Biotin immunoassay interference: A UK-based prevalence study.

BACKGROUND: Biotin interference in biotin-streptavidin-based immunoassays is increasingly reported due to individuals taking biotin-containing supplements and patients prescribed biotin. The reported prevalence of serum biotin above the lowest threshold (≥10 µg/L) for interference in Roche Diagnostics immunoassay tests is 0.8% in Australia and 7.4% in the USA. There are, however, no such data in UK populations. In a service evaluation, we therefore studied the prevalence of biotin interference in routine serum samples received in our laboratory. METHODS: Biotin was measured in 524 anonymized surplus serum samples in which at least one immunoassay test had been requested. RESULTS: The median (95% confidence intervals) for serum biotin was 0.27 µg/L (0.07-0.93 µg/L). Serum biotin was <10 µg/L in all samples, <5 µg/L in 522 (99.6%) and <1 µg/L in 513 (98.1%) samples. In four samples, serum biotin was ≥2.5 µg/L (0.8%). CONCLUSIONS: These data indicate that the probability of biotin immunoassay interference in our patient population is extremely low, with the exception of assays reporting the lowest interference thresholds (e.g. Ortho Troponin I assay [threshold ≥2.5 µg/L]).

Activity of phasic motor neurons partially transforms the neuronal and muscle phenotype to a tonic-like state.

We present a model preparation, the crayfish, to investigate chronic stimulation effects in muscle fiber type and neuronal conversion from fast to slow. The results show a presynaptic alteration in transmitter release after 1 week of stimulation at 5 Hz for a 2-h daily regime. With the same stimulation paradigm, the muscle proteins displayed on a polyacrylamide gel only start to show changes after 3 weeks. The original phasic motoneurons within 1 week display an enhanced ability to resist synaptic depression, as do tonic motoneurons. The results show that identified phasic motoneurons and muscle fibers in the crayfish can be transformed to a toniclike state, and that the nerve terminals convert prior to the muscle fibers. Electrophysiological clinical measures indicating a change in transmitter release properties may not necessarily mean that the muscle fibers have fully adapted for long-lasting effects. This preparation allows stimulation conditions to be examined with ease.

The inhibition of human adrenal steroidogenic enzyme activities by suramin.

Suramin has recently been used to treat patients with acquired immune deficiency syndrome because of the action of this drug on reverse transcriptase. Patients so treated developed the symptoms and hormonal profiles of adrenal insufficiency. To evaluate the mechanism of action of suramin on adrenalcortical function, adrenal mitochondrial and microsomal preparations from five subjects were assayed for steroidogenic enzyme activity in the presence and absence of suramin. Specifically, 3 beta-hydroxysteroid dehydrogenase/isomerase, 17 alpha-hydroxylase, 21-hydroxylase, 11 beta-hydroxylase, and 17,20-desmolase activities were measured in the presence of 0-5000 mumol/L suramin concentrations. In all assays, enzyme activities decreased in a dose-dependent fashion as suramin concentrations increased. The drug doses (calculated) that caused 50% inhibition of enzyme activity were: 21-hydroxylase activity, 50 mumol/L; 17 alpha-hydroxylase activity, 25 mumol/L; 17,20-desmolase activity, 50 mumol/L; 11 beta-hydroxylase, 2 mumol/L, and 3 beta-hydroxysteroid dehydrogenase/isomerase, 1200 mumol/L. These results suggest that suramin has a concentration-dependent inhibitory effect on the key P-450-regulated enzymatic steps in adrenal glucocorticoid steroidogenesis, which may explain the development of adrenal insufficiency in acquired immune deficiency syndrome patients treated with suramin.

Ketoconazole inhibits multiple steroidogenic enzymes involved in androgen biosynthesis in the human ovary.

Ketoconazole (KZ) has been shown to inhibit testicular and adrenal steroidogenesis and is useful in the medical management of gonadotropin-independent precocious puberty, prostatic cancer, and Cushing's syndrome. To determine whether KZ similarly affects ovarian steroidogenesis, the authors examined its effect on the activity of the human ovarian 3 beta-hydroxysteroid dehydrogenase/isomerase (3 beta-HSD), 17-hydroxylase (17-OH), and aromatase (AR) in vitro. A dose-dependent decrease in the activities of 3 beta-HSD and 17-OH was observed with increasing amounts of KZ. With 10, 50, and 100-fold excess KZ, the activity of 3 beta-HSD decreased by 59% (P less than 0.001), 73% (P less than 0.005), and 85% (P less than 0.005), respectively. At equimolar concentrations with substrate (50 microM), KZ inhibited 17-OH by 70% (P less than 0.01). No significant effect on ovarian AR activity was observed, except at the highest concentration of KZ tested. The authors conclude that low concentrations of KZ profoundly inhibit the activity of human ovarian 3 beta-HSD and 17-OH in vitro. These observations suggest that KZ might be useful in the medical management of women with hyperandrogenism, but further experimentation and clinical trials will be necessary.

Formation of the rupture site in preovulatory hamster and mouse follicles: loss of the surface epithelium.

Changes in the morphology of epithelial cells covering the sides and apex of ovarian follicles were examined in mice and hamsters during the final 13 hr before rupture using light and electron microscopy. At the time of the surge of luteinizing hormone, approximately 13 hr before follicle rupture, epithelial cells along the follicle sides are spherical, covered with microvilli, and remain so throughout the entire cycle. As ovulation approaches, cells at the apex become progressively flatter, increase in diameter, and undergo a reduction in the number and length of microvilli. By 2 hr before ovulation, the microvilli are present only along the boundary between adjacent cells and the cells are in different stages of degeneration. In some cells, the cytoplasm is electron dense and the nuclei are pyknotic. Other cells become electron lucent and cytoplasmic elements are leached from the cell. The apical plasma membrane is lost first over the center of the cell and later over the periphery. Epithelial cells detach from the apex individually until a large patch devoid of cells is formed. This includes the site of eventual rupture. The loss of epithelial cells from the apex of ovarian follicles of other species is compared with our results, and the processes involved in stretching, degeneration, and sloughing of the epithelial cells are discussed.

Gilles de la Tourette's syndrome in identical twins.

The problem we studied relates to the inheritance of Gilles de la Tourette's syndrome. The method was the investigation, including blood studies, of a pair of twins who both were affected with the syndrome. It was concluded that the twins were identical and this added to the evidence of the heritability of the disorder. The twins were affected with other but related problems of behavior; considerable similarities were found in their behavior and behavioral problems. No family history of this or tic-like disorders could be obtained. Reduction of tics occurred when haloperidol treatment began.

Segregation and linkage analysis of a large kindred of unipolar depression.

We studied segregation and linkage in a large kindred of unipolar depression. We subtyped the kindred on the basis of best fit to a single gene model and found that the cluster of "definite and probable depression, alcoholism, and drug dependency" gave the best fit. Since this is essentially the definition of depression spectrum disease (DSD), this was considered to be a DSD kindred. Using this definition of "affected" the genetic model provided a better fit to the data than the environmental model, although the difference was not statistically significant. A linkage analysis using 30 genetic markers did not suggest linkage at any of the loci tested. Finally, there was no evidence for an association between DSD and any of the 30 genetic markers.

Values and the moral context of pastoral counseling.

This paper reviews the ways in which psychology has influenced the pastoral counseling movement, focuses, upon how the role and function of the pastoral counselor have lost their unique identity, and offers the construct of a moral context as a means for rediscovering, identifying, reviving, and strengthening the pastoral counselor's professional and spiritual selfimage.