Congress Abstracts

The 12th Annual Meeting of the Japan Society for Laser Reproduction was held on March 26, 2017 at Toshi Center Hotel in Tokyo. In line with the previous annual meeting, the venue was divided into three sections: one main conference room where participants attended lectures to study and two sub-rooms for training where participants observed practical demonstrations and had the hands-on opportunity to use devices.

from a group of patients with chronic liver disease were studied with the AST method.The normal donor group (N 42)  showed an increase of AST to 7-10 U/1 with added P5P.Patients in the chronic liver disease group who had near-normal AST values showed the same increase as the normal group, while the patients with elevated AST values showed increases as high as 100.20.1.6:Automated calculation of gamma glutamyl transpeptidase in alcoholics By P. Bataller Martinez and V. Sanchis- Bayarri, Clinical Analysis Service, Provincial Hospital, Valencia, Spain It is sometimes difficult to evaluate the effects of alcohol on the hepatic cell.Patients have a tendency to minimize their consumption of alcohol in their clinical histories.One of the objective methods is to calculate quantitively the gamma glytamyl transpeptidase (GGTP).
The results of analyses of GGTP in patients from various hospital centres were studied over a three-month period.
An auto-analyser (ABA-100) with a 450 filter was used, samples were incubated at 37C, sample volume was 5/d and the analysis time was 5min.The results showed an increase in the GGTP in patients with a clinical history of presumed alcoholism, even in the absence of a rise in other enzymes, such as serum glutamate-oxalacetate (SGOT), serum glutamate-pyruvate (SGPT) and alcaline phosphatase (AP).In some patients, where the aim is to reduce the intake of alcohol rather than total abstinence, the results of a series of measurements of GGPT provides an objective control of alcohol consumption.(EC 3.2.1.30,AGS) was adapted to the ACP 5040 Eppendorfdiscrete automated analyser.The instrument was run in end- point mode at a throughput rate of 120 samples/h.The analyser was equipped with a thermojacketed flow-through device to provide the dispensers with pre- heated (at 40C) reagents.In the assay, 25#1 of sample was added to 250#1 of buffer-substrate solution (citrate buffer, 0.05mol/1, pH 4"2; 4-nitrophenyl-fl-N- acetyl-D-glucosaminide, final concen- tration 9mmol/l).After 6.5min.incu- bation at 37C the reaction was termin- ated by the addition of 250/d of 2-amino- 2-methyl-propan-l-ol/HC1 (AMP) buffer at pH 10.25.Absorbance of liberated 4-nitrophenol was read against a blank to which AMP buffer was added before incubation.
A linear relationship was found bet- ween the amount of enzyme in the assay mixture and enzyme acitivity up to 100U/1.Within-run imprecision (CV) ranged from 0"89 to 4"78%.Between-day imprecision, as determined with Hyland N 11 accuracy control serum, amounted to 4.09% (N =9, CV).Comparison with the manual method yielded a correlation coefficient of0.9885.The automated ACP 5040 procedure is fast, precise and reliable for the determination of AGS in human serum.
20.1.8:Determination of non-pregnancy total urinary oestrogens by fluorescence photometry: comparison between a classical extraction and an automated Kober-Ittrich method By R. Wolfrum, M. Trapp, H. G. Bohnet, and F. Leidenberyer, Chemistry Depart-ment, Allgemeines Krankenhaus Heidber9 and Institute for Hormone and Fertility Disorders, Hamburg, FR Germany Halket and Wolfrum published a paper in 1980 which showed that a significant correlation exists between a manual and an automated continuous flow technique for 24 h urinary total oestrogen determi- nation in pregnancy (rag range).The present study is a further contribution to the development of a reference method and describes the analytical results in 93 urine samples, in the concentration range 6-200/g/24 h, using the same automated system as the previous project (Breda Scientific) with a preceding Sephadex G- 10 step (van Kessel) and Brown's semi- automatic method.Regression analysis of the paired values shows a linear relation- ship, y= 1.14x 3.36 (y= flow technique), and a correlation coefficient (r) of 0"97 (p < 0.001).At present the automated flow technique is the only system for the simultaneous determination of dU-mg and -/g concentrations.Its use should allow external quality-control procedures to be implemented.20.1.9:Chamber analytical technique--its application to enzymatic and immuno- logical assays in the ultra micro range By E. Hoffmann-Blume and A. Horn, Institute of Physiological Chemistry, Friedrich-Schiller University,

Jena, German Democratic Republic
The chamber analytical technique allows the performance of colorimetric and fluorimetric tests in the form of fixed- point or kinetic measurements in sets of 50 samples with test volumes between 8 and 80/A at light paths between 0.2 and 2 mm.A new device is described for tem- perature-controlled automated fluori- metric and colorimetric measurements with increased sensitivity by directing the light beam twice through the solution for colorimetry.Precisions are in the range of 5-8" 10-' units of absorbance and 0"5 for fluorimetric measurements.The system is accomplished by automated volume dispensing and accessories for pre-analytical steps.
Application examples are reported: determinations of alanine aminotrans- ferase activities as well as of KM and Vm,x of alkaline phosphatase in 80#1 tests result in day-to-day CVs of 2-5 and 6-7, respectively.An ultra micro ELISA for e-fetoptotein in serum with test volumes of 10 1 and a CV of < 10 demonstrates the applicability for fluorimetry.About 150 assays can be carried out with ml of antiserum for turbidimetric determinations of albumin and apoprotein B (inter-assay CV 4-8).
With the measuring and volume dispensing automation 100-200 miniaturized tests/h can be performed.
authors' clinical laboratory computer system (PRIMULAB) with its prime ob- jective towards the service requirements of the laboratory.Therefore it includes possibilities of simultaneous optical read- ing of request forms and on-line captur- ing, processing and printing oflaboratory test data.Priority request forms, which allow the clinician to indicate the interval after which emergency test results should be available, are registered by an optical reader and arranged according to urgency by the computer.Work-sheets are replaced by displaying all the infor- mation required for accurate specimen analyses on a large, colour TV screen.The individual processing status of all tests, from as many as 30 request forms, is displayed in a colour code.For process control the updated delay time for test performance is faded in.
The computer capability for manag- ing the sample throughout and data processing minimizes the stress on technicians.This results in a reduction of the turnaround time of tests.95 of all requested tests are performed and re- ported within the interval indicated..1.11:Experiences in a clinical lab- oratory gained by a Hungarian-made programmable automatic chemical analyser By L. Bartalits and B. Bak, Hospital in Pterfy S, str. 8,Budapest 1076, Hungary and Central Research Institute for Physics, Budapest, Hungary The necessary conditions for the auto- matic instrumentation of enzyme activity determinations are examined, the operational details of the CRIP clinical chemical analyser are introduced and 18 methods for measuring enzyme activity and metabolite-concentration of body fluids are presented.The analyser is in a discrete system operated by compressed air and has a throughput of 200 samples/ h.The measurement of metabolites is performed at equilibrium point, the measurement of enzyme activity is performed by two-point kinetics, according to the Trayser-Saligson principle in an optimized reaction environment.The iron-free components of the analyser make measurement of iron by a photometric method possible. 20.1.10:.An emergency laboratory inte- grated within a laboratory data processing system By D. Neumeier, H. Sator, G. Rindfleisch and M. Knedel, Institut flit Klinische Chemic, Klinikum Grol3hadern, Ludwig- Maximilians-Universitgtt Miinchen, D-8000 Miinchen 70, FR Germany The data-processing system for the emer- gency laboratory was integrated in the 92 Session 20.2: Clinical Chemistry--Evaluation 20.2.1:The evaluation of a high-speed (9000 tests/h) multichannel (30 channels) automated analyser for clinical chemistry By Yasuyuki Hayashi and Masalazu H ineno, Department of Clinical Pathology, Juntendo University School of Medicine, 3-1-1 Hongo, Bunlyo-lu, Tokyo and R/D Engineering Department, Analytical Instruments Division,

Shimadzu
Corporation, Kyoto, Japan The Shimadzu Multichannel Analyser  was developed by the Shimadzu Corporation (Kyoto, Japan); Japanese professionals co-operated in the develop- ment--this co-operation is a guide-line of the Ministry of International Trade and Industry of Japan.The new analyser is intended to realize high capacity with minimized volumes of specimen and re- agents, as well as to be supplied at a low price. Ithas a characteristic disposable sheet made fro.m polyester resin, which is used for reaction vessels and cuvettes, and is termed a 'micro-cuvette-sheet'.The repertoire of this analyser includes serum enzymes, lipids, sugars, proteins, nitrogen compounds and other contents by kinetic assay, visible colorimetry or flame photometry.Evaluation data are discussed; the machine has been studied since May 1980.Within-day precision (as CV) was 0"5-3 and day-to-day precision was 2-8, these precisions are acceptable when compared with the usual method in the authors' laboratory.Approximately 5 carry-over was found, which is pro- bably due to the Teflon transportation tube and so may be improved on.
Analytical programmes are changeable by altering the position of a photometer or by adding optional accessories.The Shimadzu CL-30 is capable of per- forming fast analyses with small specimen volumes and reagent consumption.The instrument was evaluated for two months in the authors' laboratory.
(1) Precision at three different levels of urea was determined over a period of 20 days, using a kinetic urea reagent.
Within-run CV was better than 2"5 and day-to-day precision was better than 4.
(2) Contamination was tested by means of a kinetic Jaff6 method for creatinine.
(3) Temperature accuracy and stability were tested at 25, 30 and 37C, using a cresol-red solution.(4) The linearity and accuracy of the optics were tested at 340, 405 and 500 nm.(5) Special attention was given to the micro-computer allowing the user to choose between four curve-fit calculation modes: 4 parameter log-logit, 5 parameter logit, 5 parameter ex- ponential, 5 parameter polynomial.A quantitative turbidimetric I GG method was used to test the polynomial mode.The 5 parameter logit mode was tested by means of EMIT gentamicin.In both cases the program proved to operate satisfactorily. 20.2.3: Application of the Flexigem ana- lyser for routine laboratory analysis By E. Knoll, K. Dettmer and H. Wisser, Robert-Bosch-Krankenhaus, Department of Clinical Chemistry, Auerbachstrasse 110, 7000 StuttTart 50, FR Germany The authors have eight years' experience with a centrifugal analyser of the first generation--Gemsaec.They investigated the performance of the newly developed Flexigem, a centrifugal analyser of the third generation, and compared it with Gemsaec.It was tested over a period of three months, its practicability, accuracy and precision were examined.Three enzyme determinations (GOT, GPT and Gamma-GT), four substrate determi- nations (glucose, creatinine, triglycerides and urea) as well as the turbidimetric determinations of IGG, IGA and IGM were tested.Precision was established using control sera.Accuracy was de- termined by comparing analyses of patient samples, covering as wide a con- centration range as possible..2.4: Investigations of the activity of some enzymes by microcentrifugal ana- lyser: IL Multistat III By J. Jordanova, Higher Medical Institute, Central Clinical Laboratory, Sofa,

