BACKGROUND: Self-monitoring of blood glucose levels is recommended for all diabetic patients who receive insulin treatment, because such monitoring of glucose levels may aid in achieving better control in type II diabetes. Further, the use of point-of-care (POC) blood glucose testing in hospitals has increased substantially. In the present study, we validated the performance of ACCU-CHEK(R) Inform II Blood Glucose Meter and ACCU-CHEK(R) Performa Strip (Roche Diagnostics, Germany). METHODS: We evaluated the precision, accuracy, and maltose interference of the ACCU-CHEK(R) Inform II Blood Glucose Meter and ACCU-CHEK(R) Performa Strip. Further, precision was evaluated using dedicated quality control (QC) and Bio-Rad Whole Blood (WB) QC materials (Meter Trax(TM) Control; Bio-Rad, USA). Forty samples were used to compare the results obtained using the ACCU-CHEK(R) Inform II Blood Glucose Meter and ACCU-CHEK(R) Performa Strip with those obtained using the clinical chemistry analyzer Hitachi 7600 (Hitachi, Japan). Maltose interference was assessed at 2 glucose concentration levels at 3 maltose concentration levels. RESULTS: For each concentration level of control materials, within-run coefficient of variation (CV) and total CV obtained were less than 5%. Good correlation was obtained using the Hitachi 7600 (y = 1.02x - 0.18; r 2 = 0.996; N = 40). Effects of maltose interference were less than 10%. CONCLUSIONS: Thus, the ACCU-CHEK(R) systems show good precision and correlation with the routine clinical chemistry analyzer and allow only minimal effects of maltose interference.
Blood Glucose ; Chemistry, Clinical ; Glucose ; Humans ; Insulin ; Maltose ; Quality Control

BACKGROUND: We evaluated the analytical performance of Barozen H (i-SENS Inc., Korea), a new glucometer equipped with networking function for medical institutions, according to the ISO 15197:2003 and ISO/DIS 15197:2011 guidelines. METHODS: We measured the precision of 10 Barozen H glucometers, in terms of repeatability and intermediate precision, and determined their accuracy relative to that of automatic chemistry analyzer AU5421 (Beckman Coulter, USA). Three other glucometers-Precision PCx (Abbott, USA), Glucocard Sigma (Arkray, Japan), and SureStep Flexx (Johnson & Johnson, USA) were also evaluated, and their accuracies and hematocrit interferences were compared. RESULTS: The standard deviation and coefficient of variation of Barozen H for repeatability and intermediate precision were 0.11-0.15 mmol/L and 2.3-3.6%, respectively. With respect to accuracy, in accordance with ISO 15197:2003 criteria, Barozen H yielded 98.0% of results within +/-0.83 mmol/L or +/-20%. Further, per the ISO/DIS 15197:2011 criteria, 95.2% of results were within +/-0.83 mmol/L or +/-15%; Barozen H was the only glucometer satisfying the more stringent ISO/DIS 15197:2011 criteria. Error grid analysis showed that all results from Barozen H were in zone A, indicating its excellent clinical accuracy. Hematocrit, ranging from 20% to 60% did not cause any significant interference. CONCLUSIONS: Barozen H showed excellent analytical performance, and it was the most clinically accurate glucometer tested. It can be expected to provide reliable results satisfying ISO/DIS 15197:2011 as well as ISO 15197:2003 criteria.
Blood Glucose Self-Monitoring ; Blood Glucose* ; Chemistry ; Diabetes Mellitus ; Glucose Oxidase ; Hematocrit ; Point-of-Care Systems

BACKGROUND: We evaluated the analytical performance of Barozen H (i-SENS Inc., Korea), a new glucometer equipped with networking function for medical institutions, according to the ISO 15197:2003 and ISO/DIS 15197:2011 guidelines. METHODS: We measured the precision of 10 Barozen H glucometers, in terms of repeatability and intermediate precision, and determined their accuracy relative to that of automatic chemistry analyzer AU5421 (Beckman Coulter, USA). Three other glucometers-Precision PCx (Abbott, USA), Glucocard Sigma (Arkray, Japan), and SureStep Flexx (Johnson & Johnson, USA) were also evaluated, and their accuracies and hematocrit interferences were compared. RESULTS: The standard deviation and coefficient of variation of Barozen H for repeatability and intermediate precision were 0.11-0.15 mmol/L and 2.3-3.6%, respectively. With respect to accuracy, in accordance with ISO 15197:2003 criteria, Barozen H yielded 98.0% of results within +/-0.83 mmol/L or +/-20%. Further, per the ISO/DIS 15197:2011 criteria, 95.2% of results were within +/-0.83 mmol/L or +/-15%; Barozen H was the only glucometer satisfying the more stringent ISO/DIS 15197:2011 criteria. Error grid analysis showed that all results from Barozen H were in zone A, indicating its excellent clinical accuracy. Hematocrit, ranging from 20% to 60% did not cause any significant interference. CONCLUSIONS: Barozen H showed excellent analytical performance, and it was the most clinically accurate glucometer tested. It can be expected to provide reliable results satisfying ISO/DIS 15197:2011 as well as ISO 15197:2003 criteria.
Blood Glucose Self-Monitoring ; Blood Glucose* ; Chemistry ; Diabetes Mellitus ; Glucose Oxidase ; Hematocrit ; Point-of-Care Systems

