1
|
Van Der Veken E, Laureys M, Rodesch G, Steyaert H. Perioperative spleen embolization as a useful tool in laparoscopic splenectomy for simple and massive splenomegaly in children: a prospective study. Surg Endosc 2016; 30:4962-4967. [PMID: 26961344 DOI: 10.1007/s00464-016-4838-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 02/18/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The purpose of this prospective study is to evaluate the efficiency of perioperative spleen embolization prior to laparoscopic splenectomy indicated for hypersplenism. METHODS We conducted a prospective study exploring a technique combining ultra-selective perioperative embolization and splenectomy. Between January 2008 and March 2013, 16 splenectomies were performed in children suffering from hypersplenism due to varying hematologic diseases. Spleen embolization was performed by an interventional radiologist in the operating room (OR) just before splenectomy and during the same general anesthesia. Ages varied from 3 to 17 years. Spleen volume was measured by preoperative ultrasound. One patient underwent a laparotomy because of suspected adhesions due to previous surgery. All other operations were performed laparoscopically. RESULTS One complication arose from embolization: a perforation of the splenic artery. After immediately placing a platinum coil proximal to the perforation, the splenectomy was carried out as usual. Fourteen children (87.5 %) had splenomegaly, of which eight (50 %) had massive splenomegaly. There were no deaths, no conversions to laparotomy, no reoperations and none of these patients had to be transfused. CONCLUSIONS Perioperative spleen embolization performed in the OR by an interventional radiologist makes laparoscopic splenectomy a safer procedure. We propose a preoperative method for spleen measurement that is adapted to children: simple and massive splenomegaly is defined through patient body weight and a preoperative ultrasound. We conclude that spleen size is no more a limiting factor for laparoscopic splenectomy in children.
Collapse
Affiliation(s)
- E Van Der Veken
- Department of Pediatric Surgery, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, ULB, Brussels, Belgium.
| | - M Laureys
- Department of Radiology, CHU Brugmann, Université Libre de Bruxelles, ULB, Brussels, Belgium
| | - G Rodesch
- Department of Pediatric Surgery, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, ULB, Brussels, Belgium
| | - H Steyaert
- Department of Pediatric Surgery, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, ULB, Brussels, Belgium
| |
Collapse
|
2
|
Vos B, Laureys M. [Giant renal cyst as cause of colic obstruction]. Rev Med Brux 2009; 30:107-109. [PMID: 19517907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A 97-year old woman presented with a 2-months history of asthenia, loss of appetite, nauseas and intermittent diarrhea. She presented an important colic distension associated to an inflammatory syndrome. Microbiological documentation (blood, urine, saddles stool) was negative. Abdominal computed tomography (CT) showed a 15 cm of diameter (giant) right cortical renal cyst with colic obstruction by external colic compression. A percutaneous cyst drainage was performed allowing the evacuation of 1,500 cc. The fluid culture was positive for Raoultella ornithinolytica and Enterococcus faecalis. No antibiotics were given but inflammatory syndrome remained within normal value. Colic function remained normal.
Collapse
Affiliation(s)
- B Vos
- Service de Gériatrie, C.H.U. Brugmann, Bruxells.
| | | |
Collapse
|
3
|
Mikhalski D, Hoang AD, Bollens R, Laureys M, Loi P, Donckier V. Gonadal vein reconstruction for extension of the renal vein in living renal transplantation: two case reports. Transplant Proc 2007; 39:2681-4. [PMID: 17954206 DOI: 10.1016/j.transproceed.2007.08.088] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND When the left kidney is harvested for living donor transplantation (LDKT), the short length of the left renal vein may eventually created a technical problem for reimplantation of the graft. We report an original technique, using the donor gonadal vein to extend the left renal vein and facilitate graft implantation. CASE REPORT In the first case, the native graft gonadal vein was successfully used to extent a short renal vein after laparoscopic donor nephrectomy. The graft gonadal vein was utilized for the creation of graft venous return in the second case. Good graft function was observed in both cases. DISCUSSION This original technique could lead to a functionally acceptable anastomosis without use of supplementary donor or recipient vascular tissue and ultimately to good organ function without increased peri- or postoperative morbidity during LDKT. A precise preoperative assessment of donor vascular anatomy is a key factor for donor safety and successful LDKT.
