Ustav Klinicke Biochemie a Hematologie

Plzeň, Czech Republic

Ustav Klinicke Biochemie a Hematologie

Plzeň, Czech Republic
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Racek J.,Ustav klinicke biochemie a hematologie | Petrikova V.,Ustav klinicke biochemie a hematologie | Rajdl D.,Ustav klinicke biochemie a hematologie | Novak I.,I. interni klinika Lekarske fakulty UK
Klinicka Biochemie a Metabolismus | Year: 2017

Objective: To describe a patient intoxicated with ethylene glycol and to show possible problems of delayed diagnosis due to interference of ethylene glycol oxidative products in lactate determination. Design: Case report and evaluation of laboratory results. Settings: Department of Clinical Biochemistry and Hematology and Ist Department of Internal Medicine, Faculty of Medicine, Charles University and Faculty Hospital, Alej Svobody 80, 304 60 Pilsen (Czech Republic). Material and Methods: Case report. Results: The paper describes a patient intoxicated with ethylene glycol including diagnostic consideration, worsened by falsely increased concentration of lactate, measured amperometrically using blood-gas analyzers. Conclusion: Products of ethylene glycol oxidation (glycolic and glyoxylic acids) are the cause of falsely increased concentration of lactate when measured by a lactate enzymatic electrode with lactate oxidase and amperometric detection.

Kaderabkova O.,Klinika pracovniho lekarstvi | Machartova V.,Klinika pracovniho lekarstvi | Bajerova S.,Klinika pracovniho lekarstvi | Eechova H.,Klinika pracovniho lekarstvi | And 2 more authors.
Pracovni Lekarstvi | Year: 2011

Authors present a case study of a 31 year old welder with an unusual radiograph lung finding within the basic diagnosis of asthma bronchiale. The patient was examined for breathing troubles at the outpatient department of the clinic of occupational diseases. The deposits of metal mercury were proved in lungs and in the right heart. The radiograph finding indicated evaluation of the concentration of mercury in blood and urine samples. All samples showed significantly increased concentrations (Hg in blood up to 130 μg/l, Hg in urine up to 420 μg/l). The patient has not shown any signs of chronic mercury intoxication, in the course of the monitored period the clinical and radiograph findings have been stable, the mercury concentration in blood and urine has dropped after 3 years. The patient has not come to the control examination. We learnt from the general practitioner that the patient died due to dilatation cardiomyopathia proved by an autopsy. The etiology of the finding has not been clarified. Presumably it was a lung embolus caused by an i.v. application of mercury. The patient approved an i.v. application of drugs (Pervitin) with the aim of increasing work efficiency.

Pesek M.,Klinika Pneumologie a Ftizeologie | Bittenglova R.,Klinika Pneumologie a Ftizeologie | Fremundova L.,I. Interni Kllnika | Turkova-Sedlackova T.,Ustav Klinicke Biochemie a Hematologie | Dettmar P.W.,Castle Hill Hospital
Studia Pneumologica et Phthiseologica | Year: 2014

Background: Gastroesophageal reflux disease (GERD) is often found in interstitial lung disease, particularly in interstitial pulmonary fibrosis. An association has been found between GERD and progression of pulmonary changes, acute exacerbations and transplant rejection. The presence of pepsin in airway secretions may indicate the presence of GERD.Methods and Patients: In patients with progressive and symptomatic interstitial lung disease (IPP, IPF/UIP, EAA, sarcoidosis, LAM and CF), clinical examination included the use of Peptest (RDBiomed, Hull, UK). For the test, early morning fasting samples of coughed up sputum or saliva were collected. Patients with positive findings were evaluated with 24-hour esophageal pH and impedance monitoring. It was also ascertained from the patients whether they used proton pump inhibitors (PPIs) at the time of their examination.Results: The study group comprised 106 patients (40 males and 66 females) with a median age of 58 years (range, 23-86 years). There were 32 patients with IPP, 10 with IPF/UIP, 22 with EAA, 34 with sarcoidosis, 1 with LAM and 7 with CF. Out of 106 pepsin tests, 86 were positive (81 %). The rate of agreement with reflux disease detected by pH and impedance monitoring was 60 %. The frequency of positive Peptest results in patients treated with PPIs was 78.5 %.Conclusion: The results support the assumption that GERD is involved in the pathogenesis of interstitial lung disease exacerbations and progression and its presence may be revealed with tests to detect pepsin in airway secretions. Although antireflux therapy with PPIs or fundoplication may improve the prognosis of IPF patients, this approach may positively influence acid reflux but pepsin continues to remain in the airways of most patients treated with PPIs.

