The importance of the measurement of ATP depletion and subsequent cell damage with an estimate of size and nature of the market for a practicable method: A review designed for technology transfer

Scandinavian Journal of Clinical and Laboratory Investigation

Volumn 57, Issue 8, 1997, Pages 655-672

  Harkness, R A ^a,b   Saugstad, O D ^b  

^a UNIVERSITY OF OSLO   (Norway)

^b UNIVERSITY OF EDINBURGH   (United Kingdom)

Author keywords

Analytical methods; ATP depletion; Cell damage; Hypoxanthine; Industrial development; Market size; Technology transfer

Indexed keywords

ADENOSINE TRIPHOSPHATE; HYPOXANTHINE;

ACID BASE BALANCE; ANAEROBIC GLYCOLYSIS; BLOOD GAS ANALYSIS; CELL DAMAGE; DIAGNOSTIC VALUE; ENERGY EXPENDITURE; HUMAN; HYPOGLYCEMIA; HYPOXIA; ISCHEMIA; NORWAY; PRIORITY JOURNAL; REVIEW;

EID: 0031449277     PISSN: 00365513     EISSN: None     Source Type: Journal    
DOI: 10.3109/00365519709105227     Document Type: Review

References (160)

1. Saugstad OD. Hypoxanthine as a measure of hypoxia. Pediatr Res 1975; 9: 158-61.
2. Harkness RA. Clinical biochemistry of the neonatal period: immaturity, hypoxia and metabolic disease. J Clin Pathol 1987; 40: 1128-44.
3. Harkness RA. Hypoxanthine, xanthine and uridine in body fluids, indicators of ATP depletion. J Chromatogr Biomed Appl 1988; 429: 255-78.
4. Saugstad OD. Hypoxanthine as an indicator of hypoxia; its role in health and disease through free radical production. Pediatr Res 1988; 323: 143-50.
5. Berne RM, Rubio R. Adenine nucleotide metabolism in the heart. Circulation Res 1974; 34 Suppl III: 109-18.
6. Huizer T. Myocardial ATP catabolism and its pharmacological prevention. Amsterdam: Erasmus University and Netherlands Heart Foundation, 1991.
7. Kock R, Delvoux B, Sigmund M, Greiling H. A comparative study of the concentrations of hypoxanthine, xanthine, uric acid and allantoin in the peripheral blood of normals and patients with acute myocardial infarction and other ischaemic diseases. Eur J Clin Chem Clin Biochem 1994; 32: 837-42.
8. Remme WJ, de Jong JW, Verdoux PD. Effect of pacing induced myocardial ischemia on hypoxanthine efflux from the human heart. Am J Cardiol 1977; 40: 55-62.
9. Robbrecht J, de Buyzere M, Delanghe J, de Scheerder I, Mortier E, Vanderschueren S. Increase of hypoxanthine during cardiac surgery as measured by indirect automated enzymatic assay. Clin Chem 1989; 35: 898-9.
10. Buhl MR. Oxypurine excretion during kidney preservation; an indicator of ischaemic damage. Scand J Clin Lab Invest 1976; 36: 169-74.
11. Buhl MR. Purine metabolism in ischaemic kidney tissue. Danish Med Bull 1982; 29: 1-26.
12. Sinkeler SPT, Joosten EMG, Wevers RA, Binkhorst RA, Oerlmans FT, van Bennekom CA. Ischaemic exercise test in myoadenylate deaminase deficiency and McArdle disease: measurement of plasma adenosine, inosine and hypoxanthine. Clin Sci 1986; 70: 399-401.
13. Harkness RA, Coade SB, Walton KR, Wright D. Xanthine oxidase deficiency and 'Dalmation' hypouricaemia: incidence and effect of exercise. J Inher Metab Dis 1983; 6: 114-20.
14. Harkness RA, Simmonds RJ, Coade SB. Purine transport and metabolism in man: the effect of exercise on concentrations of purine bases, nucleosides and nucleotides in plasma, urine, leucocytes and erythrocytes. Clin Sci 1983; 64: 333-40.