Collapse
Affiliation(s)
- D Mikhalski
- Digestive Surgery, Clinic of Abdominal Transplantation, Hôpital Erasme, Université Libre de Bruxelles, 808 route de Lennik, 1070 Brussels, Belgium
| | | | | | | | | | | |
Collapse
|
4
|
|
5
|
Masudi-Mutimbu J, Vokaer M, Laureys M, Bier JC. Images in neurology - latrogenic subdural hematoma. Eur J Neurol 2006; 13:549. [PMID: 16722986 DOI: 10.1111/j.1468-1331.2006.01218.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
6
|
Naeije G, Hanappe V, Laureys M, Masudi J, Vokaer M, Bier JC. [Misdiagnosis of sinus thrombosis with reversible posterior leucoencephalopathy]. Rev Med Brux 2006; 27:181-3. [PMID: 16894957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Reversible posterior leucoencephalopathy and cerebral venous thrombosis share many symptoms. Both of them may lead to coma, and cause epilepsy or focal neurological signs. Moreover, diffuse leucoencephalopathy can be observed in both cases. Cerebral venous thrombosis needs anticoagulation which is not a riskless treatment. We describe a case of reversible posterior leucoencephalopathy in an hypertensed, seventy-year old man, presenting with a left lateral sinus hypoplasia whose clinical history and paramedical results first suggested a cerebral veinous thrombosis. Our case shows the misleadings a congenital vascular asymmetry can induce when confronted with a subacute coma.
Collapse
Affiliation(s)
- G Naeije
- Service de Neurologie, Hôpital Erasme, Bruxelles
| | | | | | | | | | | |
Collapse
|
7
|
Laureys M, Akkari K, De Smet JM. [Sudden onset of hemoptysis during (coil) embolization of a Swan-Ganz catheter induced pseudoaneurysm of the pulmonary artery]. Rev Med Brux 2006; 27:99-102. [PMID: 16736848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
We report the embolization of a pulmonary artery pseudoaneurysm consecutive to Swan-Ganz catheterization. Embolization was successful despite an iatrogenic rupture and a massive hemoptysis.
Collapse
Affiliation(s)
- M Laureys
- Services de Radiologie, Hôpital Erasme
| | | | | |
Collapse
|
8
|
Penaloza A, Laureys M, Wautrecht JC, Lheureux P, Motte S. Accuracy and safety of pretest probability assessment of deep vein thrombosis by physicians in training using the explicit Wells clinical model. J Thromb Haemost 2006; 4:278-81. [PMID: 16409489 DOI: 10.1111/j.1538-7836.2005.01740.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
9
|
Laureys M, Akkari K, De Wilde JP. Arteriomegaly. Cardiovasc Intervent Radiol 2005; 28:358-9. [PMID: 15886945 DOI: 10.1007/s00270-004-0144-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- M Laureys
- Department of Cardiovascular Imaging and Interventional Radiology, Hopital Erasme, Brussels, Belgium.
| | | | | |
Collapse
|
10
|
Journé S, De Simone P, Laureys M, Le Moine O, Gelin M, Closset J. Right hepatic artery pseudoaneurysm and cystic duct leak after laparoscopic cholecystectomy. Surg Endosc 2004; 18:554-6. [PMID: 15115027 DOI: 10.1007/s00464-003-4262-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Laparoscopic cholecystectomy (LC) seems to be associated with an increased risk of biliary or vascular injuries. Hepatic artery pseudoaneurysms (HAP) are rare complications of LC. HAP can occur in the early or late postoperative period. Patients with HAP present with abdominal pain, hemobilia, and liver function test (LFT) alterations. We report the case of a patient who was affected with a cystic duct stump leak associated with a right HAP and was treated by endoscopic biliary drainage and angiographic coil embolization.
Collapse
Affiliation(s)
- S Journé
- Medicosurgical Department of Gastroenterology, Erasmus Hospital, Free University of Brussels, 808 route de Lennik, 1070 Brussels, Belgium
| | | | | | | | | | | |
Collapse
|
11
|
Laureys M, Golzarian J, Antoine M, Desmet JM. Coil Embolization Treatment for Perioperative Pulmanary Artery Rupture Related to Swan-Ganz Catheter Placement. Cardiovasc Intervent Radiol 2004; 27:407-9. [PMID: 15129332 DOI: 10.1007/s00270-004-0164-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
12
|
Laureys M, Tannouri F, Neugroschl C. [New findings in cardiovascular imaging]. Rev Med Brux 2003; 24:A289-97. [PMID: 14606293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Many technologic improvements have allowed cardiovascular imaging to be more efficient and less invasive, especially in cardiac imaging. The main application fields are described. Advantages and disadvantages of two complementary imaging techniques are highlighted: CT-scanner and magnetic resonance imaging.
