Laboratories in the new Swiss health care system.

The objectives of the health reforms introduced in 1994 include universal coverage and cost containment. With these reforms, a new uniform for schedule and standards for laboratories have been introduced. The impact of these reforms is yet to be realized. It is predicted that with the imposition of new standards, many laboratories based in physicians' offices will disappear. Standards will also require more scientists and physicians trained in laboratory medicine.     

The Australian perspective

This presentation deals with issues of comparability and traceability in food analysis in Australia from several perspectives. This includes the current national (Australian) and increasingly international (Codex) performance-based approach to food analysis. The Australian food regulatory process will be described, particularly those aspects that impact on the analysis of food in a regulatory sense. This section will also describe two areas where specific methods have been mandated in legislation and discuss two case studies where the analytical method has impacted on the elaboration of standards. Other areas to be covered include regulation/requirements relating to supply/availability of reference materials, the use of proficiency testing as a means of ensuring comparability, and, finally, some thoughts on what role BIPM/CCQM may play in the analysis of food.Electronic Supplementary Material  Supplementary material is available for this article at

A cure for the health care crisis

To reduce medical costs while preserving access to quality care, try the good old marketplace, where consumers cast their dollar votes.     

Understanding the quality concept in health care

During the past three decades there has been an intense debate on the quality of health care. Errors in medicine, practice variations, competence of physicians, scarcity and lack of resources have all been reasons for discussing the quality of care. A clear definition of quality should explain the nature of the debate, improve uniformity of speech and facilitate meaningful actions such as quality assurance or quality improvement. However, in due course many different definitions have been proposed and principles of quality assurance in health care have been frequently questioned, because of their industrial nature. It raises questions on our understanding of quality in health care. In this paper, we (i) explore the nature of the quality concept, (ii) explain its meaning by Wittgenstein's theory on rule-following, and (iii) argue for understanding medical care as a reflexive practice, in order to integrate the meaning of quality in medical care.     

Fluorine in health care: Organofluorine containing blockbuster drugs

Organic fluorine compounds have had a profound impact on the development of bioactives for the modern pharmaceuticals market. It is estimated that up to 20% of pharmaceuticals prescribed or administered in the clinic contain a fluorine atom and 30% of the leading 30 blockbuster drugs by sales contain a fluorine. In this Highlight review, the top 10 fluorine containing pharmaceuticals (by US Sales in 2008) are highlighted. By this measure, these are currently the most significant fluorinated compounds impacting on health care. They embrace statins (Lipitor, Crestor, Vytorin, Zetia/Ezetimibe), anti-inflammatories (fluticasone propionate, Celebrex), antacids (Prevacid), antidepressants (Lexapro), neuroleptics (Risperdal) and antibiotics (Levaquin). In each case the structures and modes of action of these important drugs compounds are reviewed and representative synthetic routes are highlighted.     

示波极谱法测定保健药品中的褪黑激素

褪黑激素与HNO3在室温下发生硝基化反应生成褪黑激素的硝基化合物,加NH3·H2O终止反应并用甲酸 甲酸钠缓冲液控制反应液pH3,在原点电位-0.20V(vs.SCE),测量-0.50V处的二阶导数峰高。方法检出限为1μg/L,线性范围为1μg/L～200μg/L,相对标准偏差为2.6%～8.0%,加标回收率为92 0%～110 0%,测定结果与高效液相色谱法进行比较,无显著性差异。     

Australian Halobacteria and their retinal-protein ion pumps.

Halophiles collected in Western Australia have been found to be examples of extremely halophilic rod-shaped archaebacteria, members of the genus Halobacterium. Most of them contain retinal proteins, and these proteins differ from one another and also from both bacteriorhodopsin (bR) and halorhodopsin [and sensory rhodopsins (sR)] isolated from Halobacterium salinarium (halobium), as revealed by their peptide maps and amino acid sequences. However, these retinal proteins still have the ability to pump protons or chloride ions in the light. These new ion pumps, designated archaerhodopsins (aR) [Mukohata et al. (1988) Biochem. Biophys. Res. Commun. 151, 1339-1345], are almost identical in terms of their molecular sizes and transient photochemical properties to the ion pumps identified previously. Differences are found in the: (1) apparent extinction coefficient of dark/light-adapted aR-2; (2) titration profiles at acidic pH of the absorption spectra of all aRs; and (3) circular dichroism spectra, which are influenced by the coexistent isoprenoid bacterioruberin. The amino acid sequences of two proton pumps from the Australian halobacteria, namely aR and aR-2, are approximately 90% homologous and both sequences are about 60% homologous with that of bR. Hydropathy plots suggest that these pumps also have a seven-helical structure similar to that of bR. The amino acid residues are highly conserved in the helical regions, in particular in the case of helices C and G (91 and 84%, respectively), among the three proton pumps.     

