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See detailAutomated quantification of creatinine kinase MB isoenzyme in serum by radial partition immunoassay, with use of the Stratus analyzer
Chapelle, Jean-Paul ULg; El Allaf, M.

in Clinical Chemistry (1990), 36(1), 99-101

We evaluated the analytical and clinical performances of a new radial partition immunoassay for measuring the mass concentration of creatine kinase (CK)-MB in serum. All pipetting, washes, incubations and ... [more ▼]

We evaluated the analytical and clinical performances of a new radial partition immunoassay for measuring the mass concentration of creatine kinase (CK)-MB in serum. All pipetting, washes, incubations and data reduction were performed in 8 min by the Stratus (Dade) fluorometric analyzer. Within-assay and between-assay CVs were respectively 5.5% and 8.4% at 21 micrograms/L, and 4.2% and 3.4% at 48 micrograms/L. Assaying serial dilutions of serum samples with high CK-MB concentrations demonstrated excellent linearity. Results of the Stratus technique correlated well (n = 115, r = 0.98) with those of the Tandem-E CKMB II assay. There was no interference from hemolysis, bilirubin, rheumatoid factor, or added CK-MM (up to 3500 U/L); consequently, CK-MB can be determined in undiluted serum, even in the presence of high total CK activity. The mean CK-MB concentration in 105 blood donors was 1.9 (SD 1.3) micrograms/L. For seven myocardial infarction patients who received prompt fibrinolytic therapy, the mean CK-MB concentration was 4.5 (SD 1.8) micrograms/L at admission, and maximum concentrations, 119 (SD 94) micrograms/L, were recorded 16 h later. CK-MB returned to concentrations less than 10 micrograms/L within 72 h. [less ▲]

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See detailUsefulness of CRP determination after acute myocardial infarction
Chapelle, Jean-Paul ULg; El Allaf, M.; Pierard, Luc ULg et al

in Clinical Chemistry (1990), 36

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See detailClinical evaluation of a nephelometric myoglobin immunoassay
Dati, F.; Lammers, M.; Kapmeyer, W. H. et al

in Clinical Chemistry (1990), 36

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See detailEvolution of serum CK-MB isoforms after acute myocardial-infarction
Chapelle, Jean-Paul ULg

in Clinical Chemistry (1989, June), 35(6), 1120

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See detailChanges in isoform patterns and stability of CK-MB during storage
El Allaf, M.; Chapelle, Jean-Paul ULg

in Clinical Chemistry (1989), 35

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See detailCerebrospinal fluid IgG and IgM indexes as indicators of active neurosyphilis
Hische, EAH; Tutuarima, JA; Wolters, EC et al

in Clinical Chemistry (1988), 34

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See detailDifferentiating muscle damage from myocardial injury by meaans of the serum creatinine kinase (CK) isoenzyme MB mass measurement/total CK activity ratio
el Allaf, M.; Chapelle, Jean-Paul ULg; El Allaf, Dia ULg et al

in Clinical Chemistry (1986), 32(2), 291-5

We immunoenzymometrically measured creatine kinase (CK) isoenzyme MB in extracts of myocardium and in homogenates of five different skeletal muscles. CK-MB concentrations in the former averaged 80.9 ... [more ▼]

We immunoenzymometrically measured creatine kinase (CK) isoenzyme MB in extracts of myocardium and in homogenates of five different skeletal muscles. CK-MB concentrations in the former averaged 80.9 micrograms/g wet tissue; in the skeletal muscles it varied widely, being (e.g.) 25-fold greater in diaphragm than in psoas. CK-MB in skeletal muscles ranged from 0.9 to 44 ng/U of total CK; the mean for myocardium was 202 ng/U. In sera from 10 trauma and 36 burn patients without myocardial involvement, maximum ratios for CK-MB mass/total CK activity averaged 7 (SEM 1) ng/U and 18 (SEM 6) ng/U, respectively. Except for an infant (220 ng/U), the highest ratio we found for serum after muscular damage was 38 ng/U. In contrast, the mean maximum ratio determined in 23 cases of acute myocardial infarction exceeded 200 ng/U. Among seven determinations performed 8 to 32 h after onset of symptoms, each infarct patient demonstrated at least one ratio greater than or equal to 110 ng/U. Ratios observed after infarct were unrelated to treatment received during the acute phase. We propose a CK-MB/total CK ratio of 80 ng/U as the cutoff value for differentiating myocardial necrosis from muscular injury. [less ▲]