Collapse
Affiliation(s)
- M Laureys
- Service d'Imagerie Médicale, Département d'Imagerie Cardiovasculaire et Interventionnelle, Hôpital Erasme, U.L.B
| | | | | |
Collapse
|
13
|
Struyven J, Avni F, Balériaux D, Cassart M, David P, Gevenois PA, Golzarian J, Laureys M, Madani A, Matos C, Metens T, Scillia P, Sadeghi N, Stallenberg B, Van Gansbeke D, Zalcman M. [The medical imaging and radiology department]. Rev Med Brux 2003; 23 Suppl 2:79-84. [PMID: 12584918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
Technological developments arising from research have affected the whole wide spectrum of medical endeavor and have made a very significant impact on clinical practice and especially on imaging sciences. Ultrasonography brought spectacular advances, but CT and MRI became important landmark techniques. A further important development, which greatly increased the involvement of radiologists in direct patient management, was the growth of interventional and therapeutic techniques, called interventional radiology. Some statistics: approximately 155,000 patients per year including 19,000 CT Scans, 10,000 MRI exams, 21,000 ultrasound examinations and 1,000 therapeutic procedures. Some research activities: CT quantification of pulmonary emphysema, respiratory mechanics, MR and CT angiography, antenatal diagnosis of congenital and genetic diseases of the fetus, quantification of portal haemodynamics, MR imaging of bile and pancreatic ducts, morphologic and functional imaging of the brain, radiology of bone trauma, MR characterization in hepatic lesions.
Collapse
|
14
|
Laureys M, Roger T, David P, Balériaux D. [Incidental finding of a focal cortical heterotopy in long-term epilepsy]. JBR-BTR 2003; 86:77-9. [PMID: 12839420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
A 72-year-old woman was admitted for the work-up of an abdominal pseudomyxoma. A brain CT was performed and revealed the presence of a tumorlike lesion in the left temporal lobe. The diagnosis of focal heterotopy was suggested and confirmed by MRI. Careful clinical history revealed Grand Mal epilepsy during infancy that was well controlled by antiepileptic drugs. No imaging studies had ever been performed. This case illustrates that the diagnosis of idiopathic epilepsy should be established only after having ruled out brain disorders including heterotopy, which can be demonstrated by MRI.
Collapse
Affiliation(s)
- M Laureys
- Department of Cardiovascular and Interventional Radiology, ULB Hôpital Erasme, Brussels, Belgium
| | | | | | | |
Collapse
|
15
|
Golzarian J, Murgo S, Laureys M, Tannouri F, Struyven J. [Uterine fibroids embolization: a review]. JBR-BTR 2002; 85:7-13. [PMID: 11939221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Uterine artery embolization for symptomatic leiomyomas is a new attractive treatment in patients who do not desire pregnancy and for whom conventional therapy has failed. Uterine fibroid embolization can also be considered for patients who desire pregnancy when myomectomy is technically difficult or/and in case of recurrence after myomectomy. 90% improvements are commonly reported in abnormal bleeding, pelvic pain, and in bulk-related symptoms. This technique allows reduction of the hospital stay, the convalescence period, the morbidity and the mortality rate compared to conventional surgical treatment.