Cedikova M.,Ustav Histologie A Embryologie | Babuska V.,Ustav Lekarske Chemie A Biochemie | Rajdl D.,Ustav Klinicke Biochemie A Hematologie | Zech N.H.,Institute Reprodukcni Mediciny A Endokrinologie | And 2 more authors.
Ceska Gynekologie | Year: 2012

Objective: Follicular fluid (FF) provides an important microenvironment for the development of oocytes. The biochemical composition of the FF plays critical role in the oocyte competence. The aim of our study was to compare the levels of selected hormones in FF of infertile women and healthy fertile oocyte donors. Design: Retrospective comparative study. Setting: Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University in Prague; Department of Gynecology and Obstetrics, Charles University and University Hospital in Pilsen; Institute of Reproductive Medicine and Endocrinology, IVF Centers Prof. Zech, Plzeň. Methods: Levels of prolactin, free T3 and free T4 hormones in the FF of 146 women were analyzed. We have analysed FF of 74 infertile patients (mean age 31 years, SD = 4.65) and 72 healthy fertile oocyte donors (mean age 26 years, SD = 4.44). Only blood free samples were studied after pooling of all FF samples each patient. Levels of hormones were determined using ECLIA method (Electro-Chemi- Luminiscent Immunoassay) on the Cobas e411. Results: Results showed statistically significantly higher levels of prolactin (p=0.0006) and free T4 hormone (p=0.0246) in FF of infertile women in comparison to the group of healthy fertile oocyte donors. Conclusion: Our study confirms the presence of prolactin and thyroid hormones in FF and it can be suggested that they play a key role in the regulation of reproductive processes. The study of FF from donors and their detailed comparison with infertile patients with various gynaecological causes of infertility has great value for better understanding of regulatory mechanisms of fertility.

Babuska V.,Ustav Lekarske Chemie a Biochemie | Cedikova M.,Ustav Histologie a Embryologie | Rajdl D.,Ustav Klinicke Biochemie a Hematologie | Racek J.,Ustav Lekarske Chemie a Biochemie | And 6 more authors.
Ceska Gynekologie | Year: 2012

Objective: Follicular fluid (FF) affects oocyte development and disruption of its homeostasis has a crucial effect on egg developmental potential. The aim of this study was to compare the levels of selected oxidative stress markers in the FF of women with impaired fertility and healthy fertile oocytes donors. Design: A retrospective comparative study. Setting: Faculty of Medicine in Pilsen, Charles University in Prague; Institute of Reproductive Medicine and Endocrinology, IVF Center Prof. Zech, Pilsen. Methods: Levels of homocysteine (Hcy), malondialdehyde (MDA), glutathione peroxidase (GPx), total antioxidant capacity (AOK) and total protein (CB) were analyzed in the FF. We have analysed FF of 146 women - 74 infertile patients (mean age 31 years, SD = 4.65) and 72 healthy fertile oocyte donors (mean age 26 years, SD = 4.44). Only blood free samples were studied after pooling of all FF samples each patient. Results: The study showed a statistically significantly higher Hcy levels (p < 0.0001) in the FF of healthy fertile women compared with impaired fertility group both - comparing the two groups regardless the age and in groups of the same age range (for the age group between 20 to 29 years is p = 0.0002, for the age group between 30 to 39 years is p < 0.0001). When divided into above age ranges we found statistically significantly higher levels of MDA in the control group aged 20 to 29 years compared to same age infertile patients (p = 0.0374) and statistically significantly higher AOK in infertile women between 30 to 39 years of age compared to same age control group (p = 0.0458). Conclusion: The presence or on the contrary the absence of prooxidant parameters in the FF has an important role in the ability of conception and subsequent embryo development.

