BACKGROUND: Recent blood gas analyzers offer electrolytes, Hb-derivatives (O2 Hb, HHb, COHb, MetHb and SulfHb), content of total hemoglobin (ctHb), and metabolites (glucose and lactate) as well as conventional blood gas parameters. Evaluation and efficient control of these instruments affect greatly monitoring and therapy of patients. The authors evaluated a recently introduced blood gas analyzer, the Roche OMNI 9 (Roche Diagnostics) for precision, analytic speed, function, features and comparability with other instruments according to NCCLS guidelines to see if it was suitable for the stat analyzer. METHODS: Commercial control materials, AUTO-trol PLUS Level 1, 2, 3 (Roche Diagnostics) were analyzed to evaluate the within-day precision, the between-day precision, and patient samples were used to evaluate comparability with other instruments. RESULTS: The within-day and the between-day precisions of the Roche OMNI 9 showed a very low CV of 0- 3.93% and 0- 3.99%, respectively, in all parameters except the lactate, which had moderate CV values of 7.74% and 5.93% in Level 3 QC material (low concentration). In compari-son with the Bayer instrument, correlation was high in all parameters with the r(2) value ranging from 0.9441 to 0.9901 except for COHb (r(2)=0.4239) and MetHb (r(2)=0.0034) whose concentrations were in the lower level. Glucose (r(2)=0.991), lactate (r(2)=0.9824), and hemoglobin (r(2)=0.9961) showed a rather high correlation. The Roche OMNI 9 could analyze 40 samples of blood gas and 27 samples of full parameter per hour, which was comparable to the Bayer M855. CONCLUSIONS: The Roche OMNI 9 showed high precision and rapid turnaround time for blood gas and in a selection of glucose, lactate and hemoglobin.
Blood Gas Analysis ; Electrolytes ; Glucose ; Humans ; Lactic Acid

The purpose of this study is to investigate the spectra of a magnetic resonance spectroscopy (MRS) in accordance with the variance of TE and the volumes of metabolites in a localized voxel for the quality assurance using a designed single voxel spectroscopy QA phantom. Because a cone-shape phantom is designed as the volume of metabolite in a localized voxel is changeable, we try to analyze the peaks of each metabolite (NAA, Cr, Cho, Lac, etc.) in accordance with metabolite volume in a localized voxel as well as echo time (TE). All data were obtained using a 3T MRI/MRS machine and analyzed using jMRUI(R). The results of this study show that TE is in inverse proportion to the noise of MRS and the longer TE and the less metabolite volume in the localized voxel, the peak intensities of each metabolite decrease. In case of the lactate, its peak was observed on the all TE only if the greatest metabolite is included in the localized voxel. Then, the intensity of a metabolite is more sensitive to the metabolite volume in the localized voxel than the TE. These obtained in vitro MRS data is provide the guideline that is important for in vivo metabolite quantification. But, in the edge of cone-shape vial air bubbles were observed and spectrum could not obtained. Therefore our cone-shape MRS phantom needs to be modified in order to solve these problems.
Lactic Acid ; Magnetic Resonance Spectroscopy ; Noise ; Spectrum Analysis

