Peter Luppa

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25-Hydroxyvitamin D im Serum und Biopsie-Ergebnisse bei Frauen mit auffälliger Mammografie

Geburtshilfe und Frauenheilkunde, 2013

Knochenstoffwechsel, Knochendichte und Progesteron in der Perimenopause: eine prospektive 2-Jahres-Untersuchug

Geburtshilfe und Frauenheilkunde, 2003

[Transport of blood gas samples: is the pneumatic tube system safe?]

Der Anaesthesist

Transport of blood gas samples via a pneumatic tube system and subsequent analysis in the central... more Transport of blood gas samples via a pneumatic tube system and subsequent analysis in the central laboratory can reduce costs and errors compared to on-site testing in the operating theatre or the intensive care unit. In this study, a modern pneumatic tube transport system was tested for its usability for this purpose. A total of 4 consecutive blood gas samples were obtained intraoperatively from 54 different patients and sent to the central laboratory. Of these, 3 samples were transferred using the pneumatic tube system but by different methods and 1 sample was transported personally which served as a reference. The results of sample analysis concerning blood gases, electrolytes and haemoglobin were compared and examined for differences. No statistically significant differences could be determined between the different modes of transportation. Transport of samples for blood gas analysis via a modern pneumatic tube system is safe when samples are correctly prepared.

6a-Biotinylated Estrone: Novel Tracer in Competitive Chemiluminescence Immunoassayof Estrone in Serum

format_quoteDeveloped an immunoassay using a biotinylated estrone derivative, validated for total estrone determination in serum.format_quote

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7a-Biotinylated testosterone derivatives as tracers for a competitive chemiluminescence immunoassay of testosterone in serum

Ring core-biotinylated testosterone tracers were synthesized with bridges of three different leng... more Ring core-biotinylated testosterone tracers were synthesized with bridges of three different lengths connecting the biotin moiety to the steroid core (7␣-C n -Bio-T, n ‫؍‬ 3, 6, or 11). Together with a position 7-specific polyclonal anti-testosterone antibody, we used the 7␣-C 11 -Bio-T tracer to develop a novel, labeled-hapten competitive immunoassay for total testosterone in serum. (The C 3 and C 6 tracers proved to be not suitable for analogous immunoassays.) Enhanced chemiluminescence signal was generated by use of a second immobilized antibody and a streptavidin-horseradish peroxidase conjugate. The measuring range of the assay is 0.2-20.0 nmol/L, linearity of serial dilutions can be demonstrated, the lower detection limit is 0.125 nmol/L, and the interassay imprecisions are 13-16%. Accuracy determinations in mass spectrometry-controlled reference specimens showed a mean recovery of 95%. In addition, the assay shows low cross-reactivities, demonstrating the favorable specificity of the combination of a "nearly native" tracer with a position analog antibody. The optimized steric structure and the long spacer arm of the biotinylated testosterone tracer make this chemiluminescence assay well-suited for measuring total testosterone concentration in serum.

format_quoteThe optimal antibody dilution for effective signal generation in the chemiluminescence assay was identified, ensuring reliable assay performance.format_quote

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COMPARISON OF GLUCOSE AND GLUTAMINE-METABOLISM IN MITOGEN ACTIVATED THYMOCYTES AND IN LYMPHOBLASTOID CELL-LINES

Biological chemistry Hoppe-Seyler

Successful therapy of hepatorenal syndrome using the vasopressin-1- receptor agonist ornipressin

A 47-year-old male patient with alcoholic cirrhosis Child-Pugh grade C was admitted to our center... more A 47-year-old male patient with alcoholic cirrhosis Child-Pugh grade C was admitted to our center for evaluation of liver transplantation. Serum creatinine had increased from 1.6 to 4.3 mg/100 ml within the previous two weeks, creatinine clearance was 12 ml/min, and urinary sodium 12 mmol/24 h. The diagnosis of HRS type I was established. Diuretic treatment was discontinued. Following albumin infusion, central venous pressure was increased to above 10 cm H 2O and dopamine (2 μg/kg/min) infusion was started. However, renal function did not improve. An iv infusion of ornipressin (POR8, Sandoz; 6 IU/h) was started and dopamine infusion continued. During a four-hour interval, urinary volume and sodium excretion doubled. Therefore treatment was continued for three weeks. After 22 days, renal function had normalized (creatinine 1.2 mg/100 ml, creatinine clearance 65 ml/min, urinary sodium 62 mmol/24 h) and diuretic therapy was resumed. No adverse effects were observed. Ornipressin/dopamin...

