Seymour Winsten

A rapid micro diazo technique for measuring total bilirubin

Abstract A diazo method for the determination of total serum bilirubin is described. This procedure used standardized techniques and pre-packaged reagents. The new method was compared with the routine method used in the clinical laboratory. The results were quite comparable and there were several obvious advantages to the new method.

Laboratory evaluation of a chromogenic amylase method

Abstract An evaluation was performed of a routine amyloclastic procedure and a new commercially available chromogenic method for the assay of serum amylase. Minor modifications of the commercial method seem to result in a sensitive and reliable procedure, which compares favorably with the amyloclastic assay. The substrate appears to react within a broad pH range (6.7–8.4) and the reaction is linear for at least 30 min, which is double the normal assay incubation time. Bilirubin and hemoglobin did not seem to interfere.

Large-volume continuous-flow electrophoresis of serum proteins with glass microbeads

Abstract A continuous-flow electrophoresis apparatus utilizing siliconized Pyrex glass microbeads has been described. The apparatus has been used to separate and collect large quantities of serum proteins in a relatively short period of time. Evidence is presented to indicate that there is little or no loss of biological activity in the collected fractions.

The use of a single manifold for sugar and urea determination on the autoanalyzer.

In 1920, the famous muckraker, Lincoln Steffens, after returning from a visit to Communist Russia, stated, “I have seen Utopia and it works.” If we believed the claims of instrument manufacturers and their detail men, we would think we were approaching the Utopian Era in automation in clinical chemistry. I only hope that the automation utopia does not fade away as rapidly as the Communist utopia and that we are not left with as many problems in the field of clinical chemistry as the world has in the realm of international politics. One of the machines that heralded the advance of automation in clinical chemistry was the Technicon AutoAnalyzer.’ This instrument was introduced at our institution in June, 1957, and has been in somewhat continuous operation since that time. Though we have experimented with the assays of other chemical constituents, we have used it in the routine laboratory solely for the determination of glucose and blood urea nitrogen. During this period of time, approximately 200,000 to 250,000 individual biological assays as well as control sample assays have been performed on the instrument. Though the problems of maintenance, service, and repair have not yet been adequately solved, the instrument is an important cog in the functioning of our routine laboratory. Originally, an individual separate manifold for glucose and urea was suggested by the manufacturer.l Though the transfer from a urea to a glucose manifold could be accomplished in a relatively short space of time, there was still a definite time lag between assays of glucose and urea. In addition to the time problem there were other disadvantages. The transfer itself involved the removal of the manifold from the instrument, draining the lines, and storing it when not in use. At least four line connections as well as three to four reagent bottles had to be properly connected before the manifold could be operative. Occasionally, gross mistakes in determinations were traced to technician error in attaching the lines in the wrong sequence to the dialyzing plates. A major disadvantage to the use of the individual manifolds stems from the inertia developed by the technician against making transfers in the late afternoon, a time when sporadic and sometimes important samples arrive in the laboratory. Occasionally, analyses that should be performed immediately are left for the night technician, because the routine technician feels it is too much trouble to change the manifold. A set of tubing that could be used interchangeably for glucose and urea would overcome most of these objections and would be a valuable addition to a routine laboratory. * Technicon Instruments Corp., Chauncey, N. Y.

LIVER FUNCTION STUDIES IN CHILDREN WITH NEONATAL JAUNDICE AND BILIARY ATRESIA

For several years we have been studying the liver function patterns of adult patients with hepatobiliary disease. Recently we have expanded our investigation to include children with the clinical problems of biliary atresia and neonatal jaundice. Some of the work on the biliary atresia patients has already been pub1ished.l The major portion of our current effort deals with jaundice in the newborn, and specifically those infants whose clinical, hematological and biochemical condition warranted exchange transfusions. In 1960, through the combined efforts of the hematology and chemistry divisions of our laboratory department, we initiated an exchange transfusion service at our institution. To date, we have performed approximately 148 exchange transfusions on 69 infants. Obviously several of these children have had repeat transfusions, necessitated not only by rapidly developing hyperbilirubinemia but also by hematological, immunological and clinical evidence. Since a certain degree of morbidity and mortality still accornpanics the exchange procedure, and since it is also the consensus that only 20 per cent cf the newborn with hyperbilirubinemia will get kernicturus, we decided to investigate neonatal liver function, hoping in this fashion to supplement the usual criteria for making a decision on the need for exchange transfusion. The investigation has been fraught with technical and clinical problems and has been limited by the small number of children requiring treatment. We have therefore been able to study partially, the liver function of thirteen children, and are going to present data of a highly preliminary nature.