Collapse
Affiliation(s)
- J Golzarian
- Service d'Imagerie Médicale, Hôpital Erasme, Bruxelles, Belgique
| | | | | | | | | |
Collapse
|
16
|
Van der Schueren G, Diltoer M, Laureys M, Huyghens L. Intermittent hemodialysis in critically ill patients with multiple organ dysfunction syndrome is associated with intestinal intramucosal acidosis. Intensive Care Med 1996; 22:747-51. [PMID: 8880242 DOI: 10.1007/bf01709516] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Conventional intermittent hemodialysis in the critically ill patient can be associated with hemodynamic and respiratory instability. Intermittent hemodialysis induced arterial hypotension might be detrimental. We therefore studied the influence of intermittent hemodialysis on systemic and regional oxygen transport in critically ill patients. DESIGN Prospective descriptive study. SETTING Medical/surgical 24-bed intensive care unit in a university hospital. PATIENTS Eleven critically ill patients admitted to the intensive care unit (APACHE III score: 82 +/- 12) and developing multiple organ dysfunction syndrome with acute renal failure. All patients were mechanically ventilated and hemodynamically stable with inotropic support. Systemic oxygen transport variables were calculated, and arterial blood lactate concentration was measured before, during, and after intermittent hemodialysis. Tonometer PCO2 was measured using a tonometer, and arterial-tonometer CO2 gap was used as an indicator of intestinal intramucosal acidosis. RESULTS Intermittent hemodialysis induced an increase in calculated systemic oxygen consumption (P < 0.01). During intermittent hemodialysis there was a significantly higher need of inotropic support (P < 0.05) to maintain arterial blood pressure, cardiac index, and calculated systemic arterial oxygen delivery. The arterial-tonometer CO2 gap increased significantly during and after the procedure. CONCLUSION In critically ill patients with multiple organ dysfunction syndrome intermittent hemodialysis induces an increase in oxygen consumption. Despite higher inotropic support to maintain systemic calculated oxygen delivery intestinal intramucosal acidosis occurs during intermittent hemodialysis and may even persist after the procedure is terminated.
Collapse
Affiliation(s)
- G Van der Schueren
- Department of Intensive Care Medicine, University Hospital, University of Brussels (VUB), Belgium
| | | | | | | |
Collapse
|
17
|
Abstract
Loa loa is a filarial parasite which is mainly confined to West and Central Africa. Although considered as mildly pathogenic for people living in endemic areas, its appearance in other places might be a cause for concern. We report here the unusual finding of Loa loa microfilariae in the follicular aspirate of a 35-year-old black women during oocyte retrieval for in-vitro fertilization. Most likely these microfilariae were aspirated, along with follicular fluid, from the small blood vessels around the ovarian follicles, which are frequently lacerated during ovarian puncture. Despite the spectacular microscopic view of vigorous moving worms trapped on the cumulus cells, the presence of Loa loa microfilariae does not seem to prevent fertilization and cleavage completely.
Collapse
Affiliation(s)
- A Wisanto
- Centre for Reproductive Medicine, Academic Hospital, Vrije Universiteit Brussel, Belgium
| | | | | | | | | | | |
Collapse
|
18
|
Kempinaire A, Laureys M, Goedhuys W, Demeulemeester L, Sevens C, Smeyers-Verbeke J, Cooreman W, Neels H, Gorus FK. Spuriously Low Concentrations of Serum Iron Measured with Generation 14 Kodak Ektachem Slides: Prevalence, Possible Causes, and Partial Improvement with Generation 16 Slides. Clin Chem 1992. [DOI: 10.1093/clinchem/38.12.2457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
For sera with iron (Fe) concentrations < 4 mumol/L, Kodak Ektachem slides Generation (GEN) 14 (without ascorbic acid) yielded systematically lower results for Fe than did liquid Ferrozine-based reagents from Baker containing ascorbic acid (10 g/L, final concentration) and adapted to Cobas-Bio. During an 8-month comparison period, outliers (defined as [Fe]Cobas - [Fe]Kodak > 4 mumol/L) were seen in 21 of the 8731 sera (0.24%) tested, corresponding to < 5% of the sera with [Fe]Kodak < 4 mumol/L. In vitro addition of ascorbic acid and (or) Fe identified at least two types of outliers: type 1 (approximately 70%), characterized by [Fe]Kodak > 0.4 mumol/L, by (supra)normal Fe recovery in Kodak slides in the presence or absence of ascorbic acid (10 g/L), and by between-method differences in serum Fe (Cobas - Kodak) that were significantly correlated with serum Zn content (P < 0.0004); and type 2 (approximately 30%), tentatively ascribed to contamination by EDTA, with serum Fe by Kodak < 0.4 mumol/L and Fe recovery near 0%, both of which could be significantly and dose-dependently increased by addition of ascorbic acid (5-20 g/L). For both types of outliers, flameless atomic absorption spectrometry (AAS) yielded results that were significantly higher than concentrations by Kodak with GEN 14. Use of GEN 16 slides (containing ascorbic acid) improved concordance of Kodak results with Cobas, and hence with flameless AAS, for both types of outliers; abolished Zn dependency of results; and increased Fe results in sera with type 2 outliers, although these remained substantially lower than by Cobas. However, like other ascorbic acid-containing reagents, GEN 16 slides were more sensitive to interference by dextran-bound Fe, as assessed during in vitro addition experiments and comparisons involving samples from Fe-dextran-treated patients. GEN 16 slides are hence expected to more frequently overestimate the physiologically available protein-bound Fe in hemodialysis patients. In hospital laboratories, this new interference will probably arise more frequently than the spuriously low results with GEN 14, hence warranting further efforts in optimizing Fe slides.