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See detailThe immunochemical determinations of serum lipase in acute pancreatitis: further results.
Adam, A.; Boulanger, J.; Chapelle, Jean-Paul ULg et al

in Clinical Chemistry (1986), 32(10), 1987

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See detailDetection of anti-laminin antibodies in sera by latex agglutination.
Bernard, A. M.; Foidart, Jean-Michel ULg; Mahieu, P. et al

in Clinical Chemistry (1986), 32(8), 1468-72

We describe a latex particle agglutination assay for detecting circulating antibodies against laminin, a noncollagenous glycoprotein of basement membranes. Polystyrene latex particles on which laminin has ... [more ▼]

We describe a latex particle agglutination assay for detecting circulating antibodies against laminin, a noncollagenous glycoprotein of basement membranes. Polystyrene latex particles on which laminin has been adsorbed are incubated with serum for about 25 min at 42-45 degrees C. The agglutination is then measured by counting residual unagglutinated particles. Polyethylene glycol 6000 enhances the agglutination. The assay is fully automated, yielding results in about 45 min, for 50 samples per hour. Addition of purified laminin abolishes the agglutination of laminin-coated particles in practically all positive sera. The anti-laminin antibody titers obtained by this latex immunoassay and by radioimmunoassay correlated well in 161 sera from patients with suspected or established renal diseases. The agglutination assay more frequently gave positive results for cases of glomerulonephritis with linear deposits (20/22 cases) than for glomerulonephritis with granular deposits (7/68) or glomerulonephritis with no glomerular deposits (2/13). The finding of low anti-laminin antibody titers in sera from about 15% (34/230) of the healthy subjects suggests that these autoantibodies are pathogenic only in certain circumstances. [less ▲]

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See detailInfluence of oral contraceptives and pregnancy on constituents of the kallikrein-kininogen system in plasma.
Adam, Albert; Albert, Adelin ULg; BOULANGER, Josianne ULg et al

in Clinical Chemistry (1985), 31(9), 1533-6

We measured kininogens of low and high molecular mass along with prokallikrein activity in plasma of women with a normal menstrual cycle. We observed no difference between results for the follicular and ... [more ▼]

We measured kininogens of low and high molecular mass along with prokallikrein activity in plasma of women with a normal menstrual cycle. We observed no difference between results for the follicular and luteal phases. We assayed the same constituents in women who were taking oral contraceptives (combined estroprogestative) and found that activity of prokallikrein and concentrations of low- and high-molecular-mass kininogens were significantly increased. Lastly, we studied the components of the kallikrein-kininogen system during pregnancy. We also observed a marked increase in their concentrations in plasma, despite a decrease in total proteins. Specifically, prokallikrein and kininogens increase continuously with gestational age, reaching their maxima around the eighth month of pregnancy. At that time, more than 50% of observed results fall outside the normal reference interval. Our observations are even more striking when prokallikrein and kininogens are expressed in units per gram of total proteins, to account for the hemodilution. After delivery, the concentrations of prokallikrein and low- and high-molecular-mass kininogens decline promptly, returning to normal within three days. [less ▲]