The KAPA system in biochemical analysis. Principles-instrumentation-application

Summary The KAPA technique is a mechanized microanalytical system for biochemical analysis, particularly adapted to enzymatic analysis in research, clinical chemistry and toxicology. Total test volumes are between 5 and 80l. The reagent waste is reduced to about 0.5–5% of that with conventional tests. Fifty assays are carried out in parallel. The efficiency is between 300 assays/hour and 500/day. There are three versions of the technique. (1) Threshold tests requiring a minimum of equipment and delivering semiquantitative results; they are suitable for large scale screening and yes/no decisions. (2) Quantitative paper tests using a relatively simple measuring device and giving an analytical quality acceptable for clinical chemistry. (3) Multicuvette tests using a measuring instrument of higher sophistication, and suitable for kinetic determinations; they open a wide field of application, including colorimetric, polarimetric, nephelometric and fluorimetric evaluation, the last being the preferred evaluation mode for all three versions. The instrumental equipment comprises reaction chambers, a special measuring device, dispenser pipette, fully mechanized 50-fold multipipette and various accessories.

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Das KAPA-System in der biochemischen Analyse

Zusammenfassung Die KAPA-Technik ist ein mikroanalytisches System für die biochemische und insbesondere enzymatische Analyse in Forschung, klinischer Chemie und Toxikologie. Es werden Testvolumina zwischen 5 und 80l benutzt. Der Reagenzienverbrauch ist auf 0,5–5% gegenüber herkömmlichen Techniken gesenkt. 50 Tests werden parallel ausgeführt. Der Probendurchsatz liegt zwischen 300/Stunde und 500/Tag.Drei Versionen der Technik stehen zur Verfügung: 1. Schwellentests erfordern ein Minimum an Ausrüstung und liefern semiquantitative Ergebnisse. Sie sind den Bedingungen großer Reihenuntersuchungen und ja/nein-Entscheidungen angepaßt. 2. Für quantitative Papiertests kann ein relativ einfaches Meßgerät benutzt werden. Die analytische Qualität entspricht üblichen Empfehlungen für die klinische Chemie. 3. Multiküvettentests werden in einem Meßgerät größerer technischer Komplexität durchgeführt.Sie ermöglichen kinetische Bestimmungen und sind in weitem Rahmen für die Lösung vielfältiger analytischer Aufgaben mit kolorimetrischer, polarimetrischer, nephelometrischer und fluorimetrischer Auswertung einsetzbar. Diese wird in allen drei Versionen bevorzugt.Die Geräteausrüstung umfaßt Reaktionskammern, ein spezielles Meßgerät, Hohlkolbenpipette, vollmechanisierte 50fach-Multipipette und verschiedene Zusatzgeräte.

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Presented at the 8th International Microchemical Symposium, Graz, August 25–30, 1980.     

The isolation and synthesis of novel nematocidal dithiocyanates from an Australian marine sponge, Oceanapia sp.

Bioassay-directed fractionation of the EtOH extract of an Oceanapia sp. collected off the northern Rottnest Shelf, Australia, has yielded three novel dithiocyanates, thiocyanatins A (1), B (2a), and C (2b). The structures were determined by detailed spectroscopic analysis and confirmed by total synthesis. In addition to featuring an unprecedented dithiocyanate functionality, thiocyanatins possess an unusual 1,16-difunctionalized n-hexadecane carbon skeleton and are revealed as a hitherto unknown class of nematocidal agent.     

Steroid compounds of marine sponges. XI. Steroids of the Australian spongeTrachyopsis sp.

The compositions of two steroid fractions from the Australian spongeTrachvopsis sp. have been investigated. The fractions of steroid sulfates consisted of the trisulfates of halistanol (76%) and of 24-isopropyl-5-cholest-22-ene-2,3,6-triol (20%). In the sterol fraction, axinyssasterol (64%) and 24-isopropyl-5-cholest-22Z-en-3-ol (30%) were identified.Pacific Ocean Institute of Bioorganic Chemistry, Far Eastern Branch, USSR Academy of Sciences, Vladivostok. Translated from Khimiya Prirodnykh Soedineni, No. 2, pp. 215–218, March–April, 1990.