No abstract available.
Ascorbic Acid/*chemistry ; Blood Chemical Analysis/instrumentation/*methods ; Blood Glucose/*analysis ; Maltose/*chemistry

BACKGROUND: Diabetes mellitus is the most common endocrinopathy encountered in the perioperative period. It is a disease of glucose dysregulation and carbohydrate intolerance frequently associated with acute and long-term systemic consequences, which may significantly impact morbidity and mortality This study was performed to evaluate the effects of diabetes on perioperative patients' status. METHODS: Thirty adults patients, 15 control and 15 diabetic patients, who underwent upper abdominal surgery with general anesthesia were included in this study. We investigated blood glucose levels, arterial blood gas, blood chemistry values, and calculated alveolar- arterial oxygen tension differences. Statistical analyses were performed using the Fisher's exact test, unpaired t-test, paired t-test, and repeated measure ANOVA. Data are expressed as mean +/- SD. RESULTS: The blood glucose levels were significantly higher in the diabetic group than the control group during operation. The postoperative calcium and albumin concentrations were significantly lower in the diabetic patients than the control patients. The alveolar-arterial oxygen tension differences were significantly increased in the diabetic group compared with the control group during operation. CONCLUSIONS: This study demonstrated that the blood glucose levels were significantly increased in the diabetic patients compared with the control patients during operation. This finding suggests that blood glucose levels should be monitored and controlled within an adequate range in diabetic patients perioperatively.
Adult ; Anesthesia, General ; Blood Glucose* ; Calcium ; Chemistry ; Diabetes Mellitus ; Glucose ; Humans ; Mortality ; Oxygen ; Perioperative Period

BACKGROUND: To understand causes of abnormal reaction for the urinalysis, we analyze the interfering substances of clinical urine samples. We focused the effect of urinary vitamin C and fluorescein sodium to the urine chemistry especially glucose, hemoglobin, and leukocyte esterase. METHODS: Incidence of urinary vitamin C was determined for patients and people underwent a medical check–up. We decided dipstick results of glucose, hemoglobin, and leukocyte esterase as false negative based on urine sediment and serum glucose results. Dipstick urinalysis was tested by URiSCAN Pro III with URiSCAN 11 strip (YD Diagnostics, Korea). Urine sediments tests were performed by manual microscopic analysis or Sysmex UF–1000i (Sysmex Co., Japan). RESULTS: The incidence of vitamin C was 20.4% for all subjects. The positive rate of the medical check-up group (34.6%) was higher than others. When vitamin C was detected in clinical urine samples, 42.3%, 10.6%, and 8.2% were defined as false negative for glucose, hemoglobin, and leukocyte esterase dipstick tests, respectively. Fluorescein sodium also interfered on the results of hemoglobin and leukocyte esterase of the dipstick reagents. CONCLUSIONS: Vitamin C was frequently found in the clinical urine samples, and its incidence was higher in the people who underwent medical check-up. The urinary vitamin C and fluorescein sodium can cause interferences in urine dipstick results. Thus, it is expected that present study will give useful information to predict false negative rates of urine dipstick tests by vitamin C and fluorescein sodium.
Ascorbic Acid ; Blood Glucose ; Chemistry ; Fluorescein ; Glucose ; Humans ; Incidence ; Indicators and Reagents ; Leukocytes ; Urinalysis*

BACKGROUND: Diabetes mellitus is the most common endocrinopathy encountered in the perioperative period and has long been assumed to increase perioperative risk. However, when diabetes mellitus was segregated from old age and the complications of it, it was questioned that diabetes mellitus itself increased perioperative risk. In this study, we investigated the influence of hyperglycemia on the length of postoperative hospital stay. METHODS: We studied 100 patients undergone intra-abdominal operations with general anesthesia. These patients were divided into the hyperglycemic group (n = 20) with postoperative blood glucose level higher than 10 mM and the non-hyperglycemic group (n = 80) with glucose level lower than 10 mM and we investigated the length of postoperative hospital stay, serum electrolyte, serum chemistry, arterial blood gas values, and base excess by unmeasured anions. We also divided these patients into the diabetic patients group (n = 15) and the non-diabetic patients group (n = 85) and compared the same variables. RESULTS: The length of postoperative hospital stay was significantly prolonged in the hyperglycemic group (20.9 +/- 9.0 days) compared with the non-hyperglycemic group (16.2 +/-8.5 days), and the cumulative postoperative hospital stay curves based on Kaplan-Meier method also showed significant difference between the two groups. When we compared the length of postoperative hospital stay between the diabetic and the non-diabetic patients, there was no significant difference. CONCLUSIONS: This study demonstrated that hyperglycemia prolonged the length of postoperative hospital stay. This finding suggests that the patient's glucose level should be monitored and controlled within an adequate range perioperatively.
Anesthesia, General ; Anions ; Blood Glucose ; Chemistry ; Diabetes Mellitus ; Glucose ; Humans ; Hyperglycemia* ; Length of Stay* ; Perioperative Period