15. Harkness RA, McCreanor GM, Greenwood R. The pathogenesis of the Lesch Nyhan syndrome: ATP use is positively related to hypoxanthine supply to hypoxanthine guanine phosphoribosyltransferase. J Inher Metab Dis 1991; 14: 202-14.
16. Harris RC, Marlin DJ, Snow DH, Harkness RA. Muscle ATP loss and lactate accumulation at different work intensities in the exercising thoroughbred horse. Eur J Appl Physiol 1991; 62: 235-44.
17. Ketai LH, Simon RH, Kreit JW, Grum CM. Plasma hypoxanthine and exercise. Am Rev Resp Dis 1987; 136: 98-101.
18. Bolhuis PA, Zvart R, Bar PR, deVisser M, van den Helm HJ. Rapid determination of hypoxanthine increase in ischemic exercise tests. Clin Chem 1988; 34: 1607-10.
19. Sorlie D, Myhre K, Saugstad OD, Giersksky KE. Release of hypoxanthine and phosphate from exercising human legs with and without arterial insufficiency. Acta Med Scand 1982; 211: 281-6.
20. Dueland S, Myhre K, Dueland AN, Saugstad OD. Increased plasma hypoxanthine in humans during exposure to simulated altitude of 7620 metres (25000 feet). Aviation, Space Envir Med 1991; 62: 1044-9.
21. Bejar R, Saugstad OD, James H, Gluck L. Increased hypoxanthine concentrations in cerebrospinal fluid of infants with hydrocephalus. J Pediatr 1983; 103: 44-8.
22. Harkness RA, Lund RJ. Cerebrospinal fluid concentrations of hypoxanthine, xanthine, uridine and inosine: high concentrations of the ATP metabolite, hypoxanthine, after hypoxia. J Clin Pathol 1983; 36: 1-8.
23. Meberg A, Saugstad OD. Hypoxanthine in cerebrospinal fluid of children. Scand J Clin Invest 1978; 38: 437-40.
24. Levin SD, Brown JK, Harkness RA. Cerebrospinal fluid hypoxanthine and xanthine concentrations as indicators of metabolic damage due to raised intracranial pressure in hydrocephalic children. J Neurol Neurosurg Psychiatr 1984; 47: 730-3.
25. Castro-Gago M, Lojo S, DelRio R, Rodriguez A, Novo I, Rodriguez-Segade S. The concentrations of xanthine and hypoxanthine in cerebrospinal fluid as therapeutic guides in hydrocephalus. Child Nerv Syst 1986; 2: 109-11.
26. Swanström S, Bratteby LE. Hypoxanthine as a test of perinatal hypoxia compared to lactate, base deficit and pH. Pediatr Res 1982; 16: 156-60.
27. Thiringer K. Cord plasma hypoxanthine as a measure of fetal asphyxia. Comparison with clinical assessment and laboratory measures. Acta Paediatr Scand 1983; 72: 231-7.
28. Harkness RA, Geirsson RT, McFadyen IR. Concentrations of hypoxanthine, xanthine, uridine and urate in amniotic fluid at Caesarean section and the association of raised levels with prenatal risk factors and fetal distress. Br J Obstet Gynaecol 1983; 90: 815-20.
29. O'Connor MC, Harkness RA, Simmonds RJ, Hytten FE. Raised hypoxanthine and uridine concentrations in meconium stained amniotic fluid and during labour. Br J Obstet Gynaecol 1981; 88: 375-380.
30. Illingworth RS. Litigation and birth. J Med Defence Union 1987; 4: 14-5.
31. Chen Y, Saugstad OD, Teige B, Hagve TA, Rognum TO. Can increased excretion of hypoxanthine in urine identify genuine ALTE In: Rognum T, editor. Sudden infant death syndrome. New trends in the nineties. Oslo: Scandinavian University Press, 1995: 326-9.