PURPOSE: To investigate the 3-bond and spatial connectivity of human brain metabolites by scalar coupling and dipolar nuclear Overhauser effect/enhancement (NOE) interaction through 2D- correlation spectroscopy (COSY) and 2D- NOE spectroscopy (NOESY) techniques. MATERIALS AND METHODS: All 2D experiments were performed on Bruker Avance 500 (11.8 T) with the zshield gradient triple resonance cryoprobe at 298 K. Human brain metabolites were prepared with 10% D2O. Two-dimensional spectra with 2048 data points contains 320 free induction decay (FID) averaging. Repetition delay was 2 sec. The Top Spin 2.0 software was used for post-processing. Total 7 metabolites such as N-acetyl aspartate (NAA), creatine (Cr), choline (Cho), glutamine (Gln), glutamate (Glu), myo-inositol (Ins), and lactate (Lac) were included for major target metabolites. RESULTS: Symmetrical 2D-COSY and 2D-NOESY spectra were successfully acquired: COSY cross peaks were observed in the only 1.0-4.5 ppm, however, NOESY cross peaks were observed in the 1.0-4.5 ppm and 7.9 ppm. From the result of the 2-D COSY data, cross peaks between the methyl protons (CH3(3)) at 1.33 ppm and methine proton (CH(2)) at 4.11 ppm were observed in Lac. Cross peaks between the methylene protons (CH2(3,H alpha)) at 2.50ppm and methylene protons (CH2,(3,HB)) at 2.70 ppm were observed in NAA. Cross peaks between the methine proton (CH(5)) at 3.27 ppm and the methine proton (CH(4,6)) at 3.59 ppm, between the methine proton (CH(1,3)) at 3.53 ppm and methine proton (CH(4,6)) at 3.59 ppm, and between the methine proton (CH(1,3)) at 3.53 ppm and methine proton (CH(2)) at 4.05 ppm were observed in Ins. From the result of 2-D NOESY data, cross peaks between the NH proton at 8.00 ppm and methyl protons (CH3) were observed in NAA. Cross peaks between the methyl protons (CH3(3)) at 1.33 ppm and methine proton (CH(2)) at 4.11 ppm were observed in Lac. Cross peaks between the methyl protons (CH3) at 3.03 ppm and methylene protons (CH2) at 3.93 ppm were observed in Cr. Cross peaks between the methylene protons (CH2(3)) at 2.11 ppm and methylene protons (CH2(4)) at 2.35 ppm, and between the methylene protons(CH2 (3)) at 2.11 ppm and methine proton (CH(2)) at 3.76 ppm were observed in Glu. Cross peaks between the methylene protons (CH2 (3)) at 2.14 ppm and methine proton (CH(2)) at 3.79 ppm were observed in Gln. Cross peaks between the methine proton (CH(5)) at 3.27 ppm and the methine proton (CH(4,6)) at 3.59 ppm, and between the methine proton (CH(1,3)) at 3.53 ppm and methine proton (CH(2)) at 4.05 ppm were observed in Ins. CONCLUSION: The present study demonstrated that in vitro 2D-COSY and NOESY represented the 3-bond and spatial connectivity of human brain metabolites by scalar coupling and dipolar NOE interaction. This study could aid in better understanding the interactions between human brain metabolites in vivo 2DCOSY study.
Aspartic Acid ; Brain ; Choline ; Creatine ; Glutamic Acid ; Glutamine ; Humans ; Lactic Acid ; Protons ; Spectrum Analysis

OBJECTIVE: MR spectroscopy is a noninvasive method of monitoring in vivo metabolite concentration changes over time. In this study we evaluated the usefulness of combined magnetic resonance imaging and spectroscopy on the diagnosis of cerebral infarction. METHODS: Combined magnetic resonance imaging and spectroscopy investigations were carried out with 1.5-T system in 18 volunteers, 10 patients with acute infarction (< 8 hours). RESULTS: Acute ischemic infarctions were characterized by decreased N-acetyl aspartate and elevation of lactate. CONCLUSION: Metabolic alterations in ischemic tissue can be monitored.
Aspartic Acid ; Cerebral Infarction* ; Diagnosis ; Humans ; Infarction ; Lactic Acid ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy* ; Spectrum Analysis ; Volunteers

