Critical appraisal of two methods for determining aluminum in blood samples.

We report two methods for determining aluminum concentrations in blood. Method 1, proposed for routine monitoring of patients with chronic renal failure, includes a collection procedure that can be adopted by any renal dialysis unit, with a minimum of sample contamination. Plasma samples are diluted fourfold with HNO3/Triton X-100 matrix modifier. Method 2 is proposed for determining aluminum concentrations in patients with normal renal function, e.g., in drug studies and environmental monitoring. Samples are diluted with an equal volume of Mg(NO3)2 matrix modifier and atomized from a L'vov platform. By either method, analytical recovery of aluminum added to serum ranged between 92% and 105% throughout the linear calibration range. The reference interval (mean +/- SD) for aluminum in 22 healthy subjects by method 2 was 0.044 +/- 0.030 mumol/L.

Micro-quantity tissue digestion for metal measurements by use of a microwave acid-digestion bomb.

We describe a simple and convenient method for processing small amounts of tissue samples for trace-metal measurements by atomic absorption spectrometry, by use of a modified Parr microwave digestion bomb. Digestion proceeds rapidly (less than or equal to 90 s) in a sealed Teflon-lined vessel that eliminates contamination or loss from volatilization. Small quantities of tissue (5-100 mg dry weight) are digested in high-purity nitric acid, yielding concentrations of analyte that can be measured directly without further sample manipulation. We analyzed National Institute of Standards and Technology bovine liver Standard Reference Material to verify the accuracy of the technique. We assessed the applicability of the technique to analysis for aluminum in bone by comparison with a dry ashing procedure.

Lithium determined in serum with an ion-selective electrode.

We evaluated the performance of the lithium ion-selective electrode (ISE) in the Du Pont Na/K/Li analyzer. Lithium concentrations in 106 serum samples from patients being treated with lithium were measured in duplicate with the ISE and by flame photometry. The slope of the regression line for the two methods was 1.004 with a standard error of the estimate of 0.049 mmol/L (x = flame photometry, y = ISE). Lithium measurements by the ISE method in serum or aqueous standards were linear to greater than 2.0 mmol/L. Within-run CVs for low (0.31 mmol/L) and high (1.15 mmol/L) lithium controls were 5.9% and 1.7%, respectively (n = 20). Day-to-day CVs for the same controls were 9.8% and 3.3%, respectively (n = 20). There was no significant interference when the concentrations of sodium, potassium, calcium, or magnesium were varied, nor did intervening urinary lithium analyses affect the measurement of serum lithium. Results for lithium measurement in four serum-based survey materials compared well with results by isotope dilution/mass spectrometry.

Evaluation of a bromocresol purple method for the determination of albumin adapted to the DuPont aca discrete clinical analyzer.

We evaluated a new method for the determination of albumin on the DuPont aca discrete clinical analyzer that utilized an albumin selective dye, bromocresol purple (BCP). This dye minimizes globulin interference that occurs with bromocresol green (BCG) methods that have long (greater than 30 s) incubation times. Good correlation was observed between the new BCP method and two methods which do not show significant globulin interference: an immunological method and a rapid BCG method. Comparisons with alternate BCG methods (SMA 12/60, SMAC, and the aca) were generally not as good. The albumin results by the BCP method on specimens with elevated globulins were similar to results from the immunological and rapid BCG methods. The reference interval was 34-50 g/L. The between-day coefficient of variation ranged from 0.9 to 3.5% at three evaluation sites on 2 levels of 8 different control materials. The method was linear between 6-70 g/L. No interference was observed from hemoglobin at levels less than or equal to 5.00 g/L or from bilirubin at levels less than 342 mumol/L. Also, no interference was observed from nine common drugs that are known to bind to albumin. These studies show that accuracy, reproducibility and linearity of the BCP albumin method on the aca are acceptable for clinical use.

Optimization and evaluation of cardiac enzymes and isoenzymes measured on a random access analyzer.

Four serum enzymes and isoenzymes used in the diagnosis of acute myocardial infarction (AMI), lactate dehydrogenase LD and LD-1, creatine kinase (CK), and CK-MB have been adapted to the Technicon RA-1000 automated clinical chemistry analyzer. Analytical parameters have been adjusted to provide clinically acceptable precision for all four assays. Correlations with centrifugal analyzer procedures gave correlation coefficients ranging from 0.998 to 0.999. A limited clinical study of the CK-MB assay indicated that a discriminant value of 13 U per L could separate AMI from non-AMI patients.

Adaptation of EMIT drug assays to a random-access automated clinical analyzer.

Enzyme multiplied immunoassay technique (EMIT) assays for theophylline, carbamazepine, phenytoin, phenobarbital, valproic acid, acetaminophen, gentamicin and tobramycin, have been adapted to the Technicon RA-1000 random access analyzer. Working reagents are stable for a period of at least one week, and calibration need only be performed when preparing fresh reagents. Between-day precision ranged from 2.2 to 5.5 percent and correlations with similar EMIT assays performed on a centrifugal analyzer were satisfactory. Excellent results were obtained on proficiency testing samples when analyzed for theophylline, phenobarbital, phenytoin and acetaminophen. The procedures have been adapted to emergency testing of these four drugs.