32. Rognum TO, Hauge S, Oyasaeter S, Saugstad OD. A new biochemical method for the estimation of post mortem time. Forensic Sci Int 1991; 51: 139-46.
33. Rognum TO, Saugstad OD. Hypoanthine levels in vitreous humour: evidence of hypoxia in most infants who died of sudden infant death syndrome. Pediatrics 1991; 87: 306-13.
34. Harkness RA, Coade SB, Simmonds RJ, Duffy S. Effect of energy failure on adenine nucleotide breakdown in the placenta and other fetal tissues from rat and guinea pig. Placenta 1985; 6: 199-216.
35. 2 electrode. Pediatr Res 1975; 9: 575-9.
36. Gardiner DG. A rapid and sensitive fluorimetric assay for adenosine, inosine and hypoxanthine. Analyt Biochem 1979; 95: 377-82.
37. Clarke CA. Eighty years of this and that: Part 1. Proc R Coll Phys Edinb 1995; 25: 495-508.
38. Benson R. Ten commandments for business success. Chem Br 1995; 31: 116-7.
39. Stevenson R. Crystal ball gazing. Chem Br 1995; 31: 87-8.
40. Myners P. Comment. Chem Br 1995; 31: 507.
41. Peckham M, Smith R. Health care: what's science got to do with it? Br Med J 1995; 310: 208.
42. Smith R. Filling the lacuna between research and practice; an interview with Michael Peckham. Br Med J 1993; 307: 1403-8.
43. Smith R. Developing foresight: an interview with Sir Dai Rees. Br Med J 1994; 309: 324-6.
44. Murray AW. The biological significance of purine salvage. A Rev Biochem 1971; 40: 811-26.
45. Stone TW, Simmonds HA. Purines: Basic and clinical aspects. Lancaster: Kluwer Academic Publishers, 1991.
46. Scriver CR, Beaudet AL, Sly WS, Valle D. Purines and pyrimidines. In: Scriver et al., editors. The metabolic and molecular basis of inherited disease. Vol II Part 7 New York: McGraw Hill, 1995; 1: 655-840.
47. Siesjo BK. Brain energy metabolism. Chichester: Wiley, 1978.
48. Iles RA, Poole Wilson PA. Ischaemia, hypoxia and reperfusion. In: Cohen RD, Lewis B, Alberti KGMM, Denman AM, editors. The metabolic and molecular basis of acquired disease. Vol 1. London: Bailliere, 1990: 322-41.
49. Hand SC, Hardeewig I. Down regulation of cellular metabolism during environmental stress: mechanisms and implications. A Rev Physiol 1996; 58: 539-63.
50. Barankiewicz J, Gelfond EW, Issekutz A, Cohen A. Evidence for active purine nucleotide cycles in human mononuclear cells and cultured fibroblasts. J Biol Chem 1982; 257: 11597-600.
51. Matsumoto SS. Raivio KO, Seegmiller JE. Adenine nucleotide degradation during energy depletion in human lymphoblasts. Adenosine accumulation and adenylate energy charge correlation. J Biol Chem 1979; 254: 8956-62.
52. Atkinson DE. Cellular energy metabolism and its regulation. London: Academic Press, 1977.
53. Wedenberg K, Ronquist G, Ulmstem U, Waldenstrom A. Energy economy of human uterine muscle strips under different in vitro conditions and its dependence on tissue redox potential. Eur J Obstet Gynecol 1995; 62: 115-9.
54. Setlow P, Kornberg A. Biochemical studies of bacterial sporulation and germination XXII Energy metabolism in early stages of Bacillus megaterium sporulation. J Biol Chem 1970; 245: 3637-44.
55. Azzopardi D, Wyatt JS, Cady EB, Delpy DT, Baudin J, Stewart AL. Prognosis of newborn infants with hypoxic-ischaemic brain injury assessed by phosphorus magnetic resonance spectroscopy. Pediatr Res 1989; 25: 445-51.