Bulgaria
The activity of aspartat aminotransferase (AsAT), alanin aminotransferase (A1AT), lactate dehydrogenase (LDH),hydroxibutira dehydrogenase (HBDH) and creatine phosphokinase (CPK) in serum was studied with the micro- centrifugal analyser IL Multistat III programmed for Boerhinger's tests.The possibilites of the Multistat III increasing the number of the samples and decreasing assay time was investigated.Multistat III is shown to reduce the volume of the biological material necessary, as well as the volume of the reagents.The within- day and day-to-day reproducibility and accuracy (N 20) were examined using five commercial control sera. 20.2.5: Evaluation of the Hitachi 705 automatic analyser By C. Ferre, M. J. Castifieiras, M. J. Alsina, J. Riera and R. Galimany, Oepartmento de Analisis Clinicos (C.S.), 'Principes de Espafia', Hospitalet de Llobregat, Barcelona, Spain The Hitachi 705 automatic analyser was tested against the standard procedure laid International Congress on Automation in the Clinical Laboratory: Abstracts down by the Instrument Commission of the 'Sociedad Espafiola de Quimica Clinica'.The parameters investigated for the evaluation were: (1) linear ranges; (2) within-run and inter-run imprecision, using three different concentration levels; (3) contamination effects.
Linearity was found to exceed 1.98 mmol.
Correlation between the two methods can be represented by y= 1"090 x-0"656 with r=0"978 on 163 serum samples (where y=chromogen method, x=centrifugal technique).Carry-over was observed from concentrations higher than 0"82 mmol.Flexigem is a microprocessor-controlled centrifugal analyser, which in addition to performing routine chemistry procedures, can be programmed to perform immuno- assay and special chemistry procedures.Data for non-linear immuno-assays can be fitted to generate standard curves using one of four mathematical models: log-logit, four parameter polynomial, exponential, and five parameter logit.Thirty such curves can be stored in memory at any one time.The performance of 30 routine chemistry procedures, four Emit procedures and three immun- oglobulin procedures has been evaluated using protocols based on NCCLS PSEPs Comparison studies have been performed at three sites for key assays.Data on Theophylline was essentially identical at the two sites: site 1, r=0'97, x--18"2, = 18"1; site 2, r=0"97, x 12"8, y= 13"2, and precision was statistically equivalent.
In conclusion, the Flexigem analyser has been shown to give precise results and values obtained have been shown to be in good agreement with those obtained using established procedures.In October 1980 a workshop on multi- channel analysers was arranged under the sponsorship of the Swedish Society for Clinical Chemistry.A mulitchannel ana- lyser was defined as an instrument capable ofcarrying out more than 10 different analytical procedures on one sample, with a capacity of analysing at least 60 samples-standards-controls/h.The users of eight different systems were present at the meeting.The participants had been invited to analyse one common batch ofa control serum in a standardized fashion before the meeting.The data were analysed using a statistical model, where the imprecision could be separated into within-day imprecision, between-day imprecision and total imprecision.At the meeting the results were collected and discussed within the users' group, and the mean values for each type of multichannel analyser were calculated.The differences found between the performance of different analysers are small.These differences and the differences between different types of analysers are discussed by the authors. 20.2.9: Aurora, a new clinical analyser By Lars-Ake Carlsson, Clinicon AB, Box 148, S 161 26 Bromma, Sweden A novel instrument for kinetic and end- point measurements, the Aurora, is described.The instrument is a completely new development, having unique features in liquid handling and photometry.The Aurora analyser is able to selectively per- form up to 16 analyses on a patient sample.It is equipped with a computer with a multi-task operating system making it possible to perform several tasks simul- taneously, for example process control, input of requests, and printing of results.Sample and reagent handling is made by stepper-motor driven pumps.These pumps are highly precise (better than 0"5%) and accurate (better than 1%) and have negligible dead volume and very low carry-over (sample-sample 0"05-0.2%,method-method less than ppm).Sample and reagent are incubated in tubes in a rotor and after 10min.are sucked into a photometer for measurement.Three different reagent pumps and a special stepper mode of the reaction rotor makes it possible to add reagents twice at 12 different moments during an lmin.period.The temperature of the two in- dependent temperature control systems for the photometer and the incubation rotor are held within +0.05C from the stated temperature.The four-channel photometer is optimized for enzyme measurements (short path-length 2"5 ram) and shows low sensitivity to turbidity in patient samples and controls due to a unique optical system with a large accept- ance angle.Calculation of the slope of zero-order reactions is made by linear regression, while first-order reactions are evaluated with an integration method.
Rate curves are displayed on a VDU and are sorted on a discette if a quality figure is exceeded.Patient results are accepted only after passing an acceptance pro- cedure, where for example, a VDU presentation of controls is made.From this picture drift any excessive variation during an analysis is easily seen.Results from an external evaluation of the instrument are presented.The Astra-8 analyser (Automated Stat- Routine Analyser, Beckman Company) with modules was used for assaying serum and urine sodium, potassium, chloride, urea, carbon dioxide, glucose and creatinine, respectively.During installation the following parameters were investigated.(1) The maximum deviation between measured values and those declared by the manufacturers ranged between +3.4 and -6"2%.Ten different control sera were used to determine accuracy (300 assays).(2) To investigate the precision, 586 assays were performed.The variation coefficient varied from 0"3 to 3-0. (3)In 42 assays the carry-over effect was found to be lower than 0"1. (4)As compared to different routine methods the correlation coefficient was between 0.988 and 0'999 (800 assays).
Astra-8 uses the most recent results of analytical chemistry and data processing..2.11: Performance of three kinetic a- amylase methods on the Kone CD clinical analyser By G. A. Harff and F. Lamie, Academic Hospital, Free University, Amsterdam, The Netherlands, and Hoechst Holland N.V., Behring Diagnostics, Amsterdam, The Netherlands The maltotetraose method of General Diagnostics, the carboxymethylated starch method of Pharmacia Diagnostics and the p-nitrophenyloligosacharide method of Behring Werke were evaluated for use on the Kone CD.The deter- minations were performed at 30C, with 5 rain.lag time and 3 rain.kinetic measurement.Kone D Analysis No.
27.2 was used.The photometric response for Ortho Normal control serum (lot No. 11T222) was limA/rain, at a volume fraction of the sample of 0"0476 with the 'maltotetraose' method; 14 mA/min, at a fraction of 0"00662 with the 'starch' method; and 13 mA/min, at a fraction of 0"0385 with the 'p-nitrophenyl' method.Patients' sera showed almost the same ratio of mA/min.The volume fractions are according to the manufacturer's in- structions.A disadvantage of the 'starch' method is the need to predilute the sample because of the small volume fraction.Linearity and day-to-day pre- cision are presented.The method of comparison was the Phadebas Amylase (tablet) method, in which results are ex- pressed at 37C.Least squares regression equations were: Phadebas=x(U/1) and kinetic method y(U/1), N 60 'maltotetraose' method: y=0.095 x-0"04 r=0"973 'starch' method: y=0-434 x-0.09 r =0"993 'p-nitrophenyl' method: y=0"198 x-1.0 r=0"992 Interference was found for pyruvate (from retool/l), -ketobutaric acid (from 0.3retool/I), -ketoglutaric acid (from 0"5 retool/l) and H + (from 20retool/l) with the 'maltotetraose' method.Glucose gave an elevated initial absorbance with the 'starch' method.Bilirubin (from 350 #tool/l), H + (from 10mmol/1) and EDTA (from 5retool/l) interfered with the 'p-nitrophenyl' method.No inter- ference was found for heparin, citrate, magnesia, fluoride, Hb, bromide, phosphate, urea, acetoacetic acid, ethanol, aceton and oxalate. 20.2.12: Evaluation of the Beckman Electrolyte 2, an indirect potentiometric instrument for analysis of sodium and potassium in serum and urine By G. A. Harff and C. van Leeuwen, Department of Clinical Chemistry, Academic Hospital, Free University, PO Box 7057, 1007 MB Amsterdam, The