PURPOSE: The purpose of this study was to determine whether in vitro proton (1H) magnetic resonance spectroscopy (MRS) is useful for distinguishing between abdominal types of fluids. MATERIALS AND METHODS: Thirty fluid samples that were obtained from patients who were undergoing diagnostic or therapeutic percutaneous drainage of abdominal fluids were examined in this study. According to their gross appearance and smell, each sample was classified as either purulent fluid (n=12) or non-purulent fluid (n=18). The non-purulent fluids were subdivided into hemorrhagic fluid (n=2), serosanguinous fluid with debris (n=2), and serosanguinous fluid without debris (n=14). In addition, according to the cytologic analysis, each sample was classified as either benign fluid (n=23) or malignant fluid (n=7). A set of humoral pathological examinations that included biochemical analysis and culture of the fluid were performed for all the fluid samples. In vitro 1H MRS was performed by using a 1.5T MR system and a birdcage head coil. MR spectra were obtained by using point-resolved spectroscopy (PRESS) (TR/TE=2000/30 msec) with water suppression. The MR spectra were analyzed on the basis of agreement between a radiologist and a physicist who worked in consensus. RESULTS: The MR spectra obtained from 30 samples could be classified into 8 different patterns, according to the presence of lipid (0.9/1.3 ppm), lactate (1.3 ppm), acetate (1.9 ppm), and succinate (2.4 ppm) peaks. The MR spectral patterns of the purulent fluids (n=12) were classified as follows: pattern-1 (n=7, 58%), pattern-2 (n=2, 17%), pattern-3 (n=1, 8%), pattern-6 (n=1, 8%) and pattern-8 (n=1, 8%). The MR spectral patterns of the non-purulent fluids (n=18) were classified as follows: pattern-4 (n=1, 6%), pattern-5 (n=5, 28%), pattern-6 (n=1, 6%), pattern-7 (n=3, 17%) and pattern-8 (n=8, 44%). The MR spectral patterns of the purulent fluids were significantly different from those of the non-purulent fluids (p < .05). The MR spectral patterns of benign fluids (n=23) were classified as follows: pattern-1 (n=7, 30%), pattern-2 (n=2, 9%), pattern-3 (n=1, 4%), pattern-4 (n=1, 4%), pattern-5 (n=3, 13%), pattern-6 (n=2, 9%), pattern-7 (n=1, 4%) and pattern-8 (n=6, 26%). The MR spectral patterns of malignant fluids (n=7) were classified as follows: pattern-5 (n=2, 29%), pattern-7 (n=2, 29%) and pattern-8 (n=3, 43%). No significant difference was found between the spectral patterns of the benign and malignant fluids (p= .300). CONCLUSION: In vitro 1H MRS could be useful for differentiating between purulent fluid and non-purulent fluid.
Abscess ; Body Fluids* ; Consensus ; Drainage ; Head ; Humans ; Lactic Acid ; Magnetic Resonance Spectroscopy* ; Protons* ; Smell ; Spectrum Analysis ; Succinic Acid ; Water

PURPOSE: To develop a technique for quantifying the 13C-metabolites by performing frequency-selective hyperpolarized 13C magnetic resonance spectroscopy (MRS) in vitro which combines simple spectrally-selective excitation with spectrally interleaved acquisition. METHODS: Numerical simulations were performed with varying noise level and K(p) values to compare the quantification accuracies of the proposed and the conventional methods. For in vitro experiments, a spectrally-selective excitation scheme was enabled by narrow-band radiofrequency (RF) excitation pulse implemented into a free-induction decay chemical shift imaging (FIDCSI) sequence. Experiments with LDH / NADH enzyme mixture were performed to validate the effectiveness of the proposed acquisition method. Also, a modified two-site exchange model was formulated for metabolism kinetics quantification with the proposed method. RESULTS: From the simulation results, significant increase of the lactate peak signal to noise ratio (PSNR) was observed. Also, the quantified K(p) value from the dynamic curves were more accurate in the case of the proposed acquisition method compared to the conventional non-selective excitation scheme. In vitro experiment results were in good agreement with the simulation results, also displaying increased PSNR for lactate. Fitting results using the modified two-site exchange model also showed expected results in agreement with the simulations. CONCLUSION: A method for accurate quantification of hyperpolarized pyruvate and the downstream product focused on in vitro experiment was described. By using a narrow-band RF excitation pulse with alternating acquisition, different resonances were selectively excited with a different flip angle for increased PSNR while the hyperpolarized magnetization of the substrate can be minimally perturbed with a low flip angle. Baseline signals from neighboring resonances can be effectively suppressed to accurately quantify the metabolism kinetics.
Kinetics ; Lactic Acid ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Metabolism* ; NAD ; Noise ; Pyruvic Acid* ; Signal-To-Noise Ratio ; Spectrum Analysis