56. Koretsky AP. Insights into cellular energy metabolism from transgenic mice. Physiol Rev 1995; 75: 667-88.
57. Simmonds RJ, Coade SB, Harkness RA, Drury L, Hytten FE. Nucleotide, nucleoside and purine base concentrations in human placenta. Placenta 1982; 3: 29-38.
58. Hallgren R, Niklasson F, Terent A, Akerblom A, Widerlov E. Oxypurines in cerebrospinal fluid as indices of disturbed brain metabolism. A clinical study of ischemic brain diseases. Stroke 1983; 14: 382-8.
59. Cohen NS, Ekholm JE, Luthra MG, Hanahan DJ. Biochemical characterization of density separated human erythrocytes. Biochem Biophys Acta 1976; 419: 229-42.
60. Folbergrova J, Llunggren B, Norberg K, Siesjo BK. Influence of complete ischaemia on glycolytic metabolites, citric acid cycle intermediates and association with amino acids in the rat cerebral cortex. Brain Res 1974; 80: 265-79.
61. Hochachka PW, Mustafa T. Invertebrate facultative anaerobiosis. A reinterpretation of invertebrate enzyme pathways suggests new approaches to helminth chemotherapy. Science 1972; 178: 1056-60.
62. Hisanaga K, Onodera H, Kogure K. Changes in levels of purine and pyrimidine nucleotides during acute hypoxia and recovery in neonatal rat brain. J Neurochem 1986; 47: 1344-50.
63. Mendelson SL, Nordan SK, Young DA. Rapid changes in initiation limited protein synthesis in rat thymic lymphocytes correlate with energy charge. Biochem Biophys Acta Res Commn 1977; 79: 53-60.
64. Nowak TS, Fried RL, Lust WD, Passonneau JV. Changes in brain energy metabolism and protein synthesis following transient bilateral ischemia in the gerbil. J Neurochem 1985; 44: 487-94.
65. Dienel GA, Cruz NF, Rosenfeld SJ. Temporal profiles of proteins responsive to transient ischemia. J Neurochem 1985; 44: 487-94.
66. Burnstock G. Purinergic receptors. Recept Recogn Series B 1981; 12: 1-365.
67. Rudolphi KA, Schubert P, Parkinson FE, Fredholm BB. Neuroprotective role of adenosine in cerebral ischaemia. Trends Pharm Sci 1992; 13: 439-45.
68. Irestedt L, Dahlin I, Hertzberg T, Sollevi A, Lagercrantz H. Adenosine concentrations in umbilical cord blood of newborn infants after vaginal delivery and Caesarean section. Pediatr Res 1989; 26: 106-8.
69. Yoneyami Y, Wakatsuki M, Sawa R, Kamoi S. Takahashi H, Shin S. Plasma adenosine concentration in appropriate and small for gestational age fetuses. Am J Obstet Gynecol 1994; 170: 684-8.
70. Yoneyami Y, Shin S, Iwasaki T, Power G, Araki T. Relationship between plasma adenosine concentration and breathing movements in growth retarded fetuses. Am J Obstet Gynecol 1994; 171: 701-6.
71. Harkness RA, Cotes PM, Gordon H, McWhinney N. Prolonged pregnancy and fetal energy supply: Amniotic fluid concentrations of erythropoetin, hypoxanthine and uridine in uncomplicated prolonged pregnancy. J Obstet Gynaecol 1988; 8: 235-42.
72. Ruth V, Widnes JW, Clemons G, Raiivio KO. Postnatal changes in serum immunoreactive erythropoetin in relation to hypoxia before and after birth. J Pediatr 1990; 116: 950-4.
73. Spector R. Hypoxanthine transport through the blood brain barrier. Neurochem Res 1987; 12: 791-6.
74. Guieu R, Paganelli F, Sampieri F, Bechis G, Levy S, Rochat H. The use of HPLC to evaluate variations in the blood coronary adenosine levels during percutaneous transluminal angioplasty. Clin Chim Acta 1994; 230: 63-8.
75. Driver AG, Kukoly CA, Spence PA, Chitwood WR, Mustafa SJ. Pericardial fluid adenosine in ischemic and valvular heart disease. Chest 1995; 107: 346-51.