Netherlands
The authors evaluated and compared the Beckman Electrolyte 2 to the IL 243 flame photometer.For serum, the Beckman liquid control sera, Decision Levels 1, 2 and 3 were used to assess the within-run and between-day precision.Method comparison was performed with the IL 243 flame photometer.Deming's calculation of regression equations were used.Serum Na 4: y(ISE) 1.024 x(flame) +0"0.Syx=0"39 and serum K/: y= 1.024 x-0.093Syx=0.12.For urine mode least squares regression equations were Na4:y=0.9995x-0"95, r=0.9997 and 20.2.13: Evaluation of sodium and pot- assium determinations in serum and urine on KONE OY's Microlyte By G. A. Harff and C. van Leeuwen, Department of Clinical Chemistry, Academic Hospital, Free University, PO Box 7057, 1007 MB Amsterdam, The Netherlands Direct potentiometric determinations of the electrolytes sodium, potassium and ionized calcium in whole blood, plasma, serum and urine can be performed on the Microlyte.Dimensions of the compact apparatus are (height, depth, width) 255 x 210 x 315mm.The authors assessed sodium and potassium in serum and urine.The instrument tested contained PROM version 2.1 NCCLS protocols PSLP-2 and 3 were followed to evaluate the precision.The method of comparison was flame photometry on the IL 143.The regression equations for the serum mode were calculated according to the method of Deming.
For the urine mode the samples were manually pre-diluted five times according to the manufacturer's recommendations.
Least squares regression equations are presented.Some relevant substances were tested for interference. 20.2.14:The evaluation of biochemical parameters among the Novi Sad district population, Yugoslavia, by using the Technicon System: SMA II By A. Gavrilovff:, Lj.Risti, Z. Radujkov, M. Vuurevi, Dj.Krsti?. and D. Peni?., Institute of Pathological Physiology and Laboratory Diagnostic, Medical Faculty, Hajduk Veljkova 1, Novi Sad, Yugoslavia During two years' experience ofoperating the Technicon System SMA II, the authors examined about 25 000 patients from the Novi Sad district in Yugoslavia.
At the same time the authors determined the reference values of the above- mentioned parameters and area.In the course of routine operations, the authors have performed permanent, daily quality controls, by using different biochemical control sera.20.2.15: Application of innovative tech- nology in a new random access analyser By J. Harem, 39 Boulevard de la Muette, 95140 Garges-les-Gonesse, France New technology for discrete aspiration and delivery of micro volumes of liquids with effective elimination of contami- International Congress on Automation in the Clinical Laboratory: Abstracts nation allows rapid analysis in a random access, while maintaining a high quality of test results.This technology and its application with the new Technicon RA-1000 analyser is described.Performance data for clinical chemistry methods are also given.20.2.16:The Technicon SMAC II C 9000 series By Jean Gaumeton, 39 Boulevard de la Muette, 95140 Garges-les-Gonesse, France The Technicon SMAC II is new concept designed to support the analytical and data handling needs of the laboratory.It consists of two major components: the analytical console and data-management package.All analyses are performed automatically from 12 up to 20 chem- istries using improved techniques, for example ion-selective electrodes for sodium and potassium, bound enzyme technology for glucose and uric acid, multi-point measurement of enzymatic activity.The samples, identified by a new bar-code identification label, are treated in batches or in stat (for emergency specimens).A new statistical program using Westgard's algorithm checks the accuracy of each result on-line.With the integrated Syslab comput6r of the SMAC II, the entire laboratory organization including sample or patient reception, analytical process, secretarial tasks and laboratory management is achieved.
SMAC II is a major advance in lab- oratory efficiency.
Editorial note: The abstract of poster No. 20.2.17 is not in English and so is not published here.20.2.18: Evaluation of a third-generation centrifugal analyser: the Flexigem system By Augusto Corominas Vilardell, Residencia del lnsalud and Analysis Laboratory of Badalona, Spain After having realized the quality-control of the Gemeni system, integrated in the second generation of centrifugal ana- lysers, the author initiated a preliminary evaluation of the Flexigem system.The following aspects were considered.(1) Precision, at three different levels, of the most common tests made in any lab- oratory for biochemical analysis (glucose, cholesterol and urea), during a period of three weeks.(2) A study of contamination in tests like creatinine (Jaff6 method) calcium/cresolphthalein com- plexone.(3) Correlation of kinetic results working with three possible analyser temperatures: 25C, 30C and 37C.(4) The use of the calibration curve memory which allows work on parameter loglogit, parameter logit, parameter ex- ponential and parameter polynomial.
The author reports that the results obtained in the evaluation have been satisfactory. 20.2.19: Dry chemistry: preliminary evaluation of the Seralyzer By Francesco Aguzzi (1), Antonio Montinaro (2), Ferruccio Ceriotti (2), Rossana Colomi (1) and Murone Michelangelo (2), (1) Laboratorio Analisi Ospedale di Broni e Stradella, ltaly, (2) Laboratorio di Ricerche Cliniche Ospedale san Raffaele (Istituto di Ricovero e Cura a Carattere Scientifico), 20132 Milano, Italy The Seralyzer is a small instrument for dry-chemistry semi-automatic determin- ation of the most relevant biochemical parameters.The paper illustrates the results of a two-centre evaluation trial of the Seralyzer.Glucose, urea, bilirubin, uric acid, cholesterol, creatinine and creatinine-phosphokinase have been studied.After a familiarization period, the precision, accuracy, influence of anti- coagulants have been assessed.The results are discussed and the problems of staff training are reported.
Session 20.3: Systems for Kinetic Measurements 20.3.1:Determination of free haemoglobin in serum and plasma by an automated kinetic assay By Kurt Bauer, Institute for Clinical Chemistry and Laboratory Medicine, University of Vienna, A 1090 Wien, Lazarettg.14, Austria A kinetic assay for the determination of free haemoglobin in serum as well as in plasma is described.The method is suitable for use in automated systems.Commercially available reagent solu- tions, containing 4-aminophenazone as chromogen, and haemoglobin cyanide standard solutions were used.Procedures, reference intervals, statistics, and limitations are shown for the determina- tion in serum and heparin plasma.Because of its speed and accuracy, this test is valuable for human and animal applications. 20.3.2:An automated method for the measurement of serum phosphodiesterase I activity By C. H. Konings, Department of Clinical Chemistry, Academic Hospital, Free University, Amsterdam, The Netherlands A kinetic assay for determining phos- phodiesterase (E.C. 3.1.4.1.)in human serum was developed using a Gemsaec centrifugal analyser.40/1 of serum and 80 gl of water were mixed with 320 #1 of reagent consisting of thymidine-5'monophosphate-p-nitrophenol (T5MN) in a Tris-HC1 buffer at pH 9.65.The release of paranitrophenol from the T5'MN by the catalytic action of the enzyme is monitored for 90 at 405 nm.The assay is carried out at 30C and is linear for phosphodiesterase I activity to 260 U/1.Within-run precision for a pooled serum sample and a commercial control serum gave CVs of 4.0 and 2.7 (mean values of 35 and 69 U/1 respectively).A comparison study between the presented method and a manual assay using the same substrate is discussed.Results of scientific studies on patients' sera using this rapid and sensitive automated technique are given.A kinetic method of serum acid phos- phatase determination has been adapted to the Cobas Bio centrifugal analyser, using -naphtylphosphate as a substrate and concurrent diazotation of the released -naphtol with fast red TR.The prostatic acid phosphatase activity is in- hibited by L( + tartrate.The time necess- ary for the test was 6 min.30 s.Under the conditions described the response was linear up to 340 UI/1, repeatability and reproducibility were good.The results were compared with those obtained by a manual method using p-nitrophenylphosphate as substrate.There was a close correlation between the two methods for both total acid phosphatase (r =0"99) and prostatic acid phosphatase (r =0"97).The diagnostic value of the proposed method for the detection of prostatic carcinoma has been tested on selected patients in the urology department at Cochin Hospital.A preliminary study on 86 subjects showed no false positive results.The relation between acid phosphatase activities and the clinical stages of the disease are discussed for 21 cases of confirmed prostatic carcinoma.activities are usually measured for the exclusion of neural-tube defects.Ellman based determinations of TChE on the hydrolysis ofacetylthiocholine and detec- tion of the free thiol released by DTNB (5-5' dithiobis [2-nitrobenzoic acid]); for a direct assay of ACHE, and Dale proposed ethopropazine hydrochloride ('Lysivane'), as an inhibitor of non-specific cholinesterase.A method has been adapted for a Cobas Bio analyser.The sample volume for each determination is 20/ul.TChE is measured for 6 min. 30s at 30C in the presence of the substrate after a min.pre-incubation with DTNB in a phosphate buffer at pH 8"0.For ACHE, min.pre-incubation time with 14/m inhibitor has been considered as optimal, following preliminary studies with 1.4 #m to 28 m Lysivane for 30 to 300 s.The reactions are linear up to 200 UI/1.Within-run (CV <3) and between-run (CV < 5) precisions are excellent.Non- NTD amniotic fluids were used to estab- lish usual values.The technique proposed is easy, simple, and rapid enough to provide results during the course of an amniocentesis clinic.