Online-Qualitätssicherung patientennaher Sofortdiagnostik (Point-of-Care-Testing) unter Nutzung des Kommunikations-Systems des Krankenhauses / Online quality assurance of point-of-care testing by using the hospital information system

LaboratoriumsMedizin

Verbesserung der Therapiesicherheit durch eine einheitliche Kalibration von POCT-Glukose-Messgeräten auf Plasma Stellungnahme der Arbeitsgruppe POCT der Deutschen Vereinten Gesellschaft für Klinische Chemie und Laboratoriumsmedizin / Improvement of therapeutic safety through standardized plasma c...

LaboratoriumsMedizin, 2009

Improvement of therapeutic safety through standardized plasma calibration of blood glucose test systems at the point-of-care 1 / Statement of the POCT Working Group of the German Society for Clinical Chemistry and Laboratory Medicine (DGKL)

LaboratoriumsMedizin, 2009

C-terminal agrin fragment (CAF) as a serum biomarker for residual renal function in peritoneal dialysis patients

International Urology and Nephrology

Background C-terminal agrin fragment (CAF, size 22 kDa) is a promising new biomarker for kidney f... more Background C-terminal agrin fragment (CAF, size 22 kDa) is a promising new biomarker for kidney function. This study evaluated the usefulness of CAF as a serum biomarker for residual renal function (RRF) in patients undergoing automated peritoneal dialysis (APD). Patients and methods Serum, urine and dialysate samples were obtained in 12 end-stage renal disease patients undergoing APD. Total, renal and peritoneal clearances were calculated for CAF, creatinine, blood urea nitrogen (BUN) and cystatin c. kt/V was computed, and RRF (in ml/min) was calculated as the arithmetic mean of creatinine and BUN clearance. Correlations between the biomarkers’ serum concentrations, clearances, kt/V and RRF were computed. Results Serum CAF concentrations were highly correlated with serum concentrations of creatinine (r = 0.806, p = 0.002), BUN (r = 0.727, p = 0.007), cystatin c (r = 0.839, p = 0.001) and inversely to 24-h urinary output (r = −0.669, p = 0.017). RRF was inversely correlated with ser...

Early postoperative C-terminal agrin fragment (CAF) serum levels predict graft loss and proteinuria in renal transplant recipients

Clinical chemistry and laboratory medicine : CCLM / FESCC, Jan 18, 2015

C-terminal agrin fragment (CAF), cleavage product of agrin, was previously correlated with kidney... more C-terminal agrin fragment (CAF), cleavage product of agrin, was previously correlated with kidney function in renal transplant patients. This article studies the predictive value of CAF for long-term outcomes in renal transplant recipients. In this observational cohort study, serum CAF, creatinine and blood-urea-nitrogen (BUN) concentrations and eGFR (CKD-EPI) were assessed 1-3 months after transplantation in 105 patients undergoing kidney transplantation. Cox regression models were used to analyse the predictive value of all parameters concerning all-cause mortality (ACM), graft loss (GL), doubling of creatinine/proteinuria at the end of follow-up. Median follow-up time was 3.1 years. The mean concentrations were 191.9±152.4 pM for CAF, 176±96.8 μmol/L for creatinine, 12.6±6.2 mmol/L for BUN and 44.9±21.2 mL/min for CKD-EPI formula, respectively. In univariate analysis CAF and BUN concentrations predicted ACM (CAF: HR=1.003, 1.1-fold risk, p=0.043; BUN: HR=1.037, 1.3-fold risk, p=0...

