Salivary cortisol testing in children.

Biological markers can identify links between human biology and human behavior. Cortisol, a marker of hypothalamic-pituitary-adrenocortical axis function, is a useful measure in research. Newer technology involving the measurement of cortisol in saliva is being utilized in research studies. Salivary cortisol measurement is inexpensive and noninvasive and offers many advantages over serum testing. Although there are various methods of saliva collection, it is relatively easy to perform in both infants and children. Salivary cortisol testing may offer a significant measure for pediatric stress, coping, and health research.

Monoclonal antibodies differentially reactive with native and reductively modified Bowman-Birk protease inhibitor.

Bowman-Birk protease inhibitor (BBI) is a potent anticarcinogen that suppresses malignant transformation at nanomolar concentrations. Small amounts of BBI in its native form can be measured by immunoassay using specific monoclonal antibodies (MAbs); however, the MAbs currently available are not capable of detecting BBI metabolites in human body fluids. To develop new reagents for the study of BBI exposure and pharmacokinetics, we produced four MAbs, designated 3B6, 3E3, 4H8 and 5G2, from hybridomas derived from a mouse immunized with reductively modified BBI. The epitopes recognized by the four MAbs were characterized using BBI in its native form or modified by different methods. MAb 3B6 reacted with native BBI. Partial reduction of BBI with 720 Gy of gamma radiation in an oxygen-free solution of 100 mM formate increased the reactivity of BBI with 3B6; however, extensive reduction of BBI with 100 mM DL-dithiothreitol (DTT) completely abolished this antigenic reactivity. In contrast, the other three MAbs reacted with BBI molecules that had been reduced either with 720 Gy of radiation in formate solution or with DTT. Alkylation of the radiochemically reduced BBI with N-ethylmaleimide further increased the reactivity of BBI with 3E3, 4H8 and 5G2, possibly by preventing the formation of new disulfide bonds within the BBI molecules. The binding of 4H8 and 5G2 to BBI antigen was inhibited by the binding of 3E3, and vice versa. Thus, the epitopes recognized by 3E3, 4H8 and 5G2 are probably located close to one another on the reduced BBI molecules. These three MAbs were able to react with BBI metabolites in urine samples collected from volunteers after oral administration of BBI. The ability of these MAbs to detect BBI metabolites indicates that BBI may be reductively modified in vivo and these MAbs may be useful reagents for monitoring the uptake of BBI into human tissues in cancer chemoprevention studies with BBI.

Steroid profile for urine: reference values.

We describe a project, participated in by 24 institutions in The Netherlands and Belgium, to determine normal reference values for steroids in urine by capillary gas chromatography. Urine samples from 288 healthy volunteers were analyzed in triplicate. Reference values, expressed in mumol/24 h, were determined for androsterone, etiocholanolone, dehydroepiandrosterone, 11-keto-androsterone, 11-keto-etiocholanolone, 11-hydroxyandrosterone, 11-hydroxyetiocholanolone, pregnanediol, pregnanetriol, 11-desoxytetrahydrocortisol, tetrahydrocortisone, tetrahydrocortisol, allo-tetrahydrocortisol, and 17-keto- and 17-hydroxysteroids. We also determined reference ratios for etiocholanolone/androsterone, tetrahydrocortisone/tetrahydrocortisol, and tetrahydrocortisol/allo-tetrahydrocortisol; an upper limit of a discriminant function to establish polycystic ovarian disease; and reference values for 24-h urine volume and creatinine excretion. Reference values were determined separately for men and women, each in six age categories: 0-3 months, 4 months-12 years, 13-16 years, 17-50 years, 51-70 years, and older than 70 years. We conclude that these reference values are reliable and form a basis for quantitative interpretation of steroid profiles.

Correction of instrument- and reagent-based differences in determination of the International Normalized Ratio (INR) for monitoring anticoagulant therapy.

As recommended by the World Health Organization, standardization of prothrombin time assays involves conversion of prothrombin times into International Normalized Ratios (INR). We investigated the effect of two different methods (Nycomed's Thrombotest, and Instrumentation Laboratory's PT-fibrinogen) and three coagulation instruments (Schnitger & Gross, KC-10, and ACL) on calculations of INR. The INR plots showed considerable scatter of individual values around the regression lines when the two different methods were compared. Systematic differences in the outcome of INR calculation were related to the use of the different coagulation instruments. Prothrombin times obtained with the different instruments were linearly correlated. We used the bias of these lines to correct results for both the patients' samples and the reference samples. This correction yielded INR values from the different instruments that agreed well.

Application of diethylstilbestrol dipropionate in bulls. I. Excretion of residues in urine and faeces and histological and immunohistochemical changes in the prostate.