Collapse
Affiliation(s)
- A Kempinaire
- Department of Clinical Chemistry, Academic Hospital (AZVUB), Brussels, Belgium
| | - M Laureys
- Department of Clinical Chemistry, Academic Hospital (AZVUB), Brussels, Belgium
| | - W Goedhuys
- Department of Clinical Chemistry, Academic Hospital (AZVUB), Brussels, Belgium
| | - L Demeulemeester
- Department of Clinical Chemistry, Academic Hospital (AZVUB), Brussels, Belgium
| | - C Sevens
- Department of Clinical Chemistry, Academic Hospital (AZVUB), Brussels, Belgium
| | - J Smeyers-Verbeke
- Department of Clinical Chemistry, Academic Hospital (AZVUB), Brussels, Belgium
| | - W Cooreman
- Department of Clinical Chemistry, Academic Hospital (AZVUB), Brussels, Belgium
| | - H Neels
- Department of Clinical Chemistry, Academic Hospital (AZVUB), Brussels, Belgium
| | - F K Gorus
- Department of Clinical Chemistry, Academic Hospital (AZVUB), Brussels, Belgium
| |
Collapse
|
19
|
Kempinaire A, Laureys M, Goedhuys W, Demeulemeester L, Sevens C, Smeyers-Verbeke J, Cooreman W, Neels H, Gorus FK. Spuriously low concentrations of serum iron measured with generation 14 Kodak Ektachem slides: prevalence, possible causes, and partial improvement with generation 16 slides. Clin Chem 1992; 38:2457-64. [PMID: 1281051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
For sera with iron (Fe) concentrations < 4 mumol/L, Kodak Ektachem slides Generation (GEN) 14 (without ascorbic acid) yielded systematically lower results for Fe than did liquid Ferrozine-based reagents from Baker containing ascorbic acid (10 g/L, final concentration) and adapted to Cobas-Bio. During an 8-month comparison period, outliers (defined as [Fe]Cobas - [Fe]Kodak > 4 mumol/L) were seen in 21 of the 8731 sera (0.24%) tested, corresponding to < 5% of the sera with [Fe]Kodak < 4 mumol/L. In vitro addition of ascorbic acid and (or) Fe identified at least two types of outliers: type 1 (approximately 70%), characterized by [Fe]Kodak > 0.4 mumol/L, by (supra)normal Fe recovery in Kodak slides in the presence or absence of ascorbic acid (10 g/L), and by between-method differences in serum Fe (Cobas - Kodak) that were significantly correlated with serum Zn content (P < 0.0004); and type 2 (approximately 30%), tentatively ascribed to contamination by EDTA, with serum Fe by Kodak < 0.4 mumol/L and Fe recovery near 0%, both of which could be significantly and dose-dependently increased by addition of ascorbic acid (5-20 g/L). For both types of outliers, flameless atomic absorption spectrometry (AAS) yielded results that were significantly higher than concentrations by Kodak with GEN 14. Use of GEN 16 slides (containing ascorbic acid) improved concordance of Kodak results with Cobas, and hence with flameless AAS, for both types of outliers; abolished Zn dependency of results; and increased Fe results in sera with type 2 outliers, although these remained substantially lower than by Cobas. However, like other ascorbic acid-containing reagents, GEN 16 slides were more sensitive to interference by dextran-bound Fe, as assessed during in vitro addition experiments and comparisons involving samples from Fe-dextran-treated patients. GEN 16 slides are hence expected to more frequently overestimate the physiologically available protein-bound Fe in hemodialysis patients. In hospital laboratories, this new interference will probably arise more frequently than the spuriously low results with GEN 14, hence warranting further efforts in optimizing Fe slides.