Teplan V.,Klinika Nefrologie Transplantcentra IKEM Prague | Mahrova A.,Laborator Sportovni Motoriky | Svagrova K.,Laborator Sportovni Motoriky | Racek J.,Ustav Klinicke Biochemie a Hematologie | And 4 more authors.
Vnitrni Lekarstvi | Year: 2012

Background: Levels of the endogenous nitric oxide synthase inhibitor asymmetric dimethylarginine are elevated in patients undergoing kidney transplantation and may contribute to vascular complications. In this study we tested the hypothesis that elevated asymmetric dimethylarginine can be reduced in patients after kidney transplantation by early regular physical exercise. Selected cytokines and metabolic parameters were also analysed. Methods: Plasma samples for analysis of asymmetric dimethylarginine, adiponectin, leptin, soluble leptin receptor, resistin, visfatin, CRP, TNFα and selected metabolic parameters were obtained from randomly selected sixty eight patients after kidney transplantation who agreed to participate in a supervised aerobic exercise program for six months. Samples were collected before the training began (one month after surgery with stabilized graft function) and at six months after initiation. Sixty transplant patients matched for age, sex, HLA typing, duration of previous dialysis, history of cardiovascular disease and immunosupression regimen who did not exercise regularly and did not participate in the training program were examined as controls. Results: There were no differences in elevated asymmetric dimethylarginine levels between both groups before the training program began. After six months of exercise, asymmetric dimethylarginine concentration in the exercising group I significantly decreased (3.5 ± 0.45 vs 2.11 ± 0.35 μmol/L, P < 0.01) and was also significantly lower comparing to non-exercising group II (2.11 ± 0.23 vs 3.25 ± 0.34 μmol/L, P < 0.01). We found significant changes in exercising group I: adiponectin (15.4 ± 6.6 vs 22.3 ± 6.2 mg/mL, P < 0.01), leptin (51.3 ± 11.2 vs 20.3 ± 9.2 ng/L, P < 0.01), soluble leptin receptor (24.6 ± 8.4 vs 46.1 ± 11.4 U/mL, P < 0.01), resistin (20.8 ± 10.1 vs 14.6 ± 6.4 mg/mL, P < 0.025) and visfatin (1.8 ± 0.2 vs 1.2 ± 0.01 ng/mL, P < 0.05). Blood lipids, HbA1c, CRP and TNFα were also affected by the training program. Conclusions: Elevated asymmetric dimethylarginine level, selected adipocytokines and proinflammatory cytokines in patients after kidney transplantation were significantly influenced by early regular exercise. This regimen may decrease cardiovascular risk in patients after kidney transplantation.

Zeman D.,Ustav Laboratorni Diagnostiky | Kusnierova P.,Ustav Laboratorni Diagnostiky | Gottwaldova J.,Oddeleni Klinicke Biochemie | Kloudova A.,Oddeleni Imunologie A Alergologie | And 5 more authors.
Klinicka Biochemie a Metabolismus | Year: 2012

Objective: Quantitation of albumin and immunoglobulins in CSF and serum serves the purpose of calculation of intrathecal immunoglobulin synthesis. Quotient, i.e., concentration ratio of particular protein in CSF and serum, is assumed to be method-independent value, provided that paired CSF and serum sample is analyzed in parallel using one (CSF) calibration curve. We have observed that CSF (but not serum) IgM concentrations determined by nephelometry on Immage analyzer and by home-made sandwich ELISA were largely discrepant. This has lead us to perform a larger study comparing various methods of IgM determination in CSF and serum. Design: Comparison of various methods used for IgM quantitation in cerebrospinal fluid. Materials and Methods: Results of IgM determination on nephelometers Immage, Immage 800, BN II, and BN ProSpec, as well as by ELISA method, have been compared. Beside CSF and serum values, CSF/serum quotients and results of calculated intrathecal IgM synthesis according to Reiber's formula have been compared. Results have been evaluated by means of Passing-Bablok regression and Bland and Altman plots, using MedCalc software. Results: We have found significant differences between CSF IgM concentrations determined by rate nephelometry on Immage analyzers and end-point nephelometry on BN analyzers or ELISA, the latter two giving significantly lower values. CSF IgM concentrations determined by ELISA were in good agreement with those determined on BN analyzers. Serum IgM concentrations were slightly higher using ELISA than using either nephelometric system. We have found no significant difference in either serum IgM or CSF/serum IgM quotient between serum analysis on CSF versus serum calibration curve. IgM quotient values were significantly higher using Immage analyzers than using either BN analyzers or ELISA method. As a consequence, intrathecal IgM synthesis, based on the Immage data, was calculated in 13 of 71 samples considered negative if data of BN analyzer or ELISA were used; in 8 of these samples, intrathecal IgM synthesis could be considered as clinically significant (intrathecal fraction > 10 %). Conclusions: CSF/serum IgM quotient is far from to be method-independent; in some cases, discrepant conclusion regarding the presence of intrathecal IgM synthesis can be obtained. Until the cause of this discrepancy is found and removed, the presence of intrathecal IgM synthesis should be judged very carefully and in the context of other CSF findings when using the Immage analyzer for measurement. ELISA method is inexpensive, requires very low amount of the sample, and is the only method able to quantify IgM in almost every CSF sample. Its use in routine practice is, however, limited by higher requirements for manual work. Nevertheless, it should be used at least in experimental studies, i.e. for the purpose of the determination of distribution of CSF IgM concentration within a population.