In this experiment 20 one year old bulls received a single intramuscular injection of the anabolic preparation diethylstilbestrol dipropionate (DES-DP) (an oil preparation or an emulsion). Four animals received a corresponding placebo. The application of DES-DP to bulls caused characteristic histological alterations in the peripheral glandular epithelium of the prostate, which could be observed until four weeks after treatment. The value of histological investigation as a screening method was, however, limited by the occurrence of only few metaplastic lesions and a rapid recovery. By contrast, immunohistochemistry using a polyclonal cytokeratin antiserum K40 appeared to be a specific and very sensitive method to detect oestrogen-induced lesions in the prostate. In only two animals, six weeks after injection with the DES-emulsion, false-negative results were obtained, demonstrating the potential value of this screening method. The excretion of DES in the urine and faeces was monitored using radioimmunoassay following chromatographic purification of the urine and faeces extracts. The excretion of DES in urine was faster for animals of the oil group. The DES content in urine decreased to the 1 microgram/l level after 42 days (emulsion group) or 70 days (oil group). The excretion in faeces was comparable to that in urine. After day 21 the excretion patterns of the two excreta were indistinguishable.

The effect of age, weight-related parameters and hormonal contraceptives on andrological assays.

Serum levels of dehydroepiandrosterone-sulfate (DHEA-S), testosterone (T), sex hormone binding globulin (SHBG), T/SHBG ratio and the calculated free T were evaluated in healthy female blood donors. The influence of age and weight-related parameters were studied together with the effects of 9 different oral contraceptives. A gradual decrease with age of DHEA-S, T, T/SHBG and free T levels were observed. The Quetelet index showed a significant negative correlation with the androgen levels except for the T/SHBG ratio. In the females using contraceptives, DHEA-S levels were only significantly decreased in the group using Depo-provera. Most contraceptive users had slightly lowered T levels. Marvelon and Ministat induced an increase in the SHBG levels. Androstenedione (A) levels were studied for some of the contraceptives (Ministat, Marvelon, Lyndiol, Depoprovera); levels were found to be significantly lower than in normal premenopausal women. A highly significant correlation was demonstrated between DHEA-S and the T, T/SHBG and free T levels in the serum of 106 normal women.

Steroid profiling--an update.

Extraction of steroids from urine with C18 solid-phase extraction cartridges results in an extract containing impurities. If, during the extraction of hydrolyzed urine, an amino (NH2) column is placed in series with the C18 column, then one obtains a sample that is sufficiently clean for gas-chromatographic analysis. Analytical recovery of dehydroepiandrosterone from urine is considerably decreased by the use of increasing amounts of Helix pomatia enzyme preparation. Extraction of the steroid conjugates from urine with C18 columns before the hydrolysis stage is essential for hydrolysis with an amount of enzyme preparation that suffices for complete splitting of the polar steroid conjugates but not so much as to cause insufficient analytical recovery of dehydroepiandrosterone.

The need for a sufficient number of low level sera in comparisons of different serum vitamin B12 assays.

Eight radiochemical methods for the assay of vitamin B12 in serum were compared with the microbiological assay with Lactobacillus leichmannii ATCC 7830 using 198 individual sera of patients. There was a good agreement between the results of most samples with some kits and the microbiological assay. However, especially in the sera of vitamin B12-deficient patients large discrepancies between the results could occur. These variations were due to both the kits used and the performance of the assays in different laboratories. A sufficient number of non-pooled sera of vitamin B12-deficient patients should be included in investigations to validate radiochemical methods.

Automation in the hematology laboratory.

In the routine laboratory for hematology conflicting results may be obtained for the red blood cell parameters with the Coulter Counter Model S. These parameters2) are: mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC). When the values of the MCHC are above 36 g/dl something must be wrong with the blood sample of the patient. One of the reasons can be agglutination e.g. by cold agglutinins. The blood sample should be reanalysed before and after heating for 1 hour at 37 degrees C. If the values change: cold agglutinins are present; if no change occurs paraproteins, or other disturbing factors, such as bilirubin or high leucocyte levels, will be found. MCH values may also be high in some cases e.g. if the red blood cells are coated with antibodies (Coombs test positive) or after ingestion of medicines like Azathioprine. These examples show that it is possible in some cases to correlate immunological findings with the red blood cell parameters. In addition to the results with the Coulter Counter Model S, some observations on the Hemalog (Technicon) are also presented.

Quality control in hematology by means of values from patients.

The results of the analyses which were obtained with the Hemalog for the determination of platelets, white blood cells, red blood cells, hemoglobin and hematocrit were statistically analysed for the quality control of the determinations. Now that the testing method has been applied for 6 months, it appears from the results that it is extremely suitable for the determination of hemoglobin, red blood cells and the hematocrit and, to a lesser extent, for white blood cells and platelets.

A systematic investigation on the Hemalog.

The Hemalog system is an automated hematological instrument. From one sample this instrument determines the value for platelets (PBC), white blood cells (WBC), red blood cells (RBC), hemoglobin (Hb) and the hematocrit simultaneously. Moreover the system calculates the derived values: the mean cell volume (MCV), mean cell hemoglobin (MCH) and the mean cell hemoglobin concentration (MCHC). The values were investigated for cross sample contamination, coincidence, reproducibility, and compared with other methods. From this comparative study we can conclude that the Hemalog is a suitable and reliable instrument for hematological determination.