76. Harkness RA, Whitelaw AGL, Simmonds RJ. Intrapartum hypoxia: the association between neurological assessment of damage and abnormal excretion of ATP metabolites. J Clin Pathol 1982; 35: 999-1007.
77. Laing I, Brown JK, Harkness RA. Clinical and biochemical assessments of damage due to perinatal asphyxia: a double blind trial of a quantitative method. J Clin Pathol 1988; 41: 247-52.
78. O'Connor MC, Harkness RA, Simmonds RJ, Hytten FE. The measurement of hypoxanthine, xanthine, inosine and uridine in umbilical cord blood and fetal scalp blood samples during hypoxia. Br J Obstet Gynaecol 1981; 88: 391-90.
79. Fairweather DVI, Eskes TKAB. Amniotic fluid research and clinical applications. Amsterdam: Excerpta Medica Foundation, 1978.
80. Gaffney G, Sellers S, Flavell V, Squier M, Johnson A. Case control study of intrapartum care, cerebral palsy and death. Br Med J 1994; 308: 743-9.
81. Adams A, Harkness RA. Purine uptake from erythrocytes by rabbit tissues in vivo. Biochem Soc Trans 1973; 1: 138-9.
82. Maganasik B, Karibian D. Purine nucleolide cycles and their metabolic role. J Biol Chem 1960; 235: 2672-81.
83. Bell AH, Skov L, Lundstrom KE, Saugstad OD, Greisen G. Cerebral blood flow and plasma hypoxanthine in relation to surfactant treatment. Acta Paediatr Scand 1994; 83: 910-4.
84. Harkness RA, McCreanor GM, Simpson D, McFadyen IR. Pregnancy in and incidence of xanthine oxidase deficiency. J Inher Metab Dis 1986; 9: 407-8.
85. Harkness RA, McCreanor GM, Watts RWE. Lesch-Nyhan syndrome and its pathogenesis: purine concentrations in plasma and urine with metabolic profiles in CSF J Inher Metab Dis 1988; 11: 239-52.
86. Watts RWE, Harkness RA, Spellacy E, Taylor NF. Lesch-Nyhan syndrome: growth delay, testicular atrophy and a partial failure of the 11β-hydroxylation of steroids. J Inher Metab Dis 1987; 10: 210-23.
87. Brown GK. Pyruvate dehydrogenase E1α deficiency. J Inher Metab Dis 1992; 15: 625-33.
88. Cartier PH. Adenine uptake by isolated thymocytes. J Biol Chem 1980; 255: 4574-82.
89. Mager J, Hershko A, Zeitlin-Beck R, Shoshani T. Razin A. Turnover of purine nucleotides in rabbit erythrocytes. 1. Studies in vivo. Biochim Biophys Acta 1967; 149: 50-8.
90. Watts RWE. Some regulatory and integrative aspects of purine nucleotide biosynthesis and its control: an overview. Adv Enz Regulation 1983; 21: 33-51.
91. Pomales R, Bieber S, Friedman R, Hitchings GH. Augmentation of the incorporation of hypoxanthine into nucleic acids by administration of an inhibitor of xanthine oxidase. Biochim Biophys Acta 1963; 72: 119-20.
92. Jones DP. Renal metabolism during normoxia. hypoxia and ischemic injury. A Rev Physiol 1986; 48: 33-50.
93. Saugstad OD. The role or xanthine oxidase and its inhibitor in hypoxia: reoxygenation injury. Pediatrics 1996; 98: 103-7.
94. Mehmet H, Yue X. Squier MV, Lorek A, Cady E, Penrice J, et al. Increased apoptosis in the cingulate sulcus of newborn piglets following transient hypoxia-ischemia is related to the degree of high energy phosphate depletion during the insult. Neurosci Lett 1994; 181: 121-5.