Italy
The Trinder reaction has been widely applied in clinical chemistry in the last few years.This procedure was introduced for the automatic determination of triglycerides on the Multistat III microcentrifugal analyser.The presence of surfactants in the reaction mixture, and the peculiar design of the Multistat rotors, can result in a premature mixing of sample and reagents, thus preventing the use of the fixed-time procedure.The Multistat III's software requires at least two readings, at two different times or at two different wavelengths (bichromatic procedure).
The authors adopted the end-point bichromatic procedure and the results compare well with those obtained by the manual determination.The enzymatic determination of choles- terol using commercial kits requires from 10 to 12 min.incubation at 37C, for full development of the colour.The incub- ation time can be reduced by increasing the amount of the pancreatic cholesterolesterase in the reaction mixture (which increases the cost of the determination), or by replacing it with a more active one.
By introducing a bacteric cholesterol- esterase, the 37C incubation time was reduced to 4 min.This method has been successfully applied to the Multistat III microcentrifugal analyser with a bichro- matic procedure.The results correlate well with those obtained by the manual procedure.
96 Session 21.1: Microbiology 21.1.1:Laboratory evaluation ofthe Kirby- Bauer Disc diffusion test and the Autobac- I system By E. Boquet, C. Romeu, D. XairO and J. L. Artigalgts, Centro Hospitalario de Manresa, C Bases 6y8, Manresa, Spain The results obtained with the standardized disc diffusion test were compared to those obtained by an automated suscept- ibility testing system, the Autobac-I (Pfizzer).The comparative investigation involved over 517 micro-organisms iso- lated from clinical specimens.The values of medium discrepancies were: very major 1.27, major 2.16 and minor 4.61%.
21.1.2:An evaluation of the Replireader for the identification and sensitivity determi- nation of Gram negative bacilli By G. Mascart, G. Gazon, and Ph.
Mascart, Department of Clinical Pathology, Edith Cavell Clinic, rue Edith Cavell 32, 1180 Brussels, Belgium The authors present an evaluation of the Replireader, a new semi-automatic system for identification and antibiotic susceptibility determination of Gram negative bacilli.The basic principle ofthis system is replication on agar plates. 17biochemical plates and 22 antibiotic plates were used, and 641 Gram negative bacilli, most of which were Enterobacticereae were tested.94.5 of identifi- cations were correct.2"34 of the strains were not identified and 3.12 were misidentified.In this last category half of the strains were misidentified only as far as the species, and not the genus, were concerned.The antibiotic susceptibility results were in close agreement with those obtained with the Kirby-Bauer method.
Indeed, there was a 97.1 agreement between the two methods.Minor dis- crepancies amounted to 1" 1 and major discrepancies 1"7.The Replireader appears to be an excellent alternative to conventional methods.It is very easy to use.Quality of work can be higher than with conventional methods as a result of the systematic quality control of the plates and more complete biochemical data is used.One single inoculum is used for identification and susceptibility determination.It is possible to save time, media and reagents.
21.1.3:Rapid automated susceptibility testing with the MS-2 system By G. Szilagyi and V. Aning, Hospital of the Albert Einstein College of Medicine, Bronx, New York, USA Early reporting of antimicrobial suscept- ibility test result of bacterial isolates from clinical specimens is an important factor in the better care of hospitalized patients.Several semi-automated and automated instruments have been developed for rapid susceptibility testing.The MS-2 microbiology system (Abbott Labora- tories) is a computerized automated system which performs this analysis by photometrically monitoring turbidi- metric changes that result from bacterial growth.The MS-2 system was evaluated for the accuracy of the antimicrobial susceptibility test results.A total of 482 clinical isolates (396 gram negative and 86 gram positive) were tested and the results compared with those obtained from the conventional disc diffusion method.Dis- crepancies were categorized as very major, major and minor.Agreement was determined by organism and by antimicrobial agent.Full accord (all dis- crepancies considered) of 96.6 and essential accord (minor discrepancies excluded) of 98.1 was found with gram negative organisms.With gram positive organisms 84.0 full accord and 92.9 essential accord was observed.Mean test time for all isolates was 4.2 h..1.4:Comparative study of antibiotic sensitivities of bacteria with manual and automated methods By Lszl6 Sa196, Ervin Sziilliksi and Erzskbet Nagy, Department of Paediatrics, Department of Clinical Microbiology, Central Laboratory, University Medical School, Szeged, Hungary Only during the past few years has auto- mation made a significant impact in the clinical bacteriology laboratory.The ABAC (Sclavo, Siena, Italy) automatic system was tested.A 4 h broth-culture was prepared from the bacteria isolated from 400 clinical patients; this served as the standard starting material for the various methods.Depending on the International Congress on Automation in the Clinical Laboratory: Abstracts bacteria isolated, the sensitivity was examined for four different antibiotic or chemotherapeutic groups.The disc- diffusion test method generally employed in Hungary was compared with the results given by the ABAC system, and with the micro-organism drug-sensitivities determined under quantitative con- ditions; the latter were also obtained by micro and macro procedures.The results were evaluated, and the applications of the methods and the advantages of the automatic technique were assessed. 21.1.5:Antimocrobial susceptibility testing of Streptococcus pneumoniae by two methods By J. L. Prez, J. Lifiares, M. C. Marne and S. Romero, Servicio de Microbiologia, C. S. 'Principes de Espafia', Hospitalet de Llobregat, Barcelona, Spain Thirty clinical isolates of S. pneumoniae were tested for susceptibility to penicillin, ampicillin, tetracycline, chloramphenicol, erythromycin and clindamycin by the standard agar dilution method.Results were compared to those obtained using a commercial microdilution product, Sensititre, in which Todd-Hewitt broth was supplemented with 5 defibrinated whole horse blood.Among the 30 strains, two were resistant (MICs 2 mcg/ml), two were relatively resistant (0" 12-0.5 mcg/ml) and 25 were susceptible to penicillin by both methods.Only one strain showed a thr.ee dilutional step difference by micro- dilution broth and agar dilution, resulting in categorization as susceptible by the former method but relatively resistant by the latter.
The Sensititre and agar dilution minimum inhibitor, concentrations (MICs) were equivalent within +_ dilu- tion in 96?/o of the comparable test results for penicillin, ampicillin and chloramphenicol.The correlation was excellent for erythromycin, clindamycin and tetra- cycline.
The micro-broth dilution technique is a reliable, simple and convenient semi- automated method of determining MICs ofS.pneumoniae, with the advantage ofan extended shelf-life when stored at room temperature.
21.1.6:Microdilution aminoglycoside susceptibility testing of Pseudomonas aeruginosa with divalent cation supplemented inoculum By M. C. Marne, J. Lifiares, A. Gas6s, N. Parrero and J. L. Pbrez, Servicio de Microbiologia, C. S. 'Prncipes de Espaa', Hospitalet de Llobregat, Barcelona, Spain The concentration of magnesium and calcium in media has been cited as a factor affecting susceptibility results of aminoglycoside testing of P. aeruginosa.The purpose of this study was to compare the minimum inhibitory concentrations (MICs) obtained for three aminoglyco- sides (gentamicin, tobramycin and ami- kacin) by the sensititre technique using unsupplemented and supplemented in- oculum, with the agar dilution MICs.
Thirty one clinical strains of P. aeru- ginosa, previously checked as aminogly- coside susceptible by the disc diffusion method, were used.Tests were run in parallel with Mueller-Hinton broth un- supplemented and supplemented with 25 mg ofmagnesium and 50 mg ofcalcium/1.
Agar dilution MICs were determined by conventional methods.The susceptibility in supplemented broth had 100 agree- merit _+ one doubling dilution) with agar dilutions for the three aminoglycosides.
With the unsupplemented broth P. aeru- ginosa was found to be more susceptible than with the agar dilution method.
Differences ranged from two to four doubling dilutions for gentamicin, two to four for tobramycin and one to three for amikacin.
Divalent cation content of the testing media must be controlled for valid comparison between antipseudomonal antibiotics.The use of the sensititre microdilution procedure for MICs deter- minations with supplemented broth compares well with standard agar dilution methods, but is simpler to perform.
21.1.7:Evaluation of automated procedures for monitoring antibiotic treatment of acute bacterial infections By A. Visconti and U. Marini, Laboratory of Clinical Microbiology and Department of Internal Medicine VI, Ospedale S. Carlo Borromeo, Milan, ltaly The outcome of treatment in acute bacterial infections is very dependent on the rational choice of proper antimicrobial agents.For that purpose previous susceptibility testing of clinical isolates should be mandatory whenever possible.The most useful and important inform- ation from such testing is expected when several parameters, such as minimal inhibitory (MIC) and bactericidal (MBC) concentrations, MBC:MIC ratio (or tolerance), killing rate, growth curves inhibition, drug level in body fluids, bacterial activity of the host serum and opsonic requirements, are simultaneously evaluated at the right moments during therapy.
A number of patients with acute bacterial infections (pneumonia, menin- gitis, sepsis, pyelonephritis etc.) were studied by testing all these parameters using automated procedures, such as turbidity (MS-2 Research System) and bioluminescence (Luminometer) methods.The effects of inoculum, media, time of incubation, and other experi- mental variables were also evaluated.
The results are presented and dis- cussed by the authors.
Session 21.2: Clinical Chemistry Immunoassay 21.2.1:Comparision of automated and manual techniques for the determination of creatine kinase-MB By J. P. Chapelle, Department of Clinical Chemistry, University of Liige, rue des Bonnes-Villes, B 4020 Liege, Belgium The immuno-inhibition method for the determination of creatine kinase-MB (CK-MB) activities has been automated by the author and the results have been compared with those of two manual techniques: ion-exchange chromat- ography and polyacrylamide gel electro- phoresis (PAGE).The precision of the automated technique was evaluated through the measuring range of CK-MB, providing values of 0"8 to 4-3% CV.The linearity limit was 250 IU/L.
The automated immunological method correlated well with the chromatographic technique (r=0"98).For some serum specimens, however, the two techniques led to conflicting results, the immunological method indicating high CK-MB values (> 15% of total CK) whereas activities determined after chromatographic separation were within the normal range.PAGE indicated in those cases the absence of CK-MB and the presence of abnormally migrating CK-MM sub-bands.These forms were not inhibited by the anti-CK-M anti- bodies and were therefore responsible for an apparent CK-MB activity when the immunological technique was used.The abnormal CK-MM sub-bands were not associated with myocardial damage.
The automated immuno-inhibition technique offers advantages of time saving, increased precision and accuracy, and is easily adaptable to the laboratory routine.However, when elevated CK-MB activities (15-30% of total CK) are found, the presence of this isoenzyme must be confirmed by electrophoresis.
11.6% for T3-binding capacity.The normal range was identical to that of the manual test-kit.
The results obtained for serum thyroxine concentration and T3-binding capacity from more than 200 patients were compared with all others in vitro (by the TRH stimulation test); in addition, clinical in vivo investigations were made.Significant differences were found among the groups with euthyroid goiter without and under oestrogen medication, pregnancy, treatment with thyroxine, normals, hyper-and hypothyroid diseases.To evalute the diagnostic validity of the results the authors compared the per- centage deviation from the normal range within each group.
Although the determination of thy- roxine, T-binding capacity and FT4index make it easy to recognize diseases, further in vitro and in vivo parameters should be investigated in some cases.
21.2.3:An automated enzyme immuno- assay for serum ferritin By T. Carter, R. Bunce and T. P. Whitehead,