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See detailHuman kininogens of low and high molecular mass: quantification by radioimmunoassay and determination of reference values.
Adam, Albert; Albert, Adelin ULg; Calay, G et al

in Clinical Chemistry (1985), 31(3), 423-6

Kininogens of low and high molecular mass, highly purified from human plasma, were used to raise antisera in rabbits. To obtain immunologically intact tracers, we labeled the kininogens by the lodogen ... [more ▼]

Kininogens of low and high molecular mass, highly purified from human plasma, were used to raise antisera in rabbits. To obtain immunologically intact tracers, we labeled the kininogens by the lodogen method, followed by double chromatography, first on Sephadex G50 and then on Sephadex G200 for high-molecular-mass kininogen or on G100 for low-molecular-mass kininogen. Both assays are sensitive, accurate, and reproducible. On an equimolar basis, the high-molecular-mass kininogen cross reacted completely in the determination of low-molecular-mass analyte. Moreover, the radioimmunoassay for the former was highly specific. After optimizing the time and temperature of incubation to provide rapid and reliable results, we determined 95% reference intervals from a large sample of healthy subjects (250 men, 200 women): 109-272 and 69-116 mg/L for the low- and high-molecular-mass kininogens, respectively. [less ▲]

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See detailOn the interpretation of serial laboratory measurements in acute myocardial infarction.
Albert, Adelin ULg; Harris, E. K.; CHAPELLE, Jean-Paul ULg et al

in Clinical Chemistry (1984), 30(1), 69-76

Serial laboratory determinations are now routinely performed on patients admitted to intensive-care units. Adequate interpretation of such cumulative information for clinical decision-making purposes is a ... [more ▼]

Serial laboratory determinations are now routinely performed on patients admitted to intensive-care units. Adequate interpretation of such cumulative information for clinical decision-making purposes is a challenging problem. We describe a statistical method for predicting--sequentially as the data become available--the patient's outcome, death or survival. Thus, the method goes beyond previously reported techniques that base such prediction on only a single multivariate observation. The method has been applied to daily measurements of serum urea and lactate dehydrogenase, performed during one week on patients hospitalized in the coronary-care unit with acute myocardial infarction. Two baseline variables were also included in the dynamic risk index so derived: the age of the patient and the number of previous myocardial infarctions recorded on admission. We also discuss the problems of selecting the most-predictive laboratory tests and of determining for each test the amount of past data needed to achieve satisfactory prediction. We distinguish between global evaluation of the dynamic risk index obtained (in terms of specificity and sensitivity) and individual interpretation (in terms of posterior/prior probability ratio) of a given risk score for a particular patient. The approach described may contribute to more effective use of results of repeated laboratory tests on critically ill patients. [less ▲]

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See detailEfficient biochemical monitoring and survival assessment after an acute myocardial infarction
Albert, Adelin ULg; Chapelle, Jean-Paul ULg; Heusghem, C. et al

in Clinical Chemistry (1984), 5(abstr suppl.1), 187

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See detailSerum creatine kinase: relationship to lean body mass in a "real-life" situation
Mairiaux, Philippe ULg; Buchet, J. P.; Bettonville, M. N.

in Clinical Chemistry (1984), 30(8), 1428-9

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See detailDoes lactate dehydrogenase isoenzyme-5 contribute to the predictive power of total lactate dehydrogenase in myocardial infarction?
Chapelle, Jean-Paul ULg; Albert, A.; Smeets, J. P. et al

in Clinical Chemistry (1983), 29(5), 774-7

In 385 patients with acute myocardial infarction, lactate dehydrogenase (LD; EC 1.1.1.27) isoenzymes were determined electrophoretically 24, 48, and 72 h after admission. At those times, LD-1/LD-2 ratios ... [more ▼]

