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An improved version of a pneumatic-tube system built by Amsco, Inc. (Erie, Pa.) and its subsidiary ATC (San Rafael, Calif.) for blood-sample transportation incorporated two innovations: The sample carrier travels at a lower speed than in the previous conventional systems, and it is decelerated gradually on arrival. This tube system was pilot tested for efficiency by running blood-filled Vacutainer tubes through the 63.6-rn (210-feet) tube 10 times, a total running distance of 636 m. Serum lactate dehydrogenase and acid phosphatase activities, and potassium, all sensitive chemical indicators of erythrocyte membrane damage, were measured in blood specimens in partially or totally filled Vacutainer tubes and the results compared with those obtained from controls. No alterations were found in serum test results after 10 or 20 repetitive cycles in the totally filled tubes, but significant changes did occur in partially filled tubes after 20 cycles. If the limitations are observed, this system appears to be suitable for blood-specimen transportation.

The brain isoenzyme of creatine kinase (CK BB) occurs in trace amounts in normal serum and is moderately increased in only a small number of non-oncological conditions. Although many tissues and tumors contain CK BB, we observed serum elevations only in certain carcinomas. Eleven patients with tissue-proven small cell anaplastic carcinoma (SCAC) of the lung had striking elevations of serum CK BB and no evidence of central nervous system (CNS) metastases. Significant increases were also observed in three cases of prostatic carcinoma with no apparent CNS involvement, and in one case each of adenocarcinoma and SCAC of the lung with proven CNS metastases. Three patients with SCAC of lung without distant metastases, three with SCAC of the esophagus with distant metastases but no known CNS involvement, and 17 patients with oncological conditions other than SCAC of the lung or adenocarcinoma of the prostate have failed to show elevation in serum CK BB activity. Serum CK BB may be useful as a diagnostic marker or indicator of metastases for some carcinomas.

Pollutants generated by clinical chemistry laboratories of two cities (Buffalo, N. Y. and Rochester, N. Y.) are described. A stepwise procedure is suggested on how to deal with the toxic liquid wastes from such laboratories. A brief guideline of chemical procedures for the decontamination of selected toxic elements and compounds is included.

The Corning 940 Titrator, which measures total calcium concentration by titration with [ethylenebis(oxyethylenenitrilo)]tetraacetic acid, was evaluated for use in a hospital laboratory. Calcium values for patients' sera were about 0.3 mg/dl lower as measured with the Titrator than with the Technicon SMA 12/60 continuous-flow analyzer. A similar bias was evident when the results with the Titrator were compared with those from atomic absorption spectrophotometry. Agreement was better in the low range and worse in the high range. Within-day and between-day coefficients of variation on the Titrator were about 1.5% and 2.5%, respectively. We saw no interference from magnesium, phosphorus, bilirubin, or in the presence of lipemia. At extremely increased hemoglobin concentrations (500 mg/dl), there is a 5% inhibition. Titrator results for patients' urine samples correlated closely (n = 0.999) with those obtained with the SMA 12/60.

Nutritional assessment parameters were studied in a sample of 132 community-living well elderly. Results are presented for biochemical parameters of serum albumin, hemoglobin, and total lymphocyte count and anthropometric parameters of height, weight, mid-arm circumference, and triceps skinfold. The data show that, although there are some differences between age groups (young-old and old-old), all values remain well within normal limits established for younger individuals.

A technic for the electrophoretic separation of urinary proteins, without prior concentration of the urine, is described. Four patterns of normal proteinuria were detected, as well as patterns corresponding to disease of the glomerulus or tubules. This procedure allows for routine electrophoresis of urine of patients who have normal total urinary protein outputs.

A technique for the collection of Human Tubal Fluid (HTF) has been presented. It is a one-time procedure, coincident to other adominal surgery. The procedure has shown itself to be safe on 37 consecutive cases. The greatest quantity of HTF was obtained near the day of ovulation from patients with long fallopian tubes. A specimen with little or no turbidity usually could be withdrawn from the collection bag 24 hours after surgery. Electrophoresis of HTF in agarose resulted in patterns different from those found with the patient's serum. An altered albumin peak was noted in 2 cases, while in a third case, the HTF exhibited an increase in the s globulin fraction. Immunoelectrophoresis demonstrated that many serum constituents are present in HTF. The immunoglobulin content presented a distribution similar to that which occurs in serum. Unlike other external secretions, γ G is the major immunoglobulin constituent present in HTF. The sodium, phosphorus and magnesium content of HTF was similar to that of serum. In comparison with patient's serum, the potassium and chlorides of HTF were augmented while there was a diminution of HTF calcium. Glucose in tubal fluid was usually a half to a third of the patient's serum level. Marked elevations of amylase and lactic dehydrogenase (LDH) were noted in HTF.

When the new Erie County Medical Center (Buffalo, NY) was built, a pneumatic tube network, manufactured by Mosler Airmatic and Electronic Systems Company, was installed. This network, called the Mosler System 4000, was designed to handle 600 transactions per hour in the hospital, and therefore had to have a high carrier speed (8m/sec). When blood specimens were sent through the system, blood cells were slightly damaged and lactic dehydrogenase activity in the serum was consistently elevated. But neither acidic phosphatase, potassium, blood gases nor urinary casts were significantly affected by tube transport.

In this paper the question of noise level in laboratories was considered and the results of noise level measurements made in various areas of chemistry, hematology and microbiology laboratories in 15 hospitals in the Western New York area were presented. It was concluded that even though the measured noise levels were within the limits set by OSHA, they were sometimes quite high and should be reduced whenever possible.

Lipase activity was simultaneously determined with amylase activity in the sera of 30 hospitalized patients with acute pancreatitis. On admission to the study, 70% of patients with acute pancreatitis had increased serum amylase, 63% had increased lipase, and 83% had increased lipase, increased amylase, or both. All patients had either lipase or amylase increase at some time during the course of their disease. Lipase level elevation paralleled the amylase in the majority of cases. There were several instances of earlier elevation of the lipase level. The traditional thesis that lipase level elevation occurs later and lasts longer than that of amylase was not confirmed. Measurement of serum amylase and lipase levels together will improve diagnostic accuracy in acute pancreatitis. (JAMA229:47-50, 1974)

The shift of the lactate dehydrogenase (LDH) isoenzymes in experimental animals under hypoxia from B (aerobic) to A (anaerobic) is confirmed and its reversibility after removal of the animals to room air is reported. These experiments are interpreted as further supportive evidence of a physiological adaptive role for the lactate dehydrogenase enzyme system. The slow adaptive process observed in this experimental situation presumably requires de novo enzyme synthesis, however, in the emergency of a sudden deprivation of oxygen the liberation of preformed A LDH could be a link in the rapid chain of events resulting in depressed cardiac muscle contractility which follows myocardial infarction. A recently proposed comprehensive explanation of the role of LDH isozymes is thus extended.