Wolfson
Research Laboratories, QEMC, Birmingham, UK 'Sandwich' enzyme immunoassay (EIA) is becoming an increasingly popular alternative to radioimmunoassay.When performed with polystyrene tubes or micro-titration plates as the solid phase, precision is often unacceptably poor and, moreover, these are unsuitable for auto- mation.An EIA system using antibody- coated polystyrene balls and a specially- designed incubation module for use together with components of the Kone CD Parallel Analyser has been devel- oped.The system is versatile and allows the simultaneous analysis of96 specimens in approximately 3 h.In an assay for serum ferritin, the detection limit was about ng/ml with a working range up to 300 ng/ml and a precision of 6.5 at 100 ng/ml.labelled antigen was then measured.Precision, accuracy and correlation were the same as in a manual test-kit (PEG separation).The inter-assay coef- ficients of variation ranged from 3.1% to 5.3% for thyroxine and from 4.6% to 21.2.4:Automated labelled antibody immunoassays By Heather A. Kemp, Rhys John and J. Stuart Woodhead, Department of Medical Biochemistry, Welsh National School of Medicine, Card!if, UK A range of labelled antibody assays for use on a fully automated microprocessor- controlled immunoassay system (Kemtek 3000) has been developed.These auto- mated assays are capable of rapidly processing large numbers of samples.Examples of assays where this technology has proved particularly valuable are those of el-fetoprotein (AFP) and thyro- tropin (TSH), which are both used ex- tensively in population screening.Both are measured by the two-site method in which serum samples are reacted either simultaneously or sequentially with excess labelled antibody and solid phase antibody.Radioactivity bound to the 98 solid phase is a function of the concen- tration of antigen present.Using a cellulose-linked antibody and 125Ilabelled antibodies, a sensitive AFP assay (detection limit 6 KU/1) can be obtained with a h reaction, followed by separ- ation of the solid phase by means of filtration.Up to 100 patient samples can be processed in a total of 3 h.A screening test for congenital hypothyroidism has been developed which uses 6 mm discs of dried blood on filter paper from neonates.
Samples are reacted overnight with 25Ilabelled antibody and then for a further 2 h with cellulose-linked antibody, and finally subjected to automated filtration.The assay has a detection limit of 3-75 #/1 and a CV of only 6% at a TSH concen- tration of 30 //1.Of 14500 samples screened so far, only six repeats have been necessary; of these two were confirmed cases ofhypothyroidism.The flexibility of the Kemtek 3000 and the advantages of labelled antibody technology make the procedures suitable for high-throughput rapid-turnround immunoassays.
Session 21.3: Immunology 21.3.1:Circulating immunocomplexes.Contribution to a new automated technique for their quantification By F. L. Elorza, F. Malagon, M. E. Dorado and A. Moreno, Dpto.Bioquimica Clinica, Hospital Universitario de Sevilla, Spain Nephelometry is a turbidimetric tech- nique, which is based on the dispersion of a beam of light when it falls on a precipitate dispersed in a liquid.Quantification ofcirculating immunocomplexes is very useful for the diagnosis and followup of a great number of pathologies (hepatic disease, collagen disease etc.).
Adopting a low-cost automated tech- nique for this type of quantification would be of great utility to patient care in large hospitals.The authors present their experience with 1300 patients, classified according to their pathologies, and correlate the results of the technique with Bach's manual technique.and Technicon Chemicals Company, Animalerie Centrale 56.20, Avenue Hipocrate 56, B 1200 Brussels, Belgium PUVA treatment with psoralen (P) and long-wave ultra-violet light (UVA) of psoriasis vulgaris is associated with an incalculable long-term risk.For example, a certain structural similarity exists bet- ween photosensitiziers of this type and the aflatoxins.This gave rise to an in- vestigation of the AFP concentration in the serum ofpsoriasis patients, employing the PACIA system developed by A. Leek and using modified DAKO antisera.The principle behind this new technique is the agglutination of coated latex particles with the corresponding immunochemical reactant.The latex particles were coated with antibodies of AFP.PACIA is a continuous-flow analysis with an auto- matic particle count before and after the immunochemical reaction.Using this assay, AFP concentration in the serum of more than 100 psoriasis patients was examined.Patients who had received true PUVA long-term treatment (at least 10 years) were not included.The PACIA-AFP values of health subjects were up to 20 ng/ml; on average these were approxi- mately 10 ng/ml.In contrast, one-third of the psoriasis patients examined had values of 20 to 350 ng/ml.The study will be continued with long-term controls of psoriasis patients treated with PUYA.The current methods of assay of some anthracene purgative drugs, which deter- mine both the free and combined anthr- acene derivatives, lack sensitivity and specificity because the main pharmacological activity of the anthracene derivat- ives is shown by the glycoside form.This work reports paired-ion chromatographic analysis of the major glycosides of senna pod and some pharmaceutical preparations of senna using a Corasil C18 column with methanol (30 in water) containing 0.005 M tetrabutylmmonium phosphate (at pH 7"5) as solvent.Liquid chromatographic analysis of the same crude drug and pharmaceutical prepar- ation therefrom have been carried out using a weak anion-exchange resin with ammonium nitrate solution (0"1 M, pH 7'5) as the mobile phase.These systems allowed for the determination of senno- sides A and B in nanogram quantities, free from other adjuncts and excipients present and without derivatization and its inherent problems.The chromatographic methods used in this work cut the assay time for the drugs to about half that International Congress on Automation in the Clinical Laboratory: Abstracts required by current assay procedures, and they are recommended for use in automatic systems. 21.4.2:Significance of CK values in an adult and paediatric population seen in a university medical centre By Horacio A. Perez, Ronald Busch, Gary E. Blank, and Ajit Sanghvi, Clinical Chemistry Laboratory, University Health Center of Pittsburgh, 203 De Soto Street, Pittsburgh, PA 15261, USA The central laboratory of the authors' health centre has been, for several years now, measuring levels of total CK and CK isoenzymes in serum with the ABA-100 bichromatic analyser (Abbott Laboratories) at 30C.Isoenzyme separ- ation is obtained using ion-exchange chromatography columns based on Mercer's method.A retrospective study was conducted comprising 342 patients consecutively admitted to the hospitals during a six-month period, in whom abnormally elevated serum levels of total CK activity were present on admission and/or on subsequent days.A total of 107 patients (31) comprised the paediatric group admitted to the Children's Hospital.Elevated CK-MM isoenzyme levels were present in accidents involving trauma to skeletal muscle or brain.Elevated CK-MB levels in this group were seen in patients with Duchenne's muscular dystrophy, Reye's syndrome, and patients who had undergone com- plete liver transplantation.One patient with biliary atresia showed increased CK-BB activity in the serum.The adult patient group (69)consisted largely of patients admitted to the Coronary Care Unit with suspected and/or diagnosed acute myocardial and/or subendocardial infarction, or infarct extension.Other cases in which CK-MB activity was also demonstrated include patients with dermatomyositis, and patients who had undergone complete liver transplant- ation.Finally, patients in whom elevated total CK activity was present in the serum without concommitant elevation of CK isoenzymes were found to have pulmonary embolism, true angina pectoris, severe pneumonia, pericarditis, cerebro- vascular accidents, general surgery and cardiac catheterization.Also, cases of cardiac defibrillation and intramuscular injection were identified.
Session 21.5: Mathematics Clinical Chemistry 21.5.1:An automated system of quality control By Wieslaw Piechota, Norbert Symonowicz and Wojciech Minta, Centre of Postgraduate Medical Education, 00-909 Warsaw 60, Szaserow 128, Poland No single method of quality control is capable of detecting all possible errors which may affect laboratory diagnostic information.Therefore several methods should be used routinely.Such a task, however, poses a great burden on a laboratory.In order to ease this task, several basic methods of quality control were combined into one coherent system using a minicomputer.These methods are based on: (1) results of measurements of control specimens; (2) very unlikely and absurd values; (3) averages of patients' normal results (for a given number or batch) and for daily values; (4) com- parison of a result with a patient's previous result; and (5) physiological and pathological correlation of results of the same patient.The algorithms used in the system, with the criteria of correctness of results, are presented.The results to be checked are listed with marks indicating which of the criteria is (are) not met.The relation between the methods employed are discussed (statistical and arbitrary nature of some accepted criteria, for example precision and comparison of the same patient's results etc.) as well as the advantages for technicians and chemical pathologists.The introduction of an operational term 'reference intervals' instead ofan idealistic and abstract 'normal ranges' has revived the idea of seeking indirect methods to compute reference intervals.However, despite a few attempts, the simplest and the oldest method utilizing probability paper has not yet been evaluated com- pletely.This method was evaluated tak- ing into account the following conditions: (1) application of the method to popu- lations which were supposed to be 'healthier' than hospital patients, namely subjects who underwent preventive check- ups (N 1606) For the measurement of serum protein profiles, commercial control material was used to investigate the within-day and the between-day reproducibility of the com- plete procedure and of the densitometry component.Linearity and material stab- ility were also studied.
(1) Densitometry accounted for approxi- mately half of the total CV.
(2) The between-day CVs for the whole procedure and for the densitometry component are both increased proportionately compared with corres- ponding within-day CVs.
(3) Linearity for the different protein fractions is not the same.
(4) When the reconstituted control material is kept at room temperature and at 4C, the CVs remained within expected limits over the time of the study.
study has been performed on each of the distributions, followed by longitudinal adjustment of the same to polynomic functions.Results and conclusions are presented.
21.5.5:Measurement of creatinine by continuous flow.Vandoeuvre-les-Nancy, France The measurement of creatinine in plasma or serum by Jaff6's method is known to be affected by numerous interferences.Many modifications of the method have been proposed to partially eliminate the reac- tion of other endogenous compounds with the picric acid.The authors discuss a statistical method which enables the calculation of known interferences due to protein, glucose and urea.The reference method used for this calculation is based on the specific adsorption ofcreatinine by Lloyd's reagent (Haeckel).The formula is based on the correlation coefficients measured between the different con- stituents, and the results obtained by calculation are shown to be comparable with those of the reference method.The formula is applied to results determined for creatininemia on the SMA II (Technicon) on supposedly healthy sub- jects.The authors evaluate the relation- ship between the calculated creatinine and physiological parameters (height and weight for example).Serum samples were taken from 1800 children attending the out-patient clinics at the Primero de Octubre Maternal-Child Hospital from July 1980 to October 1981.The children's ages ranged from a few days old to 14 years and they were grouped by year.The following were determined simultaneously for each serum: glucose creatinine, uric acid, in- organic phosphorus, calcium, sodium, potassium chloride, iron, cholesterol, tri- glycerides, total protein, albumin, total bilirubin, creatinphosphokinase, lactic dehydrogenase, alkaline phosphatase, total carbon dioxide, alanine aminotrans- ferase, and aspartic aminotransferase in a continuous flow autoanalyser (SMAC).
The statistical method includes codifi- cation of data and processing on an IBM 370, carrying out a transverse study of each of the biochemical parameters, ana- lysis of respective distributions, and elim- ination of outlying observations by the Grubbs method.Likewise, a percentile European Institute of Environmental Cybernetics, Athens 514/1, Greece Modelling the system of erythropoiesis is a basic component in presenting or de- scribing processes connected with an organism's reliability (adaptive capacity) to hypokinesia (HK) (limited motor activity) or weightlessness.The aim ofthis report is to describe a mathematical model of erythropoiesis and its regu- lation, which takes the age structure ofthe red blood cell population into account.A flowchart of the model containing the principal elements and factors was prepared.Biological and medical concepts were applied in order to construct the flowchart.It was concluded that this mathematical model can be considered in 100 evaluating the influence of prolonged hypokinetic conditions, both in examin- ing the state of the erythropoietic system proper and describing a certain set of models that simulate the integral effect of hypokinesia on the organism.