Neue Analysekonzepte

POCT — Patientennahe Labordiagnostik, 2008

ABSTRACT Während sich POCT-Systeme noch in der Wachstumsphase des weltweiten Marktes befinden und... more ABSTRACT Während sich POCT-Systeme noch in der Wachstumsphase des weltweiten Marktes befinden und weitere Bereic he der Labordiagnostik erschließen, erreichen die Zentrallaboratorien mit ihrer Mechanisierung derzeit gerade den Höhepunkt der sog. Totalautomation. Wichtigste Merkmale sind dabei hochgradig konsolidierte Analysegeräte („workcells“) mit integrierter Prä- und Postanalytik — eine notwendige Reaktion auf die beschränkten Ressourcen der 1990er Jahre. Bei der Entwicklung dieser relativ großen und teuren Systeme standen Effizienzsteigerung und möglichst geringe Personalbindung im Vordergrund. Fast zwangsläufigging damit aber auch eine Zentralisierung von Laborleistungen einher, die als Kehrseite der Medaille zum Verlust der Vor-Ort-Präsenz und zur Verlängerung der Transportzeiten führte.

$Research paper thumbnail of Gemeinsame Stellungnahme zur Situation der Bewertung von Ringversuchen für Glucose mittels Systemen f\xfcr die patientennahe Sofortdiagnostik (POCT)/Joint statement on the situation of external quality control for glucose in POCT systems$

Gemeinsame Stellungnahme zur Situation der Bewertung von Ringversuchen für Glucose mittels Systemen f\xfcr die patientennahe Sofortdiagnostik (POCT)/Joint statement on the situation of external quality control for glucose in POCT systems

Laboratoriumsmedizin, 2012

ABSTRACT The directive of the Federal Association of Medical Doctors for the quality assurance of... more ABSTRACT The directive of the Federal Association of Medical Doctors for the quality assurance of medical laboratory investigations (RiliBÄK) recommends, among other things, external quality testing for point-of-care testing (POCT) devices. With assessment and evaluation of these external quality trials, problems arise, for example, poor correlation with reference method, matrix effects of the control material, and therefore as a result no granting of a certificate. In a joint statement, the present situation of such problems will be described. As a suitable control material is not available, an evaluation at this point in time can only be done on the so-called Consensus Value Model (mean value from the received results depending on the method in use). The reference method value cannot be used as the target value owing to the problems mentioned.

Stellungnahme der Arbeitsgemeinschaft “Point-of-Care Testing” der DGKL zum Thema Vernetzung von POCT-Geräten im Krankenhaus mit Zentrallabor Comments by the working group “point-of-care-testing” of the DGKL on the subject of linking POCT instruments in hospitals with a central laboratory

LaboratoriumsMedizin, 2005

[Carbohydrate-deficient transferrin (CDT) as preoperative alcohol marker in surgical risk patients]

Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen, 1998

In a prospective study the preoperative risk of alcohol addiction was evaluated in 46 patients wi... more In a prospective study the preoperative risk of alcohol addiction was evaluated in 46 patients with squamous cell carcinoma of the esophagus. In all patients the alcohol marker carbohydrate-deficient transferrin (CDT) was measured prior to esophagectomy and correlated with the incidence of postoperative withdrawal symptoms (yes/no) and the postoperative course (good/moderate/poor/fatal). Withdrawal symptoms were more frequently observed in cases of elevated CDT values (median of CDT with withdrawal 17.0 U/l vs without withdrawal 10.7 U/l; P = 0.0006). CDT values were significantly increased in case of a complicated postoperative course (median of CDT for moderate/poor/fatal postoperative course 14.0 U/l vs good course 10.8 U/l; P = 0.02). The CDT value correlated (P = 0.04) with the patient's history of preoperative alcohol consumption (normal/increased/high). In a multivariate logistic regression analysis CDT and preoperative alcohol consumption were independent parameters to p...

Renal and circulatory effects of large volume plasma expansion in patients with hepatorenal syndrome type 1

Annals of hepatology

Hepatorenal syndrome type I (HRS I) may be a consequence of circulatory dysfunction in cirrhotic ... more Hepatorenal syndrome type I (HRS I) may be a consequence of circulatory dysfunction in cirrhotic patients with portal hypertension. This uncontrolled interventional pilot study examines the hemodynamic and renal effects of large volume plasma expansion in HRS I. 14 cirrhotic patients (8 m, 6 f, age 60 (58-65) years) with HRS I received large volume plasma expansion with up to 400 mL of 20% human albumin solution per 12 over 48 h under hemodynamic monitoring by transpulmonary thermodilution. Creatinine clearances (ClCreat) were calculated for 12-h periods. Plasma expansion was withheld if criteria of volume overload [Extravascular lung Water Index (ELWI) > 9 mL/kg or Global End-Diastolic Volume Index (GEDI) > 820 mL/m(2)] were met. Paracentesis was performed according to clinical necessity and treatment continued for 48 h thereafter. Serum creatinine values were observed for 12 days. Patients received 1.6 (1.5-2.0) g of albumin per kg bodyweight and day for 48 to 96 h. During t...