Racek J.,Ustav Klinicke Biochemie a Hematologie | Ruzickova V.,Ustav Klinicke Biochemie a Hematologie | Rajdl D.,Ustav Klinicke Biochemie a Hematologie
Klinicka Biochemie a Metabolismus | Year: 2011

Objective: In USA it is possible to use determination of glycated hemoglobin (HbA1c) for diagnostics of diabetes mellitus in addition to hitherto recommended fasting plasma glucose or oral glucose tolerance test (oGTT). Aim of the study was to compare sensitivity of oGTT and HbA1c determination in diagnostics of diabetes mellitus, i.e. up to now used and proposed way, namely in our group of patients. Design: Observational comparative retrospective trial. Settings: Institute of Clinical Biochemistry and Hematology, Faculty of Medicine, Charles University and Faculty Hospital, Pilsen, Czech Republic. Material and Methods: In 255 patients, oGTT was carried out with the result of diabetes mellitus or impaired glucose tolerance (IGT); at the same time, concentration of HbA1c was determined. The patients were then classified into these diagnostic groups according to HbA1c and their categorization was compared to that according to oGTT. Results: In patients with diabetes mellitus according to oGTT, the concordance with the categorization according to HbA1c was found only in 44.4 %, in 16 % of patients normal glucose tolerance was diagnosed. In a subgroup of patients with IGT according to the results of oGTT, the concordance was in 37.9 %, in 12 % of these patients diabetes mellitus was diagnosed and 46.0 % of the cases normal glucose tolerance was assessed. Lowering diagnostic criterion for IGT leads to higher percentage of positive results but we can assume higher overlapping with the healthy population. Conclusion: Diabetes mellitus diagnostics according to HbA1c level is not comparable with the results according to oGTT. Although it is less sensitive in most cases, in some cases it offers even false positive results. It will be necessary to decide whether it is a false diagnosis or it reflects better risk of future diabetic complications.

Broz P.,Ustav Klinicke Biochemie a Hematologie | Zenkova J.,Ustav Klinicke Biochemie a Hematologie | Rezacova K.,Ustav Klinicke Biochemie a Hematologie
Klinicka Biochemie a Metabolismus | Year: 2013

Subarachnoid hemorrhage (SAH) is a serious, life-threatening cause of morbidity and mortality in the world. Despite the progression in imaging and laboratory methods remain a significant percentage of patients with SAH misdiagnosed. Virtual unenhanced CT of the brain is the investigation of choice for establishing presence of SAH. Cerebrospinal fluid (CSF) spectrophotometry is recommended in CT negative patients, when clinical suspicion remains high. The specimen for spectrophotometry has certain requirements for the collection, handling and transport to the laboratory, however, can be a valuable diagnostic tool. According to recent recommendations is appropriate to interpret the result using serum protein, serum bilirubin and CSF protein levels. In addition to CSF spectrophotometric examination other laboratory tests as CSF cytology, red cell count examination or CSF ferritin levels can be useful.

Tomesova J.,Diabetologicke Centrum I. Interni Kliniky | Gruberova J.,Diabetologicke Centrum I. Interni Kliniky | Broz P.,Ustav Klinicke Biochemie a Hematologie | Lacigova S.,Diabetologicke Centrum I. Interni Kliniky | And 2 more authors.
Vnitrni Lekarstvi | Year: 2013

Microcirculation plays an important role in pathophysiology of a number of severe diseases. At present there exist many techniques that enable evaluation of microvascular perfusion. Some of them found their scientific and clinical use even in the Czech Republic. In last decade, articles referring about individual methods can be found even on the pages of Vnitřní lékařství journal. The aim of this work is to provide a comprehensive overview of methods that have been used for examination of the microcirculation to date. After a short review of the anatomy and physiology of the microcirculation, the article provides synopsis of the theoretical and practical use of individual methods including their advantages and disadvantages.

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