PURPOSE: To determine the clinical usefulness of lactic acidosis in an evaluation of patients with suspected generalized convulsion. METHODS: This was retrospective cohort study. The correlation between the lactate level and the time to blood gas analysis (ABGA) was analyzed in patients who had a final diagnosis of seizure to exclude the time effect on the spontaneous clearance of lactate. The patient's data in the true seizure group and false seizure group was then compared. The receiver operating characteristics (ROC) curve of lactate, pH and base deficit for diagnosing true seizure was drawn. The sensitivity and specificity of the presence of hyperlactatemia or acidosis for a diagnosis of seizure and predicting epileptiform discharge at electroencephalography (EEG) was analyzed. RESULTS: Of the 173 patients suspected of having generalized convulsion, 136 patients were diagnosed with a true seizure on hospital discharge and patients whose ABGA was performed within 60 minutes after seizure showed a significantly higher arterial lactate level, lower arterial pH and base deficit than the patients whose ABGA was performed after 60 minutes of seizure onset. 62 patients whose ABGA was performed 60 minutes after symptom onset were excluded. Finally, of 111 patients, 89 patients with true seizure showed a significantly higher arterial lactate level, lower arterial pH and base deficit than the 22 patients with false seizure. The ROC curve of lactate, pH and base deficit showed a significant area under the curve for diagnosing true seizure. The presence of hyperlactatemia or acidosis showed high sensitivity for diagnosing true seizure and expecting epileptiform EEG when they were measured with 60 minutes after symptom onset. CONCLUSION: In patients with suspected generalized convulsion, upon presentation to the ED within 60 min of symptom onset, the presence of hyperlactatemia or acidosis increased the likelihood of a true seizure and might be an objective indicator for further evaluations of seizure. On the other hand, normal lactate levels and no acidosis could not exclude a true seizure.
Acidosis ; Acidosis, Lactic ; Blood Gas Analysis ; Cohort Studies ; Electroencephalography ; Hand ; Humans ; Hydrogen-Ion Concentration ; Lactic Acid ; Retrospective Studies ; ROC Curve ; Seizures ; Sensitivity and Specificity

PURPOSE: To determine the usefulness of in-vivo proton MR spectroscopy (MRS) with short TE for grading glial brain tumors. MATERIALS AND METHODS: For the purpose of tumor grading, 32 patients with pathologically confirmed glial tu-mors were examined by proton MRS. This and MRI were performed on a 1.5 T superconductive MR scanner. T2-weighted FSE images (TR/TE=4,000/100msec) were used to obtain anatomical reference images. The stim-ulated- echo acquisition mode (STEAM: TR/TE/MT=3000/30/13.7msec) was used to acquire MRS data from the localized single-voxel (2 x2 x2 cm 3 ) in both hemispheres. Residual water resonance in the spectra was re-moved using a CHESS pulse sequence. Prior to baseline correction, MRS raw-data, free induction decay sig-nals were zero-filled, apodized by an exponential function with 8Hz line-broadening, and fourier transformed. To normalize signal intensities of metabolites such as N-acetyl aspartate (NAA), total choline (Cho), myo-inosi-tol (mI), and lactate (Lac), the creatine(Cr) peak was used as a standard. RESULTS: The concentration ratios of Cho/Cr, mI/Cr, alpha-Glx, Lac, and NAA/Cr changed linearly according to tu-mor grade. Increased Cho, mI, alpha-Glx, and Lac levels were clearly seen in all grades. The most dramatic in-creases, observed in either Grade III or IV, were 78% and 228% for Cho(p<0.001), 106% and 61% for mI (p<0.001), 32% and 5% for alpha-Glx, and 727% and 450% for Lac (p<0.001), respectively. Increase of concen-tration ratio of Lac/Cr observed only in Grade III and Grade IV. The concentration ratios of NAA/Cr decreased gradually as tumor grade increased(p<0.001). CONCLUSION: The metabolic changes seen on proton MR spectroscopy using short TE might be useful for grad-ing glial brain tumors.
Aspartic Acid ; Brain Neoplasms ; Brain* ; Choline ; Fourier Analysis ; Humans ; Lactic Acid ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy* ; Neoplasm Grading ; Protons* ; Spectrum Analysis ; Water

OBJECTIVETo investigate osthole effect on femoral tissue resorption activity of rat in vitro.

