Creatine-kinase MB mass: age and sex-associated reference limits in two different platforms that use the same method.

BACKGROUND: Recent updated NACB guidelines suggest that troponins are the biomarker of choice for the detection of myocardial necrosis, but the CK-MB mass is still considered an effective and alternative indicator when troponin assays are not available. The aim of the present study was to compare the reliability of two different analytical platforms in establishing the gender-specific 99th percentile for the CK-MB mass. METHODS: Serum samples collected from healthy subjects were investigated in two different laboratories, LAB 1 (354 subjects: 222 men, 132 women; median age, 40 years, range 19-64 years) and LAB 2 (330 subjects: 224 men, 106 women; median age, 41 years, range 18-71 years), in order to determine the CK-MB mass (microg/L) using the Access((R)) CKMB method (Beckman Coulter), a two-site immunoenzymatic sandwich assay, on UniCel DxI 800 (LAB 1) and Access((R)) 2 (LAB 2) analyzers (Beckman Coulter). The related plasma samples (lithium-heparin) were also evaluated in LAB 2. RESULTS: Total imprecision (CV%), calculated in control materials, ranged from 6.00 to 9.05 (concentration range, 3.82-36.37) in LAB 1 and from 7.05 to 5.02 in LAB 2 (concentration range, 3.63-34.18). A statistically significant gender-related difference (p<0.05) was found in the whole population studied, values in men being higher than those in women: median=1.86 vs 1.22; 99th percentile=7.64 vs 5.19. The median values in subjects aged 18-28 years (group 1) were lower than those in the other 4 groups (2-5): 1.12 vs 1.59, vs 1.78, vs 1.95 and vs 2.03. The same age-related trend was also observed for CK-MB plasma values, which were comparable to those observed in the matched-serum samples: median 1.12 vs 1.10 (group 1), 1.45 vs 1.50, (group 5). CONCLUSIONS: The two different analytical platforms provide comparable results. The finding that CK-MB mass values are significantly higher in males than in females represents a relevant information, that will impact on patient classification when a myocardial necrosis has been suspected. Actually, however, numerous assays commercially available, lack of this information.

[Immunoglobulinic fragments of urinary proteins in patients affected by acute pneumonopathies, lung cancer and tuberculosis (author's transl)]. / Frammenti immunoglobulinici delle proteine urinarie nei portatori di pneumopatie acute, neoplasie polmonari e tubercolosi.

This study reports the immunoelectrophoretic analysis performed on 95 samples of urinary proteins. This analysis shows that in the majority of cases the migrant proteins in gamma position are F(ab) and Fc fragments, and free light chains with a molecular weight between 70,000 and 10,000. There is evidence of an increase in the immunoglobulinic fragments during inflammatory processes and their disappearance afterwards. This phenomenon proves that the elimination of these fragments evidences an increased synthesis of immunoglobulins and consequently also an increased catabolism.

[Role of alpha 1-antitrypsin and alpha-2 macroglobulin in hepatopathies]. / Ruolo dell'alpa 1-antitripsina e dell'alfa 2-macroglobulina nelle epatopatie.

Two pictures of alpha 1-antitrypsin deficiency, one associated with alpha 2-macroglobulin deficiency and one isolated case of the latter deficiency have been observed in three patients suffering from cirrhosis of the liver and/or hepatoma. On the basis of these cases, the literature on the subject is reviewed. The unusually high incidence of such anti-enzymatic deficiencies (three cases in the first eleven patients studied) in severe liver pathology, calls for a reassessment of such research and suggests that these tests should be carried out on a routine basis in cases of cryptogenetic cirrhosis and probably for long-term prognosis in cases of viral hepatitis.

[Local synthesis of immunoglobulins in pleural effusions. II]. / Sintesi locale di immunoglobuline nei versamenti pleurici. Nota II.

A report is given about the synthesis of IgG immunoglobulins in the pleural infiltrations. The quantity of immunoglobulins locally yielded is estimated through the ratio IgG/Albumin in the blood and in the infiltration. Evidence is given that the mechanic and neoplastic transudates are easily detectable on account of the failed local synthesis of immunoglobulins of IgG type. A short account is given of the local synthesis of IgA.

[Advantages of the combination of the technics of double arc precipitation analysis and of scaled dilutions in the study of asymptomatic monoclonal gammopathies]. / Vantaggi dell'associazione delle tecniche di analisi del doppio arco di precipitazione e delle diluizioni scalari nello studio delle gammopatie monoclonali asintomatiche.

A report is given about the opportunity and the advantages of combining the traditional scheme for the study of the pathological immunoglobulins with the analysis of the uncoupling of the bow of precipitation against IgG and the isolation of the pathological immunoglobulin through a diluition of the serum such as to bring the fraction electrophoretically dispersed to not detectable levels and make it detectable the monoclonae portion electrophoretically homogeneous.

[Proposal for an organic scheme for the survey of the proteins in the spinal fluid (author's transl)]. / Proposta di uno schema organico per lo studio delle proteine del liquido cefalo - rachidiano.

A simple technique of electroimmunodiffusion is described, which is fit for identifying the variations in the ratio IgG/Albumin in the spinal fluid (liquor). Furthermore a general scheme for the survey of the proteic situation in the spinal fluid is also proposed.

[Contributions to the interpretation of the immunoglobulins's variations in the bronchial secretions (author's transl)]. / Contributi all'interpretazione delle variazioni delle immunoglobuline nell'espettorato

Study of the relationships between the variations of the connections between the components of the bronchial secretion and the viscosity of the sputum, with particular regard to the role of the IgA IIS and to the secretory piece.

[Bidimensional I.E.F. of proteins in the bronchial secretion (author's transl)]. / Immunoelettroforesi bidimensionale di proteine del secreto bronchiale

Qualitative and quantitative determination of the proteins in the bronchial secretions (of about 50 patients suffering from chronic bronchitis) after extraction.

[Introduction to a study of the hydrosoluble proteins of the sputum (author's transl)]. / Premessa per uno studio delle proteine idrosolubili dell'espettorato

Synthesis of a study of the proteins outline of the bronchial secretion with the qualitative and quantitative determination of six protein fractions (albumin, Alfa-antitrypsin, acid Alfa-glycoprotein, haptoglobin, transferrin); comparation of the concentration of these fractions of the expectoration with those of the serum of the patient himself.