95. Kemp AM, Sibert JR. Outcome in children who nearly drown: a British Isles study. Br Med J 1991; 302: 931-3.
96. Harkness RA. Is post-hypoxic-ischemic cell damage associated with excessive ATP consumption rather than a failure of ATP production? Acta Paediatr Scand 1997; 86: 1-5.
97. Perlman JM, Tack ED. Renal injury in the asphyxiated newborn; relationship to neurological outcome. J Pediatr 1988; 113: 875-9.
98. Warnick CT, Lazarus HM. Recovery of nucleotide levels after cell injury. Can J Biochem 1981; 59: 116-21.
99. Bourchier J. Birth asphyxia and associated oliguria; relationship to outcome at 1 year. J Pediatr Child Health 1991; 27: 302-3.
100. Blair E, Stanley FJ. Intrapartum asphyxia: a rare cause of cerebral palsy. J Pediatr 1988; 112: 515-9.
101. Nelson KB, Ellenberg JH. Antecedents of cerebral palsy. Multivariate analysis of risk. N Engl J Med 1986; 315: 81-6.
102. Pasternak JF. Hypoxic-ischemic brain damage in the term infant. Pediatr Clin North Am 1993; 40: 1061-72.
103. Light DW. Effectiveness and efficiency under competition: the Cochrane test. Br Med J 1991; 303: 1253-64.
104. Scottish Stillbirth and Neonatal Death Report 1993. Edinburgh: Scottish Health Services Common Services Agency, 1994.
105. Harkness RA, Gordon H. Myometrial stimulation by a fetal distress signal? Some evidence for an adenosine based mechanism in man. J Obstet Gynaecol 1991; 11: 186-90.
106. Harkness RA, Simmonds RJ, Coade SB, Lawrence CR. Ratio of the concentration of hypoxanthine to creatinine in urine from newborn infants. A possible indicator of metabolic damage due to hypoxia. Br J Obstet Gynaecol 1983; 90: 447-52.
107. Thacker SB, Berkelman SL. Assessing the diagnostic accuracy and efficacy of selected antepartum fetal surveillance techniques. Obstet Gynecol Surv 1986; 41: 121-41.
108. O'Driscoll K, Coughlan M, Fenton V, Skelly M. Active management of labour; care of the fetus. Br Med J 1977; 2: 1451-3.
109. Krebs HB, Petres RE, Dunn LJ, Jordaan HVF, Segreti A. Intrapartum fetal heart rate monitoring III Association of meconium staining with abnormal fetal heart rate patterns. Am J Obstet Gynecol 1980; 137: 936-43.
110. Howie PW. Fetal monitoring in labour. Br Med J 1986; 292: 427-8.
111. OECD. Financing and delivering health care. A comparative analysis of OECD countries. OECD: Social Policy Studies No 4, Ch 1: 11-14.
112. Smith JH, Anand KJS, Cotes PM, Davies GS, Harkness RA, Howlett TA. Antenatal fetal heart rate variations in relation to the respiratory and metabolic status of the compromised human fetus. Br J Obstet Gynaecol 1988; 95: 980-9.
113. Osswald H, Schmitz H-J, Kempen R. Tissue content of adenosine, inosine and hypoxanthine in the rat kidney after ischaemia and postischaemic circulation. Eur J Physiol 1977; 371: 45-9.
114. Goday A, Simmonds HA, Webster DR, Levinsky RJ, Watson AR, Hoffbrand AV. Importance of platelet free preparations for evaluating lymphocyte nucleotide levels in inherited or acquired immunodeficiency syndromes. Clin Sci 1983; 65: 635-43.
115. Gannon K. Mortality associated with anaesthesia. A case review study. Anaesthesia 1991; 46: 962-6.
116. Forest JB, Rehder K, Goldsmith CH, Cahalan MK, Levy WJ, Strumin L, Bota W, et al. Multicenter study of general anesthesia I and II Anesthesiology 1990; 72: 252-68.
117. Niklasson F, Hetta J, Degrell I. Hypoxanthine. xanthine, urate and creatinine concentration gradients in cerebrospinal fluid. Ups J Med Sci 1988; 93: 225-32.
