Adrenal vein sampling (AVS) is the gold standard for localization of aldosterone producing adenoma. The anatomy of the right adrenal vein makes this procedure technically demanding and it may yield no clinical information if the adrenal veins are not adequately cannulated. Having frequently observed the technical failure of AVS, we undertook a review of 220 procedures in British Columbia, Canada.
Subjects were retrospectively identified through the laboratory information system. The following were collected: demographics, screening aldosterone concentration and renin activity/mass, results of dynamic function tests, AVS aldosterone and cortisol results. Standard calculations were performed on AVS data and site-specific success rates were compared. The effect of adrenocorticotropin hormone (ACTH) stimulation on the selectivity index (SI) and lateralization index (LI) were explored.
The overall technical success-rate of AVS procedures was only 44% in procedures where no ACTH-stimulation was used (n=200) but this rose significantly (p
Although AIDS is often thought of as a "big-city" disease, it is also becoming a serious health care issue for doctors and other health care workers in "small-city" Canada. Kingston, Ont., is one of those small cities, and of the facilities trying to come to grips with a disease about which much remains to be learned. In this article, Drs. Peter Ford and David Robertson outline their hospital's estimate of the cost, in manpower and money, of dealing with the AIDS crisis. The final estimate: roughly $700,000. Although most of the cost will involve one-time capital spending, they point out that there will likely be ongoing labour-related costs because of the special programs and increased manpower needed to deal with AIDS patients. Clearly, AIDS is no longer a big-city disease.
The author outlines the experience gained in the analysis of the discrepancies occurring between clinical and autopsy diagnoses by the records of a pathologic department of a general hospital. The discrepancies are considered for surgical and therapeutic units. The reasons underlying the discrepancies were investigated by conventional criteria and those elaborated by the experts committee specially entrusted with relevant problems.
Uppsala Biobank is the joint and only biobank organization of the two principals, Uppsala University and Uppsala University Hospital. Biobanks are required to have updated registries on sample collection composition and management in order to fulfill legal regulations. We report here the results from the first comprehensive and overall analysis of the 131 research sample collections organized in the biobank. The results show that the median of the number of samples in the collections was 700 and that the number of samples varied from less than 500 to over one million. Blood samples, such as whole blood, serum, and plasma, were included in the vast majority, 84.0%, of the research sample collections. Also, as much as 95.5% of the newly collected samples within healthcare included blood samples, which further supports the concept that blood samples have fundamental importance for medical research. Tissue samples were also commonly used and occurred in 39.7% of the research sample collections, often combined with other types of samples. In total, 96.9% of the 131 sample collections included samples collected for healthcare, showing the importance of healthcare as a research infrastructure. Of the collections that had accessed existing samples from healthcare, as much as 96.3% included tissue samples from the Department of Pathology, which shows the importance of pathology samples as a resource for medical research. Analysis of different research areas shows that the most common of known public health diseases are covered. Collections that had generated the most publications, up to over 300, contained a large number of samples collected systematically and repeatedly over many years. More knowledge about existing biobank materials, together with public registries on sample collections, will support research collaborations, improve transparency, and bring us closer to the goals of biobanks, which is to save and prolong human lives and improve health and quality of life.
A blood lead survey was conducted on samples from 2459 children aged 3-6 years to determine the prevalence of lead poisoning in children of this age in the Province of Ontario. Lead poisoning, defined as a blood lead concentration greater than or equal to 1.21 mumol 1-1 (25 micrograms dl-1), was found in 26 subjects (1.1% of the samples). The mean blood lead concentration for children from southern Ontario was 0.50 mumol l-1, and for those from northern Ontario it was 0.37 mumol l-1. Stringent quality controls and independent cross-checks of finger-prick capillary blood sampling were employed in the study. The free erythrocyte protoporphyrin levels were also monitored to detect the presence of iron deficiency in the children.
Prediagnostic steps in suspected metachromatic leukodystrophy (MLD) rely on clinical chemical methods other than enzyme assays. We report a new diagnostic method which evaluates changes in the spectrum of molecular types of sulfatides (3-O-sulfogalactosyl ceramides) in MLD urine.
The procedure allows isolation of urinary sulfatides by solid-phase extraction on DEAE-cellulose membranes, transportation of a dry membrane followed by elution and tandem mass spectrometry (MS/MS) analysis in the clinical laboratory. Major sulfatide isoforms are normalized to the least variable component of the spectrum, which is the indigenous C18:0 isoform. This procedure does not require the use of specific internal standards and minimizes errors caused by sample preparation and measurement.
Urinary sulfatides were analyzed in a set of 21 samples from patients affected by sulfatidosis. The combined abundance of the five most elevated isoforms, C22:0, C22:0-OH, C24:0, C24:1-OH, and C24:0-OH sulfatides, was found to give the greatest distinction between MLD-affected patients and a control group.
The method avoids transportation of liquid urine samples and generates stable membrane-bound sulfatide samples that can be stored at ambient temperature. MS/MS sulfatide profiling targeted on the most MLD-representative isoforms is simple with robust results and is suitable for screening.
INTRODUCTION: The establishment of Danish CancerBiobank to hold frozen blood and tissues from patients with primary cancer was made possible by a donation from the Ministry of Health and Prevention. MATERIAL AND METHODS: Danish departments of pathology already have a long experience with biobanks as they have handled paraffin-embedded tissues and have undertaken national registration of data in the nationwide pathological databank, Patobanken, for years. Furthermore, departments of clinical biochemistry are experienced in ensuring the quality of biobanks including that of blood samples. Knowledge from these two areas together with visits to biobanks in other countries was used to design and establish the Danish CancerBiobank. Five centres at the university hospitals in Aalborg, Herlev, Odense, Copenhagen and Arhus received the donation. RESULTS: A group of experts was established and made specifications for data registration and technical advice for the handling of blood and tissue and produced a draft handbook on quality assurance. CONCLUSION: The Danish CancerBiobank is unique nationally and internationally owing to 1) national recommendations for handling the materials included in the biobank, 2) centralized nationwide data registration, 3) correlation between information on blood and tissue for the single patient and 4) linking of the information to the final diagnosis through Patobanken. Furthermore, in the future it will be possible to connect to the nationwide clinical databases and other national registries. The final criteria of success for Danish CancerBiobank will be the publication of international research results of clinical importance for the treatment of patients diagnosed with cancer.