Collapse
Affiliation(s)
- A Kempinaire
- Department of Clinical Chemistry, Academic Hospital (AZVUB), Brussels, Belgium
| | | | | | | | | | | | | | | | | |
Collapse
|
20
|
van Rossem K, Vermariën H, Decuyper K, Van Reempts J, Laureys M, Bourgain R. Local tissue PO2 during and after focal brain cortical infarction in rabbits. Adv Exp Med Biol 1992; 317:717-22. [PMID: 1288194 DOI: 10.1007/978-1-4615-3428-0_86] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- K van Rossem
- Laboratory of Physiology and Physiopathology, University of Brussels VUB, Belgium
| | | | | | | | | | | |
Collapse
|
21
|
Abstract
We report a case of recurring catamenial pneumothorax with concurrent pelvic endometriosis. Thoracoscopy revealed a blue-like lesion on top of the dome of the right hemidiaphragm. Microscopic examination of biopsy specimens showed endometriosis. The patient was treated with a Gn-RH analogue and remains well without further evidence of pneumothorax after six months.
Collapse
Affiliation(s)
- H Slabbynck
- Department of Pneumology, Vrije Universiteit Brussel, Brussels, Belgium
| | | | | | | | | |
Collapse
|
22
|
Laureys M, Sion JP, Slabbynck H, Steenssens L, Cobbaert C, Derde MP, Gorus FK. Macromolecular creatine kinase type 1: a serum marker associated with disease. Clin Chem 1991; 37:430-4. [PMID: 2004451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The prevalence of circulating macromolecular creatine kinase type 1 (macro CK type 1 or CK-immunoglobulin complexes) is significantly higher in a patient population selected for CK isoenzyme assay than in age- and sex-matched blood donors (n = 1304). In greater than 8000 patients studied, 49 individuals with macro CK type 1 were identified, yielding an overall prevalence of 0.61%. Macro CK type 1 complexes occurred more frequently in women and in patients older than 70 years, and were often associated with complications of cardiovascular disease, life-threatening conditions, and poor outcome. These latter clinical associations could arise, at least partly, from the selection of patients for whom CK isoenzyme analysis was ordered.
Collapse
Affiliation(s)
- M Laureys
- Department of Clinical Chemistry, Akademisch Ziekenhuis Vrije Universiteit Brussel, Belgium
| | | | | | | | | | | | | |
Collapse
|
23
|
De Keyser J, Slabbynck H, Laureys M, Smitz J, Vervaeck M, Ebinger G. Increase in serum myoglobin, creatine kinase, and free fatty acids, during recovery from a paralytic attack in hypokalemic periodic paralysis. Clin Neurol Neurosurg 1991; 93:241-3. [PMID: 1660381 DOI: 10.1016/s0303-8467(05)80012-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In a patient with hypokalemic periodic paralysis (HPP), recovery from a paralytic attack, coinciding with the restoration of plasma potassium, was associated with a rise in serum myoglobin (Mb) and creatine kinase (CK). The increase of muscle proteins in serum was preceded by an increase in serum free fatty acids (FFA). An increased permeability of the sarcolemma, caused by an accumulation of FFA within the muscle cell, might underly the reflux of potassium into the circulation. This might represent a mechanism by which the paralytic attacks in HPP terminate.
Collapse
Affiliation(s)
- J De Keyser
- Department of Neurology, Academisch Ziekenhuis Vrije Universiteit Brussel, Belgium
| | | | | | | | | | | |
Collapse
|
24
|
Abstract
A rapid high-performance gel permeation chromatographic method to confirm the presence of enzymes with abnormally high relative molecular masses (macroenzymes) in serum is described. The technique requires 200 microliters of serum, can be automated and has been implemented for the analysis of creatine kinase (CK), lactate dehydrogenase, amylase, and alkaline phosphatase (ALP) activities. Serum fractionation according to relative molecular mass is completed within 21 min, and 84-106% of enzyme activities are recovered in the eluted fractions. The elution patterns obtained make possible the differentiation of 40 samples containing at least 10 U/l immunoglobulin-enzyme complexes, aggregated mitochondrial CK or membrane fragments carrying ALP activity from 40 control samples without these high-mass enzyme forms.