118. Agren H, Niklasson F, Hallgren R. Brain purinergic activity linked with depressive symptomatology: Hypoxanthine and xanthine in CSF of patients with major depressive disorders. Psychiatr Res 1983; 9: 179-89.
119. Ronquist G, Callerud T, Niklasson F, Friman G. Studies of biochemical markers in cerebrospinal fluid in patients with meningoencephalitis. Infect Immun 1985; 48: 729-34.
120. Livingston JH, Brown JK, Harkness RA, McCreanor GM, O'Hare AE. Cerebrospinal fluid nucleotide metabolites following short febrile convulsions. Dev Med Child Neurol 1989; 31: 161-7.
121. Tomlinson P, Sugarman ID. Complications with shunts in adults with spina bifida. Br Med J 1995; 311: 286-7.
122. Bohmer T, Kjekshus J, Vaagenes P. Biochemical indices of cerebral ischemic injury. Scand J Clin Lab Invest 1983; 43: 261-5.
123. Braghiroli A, Sacco C, Erbetta M, Ruga V, Donner CF. Overnight urinary uric acid: creatinine ratio for the detection of sleep hypoxemia. Validation study in chronic obstructive pulmonary disease and obstructive sleep apnea before and after treatment with nasal continuous positive airway pressure. Am Rev Resp Dis 1993; 148: 173-8.
124. Risk assessment. Report of a Royal Society Study Group. London, 1983.
125. Card WI, Mooney GH. What is the monetary value of a human life? Br Med J 1977; 2: 1627-29.
126. Lazzlo P, Petrakis L. A risky business. Chem Br 1995; 31: 555-6.
127. J Med Def Union. 1995; 11: 13.
128. Griner PF, Mayewski RJ, Mushin AI, Greenland P. Selection and interpretation of diagnostic tests and procedures. Principles and applications. Ann Int Med 1981; 95: 980-9.
129. Smith R. European Healthcare systems. Br Med J 1991; 303: 1457-9.
130. Westgate J, Garibaldi JM, Greene KR. Umbilical cord blood gas at delivery: a time for quality data. Br J Obstet Gynaecol 1994; 101: 1054-63.
131. Kalckar HM. Differential spectrophotometry of purine compounds by means of specific enzymes. 1. Determination of hydroxypurine compounds. J Biol Chem 1947; 167: 429-42.
132. Saugstad OD, Wung WE, Howell SB, Gluck L. Determination of plasma hypoxanthine: a comparison of high pressure liquid chromatographic and oxygen consumption methods. Analyt Biochem 1982; 122: 159-63.
133. Mansell MA, Allsop J, North ME, Simmonds RJ. Harkness RA, Watts RWE. Effect of renal failure on erythrocyte purine nucleotide, nucleoside and base concentrations and some related enzyme activities. Clin Sci 1981; 61: 757-64.
134. Simmonds RJ, Harkness RA. High performance liquid Chromatographie methods for base and nucleoside analysis in extracellular fluids and in cells. J Chromatogr Biomed Appl 1981; 226: 369-81.
135. Pietz J, Guttenberg N, Gluck L. Hypoxanthine: a marker for asphyxia. Obstet Gynecol 1988; 72: 762-66.
136. Boulieu R, Bory C, Baltassat P, Gonnet C. Hypoxanthine and xanthine levels determined by high performance liquid chromatography in plasma, erythrocytes and urine samples from healthy subjects; the problem of hypoxanthine level evolution as a function of time. Analyt Biochem 1983; 129: 398-404.
137. Dean BM, Perrett D, Sensi M. Changes in nucleotide concentrations of man, rabbit and rat during short term storage. Biochem Biophys Res Commun 1978; 80: 147-54.
138. Simmonds HA, Micheli V, Davies PM, McBride MB. Erythrocyte nucleotide stability and plasma hypoxanthine concentrations; improved ATP stability with short term storage at room temperature. Clin Chem Acta 1990; 192: 121-32.