format_quoteSignificant improvements in hemodynamic parameters were observed, including a GEDVI increase from 565 to 724 mL/m² (p=0.001) after plasma expansion treatment.format_quote

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[Efficient and rational laboratory diagnostics in otolaryngology]

HNO, 2008

This article describes the value of laboratory diagnostic procedures in the diagnostic arsenal of... more This article describes the value of laboratory diagnostic procedures in the diagnostic arsenal of otolaryngologists. The rational and therefore the rationale of the application of laboratory medical methods are critically evaluated. In the era of diagnosis-related groups a high value is placed on a rational laboratory diagnostic, in the sense of a cost-oriented medicine, so that the laboratory diagnostic procedure is always carried out in stages, just as in other diagnostic procedures. The possibilities of clinical chemistry, separated into the theme blocks "clinical chemical basic diagnostics", "haematological parameters", "coagulation investigations" and "immunological diagnostics" are demonstrated based on examples. These are aimed at the needs of otolaryngologists, in that the emphasis in each theme block is centred on the indications and evaluation of the individual laboratory investigation.

[Bone metabolism, bone density and estrogen levels in perimenopause: a prospective 2-year-study]

Zentralblatt für Gynäkologie, 2005

Bone metabolism and trabecular bone density were studied prospectively in 69 pre-, peri- and earl... more Bone metabolism and trabecular bone density were studied prospectively in 69 pre-, peri- and early postmenopausal women. Markers of bone resorption (OC = osteocalcin, BAP = bonespecific alkalic phosphatase) and bone formation (PYD = pyridinolin, DPD = desoxypyridnolin, NTX = N-terminal telopeptide crosslinked collagen type I, CTX = C-terminal telopeptide crosslinked collagen type I) in serum and urine were followed over a course of two years with five points of examination (0, 3, 6, 12 and 24 months). Bone density was measured at 0 and 24 months. The results of 40 hormonally untreated women who completed all examinations were compared regarding menopausal status and changes over the 2-year-period. While baseline tracecular bone density was lowest in early postmenoapusal women, perimenopausal women showed greatest bone loss (- 10,6 %) during the two year study period. Bone metabolism markers were highest in the postmenopausal group. Perimenopause was associated with a gradual rise in...

Diagnostic performance study of an antigen microarray for the detection of antiphospholipid antibodies in human serum

by Peter Luppa and Günther Proll

Clinical Chemistry and Laboratory Medicine (CCLM), 2014

Abstract Background: The parallelization of clinically relevant antigens in a microarray format i... more Abstract Background: The parallelization of clinically relevant antigens in a microarray format is of growing importance due to the ability to measure multiple antigen-antibody interactions. With the development of a microarray for the detection of antiphospholipid antibodies we focussed on one important autoimmune disease that is still diagnostically challenging. Reasons are the heterogeneity of the autoantibodies and the unspecific clinical symptoms. Methods: For the covalent immobilization of antigenic structures, glass transducers were coated with 11-aminoundecyltrimethoxysilane (11-AUTMS). In total 35 antiphospholipid syndrome (APS) patients, six patients with lupus erythematosus and 24 healthy controls were investigated on a microarray format using polarized imaging reflectometric interference spectroscopy. Results: The novel surface modification based on the short derivative 11-AUTMS resulted in a selective biosensor allowing a clear differentiation of patient and control samples. It combined proteinogenic as well as phospholipid-derived antigens, namely β2-glycoprotein I (β2-GPI), prothrombin, cardiolipin (CL) and a β2-GPI/CL complex. With optimized regeneration conditions, up to 20 consecutive measurements could be performed on one chip. Sensitivity was determined to be 0.800-0.929, specificity was between 0.733 and 0.969, depending on the respective antigen. Conclusions: Multiplexed determination of serological parameters has a great potential. We have shown that our biosensor is capable of detecting four different APS relevant antibodies in parallel exhibiting a sensitivity and specificity comparable to existing ELISA methods.

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