Spain
Values obtained for leukocytes, red cells, haemoglobin and packed cell volume with a Hemalog 8/90 system are com- pared with the results obtained with a Coulter S system.204 samples were pro- cessed for the leukocyte study, the corre- lation index was 0.97 and the linear regression line was y 0.35 +0"98 x (where y=values obtained with the Coulter S system and x values obtained with the Hemalog 8/90 system). 203samples were used for the red cell study, the correlation index was 0"90 and the linear regression line was y=0.03 +0.97 x. 207 samples were used for the haemoglobin study, the correlation index was 0"99 and the linear regression line was y=0"16+ 1"01 x. 200 samples were used for the packed cell volume study, the correlation index was 0.92 and the linear regression line was y =1"03+0"96 x.Also, the values for haemoglobin and packed cell volume obtained with a Hemalog 8/90 system were compared with the values obtained by manual methods (cianmetahaemoglobin and microhematocrit). 95samples were used in the haemoglobin study, the correlation index was 0"99 and the linear regression line was y=0.12+0.97x. 93 samples were used in the packed cell volume study, the correlation index was 0"99 and the linear regression line was y 1"46 + 1"01 x.
.1.2:Comparison between four auto- mated systems for leukocyte differential count By J. M. Jou, J. L1.Vives-Corrons, J. L1.Aguilar, M. J. Insa, A. Ester, J. Four automated systems for leukocyte differential count were evaluated" (a) Hematrak-360, (b) Diff-3, (c) ADC-500 and (d) Hemalog D/90.In systems a, b and c an automated leukocyte differential count was based on morphological inter- pretation from Wright stained smears, and in system d it was based on flow cytochemistry and size analysis of EDTAtreated whole blood.Blood samples were obtained from 890 ambulatory adults and 1080 hospitalized non-haematologic patients.The manual counts were inter- preted by four technologists over a period of 20 months.For each instrument the parameters studied were'(1) sample pre- paration for analysis; (2) reproducibility (c); (3) correlation coefficient (r) between the automated differential counters and the manual method; (4) comparison ofthe variations in percentage for all cell classes detected by the manual method versus the automated differential counters.In instruments a and d red blood cell morphology and semi-quantitative plate- let appreciation were also studied.
The results obtained showed good c and r for neutrophils and lymphocytes in all systems analysed but deficient for 'bands' (given by instruments a, b and c) and monocytes.Sample preparation was cumbersome in system b and differences in all cell class percentage between count and automated systems varied from 10.5 to 25. 22.1.3:Evaluation of the Technicon H600: preliminary data on utilization and signi- ficance of the red cell distribution width (ROW) By C. Izzo, L. Miano and A. M. Ferrari, Centro Diagnostico ltaliano, Via Saint Bon 20, 20147 Milan, Italy Around 80000 whole blood counts and leucocyte differential counts are performed at the Centro Diagnostico Italiano each year.A Technicon H6000 was acquired in 1981.The instrument determines the seven conventional haematological parameters (WBC, RBC, HGB, HCT, MCV, MCH, MCHC), leucocyte differential count, platelet count and indices (mean platelet volume and plateletcrit), size histograms and distributional width for red cells and platelets simultaneously on each blood sample.Analyser imprecision and correlation between H6000 and Coulter S results were evaluated.Clinical utilization and significance of the red cell distribution width (RDW) in some haematological disorders was also studied.
Imprecision was determined for low, medium and high values of all parameters, testing four replicates of 60 blood specimens each day for 20 days.Results obtained in all three groups of values showed a CV lower than 2.8 for International Congress on Automation in the Clinical Laboratory: Abstracts conventional haematological parameters, 3"6 for leucocyte differential count, 6"6 for platelet count and indices.Data on correlation between the H6000 and Coulter S, analysed by the Deming's method, showed a correlation coefficient ranging from 0.907 to 0.960.Clinical significance of RDW was evaluated on 65 patients with B-Thalassemia (TH), 62 with iron deficiency (ID), 61 with mis- cellaneous anaemia (MA) in comparison with 1500 normal controls (NC).Results were respectively: 23.2+1.4 for TH, 19.3+1.6 for ID, 15.9_+2.1 for MA, 16.5+_ 1"0 for NC.To investigate the significance of these findings a study on correlation between RDW and other parameters (MCV, osmotic fragility, serum iron and o Hb A2) was carried out.
A good negative correlation was observed only with MCV and osmotic fragility (r 0"907 and 0" 894 respectively).The Technicon H6000 is shown to be a reliable instrument, which, despite tech- nical differences, shows good correlation to Coulter S. The RDW index on the H6000 seems to be related to red cell distribution width as well as to red cell mean volume; this feature makes it particularly suitable for some clinical purposes.
22.1.4:Evaluation of Technicon H6000 haematology system to handle all routine haematology tests in a rapid, accurate and cost-effective manner By P. W. Stiffler and C. Joson, Damon Clinical Laboratories, Inc., 4720 W. Montrose Ave., Chica9o, Illinois 60641, USA The Technicon H6000 system is a one work-station, fully automated haema- tology analyser that provides in a single report the RBC, WBC, Hgb, HCT, MCV, MCH, MCHC, platelet count, platelet size histogram, red cell size histogram and a 10000 cell WBC differential (both absolute numbers and percentages of leukocyte population) plus a permanent monolayer slide all from a 0"55 ml whole blood sample.Samples are processed at a rate of up to 90/h with lag time of 10 min.by flow-through cytometry with electro- optical counting and sizing technology plus cytochemical staining.
For the 400 samples analysed, the overall correlation for the H6000 CBC and platelet counts with the Coulter S + PLUS was 0"95.The correlation for the H6000 10000 cell differential with the standard manual 100 cell differential was 0.85 for polymorphonuclear leukocytes and lymphocytes for the 160 normal samples analysed.This was mainly due to the imprecision of the manual counts.
Precision studies on the H6000 on duplicate samples was far superior to the manual readings.The H6000 system is reliable and accurate for screening out the normal human blood samples in a patient population (80o) so that only the speci- mens having blood cell abnormalities (20o) need to be screened by haematol- ogists and/or pathologists.
Therefore in the high-volume refer- ence laboratory, when the majority of blood samples are normal human blood, the H6000 makes it possible to increase precision and accuracy significantly and shorten throughput time while reducing the number of haematologists needed to do the work.

France
The H6000 provides a complete haema- tology profile from a blood sample.The 12 CBC parameters with platelet count, RBC size histogram (Price Jones curve), platelet size histogram along with the XY WBC distribution pattern are reported on one form.With the autoslide option a Wright stained smear is also provided with the results.The design and technical features of the instrument are described and its application to medicine is discussed.
22.1.6:The evaluation of two years' ex- perience with Technicon's Hemalog 8 and Hemalog D By A. Lu?:i?, R. Gruji6, K. Beri(, Z. Radujkov, D. Kerac, L. Mani6, D. Divjak and K. Anti:, Institute of Pathological Physioloty and Laboratory Diaonostics, Medical Faculty, Novi Sad, I-Iajduk Veljkova 1, Yugoslavia Basic haematological profiles, including differential leukocyte counting, have been compiled for a group of 25 000 persons with the automated systems--Hemalog 8 and Hemalog D. In the pathological reliability the haematological parameters obtained, have been evaluated and com- pared with results obtained by manual methods.The authors have demonstrated a positive correlation between results obtained by automated systems and those from the manual technique.Useful data on patients with blood malignant diseases were obtained with the Hemalog D. Session 22.2: Heamatology General 22.2.1:Correlation of the HPX and the total white count by optic microscopy By B. Cuesta, E. Rocha, J. A. Ptramo, A. L@ez Fernandez, R. Sefrbs Cordero and J. Fernandez, Clinica Universitaria, Facultad de Medicina de la Univerida de Navarra, Pamplona, Spain 1000 blood samples analysed with a Technicon Hemalog-D and by conven- tional microscopy were compared.Correlations between the HPX values with data given by the Hemalog-D were established for (a) Neutrophils; (b) Lymphocytes; (c) LUC (large unstained cells); (d) remainder; (e) total white cell count.And correlations between the HPX values obtained by conventional microscopy for (1) number of granulocytes (neutrophils, bands, immature granulocytes); (2) num- ber of neutrophils; (3) number of bands; (4) immature granulocytes (HPX) were found.The average and standard devi- ations of HPX were obtained for those individuals who are out of the two standard deviations, with their neutrophil count (given by the Hemalog-D) and the number of granulocytes obtained by microscopy.