139. Harkness RA, Coade SB, Mansell M, Simmonds RJ. Nucleotide concentrations in leucocytes and their use in controlling the quality of cell preparations. In: Rossi F, Patriarca P, editors. Biochemistry and function of phagocytes. New York: Plenum Publishing Corporation, 1982: 583-90.
140. Harkness RA, Coade SB, Webster ADB. ATP, ADP and AMP in plasma from peripheral venous blood. Clin Chim Acta 1984; 143: 91-8.
141. Guilbault GG, Brignac P, Zimmer M. Homovanillic acid as a fluorimetric substrate for oxidative enzymes. Analytical applications of the peroxidase, glucose oxidase and xanthine oxidase systems. Analyt Chem 1968; 40: 190-6.
142. Sumi T, Umeda Y. Fluorimetric determination of xanthine and hypoxanthine in tissue. Clin Chim Acta 1979; 95: 291-9.
143. Childs RE, Bardsley WG. The steady state kinetics of peroxidase with 2,2′-azino-di (3-ethyl-benzthiazoline-6-sulphonic acid) as a chromogen. Biochem J 1975; 145: 93-103.
144. James DR. Price CP. Interference in colorimetric reactions for measuring hydrogen peroxide. Ann Clin Biochem 1984; 21: 398-404.
145. DeRenzo EC. Chemistry and biochemistry of xanthine oxidase. Adv Enzymol 1949; 17: 293-328.
146. Nishino T. The conversion of xanthine dehydrogenase to xanthine oxidase and the role of the enzyme in reperfusion injury. J Biochem 1994; 116: 1-6.
147. Broughton PMG, Buckley BM. Performance requirements of tests performed nearer the patient. Scand J Clin Lab Invest 1987; 47: 99-104.
148. Inouye H, Fuchs S, Sele M, Littauer UZ. Antiinosine antibodies. Biochim Biophys Acta 1971; 240: 594-603.
149. Ferrendelli JA, Gray MH, Sedgwick WG, Chang MM. Quick freezing of the murine CNS: Comparison of regional cooling rates and metabolic levels when using liquid nitrogen or Freon-12. J Neurochem 1972; 19: 979-87.
150. Wyatt J. Non invasive assessment of cerebral oxidative metabolism in human newborn. J Roy Coll Phys Lond 1994; 28: 126-32.
151. Mathew OP, Bland H, Boxerman SB, James E. CSF lactate levels in high risk neonates with and without asphyxia. Pediatrics 1980; 66: 224-7.
152. Fysh WJ, Turner GM, Dunn PM. Neurological normality after extreme birth asphyxia. Case report. Br J Obstet Gynaecol 1982; 89: 24-6.
153. Adams JE, Abendschein DR, Jaffe AS. Biochemical markers of myocardial injury. Is MB creatine kinase the choice for the 1990s? Circulation 1993; 88: 750-63.
154. Zanardo V, Bondio M, Perini G, Temporin GF. Serum glutamic oxaloacetic transaminase and glutamic pyruvic transaminase activity in premature and full term asphyxiated newborns. Biol Neonate 1985; 47: 61-9.
155. 2-microglobulin concentrations. Pediatrics 1988; 81: 432-40.
156. Tsukahara H, Fujii Y, Kuriyama M, Tsuchida S, Hiraoka M, Kikuchi K, Sudo M. Urinary growth hormone excretion in preterm neonates. Biol Neonate 1993; 63: 8-13.
157. Whitelaw AGL. Functional imaging in neonatal neurology. Acta Paediatr 1994; 83: 345-7.
158. Trudinger BJ, Gordon YB, Grudzinskas JG, Hull MJR, Lewis PJ, Amans MEL. Fetal breathing movements and other tests of fetal well being - a comparative evaluation. Br Med J 1979; 2: 577-9.
159. Robinson R. Cost effectiveness analysis. Br Med J 1993; 307: 793-5.
160. Dilts D, Khamalah J, Plotkin A. Using cluster analysis for medical resource decision making. Med Decis Making 1995; 15: 333-47.