[The Present State of Inter-Laboratory Differences in Setting and Practicing Critical Values -Results of a Questionnaire Survey Performed to the Laboratories of Keio University-Associated Hospitals].

Presently we, Keio Endocrine and Metabolite Survey (KEMS) study group conducted a questionnaire sur- vey with respect to panic values in the laboratories belonging to Keio University-associated hospitals. As to the initial setting, most of the laboratories answered to play a leading role in preparing the necessary matters to implementation of panic values and revise them corresponding to physician's request on each occasion. In almost all laboratories, they did not verify whether the notification procedure does work to exert appropriate clinical action. The numbers of critical values answered by the 18 laboratories distributed widely in the test items (8-39) and their critical limits (10-68). As to the critical limits, the lower limits of serum K and blood glucose converged among the laboratories, however, the limits of other test items diverged. The results of the present survey regarding to critical values, although being in small scale, may submit the im- portant issue to be solved in near future. [Short Communication].

Distribution of dolichol in the serum and relationships between serum dolichol levels and various laboratory test values.

We examined the correlations between serum dolichol levels and laboratory test parameters in patients affected by disease, as well as the distribution of dolichol in sera from patients with hyperbetalipoproteinemia and hyperalphalipoproteinemia. Serum dolichol was evaluated by a reverse-phase HPLC method. After centrifugation, the serum dolichol found in healthy controls was mainly associated with medium-sized particles of the high-density lipoprotein (HDL) fraction. For patients with hyperbetalipoproteinemia, serum dolichol was also associated with the medium HDL fractions. However, for hyperalphalipoproteinemia patients the levels of large HDL and serum dolichol were increased, and serum dolichol was mainly associated with the large HDL fraction. On laboratory tests of components, the dolichol level was not correlated with the values for markers of the liver and biliary system, with the values of renal function markers, with creatine kinase activity, amylase activity or uric acid concentration, but was correlated with total cholesterol, HDL-cholesterol and apoA-I concentrations, and with lactate dehydrogenase (LDH) activity. These results suggest that serum dolichol exclusively localized in HDL, and in subpopulation, that in normocholesterolemia or hyperbeta-cholesterolemia is associated with HDL(3), which is small sized and high density HDL, however, that in hyperalphacholesterolemia is associated with HDL(2), which is large sized and lower density HDL.