Spain
Corresponding features from diverse haematological disorders, obtained from a study on automated cytochemistry, are described.The Hemalog D system was used for the analyses; this provides a differential count of the diverse groups of blood leucocytes, based on their cyto- chemical behaviour.Different types of leukaemia, both acute and chronic, have been assayed, establishing the quanti- tative measure of leukaemic and non- leukaemic cells with greater accuracy and precision than is possible with the manual differential.Different types of lymphoproliferative and myeloproliferative diseases were studied, as well as infectious mononucleosis, Hodgkin's disease, myeloma and other disorders like myeloperoxidase deficiency, erythroblastosis and the eosinophilia due to intoxi- cation by toxic colza oil.Characteristic features in the Hemalog D results, each one corresponding to a pathological entity were obtained in all cases.The automated cytochemical method is a good system for detection of several haematological disorders. 22.2.3:Hereditary myeloperoxidase de- ficiency: study of 12 cases By M. C. Jimnez Herrez, A. Viloria, M. Fernandez de Castro, C. Larrocha, J. L. Ferndndez-Chaon, M. Salinas and J. M. Gbmez Mantilla, Departamento de Laboratorio, C.S.S.S. 'La Paz', Madrid, Spain This report concerns 12 cases ofhereditary myeloperoxidase (MPO) deficiency.MPO deficiency in the azurophil granulations of the neutrophils and monocytes was detected by an automated cytochemistry system (the Hemalog D system).Cytochemical stainings included peroxidase, Sudan Black B, chloroacetate esterase and alkaline phosphatase.Quantitative enzymatic assay of peroxidase, beta- glucuronidase, acid phosphatase, lyso- zyme and alkaline phosphatase, were performed, as well as the granulocytic function and electron microscopical study.Five different families were studied, including two generations in each family.Automated cytochemical methods are considered the best way to detect myeloperoxidase deficiency. 22.2.4:Pseudothrombocytopenia (PTC) produced by platelet agglutinins in EDTAtreated blood By N. Gdmez Gdmez, M. Lozano Alvarez, F. Olmeda, F. G6mez Reino, M. J. Ferhandez-Villalta and J. M. Ferhandez- Rafiada, Gran Hospital del Estado, Diego de Le6n, 62, Madrid, Spain The authors observed a PTC in EDTAtreated blood from three patients whose platelet counts were obtained with Coulter S Plus counters.The smears showed a normal platelet number and the presence of large-size platelet aggregates.The platelet volume distribution curve in blood treated with EDTA at standard or low concentrations showed the typical flattening observed in platelet anysoci- tosis.This result was confirmed by the platelet DW.The mean platelet volume obtained with Coulter S Plus Counter was higher than anticoagulants.The ad- dition of platelet-free plasma from these patients to a nor-PRP produced a PTC following incubation at 4C and 22C, but not when incubated at 37C.Tests with neutralizing antibodies and denaturaliz- ation with 2-Dithiotreitol suggest that the plasma factor responsible for this pheno- menon is an IgM type antibody.Given the high incidence of this phenomenon it is necessary to confirm all thrombocytopenias by a second procedure (chamber or Fonio's) to avoid erroneous diagnosis and subsequent treatment of possible Werlhof's disease.Smit Sibinga, Regional Red Cross Blood Bank Gronigen-Drenthe, Groningen, The Netherlands The Regional Red Cross Blood Bank in Groningen serves a population of 1.2 M and 13 hospitals, drawing about 56 000 donations annually.Therefore, auto- mation of routine screening tests like ABO and Rhesus grouping, hepatitis and syphilis serology, and screening for irregular blood-group antibodies is of importance for running the laboratory.Preliminary studies have shown that when two types of channels are combined (low ionic strength polybrene and bromelin methyl cellulose), most of the clinically important blood-group anti- bodies can be detected, but most of these studies were performed on samples from patients.This paper describes how the channels (Marsh and Ldezari) were built for antibody screening in donor blood.The authors compare auto-analyser results with manual techniques for saline RT, albumin 37C, indirect antiglobulin test, enzyme 37C and the low ionic strength method..2.6: Hemalog D and Hemalog 8 appli- cation in peritonitis (P) diagnosis and treatment on continuous ambulatory peri- toneal dialysis (CAPD) By R. Selgas, M. Fernandez de Castro, A. Rodriguez Carmona, P. Gomez, J. M. Beberide, O. Ortega and L. Sanchez Sicilia, C.S. La Paz, Madrid, Spain Recurrent P has been found to be the most frequent complication with CAPD; under these circumstances the number of leucocytes in the peritoneum increases.A count of leucocytes is very useful for CAPD diagnosis and follow-up.24 patients on CAPD have passed 69 episodes of P; white cells count out of P in 154 samples (Hemalog-8) was: 276 +_ 36 (: +/-SEM)/mm Results: Leucocyte count in P/mm was 3461 +__ 460 (r 400-18800) and dif- ferential count (Hemalog-D): neutrophil: 88 + 6% (+ S.D.); Linphoc" 6.5 + 6; Monoc: 3-4___ 3; Eosin: 0" 8.No signifi- cant differences between types of P (according to culture) have been found; eosinophilia is not higher in negative culture P. There is no correlation between cell counts and delay in sampling or symptoms (r=0" 12).Previous P, sex and age do not correlate with count.Counts in the first six months are slightly higher (p=0"05) but neutrophil is no different.
The results of cultures have only a small influence on the count.Intra-peritoneal antibiotics provoke a progressive count decrease: (+SEM) two-three days 846+ 189/mm3; six to eight days 200+ 14; 10-12 days 155-9"4.Evolution is different in those P which have a non-effective treatment" two to three days 1685 708; six-eight days 1171+463 (p=0"05) and 10-12 days 933+213 (p=0.01).Finally, some cases with a good initial response have been followed by an increased count..2.7:Usefulness of EDTA-blood as samples or controls for haematology tests By I. M. Penttilfi, E. Puhakainen and T. Rantanen, Department of Clinical Chemistry, Kuopio University Central Hospital, SF 70210 Kuopio 21, Finland A Coulter Counter S-Plus analyser (Coulter Electronics Ltd, Harpenden, UK) was used for one and a half years for the measurement of parameters in whole blood.During the first months the sur- vival times of blood cells in EDTA-blood were measured--all cell values were found to be constant for up to 6 h at room temperature.Some difficulties with this time have been experienced because health centres are often remote.The second reason for this study was a need for quality control information.Samples analysed daily were stored at + 4C until the following morning, when they were reanalysed for the most important parameters with the Coulter Counter S-Plus analyser.9"6 231"9 9" 9" 5 0"01 0'001 0"001 0"001 0"01 Although most differences are signficant, it is evident that in routine haematology practice the daily samples can be used for the control of the Coulter Counter S-Plus analyser, in addition to commercial preparations.EDTA-samples can be analysed the morning after sample taking.The importance of anaemia is well known, but has undoubtedly been under- estimated.The high incidence of this disease in infancy, especially in developing countries, warrants routine lab- oratory diagnosis.This is essential for appropriate clinical management, im- proved surveillance and effective health control.In order to assess the effect of some childhood diseases on haemoglobin values, all patients attending an under- fives clinic in Benin, Nigeria were ex- amined and their Hb levels measured.
International Congress on Automation in the Clinical Laboratory: Abstracts Such laboratory information using a single haemoglobinometer is presented and the usefulness of this type of routine test is discussed.
deviate' calculated over reference sera results.
An efficient and easy monitoring of the chemical procedures and good result reliability is achieved.Results from different automatic analysers can also be collected, processed, controlled and reported.
Session 22.3: Electronic Data Processing

Rome, Italy
The automatic analysers in a clinical chemistry laboratory will normally take care of the analytical work-load.At the same time they usually require a dupli- cation of management procedures.
Modern computerized instruments are not able to communicate directly with the central data-bank and do not fit into manual or automatic clerical procedures, which depend upon traditional work- sheets.Moreover, security controls must match the speed of the analytical output and follow up instrument performance without delay.For this reason a local information system was developed using an Olivetti P6060 minicomputer on-line to the analysers and exchanging inform- ation with the Hospital Data Processing Center (HPDC) by means of floppy discs.
An automatic pattern recognition system (optical reader, OPR) performs positive identification of samples which are randomly analysed.Patient number sequence is automatically linked to ana- lytical output.Identified or 'personalized' result records thus obtained are then matched with request records, loaded on a floppy disc from the HDPC which processed the test requests from clinical wards and the patient personal data present in the bank.Thus, a complete clinical report is automatically assembled for each patient, it can be immediately printed in the laboratory and transferred to the data-bank for storing.Moreover, in order to relieve the technical staff from continuous surveillance of analytical output quality, the programs are built to provide alarms of troubles detected by the instrument's own software and to perform additional data validation tests.
These latter control result consistency with mathematical comparisons between chemical parameters (discrepancy tests) and with confidence limits suggested by clinical experience (alert tests).Con- currently, a real-time quality-control procedure supplies a statistical index similar to the 'standardized normal 22.3.2:Specimen identification in the EDP-supported chemical central laboratory By H. J. Gibitz and D. Hauch, Zentrallaboratorium der Landeskrankenanstalten, A 5020 Salzburg, Austria Mark-sense forms are used in the Zentrallaboratorium requests, the forms contain the name of the patient, a machine-readable patient number with seven digits is applied by the nurse with the help of an ADREMA card.Each mark-sense form is preprinted with one letter and a four-digit specimen number which is machine readable.This specimen identification is also preprinted on six self-adhesive, differently coloured labels on the right margin ofthe form but is only normally readable.These labels are stuck on to the specimen tubes by the nurse.In the specimen receiving office the tubes are distributed amongst laboratory departments following the lead colours of the labels.The mark-sense forms are read by an IBM 370.The printed working files contain the specimen identifications in an ascendant order (letters and numbers) as well as the corresponding names and numbers of the patients.
The advantages ofthis system are that the specimen, sample and patient identification is given, without change, from specimen collection to the printing of the patient report.No additional number, a day number for example, is necessary.And an expensive and time-consuming central sample distribution, which is sus- ceptible to the risk of confusion, is not required.Every functional section of the laboratory gets the exactly identified specimen directly from the patient without a time delay.Details about the production and the preprinting of the mark-sense forms and experiences ofthis system over three years are presented.22.3.3:Are patient and biological sample identifications compatible?By P. Valdiguib, Laboratoire de Biochimie, C. H. U. de Rangueil, 31054 Toulouse Cedex, France Correct identification of the many samples handled in different containers within a clinical laboratory is obviously necessary, but it is difficult.This identifi- cation must be adapted to the general procedures already in use in the lab- oratory and must be easily readable by automated machines which are popular.The 'positive' identification systems which are available are not very common yet because they are installed mainly on large and expensive analysers and they do not fit in with the normal organization of the laboratory.Moreover, they use small numbers.Patient identification, on the other hand, usually needs multidigit numbers which are difficult to handle directly during the biological process in the laboratory.The connection between these two incompatible identifications is discussed..3.4:Bar-code label reading of blood samples from donors simultaneously with blood-grouping in an autoanalyser, for the prevention of clerical errors in a routine blood-bank laboratory By R. L. McShine, A. G. J. de Stair, Z. Smit and C. Th.Smit Sibinga, Regional Red Cross Blood Bank Groningen-Drenthe, Groningen, The Netherlands The Regional Red Cross Blood Bank is a large and comprehensive blood centre in the northern Netherlands, which serves 13 hospitals and receives 56 000 donations a year.Automation has been organized to prevent clerical errors in identification and reading of samples, and to increase the standard and accuracy of routine quality control.ABO/Rhesus grouping of donor blood has been automated using a Technicon BG-15 and a connected self- designed autoanalyser with a Marsh and Lalezari channel for automated irregular antibody detection.The sampler has been adapted with a moving white-light source reading device for bar-code identification labels (Codabar).Results are read and decoded in a data-processor, stored on discette and printed for immediate con- trol.The daily results, on discette, are presented to the computer department for updating the donor file and machine- readable quarantine release using a bar- code reader-pen.This procedure has had a significant impact on clerical safety of routine quality control in the laboratory and the quarantine release division of component department.New analytical instruments of increasing sophistication are continuously being introduced into the clinical laboratory.Some drawbacks with these new instru- ments are inflexible result print-outs, meagre analytical method control reports and the absence of statistics for billing costs.With the help of Scandia Metric AB of Solna, Sweden, two Metric-85 desk top computers were successfully linked to a Greiner G-300 and a Technicon SMAII in order to collect results automatically and to improve performance of the above-mentioned functions.The system hardware consists of two Metric-85 computers each containing a Zilog Z80 CPU, 60 k bytes RAM and two Micro- polis mini-floppy disc drives with a storage capacity of 315 k bytes per drive.
The hardware system costs less than 70.000Sw. kr.(12 000 US $).The pro- grams, which are written in BASIC, were developed by Brendan Henderson.The computerized system has the following features: automatic data acquisition; out- put of patient results on self-adhesive labels; quality control reports for five controls, daily and between days; stat- istics on the number of analyses ordered by each ward; registration and retrieval of data from disc using patient I.D.; possi- bility of manual data entry and data editing; data security--passwords inhibit unauthorized access to data.Software and hardware can be used by all lab- oratory staff after only a few hours' training..3.6:Desk-top processor-based interface for chemical analysers By J. I. Dydula, O. S. Lauritsen and T. H.
Nielsen, Department of Clinical Chemistry, Frederiksberg Hospital, Copenhagen, Denmark Data in a routine laboratory appear in many ways, according to the type of analyser.In the interface area between analyser and computer, small desk-top processors (DTPs) facilitate data hand- ling.Price and flexibility of DTPs allow the decentralized data handling to be tailored to the needs of various work- stations.Benefits from this solution are: flexible data capture (on-line/off-line; I.D. numbers/results), quality control and error corrections under the control of the analyst and powerful back-up in case of computer breakdown.This presentation will focus on criteria which could be used when selecting a proper DTP configur- ation: input/output facilities, programming language, memory size, program library, vendor reliability..3.7:On-line data acquisition from a flame photometer By R. A. Lutz, Medical Chemistry Laboratory, Kantonsspital, CH 8401