METHODSSix SD rats weighted (80 ± 5) g were used to isolate and culture femoral tissue (diaphyses and metaphysis) in vitro. The cultured tissue were devided into control group, estradiol group and osthole group. The femoral tissue was treated with final concentration of 1 x 10(-5) mol/L osthole and 1 x 10(-8) mol/L estradiol culture in vitro at 48 hours after cultured. Tartrate-resistant acid phosphatase (StrACP) activity, glucose and Lactic acid content, StrACP, MCSF (Macrophage colony stimulating factor) and CTSK (Cathepsin K) mRNA was detected by Real-Time RT-PCR were detected.

RESULTSConcetration of Alkaline phosphatase activity were 2226 and 2498 in 1 x 10(-5) mol/L osthole and 1 x 10(-8) mol/L estradiol respectively. As compared with control group, the activity of StrACP of 1 x 10(-5) mol/L osthole and 1 x 10(-8) mol/L estradiol were inhibited at 6, 9, 12 days (P < 0.05); under treatment of in l x 10(-5) mol/L osthole, the content of Lactic acid were increased and the content of glucose were decreased at 3, 6, 9 days (P < 0.05); StrACP, MCSF and CTSK mRNA expression level were inhibited at 6, 9 days (P < 0.05).

CONCLUSIONOsthole can inhibit bone resorption and raise the level of nutrition metabolism of femurs tissue.

Acid Phosphatase ; metabolism ; Animals ; Bone Resorption ; prevention & control ; Coumarins ; pharmacology ; Estradiol ; pharmacology ; Femur ; drug effects ; Glucose ; analysis ; Lactic Acid ; analysis ; Male ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo study the relationship between Chinese medical syndrome types and metabolomics of non-small cell lung cancer (NSCLC) patients.

METHODSTotally 120 NSCLC patients were assigned to asthenia syndrome group and sthenia syndrome group, 60 in each group. Meanwhile, 60 cases of benign pulmonary nodules in physical examinations were recruited as the control group. Tumor tissues or benign pulmonary nodules tissues were obtained by thoracoscope. Changes of their metabolites were observed using gas chromatography-mass spectrometry (GC-MS). Their differences were studied using principal component analysis (PCA) and partial least-squares discriminant analysis (PLS-DA). ROC curve analysis was performed in different metabolic compounds of sthenia and asthenia syndromes groups. The area under the curve (AUC) was calculated to evaluate the sensitivity of diagnosing syndrome types.

RESULTSCompared with the control group, difference existed in 16 compounds. Of them , contents of citric acid, pyruvic acid, alanine, choline phosphate, glycerol phosphate choline, linoleic acid, oleic acid, lactic acid, inositol were more in the two tumors group than in the control group. Difference existed in 10 compounds between the sthenia syndrome group and the asthenia syndrome group. Of them, citric acid, pyruvic acid, alanine, choline phosphate, glycerol phosphate choline, lactic acid, and inositol were more in the asthenia syndrome group than in the sthenia syndrome group. Contents of valine, glucose, and glutamine were more in the sthenia syndrome group than in the asthenia syndrome group. ROC curve analyses of different compounds indicated that AUC of lactic acid and glucose was more than 0.8 (P < 0.01); AUC of inositol, choline phosphate, and glycerol phosphate choline was more than 0.7 (P < 0.01); AUC of valine, citric acid, glutamine, alanine, and pyruvic acid was more than 0.6 (P < 0.05).

CONCLUSIONSThere existed certain correlation between CM syndrome types and metabolomics of lung cancer. Lactic acid, glucose, inositol, choline phosphate, glycerol phosphate choline, valine, citric acid, glutamine, alanine, pyruvic acid were sensitive diagnostic compounds, and the first four kinds were most sensitive compounds.

Asian Continental Ancestry Group ; Carcinoma, Non-Small-Cell Lung ; metabolism ; Gas Chromatography-Mass Spectrometry ; Humans ; Lactic Acid ; Least-Squares Analysis ; Metabolomics ; methods ; Principal Component Analysis ; Pyruvic Acid