, the relation being close to that calculated from the anaerobic temperature coefficient of pCO2 in blood. ⋯ Electrode drift during in-vivo monitoring was greater for pCO2 (up to 12%) than for pO2 (up to 7%), but generally we observed no differences in drift between the combined and the single electrodes. We conclude that tc-pCO2 measured with a single or a combined electrode reliably predicts capillary-pCO2 in healthy adults and that changes are rapidly observed. Our conclusions regarding tc-pO2 values are less definite because of uncertain interpretation of the capillary-pO2 values.