Winterthur, Switzerland
The interfacing of a Motorola 6800 micro- processor to a IL-Flame Photometer 343 is described.This microprocessor can store results on an RAM memory module with battery back-up.If the main laboratory minicomputer (NOVA 3) is running and ready, the microprocessor 104 transmits the data, together with the serum number and additional inform- ation entered by the laboratory techni- cian.This communication uses the standard RS-232C protocol.If the mini- computer is turned off" or is not ready, the microprocessor keeps the results in its own memory until data transfer is possible.This system can be easily modified for other digital laboratory instruments and, therefore, is uniformly applicable.The system has been running for over a year and has proved reliable.
Other microprocessors interfaced to other instruments can also be branched to it, simply by adding additional RS-232C interface boards to the microprocessor bus.Only one line to the minicomputer is occupied for up to eight instruments requiring minor software modifications.
22.3.8:A low-cost data processing system for clinical laboratories By Rafael Clemente, IZASA, S. L., AragOn, 90, Barcelona, Spain A low-cost data processing system for clinical laboratories is described, stressing the following functions: information flow in the laboratory; automation of clerical tasks: filing, invoicing, etc.; time distri- bution study and improvements achieved with the inclusion of the system in a number of laboratories.Expansions of the basic equipment, up to reaching multi- user capability and 'on-line' connection of several automatic analysers, is discussed.

22.3.9:
Rentability and quality advantages--computer and sample distri- bution in laboratories By Dr Knipps, GFC--Gesellschaft fiir Computersysteme in der Medizin mbH, Holzhauser Str.159-165, 1000 Berlin 27, FR Germany The GFC-MELAS system has succeeded in gaining a top position in the market during an extremely short period.The system is used in the data processing departments of hospital laboratories.
Only those computers which corres- pond to most modern technology and flexibility as required for one or more channel measuring instruments are used.
The software is based on modular technique.The high-level programmable language can easily be understood even by personnel who are unfamiliar with data processing.Changes which are necessary in the laboratory, i.e. methods and measuring equipment can easily be performed by the personnel.The PVS Sample Distribution Station 911 is an automatic system which can be connected on-line to laboratory computer systems.The system allows nearly 700 pipettings every hour if one module is used, using three, 2000 pipettings are possible.
Segments can be easily installed during the distribution process.The system saves approximately one to two hours a day by automating the samplehandling stage.
22.3.10:On-line computers; application in quality control of results By J. M. Navarro and M. J. Alsina, Ambulatorio 'Jaime I', Vilanova la Geltru, Barcelona, Spain   Errors that arise in clinical laboratories are produced in three areas: adminis- tration, pre-analysis, and the analysis itself.Conventional quality control programmes normally show only the ana- lytical error.Now, by using computers connected on-line to autoanalysers, it is possible to identify a high percentage of all three types of error.The program is divided into the following modules, applied in sequence: analytical quality control; outliers values set by the laboratory according to the type of patient; parameter interrelations; com- patibility with diagnosis (abnormal ranges); delta check.
The purpose of this program is to carry out in real time the same operations that would normally be done by the biochemist, leaving him free to deal with those results which do not fit the require- ments listed above..3.11:Integrating a fast computerized analyser (PRISMA) in the organization of a computer-assisted centralized clinical chemical laboratory By C. Pietrzyk, W. Schmaderer, H.-J. Engelhardt, W. Vogt and M. Knedel, Institut fiir Klinische Chemie, Klinikum Groflhadern, Ludwig-Maximilians-Univer- sitfit Miinchen, D-8000 Miinchen 70, FR Germany A fast multichannel analyser in a clinical laboratory should supply precise, accurate data, quickly and at low cost.The concept of the analytical system determines precision and accuracy of the measurement, while cost and turnaround time for tests are optimal only when the analytical system is fitted to the organization of the laboratory.Bidirectional communication between analyser and laboratory com- puter system has been realized in the PRIMULAB system developed by the authors.The system offers the following features: requesting analyses and reruns is possible without expending time; patient data do not have to be entered by labor- atory personnel; results can be controlled at two levels--analysis-oriented directly on the display unit of the analyser and patient-oriented using the laboratory computer system, that stores more ex- tensive information; long-term storage of quality control data is possible in the laboratory computer.
The laboratory organization must take into account partial or total failure of the multichannel analyser, so that other analysers must replace it.Samples have to be divided and distributed according to the current need, this can be controlled directly by the computer.
International Congress on Automation in the Clinical Laboratory: Abstracts 22.3.12:Evaluation of a computer system in a private laboratory By F. Echevarne and J. I. Hornos, Laboratorio de Anfilisis del Dr F. Echevarne, Barcelona, Spain This study investigated the main features that a computer should offer to fit into a private laboratory, the authors discuss features which are absolutely necessary and those which are of marginal im- portance.The economic advantages of having a computer in a private laboratory are also presented.
22.3.13:Demands and limitations of the on-line connections between laboratory analysers and computers By V. Seco Torrecillas and J. Aznar Lucca, Laboratorio de Anlisis Clinicos; C.S.S.S. 'La Fe', Valencia, Spain The authors describe the problems they have found when connecting a computer on-line to their automatic equipment.The features a computer should have are discussed together with the type of equip- ment that should be connected.They also report on the way data is processed-from the analyser sending it to the computer to the definitive print-out of results.These points are related to the laboratory's work structure and costs and benefits of computerization are given.
22.3.14:Experiences of ,a turn-key lab- oratory computer system By Stanley Wilson, North Manchester General Hospital, Manchester, UK The author analyses his experience with a turn-key system in a laboratory of bio- chemistry in a university hospital over a period of one and a half years, since its installation.The advantages and dis- advantages of an on-line connection of a Technicon SMAC, as well as the expan- sion of the system to the haematology laboratory, are emphasized.22.3.15:Six years' experience with an on- line data-base in haemostaseology By Th.Gergely, Institute for Clinical Chemistry and Laboratory Diagnosis of the University of Vienna,Ch. Korninger,1st Medical Department of the University Hospital of Vienna, and W. Dorda, Institute for Computer Medicine at the University of Vienna, Austria The department of haemostaseology of the 1st Medical University Hospital is unique in Vienna, advising other hospitals and supervising the sensitive control of inborn and acquired haemo- staseological disorders.To improve efficiency and precision ofpatient manage- ment and control, the traditional data- base was computerized and linked with the university hospital information system: WAMIS.DOKU is a subsystem of WAMIS and handles the documen- tation of medically relevant information, such as anamnesia, physical examination and results ofdiagnostic tests.During the last six years, extensive data on the coagulation system of more than 8000 people have been collected.These data are accessible on-line for routine patient management, such as working schedules for nurses, drug prescriptions, medical reports for referring physicians as well as reminders to physicians and/or patients about necessary control check-ups and required changes in therapy.In addition, a variety of standard and sophisticated mathematical programs are available for on-line scientific work.On-line data processing has proven to be a useful tool to educate personnel--from physicians to nurses, to decrease the paper-work load and to facilitate the use ofpatient data for scientific and teaching purposes.
Session 22.4: Cost Analysis 22.4.1:Economic and quality evaluation obtained with the a1tomation of five im- munologic parameters.Experience of six years and 85 000 deterninations By F. Malagon, F. L. Elorza, M. E. The authors present their experiences, accumulated over six years, on the pro- gressive automation of a laboratory of immunology in a hospital with 1000 beds and 1000 out-patient visits per day.The results obtained with the first automated parameters (IgA, IgG, IgM, C3 and C4) are evaluated; and the technological appli- cations, automated or not, which they set up during the same period of time and with the same personnel are reported.The results are calculated on the basis of 85000 determinations during the six years ofthe study, taking into account the evolution undergone by the various para- meters (cost, time, etc.) from year to year, with the object of forseeing future needs.The results of automation have been extraordinarily positive, the savings during this time being 16 M pesetas.In university hospital with 1300 beds, automation was brought up to date by replacing 10 batch, or discrete, analysers with five selective or continuous flow analysers.With half of the staff, eight laboratory technicians instead of 16, efficiency was doubled; the average lag between sample arrival and result de- livery decreased from three to one and a half hours.Also the emergency results, 20.1.7:Automated determination of serum fl-N-acetyI-D-glucosaminidase By G. Johannsen, D. Maruhn and D. Paar, Division of Clinical Chemistry, Department of Medicine, University of Essen, FR Germany Pottet al.'s discontinuous manual assay for serum fl-N-acetyl-D-glucosaminidase 20.3.3:Automated assay of serum acid phosphatase and its use in the diagnosis of prostatic carcinoma By H. Caillens, T. D. Nguyen, R. Chiche, O. G. Ekindjian, L. Boccon-Gibod and J. Yonger, Laboratory of Clinical Chemistry and Urology Department, Cochin Hospital, Paris, France 20.3.4:Amniotic fluid cholinesterase measurement with a centrifugal analyser By F. Moreau, C. Guermeur, F. Papa, O. G. Ekindjian, R. Henrion and J. Yonger, Cochin Hospital, Paris, France Amniotic fluid total cholinesterase (TChE) and acetylcholinesterase (ACHE) 21.3.2:Determination of alpha-fetoprotein (AFP) in the serum of patients with psoriasis vuigaris by the particle counting immunoassay (PACIA) By W. Krotz, A. Leek, Angelika Welter and V. Hochstein, Heinrich-Pette-Institut ffir Experimentelle Virologie und Immunologie an der Universitiit Hamburg, Martinistrasse 52, D 2000 Hamburg 20; 22.2.5:A comparison of automatic and manual blood-group antibody screening in blood donors for routine testing By R. L. McShine, P. C. Das,C.Th.

Table 1 .
Effect.of the storage on parameters of ED TA-blood samples(N  950).Mean I is for initial values and mean 2 for results after 18 h storage at +4C.P-values are calculated by the paired t-test for analyses.