In 385 patients with acute myocardial infarction, lactate dehydrogenase (LD; EC 1.1.1.27) isoenzymes were determined electrophoretically 24, 48, and 72 h after admission. At those times, LD-1/LD-2 ratios exceeding 1 were recorded in 78.9, 88.8, and 92.2% of the cases, respectively. LD-1 ranged from 181 to 2674 U/L, or 21.9 to 66.1% of the total activity. On the first day of hospitalization, 27.3% of the patients demonstrated abnormal LD-5 (greater than 6% of total LD); this finding dropped to 20.5% and 17.4% in the two following days. Early increases in LD-5 were most frequently observed in patients associating inferior infarcts with posterior or lateral extension and having a previous history of myocardial infarction. On day 1, LD-5 was significantly increased in early deceased patients as compared to long-term survivors (9.7% vs 4.9% of total LD, p less than 0.01). LD-5 definitely contributes to the prognostic efficiency of total LD in acute myocardial infarction, but does not replace it as a risk predictor. This study confirms the superiority of total LD over the isoenzyme measurements to achieve short-term prognostication [less ▲]

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See detailImproved use of serial laboratory data in acute myocardial infarction
Albert, Adelin ULg; Chapelle, Jean-Paul ULg; Heusghem, C. et al

in Clinical Chemistry (1983), 28

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See detailprognostic value of combined data on enzymes and inflammation markers in plasma in cases of severe head injury
Bourguignat, A.; Albert, Adelin ULg; Férard, G. et al

in Clinical Chemistry (1983), 29

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See detailOn the use and computation of likelihood ratios in clinical chemistry.
Albert, Adelin ULg

in Clinical Chemistry (1982), 28(5), 1113-9

The clinical relevance of likelihood ratios (L-values) for revising the physician's diagnostic probabilities has been recognized. However, the calculation of L-values, particularly in the case of ... [more ▼]

The clinical relevance of likelihood ratios (L-values) for revising the physician's diagnostic probabilities has been recognized. However, the calculation of L-values, particularly in the case of quantitative or mixed quantitative-binary test results, raises problems that have not yet been addressed. Based on a very general assumption that yields a simple functional form for the likelihood ratio, a method is developed that allows such calculations regardless of the nature and the number of clinical laboratory tests to be interpreted simultaneously. Hence the notion of predictive value (posterior probability) is extended from binary or dichotomized tests to quantitative tests, and from univariate to multivariate clinical laboratory results. The simplicity and flexibility of this approach eliminates difficulties in computation arising from the addition of new data to an existing data base. It is hoped that this method will now allow L-values to be reported along with the original test results in daily laboratory practice. [less ▲]

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See detailFurther heterogeneity demonstarted for serum creatine kinase isoenzyme MM
Chapelle, Jean-Paul ULg; Heusghem, C.

in Clinical Chemistry (1980), 26(3), 457-62

Serum creatine kinase (EC 2.1.3.2) isoenzyme MM was resolved by isoelectric focusing into a five-band pattern, a pattern that gradually changed after the onset of myocardial infarction. Similar changes ... [more ▼]

Serum creatine kinase (EC 2.1.3.2) isoenzyme MM was resolved by isoelectric focusing into a five-band pattern, a pattern that gradually changed after the onset of myocardial infarction. Similar changes were also demonstrated in patients undergoing coronary-bypass surgery. The evolution of two CK-MB sub-bands was studied in both cases. We found that three electrophoretic bands (CK-MM, pI 7.10; MM1, pI 6.88; MB1, pI 5.61) were predominant in patterns for sera collected during the early phase of myocardial infarction, but rapidly disappeared during the following hours, whereas bands of increased electrophoretic mobility (MM2, pI 6.70; MM3, pI 6.45; MM4, pI 6.25; MB2, pI 5.34) gradually increased. MM3 was always the major band at the end of the observation period in acute myocardial infarction (mean, 61.4% of total creatine kinase activity 36 h after the peak value for total creatine kinase in serum). The CK-MM bands were also present in the serum of patients without heart disease. Changes in the electrophoretic pattern were induced by a thermolabile factor in normal human serum, which transformed the muscular or myocardial MM and MM1 bands after their release into the blood stream [less ▲]

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