Collapse
Affiliation(s)
- J P Sion
- Department of Clinical Chemistry, Academic Hospital of the Vrije Universiteit Brussel, Belgium
| | | | | | | |
Collapse
|
25
|
Gorus F, Claessens V, Goubert P, Laureys M. A sensitive bioluminescent immunoinhibition test for CK-B subunit activity and a CK-MB specific ELISA compared: correlation with agarose electrophoresis and influence of CK-isoenzyme profile on results. Clin Chem 1988; 34:1474-8. [PMID: 3390922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Searching for alternatives to the imprecise spectrophotometric tests for low-concentration creatine kinase (EC 2.7.3.2) isoenzyme MB (CK-MB), we investigated the analytical performance of two potentially superior approaches--a bioluminescent immunoinhibition assay (I, LKB-Wallac) and an ELISA (enzyme-labeled immunosorbent assay) technique (II, Hybritech)--in comparison with an electrophoretic method (III, Beckman). Only I showed good between-day precision (CV 8.3%) at the upper reference limit, allowing reproducible assay of CK-B subunit activity down to at least 3 U/L. In conditions where CK isoenzyme assays remained unaffected by CK-MM concentrations, test results were proportional to the amount of CK-MB in the sample up to at least 50 U/L for I, 120 micrograms/L for II, and 100 U/L for III (r greater than 0.998 by linear regression analysis). For CK-MB-positive samples, the data by I correlated more closely with values by III (n = 24; r = 0.994) than did results by II (n = 15; r = 0.909), but both methods were equally effective in discriminating between samples with or without electrophoretically supranormal CK-MB activity (93% sensitivity). II was entirely CK-MB specific, whereas CK-B activity by I was consistently (18/18) increased in CK-MB-negative samples containing CK-BB (n = 6; r = 0.996) or macro CK, types 1 or 2 (n = 12; r = 0.930). I is highly sensitive for screening for increased non-MM CK activity, the nature of which should be subsequently clarified by electrophoresis.
Collapse
Affiliation(s)
- F Gorus
- Clinical Chemistry Laboratory, Academic Hospital, Vrije Universiteit Brussel, Belgium
| | | | | | | |
Collapse
|
26
|
Gorus F, Claessens V, Goubert P, Laureys M. A sensitive bioluminescent immunoinhibition test for CK-B subunit activity and a CK-MB specific ELISA compared: correlation with agarose electrophoresis and influence of CK-isoenzyme profile on results. Clin Chem 1988. [DOI: 10.1093/clinchem/34.7.1474] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Searching for alternatives to the imprecise spectrophotometric tests for low-concentration creatine kinase (EC 2.7.3.2) isoenzyme MB (CK-MB), we investigated the analytical performance of two potentially superior approaches--a bioluminescent immunoinhibition assay (I, LKB-Wallac) and an ELISA (enzyme-labeled immunosorbent assay) technique (II, Hybritech)--in comparison with an electrophoretic method (III, Beckman). Only I showed good between-day precision (CV 8.3%) at the upper reference limit, allowing reproducible assay of CK-B subunit activity down to at least 3 U/L. In conditions where CK isoenzyme assays remained unaffected by CK-MM concentrations, test results were proportional to the amount of CK-MB in the sample up to at least 50 U/L for I, 120 micrograms/L for II, and 100 U/L for III (r greater than 0.998 by linear regression analysis). For CK-MB-positive samples, the data by I correlated more closely with values by III (n = 24; r = 0.994) than did results by II (n = 15; r = 0.909), but both methods were equally effective in discriminating between samples with or without electrophoretically supranormal CK-MB activity (93% sensitivity). II was entirely CK-MB specific, whereas CK-B activity by I was consistently (18/18) increased in CK-MB-negative samples containing CK-BB (n = 6; r = 0.996) or macro CK, types 1 or 2 (n = 12; r = 0.930). I is highly sensitive for screening for increased non-MM CK activity, the nature of which should be subsequently clarified by electrophoresis.
Collapse
Affiliation(s)
- F Gorus
- Clinical Chemistry Laboratory, Academic Hospital, Vrije Universiteit Brussel, Belgium
| | - V Claessens
- Clinical Chemistry Laboratory, Academic Hospital, Vrije Universiteit Brussel, Belgium
| | - P Goubert
- Clinical Chemistry Laboratory, Academic Hospital, Vrije Universiteit Brussel, Belgium
| | - M Laureys
- Clinical Chemistry Laboratory, Academic Hospital, Vrije Universiteit Brussel, Belgium
| |
Collapse
|