BACKGROUND: Intravenous administration of high doses of ascorbic acid (AA) for certain clinical conditions can cause high levels of blood AA to interfere with the measurement of blood glucose. In this study, we evaluated the potential interference by high concentrations of blood AA with glucose measurement in different instruments. METHODS: Using Hitachi 7600 chemistry autoanalyzer (Hitachi 7600) and Accu-Chek Active monitor glucometer (Accu-Check), glucose was measured in serum specimens in which AA had been added in vitro at concentrations ranging from 0 to 28, 388 micromol/L. To assess the effect of pharmacokinetics of AA on glucose concentrations, blood AA and glucose were measured serially in healthy subjects after 10 g of IV Vitamin C supplement was administered. RESULTS: Beginning at the concentration of 227 micromol/L, the blood AA interfered with glucose measurement negatively in Hitachi 7600, but positively in Accu-Chek. The extent of interference was proportional to AA concentrations in both directions. The in vivo study showed that, although both instruments were affected by high blood AA at 1 hour of IV administration, blood glucose levels were normalized at 5 hours in Hitachi 7600 and at 3 hours in Accu-Chek. CONCLUSIONS: When considering that IV high dose AA supplement is becoming more popular and the extent of its interference with blood glucose measurement is significantly high in commercial systems, it would be important for the clinical laboratory to be informed of the prescription informations of patients and the time of blood collection, and to choose a correct system for an accurate blood glucose measurement.
Administration, Intravenous ; Ascorbic Acid* ; Blood Glucose* ; Chemistry ; Glucose ; Humans ; Pharmacokinetics ; Prescriptions

OBJECTIVETo access the capability of 1H nuclear magnetic resonance (NMR) -based metabonomics in the evaluation of graft function in the perioperation period of liver transplantation.

METHODSPlasma samples of 15 male primary hepatic carcinoma patients were collected for clinical biochemical analysis and 1H NMR spectroscopy 1 day before operation, 1 day and 1 week after the operation. The NMR data were analyzed using principal component analysis.

RESULTSMetabonomic analysis indicated that, compared with those before operation, blood concentrations of valine, alanine, acetone, succinic acid, glutamine, choline, lactate, and glucose increased significantly 1 day after transplantation. One week later, the levels of lipids and choline increased notably, while those of glucose and amino acids decreased. Principal component analysis showed significant difference between metabolic profiles of plasma samples of variant periods of liver transplantation, due to the variation of the levels of glucose, lipids, lactate, and choline. A good agreement was observed between clinical chemistry and metabonomic data.

CONCLUSIONSMetabonomic analysis can clearly identify the difference between the plasma samples of primary hepatic carcinoma patients at different time during the perioperation period of liver transplantation. It therefore may be a promising new technology in predicting the outcomes of liver transplantation.

Acetone ; blood ; chemistry ; Alanine ; blood ; chemistry ; Biomarkers ; blood ; chemistry ; Blood Glucose ; chemistry ; metabolism ; Carcinoma ; blood ; chemistry ; surgery ; Choline ; blood ; chemistry ; Glutamine ; blood ; chemistry ; Humans ; Lactic Acid ; blood ; chemistry ; Liver ; metabolism ; Liver Neoplasms ; blood ; chemistry ; surgery ; Liver Transplantation ; physiology ; Magnetic Resonance Spectroscopy ; Male ; Metabolome ; Succinic Acid ; blood ; chemistry ; Treatment Outcome ; Valine ; blood ; chemistry

The antihypertensive effect of Indapamide(Fludex(R)) was studied in 31 patients of essential hypertension and following results were obtained. 1) Daily dosage was 1mg b.i.d. and total duration of medication was weeks. 2) Mean systolic and diastolic blood pressure declined by 23mmHg(14%) and 18mmHg(17%) respectively. 3) Good or fair controls were achieved in 78% of patients. 4) There was no significant change in heart rate during and after treatment. 5) There were no significant changes in fasting blood sugar, serum creatinine, K+, uric acid, ca++, transaminase and cholesterol levels before and after treatment. 6) In 5 patients transient side effects were observed which resolved spontaneously. In view of these results Indapamide appears to be effective agent for the treatment of mild to moderate hypertension and dose not cause significant change in blood chemistry.
Blood Glucose ; Blood Pressure ; Chemistry ; Cholesterol ; Creatinine ; Fasting ; Heart Rate ; Humans ; Hypertension ; Indapamide ; Uric Acid